Miracle-dz/UniFAR-FTUs huggingface dataset:
Can we Improve on how we Select Medical Students?

Getting the right policy for admission to medical school is a balancing act: be fair to society by choosing people with the potential to be good doctors; and be fair to the applicants—that diverse group of people who for many reasons want to set out on the long road to a medical career. Selection is not an exact science but we must use what evidence we have to ensure that we do our best by all concerned. There is widespread agreement that we should select future doctors on wider criteria than scores of academic success1,2, though in practice many medical schools have valued pre-admission academic scores at the expense of other considerations3. There are recognized drawbacks to the use of school exam performance even as a measure of intellectual competence. One study has shown that a major causal determinant of A level results is social class, independent of ability4, and some would-be medical students elect to focus on sciences for their school leaving exams because very high marks are more easily achieved in the physical sciences than in the humanities5. The conviction that only exam results give valid and reliable data has been trenchantly dismissed as a ‘seductive but fallacious’ belief in the precision of quantitative tests6. We are reminded that all selective instruments depend on subjective judgments and each must be accountable to the rules of reason, fairness and public scrutiny7. However, if we decide to consider non-cognitive criteria, a legitimate concern is that the many specialties of medicine need diverse skills and they must not be too narrow. We also want to be reassured, if we include noncognitive characteristics, that we can assess them reliably and that such evaluation can predict personal character over years of practice. While we need to maintain diversity of skills and personality, there are some characteristics which we demand in any doctor. Enough intellectual ability to do the job, plus honesty, integrity and conscientiousness, must be at the heart of good practice8. Helpfulness and willingness to cooperate come close behind8, while patients give high priority to interpersonal skills and empathy2. The personal welfare of the profession is another consideration9. Doctors are more vulnerable than comparable professional groups to alcoholism, drug abuse and suicide10,11. Burnout is well recognized, and has a high cost for the individual, for colleagues and for the quality of service that patients get12. One answer may be better support for psychologically vulnerable doctors12,13 (together with improved working conditions for all doctors), but perhaps we should try to evaluate ability to deal with stress right from the start.
Common neural systems for contact heat and laser pain stimulation reveal higher‐level pain processing

Our current knowledge of pain‐related neuronal responses is largely based on experimental pain studies using contact heat or nontactile laser painful stimulation. Both stimuli evoke pain, yet they differ considerably in their physical and perceptual properties. In sensory cortex, cerebral responses to either stimulus should therefore substantially differ. However, given that both stimuli evoke pain, we hypothesized that at a certain subset of cortical regions the different physical properties of the stimuli become less important and are therefore activated by both stimuli. In contrast, regions with clearly dissociable activity may belong to “lower‐level” pain processing mechanisms depending on the physical properties of the administered stimuli. We used functional magnetic resonance (fMRI) to intraindividually compare pain‐related activation patterns between laser and contact heat stimulation using four different intensities of laser and contact heat stimuli. Common and dissociable neural responses were identified by correlating perceived pain intensities with blood oxygenation level dependent (BOLD) signal changes. Only neuronal responses to stimuli that were perceived as painful were analyzed. Pain‐related BOLD signal increases independent of stimulus modality were detected in the anterior insula, anterior cingulate cortex, medial secondary somatosensory cortex, and the prefrontal cortex. These similarities are likely to reflect higher‐level pain processing, which is largely independent of the single physical parameters that determine the painful nature of the stimuli. Hum Brain Mapp 2008. © 2007 Wiley‐Liss, Inc.
Janus at the Crossroads: Perspectives on Long-term Care Trajectories for Older Women With Dementia in a Canadian Context

Purpose of the Study: Janus, the two-faced, Roman god of beginnings and transitions, is used as a metaphor to explore our personal narratives and our quantitative research on the experiences of older women with dementia in long-term care (LTC). Two research questions are addressed: (a) How do our quantitative data map onto our mothers’ experiences? (b) What lessons do our mothers’ experiences offer for the care of older women with dementia? Design and Methods: Informed by a life-course perspective, we triangulate administrative data on 3,717 women with dementia receiving LTC in British Columbia, Canada, with personal narratives—the stories of our mothers who made the transition from home care into residential (nursing home) care. Results: Our quantitative data reveal that the home care to residential care transition is the most common LTC trajectory for women with dementia who are most likely to be widowed and living alone in suburban areas. On entry into residential care, they exhibit greater frailty in terms of activities of daily living, cognition, aggression, and incontinence. Our personal narrative data on our mothers reveals that the relatively straightforward pathways through LTC for women with dementia, are often considerably more complex in a real-world context. Attention is drawn to the public and private services, hospitalization patterns, and substantial communication gaps experienced by our moms and families. Implications: A life-course perspective, and qualitative and quantitative data facilitate understanding the care journeys—health and service trajectories of older women with dementia.
Foundations of Modelling and Simulation of Complex Systems

