Miracle-dz/UniFAR-FTUs huggingface dataset:
Human factors perspective on the prescribing behavior of recent medical graduates: implications for educators

Background Junior doctors are at high risk of involvement in medication errors. Educational interventions to enhance human factors and specifically nontechnical skills in health care are increasingly reported, but there is no work in the context of prescribing improvement to guide such education. We set out to determine the elements that influence prescribing from a human factors perspective by recent medical graduates and use this to guide education in this area. Methods A total of 206 recent medical graduates of the North Western Foundation School were asked to describe their views on safety practices and behaviors. Free text data regarding prescribing behaviors were collected 1, 2, and 4 months after starting their posts. A 94.1% response rate was achieved. Qualitative analysis of data was completed using the constant comparison method. Five initial categories were developed, and the researchers subsequently developed thematic indices according to their understanding of the emerging content of the data. Further data were collected through group interviews 8–9 months into the placement to ensure thematic saturation. Results Six themes were established at the axial coding level, ie, contributors to inappropriate prescribing, contributors to appropriate prescribing, professional responsibility, prescribing error, current practices, and methods for improvement of prescribing. Utilizing appropriate theoretical elements, we describe how recent medical graduates employ situational and error awareness to guide risk assessment. Conclusion We have modeled the human factors of prescribing behavior by recent medical graduates. As these factors are related to a number of recognized elements of nontechnical skills training within health care, educators should consider design elements from such existing interventions to support prescribing improvement programs. Future research should seek to assess the effectiveness of prescribing focused nontechnical skills training.
Universals in perceived politeness: Comparison of native and non-native speakers of English

Notwithstanding its significance as a communicative apparatus tor social interaction, the general mechanism of politeness has been less clear partly because a wide variety of realization patterns of politeness strategies exist across cultures and languages. Researchers who are sensitive to the cultural and linguistic diversities of communication styles have claimed that politeness varies in its conceptualization and practices across cultures and languages, whereas linguists in pragmatics have assumed that politeness is a part of a universally rational communication system that operates in the same way for any language user. This study attempts to investigate the universal mechanism of politeness presumably built into any language system. At the same time, potential cross-cultural differences in values assigned to politeness are explored to determine what interferes with people's universal competence in perceiving politeness. In comparing native and nonnative speakers of English, people's judgments of politeness and other notions closely related to politeness were assessed for several speech act types in English. The results of the study strongly confirmed that native and non-native speakers of English are operating on a very similar inference mechanism in terms of negative politeness, and it is discussed that natural language users universally assess sentence politeness based on the pragmatic principles of negative-face concern to the hearer. However, cultural differences in the orientation to the positive aspect of politeness can seriously alter people's judgments of sentence politeness. Specifically, deference was found to be a universally important facet of politeness across cultures. However, while native speakers of English considered fnendliness to be a relatively more important aspect of politeness compared to formality, non-native speakers of English firom collectivistic cultiires such as Japan, China, and Korea perceived formality to be more important to politeness than friendliness. It was also found that conventionality of a sentence affected people's perception of sentence politeness, but not as much as perceived deference, formality, or friendliness of a
Estimating Diagnostic Accuracy of Raters Without a Gold Standard by Exploiting a Group of Experts

Summary In diagnostic medicine, estimating the diagnostic accuracy of a group of raters or medical tests relative to the gold standard is often the primary goal. When a gold standard is absent, latent class models where the unknown gold standard test is treated as a latent variable are often used. However, these models have been criticized in the literature from both a conceptual and a robustness perspective. As an alternative, we propose an approach where we exploit an imperfect reference standard with unknown diagnostic accuracy and conduct sensitivity analysis by varying this accuracy over scientifically reasonable ranges. In this article, a latent class model with crossed random effects is proposed for estimating the diagnostic accuracy of regional obstetrics and gynaecological (OB/GYN) physicians in diagnosing endometriosis. To avoid the pitfalls of models without a gold standard, we exploit the diagnostic results of a group of OB/GYN physicians with an international reputation for the diagnosis of endometriosis. We construct an ordinal reference standard based on the discordance among these international experts and propose a mechanism for conducting sensitivity analysis relative to the unknown diagnostic accuracy among them. A Monte Carlo EM algorithm is proposed for parameter estimation and a BIC‐type model selection procedure is presented. Through simulations and data analysis we show that this new approach provides a useful alternative to traditional latent class modeling approaches used in this setting.
A Laplacian Framework for Option Discovery in Reinforcement Learning

