Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects on pain of a stepwise multidisciplinary intervention (STA OP!) that targets pain and behavior in advanced dementia: A cluster randomized controlled trial

Background: Pain in nursing home residents with advanced dementia remains a major challenge; it is difficult to detect and may be expressed as challenging behavior. STA OP! aims to identify physical and other needs as causes of behavioral changes and uses a stepwise approach for psychosocial and pharmacological management which was effective in improving challenging behavior. Aim: To assess whether implementation of the stepwise multidisciplinary intervention also reduces pain and improves pain management. Design: In a cluster randomized controlled trial (Netherlands National Trial Register NTR1967), healthcare professionals of intervention units received the stepwise training, while training of the control group focused on knowledge and skills without the stepwise component. Observed and estimated pain was assessed at baseline and at 3 and 6 months post-intervention. Logistic generalized estimating equations were used to test treatment and time effects. Setting/participants: A total of 21 clusters (single nursing home units) in 12 Dutch nursing homes included 288 residents with advanced dementia (Global Deterioration Scale score 5, 6, or 7): 148 in the intervention and 140 in the control condition. Results: The multilevel modeling showed an overall effect of the intervention on observed pain but not on estimated pain; Pain Assessment Checklist for Seniors with Limited Ability to Communicate–Dutch version, mean difference: −1.21 points (95% confidence interval: −2.35 to −0.06); Minimum Dataset of the Resident Assessment Instrument pain scale, mean difference: −0.01 points (95% confidence interval: −0.36 to 0.35). Opioid use increased (odds ratio = 3.08; 95% confidence interval: 1.08–8.74); paracetamol use did not (odds ratio = 1.38; 95% confidence interval: 0.71–2.68). Conclusion: STA OP! was found to decrease “observed” pain but not estimated pain. Observing pain-related behavior might help improve pain management in dementia.
Estudio Morfométrico del Hígado de Ratón en la Enfermedad de Chagas Experimental

El objetivo de este trabajo fue caracterizar histopatologicamente y morfometricamente las alteraciones del tejido hepatico de raton, durante la fase aguda de la infeccion por la cepa MORC-2 de Trypanosoma cruzi. Esta cepa mostro acentuado tropismo por el higado, con numerosos nidos de amastigotes en los cortes examinados. El higado de los animales infectados estaba constituido por celulas menores, con citoplasma granuloso. En algunas areas, los sinusoides estaban congestionados y las celulas de Kupffer hipertroficas e hiperplasicas. El tejido hepatico mostro focos circunscritos de celulas inflamatorias en areas de necrosis, sinusoides, en torno de las venas centrolobulillares y de los espacios porta. La vena centrolobulillar estaba dilatada y congestionada, con necrosis focales y ruptura de la pared en algunos campos. Los espacios porta estaban desorganizados, a veces, con intenso infiltrado inflamatorio. En algunas areas fue posible observar degeneracion cistica (spongis hepatis). Por todo el tejido hepatico se observaron nidos de amastigotes, de tamano variable, algunos rodeados por infiltrado inflamatorio cronico. En el espacio porta, el volumen relativo de los conductos biliares y vasos sanguineos, asi como la densidad de superficie de las arterias fueron mayores en el grupo infectado
Kremers and Urdang's History of Pharmacy

In the history of pharmacy, so intimately connected with the history of medicine, the text of Kremers and Urdang has for many years been the standard work in English. Its last edition, however, was published in 1951. Retaining the main out-line of the original text, Dr. Sonnedecker has given us a revision which is indeed welcome. There are many changes. The page size has been increased and the two-column format utilized, but the total number of pages has been diminished from 622 to 464. Dr. Sonnedecker has closely adhered to the major outlines of the exposition, although one chapter on the developments in Spain has been omitted. The entire text has been rewritten, the changes sometimes taking the form merely of a few transposed phrases or clauses, and other times of substantial new insertions or omissions. The exposition flows smoothly and reads easily. The illustrations, increased more than threefold, are
Asenapine: a novel psychopharmacologic agent with a unique human receptor signature