Modelling and simulation are becoming increasingly important enablers for the analysis and design of complex systems. In application domains such as automotive design, the notion of a "virtual experiment" is taken to the limit and complex designs are model-checked, simulated, and optimized extensively before a single realization is ever made. This "doing it right the first time" leads to tremendous cost savings and improved quality. Furthermore, with appropriate models, it is often possible to automatically synthesize (parts of) the system-to-be-built. In this paper, the basic concepts of modelling and simulation are introduced. These concepts are based on general systems theory and start from the idea of a model as an abstract representation of knowledge about structure and behaviour of some system. The purpose is either analysis or design in a particular experimental context. Typically, different formalisms are used such as Ordinary Differential Equations, Queueing Networks, and State Automata. It will be shown how these different formalisms all share a common structure and differ in the choice of time base, state space, and description of temporal evolution. This allows one to classify formalisms on the one hand and to find a common ground for implementing simulators on the other hand.
Morphokinetic behavior of euploid and aneuploid embryos analyzed by time-lapse in embryoscope

BACKGROUND: Embryonic aneuploidy may result in miscarriage, implantation failure, or birth defects. Thus, it is clinically necessary to avoid the selection of aneuploid embryos during in vitrofertilization treatment. AIM: The aim of this study was to identify the morphokinetic differences by analyzing the development of euploid and aneuploid embryos using a time-lapse technology. We also checked the accuracy of a previously described model for selection of euploid embryos based on morphokinetics in our study population. MATERIALS AND METHODS: It is a retrospective study of 29 cycles undergoing preimplantation genetic screening from October 2013 to April 2015 at our center. Of 253 embryos, 167 suitable for biopsy embryos were analyzed for their chromosomal status using array-comparative genome hybridization (CGH). The morphokinetic behavior of these embryos was further analyzed in embryoscope using time-lapse technology. RESULTS: Among the analyzed embryos, 41 had normal and 126 had abnormal chromosome content. No significant difference in morphokinetics was found between euploid and aneuploid embryos. The percentage of embryos with blastulation was similar in the euploid (65.85%, 27/41) and aneuploid (60.31%, 76/126) embryos (P = 0.76). Although hard to define, majority of the chromosomal defects might be due to meiotic errors. On applying embryo selection model from Basile et al., embryos falling within optimal ranges for time to division to 5 cells (t5), time period of the third cell cycle (CC3), and time from 2 cell division to 5 cell division (t5-t2) exhibited greater proportion of normal embryos than those falling outside the optimal ranges (28.6%, 25.9%, and 26.7% vs. 17.5%, 20.8%, and 14.3%). CONCLUSION: Keeping a track of time interval between two stages can help us recognize aneuploid embryos at an earlier stage and prevent their selection of transfer. However, it cannot be used as a substitute for array CGH to select euploid embryos for transfer.
Heat Shock Transcription Factor 1 Is Involved in Quality-Control Mechanisms in Male Germ Cells1

Abstract Quality-control mechanisms in spermatogenesis are important to eliminate injured or abnormal cells, thereby protecting the organism from abnormal development in the next generation. The processes of spermatogenesis are highly sensitive to high temperatures; however, the mechanisms by which injured germ cells are eliminated remain unclear. Here, we found that heat shock proteins are not induced in male germ cells in response to thermal stress, although heat shock transcription factor 1 (HSF1) is activated. Using HSF1-null mice, we showed that apoptosis of pachytene spermatocytes was markedly inhibited in testes with a single exposure to heat and in the cryptorchid testes, indicating that HSF1 promotes apoptotic cell death of pachytene spermatocytes exposed to thermal stress. In marked contrast, HSF1 acts as a cell-survival factor of more immature germ cells, probably including spermatogonia, in testes exposed to high temperatures. These results demonstrate that HSF1 has two opposite roles in male germ cells independent of the activation of heat shock genes.
Altered early visual processing components in hallucination-prone individuals

Of the nonpathological general population, 0.5% experience one or more visual hallucinations on a regular basis without meeting the criteria for clinical psychosis. We investigated the relationship between a proneness to visual hallucinations in ‘normal’ individuals and early visual event-related potentials during the perception of faces, Mooney faces and scrambled Mooney faces. Findings indicated that individuals prone to visual hallucinations displayed significantly reduced early event-related potential components (P1, P2, but not N170) over parieto-temporal regions. These findings support previous suggestions that individuals who experience visual hallucinations exhibit abnormal early visual processing resulting from degraded visual input, in this case owing to disruption of low level visual processes.
Role of Thromboxane Receptor in C-Reactive Protein–Induced Thrombosis