Representation learning and option discovery are two of the biggest challenges in reinforcement learning (RL). Proto-value functions (PVFs) are a well-known approach for representation learning in MDPs. In this paper we address the option discovery problem by showing how PVFs implicitly define options. We do it by introducing eigenpurposes, intrinsic reward functions derived from the learned representations. The options discovered from eigenpurposes traverse the principal directions of the state space. They are useful for multiple tasks because they are discovered without taking the environment's rewards into consideration. Moreover, different options act at different time scales, making them helpful for exploration. We demonstrate features of eigenpurposes in traditional tabular domains as well as in Atari 2600 games.
Assessing the Impact of “Brain Training” on Changes in Driving Performance, Visual Behavior, and Neuropsychology

As the population has become both older and more technologically literate, a new class of “brain training” computer programs have gained in popularity. Though these programs have attracted substantial attention from scientists and consumers, the extent of their benefits, if any, remain unclear. Here the authors employ neuropsychological tests and behavioral metrics collected during periods of real-world driving (with and without manipulations of cognitive load) to evaluate the effects of training with Posit Science’s DriveSharp software. They find that DriveSharp’s training effects appear in in-lab measures of Useful Field of View but did not translate to changes in actual driving performance or changes in visual behavior in consistent or quantifiable ways in the sample assessed. The implications of these results and relevant limitations of the present research are discussed.
Butyrate modulates bacterial adherence on LS174T human colorectal cells by stimulating mucin secretion and MAPK signaling pathway

BACKGROUND/OBJECTIVES Fermentation of dietary fiber results in production of various short chain fatty acids in the colon. In particular, butyrate is reported to regulate the physical and functional integrity of the normal colonic mucosa by altering mucin gene expression or the number of goblet cells. The objective of this study was to investigate whether butyrate modulates mucin secretion in LS174T human colorectal cells, thereby influencing the adhesion of probiotics such as Lactobacillus and Bifidobacterium strains and subsequently inhibiting pathogenic bacteria such as E. coli. In addition, possible signaling pathways involved in mucin gene regulation induced by butyrate treatment were also investigated. MATERIALS/METHODS Mucin protein content assay and periodic acid-Schiff (PAS) staining were performed in LS174T cells treated with butyrate at various concentrations. Effects of butyrate on the ability of probiotics to adhere to LS174T cells and their competition with E. coli strains were examined. Real time polymerase chain reaction for mucin gene expression and Taqman array 96-well fast plate-based pathway analysis were performed on butyrate-treated LS174T cells. RESULTS Treatment with butyrate resulted in a dose-dependent increase in mucin protein contents in LS174T cells with peak effects at 6 or 9 mM, which was further confirmed by PAS staining. Increase in mucin protein contents resulted in elevated adherence of probiotics, which subsequently reduced the adherent ability of E. coli. Treatment with butyrate also increased transcriptional levels of MUC3, MUC4, and MUC12, which was accompanied by higher gene expressions of signaling kinases and transcription factors involved in mitogen-activated protein kinase (MAPK) signaling pathways. CONCLUSIONS Based on our results, butyrate is an effective regulator of modulation of mucin protein production at the transcriptional and translational levels, resulting in changes in the adherence of gut microflora. Butyrate potentially stimulates the MAPK signaling pathway in intestinal cells, which is positively correlated with gut defense.
Clinical significance of coexisting antitopoisomerase I and anticentromere antibodies in patients with systemic sclerosis: a EUSTAR group-based study.

OBJECTIVES To determine the clinical characteristics of simultaneous occurrence of antitopoisomerase (ATA) and anticentromere (ACA) autoantibodies in systemic sclerosis (SSc). METHODS Data of patients (n=4,687) fulfilling the ACR criteria for SSc and followed in the EULAR Scleroderma Trials and Research (EUSTAR) cohort were analysed. Sera from patients with simultaneous ATA and ACA were reanalyzed centrally by indirect immunofluorescence, enzyme immunoassay, and immunoblot to confirm antibody status. RESULTS A total of 29 patients (0.6%) had been documented double-positive for both ATA and ACA in the EUSTAR database. Sera of 14 cases were available for central analysis, of which 8 were confirmed to unequivocally contain both antibodies. The double-positive patients were on average 52.4 years of age, 87.5% were female, and 62.5% had diffuse cutaneous (dc) SSc. Compared with matched ACA single-positive disease, cutaneous and visceral complications were more prevalent in double-positive cases, but this prevalence did not differ significantly in comparison to ATA single-positives. CONCLUSIONS Coexistence of ATA and ACA can be found at low prevalence in SSc. The clinical features of double-positive patients are not clearly dissimilar to those of patients harbouring only ATA. The data do not support a direct involvement of these antibodies in the pathogenesis of established SSc, but may lack statistical power.
RAID5 Performance with Distributed Sparing

