Miracle-dz/UniFAR-FTUs huggingface dataset:
Patients' perceptions of the potential of breathing training for asthma: a qualitative study

Background: Poor symptom control is common in asthma. Breathing training exercises may be an effective adjunct to medication; it is therefore important to understand facilitators and barriers to uptake of breathing training exercises. Aims: To gain insight into patients' perceptions of breathing training exercises designed to help control asthma symptoms. Methods: Semi-structured think-aloud interviews were conducted with 29 people with asthma about their views of a booklet on breathing training exercises. Results: Thematic analysis showed breathing training exercises were seen as acceptable in principle because they were viewed as non-pharmacological, holistic, unobtrusive, and likely to increase patient confidence in managing symptoms. Anticipated disadvantages included the time required and perceived irrelevance for those with well-controlled asthma. These views were influenced by prior experience of changing breathing, wanting to self-manage asthma, negative views of medication, and perceived asthma control/severity. Anticipated barriers to carrying out the exercises included difficulties with nose breathing, remembering to do them, and persevering with them. Anticipated facilitators included monitoring tools and social support. Conclusions: The idea of breathing training was viewed positively as an acceptable non-pharmacological treatment that patients can do discreetly to help them breathe more easily and reduce their reliance on medication. Uptake of breathing training may be greater among those who perceive their asthma as severe and/or have negative views of medication. To enhance uptake, it might be helpful to present breathing training exercises as holistic skills that can also benefit those with mild symptoms.
Uncertainty and Variability in Health‐Related Damages from Coal‐Fired Power Plants in the United States

The health‐related damages associated with emissions from coal‐fired power plants can vary greatly across facilities as a function of plant, site, and population characteristics, but the degree of variability and the contributing factors have not been formally evaluated. In this study, we modeled the monetized damages associated with 407 coal‐fired power plants in the United States, focusing on premature mortality from fine particulate matter (PM2.5). We applied a reduced‐form chemistry‐transport model accounting for primary PM2.5 emissions and the influence of sulfur dioxide (SO2) and nitrogen oxide (NOx) emissions on secondary particulate formation. Outputs were linked with a concentration‐response function for PM2.5‐related mortality that incorporated nonlinearities and model uncertainty. We valued mortality with a value of statistical life approach, characterizing and propagating uncertainties in all model elements. At the median of the plant‐specific uncertainty distributions, damages across plants ranged from $30,000 to $500,000 per ton of PM2.5, $6,000 to $50,000 per ton of SO2, $500 to $15,000 per ton of NOx, and $0.02 to $1.57 per kilowatt‐hour of electricity generated. Variability in damages per ton of emissions was almost entirely explained by population exposure per unit emissions (intake fraction), which itself was related to atmospheric conditions and the population size at various distances from the power plant. Variability in damages per kilowatt‐hour was highly correlated with SO2 emissions, related to fuel and control technology characteristics, but was also correlated with atmospheric conditions and population size at various distances. Our findings emphasize that control strategies that consider variability in damages across facilities would yield more efficient outcomes.
Estimating numbers of unsheltered homeless people through plant-capture and postcount survey methods.

OBJECTIVES We sought to increase the accuracy of New York City's estimates of its unsheltered homeless population. METHODS We employed 2 approaches to increasing count accuracy: a plant-capture strategy in which embedded decoys (or "plants") were used to estimate the proportion of visible homeless people missed by enumerators and a postcount survey of service users designed to estimate the proportion of unsheltered homeless people who were not visible. RESULTS Plants at 17 sites (29%) reported being missed in the count, because counters either did not visit those sites or did not interview the plants. Of 293 homeless service users who were not in shelters, 31% to 41% were in locations deemed not visible to counters. CONCLUSIONS Both plant-capture estimation and postcount surveys are feasible approaches that can increase the accuracy of estimates of unsheltered homeless populations.
Instantaneous diastolic pressure–flow relationship in arterial coronary bypass grafts

