Miracle-dz/UniFAR-FTUs huggingface dataset:
Are Internal Medicine Residency Programs Adequately Preparing Physicians to Care for the Baby Boomers? A National Survey from the Association of Directors of Geriatric Academic Programs Status of Geriatrics Workforce Study

Patients aged 65 and older account for 39% of ambulatory visits to internal medicine physicians. This article describes the progress made in training internal medicine residents to care for older Americans. Program directors in internal medicine residency programs accredited by the Accreditation Council for Graduate Medical Education were surveyed in the spring of 2005. Findings from this survey were compared with those from a similar 2002 survey to determine whether any changes had occurred. A 60% response rate was achieved (n=235). In these 3‐year residency training programs, 20 programs (9%) required less than 2 weeks of clinical instruction that was specifically structured to teach geriatric care principles, 48 (21%) at least 2 weeks but less than 4 weeks, 144 (62%) at least 4 weeks but less than 6 weeks, and 21 (9%) required 6 or more weeks. As in 2002, internal medicine residency programs continue to depend on nursing home facilities, geriatric preceptors in nongeriatric clinical ambulatory settings, and outpatient geriatric assessment centers for their geriatrics training. Training was most often offered in a block format. The mean number of physician faculty per residency program dedicated to teaching geriatric medicine was 3.5 full‐time equivalents (FTEs) (range 0–50), compared with a mean of 2.2 FTE faculty in 2002 (P≤.001). Internal medicine educators are continuing to improve the training of residents so that, as they become practicing physicians, they will have the knowledge and skills in geriatric medicine to care for older adults.
Criteria for Evaluating Improvement in Schizophrenia in Psychopharmacological Research (With Special Reference to Gamma Endorphin Fragments)

A review of treatment trials with DTγE revealed widely discrepant results. Relevant variables were the variety of measures employed for monitoring psychotic symptoms, and the different criteria used to judge the degree of improvement. The authors suggest a uniform outcome criterion for early trials of new treatments, which would generate more consistent and comparable results between studies, and give a stronger indication of the value of the treatment under test. When the data from the various treatment trials of DTγE were re analysed, applying a uniform outcome criterion of improvement of a change of 80% or more on rating-scale score, the results were more consistent than would have been suspected from the original reports.
Management of Very Early Fetal Anemia Resulting From Red-Cell Alloimmunization Before 20 Weeks of Gestation

OBJECTIVE: To evaluate the results of management of very early fetal anemia (before 20 weeks of gestation) in cases of red-cell alloimmunization. METHODS: Retrospective study of the outcome of all in utero transfusions performed before 20 weeks of gestation and all pregnancies requiring an in utero transfusion before 20 weeks in our reference center from January 1990 through August 2011 in cases with severe alloimmunization. RESULTS: Twenty-five in utero transfusions were performed in 18 pregnancies in 16 patients during the study period. A vascular access was performed successfully in 22 of the 24 cases in which it was attempted. An intraperitoneal transfusion was necessary in two cases. Two in utero deaths attributable to the intravascular procedure occurred during attempts before 18 weeks of gestation and another, not associated with a transfusion, at 29 weeks. The overall survival rate was 83.3% (compared with 88.0% when the first in utero transfusion took place before 22 weeks). The risk of fetal loss for each transfusion was 8.0% before 20 weeks and 6.3% before 22 weeks. An intraperitoneal transfusion at 17 2/7 weeks allowed one fetus to survive until the first intravascular in utero transfusion could take place at 18 2/7 weeks. CONCLUSION: Fetal anemia before 20 weeks remains at high risk of lethal complications compared with later gestational ages. Technical difficulties in a vascular access are mainly encountered before 18 weeks of gestation. At an earlier gestational age, intraperitoneal transfusion may gain the days necessary to perform an intravascular transfusion more safely. LEVEL OF EVIDENCE: III
What Is an Epidemic? AIDS in Historical Perspective