Distributed sparing is a method to improve the performance of RAID5 disk arrays with respect to a dedicated sparing system with N+2 disks (including the spare disk), since it utilizes the bandwidth of all N+2 disks. We analyze the performance of RAID5 with distributed sparing in normal mode, degraded mode, and rebuild mode in an OLTP environment, which implies small reads and writes. The analysis in normal mode uses an M/G/1 queuing model, which takes into account the components of disk service time. In degraded mode, a low-cost approximate method is developed to estimate the mean response time of fork-join requests resulting from accesses to recreate lost data on the failed disk. Rebuild mode performance is analyzed by considering an M/G/1 vacationing server model with multiple vacations of different types to take into account differences in processing requirements for reading the first and subsequent tracks. An iterative solution method is used to estimate the mean response time of disk requests, as well as the time to read each disk, which is shown to be quite accurate through validation against simulation results. We next compare RAID5 performance in a system (1) without a cache; (2) with a cache; and (3) with a nonvolatile storage (NVS) cache. The last configuration, in addition to improved read response time due to cache hits, provides a fast-write capability, such that dirty blocks can be destaged asynchronously and at a lower priority than read requests, resulting in an improvement in read response time. The small write penalty is also reduced due to the possibility of repeated writes to dirty blocks in the cache and by taking advantage of disk geometry to efficiently destage multiple blocks at a time.
The cytokine temporal profile in rat cortex after controlled cortical impact

Cerebral inflammatory responses may initiate secondary cascades following traumatic brain injury (TBI). Changes in the expression of both cytokines and chemokines may activate, regulate, and recruit innate and adaptive immune cells associated with secondary degeneration, as well as alter a host of other cellular processes. In this study, we quantified the temporal expression of a large set of inflammatory mediators in rat cortical tissue after brain injury. Following a controlled cortical impact (CCI) on young adult male rats, cortical and hippocampal tissue of the injured hemisphere and matching contralateral material was harvested at early (4, 12, and 24 hours) and extended (3 and 7 days) time points post-procedure. Naïve rats that received only anesthesia were used as controls. Processed brain homogenates were assayed for chemokine and cytokine levels utilizing an electrochemiluminescence-based multiplex ELISA platform. The temporal profile of cortical tissue samples revealed a multi-phasic injury response following brain injury. CXCL1, IFN-γ, TNF-α levels significantly peaked at four hours post-injury compared to levels found in naïve or contralateral tissue. CXCL1, IFN-γ, and TNF-α levels were then observed to decrease at least 3-fold by 12 hours post-injury. IL-1β, IL-4, and IL-13 levels were also significantly elevated at four hours post-injury although their expression did not decrease more than 3-fold for up to 24 hours post-injury. Additionally, IL-1β and IL-4 levels displayed a biphasic temporal profile in response to injury, which may suggest their involvement in adaptive immune responses. Interestingly, peak levels of CCL2 and CCL20 were not observed until after four hours post-injury. CCL2 levels in injured cortical tissue were significantly higher than peak levels of any other inflammatory mediator measured, thus suggesting a possible use as a biomarker. Fully elucidating chemokine and cytokine signaling properties after brain injury may provide increased insight into a number of secondary cascade events that are initiated or regulated by inflammatory responses.
The Dangerous Edge: The Psychology of Excitement

Apter examines the reasons why people take part in dangerous activities, and explores the complex relationship between excitement, anxiety, panic and euphoria. He discusses the psychological mechanisms which court danger and the counter-instincts which seek to contain the risk. This seeking of risky but limited excitement is, he argues, an important social safety valve and channels energies and desires that would otherwise find expression in criminal and wantonly destructive activities. However, this craving for excitement can escalate and lead people to attempt ever more risky, foolhardy and ultimately fatal feats. Apter highlights these dangers and suggests ways in which such escalation can be avoided.
Consumer education philosophies. The relationship between education and consumption

This paper focuses on the relationship between education and consumption. The basic premise is that the nature of peopleÂ’s socialization into their role as a consumer will depend upon the consumer educatorÂ’s philosophy of education Â– what is the purpose of education. To develop this idea, the paper first distinguishes between two overarching intents of consumer education: (a) empowerment for self-interest relative to the power of businesses and/or (b) empowerment gained from supporting citizens to become more socially, ethically and morally responsible consumers. This is followed by an inaugural exploration of the relationship between eleven dominant educational philosophies and four types of consumer education. Consumer educators could benefi t from becoming philosophically savvy and philosophically inclusive if they wish to address the pressing moral and ethical multilemmas emerging in our consumer society. (DIPF/Orig.) Dieser Artikel nimmt die Beziehung zwischen Bildung und Konsum in den Blick. Sein Grundgedanke ist, dass die Natur der Sozialisation der Menschen in ihre Rolle als Konsumenten von der Bildungsphilosophie der Konsumpadagogen abhangt Â– vom Ziel der Bildung. Um diese Idee zu entfalten, unterscheidet der Artikel zunachst zwischen zwei ubergreifenden Absichten von Konsumbildung: (a) Empowerment zum Eigeninteresse bezogen auf die Macht von Unternehmen und/oder (b) Empowerment durch die Unterstutzung der Burger, zu sozial, ethisch und moralisch verantwortungsbewussteren Verbrauchern zu werden. Darauf folgt eine Erlauterung der Beziehung zwischen elf dominanten Bildungsphilosophien und vier Typen von Konsumbildung. Konsumpadagogen konnten davon profitieren, philosophisch versiert zu werden, wenn sie die drangenden moralischen und ethischen Multilemmata in unserer Konsumgesellschaft ansprechen mochten. (DIPF/Orig.)
Disordered Eating Among Athletes : A Comprehensive Guide for Health Professionals