Asenapine is a novel psychopharmacologic agent under development for the treatment of schizophrenia and bipolar disorder. We determined and compared the human receptor binding affinities and functional characteristics of asenapine and several antipsychotic drugs. Compounds were tested under comparable assay conditions using cloned human receptors. In comparison with the antipsychotics, asenapine showed high affinity and a different rank order of binding affinities (pK i) for serotonin receptors (5-HT1A [8.6], 5-HT1B [8.4], 5-HT2A [10.2], 5-HT2B [9.8], 5-HT2C [10.5], 5-HT 5 [8.8], 5-HT6 [9.6] and 5-HT7 [9.9]), adrenoceptors (α1 [8.9], α2A [8.9], α2B [9.5] and α2C [8.9]), dopamine receptors (D1 [8.9], D 2 [8.9], D3 [9.4] and D4 [9.0]) and histamine receptors (H1 [9.0] and H2 [8.2]). It had much lower affinity (pK i ≤ 5) for muscarinic receptors and was the only agent with affinity for H2 receptors. Relative to its D2 receptor affinity, asenapine had a higher affinity for 5-HT 2C, 5-HT2A, 5-HT2B, 5-HT7, 5-HT 6, α2B and D3 receptors, suggesting stronger engagement of these targets at therapeutic doses. Asenapine behaved as a potent antagonist (pK B) at 5-HT1A (7.4), 5-HT 1B (8.1), 5-HT2A (9.0), 5-HT2B (9.3), 5-HT 2C (9.0), 5-HT6 (8.0), 5-HT7 (8.5), D2 (9.1), D3 (9.1), α2A (7.3), α2B (8.3), α2C (6.8) and H1 (8.4) receptors. These functional effects differed from those of risperidone (pK B < 5 for 5-HT6) and olanzapine (pK B < 5 for 5-HT 1A and α2). Our results indicate that asenapine has a unique human receptor signature, with binding affinity and antagonistic properties that differ appreciably from those of antipsychotic drugs.
Expressão da proteína P53 no adenocarcinoma gástrico: correlação clínica, anatomopatológica e significância prognostica

BACKGROUND: To study the expression of p53 protein in gastric adenocarcinoma and its relationship to clinicopathological parameters such as, age, sex, infiltration of the gastric wall (T), histological type of Lauren's classification, histological differenciation, lymph node involvement, stage (TNM) and patient longevity. METHODS: Forty-five patients with the diagnosis of gastric carcinoma submitted to a sub-total gastrectomy or a total gastrectomy in the Surgical Oncology Department at the Santa Casa de Misericordia Hospital in Maceio, Alagoas and the University Hospital of the Federal University of Alagoas, Brazil during the period of January 1991 to May 2002 were analysed.The expression of the p53 protein was evaluated by an immunohistochemistry method, and compared to age, sex, infiltration of the gastric wall, histological type, histological differenciation, lymph node involvement, stage (TNM) and patient longevity. RESULTS: In the total number of patients, 27 were male (60%). The age range of all patients was 26 - 75 years (mean = 53.9 years). Forty patients (88.9%) were classified as well differenciated. As far as infiltration of the gastric wall, 28 patients (62.2%) were classified as having deep infiltration. In 25 patients (55.6%) the lymph nodes were free of disease. The histological study revealed that 29 patients (64.4%) were classified as the intestinal type of Lauren's classification. The stage (TNM) showed that 33 patients (73.3%) presented an advanced tumor. In the immunohistochemistry analysis, 18 patients (40%) were considered positive.The follow-up varied between 63 to 3920 days, with the average time being 1020.4 days. The statistical method of univariate analysis of Mantel identified the variables: age, stage, lymph node involvement and the tumor infiltration of the gastric wall as prognostic factors related to the patient with a significant statistical longevity (p<0.05). Multivariate analysis showed that only lymph node involvement was an independent prognostic factor. CONCLUSION: The author concluded that 18 (40%) of the total number of 45 patients with gastric carcinoma showed an immunohistochemistry reaction. There was no significant statistical relationship between expression of p53 protein and prognostic factors studied. Expression of p53 protein was not an independent prognostic factor.
Energy Efficient Wireless Pushing With Request Delay Information and Delivery Delay Constraint

