Miracle-dz/UniFAR-FTUs huggingface dataset:
Ten-Year Follow-up Survey of Clinical Neuropsychologists: Part II. Private Practice and Economics

Analyses of a 10-year follow-up survey of clinical neuropsychologists demonstrated significant changes in employment settings away from institutions, placing a clear majority of the field in private practice settings in 1999 (Sweet, Moberg, & Suchy, 2000). The present paper compares characteristics of practices and beliefs of clinical neuropsychologists who work in institutions versus private practice, using data from 1989, 1994, and 1999. Previous survey data had not been analyzed along the dimension of work setting. Among the significant findings are differences in age, referral sources, hours per week engaged in specific professional activities (clinical, neuropsychological, forensic, supervisory, research, teaching), ages of patients, type and frequency of data gathered in assessments, hours spent per evaluation, use of an assistant to gather data, and journal subscriptions. Economic changes within the last 5 years have had a differential impact for the two groups in terms of yearly income and hourly reimbursement. However, approximately half of the neuropsychologists in both groups have increased hours performing clinical work, hours performing administrative duties, and patient load to compensate for economic changes in the last 5 years. Decreases in clinical research and teaching activities are apparent in both groups, but in different amounts.
Modified Single-Phase Single-Stage Grid-Tied Flying Inductor Inverter With MPPT and Suppressed Leakage Current

In this paper, an improved transformerless single-phase single-stage grid-tied flying inductor inverter is presented. The negative terminal of the photovoltaic (PV) array is grounded in the improved topology, which increases reliability and suppresses the leakage current. The proposed topology has buck–boost capability without increasing the number of required components and has a high efficiency. An improved control algorithm for proper operation of the proposed topology which decreases switching losses has been investigated. Moreover, a perturbation and observation maximum power point tracking (MPPT) algorithm has been adapted to the proposed inverter, which does not utilize proportional–integral (PI) controllers, for the purpose of the MPPT. Furthermore, a design procedure of the passive elements of the converter based on the corresponding operating has been demonstrated. Simulation in MATLAB Simulink plus an experimental prototype is developed to reconfirm the designed results. Finally, a comparison study has been investigated for better clarification of the advantages and disadvantages of the proposed inverter.
ARHI, as a novel suppressor of cell growth and downregulated in human hepatocellular carcinoma, could contribute to hepatocarcinogenesis

The identification of cancer genes differentially expressed in hepatocellular carcinoma (HCC) plays an important role in understanding the molecular mechanisms of hepatocarcinogenesis. Here, ARHI gene expression was analyzed by real‐time RT‐PCR and it was significantly downregulated in 33 of the 42 (78.6%, more than two folds) HCC specimens compared with adjacent noncancerous livers (P < 0.01). In addition, ARHI expression was reduced in some HCC samples at protein level confirmed by immunohistochemistry. Furthermore, our data suggested that the overexpression of ARHI can significantly inhibit cell growth and colony formation of Hep3B cells (P < 0.01), whilst silencing endogenous ARHI gene by RNAi could promote cell growth of Huh‐7 and Focus. LOH of microsatellite markers D1S2806 and D1S2803 was only found in 2.4% (1 of 42 HCCs) of HCC cases. The expression of ARHI was obviously re‐expressed in some HCC cells, Bel‐7402, Bel‐7405, QGY‐7703 and Hep3B, by a demethylation agent, 5‐aza‐2′‐deoxycytidine (DAC). DNA hypermethylation within ARHI promoter was identified in 47.1% of HCC specimens without ARHI expression. Our current observations provide evidences that ARHI downregulated in HCCs could play a role in liver cancer via acting as a tumor suppressor gene, which mainly was triggered by the epigenetic events in HCC specimens. © 2008 Wiley‐Liss, Inc.
Pharmacy technician-to-pharmacist ratios: a state-driven safety and quality decision.

