Miracle-dz/UniFAR-FTUs huggingface dataset:
Modeling Teacher Supports Toward Self-Directed Language Learning Beyond the Classroom: Technology Acceptance and Technological Self-Efficacy as Mediators

This study explored the contributions of teacher supports toward students’ self-directed language learning beyond the classroom and investigated whether technology acceptance and technological self-efficacy could be the mediators between teacher supports and students’ self-directed language learning in a sample of Chinese undergraduate students. A total of 197 freshmen students in one university in Eastern China participated in the questionnaires concerning teacher supports, technology acceptance, technological self-efficacy and self-directed language learning. The study highlighted the results: (1) perceived usefulness mediated the relationship between teacher affective supports and students’ self-directed language learning as well as the relationship between teacher capacity supports and students’ self-directed language learning; (2) technological self-efficacy mediated the relationship between teacher affective supports and students’ self-directed language learning as well as the relationship between teacher behavior supports and students’ self-directed language learning; and (3) perceived easy of use had no noticeable mediating functions, but exerted an indirect influence on students’ self-directed language learning. These findings extended previous researches by considering both the external factors (i.e., teacher supports) and the internal factors (i.e., technology acceptance and technological self-efficacy) of influencing students’ self-directed language learning, thereby contributing to enhancing our understanding of the joint drive of the inherent and extrinsic power mechanisms. This study indicated the significance of elevating teachers’ awareness of the substantial supports in enhancing students’ self-directed language learning beyond the classroom and would inform that the future research on teachers’ compliance in relation to technology use be converted from institutional mandates into teachers’ conscientious behaviors.
Glucagon treatment in type 1 diabetes -with focus on restoring plasma glucose during mild hypoglycemia .

Type 1 diabetes is a chronic disease caused by an autoimmune destruction of the insulin-producing cells in the pancreas, leading to a condition with insulin deficiency and elevated blood glucose levels. Individuals with type 1 diabetes are therefore recommended to frequently inject insulin subcutaneously to keep near-normal blood glucose levels, preventing the progression and onset of diabetes-related complications, i.e. kidney failure, blindness, amputation, stroke and heart attack. Unfortunately, the intensified insulin therapy is associated with risk of hypoglycemia- impeding individuals from reaching recommended treatment goals. In this PhD thesis, we hypothesized that low-dose glucagon may complement existing insulin therapy in improving glucose control by treating and preventing mild hypoglycemia. The aim was to determine whether low-dose glucagon could treat insulin-induced mild hypoglycemia sufficiently, and to investigate conditions that might impair the efficacy of glucagon. We showed that the glucose response to low-dose glucagon was dose-dependent but was impaired during high blood levels of insulin, after one week of low carbohydrate diet and perhaps 8-9 hours after ethanol intake. These findings are clinically relevant when blood glucose levels are controlled through insulin and glucagon delivery.
Changes in nursing practice: associations with responses to and coping with errors.

AIMS AND OBJECTIVE To investigate emotional responses of nurses and perceived senior staff responses to errors, error-coping strategies used by nurses and how these are associated with constructive or defensive changes in nursing practice. BACKGROUND Healthcare professionals have generally reported distressing emotional responses to errors and fear concerns about their consequences. However, errors can also be part of a developmental process, by offering opportunities for learning and leading to constructive changes in clinical practice. DESIGN Prospective, correlational, multicentre study. METHODS Five hundred and thirty-six structured questionnaires completed from nurses employed in various hospital departments were considered eligible for data extraction. The revised questionnaire used was evaluated for content validity. RESULTS Data analysis indicated that positive perceived senior staff responses (p = 0·030), accepting error responsibility (p = 0·031) and seeking social support (p = 0·019) predicted constructive changes in nursing practice, while negative perceived senior staff responses (p = 0·040) and error escape-avoidance (p = 0·041) predicted defensive changes. CONCLUSIONS Errors promote constructive changes in clinical practice when nurses are encouraged to use adaptive error-coping strategies within a supportive, non-blaming culture. RELEVANCE TO CLINICAL PRACTICE These findings highlight the role of senior staff in the establishment of a supportive, trustful ward climate, so that nurses can learn from errors, prevent their recurrence and improve patient safety.
Clinical Outcome of Video-Assisted Thymectomy for Myasthenia Gravis and Thymoma

