Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment of personality disorder using a whole of service stepped care approach: A cluster randomized controlled trial

Background and objectives People with personality disorders are prevalent in emergency and inpatient mental health services. We examined whether implementing a stepped care model of psychological therapy reduces demand on hospital units by people with personality disorder, in a cluster randomized controlled trial. Method A total of 642 inpatients (average age 36.8, 50.5% female) with a primary ICD-10 personality disorder were recruited during 18 months baseline, then monitored during an 18 month active trial phase. In the active trial phase two equivalent sites were randomised to either treatment as usual (TAU), or a whole of service intervention that diverted people away from hospital and into stepped care psychological therapy clinics. The study design was cost neutral, with no additional staff or resources deployed between sites. A linear mixed models analysis evaluated outcomes. Results As predicted, demand on hospital services reduced significantly in the intervention compared to TAU site. The intervention site evidenced shorter bed days, from an average of 13.46 days at baseline to 4.28 days per admission, and patients were 1.3 times less likely to re-present to the emergency department compared to TAU. Direct cost savings for implementing the approach was estimated at USD$2,720 per patient per year. Limitations included not directly comparing individual symptom changes. Conclusions Using a whole of service stepped care model of treatment for personality disorder significantly reduced demand on hospital services.
Bond strength and quality of the hybrid layer of one-step self-etch adhesives applied with agitation on dentin.

OBJECTIVES This study evaluated the effect of the application mode on the microtensile resin-dentin bond strength (microTBS) and silver nitrate uptake (SNU) of three one-step self-etch adhesives systems (Clearfil S3 Bond [S3], Xeno III [XE] and Adper Prompt L-Pop [AD]). MATERIALS AND METHODS The occlusal enamel of 30 caries-free extracted molars was removed with a slow-speed diamond saw under copious water-cooling in order to expose a flat dentin surface. The adhesives were applied passively or with agitation. After light-curing (600 mW/cm2 for 10 seconds), composite buildups were constructed incrementally and the specimens were stored in water (37 degrees C/24 hours). The specimens were longitudinally sectioned in the "x" and "'y" direction to obtain bonded sticks (0.8 mm2) to be tested immediately in tension at 0.5 mm/minute. For SNU, two bonded sticks from each tooth were coated with nail varnish, placed in silver nitrate and polished down with SiC paper. The microTBS and SNU data were submitted to two-way ANOVA and Tukey's test (alpha=0.05). RESULTS Regarding the microTBS, only the main factor mode of application was statistically significant (p = 0.01). All adhesives showed higher microTBS when applied with agitation. Regarding SNU, only the main factor adhesive was statistically significant (p = 0.001). A higher amount of silver nitrate uptake, located in both the hybrid and adhesive layer, occurred for AD, regardless of the mode of application. CONCLUSIONS Application with agitation on the dentin surface is a clinical tool capable of improving the resin-dentin bond strength of one-step self-etch adhesives; however, this clinical approach does not improve the hybrid layer resistance to silver nitrate uptake.
Conjugate vaccine serotypes persist as major causes of non-invasive pneumococcal pneumonia in Portugal despite declines in serotypes 3 and 19A (2012-2015)

