Miracle-dz/UniFAR-FTUs huggingface dataset:
Using a learning coach to develop family medicine residents' goal-setting and reflection skills.

BACKGROUND Self-directed learning (SDL) skills, such as self-reflection and goal setting, facilitate learning throughout a physician's career. Yet, residents do not often formally engage in these activities during residency. INTERVENTION To develop resident SDL skills, we created a learning coach role for a junior faculty member to meet with second-year residents monthly to set learning goals and promote reflection. METHODS The study was conducted from 2008-2010 at the Brown Family Medicine Residency in Pawtucket, Rhode Island. During individual monthly meetings with the learning coach, residents entered their learning goals and reflections into an electronic portfolio. A mixed-methods evaluation, including coach's ratings of goal setting and reflection, coach's meeting notes, portfolio entries, and resident interviews, was used to assess progress in residents' SDL abilities. RESULTS Coach ratings of 25 residents' goal-setting ability increased from a mean of 1.9 to 4.6 (P < .001); ratings of reflective capacity increased from a mean of 2.0 to 4.7 (P < .001) during each year. Resident portfolio entries showed a range of domains for goal setting and reflection. Resident interviews demonstrated progressive independence in setting goals and appreciation of the value of reflection for personal development. CONCLUSIONS Introducing a learning coach, use of a portfolio, and providing protected time for self-reflected learning allowed residents to develop SDL skills at their own pace. The learning coach model may be applicable to other residency programs in developing resident lifelong learning skills.
Relationship Between Body Mass Index, Nutrition, Strength, and Function in Elderly Individuals With Chronic Obstructive Pulmonary Disease

PURPOSE: Individuals with severe chronic obstructive pulmonary disease are frequently characterized as cachectic and suffering from generalized weight loss and muscle wasting. Loss of body mass is associated with disability and premature mortality, and body mass index (BMI) has been used as a marker for nutritional status and to predict survival. This cross-sectional study evaluated the association between BMI (kg/m2), nutritional intake, strength, and function in 19 elderly (70 ± 1 years) men and women (BMI = 27.8 ± 1.1 kg/m2) enrolled in a pulmonary rehabilitation program. METHODS: Three-day prospective diet records were collected and analyzed using Food Processor software. Upper and lower body strength was measured using 1 repetition maximum testing for chest and leg press. Function (endurance, strength, and power) was assessed using the Senior Fitness Test battery (6-minute walk, up-and-go, chair stand, arm curl). RESULTS: BMI was positively associated with upper (P < .05) and lower (P < .01) body strength but was not related to nutrition or function. Total daily caloric (kcal/d), protein (g/d), and carbohydrate (g/d) intakes were positively related to upper body strength (P < .01, P < .01, and P < .05, respectively) and lower body strength (P < .05, P < .05, and P < .05, respectively) and 6-minute walk (P < .05). Fat intake (g/d) was positively related to upper body strength (P < 0.05) alone. CONCLUSIONS: Despite health concerns regarding obesity and overweight, clinicians should consider the impact of BMI and dietary intake before initiating weight loss interventions in patients with chronic obstructive pulmonary disease.
Molecular genetics and biochemistry of Yersinia lipopolysaccharide

Studies on the molecular genetics of bacterial LPS1 serve at least two main purposes: (i) to help develop an understanding of the biology, biochemistry and genetics of this bacterial surface macro‐molecule, and (ii) to provide a basis for both vaccine development and virulence experiments. Both of these goals have been the driving force in studies of Yersinia LPS carried out during the last decade. Here we will review the progress made in the molecular genetics and biochemistry of Yersinia LPS. A deep understanding has been achieved with respect to Y. enterocolitica serotype 0:3, reaching as far as a detailed analysis of the gene clusters directing the biosynthesis of the outer core oligosaccharide and of the O‐ag2. The O‐ag gene clusters of Y. enterocolitica serotype 0:8 and Y. pseudotuberculosis serotypes 0:2a and 0:5a have also been cloned and partially characterized. LPS biosynthesis of these Yersinia species includes examples of the two major variations recognized in the biosynthesis of this macromolecule: (i) homopolymeric or O‐antigen polymerase‐independent biosynthesis, and (ii) heteropolymeric or O‐antigen polymerase‐dependent biosynthesis.
Social Responsibility of Educators

