Miracle-dz/UniFAR-FTUs huggingface dataset:
Survey of Physician Well-Being and Health Behaviors at an Academic Medical Center

Abstract Purpose: The study aims were to ascertain, among attending and house staff at a single academic medical center, the prevalence of and risk factors for psychiatric symptoms and disorders and for personal health behaviors. Methods: A self-administered, anonymous 72-item survey of physicians was conducted in February 2003. Results: Response rate was 37.6%. The prevalence of current depressive symptoms was 29%. AUDIT scores consistent with high likelihood of harmful alcohol consumption were prevalent in 6%. Almost 5% acknowledged use of sedatives or hypnotics without a prescription in the prior 12 months. Characteristics independently associated with current depressive symptoms included: living alone, full time salaried faculty status, not having a primary care physician, female sex, and age < 50 years. Factors associated with high risk of harmful alcohol consumption included: male sex, house staff status, and not being exclusively heterosexual. Conclusions: The prevalence of recent depressive symptoms among responding physicians was nearly 30%. Interventions to engage physicians in primary care relationships and social support to confidentially disclose potentially stigmatizing characteristics may facilitate earlier case finding of those at risk for depression, suicide, and substance abuse
Cross-year peer tutoring on internal medicine wards: Effects on self-assessed clinical competencies–A group control design study

Background: Peer-assisted learning (PAL) has become a well-accepted teaching method within medical education. However, descriptions of on-ward PAL programmes are rare. We introduced a PAL programme with a focus on clinical competencies on internal medicine wards. Aims: To assess the effects of an on-ward PAL programme on self-assessed clinical competencies. Method: A total of 168 medical students were randomly assigned to one of the seven intervention wards or one of the seven control wards. During their 5-week ward-placement, the intervention group (IG; n = 88) received 10 patient-centred tutorials lead by final year tutors: (I) history taking, (II) physical examination, (III) blood withdrawal, (IV) infusion, (V) patient files, (VI and VII) ECG, (VIII–X) chart rounds. The control group (CG; n = 80) did not take part in the PAL programme. Clinical competencies were self-assessed pre- and post-intervention. Results: For five of the ten assessed clinical competencies, increases in self-confidence ratings were significantly higher in the IG as compared to CG. Conclusions: Results provide preliminary evidence to suggest that PAL programmes on internal medicine wards and with final year students as peer tutors may represent a valuable additional tool within medical clerkships. However, the findings must be confirmed and clarified in further research.
Tessellating the Moduli Space of Strictly Convex Projective Structures on the Once-Punctured Torus

ABSTRACT We show that associating the Euclidean cell decomposition due to Cooper and Long to each point of the moduli space of marked strictly convex real projective structures of finite volume on the once-punctured torus gives this moduli space a natural cell decomposition. The proof makes use of coordinates due to Fock and Goncharov, the action of the mapping class group as well as algorithmic real algebraic geometry. We also show that the decorated moduli space of marked strictly convex real projective structures of finite volume on the thrice-punctured sphere has a natural cell decomposition.
Cervical Spine Ligament Injury during Simulated Frontal Impact

Study Design. The supraspinous and interspinous ligaments, ligamentum flavum, and capsular and posterior longitudinal ligament strains were monitored during simulated frontal impact of whole cervical spine specimens with muscle force replication and compared with corresponding physiologic strain limits. Objectives. To quantify the strains in the cervical spine ligaments during simulated frontal impact and investigate injury mechanisms. Summary of Background Data. Clinical and biomechanical studies have documented injuries to cervical spine ligaments during frontal impact. There are no biomechanical studies investigating subfailure injury mechanisms to these ligaments during simulated frontal impacts of increasing severity. Methods. The whole cervical spine with muscle force replication model and a bench-top sled were used to simulate frontal impacts at 4, 6, 8, and 10g horizontal accelerations of the T1 vertebra. The peak ligament strains during frontal impacts were compared with physiologic strain limits determined during intact flexibility testing. Results. Significant increases (P < 0.05) in the supraspinous and interspinous ligaments and the ligamentum flavum strains beyond physiologic limits were observed throughout the cervical spine, with the highest strains occurring at C3–C4. Significant increases were observed in the capsular ligament strains only during the 10g impact, whereas the posterior longitudinal ligament strains did not exceed physiologic limits. Conclusions. The supraspinous and interspinous ligaments and the ligamentum flavum may be at risk for injury due to excessive strains during frontal impacts.
The benefit of laparoscopic partial nephrectomy in high body mass index patients.

