Miracle-dz/UniFAR-FTUs huggingface dataset:
Internet-based learning in the health professions: a meta-analysis.

CONTEXT The increasing use of Internet-based learning in health professions education may be informed by a timely, comprehensive synthesis of evidence of effectiveness. OBJECTIVES To summarize the effect of Internet-based instruction for health professions learners compared with no intervention and with non-Internet interventions. DATA SOURCES Systematic search of MEDLINE, Scopus, CINAHL, EMBASE, ERIC, TimeLit, Web of Science, Dissertation Abstracts, and the University of Toronto Research and Development Resource Base from 1990 through 2007. STUDY SELECTION Studies in any language quantifying the association of Internet-based instruction and educational outcomes for practicing and student physicians, nurses, pharmacists, dentists, and other health care professionals compared with a no-intervention or non-Internet control group or a preintervention assessment. DATA EXTRACTION Two reviewers independently evaluated study quality and abstracted information including characteristics of learners, learning setting, and intervention (including level of interactivity, practice exercises, online discussion, and duration). DATA SYNTHESIS There were 201 eligible studies. Heterogeneity in results across studies was large (I(2) > or = 79%) in all analyses. Effect sizes were pooled using a random effects model. The pooled effect size in comparison to no intervention favored Internet-based interventions and was 1.00 (95% confidence interval [CI], 0.90-1.10; P < .001; n = 126 studies) for knowledge outcomes, 0.85 (95% CI, 0.49-1.20; P < .001; n = 16) for skills, and 0.82 (95% CI, 0.63-1.02; P < .001; n = 32) for learner behaviors and patient effects. Compared with non-Internet formats, the pooled effect sizes (positive numbers favoring Internet) were 0.10 (95% CI, -0.12 to 0.32; P = .37; n = 43) for satisfaction, 0.12 (95% CI, 0.003 to 0.24; P = .045; n = 63) for knowledge, 0.09 (95% CI, -0.26 to 0.44; P = .61; n = 12) for skills, and 0.51 (95% CI, -0.24 to 1.25; P = .18; n = 6) for behaviors or patient effects. No important treatment-subgroup interactions were identified. CONCLUSIONS Internet-based learning is associated with large positive effects compared with no intervention. In contrast, effects compared with non-Internet instructional methods are heterogeneous and generally small, suggesting effectiveness similar to traditional methods. Future research should directly compare different Internet-based interventions.
Topical prostaglandin F2alpha treatment reduces collagen types I, III, and IV in the monkey uveoscleral outflow pathway.

BACKGROUND Topical prostaglandin F2alpha isopropyl ester increases uveoscleral outflow in monkeys and humans. OBJECTIVE To investigate the effects of prostaglandin F2alpha isopropyl ester with topical administration on collagen types I, III, and IV within the anterior segment tissue of monkey eyes. METHODS Eight eyes of 4 cynomolgus monkeys were evaluated. One eye of each monkey was treated with 2 microg of prostaglandin F2alpha isopropyl ester twice daily for 5 days, and intraocular pressure reduction was confirmed. These eyes were fixed in methacarn, and paraffin sections were immunostained using antibodies to collagen types I, II, or IV. To measure staining intensity, optical density (OD) was determined using 2-dimensional imaging densitometry. Mean OD scores along line segments placed over the ciliary muscle were determined. RESULTS Mean+/-SD OD scores for collagen types I, III, and IV were less in the ciliary muscle of prostaglandin-treated eyes than in vehicle-treated eyes by 52%+/-7%, 45%+/-6%, and 45%+/-5%, respectively. In the sclera adjacent to the ciliary body, mean OD scores for collagen types I and III were less in prostaglandin-treated eyes, by 43%+/-32% and 45%+/-13%, respectively. The scleral stroma was minimally immunoreactive for collagen type IV. All differences were significant by the paired Student t test (P<.05). CONCLUSIONS This study shows reduced collagen types I, III, and IV immunoreactivity in the ciliary muscle and adjacent sclera following topical prostaglandin F2alpha isopropyl ester treatment. These reductions may contribute to the increased uveoscleral outflow observed with topical prostaglandin treatment. CLINICAL RELEVANCE The cellular mechanism by which certain prostaglandins lower intraocular pressure is not known. The present study provides immunohistochemical data demonstrating that intraocular pressure reduction that occurs with topical prostaglandin F2alpha is associated with a reduction of collagens within the uveoscleral outflow pathway.
Increasing rates of malarial fever with deteriorating immune status in HIV-1-infected Ugandan adults