Proactively pushing content to users is a promising way of coping with the explosively growing traffic demand of next-generation mobile networks. However, it is unclear whether content pushing can improve the energy efficiency of delay-constrained wireless communication systems over fading channels. With pushing, the energy consumption can be reduced due to the extended transmission time duration. But if the user never needs the pushed content, pushing may lead to wasted energy. Based on the random content request delay, this paper derives the user request probability thresholds that determine whether a content file should be pushed under two different quality-of-service requirements, namely, average delay and delay-outage constraints. Moreover, optimal strategies to allocate transmission power in content pushing and on-demand delivery stages are also proposed. It is shown that the energy efficiency of systems with pushing can be significantly improved as the content request probability increases. Numerical results validate the effectiveness of the proposed power allocation strategies for different delay constraints, compared with the corresponding on-demand schemes.
Antipsychotics and hyperprolactinaemia: Clinical recommendations

A group of international experts in psychiatry, medicine, toxicology and pharmacy assembled to undertake a critical examination of the currently available clinical guidance on hyperprolactinaemia. This paper summarises the group's collective views and provides a summary of the recommendations agreed by the consensus group to assist clinicians in the recognition, clinical assessment, investigation and management of elevated plasma prolactin levels in patients being treated for severe mental illness. It also deals with the special problems of particular populations, gives advice about information that should be provided to patients, and suggests a strategy for routine monitoring of prolactin. The recommendations are based upon the evidence contained in the supplement 'Hyperprolactinaemia in schizophrenia and bipolar disorder: Clinical Implications' (2008). The guidance contained in this article is not intended to replace national guidance (such as that of the National Institute of Clinical Excellence), however, it does provide additional detail that is unlikely to be covered in existing guidelines, and focuses on areas of uncertainty and disagreement. We hope it will add to the debate about this topic.
Lithium carbonate in the management of cannabis withdrawal in humans: an open-label study

Cannabis is the most widely used illicit substance in the world. Estimates suggest that approximately 10—20% of cannabis users meet criteria for cannabis dependence and a significant proportion experience withdrawal discomfort on cessation of use. To date, there has been an absence of any clinically validated treatments to manage withdrawal. The current study is an open-label trial exploring the utility of lithium carbonate for the management of cannabis withdrawal symptoms in treatment seeking adult humans. In total, 20 participants were recruited to the study (19 men). All met DSM-IV cannabis-dependence criteria and had been smoking cannabis daily or almost daily for a mean 9 years. Participants were admitted to an inpatient detoxification facility and prescribed lithium 500 mg b.d. for 7 days. Cannabis withdrawal was assessed daily with the Marijuana Withdrawal Checklist (MWC). Two participants were withdrawn from the trial because of possible adverse effects. Sixty percent of participants completed the 7-day treatment program. Follow-up was conducted at a mean of 107 days following treatment. The mean percentage of days abstinent in the period between treatment cessation and follow-up was 87.57%. Twenty-nine percent of participants (n = 5) reported continuous abstinence that was biochemically verified at follow-up. Agreement between self-reported cannabis use and urinalysis at follow-up was moderate (κ = 0.47). Significant reductions in symptoms of depression and anxiety and cannabis-related problems were also reported. This study provides evidence for the potential clinical utility and safety of lithium in the management of cannabis withdrawal. A randomised, placebo-controlled trial is recommended.
An Integrated Approach to Aural Rehabilitation

