Miracle-dz/UniFAR-FTUs huggingface dataset:
Exploring Scholarship and the Emergency Medicine Educator: A Workforce Study

Introduction Recent literature calls for initiatives to improve the quality of education studies and support faculty in approaching educational problems in a scholarly manner. Understanding the emergency medicine (EM) educator workforce is a crucial precursor to developing policies to support educators and promote education scholarship in EM. This study aims to illuminate the current workforce model for the academic EM educator. Methods Program leadership at EM training programs completed an online survey consisting of multiple choice, completion, and free-response type items. We calculated and reported descriptive statistics. Results 112 programs participated. Mean number of core faculty/program: 16.02 ± 7.83 [14.53–17.5]. Mean number of faculty full-time equivalents (FTEs)/program dedicated to education is 6.92 ± 4.92 [5.87–7.98], including (mean FTE): Vice chair for education (0.25); director of medical education (0.13); education fellowship director (0.2); residency program director (0.83); associate residency director (0.94); assistant residency director (1.1); medical student clerkship director (0.8); assistant/associate clerkship director (0.28); simulation fellowship director (0.11); simulation director (0.42); director of faculty development (0.13). Mean number of FTEs/program for education administrative support is 2.34 ± 1.1 [2.13–2.61]. Determination of clinical hours varied; 38.75% of programs had personnel with education research expertise. Conclusion Education faculty represent about 43% of the core faculty workforce. Many programs do not have the full spectrum of education leadership roles and educational faculty divide their time among multiple important academic roles. Clinical requirements vary. Many departments lack personnel with expertise in education research. This information may inform interventions to promote education scholarship.
Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio as Prognostic Predictors for Hepatocellular Carcinoma Patients with Various Treatments: a Meta-Analysis and Systematic Review

Background/Aims: Systemic inflammatory response (SIR) is widely considered as a preoperative risk factor for hepatocellular carcinoma (HCC) outcomes. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), two of the prognostic indices, have been investigated in post-therapeutic recurrence and survival of HCC. Here, we quantify the prognostic value of these two biomarkers and evaluate their consistency in different HCC therapies. Methods: A systematic review of electronic database of the Web of Science, Embase, PubMed and the Cochrane Library was conducted to search for associations between the NLR and PLR in the blood and clinical outcomes of HCC. Overall survival (OS) and recurrence-free survival (RFS) were the primary outcomes, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were explored as effect measures. Subgroup analyses were performed to explore the heterogeneity of different therapies. Results: A total of 24 articles comprising 6318 patients were included in the meta-analysis. Overall, the pooled outcomes revealed that a high NLR before treatment predicted a poor OS (HR: 1.54, 95% CI: 1.34 to 1.76, p<0.001) and poor RFS (HR: 1.45, 95% CI: 1.16 to 1.82, p=0.001). Moreover, an increased PLR predicted a poor OS (HR: 1.63, 95% CI: 1.34 to 1.98, p<0.001) and earlier HCC recurrence (HR: 1.52, 95% CI: 1.21 to 1.91, p<0.001). In addition, both the NLR and PLR were identified as independent risk factors for predicting OS and RFS in HCC patients in a subgroup analysis of different treatment types, including curative or palliative therapy; however, these results were not found in the sorafenib subgroup due to limited clinical research. Conclusion: An increased NLR or PLR indicated poor outcomes for patients with HCC. The NLR and PLR may be considered as reliable and inexpensive biomarkers for making clinical decisions regarding HCC treatment.
Acute S100B in serum is associated with cognitive symptoms and memory performance 4 months after paediatric mild traumatic brain injury

Abstract Objective: This study explored whether acute serum marker S100B is related with post-concussive symptoms (PCS) and neuropsychological performance 4 months after paediatric mild traumatic brain injury (mTBI). Research design and methods: This prospective short-term longitudinal study investigated children (aged 6–16 years) with mTBI (n = 36, 16 males) and children with orthopaedic injuries (OI, n = 27, 18 males) as a control group. S100B in serum was measured during the acute phase and was correlated with parent-rated PCS and neuropsychological performance 4 months after the injury. Main outcomes and results: The results revealed no between-group difference regarding acute S100B serum concentration. In children after mTBI, group-specific significant Spearman correlations were found between S100B and post-acute cognitive PCS (r = 0.54, p = 0.001) as well as S100B and verbal memory performance (r = −0.47, p = 0.006). In children after OI, there were insignificant positive relations between S100B and post-acute somatic PCS. In addition, insignificant positive correlations were found between neuropsychological outcome and S100B in children after OI. Conclusions: S100B was not specific for mild brain injuries and may also be elevated after OI. The group-specific association between S100B and ongoing cognitive PCS in children after mTBI should motivate to examine further the role of S100B as a diagnostic biomarker in paediatric mTBI.
Vascular Reactivity in Preeclampsia Assessed Noninvasively Using Maternal Brachial Artery Hyperemic Response