We reviewed our experience of video-assisted thoracoscopic thymectomy for myasthenia gravis and thymomas in 119 patients, aged 12–83 years, who were treated between 1998 and 2007. Disease severity was graded using the Osserman classification. To prevent rupture of the tumor capsule and tumor seeding, thymomas were resected using a modified no-touch technique. Thymoma diameters were 10–90 mm (mean, 50 mm). There were no operative deaths, 12 (10%) patients had complications, and 87 (73.1%) improved by 1 or more Osserman grades postoperatively. After follow-up of 1.9–10 years (mean, 4.9 years), 74 (62%) patients remained asymptomatic, with 21% in complete stable remission. Using multivariate regression analysis, there were no statistical differences in median pre- and postoperative Osserman grades with regards to age, sex, duration of symptoms, and presence of thymoma. Video-assisted thoracoscopic thymectomy for myasthenia gravis and selected thymomas can achieve long-term clinical outcomes comparable to those of standard approaches.
Sex Disparities in Cancer Mortality and Survival

Background: Previous research has noted higher cancer mortality rates and lower survival among males than females. However, systematic comparisons of these two metrics by sex have been limited. Methods: We extracted U.S. vital rates and survival data from the Surveillance, Epidemiology and End Results Database for 36 cancers by sex and age for the period 1977 to 2006. We compared sex-specific mortality rates and examined male-to-female mortality rate ratios (MRR). We also extracted case data which included age and date of diagnosis, sex, primary cancer site, tumor stage and grade, survival time, vital status, and cause of death. Relative cancer-specific HRs for death in the 5-year period following diagnosis were estimated with Cox proportional hazards models, adjusted for covariates. Results: For the vast majority of cancers, age-adjusted mortality rates were higher among males than females with the highest male-to-female MRR for lip (5.51), larynx (5.37), hypopharynx (4.47), esophagus (4.08), and urinary bladder (3.36). Cancer-specific survival was, for most cancers, worse for males than females, but such disparities were drastically less than corresponding MRRs [e.g., lip (HR = 0.93), larynx (HR = 1.09), hypopharynx (HR = 0.98), esophagus (HR = 1.05), and urinary bladder (HR = 0.83)]. Conclusions: Male-to-female MRRs differed markedly while cancer survival disparities were much less pronounced. This suggests that sex-related cancer disparities are more strongly related to etiology than prognosis. Impact: Future analytic studies should attempt to understand causes of observed sex disparities in cancer. Cancer Epidemiol Biomarkers Prev; 20(8); 1629–37. ©2011 AACR.
Multisite monitoring of choline using biosensor microprobe arrays in combination with CMOS circuitry

Abstract A miniature device enabling parallel in vivo detection of the neurotransmitter choline in multiple brain regions of freely behaving rodents is presented. This is achieved by combining a biosensor microprobe array with a custom-developed CMOS chip. Each silicon microprobe comprises multiple platinum electrodes that are coated with an enzymatic membrane and a permselective layer for selective detection of choline. The biosensors, based on the principle of amperometric detection, exhibit a sensitivity of 157±35 µA mM-1 cm-2, a limit of detection of below 1 µM, and a response time in the range of 1 s. With on-chip digitalization and multiplexing, parallel recordings can be performed at a high signal-to-noise ratio with minimal space requirements and with substantial reduction of external signal interference. The layout of the integrated circuitry allows for versatile configuration of the current range and can, therefore, also be used for functionalization of the electrodes before use. The result is a compact, highly integrated system, very convenient for on-site measurements.
An Investigation into the differences between the Bioscreen and the traditional plate count disinfectant test methods