Non-invasive pneumococcal pneumonia (NIPP) is a frequent cause of morbidity and mortality worldwide. The 13-valent pneumococcal conjugate vaccine (PCV13) was included in the national immunization program of children living in Portugal in 2015. Until then, PCV7 (since late 2001) and PCV13 (since early 2010) were given through the private market. We determined the serotype distribution and antimicrobial susceptibility of isolates causing adult NIPP in 2012–2015 and compared the results with previously published data (2007–2011). There were 50 serotypes among the 1435 isolates. The most common were serotypes: 3 (14%), 11A (8%), 19F (6%), 23A (5%), 6C (5%), 19A (4%), 23B (4%), 9N (4%) and non-typable isolates (4%). When considering data since the availability of PCV13 for children in the private market, the proportion of PCV13 serotypes declined from 44.0% in 2010 to 29.7% in 2015 (p < 0.001), mainly due to early decreases in the proportions of serotypes 3 and 19A. In contrast, during the same period, PCV7 serotypes (11.9% in 2012–2015) and the serotypes exclusive of the 23-valent polysaccharide vaccine (26.0% in 2012–2015), remained relatively stable, while non-vaccine types increased from 27.0% in 2010 to 41.9% in 2015 (p<0.001). According to the Clinical and Laboratory Standards Institute (CLSI) breakpoints, penicillin non-susceptible and erythromycin resistant isolates accounted for 1% and 21.7%, respectively, of the isolates recovered in 2012–2015, with no significant changes seen since 2007. Comparison of NIPP serotypes with contemporary invasive disease serotypes identified associations of 19 serotypes with either disease presentation. The introduction of PCV13 in the national immunization program for children from 2015 onwards may lead to reductions in the proportion of NIPP due to vaccine serotypes but continued NIPP surveillance is essential due to a different serotype distribution from invasive disease.
Lingual Distribution of Tuberculosis Patients in Karachi - A Demographic Analysis

The main objective of this paper is to investigate tuberculosis patients' demographic distribution including their sociocultural impacts among various ethnic groups in the study area. Data was collected through questionnaire survey (interviewing patients) at TB diagnostic centers in the study area over a period of eight months (March to October 2013). Analysis was made with the help of Microsoft excel and SPSS version 20 for demographic analysis.The questionnaire survey revealed the respondents in terms of languages as Urdu (33.28), Sindhi (20.63), Punjabi (14.98), Pashtu (11.48), Seraiki (10.48%) and other languages 14.81. Researchers have identified other languages (which included, Hindko, Balti, Persian, Brahvi, Marwari, Gilgiti, Gujrati) as being the most vulnerable/impoverished lingual groups in the study area. Demographically, Urdu speaking TB patients were recorded as 53% females, but the case of Sindhi speaking female patients was slightly high (50.81%) compared to males. Punjabi speaking patients were found to number almost similar to the Urdu speaking patients as the percentage of females was 52.22%. Pashtu speaking females amounted to 44.9 %, while males recorded highest percentage i.e. 55.07%. The occurrence of TB in the purview of lingual distribution of population in Karachi provides an insight into the transmission of the disease especially in the context of the global as well as local environment, cultural and politico- economic scenario.
Analysis of Internet-Based Health Assessments

Health-assessment tools assist practitioners in developing interventions to promote health. An increasing number of online health assessments have evolved recently, creating a need to evaluate for usefulness and effectiveness. This study reviewed 42 online health assessments based on recommendations developed by the Scientific Panel on Interactive Communication and Health. Four types of health assessments were reviewed, with Health Status/Positive Well-Being types, as a whole, demonstrating the highest scores. At least 75% of all sites received maximum scores for items related to background of developers and sponsors, purpose of site, and site design. Fewer than 1 of 5 sites received a maximum score for content issues, confidentiality, and evaluation results and effectiveness. Particularly poor scores were received for the evaluation criteria. Developers of online health assessments need to modify sites to incorporate evaluation results and effectiveness. Practitioners need to be cautious in using sites with no reported evaluation efforts.
Arbuscular mycorrhizal fungi reduce arsenic uptake and improve plant growth in Lens culinaris

