Miracle-dz/UniFAR-FTUs huggingface dataset:
What is wrong with assessment in postgraduate training? Lessons from clinical practice and educational research

Workplace-based assessment is more commonly given a lukewarm than a warm welcome by its prospective users. In this article, we summarise the workplace-based assessment literature as well as our own experiences with workplace-based assessment to derive lessons that can facilitate acceptance of workplace-based assessment in postgraduate specialty training. We propose to shift the emphasis in workplace-based assessment from assessment of trainee performance to the learning of trainees. Workplace-based assessment should focus on supporting supervisors in taking entrustment decisions by complementing their “gut feeling” with information from assessments and focus less on assessment and testability. One of the most stubborn problems with workplace-based assessment is the absence of observation of trainees and the lack of feedback based on observations. Non-standardised observations are used to organise feedback. To make these assessments meaningful for learning, it is essential that they are not perceived as summative by their users, that they provide narrative feedback for the learner and that there is a form of facilitation that helps to integrate the feedback in trainees’ self-assessments.
Predicting Late-stage Breast Cancer Diagnosis and Receipt of Adjuvant Therapy: Applying Current Spatial Access to Care Methods in Appalachia

Purpose:The 2-step floating catchment area (2SFCA) method of measuring access to care has never been used to study cancer disparities in Appalachia. First, we evaluated the 2SFCA method in relation to traditional methods. We then examined the impact of access to mammography centers and primary care on late-stage breast cancer diagnosis and receipt of adjuvant hormonal therapy. Methods:Cancer registries from Pennsylvania, Ohio, Kentucky, and North Carolina were linked with Medicare data to identify the stage of breast cancer diagnosis for Appalachia women diagnosed between 2006 and 2008. Women eligible for adjuvant therapy had stage I, II, or III diagnosis; mastectomy or breast-conserving surgery; and hormone receptor–positive breast cancers. Geographically weighted regression was used to explore nonstationarity in the demographic and spatial access predictor variables. Results:Over 21% of 15,299 women diagnosed with breast cancer had late-stage (stages III–IV) diagnosis. Predictors included age at diagnosis [odds ratio (OR)=0.86; P<0.001], insurance status (OR=1.32; P<0.001), county primary care to population ratio (OR=0.95; P<0.001), and primary-care 2SFCA score (OR=0.96; P=0.006). Only 46.9% of eligible women received adjuvant hormonal therapy, and predictors included comorbidity status (OR=1.18; P=0.047), county economic status (OR=1.32; P=0.006), and mammography center 2SFCA scores (OR=1.12; P=0.021). Conclusions:Methodologically, the 2SFCA method offered the greatest predictive validity of the access measures examined. Substantively, rates of late-stage breast cancer diagnosis and adjuvant hormonal therapy are substandard in Appalachia.
A bound on mean-square-estimate error

A lower bound on mean-square-estimate error is derived as an instance of the covariance inequality by concatenating the generating matrices for the Bhattacharyya and Barankin bounds; it represents a generalization of the Bhattacharyya, Barankin, Cramer-Rao, Hammersley-Chapman-Robbins, Kiefer, and McAulay-Hofstetter bounds in that all of these bounds may be derived as special cases. The bound is applicable to biased estimates' of functions of a multidimensional parameter. Termed the hybrid Bhattacharyya-Barankin bound, it may be written as the sum of the mth-order Bhattacharyya bound and a nonnegative term similar in form to the rth-order Hammersley-Chapman-Robbins bound. It is intended for use when small-error bounds, such as the Cramer-Rao bound, may not be tight; unlike many large-error bounds, it provides a smooth transition between the small-error and large-error regions. As an example application, bounds are placed on the variance of unbiased position estimates derived from passive array measurements. Here, the hybrid Bhattacharyya-Barankin bound enters the large-error region at a larger SNR and, in the large-error region, is noticeably greater than either the Hammersley-Chapman-Robbins or the Bhattacharyya bounds. >
Occurrence and Geographic Distribution of Wheat Fusarium Head Blight and Fusarium Root Rot in Jendouba ’ s Areas of Tunisia