Objective—Thromboxane A2 and prostacyclin are thromboregulatory prostaglandins. The inflammatory C-reactive protein (CRP) promotes thrombosis after vascular injury, presumably via potentiation of thromboxane activity. Using a genetic approach, we investigated the role of thromboxane receptor (TP) pathway in CRP-induced thrombosis. Methods and Results—Four genetically engineered mice strains were used: C57BL/6 wild-type, human CRP transgenic (CRPtg), thromboxane receptor–deficient (Tp−/−), and CRPtgTp−/− mice. CRP and TP expression were correlated, and suppression of CRP expression using small interfering RNA/CRP led to reduction in TP expression. Platelet–endothelial adherence was increased in CRPtg and suppressed in CRPtgTP−/− and CRPtg cells that were suppressed with TP small interfering RNA. TP deficiency in both platelets and endothelial cells was synergistic in affecting platelet–endothelial interactions. Time until arterial occlusion, measured after photochemical injury, was significantly shorter in CRPtg and prolonged in CRPtgTp−/− compared with controls (n=10–15, 35±3.4, 136±13.8, and 67±8.9 minutes, respectively; P<0.05). Conclusion—TP pathway is of major importance in CRP-induced thrombosis. The expression of TP is increased in CRPtg endothelial cells, and its blockade significantly suppresses the prothrombotic effect of CRP.
Hospitalization patterns in severe acute asthma in children

We set out to determine associations between hospitalization and disease severity before and 2 hours after initiation of asthma therapy in the Emergency Department, and to describe the outcome of patients admitted and discharged. This is a retrospective review of data and charts from a randomized, double blind, placebo‐controlled trial (R.C.T.) of 120 asthmatics 5–17 years of age with baseline forced expiratory volume in 1 second (FEV1) <50% predicted, treated with 3 or 1 or 0 doses of nebulized ipratropium added to three albuterol nebulizations administered over 1 hour. None of the clinical parameters measured at baseline were associated with hospitalization. However, by 2 hours after initiation of therapy, both the FEV1 percent of predicted values (% pred.) and the total asthma score were associated with likelihood of hospital admission. Baseline O2 saturation <92% indicated a longer hospital stay (75.3 ± 51 hours vs. 43.0 ± 24.4 hours, P = 0.015) and a later onset of infrequent nebulizations (46.7 ± 35.1 vs. 26.6 ± 17.4 hours, P = 0.006). By 2 hours, those with a post‐treatment FEV1 % pred ≤30% and an asthma score ≥6 of 9 had a high likelihood of hospitalization (86 and 80%, respectively, combined probability 100%), whereas FEV1 % pred ≥60% and total asthma score <3 were associated with successful discharge (probability of 92 and 83%, respectively). We conclude that pre‐treatment assessments were not associated with hospitalization, while patients with post‐treatment FEV1 % pred ≤30% and a score ≥6 had high likelihood of hospitalization. Pediatr. Pulmonol. 1997; 23:184–192 © 1997 Wiley‐Liss, Inc.
Changes in Protein Domains outside the Catalytic Site of the Bacteriophage Qβ Replicase Reduce the Mutagenic Effect of 5-Azacytidine

ABSTRACT The high genetic heterogeneity and great adaptability of RNA viruses are ultimately caused by the low replication fidelity of their polymerases. However, single amino acid substitutions that modify replication fidelity can evolve in response to mutagenic treatments with nucleoside analogues. Here, we investigated how two independent mutants of the bacteriophage Qβ replicase (Thr210Ala and Tyr410His) reduce sensitivity to the nucleoside analogue 5-azacytidine (AZC). Despite being located outside the catalytic site, both mutants reduced the mutation frequency in the presence of the drug. However, they did not modify the type of AZC-induced substitutions, which was mediated mainly by ambiguous base pairing of the analogue with purines. Furthermore, the Thr210Ala and Tyr410His substitutions had little or no effect on replication fidelity in untreated viruses. Also, both substitutions were costly in the absence of AZC or when the action of the drug was suppressed by adding an excess of natural pyrimidines (uridine or cytosine). Overall, the phenotypic properties of these two mutants were highly convergent, despite the mutations being located in different domains of the Qβ replicase. This suggests that treatment with a given nucleoside analogue tends to select for a unique functional response in the viral replicase. IMPORTANCE In the last years, artificial increase of the replication error rate has been proposed as an antiviral therapy. In this study, we investigated the mechanisms by which two substitutions in the Qβ replicase confer partial resistance to the mutagenic nucleoside analogue AZC. As opposed to previous work with animal viruses, where different mutations selected sequentially conferred nucleoside analogue resistance through different mechanisms, our results suggest that there are few or no alternative AZC resistance phenotypes in Qβ. Also, despite resistance mutations being highly costly in the absence of the drug, there was no sequential fixation of secondary mutations. Bacteriophage Qβ is the virus with the highest reported mutation rate, which should make it particularly sensitive to nucleoside analogue treatments, probably favoring resistance mutations even if they incur high costs. The results are also relevant for understanding the possible pathways by which fidelity of the replication machinery can be modified.
External and Internal Barriers to Studying Can Affect Student Success and Retention in a Diverse Classroom