Arsenic (As) is a carcinogenic and hazardous substance that poses a serious risk to human health due to its transport into the food chain. The present research is focused on the As transport in different lentil genotypes and the role of Arbuscular Mycorrhizal Fungi (AMF) in mitigation of As phyto-toxicity. Arsenic transport from soil to root, shoot and grains in different lentil genotypes was analyzed by flow injection hydride generation atomic absorption spectrophotometry. AMF were applied for the reduction of As uptake as well as the improvement of plant growth in lentil genotypes. Arsenic phyto-toxicity was dose-dependent as evidenced by relatively higher shoot length, fresh and dry weight of root and shoot in 5 and 15 mgkg-1 As-treated lentil plants than that in 100 mgkg-1 As-treated lentil. Arsenic accumulation occurred in roots and shoots of all BARI-released lentil genotypes. Arsenic accumulation in grains was found higher in BARI Mashur 1 than other lentil genotypes. AMF treatment significantly increased growth and biomass accumulation in lentil compared to that in non-AMF plants. Furthermore, AMF effectively reduced the As concentrations in roots and shoots of lentil plants grown at 8 and 45 mgkg-1 As-contaminated soils. This study revealed remarkable divergence in As accumulation among different BARI-released lentil genotypes; however, AMF could reduce As uptake and mitigate As-induced phyto-toxicity in lentil. Taken together, our results suggest a great potential of AMF in mitigating As transfer in root and shoot mass and reallocation to grains, which would expand lentil cultivation in As-affected areas throughout the world.
Combination of Diffusion and Perfusion for Multi-parametric Treatment Response Mapping of Human High Grade Glioma

T. L. Chenevert, C. J. Galban, D. A. Hamstra, C. I. Tsien, L. R. Junck, P. C. Sundgren, C. R. Meyer, M. K. Ivancevic, T. C. Kwee, S. E. Rohrer, and B. D. Ross Radiology MRI, University of Michigan, Ann Arbor, Michigan, United States, Radiation Oncology, University of Michigan, Ann Arbor, Michigan, United States, Neurology, University of Michigan, Ann Arbor, Michigan, United States, MRI, Philips Medical Systems, Cleveland, Ohio, United States
Studies on Habituation of Vestibulospinal Reflexes

The influence of repetitive applications of optokinetic and vestibular stimuli upon the vestibulospinal responses, measured by the stepping test, was investigated both in an optokinetic training and vestibular habituation test series. Repeated applications of optokinetic and vestibular stimuli modified the rotation angles of the stepping test, i.e. vestibulospinal responses, resulting in a response decline of rotation angles which was still present after 1 month.
Non-alcoholic fatty liver disease and pregnancy complications among Sri Lankan women: A cross sectional analytical study

Background Non-alcoholic fatty liver disease (NAFLD) is the commonest cause of liver disease worldwide and is the hepatic manifestation of metabolic syndrome. Effects of NAFLD on pregnancy is still unclear with few studies showing an association to gestational diabetes and pre-eclampsia. We aimed to describe the association between the NAFLD and pregnancy complications. This is the first study, to our knowledge, in a South Asian population. Method A cross sectional analytical study was done in Teaching Hospital, Ragama, Sri Lanka. Women carrying a singleton pregnancy, admitted for delivery were assessed for NAFLD with liver ultrasound scan. Data were extracted from interviewer administered questionnaire and antenatal and inpatient records. Pregnancy complications and labour outcomes were compared between the women with NAFLD and women without NAFLD (non-NAFLD). Results Out of the 573 women who participated, 18.2% (n = 104) were found to have NAFLD. Out of them, 58 (55.8%), 32(30.8%), and 14(13.5%) had fatty liver grade 1,2 and 3 respectively. Women with NAFLD were 2 times more likely to develop gestational hypertension and pre-eclampsia compared to the women in the non-NAFLD group, after adjusting for BMI, age and Hyperglycaemia in pregnancy [Adjusted OR 2.09, (95% CI 1.07–4.10)]. There was no association between the grade of steatosis and a composite outcome of gestational hypertension and pre-eclampsia, within the NAFLD group. Composite outcome of gestational diabetes mellitus and diabetes in pregnancy diagnosed during pregnancy was a significant complication in the NAFLD group compared to non-NAFLD group in the bivariate analysis (27.2% vs 17.7%; p<0.05), but the significance disappeared after adjusting for confounders. The current study did not demonstrate a significant association between NAFLD with preterm labour, caesarean section rate, low birth weight, and Apgar score of the baby. Conclusion Women with NAFLD had a 2-fold higher risk of developing gestational hypertension and pre-eclampsia during pregnancy compared to women without NAFLD, after controlling for other confounding variables.
mHealth consumer apps: the case for user-centered design.