Mycological analysis of infested wheat plants (Triticum durum L.) collected from 68 fields in the low valley of Medjerda (Bousselem, Brahim, Bir lakhther, Souk essebet, Jendouba Northern, Oued Meliz and Ghardimaou) was performed in 2006. Eight hundred and fifty three isolates were obtained from the feet and root; 1580 isolates were identified from the head. On the collar, we identified Fusarium solani (52.5%), F. culmorum (27%), F. graminearum (11%) and F. oxysporum (9.5%). These species were present in all prospected areas except for F. graminearum which was not found in Bousselem. As for head blight, in addition of these four species which were isolated at a 28, 13, 16 and 30% frequency, respectively, we detected F. equiseti (9%) in Oued Mliz and F. poae (4%) with an important frequency in Souk Essebet area. The technique adopted to efficiently isolate Fusarium species was very satisfactory. Our study shows a frequent cooccurrence in single fields of several species of Fusarium. _____________________________________________________________________________________________________________
Fibroblast Growth Factor Homologous Factor 1B Binds to the C Terminus of the Tetrodotoxin-resistant Sodium Channel rNav1.9a (NaN)*

In this study we demonstrate a direct interaction between a cytosolic fibroblast growth factor family member and a sodium channel. A yeast two-hybrid screen for proteins that associate with the cytoplasmic domains of the tetrodotoxin-resistant sodium channel rNav1.9a (NaN) led to the identification of fibroblast growth factor homologous factor 1B (FHF1B), a member of the fibroblast growth factor family, as an interacting partner of rNav1.9a. FHF1B selectively interacts with the C-terminal region but not the other four intracellular segments of rNav1.9a. FHF1B binds directly to the C-terminal polypeptide of rNav1.9a both in vitro and in mammalian cell lines. The N-terminal 5–77 amino acid residues of FHF1B are essential for binding to rNav1.9a. FHF1B did not interact with C termini of two other sodium channels hNav1.7a (hNaNE) and rNav1.8a (SNS), which share 50% similarity to the C-terminal polypeptide of rNav1.9a. FHF1B is the first growth factor found to bind specifically to a sodium channel. Although the functional significance of this interaction is not clear, FHF1B may affect the rNav1.9a channel directly or by recruiting other proteins to the channel complex. Alternatively, it is possible that rNav1.9a may help deliver this factor to the cell membrane, where it exerts its function.
Induction of Tyrosine Phosphorylation of UV-Activated EGFR by the Beta-Human Papillomavirus Type 8 E6 Leads to Papillomatosis

Epidemiological evidence is accumulating that beta-human papillomaviruses (HPV) synergize with UV-light in the development of precancerous actinic keratosis, and cutaneous squamous cell carcinomas (cSCC), one of the most common cancers in the Caucasian population. We previously demonstrated the tumorigenic activity of beta-HPV type 8 (HPV8) in the skin of transgenic mice and its cooperation with UV-light. Analysis of underlying mechanisms now showed that in keratinocytes expressing the HPV8E6 protein a transient increase of tyrosine phosphorylated epidermal growth factor receptor (EGFR) in response to UV-irradiation occurred, while EGFR tyrosine phosphorylation, i.e., receptor tyrosine kinase (RTK)-activity was hardly affected in empty vector control cells. FACS and immunofluorescences revealed that the EGFR was internalized into early endosomes in response to UV-exposure in both, HPV8E6 positive and in control cells, yet with a higher rate in the presence of HPV8E6. Moreover, only in HPV8E6 expressing keratinocytes the EGFR was further sorted into CD63+ intraluminal vesicles, indicative for trafficking to late endosomes. The latter requires the ubiquitination of the EGFR, and in correlation, we could show that only in HPV8E6 positive keratinocytes the EGFR was ubiquitinated upon UV-exposure. HPV8E6 and tyrosine phosphorylated EGFR directly interacted which was enhanced by UV-irradiation. The treatment of K14-HPV8E6 transgenic mice with Canertinib, an inhibitor of the RTK-activity of the EGFR, suppressed skin papilloma growth in response to UV-irradiation. This confirms the crucial role of the RTK-activity of the EGFR in HPV8E6 and UV-mediated papillomatosis in transgenic mice. Taken together, our results demonstrate that HPV8E6 alters the signaling of the UV-activated EGFR and this is a critical step in papilloma formation in response to UV-light in transgenic mice. Our results provide a molecular basis how a beta-HPV type may support early steps of skin tumor formation in cooperation with UV-light.
Point-of-Care Ultrasound Diagnosis of Left-Sided Endocarditis

