Miracle-dz/UniFAR-FTUs huggingface dataset:
Teaching Medical Students About Medical Errors and Patient Safety: Evaluation of a Required Curriculum

Purpose To assess the effectiveness of a brief curriculum about patient safety and medical errors with third-year medical students. Method From 2000–03, third-year medical students at New York Medical College, Valhalla, New York, were required to participate in a new curriculum on patient safety and medical errors during their family medicine clerkships. Five hundred seventy-two students participated in a four-hour curriculum that included interactive discussion, readings, a videotape session with a standardized patient, and a small-group debriefing facilitated by a family physician. Before and after participating in the curriculum, students were asked to complete questionnaires on self-awareness about patient communication and safety. Curriculum evaluations and follow-up surveys were also distributed. Responses to each statement on the before and after questionnaires were compared using the Wilcoxon signed-rank test for matched data. Results Five hundred eleven (89%) students reported that the opportunity to present an error to a patient increased their confidence about discussing this issue with patients, and 537 (94%) students reported that they strongly agreed or agreed that the standardized patient and feedback exercise was a useful learning experience. A total of 535 before and after questionnaires were used in the analysis. A comparison of before and after questionnaire data revealed statistically significant increases in the self-reported awareness of students' strengths and weaknesses in communicating medical errors to patients (p ≤ .01). Conclusion These findings suggest that awareness about patient safety and medical error can be increased and sustained through the use of an experiential curriculum, and the students rated this as a valuable experience.
Sound Levels in the Human Uterus

Objective: We sought to determine the degree to which noises and voices are attenuated or enhanced as they pass into the uterus. Methods: In eight parturients, a hydrophone in the uterus was used to measure sound pressure levels for externally generated one-third-octave band noises, male and female voices, and the subject's voice. Results: Low-frequency sounds (0.125 kHz) generated outside the mother were enhanced by an average of 3.7 dB. There was a gradual increase in attenuation for increasing frequencies, with a maximum attenuation of 10.0 dB at 4.0 kHz. Sound attenuation was slightly less if the insonation was from in front of the woman rather than behind. Intrauterine sound levels of the mother's voice were enhanced by an average of 5.2 dB, whereas external male and female voices were attenuated by 2.1 and 3.2 dB, respectively. The effect of frequency on attenuation, the differences between front and back insonation, and the differences between speakers in attenuation were all statistically significant. Conclusions: The intrauterine environment is rich with externally generated sounds. This may imply fetal risk from maternal noise exposure and may aid in understanding fetal imprinting from prenatal exposure to voices.
Morphine‐related apnoea in CPAP‐treated preterm neonates

Background: Morphine can be used to treat pain in preterm neonates with CPAP because of its analgetic potency; however, it is known to induce apnoea. Aim: To evaluate this risk of apnoea. Methods: We retrospectively analysed 91 preterm neonates with CPAP who received morphine intravenously. The incidence of apnoea 4 h before and after morphine administration was compared. The data were analysed for three dosage groups (<0.01, 0.01–0.03 and 0.03 mg/kg) and according to the incidence of apnoea before morphine application. Results: In the whole group (gestational age 29.1±2.9 wk, morphine dosage 0.017±0.01 mg/kg) we did not find differences in apnoea before and after morphine (0.9±1.8 vs 1.1±1.8 apnoea). The only significant increase in apnoea was seen in the subgroup of patients receiving > 0.03 mg/kg (0.3±0.67 vs 1.5±2.5 apnoea). Interestingly, we found a significantly delayed increase in apnoea in the fourth hour.
Plasmid rolling‐circle replication: recent developments