OBJECTIVE To discuss the policy of pharmacy technician-to-pharmacist ratios by comparing Florida as an example of legislative-led authority versus Tennessee as an example of board of pharmacy-led ruling. SUMMARY Over the past 2 years, the Florida legislature has debated the issue of pharmacy staffing ratios, initially leaving the Florida Board of Pharmacy with little authority to advocate for and enact safe technician staffing ratios. Anticipating this situation, the Tennessee Board of Pharmacy created rules to meet pharmacy staffing needs while protecting the authority of the pharmacist-in-charge and promoting patient safety. Before enacting rules, members of the board toured the state and talked about proposed rule changes with pharmacists. The final rule sets the pharmacy technician-to-pharmacist ratio at 2:1 but permits a 4:1 ratio based on public safety considerations and availability of at least two Certified Pharmacy Technicians. CONCLUSION Pharmacists and leaders within the profession should conduct further research on appropriate and safe ratios of pharmacy technicians to pharmacists, with a focus on safety and quality of care.
Improving undergraduate students programming skills through Collaborative Adversarial Pair Learning

Collaborative learning has been used extensively in undergraduate education to improve learning for all students. To improve performance in computer science courses, our study incorporated a new, although related, pedagogical approach entitled Collaborative-Adversarial Pair Learning (CAPL). The CAPL employs a software development technique called Collaborative-Adversarial Pairs (CAP) to teach computer science courses. We have demonstrated that CAP is effective in helping engineers discover software requirements. It seems a natural extension to use the techniques of CAP to help students discover concepts in computer science. In this paper, we describe the design and implementation of a CAPL model for a computer programming course (Software Engineering I), and then present the results of an evaluation of the model when compared to traditional instruction in Software Engineering I.
Six-year follow-up of a characteristic osteolytic lesion in a patient with tumor-induced osteomalacia.

OBJECTIVE Tumor-induced osteomalacia is a rare paraneoplastic syndrome characterized by hypophosphatemia and inappropriately normal or low 1,25-dihydroxyvitamin D. CLINICAL CASE Here, we report a 6-year postoperative follow-up of a patient with oncogenic osteomalacia with a distinctive skeletal manifestation. The latter was characterized by an almost linear lytic lesion of a few millimeters with irregular borders, mainly involving the trabecular compartment but extending into cortical shell, located in the middle third of the right fibula. Six years after tumor resection, a sclerotic repair with a complete recovery was observed. Furthermore, we monitored a striking increase in bone mineral density throughout the observation period, reaching a peak of 73% over basal values at lumbar spine after 2 years; at total femur and radius, the peak was 47.5 and 4.6% respectively, after 4 years from tumor resection. CONCLUSIONS We report for the first time that an osteolytic lesion may be part of the skeletal involvement in tumor-induced osteomalacia.
Pressure vs flow triggering during pressure support ventilation.

BACKGROUND Adult mechanical ventilators have traditionally been pressure- or time-triggered. More recently, flow triggering has become available and some adult ventilators allow the choice between pressure or flow triggering. Prior studies have supported the superiority of flow triggering during continuous positive airway pressure, but few have compared pressure and flow triggering during pressure support ventilation (PSV). The purpose of this study was to compare pressure and flow triggering during PSV in adult mechanically ventilated patients. METHODS The study population consisted of 10 adult patients ventilated with a mechanical ventilator (Nellcor-Puritan-Bennett 7200ae) in the PSV mode. In random order, we compared pressure triggering of -0.5 H2O, pressure triggering -1 cm H2O, flow triggering of 5/2 L/min, and flow triggering 10/3 L/min. Pressure was measured for 5 min at the proximal endotracheal tube using a data acquisition rate of 100 Hz. From the airway pressure signal, trigger pressure (deltaP) was defined as the difference between positive end-expiratory pressure (PEEP) and the maximum negative deflection prior to onset of the triggered breath. Pressure-time product (PTP) was defined as the area produced by the pressure waveform below PEEP during onset of the triggered breath. Trigger time (deltaT) was defined as the time interval below PEEP during onset of the triggered breath. RESULTS A pressure trigger of -0.5 cm H2O was significantly more sensitive than the other trigger methods for deltaP, PTP, and deltaT (p<0.001). There was also a significant difference between patients for deltaP, deltaT, and PTP for each trigger method (p<0.001). CONCLUSIONS For this group of patients, flow triggering was not superior to pressure triggering at -0.5 cm H2O during PSV.
Specific design features of an interpretative phenomenological analysis study.