mHealth applications, or “apps” as they are more commonly known, offer the opportunity to improve healthcare delivery and clinical outcomes. The ability to monitor patients remotely can enable patient risk-factor management and improve treatment compliance, thus allowing early detection of medical complications and ultimately preventing unnecessary hospitalizations. In addition to enhancing the delivery of care, one of the most significant opportunities that mHealth offers is in the consumer health domain, allowing patients to actively engage in and self manage their condition. Mobile phones also allow for the design of timely interventions based on user behavior. mHealth-mediated behavioral interventions can produce cognitive, behavioral, emotional, and social health-oriented responses. As such, mHealth apps are particularly appropriate for problems where treatments depend on patient behavioral change, such as those related to smoking, obesity, diabetes, and other chronic conditions. Despite the many potential benefits of mHealth apps, pilot studies aimed at evaluating the effectiveness of mHealth interventions have yielded mixed results. Furthermore, a quarter of all app downloads are used only once. Consumers often do not return to applications that do not immediately engage them, therefore undermining the intervention’s potential effectiveness. Regrettably, there is no simple formula for designing engaging and effective mHealth apps. Currently, many electronic health (eHealth) and mHealth interventions are designed on the basis of existing healthcare system constructs and may not be as effective as those that involve end users in the design process. Moreover, designers often base their designs on assumptions that are not validated with primary user input. The resulting systems may lack key features, and subsequent evaluations of the effectiveness of the interventions may be compromised. For this reason, we employ the user-centered design (UCD) process—an evidence-based approach informed by the needs and understanding of a specific end-user group. In our experience, designing mHealth and other apps, UCD plays a key role in achieving user engagement, thus improving the likelihood of the intervention’s effectiveness. The World Health Organization agrees, and advises that user evaluation be incorporated into the mHealth project lifecycle to ensure effective outcomes. mHealth Consumer Apps The Case for User-Centered Design
A double‐blind study with a new monodrug Kan Jang: Decrease of symptoms and improvement in the recovery from common colds

In a placebo‐controlled double‐blind study, the therapeutic effect of Kan Jang tablets made from Andrographis paniculata (Barm. F.) (Ness) dried extract was tested in patients with common colds. The patients were divided in two groups, in which group 1 (n = 33) received 1200 mg of Andrographis paniculata and group 2 (n = 28) a placebo (P).
Tumor infiltrating lymphocytes expanded from pediatric neuroblastoma display heterogeneity of phenotype and function

Adoptive transfer of ex vivo expanded tumor infiltrating lymphocytes (TILs) has led to clinical benefit in some patients with melanoma but has not demonstrated convincing efficacy in other solid cancers. Whilst the presence of TILs in many types of cancer is often associated with better clinical prognosis, their function has not been systematically evaluated across cancer types. Responses to immunological checkpoint inhibitors in a wide range of cancers, including those for which adoptive transfer of expanded TILs has not shown clinical benefit, has clearly delineated a number of tumor type associated with tumor-reactive lymphocytes capable of effecting tumor remissions. Neuroblastoma is an aggressive childhood solid cancer in which immunotherapy with GD2-directed antibodies confers a proven survival advantage through incompletely understood mechanisms. We therefore evaluated the feasibility of ex vivo expansion of TILs from freshly resected neuroblastoma tumors and the potential therapeutic utility of TIL expansions. TILs were successfully expanded from both tumor biopsies or resections. Significant numbers of NKT and γδT cells were identified alongside the mixed population of cytotoxic (CD8+) and helper (CD4+) T cells of both effector and central memory phenotypes. Isolated TILs were broadly non-reactive against autologous tumor and neuroblastoma cell lines, so enhancement of neuroblastoma killing was attained by transducing TILs with a second-generation chimeric antigen receptor (CAR) targeting GD2. CAR-TILs demonstrated antigen-specific cytotoxicity against tumor cell lines. This study is the first to show reproducible expansion of TILs from pediatric neuroblastoma, the high proportion of innate-like lymphocytes, and the feasibility to use CAR-TILs therapeutically.
Informing cancer patients: Truth telling and culture

