Miracle-dz/UniFAR-FTUs huggingface dataset:
Mental Health Assessment and Intervention for People With Complex Communication Needs Associated With Developmental Disabilities

Abstract This paper addresses the issues of assessment and psychological interventions of mental health in people with complex communication needs of people with intellectual disability and/or cerebral palsy. The literature indicates that research data have been lacking in this area, with a dearth of appropriate assessment tools and information on how to adapt evidence-based psychological interventions for this group. Existing psychological intervention research has been characterized by case studies and quasi-experimental designs with adults with mild intellectual disability who possess relatively good communication skills. In addition, there have been a few experimental studies with a focus on anger management with this group. In light of the lack of an empiric base, clinical practice for people with complex communication needs must draw on the evidence base for the general population, and adaptations of key elements of psychological therapies. Given the paucity of research addressing the mental health issues of people with complex communication needs, there is a need for the development of mental health assessment tools that enable clinicians to directly obtain information from the individual and for building the evidence base for counseling people with complex communication needs.
Effects of a Web-Based Intervention for Stress Reduction in Primary Care: A Cluster Randomized Controlled Trial

Background Preliminary findings suggest that Web-based interventions may be effective in achieving significant stress reduction. To date, there are no findings available for primary care patients. This is the first study that investigates a Web-based intervention for stress reduction in primary care. Objective The aim was to examine the short-term effectiveness of a fully automated Web-based coaching program regarding stress reduction in a primary care setting. Methods The study was an unblinded cluster randomized trial with an observation period of 12 weeks. Individuals recruited by general practitioners randomized to the intervention group participated in a Web-based coaching program based on education, motivation, exercise guidance, daily text message reminders, and weekly feedback through the Internet. All components of the program were fully automated. Participants in the control group received usual care and advice from their practitioner without the Web-based coaching program. The main outcome was change in the Perceived Stress Questionnaire (PSQ) over 12 weeks. Results A total of 93 participants (40 in intervention group, 53 in control group) were recruited into the study. For 25 participants from the intervention group and 49 participants from the control group, PSQ scores at baseline and 12 weeks were available. In the intention-to-treat analysis, the PSQ score decreased by mean 8.2 (SD 12.7) in the intervention group and by mean 12.6 (SD 14.7) in the control group. There was no significant difference identified between the groups (mean difference –4.5, 95% CI –10.2 to 1.3, P=.13). Conclusions This trial could not show that the tested Web-based intervention was effective for reducing stress compared to usual care. The limited statistical power and the high dropout rate may have reduced the study’s ability to detect significant differences between the groups. Further randomized controlled trials are needed with larger populations to investigate the long-term outcome as well as the contents of usual primary care. Trial Registration German Clinical Trials Register DRKS00003067; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do? =DRKS00003067 (Archived by WebCite at http://www.webcitation.org/6eXk0PXmO)
A framework for designing congestion-aware deterministic routing

In this paper, we present a system-level Congestion-Aware Routing (CAR) framework for designing minimal deterministic routing algorithms. CAR exploits the peculiarities of the application workload to spread the load evenly across the network. To this end, we first formulate an optimization problem of minimizing the level of congestion in the network and then use the simulated annealing heuristic to solve this problem. The proposed framework assures deadlock-free routing, even in the networks without virtual channels. Experiments with both synthetic and realistic workloads show the effectiveness of the CAR framework. Results show that maximum sustainable throughput of the network is improved by up to 205% for different applications and architectures.
Community Detection on Ego Networks via Mutual Friend Counts

Community detection is an important tool for understanding the structure of social networks, and spectral clustering is the standard algorithm for performing community detection within the statistics literature. However, its polynomial-order runtime means it cannot be applied to contemporary social networks with billions of nodes. To address this computational challenge we provide a statistical analysis of a simple algorithm that solves a more tractable problem: community detection for the ego network. Under a broad class of parametrizations for the stochastic block model on the data, this algorithm recovers the correct community labels for the given ego network. Simulations show that this algorithm outperforms spectral clustering when the number of communities is large.
A Survey of Rheumatoid Arthritis Patients Self-Efficacy

This paper describes the self-efficacy of rheumatoid arthritis (RA) patients and its relationship to their disability and knowledge of their disease and its treatments. The sample was 252 RA patients, and the data were collected in August 2004 (response rate 89.0%) using self-reported questionnaires. The data were analysed using descriptive and non-parametric statistical methods. The main findings were that patient self-efficacy was strong except for pain self-efficacy when the patients needed to treat arthritis pain using methods other than pain medication. Weak patient self-efficacy correlated with a high degree of disability. The patients who considered their current and future health status poor had low pain and function self-efficacy (PSE and FSE, respectively). A high knowledge level did not correlate with strong self-efficacy. In conclusion, health care professionals (e.g. rheumatology nurses) should teach non-medical pain management techniques to RA patients who have low self-efficacy when using pain-reducing methods other than medication.
Aggregatibacter Actinomycetemcomitans – Its Role in Periodontitis