OBJECTIVE: To estimate if women with preeclampsia had measurable differences in the brachial artery waveforms after blood flow occlusion. METHODS: In a cross-sectional study, 14 preeclamptic and 28 matched normotensive women were assessed. Hemolysis, elevated liver enzymes, low platelets syndrome patients were excluded. All patients had baseline brachial Doppler flow velocities while resting in the left lateral position and after a 60-second forearm occlusion. Doppler waveforms were analyzed from the brachial artery 30–45 seconds after the release of the blood pressure cuff. We analyzed the classical Doppler waveform parameters of systolic diastolic, mean velocity and pulsatility index, time taken to achieve peak systolic velocity, systolic acceleration time, the percentage of time in each cycle to achieve peak systolic velocity, and systolic acceleration from 3 waveforms. Comparison of the percentage change in each of these parameters between the groups was done using t tests. RESULTS: Before brachial artery occlusion, systolic acceleration time was significantly less in the preeclamptic group (77.5 ± 14.4 milliseconds versus 93.2 ± 11.7 milliseconds; (P < .001). After occlusion, the percentage change in the systolic acceleration and systolic acceleration time was increased in the normotensive group (P < .001). CONCLUSION: There was significantly increased impedance to blood flow downstream assessed by Doppler waveform analysis after a period of forearm ischemia (blood pressure occlusion) in the women with preeclampsia. LEVEL OF EVIDENCE: II-1
Population attributable risk estimates for risk factors associated with hypertension in an Indian population

Background: Little evidence exists regarding the magnitude of contribution of risk factors associated with hypertension in India. Determination of potentially modifiable risk factors is necessary to focus prevention strategies. Design: Age-matched case–control study. Methods: A total of 350 hypertensive cases and 350 controls of both sexes in the age group 20–65 years. Hypertension was defined according to JNC VII criteria. Adjusted odds ratio (OR) and population attributable risk percentage (PAR %) for hypertension were calculated. Results: In multivariate analysis, tobacco users (either tobacco chewing/smoking or both) (adjusted OR 5.1, 95% CI 3.6–7.3), tobacco chewing (adjusted OR 3.2, 95% CI 2.2–4.6), smoking (adjusted OR 2.9, 95% CI 1.9–4.4), and alcohol consumption (adjusted OR 1.5, 95% CI 1.1–2.2) was the strongest determinants of hypertension. A dose–response relation was found between the number of cigarettes smoked per day (χ2 for trend = 26.07; p < 0.0001) and the amount of alcohol consumption per day (χ2 for trend = 24.26; p < 0.0001) and the risk of hypertension. PARs were 70.3% (95% CI 63.0–77.5) for tobacco use, 45.3% (95% CI 37.1–53.4) for tobacco chewing, 31.5% (95% CI 21.3–40.9) for smoking, and 33.6% (95% CI 22.9–44.4) for alcohol consumption. Conclusion: Our results indicate that incident hypertension cases are largely attributable to the habit of tobacco use and alcohol consumption. Therefore, changing these selected lifestyle factors needs to be prioritized as a major strategy for reducing incidence of hypertension in our population.
Immature nicastrin stabilizes APH‐1 independent of PEN‐2 and presenilin: identification of nicastrin mutants that selectively interact with APH‐1