A 56-year-old male presented to the emergency department (ED) with fatigue, generalized weakness, cough without hemoptysis or dyspnea, occasional fever, night sweats, dark stools, and weight loss for months. Physical exam revealed a cachectic gentleman with bilateral distal pitting edema. Cardiac and respiratory exams revealed no adventitious sounds. Stool guaiac was negative for blood. Complete blood count revealed mild anemia without leukocytosis, and chest radiograph showed cardiomegaly with left pleural effusions. Initial providers were most concerned for malignancy, although differential included tuberculosis or endocarditis. Given the reassuring exam and chronicity of symptoms, initial disposition plan was discharge with close follow up for malignancy evaluation. With the consideration of endocarditis, a point-of-care cardiac ultrasound was performed revealing a mobile mass on the aortic valve and an irregular mitral valve (Video). After blood cultures and broad-spectrum antibiotics, the patient was admitted. Transthoracic echocardiogram (TTE), demonstrated vegetations on the mitral and aortic valves. Blood cultures grew enterococcus. The patient underwent mitral and aortic valve replacements without complications and was discharged home. Infective endocarditis (IE) is an uncommon disease and a challenging diagnosis to make in the ED. Symptoms are nonspecific, murmurs can be difficult to auscultate, and skin manifestations are rare. Though transesophageal echocardiogram is the most sensitive modality for evaluation of suspected IE, it is not available in most EDs. TTE only has sensitivity of 50–70%; however, larger lesions (>10mm) have a sensitivity of 84%. 1 Vegetations are mobile, irregularly shaped structures usually on the upstream side of valves, with motion irrespective of valve. Differential includes myxomatous process, tumors, thrombi, or imaging artifact.2 Point-of-care ultrasound (POCUS) has been reported to diagnose both right- and left-sided IE.3,4 Though not definitive, POCUS can dramatically change disposition and expedite care in patients for whom emergency physicians are considering IE.
Doping of Ta2O5 as a way to extend its potential for DRAM applications

The doping of Ta<inf>2</inf>O<inf>5</inf> films with a proper element or its mixing with another high-k dielectric as a breakthrough to tailor Ta<inf>2</inf>O<inf>5</inf> properties towards meeting the criteria for future technological nodes are discussed. Essential in the engineering of advanced DRAM storage capacitors parameters and characteristics of Ti-doped Ta<inf>2</inf>O<inf>5</inf>, Hf-doped Ta<inf>2</inf>O<inf>5</inf> and mixed HfO<inf>2</inf>-Ta<inf>2</inf>O<inf>5</inf> layers as an illustration of both the benefits and the disadvantages of modified Ta<inf>2</inf>O<inf>5</inf>-based stacks are presented.
Cognitive Distortions of Religious Professionals Who Sexually Abuse Children

This study uses grounded theory to investigate the cognitive distortions in the self-report statements of 14 clergymen who had sexually abused children. These clergy were residents at an assessment and treatment center for child molesters. The content of the offenders' cognitive distortions was identified and categorized into thematic groups. These categories were found to relate to the various stages of the offending cycle. A tentative model was generated that illustrates the relationship between the categories and the hypothesized sequence of thought facilitating the initiation and maintenance of sexually abusive behavior. In addition, a number of cognitive processes were identified as contributing to offenders' beliefs. The study also reveals that the clergymen used their religious role and relationship with God within their distorted beliefs. These beliefs were predominantly concentrated in the areas of giving themselves permission to offend, denial of likelihood of getting caught, reduction of guilt after offending, and maintaining a positive sense of self.
PENGARUH ALOKASI PEMBIAYAAN SEKTOR-SEKTOR EKONOMI OLEH PERBANKAN SYARIAH TERHADAP PRODUK DOMESTIK REGIONAL BRUTO (PDRB) PROVINSI JAWA TIMUR

