Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictors of Nursing Home Placement from Assisted Living Settings in Canada*

RÉSUMÉ Cette étude visait à évaluer l’incidence de placement dans un établissement de soins de longue durée (SLD) et d’identifier les facteurs prédictifs de placement résidentiel et d’installation parmi résidents âgés dans établissements aidant à la vie autonome en Alberta, au Canada. 1,086 résidents de 59 installations en Alberta ont été inclus. Infirmières de recherche ont effectué des évaluations de résidents interRAI-AL et ont interrogé les aidants familiaux et les administrateurs. Les prédicteurs de placement ont été identifiés avec des modèles de risques proportionnels de Cox multivariés. L’incidence cumulative SLD de l’admission était de 18,3 pour cent en 12 mois. Le risque de placement a augmenté significativement pour les résidents âgés et ceux avec des relations sociales médiocres, peu d’implication dans les activités, la dépreciation cognitive et/ou fonctionnelle, l’instabilité de la santé,une histoire des chutes et des hospitalisations récentes/visites à l’urgence, et l’incontinence urinaire sévère. Une diminution du risque de placement a été montré pour les résidents de grandes établissements avec une infirmière autorisée et/ou une infirmière auxiliaire autorisée disponible 24 heures par jour et un médecin de premier recours affilié. Nos résultats font ressortir les domaines cliniques et politiques ou des interventions ciblées peuvent retarder les admissions SLD. ABSTRACT We sought to estimate the incidence of long-term care (LTC) placement and to identify resident- and facility-level predictors of placement among older residents of designated assisted living (AL) facilities in Alberta, Canada. Included were 1,086 AL residents from 59 facilities. Research nurses completed interRAI-AL resident assessments and interviewed family caregivers and administrators. Predictors of placement were identified with multivariable Cox proportional hazards models. The cumulative incidence of LTC admission was 18.3 per cent by 12 months. Significantly increased risk for placement was evident for older residents and those with poor social relationships, little involvement in activities, cognitive and/or functional impairment, health instability, recent falls and hospitalizations/emergency department visits, and severe bladder incontinence. Residents from larger facilities, with an LPN and/or RN on-site 24/7 and with an affiliated primary care physician, showed lower risk of placement. Our findings highlight clinical and policy areas where targeted interventions may delay LTC admissions.
Lumbar medial branch radiofrequency neurotomy in New Zealand.

OBJECTIVE This study aims to determine the effectiveness of lumbar medial branch radiofrequency neurotomy (RFN) performed by two practitioners trained according to rigorous guidelines. DESIGN Prospective, outcome study of consecutive patients with chronic back pain treated in a community setting. INTERVENTIONS A total of 106 patients, selected on the basis of complete relief of pain following controlled, diagnostic, medial branch blocks, were treated with RFN according to the guidelines of the International Spine Intervention Society. OUTCOME MEASURES Successful outcome was defined as complete relief of pain for at least 6 months, with complete restoration of activities of daily living, no need for any further health care, and return to work. Patients who failed to meet any of these criteria were deemed to have failed treatment. RESULTS In the two practices, 58% and 53% of patients achieved a successful outcome. Relief lasted 15 months from the first RFN and 13 months for repeat treatments. Allowing for repeat treatment, patients maintained relief for a median duration of 17-33 months, with some 70% still having relief at follow-up. CONCLUSION Lumbar RFN can be very effective when performed in a rigorous manner in appropriately selected patients. Chronic back pain, mediated by the lumbar medial branches, can be stopped and patients fully restored to normal living, if treated with RFN.
Marital Status, Childlessness, and Social Support among Older Canadians*