It is now well established that a large majority of small, multicopy plasmids of Gram‐positive bacteria use the rolling‐circle (RC) mechanism for their replication. Furthermore, the host range of RC plasmids now includes Gram‐negative organisms as well as archaea. RC plasmids can be broadly classified into at least five families, individual members of which are spread among widely different bacteria. There is significant homology in the basic replicons of plasmids belonging to a particular family, and there is compelling evidence that such plasmids have evolved from common ancestors. Major advances have recently been made in our understanding of plasmid RC replication, including the characterization of the biochemical activities of the plasmid initiator proteins and their interaction with the double‐strand origin, the domain structure of the initiator proteins and the molecular basis for the function of single‐strand origins in plasmid lagging strand synthesis. Over the past several years, there has been a ‘renaissance’ in studies on RC replication as a result of the discovery that many plasmids replicate by this mechanism, and studies in the next few years are likely to reveal new and novel mechanisms used by RC plasmids for their regulated replication.
Age Differences in Death and Suicidal Ideation in Anxious Primary Care Patients

ABSTRACT Objectives: The objective of this study was to examine age differences in the likelihood of endorsing of death and suicidal ideation in primary care patients with anxiety disorders. Method: Participants were drawn from the Coordinated Anxiety Learning and Management (CALM) Study, an effectiveness trial for primary care patients with panic disorder (PD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and/or social anxiety disorder (SAD). Results: Approximately one third of older adults with anxiety disorders reported feeling like they were better off dead. Older adults with PD and SAD were more likely to endorse suicidal ideation lasting at least more than half the prior week compared with younger adults with these disorders. Older adults with SAD endorsed higher rates of suicidal ideation compared with older adults with other anxiety disorders. Multivariate analyses revealed the importance of physical health, social support, and comorbid MDD in this association. Conclusions: Suicidal ideation is common in anxious, older, primary care patients and is particularly prevalent in socially anxious older adults. Findings speak to the importance of physical health, social functioning, and MDD in this association. Clinical Implications: When working with anxious older adults it is important to conduct a thorough suicide risk assessment and teach skills to cope with death and suicidal ideation-related thoughts.
A categorical generalization of Scott domains

Algebraic CPOs naturally generalize to finitely accessible categories, and Scott domains (i.e., consistently complete algebraic CPOs) then correspond to what we call Scott-complete categories: finitely accessible, consistently (co-)complete categories. We prove that the category SCC of all Scott-complete categories and all continuous functors is cartesian closed and provides fixed points for a large collection of endofunctors. Thus, SCC can serve as a basis for semantics of computer languages.
The Law and Economics of Company Stock in 401(k) Plans

Some 11 million participants in 401(k) plans invest more than 20 percent of their retirement savings in their employer’s stock. Yet investing in the stock of one’s employer is risky: single securities are riskier than diversified portfolios, and an employee’s human capital typically is positively correlated with the company's performance. In the worst‐case scenario, workers can lose their jobs and much of their retirement wealth simultaneously. For workers who expect to work for a company for many years, a dollar of company stock can be valued at less than 50 cents after accounting for risk. However, employees still invest voluntarily in their employer's stock, and many employers insist on making matching contributions in stock. We provide evidence that employees underestimate the risk of owning company stock, while employers overestimate the benefits associated with employee stock ownership. We then analyze the likely effects of current and proposed regulations in this context.
An Adaptive Data Reporting Scheme Considering Node Contexts in Wireless Sensor Networks

Advancements in sensor technology have enabled the development of extremely small, low-power, low-cost sensing devices. Recently, wireless sensor networks (WSNs) with thousands of those tiny sensors have become increasingly common. The existing and potential WSN applications span a wide spectrum across various domains. In terms of data reporting schemes, WSNs can be categorized as time-driven and event-driven networks, both with their own pros and cons. In this paper, we propose a novel technique to combine these two data reporting schemes in such a way that the network identifies sensor nodes that will potentially detect an event in the near future and enables them to be proactively involved in the data reporting process. When selecting such nodes, our approach takes into consideration node contexts such as locality and past history of the sensed attributes. In so doing, both energy efficiency and proactive analysis of the environment, which is a major limitation of the event-driven data reporting scheme, can be achieved. To verify the effectiveness of our approach, we conducted several experiments with various synthetic scenarios, the results show that our approach is able to provide sufficient information for proactive actions from users with moderate consumption of energy.
Alcohol and residential, recreational, and occupational injuries: a review of the epidemiologic evidence.