BackgroundFalciparum malaria and HIV-1 infection are two of the most important health problems facing sub-Saharan Africa. No convincing evidence of an association between symptomatic malaria and HIV-1 infection has been found. ObjectiveTo investigate the effect of HIV-associated immunosuppression on malarial fever rates. DesignAn observational cohort study in HIV-specific, primary healthcare clinics in Entebbe, Uganda, on 1371 HIV-1-infected adults participating in a randomized trial of 23-valent pneumococcal vaccine. MethodsCohort members underwent routine 6 monthly surveillance and had open clinic access when sick. Episodes of fever were assessed according to standardized protocols. Rates of malaria are described according to HIV immune status determined by CD4 T cell counts. ResultsIncidence rates of Plasmodium falciparum malarial fever showed a marked inverse relationship with CD4 T cell count; 140, 93 and 57 cases per 1000 pyo for CD4 T cell groups < 200, 200–499 and > 500 respectively, P < 0.001. Malarial fever definitions incorporating parasite density criteria (derived from asymptomatic surveillance) to correct for chance findings of fever and P. falciparum parasitaemia, did not affect the association of incidence rates with immunosuppression. ConclusionThese data support an interaction between symptomatic P. falciparum and HIV. Emphasis on mosquito avoidance measures should be an important component of education and counselling of HIV/AIDS patients in malaria-endemic areas, and suggests an additional HIV-related public health problem in Africa.
Inguinal Endometriosis: Three Cases and Literature Review

Three cases of endometriosis infiltrating the round ligament are presented. The initial diagnosis was irreducible hernia, since this rare nosologic entity often causes unusual preoperative symptoms and diagnostic problems. Diagnosis is frequently made by histologic examination. The rarity of inguinal endometriosis should not exclude it from a possible diagnosis in cases with a painful mass in the inguinal region in a fertile woman, especially if the groin mass is associated in size and tenderness with menstrual variability. Surgery is the treatment of choice and is curative; laparoscopy is suggested during the same operation to evaluate the intraperitoneal conditions.
Mathematical Models and Methods for Behavior in Social Networks: Urban Crime, Self-Exciting Interactions, and Information Spread

We present three applications of mathematics to problems in the study of social networks. The problems are different enough that each requires its own model and set of methods. We investigate these models through theory and simulation. The first application is to urban crime and police response. We prove some stability results for an agent-based model and present an efficient algorithm for numerical simulation. The second application is to communication patterns in social networks. Adopting a point-process model to reflect observed temporal bursts in communication, we discuss parameter estimation for such models. We then consider the problem of filling in missing data in records of communication, formulating it as a variational problem and developing a numerical method to solve it. The third application is to the spread of information within social networks. We introduce a simple model, provide some theoretical results, and discuss results of simulations.
The course of the urinary DPD-crosslink secretion in metastatic breast cancer--a possibility for response assessment.

BACKGROUND Urinary deoxypyridinoline (DPD)-crosslinks have been shown to be a highly specific parameter for type I collagen metabolism. MATERIALS AND METHODS In a prospective breast cancer study, urine samples were collected in after-care patients and in patients with bone metastases. DPD-crosslinks were measured every three weeks using a fully automated chemiluminescence immunoassay. Bone metastases were confirmed by bone scan and/or x-ray, and were followed-up over six months. To validate the test, a receiver operating characteristics (ROC)-curve was set up to find the DPD cut-off concentration which separates patients with no evidence of disease (NED) from patients with bone metastases. RESULTS 73 breast cancer patients (41 with NED, 32 with bone metastases) were included into the ROC analysis. At a DPD cut-off value of 8 nmol/mmol creatinine, we found the best sensitivity (84.4%) for the detection of bone metastases with a specificity of 70.7%. Patients with stable bone disease under intravenous pamidronate treatment (90 mg q3w) and specific therapy had a significant (p = 0.007) fall of the DPD-crosslinks in comparison to the progressive subset with 72.7% falling below 8 nmol/mmol. CONCLUSIONS We conclude that the net bone turnover is not increased at a DPD-crosslinks elimination < 8 nmol/mmol.
Diminished pheromone‐induced sexual behavior in neurokinin‐1 receptor deficient (TACR1−/−) mice