RÉSUMÉ Malgré les preuves de la diversification croissante des structures familiales, on connaît peu de conséquences de l'état matrimonial et parental pour l'accès à l'aide sociale dans la vie plus tard. En utilisant les données de l'Enquête sociale générale de 2007 de Statistique Canada, cette étude a évalué l'impact des intersections de l'état matrimonial et parental sur le soutien social chez les adultes âgés de 60 ans et plus (n = 11 503). Modèles probit de regréssion en deux étapes ont indiqué que, parmi ceux qui sont actuellement mariés ou séparés/divorcés, les personnes sans enfants étaient plus susceptibles de déclarer un soutien instrumental (domestique, transport) et émotionnel des personnes hors du ménage. A l'inverse, chez les personnes âgées célibataires ou veuves, être sans enfant a été associée à du soutien interne réduit, mais sans différences dans un autre support. Les résultats suggèrent que les intersections de l'état matrimonial et parental ne sont pas uniformément positive, neutre ou négative à l'égard des implications pour le soutien social extra-ménage. Les travaux futures devraient répondre à la complexité de ces relations afin de mieux comprendre les structures familiales qui évoluent rapidement. ABSTRACT Despite evidence of increasing diversification of family structures, little is known regarding implications of marital and parental status for access to social support in later life. Using data from Statistics Canada’s 2007 General Social Survey, this study assessed the impact of marital and parental status intersections on social support among adults aged 60 and older (n = 11,503). Two-stage probit regression models indicated that among those who were currently married or separated/divorced, childless individuals were more likely to report instrumental (domestic, transportation) and emotional support from people outside the household. Conversely, among never-married or widowed older adults, being childless was associated with reduced domestic support but without differences in other support domains. Findings suggest that marital and parental status intersections are not uniformly positive, neutral, or negative regarding implications for extra-household social support. Future work should address complexities of these relationships in order to better understand rapidly changing family structures.
Interleaved spiral‐in/out with application to functional MRI (fMRI)

The conventional spiral‐in/out trajectory samples k‐space sufficiently in the spiral‐in path and sufficiently in the spiral‐out path to enable creation of separate images. We propose an “interleaved spiral‐in/out” trajectory comprising a spiral‐in path that gathers one half of the k‐space data, and a complimentary spiral‐out path that gathers the other half. The readout duration is thereby reduced by approximately half, offering two distinct advantages: reduction of signal dropout due to susceptibility‐induced field gradients (at the expense of signal‐to‐noise ratio [SNR]), and the ability to achieve higher spatial resolution when the readout duration is identical to the conventional method. Two reconstruction methods are described; both involve temporal filtering to remove aliasing artifacts. Empirically, interleaved spiral‐in/out images are free from false activation resulting from signal pileup around the air/tissue interface, which is common in the conventional spiral‐out method. Comparisons with conventional methods using a hyperoxia stimulus reveal greater frontal‐orbital activation volumes but a slight reduction of overall activation in other brain regions. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.
Effects of CBV, CBF, and blood‐brain barrier permeability on accuracy of PASL and VASO measurement

Cerebral blood flow, cerebral blood volume (CBV), and water permeability through blood‐brain barrier are important hemodynamic parameters in brain physiology. Pulsed arterial spin labeling and vascular‐space occupancy techniques have been used to measure regional cerebral blood flow and CBV, respectively. However, these techniques generally ignore the effects of one hemodynamic parameter on the measurement of others. For instance, the influences of CBV changes on arterial spin labeling or the permeability effects on vascular‐space occupancy typically were not accounted for in the quantification of blood flow or volume. In the current work, the biophysical effects of CBV on pulsed arterial spin labeling and permeability on vascular‐space occupancy signals are evaluated using a general two‐compartment model. The dependence of these effects on the T1 at various field strengths is also assessed by simulations. Results indicate that CBV has negligible to small influences on pulsed arterial spin labeling signal (<6.6% at 3 T) and permeability effects are negligible on vascular‐space occupancy signal (<0.1% at 3 T) under normal physiologic conditions. In addition, CBV effect on pulsed arterial spin labeling is further diminished at high field strengths, but residual blood contamination in vascular‐space occupancy signal may be enhanced at high fields due to the reduced difference between extra‐ and intravascular T1 values. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
Noninterventional observational study using high-dose controlled-release oxycodone (CR oxycodone) for cancer pain management in outpatient clinics.