While both ancient historical and present day literature strongly associate alcohol and injuries, the exact role of alcohol in the causation of injuries is often unclear. Many popular myths surround the use of intoxicating agents. For example, at the turn of the century, alcohol was widely praised for its ability to provide the needed stimulation for long and arduous work (16). Even today alcohol is commonly associated with providing the stimulation for work, and when friends are asked over to help paint the house or to a "moving
SMOKING CESSATION AFTER ACUPUNCTURE TREATMENT

Acupuncture is applied, especially in treatment of pain, hemiplegia, obesity, and psychological illnesses including addiction. Recently, ear and body acupuncture have been frequently used in the treatment of smoking. An increase in levels of endorphin, enkephalin, epinephrine, norepinephrine, serotonin, and dopamine in the central nervous system and plasma has been reported as the most important mechanism of acupuncture. That is, acupuncture application may increase the levels of endorphin, enkephalin, epinephrine, norepinephrine, serotonin, and dopamine in the central nervous system and plasma. The authors think that acupuncture application provides the patients with deterioration in the taste of smoking, decrease in desire of smoking, and the obstruction of psychological symptoms that appear as a result of smoking cessation. Because of these effects it is presumed that acupuncture application may be used as an important method for smoking cessation treatment.
de recherche Responsiveness of 5-HT 1 A and 5-HT 2 receptors in the rat orbitofrontal cortex after long-term serotonin reuptake inhibition

Rev Psychiatr Neurosci 2005;30(4) © 2005 CMA Media Inc. Background: The only antidepressant drugs that are effective in the treatment of obsessive–compulsive disorder (OCD) are those that effectively block the reuptake of serotonin (5-hydroxytryptamine; 5-HT). In humans, positron emission tomography studies have implicated the orbitofrontal cortex (OFC) in the mediation of OCD symptoms. In animals, administration of selective serotonin reuptake inhibitors (SSRIs) for 8 weeks (but not 3 weeks) led to increased release of 5-HT in the OFC, because of desensitization of the terminal 5-HT autoreceptors. However, the increase in synaptic levels of 5-HT in the OFC after long-term administration of SSRIs might be cancelled out by desensitization of postsynaptic 5-HT receptors. This study was undertaken to investigate if these OFC receptors adapt under such conditions. Methods: In vivo electrophysiologic techniques were used in this animal study. Male Sprague–Dawley rats received the SSRI paroxetine or vehicle control, delivered by implanted osmotic minipumps, for 3 or 8 weeks. With the rats under anesthesia, neuronal responsiveness to the microiontophoretic application of various drugs was assessed by determining the number of spikes suppressed per nanoampere of ejection current. Results: After administration of paroxetine for either 3 weeks or 8 weeks, there was no modification in the inhibitory effect of 5-HT, the preferential 5-HT2A receptor agonist (+)-1-(4-iodo-2,5-dimethoxyphenyl)-2-aminopropane hydrochloride (DOI) or the preferential 5-HT2C receptor agonist 3-chlorophenyl piperazine dihydrochloride (mCPP). In contrast, the inhibitory effect of the 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propilamino)-tetralin (8-OH-DPAT) was attenuated in the OFC after both 3 and 8 weeks of paroxetine administration. Conclusion: These results indicate a desensitization of postsynaptic 5-HT1A receptors in the OFC but a lack of compensatory adaptation of the 5-HT receptor(s) mediating the main effect of 5-HT in this brain region. These observations imply that the activation of normosensitive postsynaptic 5-HT2-like receptors may mediate the effect of enhanced 5-HT release in the OFC.
Leader-Following Consensus Control for Multi-Agent Systems Under Measurement Noises