OBJECTIVE The aims of the present study were to evaluate the effect of body mass index on the surgical outcomes of open partial nephrectomy and laparoscopic partial nephrectomy, and to analyze whether higher body mass index patients may derive greater benefit from laparoscopic partial nephrectomy. METHODS We reviewed 110 patients who underwent open partial nephrectomy and 47 patients who underwent laparoscopic partial nephrectomy at our institution. We analyzed the data to determine what kind of factor would be associated with prolonged operative time, increased estimated blood loss and prolonged ischemic time, and compared the result of open partial nephrectomy with that of laparoscopic partial nephrectomy. RESULTS A statistically significant correlation was observed between body mass index and operative time or estimated blood loss in open partial nephrectomy. Multivariate analysis also demonstrated that body mass index was an independent predictor for prolonged operative time and higher estimated blood loss in open partial nephrectomy, but not in laparoscopic partial nephrectomy. In the normal body mass index group (body mass index<25.0 kg/m2), although mean operative time in the laparoscopic partial nephrectomy group was significantly longer than that in the open partial nephrectomy group, the difference was relatively small. In the high body mass index group (body mass index≥25.0 kg/m2), the mean operative time of the two groups was not statistically different. The estimated blood loss of open partial nephrectomy was significantly higher than that of laparoscopic partial nephrectomy in both groups. In both operative procedures, tumor size was an independent predictor for prolonged ischemic time in multivariate analysis. CONCLUSIONS Body mass index was an independent predictor for prolonged operative time and higher estimated blood loss in open partial nephrectomy but not in laparoscopic partial nephrectomy. Laparoscopic partial nephrectomy was less influenced by body mass index and had a greater benefit, especially in high body mass index patients.
Effect of memory support and elicited production on fast mapping of new words by adolescents with Down syndrome.

PURPOSE The purpose of this study was to determine whether memory support and elicited production differentially benefited fast mapping of new vocabulary (comprehension, production accuracy, and speed) in adolescents with Down syndrome (DS) compared with typically developing (TD) children matched for syntax comprehension. The study also examined predictors of individual difference within groups. METHOD The ability of 19 adolescents with DS to fast map new noun vocabulary was compared with 18 TD children matched for syntax comprehension. The effects of memory support (5 examiner repetitions of the novel word vs. 1) and elicited production (2 repetitions by child vs. none) were evaluated in a repeated-measures design with counterbalancing of tasks. RESULTS For novel word comprehension, low memory support impaired the TD but not DS participants. DS participants were slower to respond correctly in all conditions but benefited more from memory support than TD participants in speed of response. For novel word production, high memory support benefited all participants in the no-elicited-production condition. Elicited production improved performance equally in the 2 memory conditions. Standard comprehension measures predicted fast-mapped comprehension: vocabulary in the case of the DS group, syntax in the case of the TD group. Auditory short-term memory measures predicted fast-mapped production in the TD group but not the DS group. Hearing and grammatical morpheme comprehension predicted novel word production in the DS group. CONCLUSIONS DS participants' speed of comprehension of fast-mapped words was differentially increased compared with the TD syntax-comprehension-matched group, by memory support. Elicited production improved production fast-mapping for all participants, and memory support improved it in the absence of elicited production. Comprehension predicted individual differences in fast-mapped comprehension in DS; in addition, hearing predicted production.
Knockout of the Host Resistance Gene Pkr Fully Restores Replication of Murine Cytomegalovirus m142 and m143 Mutants In Vivo

ABSTRACT Murine cytomegalovirus (MCMV) proteins m142 and m143 are essential for viral replication. They bind double-stranded RNA and prevent protein kinase R-induced protein synthesis shutoff. Whether the two viral proteins have additional functions such as their homologs in human cytomegalovirus do remained unknown. We show that MCMV m142 and m143 knockout mutants attain organ titers equivalent to those attained by wild-type MCMV in Pkr knockout mice, suggesting that these viral proteins do not encode additional PKR-independent functions relevant for pathogenesis in vivo.
A marginal zone pattern may be found in different varieties of non‐Hodgkin's lymphoma: the morphology and immunohistology of splenic involvement by B‐cell lymphomas simulating splenic marginal zone lymphoma