Objective: The objective of this study was to describe the diastolic pressure–flow relationship and to assess critical occlusion pressure in arterial coronary bypass grafts in human beings. Methods and results: Fifteen patients were studied following elective surgical coronary artery bypass grafting. Flow in the left internal mammary artery bypass to the left anterior descending artery was measured and simultaneously, aortic pressure, coronary sinus pressure and left ventricular end‐diastolic pressure were recorded. The zero‐flow pressure intercept as a measure of critical occlusion pressure was extrapolated from the linear regression analysis of the instantaneous diastolic pressure–flow relationship. Mean diastolic flow was 46 ± 17 mL min−1, mean diastolic aortic pressure was 60.5 ± 10.0 mmHg. Diastolic blood flow was linearly related to the respective aortic pressure in all patients (R‐values 0.7–0.99). The regression lines had a mean slope of 2.1 ± 1.2 mL min−1 mmHg−1. Mean critical occlusion pressure was 32.3 ± 9.9 mmHg and exceeded mean coronary sinus pressure and mean left ventricular end‐diastolic pressure by factors of 3.1 and 2.6, respectively. Conclusions: Our data demonstrate the presence of a vascular waterfall phenomenon in the coronary circulation after internal mammary artery bypass grafting. Critical occlusion pressure in arterial grafts considerably exceeds coronary sinus pressure as well as left ventricular end‐diastolic pressure and should thus be used as the effective downstream pressure when calculating coronary perfusion pressure. Our data further suggest that the slope of diastolic pressure–flow relationships provides a more rational approach to assess regional coronary vascular resistance than conventional calculations of coronary vascular resistance.
When Should Trainees Call for Help With Invasive Procedures?

Primum non nocere , Latin for “First do no harm,” is a fundamental bioethical principle indoctrinated into each of us at the commencement of our medical education and continuously reinforced during residency and fellowship training. Even though our training models have progressed from the cynical “see one, do one, teach one” to graduated autonomy, there remains significant room for improvement because inadequate resident supervision has been associated with patient harm and poor outcomes.1 In a national survey, Baldwin et al2 identified significant gaps in resident supervision, and in a study of 240 closed malpractice cases involving trainees across all subspecialties, 58% involved lack of trainee competence or knowledge, with lack of supervision in 54% of cases versus only 7% in nontrainees.3 In a prospective study of supervised endotracheal intubations, attending supervision was associated with a significant decrease in complications.4 As part of a quality improvement program to investigate the causes of radial artery trauma to infants in our ICU, we realized that we had no policy that proactively defined the number of independent attempts at radial artery sampling by a physician trainee. The image is that of an infant’s wrist after 21 attempts (we counted the holes) at obtaining a radial artery sample by a trainee during fellowship (Fig 1). After the clinical team decided that an arterial sample was indicated in this infant, the fellow disappeared behind the … Address correspondence to Adam C. Adler, MD, MS, Department of Anesthesiology, Texas Children’s Hospital, 6621 Fannin St, Suite A3300, Houston, TX 77030. E-mail: axadler{at}texaschildrens.org
HOMOGENEITY OF THE GENETIC VARIANCE‐COVARIANCE MATRIX FOR ANTIPREDATOR TRAITS IN TWO NATURAL POPULATIONS OF THE GARTER SNAKE THAMNOPHIS ORDINOIDES

Quantitative genetic models of evolution rely on the genetic variance‐covariance matrix to predict the phenotypic response to selection. Both prospective and retrospective studies of phenotypic evolution across generations rely on assumptions about the constancy of patterns of genetic covariance through time. In the absence of robust theoretical predictions about the stability of genetic covariances, this assumption must be tested with empirical comparisons of genetic parameters among populations and species. Genetic variance‐covariance matrices were estimated for a suite of antipredator traits in two populations of the northwestern garter snake, Thamnophis ordinoides. The characters studied include color pattern and antipredator behaviors that interact to facilitate escape from predators. Significant heritabilities for all traits were detected in both populations. Genetic correlations and covariances were found among behaviors in both populations and between color pattern and behavior in one of the populations. Phenotypic means differed among populations, but pairwise comparisons revealed no heterogeneity of genetic parameters between the populations. The structure of the genetic variance‐covariance matrix has apparently not changed significantly during the divergence of these two populations.
Opposite Responding as a Measure of Creativity