Abstract This paper is concerned with leader-following consensus control for multi-agent systems under measurement noises. Time-varying consensus gains are introduced into the network protocol designed. By using the tools of stochastic analysis and algebraic graph theory, a sufficient condition is obtained for the protocol to ensure strong mean square consensus under the fixed topologies. This condition is shown to be necessary and sufficient in the noise-free case. In addition, by using a common Lyapunov function, the result is extended to the switching topology case.
Variation in immunoglobulin G and albumin concentrations during lumbar CSF removal

We studied the variation in immunoglobulin G (IgG) and albumin concentrations in serial sampling of the first 25 ml of CSF during lumbar puncture (LP). A linear decremental gradient averaged 15% for both IgG and albumin. Both direction and magnitude of the gradient were unaffected by the position of the patient. In 12 patients with MS, the CSF IgG: albumin quotient was 5.5% greater when computed from the last aliquot, but this difference was not significant. These protein gradients affect the absolute concentrations but are not likely to affect the interpretation of immunoglobulin indices or electrophoresis patterns.
Communities of practice: a framework for second language learning research

This paper is a review of second language learning studies that have used Lave and Wenger’s (1991) concept of Communities of Practice as a framework for research. This framework has been of particular interest to researchers concerned with nonnative speakers in native-speaking academic environments, the process by which nonnativespeaking academics establish themselves as members of native-speaking academic discourse communities, and the process of negotiation of and construction of identity in groups. This paper also includes suggestions for further research based on the COP model, particularly for research that could focus on Japanese universities as communities of practice and Japanese university students as members of diverse communities of practice. The term “Communities of Practice” refers to a theoretical model of the process of learning that has been formulated and developed in the work of Jean Lave and Etienne Wenger (Lave & Wenger, 1991; Wenger, 1998) and John Seely Brown, Allan Collins, and Paul Duguid (Brown, Collins & Duguid, 1989; Brown & Duguid, 1991). The concept of COP has been applied both as a research framework and a practical organizational tool in the areas of business, government, education, professional associations, development projects, and civic life (Wenger, nd., p. 4). Some researchers in TESOL have used COP as a framework for investigating various aspects of second language learning. In this paper I would like to examine and describe the ways in which Lave and Wenger’s version of the COP model has been used as a tool in second language learning research. I would then like to use the insights gained from this examination as a starting point to consider how the COP framework might be used to investigate learning in universities in
THE HEART AND PULMONARY CIRCULATION IN CHILDREN AT HIGH ALTITUDES: PHYSIOLOGICAL, ANATOMICAL, AND CLINICAL OBSERVATIONS.

Physiologic and anatomic changes have been demonstrated in healthy children born and living at high altitudes. Electrocardiographic and vectorcardiographic studies indicate that after birth the right ventricular preponderance remains throughout infancy and childhood. Anatomic observations have confirmed the presence of right ventricular hypertrophy in healthy children of high altitudes. Cardiac catheterizations reveals mild pulmonary hypertension associated with increased pulmonary vascular resistance, the degree of pulmonary hypertension being higher under 5 years of age. The increased pulmonary resistance is principally related to structural changes of the pulmonary vasculature, while arteriolar vasoconstriction and polycythemia are secondary factors. Pulmonary hypertension and right ventricular hypertrophy are not associated with any kind of symptoms in high-altitude children, and we must understand these changes as related in some way to the mechanisms of natural acclimatization. Patent ductus arteriosus is more frequent at high altitudes than at sea level, and the incidence augments gradually as altitude above sea level increases, the relationship following a curve of parabolic type. It is probable that at high altitude hypoxia and pulmonary hypertension, which remain as chronic conditions after birth, are factors related to the patency of ductus arteriosus. High altitude pulmonary edema may occur in healthy children returning to altitude after being at sea level for a few days or weeks. Rapid improvement of the clinical condition is obtained after continuous oxygen administration; however, death may occur if early treatment is not given. Cardiac catheterization reveals a normal pulmonary wedge pressure and a degree of pulmonary hypertension two or three times greater than that corresponding to healthy children of high altitude. The mechanism of high altitude pulmonary edema is discussed.
Effects of perinatal asphyxia on rat striatal cytoskeleton