Penelitian ini bertujuan untuk membangun fakta dengan menyelidiki hubungan antara pembiayaan sektor ekonomi terhadap PDRB Jawa Timur,Metode penelitian ini adalah kuantitatif deskriptif dengan menggunakan data time series tahun 2010-2015 periode triwulanan dan mem-proxy-kan ke empat sektor utama lapangan kerja berdasarkan Nawacita, yaitu sektor pertanian, kehutanan, dan perikanan, sektor pertambangan, sektor industri pengolahan, dan sektor konstruksi. Uji pengaruh dalam penelitian ini menggunakan metode regresi linier sederhana dan berganda dengan bantuan software SPSS 21.00. Hasil uji model pengaruh pembiayaan sektor ekonomi Nawacita oleh perbankan Syariah di Jawa Timur terhadap PDRB menunjukan bahwa tidak seluruh pembiayaan sektor ekonomi di Jawa Timur memberikan pengaruh positif dan signifikan terhadap PDRB Provinsi Jawa Timur secara umum. Sementara itu, hasil uji model pengaruh pembiayaan sektor ekonomi Nawacita secara sektor per sektor terhadap PDRB sektor ekonomi Nawacita mendapatkan hasil bahwa semua pembiayaan berpengaruh positif dan signifikan terhadap PDRB sektor masing-masing, kecuali sektor pertanian, kehutanan, dan perikanan yang berpengaruh positif namun tidak signifikan. Rendahnya tingkat pengaruh dan signifikansi pembiayaan sektor pertanian, kehutanan, dan perikanan terhadap PDRB secara umum maupun PDRB sektor pertanian, kehutanan, dan perikanan disebabkan karena rendahnya akses petani dalam mendapatkan pembiayaan oleh perbankan syariah, baik karena akses lokasi maupun petani sendiri yang belum bankable.
Speaking up: using OSTEs to understand how medical students address professionalism lapses

Background Objective-structured teaching encounters (OSTEs) are used across many disciplines to assess teaching ability. The OSTE detailed in this paper assesses 191 fourth-year medical students’ (M4) ability to identify and address lapses in professionalism based on Association of American Medical Colleges’ professionalism competencies. The research questions addressed are • How frequently do M4s address professionalism lapses observed during an OSTE? • What factors influence whether M4s provide feedback when they observe professionalism lapses in an OSTE? Methods Standardized patients (SPs) and standardized learners (SLs) were recruited and trained to participate in a standardized encounter with specific cognitive, social, and behavioral errors, including professionalism lapses. M4s viewed this encounter and then offered feedback to the SL, while remotely observed by faculty. Post-encounter, the SL and faculty completed identical checklists to assess both teaching readiness and ability to address professionalism concerns. Results An analysis of frequencies showed that six of the Association of American Medical Colleges’ nine professional competencies were addressed in the checklist and/or discussed in the focus group. Analysis of transcribed debriefing sessions confirmed that M4s did not consistently address professionalism lapses by their peers. Conclusions In focus groups, M4s indicated that, while they noticed professionalism issues, they were uncomfortable discussing them with the SLs. Findings of the current study suggest how medical educators might support learners’ ability to address lapses in professionalism as well as topics for future research.
Pulmonary Complications in Survivors of Childhood Hematological Malignancies: Single-Center Experience

Children treated for cancer face the risk of complications later in life, including pulmonary dysfunction. The objective of this study was to evaluate frequency and severity of pulmonary complications in survivors of childhood leukemia and lymphoma treated with chemotherapy alone or combined with radiotherapy. Seventy cancer survivors of hematological malignancies were evaluated for pulmonary complications through history taking, chest examination, high-resolution computed tomography (HRCT) chest, and pulmonary function testing (PFTs). Although most survivors were not clinically compromised, the spectrum of impaired PFTs included obstructive pattern (14.3%), restrictive pattern (5.7%), and mixed pattern (20%). Significant pulmonary dysfunction was seen in children older than 10 years of age (P = .003), and in patients treated with combined chemotherapy and radiotherapy (72.7%) compared with those treated with chemotherapy alone (25%) (P = .001). Cumulative dose of bleomycin was significantly associated with abnormal PFTs (P = .04). Multivariate analysis revealed methotrexate therapy as significant predictor of abnormal PFTs (P = .002). Male patients who received combined therapy showed higher frequency of restrictive, obstructive lung disease, abnormal respiratory reactance, and peripheral airway disease (P = .007, P = .04, P = .002, P = .003, P = .05, respectively). Those with abnormal CT findings (n = 14) had lower forced vital capacity (FVC%), forced expiratory volume in 1 second (FEV1%), and peak expiratory flow (PEF%) when compared to cases with normal CT (P = .001, P <0.001, P = .001, respectively). Subclinical pulmonary function abnormalities are found in survivors of childhood hematological malignancies previously treated and off therapy. Pulmonary dysfunction is more evident with combined chemotherapy and radiotherapy, bleomycin, and methotrexate are the most incriminated chemotherapeutic agents, and males are at higher risk than females; therefore a specific and extended follow-up is warranted.
Plasma levels of androstenedione, epitestosterone, testosterone and oestrogens in cows at parturition.