Truth-telling about life-threatening cancer illness is a controversial matter. Few studies have explored attitudes towards truth-telling among people from migrant communities. The purpose of this grounded theory study was to explore this issue among white British and British south Asian community workers in the Metropolitan Borough of Walsall. Recommendations for practice are discussed and directions for further research are highlighted.
Evaluación de la calidad de productos lácteos por medio de la nariz electrónica

The electronic nose, instrument that uses a group of sensors and a system of pattern recognition for the qualitative analysis of aroma, has found many applications in the food industry, because of its versatility. In this work a brief description of the electronic nose, its operation mode and its advantages and disadvantages were carried out. Moreover, the main applications of this instrument in the food industry, with special emphasis on the dairy industry, have been reviewed. These applications include the detection of microorganisms in milk, the identification of off-flavours in milk, the shelf life of milk and various types ofcheeses, the identification of mastitic milk, the classification of cheeses according to their time of ripening, the discrimination of cheeses by geographic origin and the control of the milk fermentation, among other. The results of this review indicate that electronic nose could be used as an instrument for the rapid quality control of dairy products.
Oligomerization and insertion of antimicrobial peptide TP4 on bacterial membrane and membrane-mimicking surfactant sarkosyl

Antimicrobial peptides (AMPs) are important components of the host innate defense mechanism against invading microorganisms. Although AMPs are known to act on bacterial membranes and increase membrane permeability, the action mechanism of most AMPs still remains unclear. In this report, we found that the TP4 peptides from Nile tilapia anchored on E. coli cells and enabled them permeable to SYTOX Green in few minutes after TP4 addition. TP4 peptides existed in small dots either on live or glutaraldehyde-fixed cells. TP4 peptides were driven into oligomers either in soluble or insoluble form by a membrane-mimicking anionic surfactant, sarkosyl, depending on the concentrations employed. The binding forces among TP4 components were mediated through hydrophobic interaction. The soluble oligomers were negatively charged on surface, while the insoluble oligomers could be fused with each other or piled on existing particles to form larger particles with diameters 0.1 to 20 μm by hydrophobic interactions. Interestingly, the morphology and solubility of TP4 particles changed with the concentration of exogenous sarkosyl or trifluoroethanol. The TP4 peptides were assembled into oligomers on or in bacterial membrane. This study provides direct evidence and a model for the oligomerization and insertion of AMPs into bacterial membrane before entering into cytosol.
Diversity and relative abundance of ammonia- and nitrite-oxidizing microorganisms in the offshore Namibian hypoxic zone

Nitrification, the microbial oxidation of ammonia (NH3) to nitrite (NO2–) and NO2– to nitrate (NO3–), plays a vital role in ocean nitrogen cycling. Characterizing the distribution of nitrifying organisms over environmental gradients can help predict how nitrogen availability may change with shifting ocean conditions, for example, due to loss of dissolved oxygen (O2). We characterized the distribution of nitrifiers at 5 depths spanning the oxic to hypoxic zone of the offshore Benguela upwelling system above the continental slope off Namibia. Based on 16S rRNA gene amplicon sequencing, the proportional abundance of nitrifiers (ammonia and nitrite oxidizers) increased with depth, driven by an increase in ammonia-oxidizing archaea (AOA; Thaumarchaeota) to up to 33% of the community at hypoxic depths where O2 concentrations fell to ~25 μM. The AOA community transitioned from being dominated by a few members at oxic depths to a more even representation of taxa in the hypoxic zone. In comparison, the community of NO2–-oxidizing bacteria (NOB), composed primarily of Nitrospinae, was far less abundant and exhibited higher evenness at all depths. The AOA:NOB ratio declined with depth from 41:1 in the oxic zone to 27:1 under hypoxia, suggesting potential variation in the balance between NO2– production and consumption via nitrification. Indeed, in contrast to prior observations from more O2-depleted sites closer to shore, NO2– did not accumulate at hypoxic depths near this offshore site, potentially due in part to a tightened coupling between AOA and NOB.