Although a majority of under-represented minority (URM) students begin their postsecondary education at community colleges, little is known about barriers to success and retention for transfer-bound science students. This study focuses on some of the barriers that affect these students’ ability to study adequately for a community college “gateway” course. It tests whether instructors’ expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers to studying, such as lack of motivational, cognitive, and metacognitive abilities, all of which have been shown to impact academic success and retention. It also tests whether students who faced such barriers were less likely to succeed in and complete the course, as well as whether time spent studying was related to course success. The findings reported here show that community college students do not have enough available time to study and that external and internal barriers are both prevalent among these students. In addition, students who faced such barriers are more likely to fail or drop the class. Results also show that study time is positively correlated with retention, but not performance, as well as with some motivational, cognitive, and metacognitive dimensions of self-regulated learning. These findings lead to new questions, including whether student success in a community college class is associated with the use of cognitive and metacognitive learning strategies for students with no prior degrees, and whether increased course structure may improve success for college students with lower self-regulated abilities.
Family Background and State of Mental Health in a Group of Diabetic Schoolchildren

In a material of 145 diabetic and 126 matched non‐diabetic schoolchildren aged 7–20 years, the social and family structure was investigated. Family history of mental disturbances and actual mental symptoms of the children were obtained by interviews with the mothers. A diagnosis of the mental health of the children and their mothers was arrived at by clinical judgement. Roughly half the diabetic series was treated more strictly and intensely than the other.
Cutaneous Neoplasms With Prominent Verocay Body–Like Structures: The So-called “Rippled Pattern”

A striking appearance resulting from alternating areas of epithelial cell cords and stroma seen in some cutaneous adnexal neoplasms has been referred to as the “rippled pattern. ” Histologically, this pattern may be indistinguishable from Verocay bodies described in schwannomas. A number of common and clinically diverse cutaneous neoplasms can be linked by the presence of this unusual growth pattern. The heterogeneous group of tumors that have been known to demonstrate this feature includes those with epithelial, adnexal, fibrohistiocytic, mesenchymal, and melanocytic lineage. The objective of this review is to alert the dermatopathologist to the range of neoplasms, which can potentially show this attribute, so that a misdiagnosis can be avoided.
Analysis of a gain-of-function FGFR2 Crouzon mutation provides evidence of loss of function activity in the etiology of cleft palate

Cleft palate is a common birth defect in humans and is a common phenotype associated with syndromic mutations in fibroblast growth factor receptor 2 (Fgfr2). Cleft palate occurred in nearly all mice homozygous for the Crouzon syndrome mutation C342Y in the mesenchymal splice form of Fgfr2. Mutant embryos showed delayed palate elevation, stage-specific biphasic changes in palate mesenchymal proliferation, and reduced levels of mesenchymal glycosaminoglycans (GAGs). Reduced levels of feedback regulators of FGF signaling suggest that this gain-of-function mutation in FGFR2 ultimately resembles loss of FGF function in palate mesenchyme. Knowledge of how mesenchymal FGF signaling regulates palatal shelf development may ultimately lead to pharmacological approaches to reduce cleft palate incidence in genetically predisposed humans.
Elder Abuse and Neglect in Latino Families : An Ecological and Culturally Relevant Theoretical Framework for Clinical Practice

There is a scarcity of theoretical frameworks capable of describing precursors and dynamics associated with elder abuse and neglect in Latino families. The present manuscript seeks to address this gap in the literature by presenting an integrative theoretical framework that fosters an ecological and cultural understanding of elder abuse and neglect among Latinos. The proposed model rests on the premise that Latino families caring for elder adults have the ability to adapt to the demands of aging only if they are supported by nurturing environments. The usefulness of the model is threefold. First, the proposed model describes elder abuse and neglect as multifactorial phenomena and identifies specific risk factors associated with the etiology and maintenance of elder abuse and neglect in Latino families. Second, the model provides clinical applications, including reflections about the therapists’ need to extend their scope of practice beyond traditional family therapy interventions. A brief case study is presented that illustrates the clinical application of the model with a Latino family. Implications for future research are discussed.