Audiologists disagree about the value of specific aspects of aural rehabilitation (AR) to be used with adults who have adventitious hearing impairment. Some believe that fitting a client with appropriate amplification is sufficient, while others support a counseling-oriented approach, excluding any specific communication skill building training. Among those who believe in the need for skill building there is disagreement about the form it should take. For example, some work on speechreading and auditory training separately while others train in a bisensory mode; some only train synthetic skills while others add analytic training. Renewed interest in AR is evidenced by studies evaluating the efficacy of AR for adults using cochlear implants (Gagné, 1992), the use of computers with video interactive training (Rubinstein, Cherry, & Small, 1993; Tye-Murray, 1992a; Tye-Murray, Tyler, Bong, & Nares, 1988), and the increasing number of audiologists providing this service (Schow, Balsara, Smedley, & Whitcomb, 1993). This article describes an integrated individualized AR program that has been operating at the Brooklyn College Speech and Hearing Center for the past 15 years, serving over 100 hearing-impaired clients and their significant others. Most aspects of this program are not unique but generally reflect current approaches being advocated. The program includes all of the major components outlined by the American SpeechLanguage-Hearing Association's (ASHA's) Committee on Rehabilitation Audiology (1974, 1984): diagnosis, selection of appropriate amplification, orientation to care and use of amplification, communication skill building, counseling the client and significant others, and assessment of program effectiveness. This AR program begins during the audiological evaluation in the form of educational and adjustment counseling. Individuals with hearing problems are encouraged to consider appropriate amplification. This may require the inclusion of certain test procedures to help convince the client that amplification is warranted. For example, a client with a moderate bilateral loss who indicates that hearing is not a problem is administered a monosyllabic word recognition test in sound field at a normal conversational level (50 dB HL). The difference between this score and that obtained at PB Max can help the audiologist demonstrate the potential value of amplification. Counseling the client in the form of a dialogue can help some individuals accept the possibility of amplification (Rubinstein, 1990). The audiologist must provide individuals with hearing impairment the information needed to make informed decisions. (See Rubinstein in this issue.)
The strategic analysis of intangible resources

Sustainable competitive advantage results from the possession of relevant capability differentials. The feedstock of these capability differentials is intangible resources which range from patents and licenses, to reputation and know-how. A framework of intangible resources has been produced which formed the basis for a national survey of chief executives in the U.K. Some of the more significant findings of the survey were that: employee know-how and reputation are perceived as the resources which make the most important contribution to business success; and that for most companies operations is the most important area of employee know how. This article argues, by means of both theoretical reasoning and empirical evidence, that the analysis of intangible resources should play a major role in the strategic management process.
Always best connected

Over the last few years, we have experienced a variety of access technologies being deployed. While 2G cellular systems evolve into 3G systems such as UMTS or cdma2000, providing worldwide coverage, wireless LAN solutions have been extensively deployed to provide hotspot high-bandwidth Internet access in airports, hotels, and conference centers. At the same time, fixed access such as DSL and cable modem tied to wireless LANs appear in home and office environments. The always best connected (ABC) concept allows a person connectivity to applications using the devices and access technologies that best suit his or her needs, thereby combining the features of access technologies such as DSL, Bluetooth, and WLAN with cellular systems to provide an enhanced user experience for 2.5G, 3G, and beyond. An always best connected scenario, where a person is allowed to choose the best available access networks and devices at any point in time, generates great complexity and a number of requirements, not only for the technical solutions, but also in terms of business relationships between operators and service providers, and in subscription handling. This article describes the concept of being always best connected, discusses the user experience and business relationships in an ABC environment, and outlines the different aspects of an ABC solution that will broaden the technology and business base of 3G.
High-Performance Gas Sensor Using a Large-Area WS2 xSe2-2 x Alloy for Low-Power Operation Wearable Applications.