γ‐Secretase is a high molecular mass aspartyl protease complex composed of presenilin (PS1 or PS2), nicastrin (Nct), anterior pharynx‐defective‐1 (APH‐1) and presenilin enhancer‐2 (PEN‐2). The complex mediates the intramembraneous proteolysis of β‐secretase cleaved β‐amyloid precursor protein (APP) leading to the secretion of the Alzheimer's disease‐associated amyloid β‐peptide (Aβ). In order to dissect functionally important domains of Nct required for γ‐secretase complex assembly, maturation, and activity we mutated evolutionary conserved amino acids. The mutant Nct variants were expressed in a cellular background with significantly reduced endogenous Nct. Mutant Nct was functionally investigated by its ability to restore PS, APH‐1 and PEN‐2 expression as well as by monitoring the accumulation of the APP C‐terminal fragments, the immediate substrates of γ‐secretase. We identified three independent mutations within the ectodomain of Nct, which rescued expression of APH‐1 but not of PEN‐2 or PS and thus failed to restore γ‐secretase activity. Interestingly, these immature Nct variants selectively bound to APH‐1, suggesting a stable Nct/APH−1 interaction independent of PS and PEN‐2. Consistent with this finding, expression of APH‐1 remained largely unaffected in the PS double knock‐out and immature Nct co‐immunoprecipitated with APH‐1 in the absence of PS and PEN‐2. Taken together, our findings suggest that immature Nct can stably interact with APH‐1 to form a potential scaffold for binding of PS and PEN‐2. Moreover, binding of the latter two complex partners critically depends on the integrity of the Nct ectodomain.
Mitochondrial DNA Analysis of the Domestic Dog: Control Region Variation Within and Among Breeds

ABSTRACT: The mitochondrial DNA (mtDNA) control regions of 125 domestic dogs (Canis familiaris) encompassing 43 breeds, as well as one coyote and two wolves were sequenced and subsequently examined for sequence variation in an effort to construct a reference dog mtDNA data set for forensic analysis. Forty informative variable sites were identified that described 45 haplotypes, 29 of which were observed only once. Substantial variation was found both within and among breeds in the mtDNA derived from tissue, indicating that analysis of the mtDNA derived from dog hairs could be a valuable, discriminating piece of evidence in forensic investigations. The dog data set single nucleotide polymorphisms (SNPs) ranged from having one to six changes on a phylogenetic tree. On average, there were 1.9 character changes for each variable position on the tree. The most variable sites (with four or more changes each, listed from the most changes to the fewest) observed were 15,639 (L=6), 16,672 (L=5), 15,955 (L=4), 15,627 (L=3), 16,431 (L=3), and 16,439 (L=3). These sites were consistent with other reports on variable positions in the dog mtDNA genome. A total of 26 SNPs were chosen to best identify all major clusters in the domestic dog data set. The descriptive analyses revealed that this data set is similar to other published canine data sets and further demonstrates that this domestic dog data set is a useful resource for forensic applications. This reference data set has been compiled and validated against the published dog genetic literature with an aim to aid forensic investigations that seek to incorporate mtDNA sequences and SNPs from trace evidence such as dog hair.
Bone mineral loss and recovery after 17 weeks of bed rest

The purpose of this work was to determine the rate and extent of bone loss and recovery from long‐term disuse and in particular from disuse after exposure to weightlessness. For this purpose, bed rest is used to simulate the reduced stress and strain on the skeleton. This study reports on the bone loss and recovery after 17 weeks of continuous bed rest and 6 months of reambulation in six normal male volunteers. Bone regions measured were the lumbar spine, hip, tibia, forearm, calcaneus, total body, and segmental regions from the total‐body scan. The total body, lumbar spine, femoral neck, trochanter, tibia, and calcaneus demonstrated significant loss, p < 0.05. Expressed as the percentage change from baseline, these were 1.4, 3.9, 3.6, 4.6, 2.2, and 10.4, respectively. Although several areas showed positive slopes during reambulation, only the calcaneus was significant (p < 0.05), with nearly 100% recovery. Segmental analysis of the total‐body scans showed significant loss (p < 0.05) in the lumbar spine, total spine, pelvis, trunk, and legs. During reambulation, the majority of the regions demonstrated positive slopes, although only the pelvis and trunk were significant (p < 0.05). Potential redistribution of bone mineral was observed: during bed rest the bone mineral increased in the skull of all subjects. The change in total BMD and calcium from calcium balance were significantly (p < 0.05) correlated, R = 0.88.
Photogrammetric Analysis of Palpebral Fissure Dimensions and its Position in Malaysian South Indian Ethnic Adults by Gender