The concentration of total unconjugated oestrogens in the peripheral plasma of cows increased from 2.00 +/- 0.20 (S.E.M.) ng/ml 7 days before to 3.87 +/- 0.50 ng/ml 1 day before parturition and declined to values below 0.30 ng/ml on day 2 post partum. The concentrations of androstenedione, epitestosterone and testosterone remained approximately constant at 0.90 +/- 0.10, 0.92 +/- 0.08 and 0.40 +/- 0.20 ng/ml respectively during the last week of pregnancy. After parturition the concentration of the three androgens declined rapidly. Similar to data obtained in goats we did not find a marked increase in androgen levels in the peripheral blood of cows before parturition.
Utilization of a dispersion-shifted fiber for simultaneous measurement of distributed strain and temperature through Brillouin frequency shift

We propose and realize a new method that utilizes a dispersion-shifted fiber having compound compositions with different temperature coefficients in core to simultaneously measure the distributed strain and temperature based on Brillouin frequency shift. In a 3682-m sensing length of large-effective-area nonzero dispersion-shifted fiber, a temperature resolution of 5/spl deg/C, a strain resolution of 60 /spl mu//spl epsi/, and a spatial resolution of 2 m are achieved simultaneously.
Embodied Ethics and Contemporary Paganism

Contemporary understandings of ethics consistently situate them as the result of a focussed rational and intellectual process within a narrow range of academic and religious areas. I challenge this approach, and theorise an embodied approach to ethics as both possible and desirable. I argue that such an approach may be most easily located in the contemporary Pagan approach to environmental ethics, given that the rhetoric of Paganism valorises the body and privileges the natural environment. While I agree that Paganism is indeed a nature religion, I theorise that there are two simultaneous yet contradictory discourses of nature informing Paganism: the animist (privileging nature qua nature) and the esoteric (privileging a symbolic understanding of nature). I assert that my qualitative fieldwork demonstrates that some Pagans have developed an embodied ethic through close relationship with nature. I acknowledge that the development of such a profound relationship requires considerable effort and a great deal of time. I then compare this against quantitative data from an online survey of self-identifying Pagans in order to establish the extent to which such an approach might be representative. The Initial analysis of the online data supports the assertion that my respondents are likely to express positive attitudes to the environment, but are unlikely to participate in activism in relation to a number of specified areas. Deeper analysis compares the data between different groups identified along the animist/esoteric scale, and suggests that those Pagans who are more influenced by the animist discourse are indeed more likely to express environmentally friendly attitudes and to take part in activism. I conclude that such an embodied environmental ethic is possible, although this may be substantially contingent upon lifestyle. I posit that by understanding the diversity of discourses informing Pagan approaches to nature, academics may be able to more accurately interpret the diversity of Pagan approaches, and Pagans themselves may be able to move forward in discussions between their various traditions.
Physical localization of the flocculation gene FLO1 on chromosome I of Saccharomyces cerevisiae

The genetics of flocculation in the yeast Saccharomyces cerevisiae are poorly understood despite the importance of this property for strains used in industry. To be able to study the regulation of flocculation in yeast, one of the genes involved, FLO1, has been partially cloned. The identity of the gene was confirmed by the non‐flocculent phenotype of cells in which the C‐terminal part of the gene had been replaced by the URA3 gene. Southern blots and genetic crosses showed that the URA3 gene had integrated at the expected position on chromosome I. A region of approximately 2 kb in the middle of the FLO1 gene was consistently deleted during propagation in Escherichia coli and could not be isolated. Plasmids containing the incomplete gene, however, were still able to cause weak flocculation in a nonflocculent strain. The 3′ end of the FLO1 gene was localized at approximately 24 kb from the right end of chromosome I, 20 kb centromere‐proximal to PHO11. Most of the newly isolated chromosome I sequences also hybridized to chromosome VIII DNA, thus extending the homology between the right end of chromosome I and chromosome VIII to approximately 28 kb.