We are interested in examining the social responsibility of education through an explorative study on a sample of teachers and students. Teachers should promote some values that conduct the behavior of students. Our ambition is to introduce the idea that the "citizenship" could be an explanatory framework of successful learning. Two arguments can justify our idea. First, the social orientation is yet established through our religions and reinforced by our parents. Culture and others some endogenous factors may encourage this social trend. Second, the citizenship is in its self the output of learning strategies. This indicates that active learning is inherent to social responsibility of active citizens teachers and thereby citizens students. So is important to reveal this problematic in order to stimulate our teachers together with students to pursue a social responsibility in their behaviors to get not only an actual citizen generation but also to ensure getting a future citizen generation. Through this study we hope influencing people, (teachers and students in particular) to act and be stimulated toward correct and responsible behavior.
Geometric Parameters of the In Vivo Tissues at the Lumbosacral Joint of Young Asian Adults

Study Design. Magnetic resonance images (MRIs) were used to determine the geometry of the tissues studied. Objective. To investigate the geometric parameters of tissues around the lumbosacral joint. Summary of Background Data. Cross-sectional area (CSA), moment arms, and line of action of the tissues located at lumbosacral joint (L5–S1), which are important in the study of spinal mechanics and models for the investigation of low back pain. It was insufficient information to describe the relative dimension of spinal tissues except muscles around the lumbar spine. Methods. MRIs from eight asymptomatic young Taiwanese male adults were collected to present CSA, moment arms, and line of action of the tissues located at lumbosacral joint (L5–S1). Four pairs of trunk muscles, erector spinae, rectus abdominis, abdominal oblique externus, and psoas muscles, ligamentum flavum, and facet joints at the bilateral sides were studied. Results. Spinal tissues at the level of lumbosacral joint were determined. The CSAs of the spinal elements at the L5–S1 normalized by the CSA of trunk ranged from 5.42% (the erector spinae) to 0.14% (the ligamentum flavum). The moment arm of the spinal elements relative to the trunk width and depth ranged from 40.91% (rectus abdominis at the y direction) to 0.38% (ligamentum flavum at the x direction). The profile of geometric elements of lumbosacral joint in the Asian male subjects was similar to the data collected from the white population. The data also showed that right–left symmetry in the aforementioned dimension. Conclusion. Normalized data of the CSA, moment arm, and line of action of the spinal tissues at the L5–S1 joint were reported in vivo through the MRI techniques. The profile of geometric elements of lumbosacral joint in the Asian male subjects did not differ from the white population. In addition to muscles, the geometry of facet joint and ligament was determined, which would be important to the calculation of force distribution on the lumbosacral joint.
Preceding profound deafness and co-factors promote development of endolymphatic hydrops in preliminary patients with delayed endolymphatic hydrops

Abstract Conclusion: Profound deafness (PD) is unlikely to be the only cause of endolymphatic hydrops (EH) in patients with delayed endolymphatic hydrops (DEH). Further studies in large patient cohorts are required to determine the etiologic co-factors involved in the development of EH in patients with PD and DEH. Objectives: DEH usually occurs in patients with sustained unilateral PD who then develop episodic vertigo or fluctuating hearing loss. The latency can vary markedly between PD and development of DEH, but the factors affecting inner ear homeostasis and causing EH during this latency period remain unclear. The study aimed to assess the differences in EH and functional status of the inner ear between patients with PD only and those with DEH. Method: Two PD and 10 DEH patients who had developed PD in early childhood were enrolled. Gadolinium-enhanced magnetic resonance imaging of the inner ear was performed in all patients to assess the degree of EH in the vestibule and cochlea. Results: There was no evidence of EH in the affected ears of patients with PD alone. DEH patients, however, showed significant EH in either the cochlea or vestibule, suggesting that EH development and DEH onset were strongly correlated.
Sleep quality, short-term and long-term CPAP adherence.