Perinatal asphyxia (PA) is a medical condition associated with a high short‐term morbimortality and different long‐term neurological diseases. In previous works, we have shown that neuronal and synaptic changes in rat striatum lead to ubi‐protein accumulation in post‐synaptic density (PSD) after six months of sub‐severe PA. However, very little is known about the synaptic and related structural modifications induced by PA in young rats. In the present work, we studied neuronal cytoskeleton modifications in striatum induced by subsevere PA in 30‐day‐old rats. We observed a significant decrease in the number of neurons, in particular calbindin immunoreactive neurons after PA. In addition, it was also observed that actin cytoskeleton was highly modified in the PSD as well as an increment of F‐actin staining by Phalloidin‐alexa488 in the striatum of PA rats. Using correlative fluorescence‐electron microscopy photooxidation, we confirmed and extended confocal observations. F‐actin staining augmentation was mostly related with an increment in the number of mushroom‐shaped spines. Consistent with microscopic data, Western blot analysis revealed a β‐actin increment in PSD in PA rats. On the other hand, MAP‐2 immunostaining was decreased after PA, being NF‐200 expression unmodified. Although neuronal death was observed, signs of generalized neurodegeneration were absent. Taken together these results showed early post‐synaptic F‐actin cytoskeleton changes induced by PA with slightly modifications in the other components of the neuronal cytoskeleton, suggesting that F‐actin accumulation in the dendritic spines could be involved in the neuronal loss induced by PA. Synapse, 2012. © 2011 Wiley Periodicals, Inc.
Impact of combined estradiol and norethindrone therapy on visuospatial working memory assessed by functional magnetic resonance imaging.

CONTEXT Hormones regulate neuronal function in brain regions critical to cognition; however, the cognitive effects of postmenopausal hormone therapy are controversial. OBJECTIVE The goal was to evaluate the effect of postmenopausal hormone therapy on neural circuitry involved in spatial working memory. DESIGN A randomized, double-blind, placebo-controlled crossover study was performed. SETTING The study was performed in a tertiary care university medical center. PARTICIPANTS Ten healthy postmenopausal women of average age 56.9 yr were recruited. INTERVENTIONS Volunteers were randomized to the order they received hormone therapy (5 microg ethinyl estradiol and 1 mg norethindrone acetate). Subjects received hormone therapy or placebo for 4 wk, followed by a 1-month washout period with no medications, and then received the other treatment for 4 wk. At the end of each 4-wk treatment period, a functional magnetic resonance imaging study was performed using a nonverbal (spatial) working memory task, the Visual Delayed Matching to Sample task. MAIN OUTCOME MEASURE The effects of hormone therapy on brain activation patterns were compared with placebo. RESULTS Compared with the placebo condition, hormone therapy was associated with a more pronounced activation in the prefrontal cortex (BA 44 and 45), bilaterally (P < 0.001). CONCLUSIONS Hormone therapy was associated with more effective activation of a brain region critical in primary visual working memory tasks. The data suggest a functional plasticity of memory systems in older women that can be altered by hormones.
Household Responses to Food Subsidies: Evidence from India

The Indian Public Distribution System is one of the world’s largest food security programs and provides a monthly quota of cereals at discounted prices to poor households. I study the effect of the program on nutritional outcomes by exploiting variations in value of the subsidy resulting from differences in state program rules and local market prices. Using household consumption data, I find a small but positive impact on calories from all food groups, not just cereals. The impact on caloric intake is substantially smaller in states where corruption is high.