PURPOSE Efficacy, safety, and quality of life (QoL) for patients receiving larger doses of controlled-release oxycodone (CR oxycodone) in outpatient clinics are evaluated. METHODS The use of high-dose CR oxycodone and adjuvant drugs for pain management, pain intensity, parameters associated with quality of life, and adverse effects in cancer patients treated with high-dose CR oxycodone (≥80 mg/day) was prospectively observed for 8 weeks. Data from 486 cancer patients receiving high-dose CR oxycodone were collected from 44 hospitals during the period from February 2009 to March 2010. RESULTS Three hundred eighteen of the total 486 patients treated with high-dose CR oxycodone were followed up for 8 weeks. Pain intensity significantly improved from a mean numeric rating scale (NRS) 5.49 to NRS 4.33 (P < 0.0001). Dosage of CR oxycodone increased from a mean of 130.0 to a mean of 174.9 (P < 0.0001). QoL including activity, walking, and sleeping significantly improved after 8 weeks. At baseline, 138 complained of adverse effects, of which constipation (30.2%) was the most common followed by dry mouth (8.8%) and dizziness (8.2%). After 8 weeks, 128 patients complained of adverse effects such as constipation (27.0%), nausea (5.7%), dry mouth (5.7%), and dizziness (5.0%). After 8 weeks of high-dose CR oxycodone, adverse effects did not increase. CONCLUSION This study suggests that over an 8-week period, the use of high-dose CR oxycodone for cancer pain management is efficient, safe, and tolerable in outpatient clinics.
Extending the scope and use of design rationale records

Abstract During the course of the design of a complex artifact many thousands of objects will be created that will refer to many different types of information. Thus, an effective design support system must be able to store various types of data and allow easy navigation of the resulting extensive network of objects. In addition, the quality of the design records (both the record of the design artifact and rationale) is increased by the quality and quantity of information which the designer is able to record. In this paper we describe two new developments to Kbds a design support system for chemical process design, which enable easier navigation of the design network, and a fuller representation of the design process. In addition, we show how these extensions may be used together to improve the quality of the design information recorded—both for the evolution of the design artifact and the supporting rationale. The first development enables the designer to record a variety of complementary types of document within the process design history, fulfilling the task of improving the design information recorded. The second enhancement to Kbds eases the navigation of the design history by categorizing design objects according to a user-defined set of keywords. The categorization of design objects is carried out semiautomatically using, in part, the various design representations (documents) enabled through the first extension and enables rapid navigation of the design network. Finally, a method of checking the consistency of design rationale structures using keywords is also described. Thus, various representations may be used to generate keywords that in turn may be used to improve the quality of design rationale records. An example showing this situation is described.
Uso do acamprosato no tratamento do zumbido: um estudo duplo-cego

Nowadays, the treatment of tinnitus is still a great challenge for the otolaryngologists. Many facts remain unknown in its pathophysiology, leading to many different therapies, with irregular results. Acamprosate is a drug used in alcoholism treatment, due to its regulating effects in glutamatergic and GABA neurotransmission, and has never been used before in the treatment of tinnitus AIM: To evaluate efficacy and safety of the acamprosate in the treatment of sensorineural tinnitus. STUDY DESIGN: randomized clinical trial. MATERIAL AND METHOD: 50 patients with sensorineural tinnitus were divided into two groups: 25 received acamprosate and 25 placebo, for a period of 3 months, in a prospective double-blind study, being analyzed for its efficacy and safety by the subjective score from 1 to 10 given by the patient. RESULTS: We found a high index of success in the relief of tinnitus, about 86.9%. In 47.8% of the cases we found more than 50% relief. The incidence of side effects was low, 12%, all of them mild. CONCLUSION: Acamprosate, a drug used in the treatment of alcoholism, is a safe and successful alternative for sensorineural tinnitus' treatment.
Wearable Sensor/Device (Fitbit One) and SMS Text-Messaging Prompts to Increase Physical Activity in Overweight and Obese Adults: A Randomized Controlled Trial.