STUDY OBJECTIVES Adherence to CPAP therapy is low in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). The purpose of the present study was to evaluate the utility of measures of sleep architecture and sleep continuity on the CPAP titration study as predictors of both short- and long-term CPAP adherence. METHODS 93 patients with OSAHS (RDI 42.8 ± 34.3/h) underwent in-laboratory diagnostic polysomnography, CPAP titration, and follow-up polysomnography (NPSG) on CPAP. Adherence to CPAP was objectively monitored. Short-term (ST) CPAP adherence was averaged over 14 days immediately following the titration study. Long-term (LT) CPAP adherence was obtained in 56/93 patients after approximately 2 months of CPAP use. Patients were grouped into CPAP adherence groups for ST (< 2 h, 2-4 h, and > 4 h) and LT adherence (< 4 h, > 4 h). Sleep architecture, sleep disordered breathing (SDB) indices, and daytime outcome variables from the diagnostic and titration NPSGs were compared between CPAP adherence groups. RESULTS There was a significant relationship between ST and LT CPAP adherence (r = 0.81, p < 0.001). Neither ST nor LT adherence were related to demographic variables, baseline severity of untreated SDB, sleep architecture, or measures of daytime impairment. Good CPAP adherence groups had significantly lower %N2 and greater %REM on the titration NPSG. A model combining change in sleep efficiency and change in sleep continuity between the diagnostic and titration NPSGs predicted 17% of the variance in LT adherence (p = 0.006). CONCLUSIONS These findings demonstrate that characteristics of sleep architecture, even on the titration NPSG, may predict some of the variance in CPAP adherence. Better sleep quality on the titration night was related to better CPAP adherence, suggesting that interventions to improve sleep on/prior to the CPAP titration study might be used as a therapeutic intervention to improve CPAP adherence.
Recalling semantic information about newly learned faces and voices

Several findings showed that semantic information is more likely to be retrieved from recognised faces than from recognised voices. Earlier experiments, which investigated the recall of biographical information following person recognition, used stimuli that were pre-experimentally familiar to the participants, such as famous people's voices and faces. We propose an alternative method to compare the participants’ ability to associate semantic information with faces and voices. The present experiments allowed a very strict control of frequency of exposure to pre-experimentally unfamiliar faces and voices and ensured the absence of identity clues in the spoken extracts. In Experiment 1 semantic information was retrieved from the presentation of a name. In Experiment 2 semantic and lexical information was retrieved from faces and/or voices. A memory advantage for faces over voices was again observed.
Regime and Leader Instability Under Two Forms of Military Rule

The finding that military regimes are more fragile than other authoritarian regimes represents one of the few stylized facts in comparative politics. However, the existing literature contains substantial differences in the theoretical explanations for military regime instability and operationalizations of military rule. To assess competing explanations, we examine regime and leader instability after distinguishing between collegial and personalist military rule. We show that regime and leader insecurity characterize only collegial military regimes. Particularly, the fragility of collegial military regimes comes from a heightened likelihood of democratization, not more frequent transitions to alternative autocratic regimes. In addition, leaders of collegial military regimes face higher risks of both regular and irregular turnovers than other autocrats. Also, irregular exits of collegial military leaders tend to occur through reshuffling, rather than regime-changing, coups. The results strongly support theories focusing on military officers’ preference for unity over other explanations.
SB 207499 (Ariflo), a second generation phosphodiesterase 4 inhibitor, reduces tumor necrosis factor alpha and interleukin-4 production in vivo.