Studies in mice with targeted deletions of tachykinin genes suggest that tachykinins and their receptors influence emotional behaviors such as aggression, depression and anxiety. Here, we investigated whether TAC1‐ and TAC4‐encoded peptides (substance P and hemokinin‐1, respectively) and the neurokinin‐1 receptor (NK‐1R) are involved in the modulation of sexual behaviors. Male mice deficient for the NK‐1R (TACR1 −/−) exhibited decreased exploration of female urine in contrast to C57BL/6 control mice and mice deficient for NK‐1R ligands such as TAC1 −/−, TAC4 −/− and the newly generated TAC1 −/− /TAC4 −/− mice. In comparison to C57BL/6 mice, mounting frequency and duration were decreased in male TACR1 −/− mice, while mounting latency was increased. Decreased preference for sexual pheromones was also seen in female TACR1 −/− mice. Furthermore, administration of the NK‐1R‐antagonist L‐703,606 decreased investigation of female urine by male C57BL/6 mice, suggesting an involvement of NK‐1R in urine sniffing behavior. Our results provide evidence for the NK‐1R in facilitating sexual approach behavior, as male TACR1 −/− mice exhibited blunted approach behavior toward females following the initial interaction compared with C57BL/6 mice. NK‐1R signaling may therefore play an important role in pheromone‐induced sexual behavior.
Porcine somatotropin (pST) increases IGF-I mRNA abundance in liver and subcutaneous adipose tissue but not in skeletal muscle of growing pigs.

The present study was undertaken to determine the effects of exogenous porcine somatotropin (pST) on IGF-I gene expression in liver, skeletal muscle (longissimus dorsi), and s.c. adipose tissue of growing pigs. Twenty prepubertal gilts (approximately 60 kg BW) were allotted to four treatment groups (n = 5) and treated with either 0, 35, 70, or 140 micrograms/kg BW of recombinantly derived pST by daily i.m. injection for 7 d. Serum concentrations of IGF-I were determined by RIA and IGF-I mRNA levels were determined by direct counting of individual samples on slot blots. Administration of pST increased IGF-I concentration in serum. This was accompanied by significant increases (P < .05) in IGF-I mRNA abundance in liver and s.c. adipose tissue; the effects were maximal at the lowest dose of pST. Insulin-like growth factor I mRNA levels were increased 2.5- and 4.5-fold, respectively. Levels of IGF-I mRNA were very low in longissimus muscle and were unaffected by administration of pST. When expressed as picograms of mRNA/10 micrograms of total RNA, IGF-I mRNA levels were highest in s.c. adipose tissue. Levels of IGF-I mRNA were 1.9-fold higher in s.c. adipose tissue than in liver of control animals, and pST administration increased this difference to 3.2-fold. Our results suggest that 1) the effects of pST administered by daily i.m. injection on IGF-I gene expression in pigs are tissue-specific and 2) the stimulatory effects of pST administered in this manner on muscle growth in pigs are not associated with increased expression of the IGF-I gene in skeletal muscle.
CD4% is the best predictor of development of AIDS in a cohort of HIV‐infected homosexual men

To determine the relationships between individuals' baseline T-cell subsets, their rates of change with time, and AIDS-free survival time, data were collected at 6-monthly intervals from 379 HIV-seropositive homosexual Sydney men, of whom 31 developed AIDS during the 3-year observation period. Both CD4% and rate of change of CD4% in an individual had significant prognostic value in determining AIDS-free survival time. Compared with subjects whose CD4% remained stable, subjects whose CD4% dropped by 7% or more in a year had a relative hazard of 35.1 (95% confidence interval = 11.7–105.6, P < 0.001) of developing AIDS. Increasing CD4% had a significant protective effect, reducing the risk of developing AIDS. CD4%, CD4 cell count and CD4:CD8 ratios showed steeper declines in subjects who were later diagnosed with AIDS than in those who remained AIDS-free. The rates of immunological change in AIDS-free seroconverters and seropositives were similar, despite indeterminate differences in durations of infections. In the multivariate Cox regression analysis, baseline CD4%, the rate of change of CD4%, and baseline lymphocyte count were associated with AIDS-free survival time. Baseline CD4% had greater prognostic value than baseline CD4 cell count. Baseline CD8%, baseline CD8 count, their rates of change and their mean square errors were not independently significant in this analysis. These findings are important for clinicians monitoring HIV infection in an individual and for entry criteria and monitoring procedures in clinical trials. They also have implications for resource-poor settings; prognosis based on CD4% can be made with a flow cytometer without a full blood count. Data were collected before zidovudine was available and thus reflect the natural history of HIV infection.
Prospective study of the incidence, timing and treatment of pouchitis in 104 consecutive patients after restorative proctocolectomy.