Strong evidence is available on the role of Aggregatibacteractinomycetemcomitans (A.a) as the causative agent of localised juvenile periodontitis(LJP), a disease characterised by rapid destruction of the tooth-supporting tissues. This organism possesses a large number of virulence factors with a wide range of activities which enable it to colonise the oral cavity, invade periodontal tissues, evade host defences, initiate connective tissue destruction and interfere with tissue repair. Adhesion to epithelial and tooth surfaces is dependent on the presence of surface proteins and structures such as microvesicles and fimbriae. Invasion has been demonstrated in vivo and in vitro. The organism has a number of means of evading host defences, which include: (i) production of leukotoxin; (ii) producing immunosuppressive factors; (iv) secreting proteases capable of cleaving IgG; and (v) producing Fc-binding.
Synthesis and properties of light weight magnesium–cenosphere composite

Significantly light weight magnesium composite foams are synthesised by addition of fly ash cenosphere particles (waste from coal-fired power plants) in biocompatible pure magnesium using solidification-based disintegrated melt deposition technique. The density of the composite foams synthesised in this study approaches that of plastics- and polymer-based composites. Microstructure development of Mg/cenosphere composite foams was favourable as they exhibited better dimensional stability (reduced coefficient of thermal expansion) and remarkable improvements in tensile strengths, compressive strengths, compressive total strain and microhardness. The present study highlights the processing, microstructure and mechanical properties of Mg/cenosphere composite foams which hold great potential as light weight metal-based green materials for diverse weight critical applications spanning from engineering to biomedical sector.
Establishing a Link Between Prescription Drug Abuse and Illicit Online Pharmacies: Analysis of Twitter Data

Background Youth and adolescent non-medical use of prescription medications (NUPM) has become a national epidemic. However, little is known about the association between promotion of NUPM behavior and access via the popular social media microblogging site, Twitter, which is currently used by a third of all teens. Objective In order to better assess NUPM behavior online, this study conducts surveillance and analysis of Twitter data to characterize the frequency of NUPM-related tweets and also identifies illegal access to drugs of abuse via online pharmacies. Methods Tweets were collected over a 2-week period from April 1-14, 2015, by applying NUPM keyword filters for both generic/chemical and street names associated with drugs of abuse using the Twitter public streaming application programming interface. Tweets were then analyzed for relevance to NUPM and whether they promoted illegal online access to prescription drugs using a protocol of content coding and supervised machine learning. Results A total of 2,417,662 tweets were collected and analyzed for this study. Tweets filtered for generic drugs names comprised 232,108 tweets, including 22,174 unique associated uniform resource locators (URLs), and 2,185,554 tweets (376,304 unique URLs) filtered for street names. Applying an iterative process of manual content coding and supervised machine learning, 81.72% of the generic and 12.28% of the street NUPM datasets were predicted as having content relevant to NUPM respectively. By examining hyperlinks associated with NUPM relevant content for the generic Twitter dataset, we discovered that 75.72% of the tweets with URLs included a hyperlink to an online marketing affiliate that directly linked to an illicit online pharmacy advertising the sale of Valium without a prescription. Conclusions This study examined the association between Twitter content, NUPM behavior promotion, and online access to drugs using a broad set of prescription drug keywords. Initial results are concerning, as our study found over 45,000 tweets that directly promoted NUPM by providing a URL that actively marketed the illegal online sale of prescription drugs of abuse. Additional research is needed to further establish the link between Twitter content and NUPM, as well as to help inform future technology-based tools, online health promotion activities, and public policy to combat NUPM online.
The conservation value of karst dolines for vascular plants in woodland habitats of Hungary: refugia and climate change

Limestone (karst) surfaces in Hungary are rich in dolines, in which many endangered vascular plant species occur. To date, the majority of studies dealing with doline vegetation have focused on the local rather than the landscape level, without using comparative data from other areas. However, in this study we aimed to compare the vegetation pattern and species composition of dolines under different climate regimes of Hungary with regard to regional species pools. The fieldwork was carried out between 2005 and 2012. Twenty dolines were selected in the Mecsek Mountains (southern Hungary) and nine dolines in the Aggtelek Karst area (northern Hungary). More than 900 vascular plants and more than 2000 plots were included in the study. The moving split window (MSW) technique, nestedness analysis and principal coordinates analysis (PCoA) were used to reveal the vegetation patterns in dolines. Although we found remarkable differences between the species composition of the two regions, dolines of both regions play a similar role in the preservation of different groups of species. Many plants, in particular mountain species, are restricted to the bottom of dolines where appropriate environmental conditions exist. In addition, depending on the doline geometry, many species of drier and warmer forests have colonized the upper slopes and rims. Thus, we can conclude that karst dolines of Hungary can be considered as reservoirs for many vascular plant species, therefore they are particularly important from a conservation point of view. Moreover, these dolines will likely become increasingly indispensable refugia for biodiversity under future global warming. Aggtelek Karst area; global warming; Mecsek Mountains; relict species; transects
The Pacific Decadal Oscillation, Revisited