BACKGROUND Studies have shown self-monitoring can modify health behaviors, including physical activity (PA). This study tested the utility of a wearable sensor/device (Fitbit(®) One™; Fitbit Inc., San Francisco, CA) and short message service (SMS) text-messaging prompts to increase PA in overweight and obese adults. MATERIALS AND METHODS Sixty-seven adults wore a Fitbit One tracker for 6 weeks; half were randomized to also receive three daily SMS-based PA prompts. The Fitbit One consisted of a wearable tracker for instant feedback on performance and a Web site/mobile application (app) for detailed summaries. Outcome measures were objectively measured steps and minutes of PA by intensity using two accelerometers: Actigraph™ (Pensacola, FL) GT3X+ (primary measure) at baseline and Week 6 and Fitbit One (secondary measure) at baseline and Weeks 1, 2, 3, 4, 5, and 6. RESULTS Mixed-model repeated-measures analysis of primary measures indicated a significant within-group increase of +4.3 (standard error [SE]=2.0) min/week of moderate- to vigorous-intensity PA (MVPA) at 6-week follow-up (p=0.04) in the comparison group (Fitbit only), but no study group differences across PA levels. Secondary measures indicated the SMS text-messaging effect lasted for only 1 week: the intervention group increased by +1,266 steps (SE=491; p=0.01), +17.8 min/week MVPA (SE=8.5; p=0.04), and +38.3 min/week total PA (SE=15.9; p=0.02) compared with no changes in the comparison group, and these between-group differences were significant for steps (p=0.01), fairly/very active minutes (p<0.01), and total active minutes (p=0.02). CONCLUSIONS These data suggest that the Fitbit One achieved a small increase in MVPA at follow-up and that the SMS-based PA prompts were insufficient in increasing PA beyond 1 week. Future studies can test this intervention in those requiring less help and/or test strategies to increase participants' engagement levels.
Prescription opioids for occupational injury: results from workers' compensation claims records.

OBJECTIVE The objective of this study is to identify the prevalence of opioid prescription use in an Australian workers' compensation population and assess predictors of long-term use. DESIGN Retrospective administrative data analysis. SETTING WorkSafe Victoria (Australia) workers' compensation. SUBJECTS Workers with a workers' compensation claim were included if the injury/illness started in 2008 or 2009 (N = 54,931). METHODS Claim payments records dating up to 2 years postinjury were analyzed to determine receipt of prescription opioids. Long-term use was defined as use of any opioid beyond 1 year postinjury. RESULTS Within the follow-up period, 8,933 (16.3%) workers claimed prescription opioids: 10.0% claimed opioids in the first year only, and 6.3% claimed opioids beyond the first year. The most commonly received opioids were codeine (10.4%), oxycodone (7.5%), and tramadol (5.0%). Dextropropoxyphene, which is considered unsafe in many countries because of potentially fatal side effects, was used by 1.9% of injured workers. Progression to long-term use of opioids was common (N = 3,446; 39%): age (35-64 years; the association with age followed an inverse U-shaped curve), women, laborers, lower socioeconomic status, greater work disability, and greater hospital expense were associated with opioid use beyond the first year postinjury. CONCLUSION Prescription opioid use for workplace injury in Australia is common but not as common as reports from U.S. workers' compensation schemes. The type of opioid and number of repeat prescriptions are factors that should be carefully considered by practitioners prescribing opioids to injured workers: progression to long-term use is common and not fully explained by injury severity.
Reactions of young children to the MRI scanner environment