OBJECTIVE To determine the incidence timing and effectiveness of treatment of symptomatic pouchitis following restorative proctocolectomy with ileal J-pouch anal anastomosis. DESIGN A cohort analytical study. SETTING University hospitals, a tertiary referral center; all subjects entered into the study followed up for a minimum of 12 months (mean follow-up, 40 months). PATIENTS One hundred four consecutive patients undergoing restorative proctocolectomy with ileal J-pouch anal anastomosis for either ulcerative colitis (n = 97) or familial adenomatous polyposis (n = 7) between June 1986 and December 1994. INTERVENTIONS Patients with symptomatic pouchitis were treated with either oral metronidazole or ciprofloxacin. OUTCOMES Diagnosis of pouchitis was determined by clinical symptoms and confirmed with endoscopy. Response to oral antibodies was determined by resolution of symptoms. RESULTS Fifty-two patients (50%) experience at lest 1 episode of pouchitis. The first episode of pouchitis occurred within the first 12 months after restoration of intestinal continuity in 56% of the cases. In 2 patients it occurred after 30 months. Response to antibiotic treatment was 96%. Two thirds of patients had multiple episodes. Chronic pouchitis occurred in 6 patients, necessitating pouch removal in 2. CONCLUSIONS The incidence of pouchitis after ileal J-pouch anal anastomosis is approximately 50% with two thirds of these patients having multiple episodes. Chronic pouchitis occurs in a minority of patients. In chronic pouchitis, the risk of pouch loss is substantial.
Subtalar Arthrodesis in Children

We present a clinical and radiological retrospective study of 30 patients (51 feet) with valgus deformity of the feet who had three different types of subtalar extraarticular and intraarticular arthrodesis. Children with cerebral palsy, myelomeningocele, and agenesis of the corpus callosum associated with progressive polyneuropathy were studied. The results were considered excellent and satisfactory in 73% of the feet. The combined Grice-Green-Batchelor procedure gave the best results, with 84% excellent and satisfactory results, with bony union in 96% of the feet. Weight-bearing films of the ankles in the anteroposterior plane are essential to determine the true extent of the deformity before operation.
Transcatheter device closure of perimembranous ventricular septal defect in children treated with prophylactic oral steroids: acute and mid-term results of a single-centre, prospective, observational study

Abstract Background and Objective Although transcatheter closure of perimembranous ventricular septal defect is emerging as an accepted, viable alternative, conduction disturbances still remain a major concern. Although steroid treatment has shown encouraging results with complete recovery, efficacy of prophylactic use of steroids is still speculative. We aim to study the mid-term outcome of perimembranous ventricular septal defect closure in children who received prophylactic oral steroids. Materials and methods A prospective study was designed and antegrade device closure was attempted in eligible children who met the following inclusion criteria: age 3–18 years and weight >10 kg, defect diameter ⩽12 mm, and symptomatic, haemodynamic changes or history of infective endocarditis. Prophylactic steroid protocol consisted of 2 weeks oral prednisolone (1 mg/kg/day) initiated immediately after the procedure, and in the event of bradyarrhythmia it was escalated to 2 mg/kg. Patients were regularly followed-up at 1, 6, and 12 months and then annually. Patients with post-procedure heart block underwent Holter monitoring after a minimum of 1 year interval. Results Between May, 2007 and August, 2012, successful device closure was accomplished in 290/297 patients. Mean age and weight were 9±3.12 years and 21±8.27 kg, respectively. The defect measured 5±1.38 mm on echocardiography. Mean fluoroscopy time was 12.98±8.64 minutes. Eight patients with major complications included one each with device embolisation, haemolysis, severe aortic regurgitation, and five with bradyarrhythmias, including complete atrioventricular block in three, Mobitz II in one, and bifascicular block in one. Patients with complete atrioventricular block responded to high-dose steroid and temporary pacemaker. Minor complications included post-procedure heart block (n=22) and blood loss (n=2). At 18.23±13.15 months follow-up, 8/27 (five major, 22 minor) with arrhythmia had persistent post-procedure heart block of no clinical consequences. Conclusion In our patient population, transcatheter device closure of the perimembranous ventricular septal defect with prophylactic oral steroid resulted in excellent closure rate and acceptably low incidence of conduction disturbances at mid-term follow-up.
The Thrombopoietin Level in the Cord Blood in Premature Infants Born to Mothers with Pregnancy-Induced Hypertension