Investigations of biocide efficacy by automated methods involving optical density measurements, e.g. using the recently published ‘Bioscreen’ method, are complicated by the fact that a poor correlation often exists between the log reductions obtained using the automated method vs those obtained by the traditional plate count methods. It was hypothesized that the differences observed between the two methods were due to the level of cell injury, which was masked by the optical density methods but which was recognized by the plate counts. Comparisons of log reductions following a disinfection test always showed the Bioscreen method to be overestimating the log reductions with respect to the plate counts. A correlation between colony size on the plates and the ‘Bioscreen’ results for a fixed disinfectant concentration and contact time was found using Global Imaging software. The results obtained also suggested that the observed colony area was dependent on the amount of injury incurred by a microbe during the disinfection process. A mathematical model of injury was developed which predicted the observed differences between the Bioscreen and the traditional plate method. The model further suggested a possible reason for biocidal lags.
The splicing factor SRSF6 is amplified and is an oncoprotein in lung and colon cancers

An increasing body of evidence connects alterations in the process of alternative splicing with cancer development and progression. However, a direct role of splicing factors as drivers of cancer development is mostly unknown. We analysed the gene copy number of several splicing factors in colon and lung tumours, and found that the gene encoding for the splicing factor SRSF6 is amplified and over‐expressed in these cancers. Moreover, over‐expression of SRSF6 in immortal lung epithelial cells enhanced proliferation, protected them from chemotherapy‐induced cell death and converted them to be tumourigenic in mice. In contrast, knock‐down of SRSF6 in lung and colon cancer cell lines inhibited their tumourigenic abilities. SRSF6 up‐ or down‐regulation altered the splicing of several tumour suppressors and oncogenes to generate the oncogenic isoforms and reduce the tumour‐suppressive isoforms. Our data suggest that the splicing factor SRSF6 is an oncoprotein that regulates the proliferation and survival of lung and colon cancer cells.
Long term data of endovascularly treated patients with severe and complex aortoiliac occlusive disease.

AIM This paper presents the recent data of the largest series (20 patients) of endovascularly treated patients and the first long term data of 9 patients with severe aortoiliac occlusive disease. METHODS Between 2003 and 2012, 20 consecutive patients (14 men; 70 %) with Leriche syndrome underwent recanalization with solely endovascular means at our centre. The treatment strategy comprised the antegrade (transbrachial) recanalization of the occluded segments followed by retrograde (transfemoral) angioplasty with selective stent placement in the infrarenal aorta and primary stent placement in the iliac arteries. Before discharge, after 30 days and every year after the procedure, a clinical, as well as a duplex ultrasonographic examination including measurement of the ankle-brachial index was done. RESULTS Bilateral success was achieved in 17 patients (85%). Unilateral success was achieved in three patients (15%). In one patient (5%) an early reocclusion of the stented segments occurred, necessitating bypass grafting. In nine patients long term data were evaluated. Here, the ankle brachial index (ABI) significantly increased (0.85 ± 0.15 vs. 0.51 ± 0.11 at baseline; P=0.002). Compared to baseline, the difference in the distribution of Rutherford category and the improvement of walking capacity were statistically significant (P=0.0006, P=0.01, respectively). CONCLUSION This study shows the feasibility of solely endovascular management of severe aortoiliac occlusive disease with a high rate of success and low rate of complications. Significant clinical improvement of patients in long term follow up makes the endovascular approach a viable alternative to open surgery.
Impact of visit copayments on outpatient mental health utilization by members of a health maintenance organization.