Like the previous essay, this chapter was a product of the academic world's collective response to AIDS. More generally, however, I was intrigued by the challenge of trying to define and describe an epidemic. We have come to use the term so casually and metaphorically that I felt the logical way to think about the root meaning of epidemic was to see it historically, to create an ideal-typical picture of an epidemic based on repetitive patterns of past events. And in the following pages I have tried to abstract and present the narrative structure of an epidemic as historically experienced. In some ways our generation's encounter with AIDS fits nicely into the dramaturgic pattern I suggest; in other ways recent events have evolved so rapidly that it does not. Within the space of a decade America's perception of AIDS as an acute, epidemic phenomenon has shifted subtly but inexorably: the social identity of this novel ailment has shifted into that of chronic and intractable illness, more akin to tuberculosis than cholera, leukemia than plague. In either guise, however, experience with AIDS has precisely reflected the varied realities that constitute the world's health care system as well as the social-structural and attitudinal factors that have interacted to create patterns of social response to the disease.
The effect of vildagliptin therapy on atherogenic postprandial remnant particles and LDL particle size in subjects with Type 2 diabetes

Dipeptidylpeptidase 4 (DPP-4) inhibitors are recommended as second-line anti-hyperglycaemic therapy after metformin. Cardiovascular endpoint studies with DPP-4 inhibitors are ongoing, but so far a variety of surrogate markers are used to assess cardiovascular benefits of these agents [1]. Our previous study was the first to demonstrate that a DPP-4 inhibitor vildagliptin reduces postprandial plasma triglycerides and chylomicron triglycerides, chylomicron apolipoprotein (apo) B-48 and chylomicron cholesterol, suggesting improvement in the metabolism of postprandial intestinal triglyceride-rich lipoprotein particles [2]. Recently, our findings have been confirmed with sitagliptin [3] and alogliptin [4] therapies suggesting a class effect. It is, however, not known if DPP-4 inhibitors alleviate the atherogenic properties of small postprandial triglyceriderich lipoprotein remnants and if the changes in triglyceriderich lipoprotein metabolism are reflected to LDL particle size. We studied 23 drug-naive subjects with diabetes who underwent an oral fat load before and during vildagliptin 50 mg or placebo twice daily. The fat-rich test meal contained 1000 kcal, 72 g fat (saturated fat 64.5%, monounsaturated fat 30.4%, polyunsaturated fat 5.1%) with a polyunsaturated/saturated fatty acid (P/S) ratio of 0.08, 490 mg cholesterol, 50 g carbohydrate and 35 g protein. We measured remnant-like particle cholesterol, remnant-like particle triglycerides, apoA5 and apoCIII preprandially and 3, 4, 6 and 8 h postprandially and LDL particle size preprandially and 4 h postprandially at week 0 and week 4 during vildagliptin or placebo. ApoA5 and apoCIII were quantified in total plasma by commercial ELISA kits (Millipore Corporation, Bedford, MA, USA and Assaypro, St Charles, MO, USA, respectively). Plasma remnant-like particle cholesterol and remnant-like particle triglycerides were analysed with commercial immunoseparation assay (Otsuka Pharmaceutical, Osaka, Japan). Gradient gel analysis was used to assess LDL particle size [5]. An analysis of covariance (ANCOVA) model including terms for treatment, baseline value and treatment 9 baseline interaction was used for statistical comparisons. Treatment with vildagliptin produced significant reduction in postprandial triglyceride area under the curve by –32% (P = 0.001) and remnant-like particle triglyceride area under the curve by –38% (P = 0.01) from week 0 to week 4, while no change occurred with placebo (+9% and
Effect of Plyometric Training on Lower Limb Biomechanics in Females