Objectives: To investigate the level of thrombopoietin in the cord blood of preterm infants, and its relationship with neonatal platelet count and pregnancy-induced hypertension. Study Method: Thrombopoietin levels in the cord blood of preterm neonates, with or without maternal pregnancy-induced hypertension, were measured by enzmye-linked immunosorbent assay. Results: The platelet count was significantly lower in very low birth weight infants, infants with maternal pregnancy-induced hypertension, and infants with maternal thrombocytopenia. Neonatal thrombocytopenia was associated with maternal pregnancy-induced hypertension and very low birth weight. The neonatal platelet count was correlated significantly with the birth weight and the maternal platelet count. There was no difference in the cord blood level of thrombopoietin between infants born to mothers with pregnancy-induced hypertension and those without. No correlation was found between the thrombopoietin level and the neonatal platelet count. A positive correlation between the cord blood thrombopoietin and the maternal platelet count was identified. Conclusion: Maternal pregnancy-induced hypertension and very low birth weight were significantly associated with thrombocytopenia in premature infants, which cannot be explained by decreased thrombopoietin level.
Hydrodynamic behaviour of nummulitids

Grosforaminiferen unterschiedlicher systematischer Zugehorigkeit bildeten in verschiedenen geologischen Zeiten machtige Ablagerungen, die sich raumlich weit erstrecken. Solche Ablagerungen von Nummulites sind uber einen Zeitraum von ca. 30 Millionen Jahren vom Jungeren Paleozan bis in das Altere Oligozan immer wieder anzutreffen. Die Interpretation der Umweltbedingungen zum Zeitpunkt dieser Ablagerungen war in den letzten 50 Jahren ein heiser Diskussionspunkt. Dies liegt teilweise in den Schwierigkeiten der Interpretation fossiler Gesteine selbst, insbesondere wenn der aktualistische Bezug durch das Fehlen rezenter vergleichbarer Organismen nicht angewendet werden kann. Ein Weg zur Klarung ist die Untersuchung der hydrodynamischen Eigenschaften von Nummuliten-Gehausen. In den letzten 50 Jahren konnten Sedimentologen in zahlreichen Arbeiten die hydrodynamischen Eigenschaften von Sedimentkornern erklaren, insbesondere was den Transport und die Ablagerung wahrend unterschiedlicher Wasserbewegungen (oszillatorisch oder gerichtet) sowohl im seichten als auch im tieferen Wasser betrifft. Zur selben Zeit erklarten Palaontologen die Verbreitung lebender Gros-Foraminiferen unter Verwendung komplexer statistischer Methoden. Mit diesem Datensatz ist es nun moglich, mit wenigen Kennzahlen (Parametern), die Anreicherung der fossilen Formen zu erklaren. Innerhalb der Nummuliten, bei denen zahlreiche Gehausemerkmale von Umweltbedingungen beeinflusst wurden, benotigt man nur zwei, namlich die Gehauseform und die Dichte, um das Abheben, die Transportweite und das Absinken zu berechnen. Zur Berechnung der beiden oben genannten Kennzahlen genugen zwei Abmessungen, namlich der Gehausedurchmesser und die Gehausedicke. Nach Berechnung der hydrodynamischen Parameter wurden diese mit experimentellen Werten verglichen. Da diese Korrelation extrem signifikant ist, lassen sich die hydrodynamischen Parameter fur alle Formen mit nummulitiden Gehausen berechnen. Die Transportfahigkeit der Gehause konnte anhand ihrer Sinkgeschwindigkeit definiert werden: man findet Foraminiferen am haufigsten in jener Wassertiefe, wo die Wasserenergie schon zu schwach ist, um die Gehause abzuheben. Weil die Foraminiferen, um die Photosynthese ihrer Symbionten zu ermoglichen, so viel Licht wie moglich zu absorbieren versuchen, leben sie bevorzugt in jener kritischen Tiefe, wo einerseits das Licht noch intensiv ist, andererseits die Wasserenergie nicht zu hoch ist. Um vom Substrat nicht abgehoben zu werden, mussen die Foraminiferen Gehause mit bestimmten Widerstandkoeffizienten bauen. Durch die hohe Korrelation zwischen den hydrodynamischen Gehauseparametern und der Wasserenergie, die durch die oszillatorische Wellenbewegung am Boden wirkt, lasst sich die durchschnittliche Wassertiefe, in der die Foraminiferen lebten, ermitteln. Wichtig ist jedoch, dass nicht nur die Transportfahigkeit der Gehause, sondern auch die Funktion von strukturellen Gehausemerkmalen die Tiefeverteilung der einzelnen Arten charakterisieren.