AbstractThe Pacific decadal oscillation (PDO), the dominant year-round pattern of monthly North Pacific sea surface temperature (SST) variability, is an important target of ongoing research within the meteorological and climate dynamics communities and is central to the work of many geologists, ecologists, natural resource managers, and social scientists. Research over the last 15 years has led to an emerging consensus: the PDO is not a single phenomenon, but is instead the result of a combination of different physical processes, including both remote tropical forcing and local North Pacific atmosphere–ocean interactions, which operate on different time scales to drive similar PDO-like SST anomaly patterns. How these processes combine to generate the observed PDO evolution, including apparent regime shifts, is shown using simple autoregressive models of increasing spatial complexity. Simulations of recent climate in coupled GCMs are able to capture many aspects of the PDO, but do so based on a balance of .
Naltrexone Maintenance Fails to Alter Amphetamine Effects on Intracranial Self-Stimulation in Rats

Pharmacotherapy to treat stimulant use disorders continues to be an unmet medical need. Some evidence supports both the role of opioids in mediating abuse-related amphetamine effects and the potential utility of opioid antagonists as therapeutic candidates for treating amphetamine abuse. This study used intracranial self-stimulation (ICSS) to evaluate effects of exposure to and termination of naltrexone maintenance on rewarding amphetamine effects in an ICSS procedure in rats. Morphine and cocaine were included as a positive and negative controls, respectively. Male Sprague–Dawley rats (N = 40) were trained to lever press for electrical brain stimulation to the medial forebrain bundle via an implanted electrode. Rats were then implanted with osmotic pumps delivering naltrexone (0.001 mg/kg/h, SC, 0.01 mg/kg/h, SC, or 0.1 mg/kg/h, SC) or saline for 14 days. Cumulative dose-effect curves were determined for amphetamine (0.032 mg/kg to 0.32 mg/kg), cocaine (1 mg/kg to 10 mg/kg), and morphine (1 mg/kg to 10 mg/kg) during the 2nd week of naltrexone maintenance. Additionally, dose-effect curves for morphine and amphetamine were determined again 24 hr after pump removal. Our results suggest that (a) exposure to and termination of naltrexone maintenance do not affect baseline ICSS responding, (b) naltrexone doses sufficient to antagonize morphine did not alter amphetamine or cocaine effects, and (c) termination of naltrexone treatment produced weak evidence for increased morphine sensitivity but no change in amphetamine effects. Our results do not support naltrexone as a pharmacotherapy for amphetamine and cocaine abuse and also suggest that termination from chronic naltrexone does not increase sensitivity to abuse-related morphine or amphetamine effects in ICSS.
Genetic evolution, plasticity, and bet‐hedging as adaptive responses to temporally autocorrelated fluctuating selection: A quantitative genetic model

Adaptive responses to autocorrelated environmental fluctuations through evolution in mean reaction norm elevation and slope and an independent component of the phenotypic variance are analyzed using a quantitative genetic model. Analytic approximations expressing the mutual dependencies between all three response modes are derived and solved for the joint evolutionary outcome. Both genetic evolution in reaction norm elevation and plasticity are favored by slow temporal fluctuations, with plasticity, in the absence of microenvironmental variability, being the dominant evolutionary outcome for reasonable parameter values. For fast fluctuations, tracking of the optimal phenotype through genetic evolution and plasticity is limited. If residual fluctuations in the optimal phenotype are large and stabilizing selection is strong, selection then acts to increase the phenotypic variance (bet‐hedging adaptive). Otherwise, canalizing selection occurs. If the phenotypic variance increases with plasticity through the effect of microenvironmental variability, this shifts the joint evolutionary balance away from plasticity in favor of genetic evolution. If microenvironmental deviations experienced by each individual at the time of development and selection are correlated, however, more plasticity evolves. The adaptive significance of evolutionary fluctuations in plasticity and the phenotypic variance, transient evolution, and the validity of the analytic approximations are investigated using simulations.
Eight Questions About Physician-Rating Websites: A Systematic Review