A proposal for using rapid opposite responding to the Kent-Rosanoff Word Association list as a measure of creativity is presented. Although a complex matter, this measure has the advantage of using a well standardized test as its basis. The proposed scoring system is based on the difference between the number of opposite and primary responses and the difference between mean response latency in those categories. This measure correlates significantly with assessed creativity in a group of successful executives.
Effects of ossicular prosthesis mass and section of the stapes tendon on middle ear transmission.

BACKGROUND The effects of changing prosthesis mass on middle ear transmission have not been previously systematically studied. Neither has the effect of stapes tendon sectioning. These are important parameters that can be surgically varied. HYPOTHESIS Because the middle ear is compliance dominated at low frequencies, prosthesis mass will affect transmission of higher frequencies in the middle ear. METHODS Eight fresh cadaveric temporal bones, with the incus removed, were loaded with a replacement prosthesis from the tympanic membrane to the stapes head. Laser Doppler vibrometry was used to measure stapes footplate vibrations. Vibrations were measured in response to chirps from 250 to 8 kHz at 90 dB SPL in the ear canal. The unloaded prosthesis mass was approximately 16 mg. Loadings with masses of approximately 2, 12, and 30 mg were placed on the stem. Recordings were repeated after cutting the stapes tendon. RESULTS Mass loading affected the higher frequencies only, with significant effects only above 4 kHz. There was little low-frequency effect. Stapes tendon section showed an improvement in the lower frequencies but did not reach statistical significance. CONCLUSIONS Mass of prostheses affects mainly higher frequencies. There is no drop in lower frequencies from using lower masses, so lighter-mass prostheses may be preferred. Stapes tendon section does not have a detrimental effect on middle ear transmission after ossiculoplasty.
ON THE WEAKENING OF THE POLAR MAGNETIC FIELDS DURING SOLAR CYCLE 23

The Sun's polar fields are currently ∼40% weaker than they were during the previous three sunspot minima. This weakening has been accompanied by a corresponding decrease in the interplanetary magnetic field (IMF) strength, by a ∼20% shrinkage in the polar coronal-hole areas, and by a reduction in the solar-wind mass flux over the poles. It has also been reflected in coronal streamer structure and the heliospheric current sheet, which only showed the expected flattening into the equatorial plane after sunspot numbers fell to unusually low values in mid-2008. From latitude–time plots of the photospheric field, it has long been apparent that the polar fields are formed through the transport of trailing-polarity flux from the sunspot latitudes to the poles. To address the question of why the polar fields are now so weak, we simulate the evolution of the photospheric field and radial IMF strength from 1965 to the present, employing a surface transport model that includes the effects of active region emergence, differential rotation, supergranular convection, and a poleward bulk flow. We find that the observed evolution can be reproduced if the amplitude of the surface meridional flow is varied by as little as 15% (between 14.5 and 17 m s−1), with the higher average speeds being required during the long cycles 20 and 23.
Risk factors for calculus formation in patients with renal transplants.

OBJECTIVE To investigate the risk factors for stone formation in patients with functioning renal transplants in whom renal calculi develop. PATIENTS AND METHODS Renal calculi developed in six of 178 patients with functioning renal transplants under current review, an incidence of 3%. Risk factors for stone formation were investigated in five of these patients and compared with a randomly selected control group of 41 transplant patients with no stone problems. RESULTS Patients with transplant calculi typically passed smaller volumes of significantly more concentrated and alkaline urine with greater urinary excretion of uric acid (P < 0.05). Urine calcium excretion was also increased. Crystalluria was present in three of five stone formers compared with two of 25 controls. Overall, metabolic abnormalities included hypocitraturia (75%), hyperparathyroidism (36%), hypophosphataemia (24%) and hypercalcaemia (10%). Urinary infection was common (50%) and urinary output of magnesium and phosphate was at the lower end of normal for all patients. CONCLUSION These results suggest a multifactorial aetiology for stone formation in renal transplant recipients. Approaches to prevention and management are discussed.
Maternal use of selective serotonin‐reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn

Use of selective serotonin reuptake inhibitors (SSRIs) in late pregnancy has been associated with persistent pulmonary hypertension of the newborn (PPHN), a rare condition with substantial infant mortality and morbidity. Although the increase in absolute risk is small on a population level, it may be of concern to many patients. It remains unclear the extent to which the increased risks reported for PPHN are explained by the underlying maternal illness rather than the use of SSRIs.
Disparity‐induced accommodation in late‐onset myopia

The effect of disparity‐vergence on the accommodation response (AR) was measured in 10 late‐onset myopes (LOMs) and 10 emmetropic subjects during the course of a 10 minute near‐vision task (working distance 33cm). Disparity was induced by the introduction of 3 and 6Δ base‐out prisms placed before the right eye, and the resulting AR for the left eye was measured at 1 min intervals using an objective infr‐red optometer. LOMs showed a significant increase in AR with increasing disparity whereas emmetropes showed no significant differnce in AR for all disparity conditions. The implications of these findings are discussed with reference to the aetiology of late‐onset myopia.
Late maturers at a performance disadvantage to their more mature peers in junior Australian football

Abstract Children and adolescents mature at different rates such that individuals competing in the same competition may differ in physical and biological maturity despite being of similar chronological age. Whether or not differences translate into on-field performance in competition is relatively unknown. This study investigated the influence of biological maturity on fitness and match running performance in junior Australian football. Eighty-seven under-15 years players were categorised into early (n = 20), average (n = 45) and late (n = 22) maturity groups based on self-reported and anthropometric assessment of biological maturity. Running movements during competition were collected using GPS (5 Hz) technology. Early maturers were heavier and taller than all other boys (P < 0.05), while biological maturity was significantly correlated to 20 m sprint (r = 0.53, P < 0.01). Total distance, high-intensity (>14.4 km · h−1) running distance and number of high-intensity efforts were significantly greater (20.8%, 53.6%, 31.7%, respectively; P < 0.01) in early compared to late maturers. Number of sprints and peak speed in competition were not different. Pubertal development and maturity status partially explained the differences between players in physical size, functional running fitness and match running performance. Late maturing players in this Australian football under-15 age group were at a physical and performance disadvantage to their earlier maturing peers.
Comparative Study of Conventional, Fuzzy Logic and Neural PID Speed Controllers with Torque Ripple Minimization for an Axial Magnetic Flux Switched Reluctance Motor

Three speed controllers for an axial magnetic flux switched reluctance motor with only one stator, are described and experimentally tested. As it is known, when current pulses are imposed in their windings, high ripple torque is obtained. In order to reduce this ripple, a control strategy with modified current shapes is proposed. A workbench consisting of a machine prototype and the control system based on a microcontroller was built. These controllers were: a conventional PID, a fuzzy logic PID and a neural PID type. From experimental results, the effective reduction of the torque ripple was confirmed and the performance of the controllers was compared.
Does an unspecified cosmological constant solve the problem of time in quantum gravity?

In unimodular gravity, an unspecified cosmological constant appears as a variable canonically conjugate to a four-volume variable, the cosmological time. It was suggested that this time sets the conditions of quantum measurements and solves thereby the interpretation problems of quantum geometrodynamics. By analyzing the relationship of the cosmological time to hypertime (the collection of spacelike hypersurface), we highlight the difficulties of such a position.
Airborne total gaseous mercury and exposure in a Venezuelan mining area