Background: Anthropometric data describing the palpebral fissure and its position is available for various populations. Unfortunately there is no data available for Malaysian South Indian. Aim: The present study was undertaken to determine the normative values for Malaysian South Indian according to gender. Materials and Methods: Anthropometric measurement was done on standardized photographs taken from 300 MSI aged 18-26 years. The parameters were measured using computerized software. Results: Significant sexual difference was observed in all parameters except canthal index, which includes palpebral fissure width (male, 30.9 mm; female, 29.62 mm), palpebral fissure height (male, 11.06 mm; female, 11.48 mm), palpebral fissure inclination (male, 4.72°; female, 7.04°), outercanthal distance (male, 97.15 mm; female, 91.78 mm), interpupillary distance (male, 68.09 mm; female, 63.6 mm), intercanthal distance (male, 34.1 mm; female, 32.77 mm), and canthal index (male, 35.22 mm; female, 35.86±4.44 mm). Conclusions: Sexual dimorphism was found in all parameters. Comparison of our results with other studies revealed the variation and similarities in key parameters. Establishing normative values and understanding the facial morphology of different ethnic groups is important in designing the treatment planning for an aesthetic oculoplastic procedure.
Histopathologic and Ultrastructural Alterations of White Liver Disease in Sheep Experimentally Depleted of Cobalt

Many cobalt-deficient sheep develop liver lesions known as ovine "white liver" disease, but the etiology of these changes is controversial. It has been suggested that cofactors are required for development of liver damage in cobalt-deficient sheep. In this study, one group of lambs (n=5) was fed a diet low in cobalt (4.5 μg/kg) while a group of control lambs (n=4) received the same diet after it had been supplemented with cobalt (1000 μg/kg). All cobalt-depleted lambs had reduced growth rate, anorexia, lacrimation, and alopecia, and they eventually became emaciated (mean body weight at end of study: 83% of initial body weight). Plasma concentrations of bilirubin and serum activity of glutamate-oxaloacetate transferase were elevated in these animals, while plasma concentrations of vitamin B12 were reduced (less than 220 pmol/L from day 42). Fatty degeneration of the liver associated with reduced concentrations of vitamin B12 (14.5 pmol/g) was seen in these animals at necropsy at 196 days. Microscopic liver lesions included accumulation of lipid droplets and lipofuscin particles in hepatocytes, dissociation and necrosis of hepatocytes, and sparse infiltration by neutrophils, macrophages, and lymphocytes. Ultrastructural hepatocytic alterations included swelling, condensation and proliferation of mitochondria, hypertrophy of smooth endoplasmic reticulum, vesiculation and loss of arrays of rough endoplasmic reticulum, and accumulation of lipid droplets and lipofuscin granules in cytoplasm of hepatocytes. No liver lesions were seen in control lambs. The results of this study indicate that cofactors are not a prerequisite to development of hepatic damage in cobalt-deficient sheep. Reduced activities of the vitamin B12-dependent enzymes, methylmalonyl CoA mutase and methionine synthase, and lipid peroxidation are of likely pathogenetic importance in the development of the lesions.
Identity diffusion and psychopathology: comparison between adult psychiatric patients and normals.

OBJECTIVES This research studied the characteristics of self representations and ego identity in adult psychiatric patients with different mental disorders according to DSM-IV (APA, 1994) and Kernberg's structural criteria for personality organizations (1986). DESIGN AND METHODS We constructed Identity Diffusion Questionnaire (IDQ), a self-report measure based on Kernberg's criteria for identity diffusion (1986), and Actual Self - Ideal Self - Significant Other Scales (AISS), a measure for discrepancies between perceived actual self, ideal self and significant other. Both measurements reached sufficiently internal consistency and construct validity. The sample of 186 adult psychiatric in- and outpatients and 109 controls of both sexes served as subjects in the study. RESULTS All groups of patients reached higher scores on IDQ and AISS compared to healthy controls. Patients revealed more identity problems than normals and they also had bigger discrepancy between actual and ideal self than healthy participants. CONCLUSION These results support psychodynamic and cognitive theories and empirical studies that disturbances in self representations and ego identity are related to many different mental disorders. Results also confirmed the claim that identity disturbances are related to big discrepancies in representation of real and ideal self. The hypothesis that severity of identity diffusion is in a positive correlation with severity of pathology was not confirmed. There may be some uncontrolled factors which influenced the results. Despite some theoretical and methodological limitations the present study confirms the relation between disturbances of ego identity and different psychopathology.
Progressive recovery of learning during regeneration of a single synapse in the medicinal leech