The ability of the second generation phosphodiesterase 4 inhibitor SB 207499 (Ariflo), [c-4-cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)-r-l-cyclohexane carboxylic acid], to inhibit inflammatory cytokine production in vivo was evaluated and compared to that of rolipram, a first generation phosphodiesterase 4 inhibitor. To examine human tumor necrosis factor alpha (TNFalpha) production, human monocytes were adoptively transferred into Balb/c mice and challenged with lipopolysaccharide (LPS). In this model, SB 207499 inhibited human TNFalpha production with oral ED50 of 4.9 mg/kg. Similarly, R-rolipram inhibited human TNFalpha production with an ED50 of 5.1 mg/kg, p.o. In contrast to their equipotent activity against TNFalpha production, SB 207499 (ED50 = 2.3 mg/kg, p.o.) was 10-fold less potent than R-rolipram (ED50 = 0.23 mg/kg, p.o.) in reversing reserpine-induced hypothermia, a model of antidepressant activity. In time course studies, SB 207499 (30 mg/kg, p.o.) inhibited TNFalpha production for at least 10 hr; substantial plasma concentrations of SB 207499 were detected over the same interval. The ability of SB 207499 to modulate interleukin-4 production in vivo was assessed in a chronic oxazolone-induced contact sensitivity model in Balb/c mice. In this model, topical administration of SB 207499 (1000 microgram) inhibited intralesional concentrations of interleukin-4 (55%; P <.01). The results demonstrate that SB 207499 is a potent inhibitor of inflammatory cytokine production in a variety of settings in vivo. Moreover, although it is as potent as R-rolipram in inhibiting TNFalpha production, it has substantially less central nervous system activity. Thus SB 207499 represents an excellent candidate with which to evaluate the antiinflammatory potential of PDE4 inhibitors.
Structural Determinants of Ligand and Cell Surface Binding of Insulin-like Growth Factor-binding Protein-3*

Among the well defined insulin-like growth factor (IGF)-binding proteins (IGFBPs), IGFBP-3 is characterized by its interaction with an acid-labile glycoprotein (ALS) in the presence of IGFs. To identify the structural determinants on IGFBP-3 required for ligand binding and cell association, five recombinant human IGFBP-3 variants were expressed in Chinese hamster ovary cells: deletions of amino acids 89–264, 89–184, and 185–264, and site-specific mutations228KGRKR → MDGEA and253KED → RGD. The basic carboxyl-terminal region of IGFBP-3 was required for binding to heparin. The deletion variants had greatly decreased IGF binding ability as assessed by ligand blotting and solution binding assays; affinity cross-linking indicated at least a 20-fold decrease in IGF affinity. The RGD mutant had a 4–6-fold reduced affinity for both IGFs, but the MDGEA mutant bound IGF-I with near normal affinity and IGF-II with a 3-fold reduction in affinity. The three deletion variants were incapable of binding ALS; but of the site-specific variants, the MDGEA mutant bound ALS with 90% lower affinity (K a = 2.5 ± 0.9 liters/nmol) than seen for rhIGFBP-3 (K a = 24.3 ± 5.2 liters/nmol), whereas the RGD mutation had no effect on ALS affinity (K a = 21.7 ± 4.5 liters/nmol). The ability of IGFBP-3 to associate with the cell surface was lost in variants lacking residues 185–264 and in the 228KGRKR → MDGEA mutant. We conclude that residues 228–232 of IGFBP-3 are essential for cell association and are required for normal ALS binding affinity.
High fitness is associated with a healthier programming of body composition at adolescence

The programming effect of birth weight on later body composition has become of increasing interest in recent years. This programming effect is affected by factors such as gender. Physical fitness could be another factor of influence. This study aimed to examine whether handgrip strength (HG) or cardiovascular fitness (CVF) modify the associations between birth weight and body composition in adolescents. A sample of 1,740 (942 females) adolescents aged 13 to 18.5 years, born at more than 35 weeks of gestation, from the AVENA study was studied. Waist circumference was measured, percentage body fat was calculated from skinfold thicknesses and fat free mass was derived by subtracting fat mass from total body weight. HG and CVF were assessed using the HG test and the 20 m shuttle run test, respectively. Birth weight was positively associated with fat free mass in females with high (above the median) CVF (P < 0.001), but not in those with low (below the median) CVF. In contrast, birth weight was positively associated with total and central adiposity in males with low HG (both P = 0.002), but not in those with high HG. These results suggest that the programming effect of birth weight on later body composition is dependent on gender and fitness level. A high birth weight may have a healthy programming effect on body composition in those adolescents with a high fitness level, being associated with increased fat free mass levels in females and not showing the increased adiposity levels observed in unfit males. Am. J. Hum. Biol., 2008. © 2008 Wiley‐Liss, Inc.
Persistent T cell and B cell activities in the duodenal mucosa of AIDS patients