Objective:To verify the effects of plyometric training on lower limb kinematics, eccentric hip and knee torques, and functional performance. Design:Cohort study. Setting:Research laboratory. Participants:Thirty-six females were divided into a training group (TG; n = 18) that carried out the plyometric training for 8 weeks, and a control group (CG; n = 18) that carried out no physical training. Interventions:Twenty-four plyometric training sessions during approximately 8 weeks with 3 sessions per week on alternate days. Main Outcomes Measures:Lower limb kinematics (maximum excursion of hip adduction, hip medial rotation, and knee abduction during the single leg squat), eccentric hip (abductor, adductor, medial, and lateral rotator) isokinetic peak torques and knee (flexor and extensor) isokinetic peak torques, and functional performance (triple hop test and the 6-m timed hop test). Results:After 8 weeks, only the TG significantly reduced the values for the maximum excursion of knee abduction (P = 0.01) and hip adduction (P < 0.001). Similarly, only the TG significantly increased the eccentric hip abductor (P < 0.001) and adductor (P = 0.01) torques. Finally, only the TG significantly increased the values in the triple hop test (P < 0.001) and significantly decreased the values in the 6-m timed hop test (P < 0.001) after intervention. Conclusion:Plyometric training alters lower limb kinematics and increases eccentric hip torque and functional performance, suggesting the incorporation of these exercises in preventive programs for ACL injuries.
CLINICOPATHOLOGICAL STUDY IN AN OVINE MODEL OF EXPERIMENTAL ACUTE MYOCARDIAL INFARCTION

Summary To evaluate the prognostic significance of clinicopathological measurement in the diagnosis of acute myocardial infarction (MI) in sheep, acute MI was induced by ligation of left anterior descending coronary artery (LAD). For this purpose, twenty four healthy sheep were divided into the sham-operated or control group (group I, thoracotomy without MI) and the experimental group (group II, with MI) (n=12 in each), then all animals were subjected to the echocardiographic and clinicopathological analysis 2 days post-MI. Echocardiography revealed significant differences in left ventricular end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), LV ejection fraction (LVEF) and LV fractional shortening (LVFS) between groups (P<0.05). In biochemical analysis, the mean values of troponin (Trop), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) increased in the MI group compared with the control group (P<0.05). In conclusion, alterations in echocardiographic and early clinopathological mean values were observed in an ovine model of the experimental acute MI, which could aid researchers in interpreting their results when using this model for MI studies.
Optimizing the bit aspect ratio of a recording system using an information-theoretic criterion

The objective of this work is to find the optimal symbol separation T and track width TW so as to maximize the inlormation density D in bits/inch'. Here D is defined as the information density per unit area of the recording medium where Cid is the i.u. d. channel capacity, i.e., the information rate (in bitslchannel-use) between the channel input and the channel output, assuming that the channel input is a sequence of independent and uniformly distributed (i.u.d.) binary random variables, We fit the datadependent autoregressive (AR) noise model in [I] to the recording channel, and then estimate the i.u. d. channel capacity C,u by computing the i.u. d. capacity ofthe model. The method used to compute the i.u. d. capacity of the data-dependent AR noise model was proposed in.
THE LYOT PROJECT DIRECT IMAGING SURVEY OF SUBSTELLAR COMPANIONS: STATISTICAL ANALYSIS AND INFORMATION FROM NONDETECTIONS

The Lyot project used an optimized Lyot coronagraph with extreme adaptive optics at the 3.63 m Advanced Electro-Optical System telescope to observe 86 stars from 2004 to 2007. In this paper, we give an overview of the survey results and a statistical analysis of the observed nondetections around 58 of our targets to place constraints on the population of substellar companions to nearby stars. The observations did not detect any companion in the substellar regime. Since null results can be as important as detections, we analyzed each observation to determine the characteristics of the companions that can be ruled out. For this purpose, we use a Monte Carlo approach to produce artificial companions and determine their detectability by comparison with the sensitivity curve for each star. All the non-detection results are combined using a Bayesian approach and we provide upper limits on the population of giant exoplanets and brown dwarfs for this sample of stars. Our nondetections confirm the rarity of brown dwarfs around solar-like stars and we constrain the frequency of massive substellar companions (M>40 MJ) at orbital separation between and 10 and 50 AU to be ≲20%.
Perceptions of School Among Childhood Cancer Survivors