Aims: Splenic marginal zone lymphoma (SMZL) is characterized by a micronodular infiltrate of the splenic white pulp, centred on pre‐existing follicles, with a peripheral rim of ‘marginal’ zone B‐cells, always accompanied by a variable degree of red pulp infiltration. These histological features can be closely mimicked by a variety of other small B‐cell lymphomas when they involve the spleen, which makes recognition of SMZL difficult. We therefore have compared the histopathological and immunohistochemical features of other non‐Hodgkin's lymphoma (NHL) types with those of SMZL.
Addition of New Cells to the Olfactory Bulb of Adult Zebrafish a

ABSTRACT: We have been examining patterns of cell proliferation in the brain of adult zebrafish. Understanding this process in fish may lead to important insights due to the tremendous regenerative capabilities of these animals. Fish were exposed to a 1% solution of the thymidine analog 5‐bromo‐2′‐deoxyuridine (BrdU) for 1 hr before being returned to small aquaria that received frequent water changes. Animals were overanesthetized and perfused with Bouin's fixa tive solution after two survival periods (4 hr or 3‐4 weeks). Paraffin immunohistochemistry using a monoclonal antibody against BrdU was used to visualize the newly generated cells. Quantitative analyses were performed on serial, 10‐mm sections from 4 animals for each survival group. Statistical determinations were based on the nonparametric Mann‐Whitney U test. The ave rage number of BrdU‐labeled nuclear profiles in the bulbs, from analysis of every 5th section, was significantly different between the two groups (22.0 ± 6.8 [SEM] for the 4‐hr group and 136.7 ± 11.3 for the 4‐wk group; p < 0.05). The volumes of the bulbs, however, were not different between the two groups (p > 0.5). These data indicate that either cells divided repeatedly during the longer survival period or cells migrated into the bulb from other brain regions. To examine this phenomenon further, the location of the new cells was analyzed in three mid‐bulb sections (20 μm apart) from each animal. Both the area and number of labeled nuclei in each lamina were measured to obtain an average profile density. Comparison of the 4‐hr and the 4‐wk groups showed that density was significantly greater in all bulb layers in the long survival group (p < 0.05 for all). In the 4‐hr survival group, cells were found mainly in the olfactory nerve layer. When examined after 4 wk, proportionately more labeled cells were found in the internal cell layer. This addition of new cells could be a result of neurogenesis, gliogenesis, and/or angiogenesis. We are currently performing double‐labeling experiments to determine the types of cells that are added to the adult bulb. In addition, our future plans include investigating the origin of these cells and the signals that direct their formation.
The effects of a flipped classroom on achievement and student attitudes in secondary chemistry

In this investigation flipping was used to see if improvement occurred in achievement and with students’ attitudes toward chemistry. Flipping means lecture content usually delivered in the classroom was instead presented through asynchronous videos via the internet in advance of class. This was done in a suburban high school chemistry course. Results from unit tests were analyzed to see the change in summative achievement; while student surveys and interviews were analyzed to see the change in students’ attitudes toward chemistry. Results revealed no significant change in achievement with only marginal improvement in positive attitudes toward chemistry. Student comments and interviews showed that students did not have a positive response to using flipping to introduce new content but had a positive attitude towards using flipping in other roles.
Use of phytotherapy in dentistry

Over the past decade, interest in drugs derived from medicinal plants has markedly increased. This study was aimed at a literature review focusing on studies investigating herbal drugs and other natural products, as well as their therapeutic application, side effects and possible drug interactions. Few studies were found to support their rational use in dentistry. Since there is an increasing use of phytotherapeutic agents in dentistry, further studies are needed to evaluate their safety and effectiveness for clinical use. Copyright © 2008 John Wiley & Sons, Ltd.
Influence of increased intra-abdominal pressure on fluid responsiveness predicted by pulse pressure variation and stroke volume variation in a porcine model*