Two-dimensional (2D) transition-metal dichalcogenides (TMDCs) have attracted considerable attention as promising building blocks for a new generation of gas-sensing devices because of their excellent electrical properties, superior response, flexibility, and low-power consumption. Owing to their large surface-to-volume ratio, various 2D TMDCs, such as MoS2, MoSe2, WS2, and WSe2, have exhibited excellent gas-sensing characteristics. However, exploration toward the enhancement of TMDC gas-sensing performance has not yet been intensively addressed. Here, we synthesized large-area uniform WS2 xSe2-2 x alloys for room-temperature gas sensors. As-synthesized WS2 xSe2-2 x alloys exhibit an elaborative composition control owing to their thermodynamically stable sulfurization process. Further, utilizing uniform WS2 xSe2-2 x alloys over a large area, we demonstrated improved NO2-sensing performance compared to WSe2 on the basis of an electronic sensitization mechanism. The WS0.96Se1. 04 alloy gas sensor exhibits 2.4 times enhanced response for NO2 exposure. Further, we demonstrated a low-power wearable NO2-detecting wristband that operates at room temperature. Our results show that the proposed method is a promising strategy to improve 2D TMDC gas sensors and has a potential for applications in advanced gas-sensing devices.
Energy Efficiency Analysis of Heterogeneous Cellular Networks With Extra Cell Range Expansion

The split control and user plane is key to the future heterogeneous cellular network (HCN), where the small cells are dedicated for the most data transmission while the macrocells are mainly responsible for the control signaling. Adapting to this technology, we propose a general and tractable framework of extra cell range expansion (CRE) by introducing an additional bias factor to enlarge the range of small cells flexibly for the extra offloaded macrousers in a two-tier HCN, where the macrocell and small cell users have different required data rates. Using stochastic geometry, we analyze the energy efficiency (EE) of the extra CRE with joint low power transmission and resource partitioning, where the coverages of EE and data rate are formulated theoretically. Numerical simulations verify that the proposed extra CRE can improve the EE performance of HCN, and also show that deploying more small cells can provide benefits for EE coverage, but the EE improvement becomes saturated if the small cell density exceeds a threshold. Instead of establishing the detail configuration, this paper can provide some valuable insights and guidelines to the practical design of future networks, especially for the traffic offloading in HCN.
Demonstrated Efficacy of Models of Marriage and Family Therapy: An Update of Gurman, Kniskern, and Pinsof's Chart.

Abstract Opportunities for third-party reimbursement, marriage and family therapy (MFT) legislation, and federal funding depend largely on evidence supporting the efficacy of specific family therapies in treating specific disorders. The following comprehensive review of literature attempts to answer this “specificity question. ” The article summarizes outcome research (1986-95) relating to the efficacy of specific modalities of MFT in treating certain disorders and updates the chart originally introduced by Gurman, Kniskern, and Pinsof (1986). Implications for clinical practice and research are discussed.
Building multicluster 802.15.4 networks: issues and open problems

The 802.15. 4 communication standard is being increasingly used in wireless sensor networks, thanks to industry-wide support it has enjoyed in recent years. However, its support for bridging and building multicluster networks is still minimal, and a number of open issues preclude its even wider usage in practice. In this article we highlight the most important aspects of building multicluster 802.15. 4 networks, review some of the design alternatives for implementing the bridging function, and discuss their pertinent properties in terms of ease of scheduling, performance, scalability, and security.
Docitive networks: an emerging paradigm for dynamic spectrum management [Dynamic Spectrum Management]

Prime design goals for next-generation wireless networks to support emerging applications are spectral efficiency and low operational cost. Among a gamut of technical solutions, cognitive approaches have long been perceived as a catalyst for the above goals by facilitating the coexistence of primary and secondary users by means of efficient dynamic spectrum management. While most available techniques today are essentially opportunistic in nature, a truly cognitive device needs to exhibit a certain degree of intelligence to draw optimum decisions based on prior observations and anticipated actions. Said intelligence however, comes along with high complexity and poor convergence, which currently prevents any viable deployment of cognitive networks. We thus introduce an emerging and largely unexplored concept of docitive networks, where nodes effectively teach other nodes with the prime aims of reducing cognitive complexity, speeding up the learning process, and drawing better and more reliable decisions. To this end, we review some important concepts borrowed from the machine learning community for both centralized and decentralized systems, in order to position the emerging docitive with known cognitive approaches. Finally, we validate introduced concepts in the context of a primary digital television system dynamically coexisting with IEEE 802.22 secondary networks. For this scenario, we demonstrate the superiority of various unprecedented docitive over known opportunistic/cognitive algorithms.