AIM Report of an innovative use of interpretative phenomenological analysis (IPA) to enable an in-depth study of the experiences of disengagement from mental health services of black men with diagnoses of severe and enduring mental illness. BACKGROUND The aim of IPA is to explore the sense that participants make of their personal and social worlds, while recognising the contribution of the researcher in interpreting the participants' interpretations of their experiences. REVIEW METHODS Seven black male research participants were recruited to the study. The components of the study that contribute to the body of literature on IPA research design include: an engagement stage in the research; a second clarifying interview; discussion of clarifying questions and emergent themes with two academic service-users; and a post-interview meeting to discuss the themes emerging from the research study. DISCUSSION The paper focuses on the contribution of the four specific design features of the study and how these enabled the researcher to engage with a population that is often deemed 'hard to reach'. CONCLUSION The four distinctive methodological developments in the study emphasise the flexibility of IPA. These innovations assisted the researcher in developing a broader double hermeneutic that enabled reporting of the experiences of disengagement from mental health services of black men with diagnoses of severe and enduring mental illness. IMPLICATIONS FOR RESEARCH/PRACTICE The distinctive design of this study further emphasises the flexibility of IPA, while simultaneously showing fidelity to the core principles underlying the research methodology.
An appraisal of acitretin therapy in children with inherited disorders of keratinization

Retinoid therapy represents the treatment of choice for severe inherited disorders of keratinization. This paper reviews our experience of acitretin, compares acitretin with etretinate and defines guidelines for treatment. Forty‐six children have received acitretin since 1992 in our hospital: 29 children had either lamellar ichthyosis (nine), non‐bullous ichthyosiform erythroderma (five), bullous ichthyosiform erythroderma (four), Sjögren‐Larsson syndrome (three) or another rare condition (eight). The other 17 children who had psoriasis (16) and extensive viral warts (one), were excluded. Data on efficacy and tolerability of retinoid therapy were available for all but one patient. The cumulative follow‐up was 472 months for acitretin. The mean (± standard deviation) optimal dosage for acitretin was 0‐47 ± O17mg/kg per day, and this did not significantly differ between disorders. The overall improvement was considerable, with only three patients responding poorly. Mild to moderate mucocutaneous dryness was frequent. Minor abnormalities of liver function tests (four patients) and triglycerides (one patient) never led to changes of therapy. Irreversible side‐effects did not occur. Acitretin therapy for children with inherited keratinization disorders is best started at 0‐5 mg/kg per day. It represents a safe and effective treatment, provided that the minimal effective dose is maintained and that side‐effects are carefully monitored. When switching from etretinate to acitretin, a 20% reduction is recommended if the etretinate dose is over 0‐75 mg/kg per day or if side‐effects are dose limiting. Otherwise the same dose can be used.
El proceso colonial en el alto Orinoco-Río Negro (siglos XVI a XVIII)

El libro del antropólogo Mariano Useche es resultado de una labor de consulta paciente entre las, relativamente abundantes, fuentes bibliográficas sobre la historia colonial del Orinoco y Guayan a. Cabe anotar que todos los documentos citados en esta obra, son fuentes primarias respecto a la generalidad de los hechos de que se ocupan. El método de contar la historia mediante el acopio de una enorme cantidad de información documental no es nuevo, pero es el más apropiado para reconstruir el proceso colonial en el Alto Orinoco Rio Negro entre los siglos XVI a XVIII, como lo demuestran los resultados de esta investigación histórica. Con anterioridad a esta publicación, en Co~ lombia sólo se contaba con la tesis de doctorado de la antropóloga Nancy Morey (1975), sobre la etnohistoria de los guahibos de los Llanos de Colombia y Venezuela, trabajo comparable al de Useche. Este último, apartándose un poco de la metodologia seguida por M o rey en cuanto a delimitación territorial y aspectos socioculturales estudiados se refiere, retoma la cronologia de la conquista y ocupación de este extenso territorio por los europeos, logrando abarcar asi un periodo muy importante de la historia americana caracterizado por descubrimientos geográficos y el contacto con grupos nativos hasta entonces desconocidos para los occidentales. El más importante de dichos descubrimientos fue el rio Casiquiare, que comunica las dos cuencas hidrográficas más grandes del continente suramericano, las de los rfos Orinoco y Amazonas. Este hecho llevó a la delimitación territorial de las posesiones en ultramar, a dos estados europeos colonialistas importantes de finales del siglo XVIII: España y Portugal. Como se dijo anteriormente, al tomar el autor como núcleo para su estudio la expansión del estado colonial español en la región Alto rio Orinoco-rfo Negro, se logra reconstruir ese proceso y su impacto sobre los pueblos indígenas. El resultado es un esquema explicativo del devenir colonial con base en datos relativos a la situación
Reductions in basal limb blood flow and vascular conductance with human ageing: role for augmented α‐adrenergic vasoconstriction