The aim was to investigate how childhood cancer survivors perceive school and whether their perceptions differ from corresponding descriptions of peers. Survivors (n = 48) currently attending educational institutions (median 5 years post diagnosis; now aged 12-21 years) from a national cohort of school-age children were compared with matched peers (n = 47). Data were collected through interviews and analyzed qualitatively and quantitatively. The results indicate that survivors and peers perceive school similarly; almost 90% described high well-being in school and indicated that they were motivated and received no additional tutoring; approximately 60% reported no difficulties achieving learning objectives. A few differences were found; survivors described themselves as more satisfied with their academic performance and school environment, but less satisfied with friends, than peers did. Previous treatment with radiation was associated with lower academic satisfaction among survivors. It is suggested that survivors perceive school overall as positive and do not have more problems reaching educational goals than their peers. However, quality of relationships with friends needs further investigation.
Intention to treat analysis: how frequently is it used in ENT randomised controlled trials?

As per the CONsolidated Standards Of Reporting Trials (CONSORT), authors reporting randomised controlled trials (RCT) are required to indicate the analytic approach used in their trials. In a survey of reports of RCT in medical journals conducted by Hollis et al. in 1997, it was shown that the intention to treat approach is inadequately applied. Intention to treat (ITT) analysis is a method of analysis in randomised trials whereby patients randomly assigned to one of the treatment arms are all analysed together irrespective of whether they complete ⁄ receive this treatment or not. This strategy helps to maintain the principle benefits of randomisation and allows non-compliance by participants and deviations from protocols to be taken into account during analysis. This is especially important in pragmatic trials, which are designed to find out how effective a treatment is in routine clinical practice. On the other hand, an explanatory trial is designed to find the efficacy of a treatment under ideal, experimental conditions. Whereas an ITT analysis in this trial design is also useful, it is not always mandatory. For example, if the protocol violations are significantly large, the analysis could also be done on per protocol or as treated basis to find the efficacy of the intervention under investigation. Per protocol analysis (PPA) is a method of analysing only subjects who have strictly followed the protocol and as treated analysis analyses all subjects who have received one kind of intervention irrespective of their initial randomisation. However, these results cannot be generalised to everyday practice. Hampton has described an excellent method of presenting results in trials with withdrawals, which is documented by Pocock in his book on clinical trials. In this, he mentions including all patients in the main analysis followed by an additional analysis providing separate comparison for those continuing the trial and for those withdrawn. This can provide further insight into the effect of withdrawals on the results. Any deviation from randomised allocation in a clinical trial setting could lead to unavailable data for analysis, i.e. missing values. ITT analysis can be applied easily when complete data set is available for all randomised participants. However, protocol deviations do frequently occur in routine clinical practice, hence, it is extremely important to consider this when estimating effectiveness of treatment under investigation in the clinical setting. To follow the principles of ITT analysis, it is essential to minimise the missing values. There is no consensus on how to handle these missing values, different methods being appropriate in different settings.
An integrative review of American nurses' perceived cultural self-efficacy.

PURPOSE To review use of the Cultural Self-Efficacy Scale (CSES) and to summarize the cumulative findings. METHODS A combination of literature searches and questionnaires to those who have requested the scale indicated 26 known uses. Fifteen reported sufficient data for statistical analysis. FINDINGS Of the 26 known uses of the CSES, 8 were published in peer-reviewed journals, 5 in dissertations, 8 in theses, and 3 as data sets only. Two additional theses were not retrievable for the study. On a 5-point Likert-type scale, nurses reported the highest degree of self-efficacy with African American (3.1) and Hispanic (3.1) patients and the lowest with Asian American patients (2.4). Six of the reports include Cronbach's alpha coefficients, ranging from . 86 to . 98. In the final sample of 15 studies, nurses did not report feeling confident caring for patients from other cultures. CONCLUSIONS Although the CSES has been used in many settings with over 3,000 nurses, inconsistencies in the data preclude specific conclusions. Further research is needed using consistent reporting practices and sufficient predictor variables to draw further conclusions regarding the scale's psychometric properties.
Explicit Solutions for Optimal Stopping of Linear Diffusion and its Maximum