Seventy children aged 2 to 7 years were exposed to the MRI environment through a series of steps typical of a research study. Their willingness to proceed through the process was used to estimate the prevalence of fear. Thirty‐seven children (53%; 95% confidence interval [41%, 65%]) completed the approach sequence. Although the correlation of child age in months (Mean (M) = 60.1, standard deviation = 16.5, N = 70) and highest successful step (M = 5.8, standard deviation = 2.6, 95% confidence interval [5.2, 6.4]) completed was not statistically significant at the 0.05 level, r (68) = 0.21, P = 0.08, 95% confidence interval [−0.03, 0.42], the proportion of children aged 6‐7 years who successfully completed all steps (14 of 21, 67%, 95% confidence interval [50%, 84%]) was significantly different from the proportion of children aged 2‐3 years who completed all steps (six of 23, 26%, 95% confidence interval [11%, 41%]) (Fisher's exact test, two‐tailed P = 0.0148). A failure rate of at least 50% should be included into group size calculations when performing studies with young children (2‐7 years), in addition to motion and other experimental factors. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
Correlates of gait speed in advanced knee osteoarthritis.

OBJECTIVE This study aims to evaluate correlates of gait speed, a measure of disability, in older adults with advanced knee osteoarthritis (OA) and chronic pain. DESIGN/SETTING/SUBJECTS/METHODS Baseline data were analyzed from a clinical trial of 190 participants aged >50 with advanced knee OA (according to clinical and radiographic American College of Rheumatology criteria) and chronic pain. Data included 4-meter gait speed, quality of life (Short Form Health Survey 36 global health subscale), knee pain (Western Ontario and McMasters Universities Osteoarthritis Index [WOMAC]), depressive symptoms (Center for Epidemiologic Studies Depression Scale), coping strategies (catastrophizing subscale and Cognitive Strategies Questionnaire), self-efficacy (Athritis Self-efficacy Scale [ASES]), comorbidity (Cumulative Illness Rating Scale), analgesic use, and pain comorbidities (location, frequency, and intensity). A multivariable regression model was used to investigate these variables as they relate to gait speed. RESULTS In the univariate analysis, the following variables were associated with gait speed: knee pain (per WOMAC), age, depressive symptoms, global health, catastrophizing, ASES function and other, comorbidity, and opioid use (all P values <0.05). In the fully adjusted multivariate model, controlling for knee pain, significant associations between gait speed and age (β = -0.006; P < 0.001), ASES function (β = 0.003; P < 0.001), and opioid use (β = -0.082; P = 0.009) persisted. The correlation between opioid dose and gait speed (among opioid users) was not statistically significant (r = 0.04; P = 0.81). CONCLUSION In a cross-sectional study of older adults with advanced knee OA and chronic pain, we found that age, arthritis function self-efficacy, and opioid use (but not dose) were significantly associated with decreased gait speed.
Comparison of three different regimens of oral azithromycin in the treatment of acne vulgaris

Background: Acne vulgaris is a common skin disease that involves pilosebaceous units. Oral antibiotics are the most widely administered drugs, which are prescribed as systemic therapy for treatment of moderate to severe acne vulgaris. Azithromycin is one of the antibiotics that has been recently used for acne treatment. There are several protocols of oral azithromycin in the treatment of acne. Objective: To compare three various regimens of oral azithromycin in the treatment of acne. Materials and Methods: Sixty-four patients with moderate to severe acne were divided into three groups randomly. First group (21 patients) received azithromycin as follow: five consecutive days, 500 mg on the first day and 250 mg daily for a further four days per month. Second group (22 patients): 500 mg daily for four consecutive days per month and the last group (21 patients): 250 mg daily thrice weekly. After the baseline visit, patients were scheduled to return at four-weekly intervals among 12 weeks. Result: There were no differences between three groups in decreasing of acne grading score. ( P >0.05). Efficacy of minimal dose was equal to maximum dose of azithromycin in treatment of acne. Oral azithromycin in all groups resulted in a significant decrease in acne grading score in each consecutive visit ( P Conclusion: Because of expensiveness of azithromycin,, we recommend azithromycin in low dose (1500 mg monthly) which is as effective as a high dose (3000 mg monthly) with lower cost, has more compliance and fewer side-effects.