Objective:As HIV infection most commonly occurs via a mucosal surface, and as gastrointestinal symptoms are very frequent among HIV-infected patients, we investigated the functional properties of residual lymphocytes in the duodenal mucosa from HIV-infected individuals. Design:Duodenal biopsies and blood samples were obtained from 19 HIV-infected patients [Centers for Disease Control and Prevention (CDC) stage III] and from 19 controls. Methods:Phenotypic analysis of lymphocytes was performed by flow cytometry and/or immunocytochemistry. Interferon γ (IFN-γ), interleukin (IL) 4 and immunoglobulin secretions were analysed by enzyme-linked immunospot techniques. The phenotype of cytokine-producing cells was analysed by flow cytometry. Results:The proportions of duodenal T lymphocytes from HIV-infected patients spontaneously secreting IFN-γ or IL-4 were not lower than those from healthy controls. In patients with a high intestinal mucosal viral load, they were higher than in controls (P < 0.05). The proportions of immunoglobulin-secreting cells were significantly raised in HIV-infected patients for the three main isotypes. Conclusions:T- and B-cell populations of the intestinal mucosa remain functional or are even activated in patients with AIDS, even when the numbers of both mucosal and circulating CD4+ lymphocytes are strongly decreased.
Epstein–Barr virus and carcinomas: Undifferentiated carcinomas but not squamous cell carcinomas of the nasopharynx are regularly associated with the virus

The Epstein–Barr virus (EBV) is consistently associated with undifferentiated nasopharyngeal carcinoma (NPC). There is, however, conflicting evidence as to whether squamous cell NPCs are also EBV associated. Moreover, it has been proposed that other epithelial tumours, particularly thymomas and thymic carcinomas, should be included in the group of EBV‐associated neoplasias. However, since the viral DNA in these studies was demonstrated only in extracted DNA, the cellular origin of the viral DNA is uncertain. We have therefore investigated 152 epithelial tumours from various sites for the presnece of EBV‐DNA by in situ hybridization with 35S‐labelled probes. Sixty‐eight of 77 undifferentiated NPCs showed an EBV‐specific autoradiographic signal, thus confirming the strong association of this tumour type with EBV even in geographical areas where undifferentiated NPC is not endemic. None of eight squamous cell NPCs showed an EBV‐specific signal. All of 15 carcinomas with a similar morphology to undifferentiated NPC but from different anatomic sites (thymus, tonsil, breast) were EBV‐negative as were 9 thymomas, 26 squamous cell carcinomas of the palatine tonsil, and 14 cervical carcinomas. Our results therefore suggest a unique association of EBV with undifferentiated NPC and support concepts assigning different biological properties to undifferentiated NPC as compared with squamous cell NPC.
The yopJ locus is required for Yersinia‐mediated inhibition of NF‐κB activation and cytokine expression: YopJ contains a eukaryotic SH2‐like domain that is essential for its repressive activity

Upon exposure to bacteria, eukaryotic cells activate signalling pathways that result in the increased expression of several defence‐related genes. Here, we report that the yopJ locus of the enteropathogen Yersinia pseudotuberculosis encodes a protein that inhibits the activation of NF‐κB transcription factors by a mechanism(s), which prevents the phosphorylation and subsequent degradation of the inhibitor protein IκB. Consequently, eukaryotic cells infected with YopJ‐expressing Yersinia become impaired in NF‐κB‐dependent cytokine expression. In addition, the blockage of inducible cytokine production coincides with yopJ‐dependent induction of apoptosis. Interestingly, the YopJ protein contains a region that resembles a src homology domain 2 (SH2), and we show that a wild‐type version of this motif is required for YopJ activity in suppressing cytokine expression and inducing apoptosis. As SH2 domains are found in several eukaryotic signalling proteins, we propose that YopJ, which we show is delivered into the cytoplasm of infected cells, interacts directly with signalling proteins involved in inductive cytokine expression. The repressive activity of YopJ on the expression of inflammatory mediators may account for the lack of an inflammatory host response observed in experimental yersiniosis. YopJ‐like activity may also be a common feature of commensal bacteria that, like Yersinia, do not provoke a host inflammatory response.