The leech escape reflex—shortening of the body—can change with nonassociative conditioning, including sensitization, habituation, and dishabituation. Capacity for sensitization, which is an enhancement of the reflex, is lost when a single S‐interneuron is ablated, but the reflex response itself remains. In the present experiments, the S‐interneuron's axon in the living leech was filled with 6‐carboxyfluorescein (6‐CF) dye and cut with an argon laser microbeam (λ = 488 nm). In contrast to sham‐operated animals, axotomized preparations did not sensitize, reflecting the key role of the S‐cell. By 2 weeks or more, S‐cell axons had regenerated and reestablished synapses at their usual locations with neighboring S‐cells. By 4 weeks, this restored the ability to sensitize to a level indistinguishable from that of controls, but an intermediate state of recovery was seen from 2–3 weeks after injury—a period not previously examined. The small capacity for sensitization among newly regenerated preparations was significantly lower than in sham controls but appeared higher than in animals whose cut S‐cell axon had not regenerated its synapse. The results confirm the crucial role of the S‐cell in sensitization. Moreover, full sensitization does not occur immediately upon synapse regeneration. J. Comp. Neurol. 457:67–74, 2003. © 2003 Wiley‐Liss, Inc.
Melanocortin‐3 Receptor mRNA Expression in Pro‐Opiomelanocortin Neurones of the Rat Arcuate Nucleus

The melanocortins α‐ and γ‐melanocyte‐stimulating hormones (α‐ and γ‐MSH) derive from the pro‐opiomelanocortin (POMC) precursor. Melanocortins exert a wide range of biological activities in the brain through activation of at least three distinct melanocortin receptor (MC‐R) subtypes. In order to determine whether POMC neurones can modulate their own activity, we looked for the possible expression of the MC3‐R gene in POMC‐positive cell bodies in the rat hypothalamus. In situ hybridization experiments revealed that the density of MC3‐R mRNA is particularly high in the arcuate nucleus which contains the main population of POMC neurones in the brain. The occurrence of MC3‐R mRNA in POMC‐positive cell bodies was demonstrated using a double‐labelling in situ hybridization technique. The proportion of POMC neurones expressing MC3‐R mRNA was significantly higher in the most rostral (43.5%) than in the most posterior part of the arcuate nucleus (8.2%). These results indicate that melanocortins likely exert a direct regulatory feedback on POMC neurones through activation of MC3‐R receptors. Our data also suggest that MC3‐R may be involved in the neuroendocrine responses induced by centrally administered melanocortins.
Twinning in cattle: I. Foundation animals and genetic and environmental effects on twinning rate.

Foundation cows were selected using prior records from one of two sources, private herds or other projects at the Research Center. Comparing twinning rates before and after selection, the repeatability was lower for those from the first (.08) than for those from the second (.16) source with a combined value of . 12. Realized heritability of single-parity twinning rate estimated from selection of parents and response in daughters of foundation females was . 06. Paternal half-sib estimate of heritability of twinning rate was . 02 +/- . 07. Estimates of repeatability computed from calving records of females born in the project indicate that permanent environmental effects on twinning rate in cattle are small. Mean calving rate of females born in the project was 1.11 in the data set that included all data and 1.09 in the data set that excluded females from highly selected parents. Twinning rate was greater (P less than .05) in fall than in spring calving (1.13 vs 1.06). Data on twinning rate of a sample of the Swedish Friesian breed were summarized. Mean twinning rate of the Swedish Friesian breed is 2.57%. Age adjusted mean twinning rate of daughters of 32 half-sib sons of one particular Swedish Frieisan sire averaged 5.4% and ranged from . 9% to 13.6%. There was no indication of a bimodal distribution, which would be expected if a single gene with a major effect on twinning rate were segregating. The estimated genetic standard deviation (sigma-xn) for mean twinning rates of the 32 sire progeny groups was 1.8%. Observed range among son progenies was . 127 or 7.2 sigma-xn, in reasonable agreement with the hypothesis that twinning rate in this population is inherited as a quantitative trait.