OBJECTIVE The authors examined the impact of increasing cost sharing on use of outpatient mental health services. METHOD A quasi-experimental design was used to study outpatient utilization by members of a health maintenance organization (HMO) who were subject to increasing copayments for mental health visits (state government employees and dependents). Their outpatient mental health utilization was compared with that of similar HMO members who were not subject to cost sharing (federal government employees and dependents). Analyses compared both likelihood of any service use and number of visits per year among service users. RESULTS Institution of $20/visit copayments was associated with a 16% decrease in likelihood of service use but no change in visit rate among service users. A subsequent copayment increase to $30/visit resulted in no significant change in likelihood of use but was associated with a 9% decrease in visits per year among those using services. The impact of the first copayment change on likelihood of using services did not vary according to level of clinical need (as measured by prior service use and psychotropic drug use). CONCLUSIONS In this staff-model HMO, modest visit copayments significantly reduced initial access to mental health treatment and had a smaller effect on treatment intensity. Copayments restricted access regardless of clinical need. Designers of mental health benefits must consider the impact of copayments on those with the greatest need for treatment.
Trends in the association between smoking history and general/central obesity in Catalonia, Spain (1992-2003).

OBJECTIVES To examine trends in the relationship between smoking history and both general and central fatness in adults from a Mediterranean setting. Materials and methods: The ENCAT 1992-1993 and 2002-2003 surveys were used; samples consisted of 482 men, 589 women from 1992-1993, and 515 men, 613 women from 2002-2003, aged 25-60 years. Measured anthropometry and self-reported data on smoking habits, diet, lifestyle and SES were collected. General fatness was defined as WHO's BMI overweight and obesity, and central fatness was defined as WHO's Increased-Risk-for-metabolic-complications Waist Circumference (IR WC) and Substantially-Increased-Risk WC (SIR WC). Simple logistic regression was used to estimate multivariate-adjusted associations between general/central fatness and smoking history. RESULTS By 2002-2003, most associations observed in 1992-1993 had been strongly attenuated: only male current-heavy-smoking remained associated with IR/SIR WC (three-fold) and female current-moderate-smokers were 0.57 times less likely to have an IR/SIR WC (p < 0.10). CONCLUSIONS Although causality cannot be established, results suggest a positive association between heavy smoking and central fatness among men, but no association between former smoking and general/central fatness; findings strengthen arguments for promoting smoking cessation to reduce smoking -and obesity- associated morbidity and mortality.
Shiga-like toxin production and attaching effacing activity of Escherichia coli associated with calf diarrhea.

Four hundred twenty-nine isolates of Escherichia coli from calves were tested for the production of HeLa cell cytotoxin(s). Isolates that produced enough cytotoxin to be detected in culture supernatants of iron-depleted broth were considered to produce increased amounts of cytotoxins. Isolates also were tested for homology with a DNA probe for a gene that encodes localized adherence of human enteropathogenic E coli. Four isolates produced increased amounts of cytotoxin that was neutralized by Shiga antitoxin (toxin designated as Shiga-like toxin-I [SLT-I]). A 5th isolate produced increased amounts of cytotoxin (SLT+) that was not neutralized by the Shiga antitoxin, but was neutralized by antitoxin against a variant of SLT (toxin designated as SLT-II). None of the isolates hybridized with the probe for the localized adherence gene. Three of the SLT+ isolates belonged to human enteropathogenic E coli serogroups O26 and O111. All 5 of the SLT+ isolates were from calves with diarrhea, but none of the 5 SLT+ isolates contained genes for classic heat-labile or heat-stable enterotoxins, for K99 fimbriae, or for invasiveness; neither did any of them adhere to HeLa cells in culture. Three of the 5 SLT+ isolates had attaching and effacing activities when inoculated into ligated intestinal loops of rabbits. One of the isolates with attaching and effacing activity in rabbits was originally isolated from a calf with lesions characteristic of those produced by attaching effacing E coli (AEEC). Calves inoculated with this SLT+ AEEC isolate developed focal colonic lesions characteristic of those produced by AEEC, but did not develop diarrhea. (ABSTRACT TRUNCATED AT 250 WORDS)
The age peak in childhood acute lymphoblastic leukemia