Objective:Dynamic variables of fluid responsiveness such as pulse pressure variation (PPV) and stroke volume variation (SVV) have been shown to reliably predict the response to fluid administration in different patient populations. The influence of increased intra-abdominal pressure (IAP) on the predictive ability of these variables is currently under debate. Therefore, the present study was designed to evaluate whether PPV and SVV are suitable for predicting fluid responsiveness during elevated IAP. Design:Prospective controlled experimental study. Setting:Animal research laboratory. Subjects:14 anesthetized and mechanically ventilated pigs. Interventions:Pigs were studied at different experimental stages: normovolemia at baseline conditions, after induction of pneumoperitoneum (PP) by increasing IAP up to 25 mm Hg, followed by releasing PP and performing a fluid load with 1000 cc hydroxyl-ethyl starch 6%, and finally after inducing PP again. Cardiac output, stroke volume, central venous pressure, and pulmonary artery occlusion pressure were obtained by pulmonary artery thermodilution. Additionally, global end-diastolic volume (GEDV) was measured by transpulmonary thermodilution. PPV and SVV were monitored continuously by pulse contour analysis. Measurements and Main Results:PP induced significant changes in peak airway pressure, esophageal pressure, chest wall compliance, SVV, PPV, central venous pressure, and pulmonary artery occlusion pressure independent of loading conditions. As assessed by receiver operating characteristic curve analysis, PPV, SVV, and GEDV accurately predicted fluid responsiveness before IAP was increased (area under the curve: 0.90, 0.91 and 0.91). A PPV value of ≥11.5%, a SVV value of ≥9.5%, and a GEDV value of ≤963 mL accurately predicted an increase in stroke volume ≥15%. After increasing IAP, the ability of SVV to predict fluid responsiveness was abolished, whereas it was preserved with both PPV and GEDV, although the threshold value for PPV dramatically increased up to ≥20.5%. Conclusions:In this animal model PPV and GEDV proved to be sensitive and specific predictors of fluid responsiveness even during increased IAP.
Phorbol ester reduces constitutive nuclear NFχB and inhibits HIV‐1 production in mature human monocytic cells

NFχB is a potent mediator of specific gene expression in human monocytes and has been shown to play a role in transcription of the HIV‐1 genome in promonocyte leukemias. There is little information available on the response of NFχB to cytokines in normal human monocytes. We have used a 32P‐labeled oligonucleotide derived from human immunodeficiency virus (HIV‐1) long terminal repeat, which contains a tandem repeat of the NFχB binding sequence, as a probe in a gel retardation assay to study this transcription factor. Using this assay, we have detected NFXB in extracts of nuclei from normal human monocytes. Treatment of normal monocytes with 12‐0‐tetradecanoyl phorbol‐13‐acetate (TPA) for 4‐24 h caused the complete disappearance of NFχB from nuclear extracts of monocytes. A similar result was obtained with the mature monocytic leukemia cell line THP‐1. The constitutive transcription factor SPI was unaffected by addition of TPA. The disappearance of NFXB from the nucleus was concentration dependent between 10 and 50 ng/ml of phorbol ester. In THP‐1 cells, TPA also induced a new, faster‐migrating NFXB species not induced in monocytes. Protein kinase C inhibitor staurosporine, but not cyclic nucleotide‐dependent protein kinase inhibitor HA‐1004, also dramatically reduced constitutive levels of nuclear NFχB. Finally, TPA addition to monocytes infected with HIV‐1 inhibited HIV‐1 replication, as determined by reverse transcriptase assays, in a concentration‐dependent manner. These results are in striking contrast to the increase in nuclear NFχB and HIV‐1 replication induced by phorbol esters in promonocyte leukemia cells U937 and HL‐60, and emphasize the importance of studying cytokine regulation of HIV‐1 in normal monocytes.
Glassy Cell Carcinoma Predominantly Commits to a Squamous Lineage and is Strongly Associated With High-risk Type Human Papillomavirus Infection