Background Physician-rating websites are currently gaining in popularity because they increase transparency in the health care system. However, research on the characteristics and content of these portals remains limited. Objective To identify and synthesize published evidence in peer-reviewed journals regarding frequently discussed issues about physician-rating websites. Methods Peer-reviewed English and German language literature was searched in seven databases (Medline (via PubMed), the Cochrane Library, Business Source Complete, ABI/Inform Complete, PsycInfo, Scopus, and ISI web of knowledge) without any time constraints. Additionally, reference lists of included studies were screened to assure completeness. The following eight previously defined questions were addressed: 1) What percentage of physicians has been rated? 2) What is the average number of ratings on physician-rating websites? 3) Are there any differences among rated physicians related to socioeconomic status? 4) Are ratings more likely to be positive or negative? 5) What significance do patient narratives have? 6) How should physicians deal with physician-rating websites? 7) What major shortcomings do physician-rating websites have? 8) What recommendations can be made for further improvement of physician-rating websites? Results Twenty-four articles published in peer-reviewed journals met our inclusion criteria. Most studies were published by US (n=13) and German (n=8) researchers; however, the focus differed considerably. The current usage of physician-rating websites is still low but is increasing. International data show that 1 out of 6 physicians has been rated, and approximately 90% of all ratings on physician-rating websites were positive. Although often a concern, we could not find any evidence of "doctor-bashing". Physicians should not ignore these websites, but rather, monitor the information available and use it for internal and ex-ternal purpose. Several shortcomings limit the significance of the results published on physician-rating websites; some recommendations to address these limitations are presented. Conclusions Although the number of publications is still low, physician-rating websites are gaining more attention in research. But the current condition of physician-rating websites is lacking. This is the case both in the United States and in Germany. Further research is necessary to increase the quality of the websites, especially from the patients’ perspective.
Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study

Objective: Cannabis may alleviate some symptoms associated with multiple sclerosis (MS). This study investigated the effect of an orally administered standardized Cannabis sativa plant extract in MS patients with poorly controlled spasticity. Methods: During their inpatient rehabilitation programme, 57 patients were enrolled in a prospective, randomized, double-blind, placebo-controlled crossover study of cannabis-extract capsules standardized to 2.5 mg tetrahydrocannabinol (THC) and 0.9 mg cannabidiol (CBD) each. Patients in group A started with a drug escalation phase from 15 to maximally 30 mg THC by 5 mg per day if well tolerated, being on active medication for 14 days before starting placebo. Patients in group B started with placebo for seven days, crossed to the active period (14 days) and closed with a three-day placebo period (active drug dose escalation and placebo sham escalation as in group A). Measures used included daily self-report of spasm frequency and symptoms, Ashworth Scale, Rivermead Mobility Index, 10-m timed walk, nine-hole peg test, paced auditory serial addition test (PASAT), and the digit span test. Results: In the 50 patients included into the intention-to-treat analysis set, there were no statistically significant differences associated with active treatment compared to placebo, but trends in favour of active treatment were seen for spasm frequency, mobility and getting to sleep. In the 37 patients (per-protocol set) who received at least 90% of their prescribed dose, improvements in spasm frequency (P- 0.013) and mobility after excluding a patient who fell and stopped walking were seen (P- 0.01). Minor adverse events were slightly more frequent and severe during active treatment, and toxicity symptoms, which were generally mild, were more pronounced in the active phase. Conclusion: A standardized Cannabis sativa plant extract might lower spasm frequency and increase mobility with tolerable side effects in MS patients with persistent spasticity not responding to other drugs.
Longitudinal trends in serum ferritin levels and associated factors in a national incident hemodialysis cohort

&NA; Background: The rise in serum ferritin levels among US maintenance hemodialysis patients has been attributed to higher intravenous iron administration and other changes in practice. We examined ferritin trends over time in hemodialysis patients and whether iron utilization patterns and other factors [erythropoietin‐stimulating agent (ESA) prescribing patterns, inflammatory markers] were associated with ferritin trajectory. Methods: In a 5‐year (January 2007‐December 2011) cohort of 81 864 incident US hemodialysis patients, we examined changes in ferritin averaged over 3‐month intervals using linear mixed effects models adjusted for intravenous iron dose, malnutrition and inflammatory markers. We then examined ferritin trends across strata of baseline ferritin level, dialysis initiation year, cumulative iron and ESA use in the first dialysis year and baseline hemoglobin level. Results: In models adjusted for iron dose, malnutrition and inflammation, mean ferritin levels increased over time in the overall cohort and across the three lower baseline ferritin strata. Among patients initiating dialysis in 2007, mean ferritin levels increased sharply in the first versus second year of dialysis and again abruptly increased in the fifth year independent of iron dose, malnutrition and inflammatory markers; similar trends were observed among patients who initiated dialysis in 2008 and 2009. In analyses stratified by cumulative iron use, mean ferritin increased among groups receiving iron, but decreased in the no iron group. In analyses stratified by cumulative ESA dose and baseline hemoglobin, mean ferritin increased over time. Conclusions: While ferritin trends correlated with patterns of iron use, increases in ferritin over time persisted independent of intravenous iron and ESA exposure, malnutrition and inflammation.