Abstract This paper presents a short-term monitoring study of total gaseous mercury (TGM) in air, and exposure to airborne mercury. The evaluation was carried out in polluted mining sites (El Callao, Venezuela), where for decades mercury has been used in diverse stages of gold mining activities. The contamination is mainly due to emission of Hg0 during gold amalgamation and burning, which can cause direct human health risks. Total gaseous mercury (TGM) in air was analysed in mill, jewellery and indoor house sites, and at different heights (height profiles near the surface) at polluted and not polluted sites. Mercury concentration in air was measured with a portable mercury analyser (Lumex Ra-915+). Time weighted average mercury (TWA) was calculated for the evaluation of mercury exposure. TWA values ranged between 0.28 µg m−3 and >100 µg m−3. These measurements were done during sunny and dry days. In the case of mills and gold workshops, the values were over the limit recommended by the World Health Organization to exposure (25 µg m−3) and NIOSH limit (50 µg m−3). Indoors in a house, the air Hg average value was 2.58 µg m−3 exceeding EPA (0.3 µg m−3) and ATSDR (1 µg m−3) guidelines. The mercury concentration at different height profiles, varied between 1766 µg m−3 and 0.014 µg m−3. Mercury height profiles were described by a power function model of the form c(Hg) = ah−b, where a parameter describes the magnitude of Hg emission. For polluted sites there was a significant correlation between a and Hg in soil or Hg emission from soil to air, while b is only significantly correlated with air temperature. An air and soil mercury measurement transect was carried out at a mill site up to a distance of 1000 m, and it was observed that the air mercury concentration decreases with increasing distance from the mill site, and inversely to Hg soil content.
Mammalian target of rapamycin, insulin resistance and hidradenitis suppurativa: a possible metabolic loop

mosomal STS was detectable by fluorescent in situ hybridization analysis, suggesting no gross deletion of the STS locus. Suspecting the possible involvement of minor mutation(s), all the 10 exons of STS were sequenced, revealing that each patient had different single nucleotide substitutions in close proximity within exon 7. Patient 1 had a T>G substitution at nucleotide 1049, changing a valine to a glycine (c.1049T>G, p.V350G; Fig. 1e), whereas patient 2 had a G>A substitution at nucleotide 1075, changing a glycine to an arginine (c.1075G>A, p.G359R; Fig. 1f). The possibility of polymorphism was excluded using a world-wide SNPs database. To date, 20 point mutations of STS, including those reported here, have been identified in XLRI (Fig. 2b). Of these, 15 (75%) were missense mutations and the remaining 5 (25%) were nonsense mutations. The majority of these mutations (18/20, 90%) were localized exclusively within the downstream of exon 7, supporting the hypothesis that this region is essential for in vivo enzyme activity. More precisely, STS protein has 26 substrate binding and 10 catalytic sites that are highly homologous to those in other sulfatase family members, aryl sulfatase A and B. These characteristic amino acids are indispensable for maintenance of the tertiary structure, substrate binding/scaffolding and catalytic activity. Nevertheless, none of these functional amino acids, except two substrate binding sites (T165 and E349), relate to the 20 STS point mutations. Combining these assumptions with the considerably high incidence of complete STS deletion in XLRI, it is conceivable that STS point mutations sufficiently affect the baseline enzymatic activity to elicit the development of the disease. To look for mutation-specific conformational alterations, we aligned the secondary and tertiary structures of STS (Fig. 2c,d). It comprises tandem transmembrane domains across the cytoplasmic domain within exon 5, two post-translational glycosylation sites, five Ca binding sites and six disulphide bonds, thereby forming the ‘mushroom-like’ configuration embedded into the lumenal membrane of the endoplasmic reticulum. Interestingly, all mutations were clustered within the lumen side, but not within the transmembrane or cytoplasmic domains (Fig. 2d), indicating that the lumenal portion of STS is highly sensitive to the transversion of a single amino acid, albeit to a lesser extent with basic secondary structures (e.g. a-helices; Fig. 2b). Collectively, STS point mutations demonstrate restricted localization, causing efficient impairment of the corresponding enzyme activity, and are more unlikely to be responsible for the phenotypic heterogeneity in XLRI subjects.