1 Basal whole‐limb blood flow and vascular conductance decrease with age in men. We determined whether these age‐associated changes in limb haemodynamics are mediated by tonically augmented sympathetic α‐adrenergic vasoconstriction. 2 Seven young (28 ± 2 years; mean ±s.e.m.) and eight older (64 ± 2 years) healthy, normotensive adult men were studied. Baseline femoral artery blood flow (Doppler ultrasound) and calculated vascular conductance were 29 and 31 % lower, respectively, and vascular resistance was 53 % higher in the older men (all P < 0.001). 3 Local (intra‐femoral artery) α‐adrenergic receptor blockade with phentolamine evoked greater increases in femoral blood flow (105 ± 11 vs. 60 ± 6 %) and vascular conductance (125 ± 13 vs. 66 ± 7 %), and reductions in vascular resistance (55 ± 2 vs. 39 ± 3 %) in the experimental limb of the older compared with the young men (all P < 0.001). As a result, α‐adrenergic receptor blockade eliminated the significance of the age‐associated differences in absolute levels of femoral blood flow (500 ± 51 vs. 551 ± 35 ml min−1), vascular conductance (6.02 ± 0.73 vs. 6.33 ± 0.26 U), and vascular resistance (0.17 ± 0.03 vs. 0.16 ± 0.01 U; P= 0.4–0.8, n.s.). Femoral haemodynamics in the control limb were unaffected by phentolamine administration in the contralateral (experimental) limb. Complete α‐adrenergic receptor blockade was demonstrated by the absence of vasoconstriction in the experimental limb in response to the cold pressor test. Local propranolol was administered to control for any β‐adrenergic effects of phentolamine. Propranolol did not affect haemodynamics in the experimental or control limbs. 4 Our results indicate that the age‐related reductions in basal limb blood flow and vascular conductance are mediated largely by chronically elevated sympathetic α‐adrenergic vasoconstriction. This may have important physiological and pathophysiological implications for the ageing human.
Fimbriated Porphyromonas gingivalis Is More Efficient than Fimbria-Deficient P. gingivalis in Entering Human Dendritic Cells In Vitro and Induces an Inflammatory Th1 Effector Response

ABSTRACT Porphyromonas gingivalis is a fimbriated mucosal pathogen implicated in chronic periodontitis (CP). The fimbriae are required for invasion of the gingival mucosa and for induction of CP in animal models of periodontitis. CP is associated with infection of immature dendritic cells (DCs) by P. gingivalis in situ and with increased numbers of dermal DCs (DDCs) and mature DCs in the lamina propria. The role of fimbriae in gaining entry into human DCs and how this modulates the inflammatory and effector immune responses, however, have not been explored. To address this, we generated monocyte-derived DCs (MDDCs) in vitro which phenotypically and functionally resemble DDCs. We show here that virulent fimbriated P. gingivalis 381, in contrast to its fimbria-deficient mutant, P. gingivalis DPG3, efficiently gains entry to MDDCs in a manner dependent on active cell metabolism and cytoskeletal rearrangement. In addition, uptake of 381, unlike DPG3, induces DCs to undergo maturation, upregulate costimulatory molecules, and secrete inflammation cytokines interleukin-1β (IL-1β), IL-6, tumor necrosis factor alpha, IL-10, and IL-12. Moreover, MDDCs pulsed with 381 also stimulated a higher autologous mixed lymphocyte reaction and induced a Th1-type response, with gamma interferon (IFN-γ) being the main cytokine. Monocytes used as controls demonstrated fimbria-dependent uptake of 381 as well but produced low levels of inflammatory cytokines compared to MDDCs. When MDDCs were pulsed with recombinant fimbrillin of P. gingivalis (10 μg/ml), maturation of MDDCs was also induced; moreover, matured MDDCs induced proliferation of autologous CD4+ T cells and release of IFN-γ. Thus, these results establish the significance of P. gingivalis fimbriae in the uptake of P. gingivalis by MDDCs and in induction of immunostimulatory Th1 responses.
The two distinct phospholipases C of Listeria monocytogenes have overlapping roles in escape from a vacuole and cell-to-cell spread