White children have a much higher incidence rate of acute lymphoblastic leukemia (ALL) than do African American children. This discrepancy, coupled with the geographic and temporal variations in the incidence of childhood ALL, have led to speculation that factors associated with socioeconomic status (SES) may play an important role in its etiology. Because most of the variation is accounted for by the occurrence of a peak in incidence between the ages of 2 and 5 years, the purpose of this study was to compare the SES of children diagnosed with ALL between the peak ages of 2‐5 years with those children diagnosed at other ages (birth‐1 year and 6‐14 years).
Male Rett Phenotypes in T158M and R294X MeCP2-mutations

We report on three patients with MeCP2 mutation and male Rett phenotypes. Two brothers with T158M mutations and normal karyotype had a severe early onset encephalopathy, progressive microcephaly, severe feeding problems, breathing and sleep disturbances. They died at the ages of 1 year and 8 months, and 3 years and 1 month. This mutation has previously been reported in three males. The phenotypes show a strong resemblance, and might in fact represent a clinical-genetic entity of the T158M mutation within the complex of congenital encephalopathies in males with MeCP2 mutations. We also report a 3-year-old boy with a R294X mutation, normal karyotype, and a more protracted course. He was inactive and sucked poorly from start. The head growth decelerated from the age of 6 months and the feeding problems increased requiring gastrostomy. He had a rapid deterioration period at 2 years and lost sitting and hand grasping functions. He had prolonged periods with tremor and epileptic myoclonus, shifting tonus, and dystonic extension of the trunk and legs, bruxism, and irregular breathing. He was clinically stable with preserved visual and emotional contact function by the age of four years. None of the boys had dysmorphic features.
Chronic Pain in the Outpatient Palliative Care Clinic

Chronic pain is common. Many patients with cancer and other life-limiting illnesses have chronic pain that is related to their disease, and some have comorbid chronic nonmalignant chronic pain. As palliative care continues to move upstream and outpatient palliative care programs develop, palliative care clinicians will be called upon to treat chronic pain. Chronic pain differs from acute pain in the setting of advanced disease and a short prognosis in terms of its etiology, comorbidities—especially psychiatric illness and substance abuse—and management. To successfully care for these patients, palliative care providers will need to learn new clinical competencies. This article will review chronic pain management core competencies for palliative care providers.
Expression of MUC2‐mucin in colorectal adenomas and carcinomas of different histological types

The expression of mucin MUC2 was investigated in normal colonic tissue, in colonic adenomas and in carcinomas of the mucinous and non‐mucinous type. The latter were subdivided into carcinomas originating from the adenoma‐carcinoma sequence (ACS) and de novo (DN) carcinomas. The expression was assayed by immunohistochemistry with the monoclonal anti‐MUC2 antibody CCP58 and by mRNA semiquantitation. MUC2 protein epitope CCP58 was strongly expressed in 21 % of normal colonic tissues, in 40% of villous and in 48% of tubular adenomas. Mucinous carcinomas exhibited strong expression in 72%, ACS carcinomas in 21 % and DN adenocarcinomas in none of the tumors investigated. Compared with the adjacent non malignant tissue (transitional mucosa), CCP58 epitope expression in the tumor was higher in 74% of mucinous carcinomas, but equal or lower in 69% of ACS carcinomas and in 100% of de novo carcinomas. The alterations of MUC2 expression detected by immunohistochemistry in adenocarcinomas were confirmed on mRNA level. These data indicate that the MUC2 expression pattern is different in the 3 carcinoma types investigated. MUC2 over‐expression occurs in the adenomatous tissue. It is always maintained in mucinous carcinomas, but frequently decreased in non‐mucinous ACS carcinomas. DN carcinomas are most frequently associated with decreased expression of MUC2. © 1994 Wiley‐Liss, Inc.