We provide, in a general setting, explicit solutions for optimal stopping problems that involve diffusion process and its running maximum. Our approach is to use the excursion theory for Levy processes. Since general diffusions are, in particular, not of independent increments, we use an appropriate measure change to make the process have that property. Then we rewrite the original two-dimensional problem as an infinite number of one-dimensional ones and complete the solution. We show general solution methods with explicit value functions and corresponding optimal strategies, illustrating them by some examples.
A novel distributed fair relay selection strategy for cooperative wireless system

In this paper, we design a distributed relay selection strategy to achieve equal power consumption for all available relay nodes in AF cooperative system. This strategy gives a closed-form expression for the weight coefficient introduced to achieve the required fairness. It aims to reduce the complexity of the conventional centralized strategy that also tries to divide the total consumed power equally among the relay nodes but requires a knowledge of the average signal-to-noise ratios (SNRs) of the relay path for all relay nodes, a central controller, and a numerical equation-solving method to find the corresponding weight coefficient for each relay node. We show that our distributed strategy can divide the power consumption fairly and approach the equal average power consumption when only the average SNRs of the relay path are known locally. Also we show that our proposed strategy still provides similar outage probability as that provided by the conventional one.
Age-related differences in the timing of stimulus and response processes during visual selective attention: performance and psychophysiological analyses.

In this study, age-related differences in the selection of visual information were investigated. Two groups of younger and older subjects performed focused- and divided-attention (i.e., visual search) tasks. In the focused-attention task, centrally presented target letters could be flanked by compatible or incompatible noise letters. In the visual-search task, targets could be cued or uncued, and target locations could be spatially compatible or incompatible with the responding hand. P3 latency, lateralized readiness potentials, the electromyogram, and reaction times were used to detect possible age-related differences in the timing of stimulus- and response-related processes during selective processing of information. In the focused-attention task, performance of older subjects showed greater interference by incompatible flankers than did that of younger subjects because of stronger response competition caused by partial activation of the incorrect response channel by the incompatible flankers. No evidence was found of specific age-related differences in the efficiency of visual search in a divided-attention task. Furthermore, in both tasks, younger subjects showed an earlier start of response execution (in the electromyogram) relative to the onset of response preparation (lateralized readiness potential) and a higher percentage of incorrect electromyographic activity than did older subjects.
Resistant Starch Contents and the in Vitro Starch Digestibility of Thai Starchy Foods

Samples from 29 starchy foods and 11 cultivars of banana were analyzed for their contents of resistant starch (RS), digestible starch and total starch, as well as the in vitro starch digestibility. The RS analysis was based on a-amylase and amyloglucosidase hydrolysis followed by colorimetric assay of the glucose released. The results showed that the main RS sources were found in the legume group (10.3 ± 1.2% to 22.9 ± 0.0%), glass noodle products (9.1 ± 0.8% to 11.3 ± 1.5%) and bananas (52.2 ± 4.1% to 61.4 ± 2.3%). For the rice group, the effect of processing methods on the retrograded RS formation was investigated. Khanomjean produced with fermentation had a higher RS content (8.5 ± 1.1%) than that of the cooked white rice of the high-amylose cultivar. With the rice snacks, the process for puffing kaotung and kaokreupvor by frying and roasting produced a higher RS content (2.6 ± 0.0% and 2.9 ± 0.3%, respectively) than in the raw samples. Among the rice noodles, vermicelli contained a higher RS content than the others. Moreover, a gelatinization effect on the RS contents was clearly evident, with the gelatinized cassava starch (2.2 ± 0.0%) having a lower RS content than the commercial starch (44.6 ± 0.3%), whereas the commercial RS content was high (58.5%). Finally, the test on in vitro starch digestibility showed that the legume samples, particularly with red beans, had the lowest rate of starch digestibility compared to the other samples.