Glassy cell carcinoma (GCC) has been believed to have originated from reserve or uncommitted cells as a poorly differentiated adenosquamous carcinoma. This study includes immunoprofiles of p63, cytokeratin 17 (CK17), and CD44 to clarify which lineage of GCC is committed to human papillomavirus (HPV) detection, and to verify whether or not HPV plays a role in GCC. Nine uterine GCCs showing overwhelmingly glassy features were evaluated by an HPV genotyping chip and by immunohistochemistry for E-cadherin, CD44, p63, CEA, erb-B2, cytokeratin 17, and p16. An HPV genotyping DNA chip array with multiple oligonucleotide probes of L1 sequences from 26 types of HPV was introduced. GCCs were variably stained, except for CD44 which was stained unanimously. A lack of E-cadherin was found in 4 cases, frequent expression of p63 in 6/9 (66.7%), mucin stain or CEA in 5/9 (55.6%), and coexpression of p63 in 4. HPV prevalence in GCC was found in 6/9 cases (66.7%). HPV-18 and HPV-32 were the most common types detected. The remaining cancers were infected by HPV-31, HPV-35, HPV-39, and HPV-68. Multiple infections were found in 2 out of 6 cases. GCC could not be precisely categorized, but was committed to squamous lineages and was strongly associated with high-risk type HPV infection.
Associations between substance use disorders and suicide or suicide attempts in people with mental illness: a Danish nation‐wide, prospective, register‐based study of patients diagnosed with schizophrenia, bipolar disorder, unipolar depression or personality disorder

AIM To estimate and test associations between substance use disorders (SUDs) and both completed suicides and suicide attempts in a population with severe mental illness. DESIGN Register-based cohort study with adjusted Cox regression of substance use disorders as time-varying covariates. SETTING Denmark. PARTICIPANTS People born in Denmark since 1955 with a diagnosis of schizophrenia (n = 35 625), bipolar disorder (n = 9279), depression (n = 72 530) or personality disorder (n = 63 958). MEASUREMENTS Treated SUDs of alcohol and illicit substances identified in treatment registers; suicide attempt identified in treatment registers; and completed suicides identified in the Cause of Death register. Covariates were sex and age at diagnosis. FINDINGS Having any SUD was associated with at least a threefold increased risk of completed suicide when compared with those having no SUD. Alcohol misuse was associated with an increased risk of completed suicide in all populations with hazard ratios (HR) between 1.99 [95% confidence interval (CI) = 1.44-2.74] and 2.70 (95% CI = 2.40-3.04). Other illicit substances were associated with a two- to threefold risk increase of completed suicide in all populations except bipolar disorder, and cannabis was associated with increased risk of attempted suicide only in people with bipolar disorder (HR = 1.86, 95% CI = 1.15-2.99). Alcohol and other illicit substances each displayed strong associations with attempted suicide, HR ranging from 3.11 (95% CI = 2.95-3.27) to 3.38 (95% CI = 3.24-3.53) and 2.13 (95% CI = 2.03-2.24) to 2.27 (95% CI = 2.12-2.43), respectively. Cannabis was associated with suicide attempts only in people with schizophrenia (HR = 1.11, 95% CI = 1.03-1.19). CONCLUSION Substance use disorders are associated strongly with risk of completed suicides and suicide attempts in people with severe mental illness.
Calcification of the aortic valve in the dialyzed patient.

Cardiovascular disease is the leading cause of mortality in patients with end-stage renal disease (ESRD), with cardiac disease alone accounting for 40% of all deaths. Ischemic heart disease, heart failure, and cardiomyopathy are the most frequent causes of cardiac death ([1][1]), but valvular
Responses of the pea aphid transcriptome to infection by facultative symbionts

Serratia symbiotica is a facultative symbiont of pea aphids (Acyrthosiphon pisum) that provides tolerance to heat stress. Although the phenotypic effects of facultative symbionts upon hosts have been studied in some detail, little is known about the molecular and genomic basis of these interactions. Previous studies show a large impact of S. symbiotica upon the aphid metabolome. Whole‐genome transcriptional profiling and next‐generation sequencing demonstrated expression of 94% of RefSeq genes from the pea aphid genome, providing the largest dataset to date on aphid gene expression. However, only 28 genes showed changes in expression with S. symbiotica infection, and these changes were of small magnitude. No expression differences in genes involved in innate immunity in other insects were observed. Therefore, the large metabolic impact of S. symbiotica is most likely a result of metabolism of the symbiont itself, or of post‐transcriptional modification of host gene expression. Although S. symbiotica has a major influence on its host's metabolome and resistance to heat, it induces little change in gene expression in its host.