Listeria monocytogenes secretes two distinct phospholipases C, a phosphatidylinositol-specific phospholipase C (PI-PLC) and a broad-range phospholipase C (PC-PLC). In this study, single in-frame deletion mutants with mutations in each PLC and a double mutant lacking both PLCs were characterized with regard to virulence in mice, escape from a primary vacuole, and cell-to-cell spread in cell culture. The mutant lacking PI-PLC, previously shown to be twofold less virulent than the wild type in mice, had a minor defect in escape from a primary vacuole but was not notably affected in cell-to-cell spread. The mutant lacking PC-PLC was 20-fold less virulent in mice and was defective in cell-to-cell spread but had no measurable defect in escape from a primary vacuole. The mutant lacking both PLCs was 500-fold less virulent in mice and was severely diminished in its ability to escape from the primary vacuole and to spread cell to cell. Cellular levels of diacylglycerol and ceramide, products of PLC activity, accumulated beginning 3 to 4 h after infection of cells with wild-type bacteria. The bacterial PLCs were partially responsible for this activity, since cells infected with the mutant lacking both PLCs had a reduced increase in diacylglycerol and no increase in ceramide. Elevation of diacylglycerol in the absence of bacterial PLCs indicated that host cell phospholipase(s) was activated during infection. The results of this study were consistent with the two bacterial PLCs having overlapping functions throughout the course of intracellular infection. Furthermore, the PC-PLC, and possibly PI-PLC, appeared to be enzymatically active intracellularly.
MYC and BCL2 protein expression predicts survival in patients with diffuse large B‐cell lymphoma treated with rituximab

Diffuse large B‐cell lymphoma (DLBCL) is a heterogeneous disease and “double‐hit” DLBCL, with both MYC and BCL2 translocations has a poor prognosis. In this study, we investigated whether MYC and BCL2 protein expression in tissue would predict survival in DLBCL. The study included 106 cases of de novo DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine and prednisone (R‐CHOP) or CHOP‐like regimens. The results were validated on an independent cohort of 205 DLBCL patients. Patients with low expression of BCL2 (≤30%) and MYC (≤50%) had the best prognosis, whereas those with high BCL2 (>30%) and MYC (>50%) had the worst outcome. In multivariate analysis, the combination of the BCL2 and MYC was an independent predictor of overall survival (OS) and event‐free survival (EFS) (P = 0·015 and P = 0·005, respectively). The risk of death was nine times greater for patients with high BCL2 and MYC compared to those with low expression. High BCL2 and MYC was a strong predictor of poor OS (P < 0·001) and EFS (P = 0·0017) in patients with the germinal centre B‐cell (GCB) type, but not in the non‐GCB type. In DLBCL, high co‐expression of MYC and BCL2 was an independent predictor of poor survival, and could be used to stratify patients for risk‐adapted therapies.
Platelet C4d is highly specific for systemic lupus erythematosus.

OBJECTIVE Complement-activation product C4d is deposited on normal erythrocytes, while abnormal levels have been observed on the surface of erythrocytes of patients with systemic lupus erythematosus (SLE). This study examines whether C4d also deposits on human platelet surfaces, and whether platelet-bound C4d may provide a biomarker for SLE. METHODS We conducted a cross-sectional study of 105 patients with SLE, 115 patients with other diseases, and 100 healthy controls. Levels of C4d on the surface of platelets were examined by flow cytometry and scanning confocal microscopy. Statistical analyses were performed to determine the clinical variables associated with platelet C4d. RESULTS Abnormal levels of platelet C4d were found to be highly specific for SLE. Platelet C4d was detected in 18% of patients with SLE, being 100% specific for a diagnosis of SLE compared with healthy controls and 98% specific for SLE compared with patients with other diseases (P < 0.0001). In addition, platelet C4d was significantly associated with positivity for lupus anticoagulant (P < 0.0001) and anticardiolipin antibodies of the IgG (P = 0.035) or the IgM (P = 0.016) isotype. Platelet C4d was also significantly associated with SLE disease activity according to the SLE Disease Activity Index (P = 0.039), low serum C4 (P = 0.046), an elevated erythrocyte sedimentation rate (P = 0.006), and abnormal levels of C4d on erythrocytes (P < 0.0001). CONCLUSION This observation suggests that platelet-bound C4d may be a useful biomarker for SLE and may be a clue to the pathogenic mechanisms responsible for the myriad thrombotic and vascular complications of lupus associated with antiphospholipid antibodies.