Part I Nature and Scope of Disordered Eating Among Athletes Chapter 1. Disordered Eating Categories and Their Application to Athletes Chapter 2. Prevalence of Disordered Eating Among Athletes Chapter 3. Etiology of Disordered Eating in Athletes Chapter 4. Disordered Eating in Male Athletes Part II Effects of Disordered Eating Chapter 5. Effects of Disordered Eating on Performance Chapter 6. Effects of Disordered Eating on Health Part III Managing Disordered Eating in Athletes Chapter 7. Preventing Disordered Eating in Athletes Chapter 8. Identifying Disordered Eating in Athletes Chapter 9. Treatment Considerations for Athletes With Disordered Eating Chapter 10. Managing Athletes With Disordered Eating Chapter 11. Successful Eating Disorder Screening, Prevention, and Treatment Programs for Athletes
New Tricks of an Old Pattern

Background: Most scorpion venom peptides adopt a single structural scaffold around four strictly conserved cysteines. Results: Two K+ channel-blocking peptides from Tityus venoms share this cysteine spacing but fold into a distinct cystine-stabilized helix-loop-helix scaffold. Conclusion: These peptides define a new structural group of scorpion venom peptides. Significance: Cysteine spacing does not dictate the three-dimensional fold of small disulfide-rich proteins. Scorpion venoms are a rich source of K+ channel-blocking peptides. For the most part, they are structurally related small disulfide-rich proteins containing a conserved pattern of six cysteines that is assumed to dictate their common three-dimensional folding. In the conventional pattern, two disulfide bridges connect an α-helical segment to the C-terminal strand of a double- or triple-stranded β-sheet, conforming a cystine-stabilized α/β scaffold (CSα/β). Here we show that two K+ channel-blocking peptides from Tityus scorpions conserve the cysteine spacing of common scorpion venom peptides but display an unconventional disulfide pattern, accompanied by a complete rearrangement of the secondary structure topology into a CS helix-loop-helix fold. Sequence and structural comparisons of the peptides adopting this novel fold suggest that it would be a new elaboration of the widespread CSα/β scaffold, thus revealing an unexpected structural versatility of these small disulfide-rich proteins. Acknowledgment of such versatility is important to understand how venom structural complexity emerged on a limited number of molecular scaffolds.
Formation and evolution of late-type dwarf galaxies — I. NGC 1705 and NGC 1569

We present one-zone chemical evolution models for two dwarf starburst galaxies, NGC 1705 and NGC 1569. Though especially designed for the inner ∼1 kpc region, where numerous H n regions and most of the stars are observed, the models also account for the presence of extended gaseous and dark matter haloes, and properly compute the binding energy of the gas heated by supernova explosions. Using information about the past star formation history and initial mass function of the systems previously obtained from Hubble Space Telescope optical and near-infrared colour-magnitude diagrams, we identify possible scenarios of chemical enrichment and development of galactic winds. We assume that the galactic winds are proportional to the Type II and Type Ia supernova rates. As a consequence, they do not necessarily go to zero when the star formation stops. In order not to overestimate the current metallicity of the interstellar gas inferred from H II region spectroscopy, we suggest that the winds efficiently remove from the galaxies the metal-rich ejecta of dying stars. Conversely, requiring the final mass of neutral gas to match the value inferred from 21-cm observations implies a relatively low efficiency of interstellar medium entrainment in the outflow, thus confirming previous findings that the winds driving the evolution of typical starbursts are differential. These conclusions could be different only if the galaxies accrete huge fractions of unprocessed gas at late times. By assuming standard stellar yields we obtain a good fit to the observed nitrogen-to-oxygen (N/O) ratio of NGC 1569, while the mean N/O ratio in NGC 1705 is overestimated by the models. Reducing the extent of hot bottom burning in low-metallicity intermediate-mass stars does not suffice to solve the problem. Localized self-pollution from stars more massive than 60 M ○. in NGC 1705 and/or funnelling of larger fractions of nitrogen through its winds are then left to explain the discrepancy between model predictions and observations. Inspection of the log(N/O) versus log(O/H)+12 diagram for a large sample of dwarf irregular and blue compact dwarf galaxies in the literature favours the latter hypothesis, but the physical mechanisms responsible for such a selective loss of metals remain unclear.