Miracle-dz/UniFAR-FTUs huggingface dataset:
Learning to use learning resources during medical school and residency.

OBJECTIVES This study (1) examined the natural history of learning to use learning resources by medical students and residents and (2) considered whether that history is consistent with the ways in which physicians approach their learning tasks. METHODS The authors conducted and analyzed thirty-two open-ended interviews of first-year and third-year medical students and first-year and senior residents in internal medicine, family medicine, or pediatrics. RESULTS AND DISCUSSION Learning to use learning resources occurs at the same time as learning done to address instructional and clinical problems that physicians-in-training face, with all kinds of learning following well-documented stages. Skills for using resources are developed gradually and by overcoming barriers such as time constraints and existing habits. CONCLUSIONS Implications of the natural history of learning to use learning resources can be employed by librarians and medical teachers to facilitate self-directed learning for physicians-in-training. Specific recommendations are provided.
Profits in the Long Run

Profits in the Long Run asks two questions: Are there persistent differences in profitability across firms? If so, what accounts for them? This book answers these questions using data for the 1000 largest US manufacturing firms in 1950 and 1972. It finds that there are persistent differences in profitability and market power across large US companies. Companies with persistently high profits are found to have high market shares and sell differentiated products. Mergers do not result in synergistic increases in profitability, but they do have an averaging effect. Companies with above normal profits have their profits lowered by mergers. Companies with initially below normal profits have them raised. In addition, the influence of other variables on long-run profitability, including risk, sales, diversification, growth and managerial control, is explored. The implications of antitrust policy are likewise addressed.
An Investigation into the Mechanism of Water Treeing in Polyethylene High-Voltage Cables

Water treeing is a well known fracture phenomenon in polyethylene (PE) and crosslinked polyethylene (XLPE) high voltage cable insulation. We studied two phenomena: (1) The insulation material is mechanically fatigued by electrostriction as is shown by measuring the relevant electrostriction constant, which moreover is compared with literature values on other polymers. The observed "electrostriction" is found to originate mainly from the Coulomb force. Using a simple model, the deformation mode at the end of a water tree channel can be described and the strain amplitude of the PE at the water interface can be calculated. (2) Under high voltage, the surface tension at the PE-water interface decreases strongly as we found experimentally. The observation that this decrease is proportional to the square of the applied field strength is explained. The joint effect of the Coulomb force and the reduced surface tension may cause a fracture phenomenon, well known in the field of polymers, called environmental fatigue failure (or thermal softening). The same assumption is made as in "common" environmental stress cracking of PE with aqueous detergents, viz. that the low surface tension plays an essential and not a coincidental role.
The influence of selection for ethanol withdrawal severity on traits associated with ethanol self-administration and reinforcement.

BACKGROUND Several meta-analyses indicate that there is an inverse genetic correlation between ethanol preference drinking and ethanol withdrawal severity, but limited work has characterized ethanol consumption in 1 genetic animal model, the Withdrawal Seizure-Prone (WSP) and-Resistant (WSR) mouse lines selected for severe or mild ethanol withdrawal, respectively. METHODS We determined whether line differences existed in: (i) operant self-administration of ethanol during sucrose fading and under different schedules of reinforcement, followed by extinction and reinstatement of responding with conditioned cues and (ii) home cage drinking of sweetened ethanol and the development of an alcohol deprivation effect (ADE). RESULTS Withdrawal Seizure-Prone-1 mice consumed more ethanol than WSR-1 mice under a fixed ratio (FR)-4 schedule as ethanol was faded into the sucrose solution, but this line difference dissipated as the sucrose was faded out to yield an unadulterated 10% v/v ethanol solution. In contrast, WSR-1 mice consumed more ethanol than WSP-1 mice when a schedule was imposed that procedurally separated appetitive and consummatory behaviors. After both lines achieved the extinction criterion, reinstatement was serially evaluated following oral ethanol priming, light cue presentation, and a combination of the 2 cues. The light cue produced maximal reinstatement of responding in WSP-1 mice, whereas the combined cue was required to produce maximal reinstatement of responding in WSR-1 mice. There was no line difference in the home cage consumption of a sweetened ethanol solution over a period of 1 month. Following a 2-week period of abstinence, neither line developed an ADE. CONCLUSIONS Although some line differences in ethanol self-administration and reinstatement were identified between WSP-1 and WSR-1 mice, the absence of consistent divergence suggests that the genes underlying these behaviors do not reliably overlap with those that govern withdrawal severity.
The occurrence of reactions and impairments in leprosy: experience in the leprosy control program of three provinces in northeastern Thailand, 1987-1995 [correction of 1978-1995]. II. Reactions.

AIM This is the second paper in a series of three papers on the occurrence of reactions and impairments in leprosy in Thailand, and focuses on the prevalence and incidence of reactions, including silent neuropathy. STUDY DESIGN A population-based, prospective cohort study. STUDY POPULATION All 640 newly diagnosed and registered leprosy patients in three neighboring provinces in northeastern Thailand registered between October 1987 and September 1990 were included [420 paucibacillary (PB) and 220 multibacillary (MB)]. This group was followed up (actively and passively) until the end of 1995. METHODS Clinical data and data on the sensibility and motor function of the eyes, hands and feet were obtained when appropriate. The occurrence of reactions, including silent neuropathy, at the beginning of, during and after treatment was ascertained. During surveillance mild late reactions were also recorded. RESULTS Severe reversal reactions (RR) at the start of and during treatment were seen in 2.6% [confidence interval (CI) 1.1-4.1] of the PB and 29% (CI 23-35) of the MB patients. In the PB group the majority (82%) of severe RR were found at the start of treatment. In the MB group 35% of the severe RR were found at the start of treatment and another 59% during the first year of treatment. It is shown that there is a statistically highly significant increasing proportion of patients with severe RR starting from tuberculoid and going toward borderline lepromatous. The incidence rate of severe RR during treatment was 1.4 (CI 0.46-4.5) per 100 person-years at risk (PYAR) for PB patients and 12 (CI 9.0-16) per 100 PYAR for MB patients. Late (mild and severe) RR were seen in 2.7% of the PB and 9% of the MB patients (35% of these reactions being considered severe). Late reactions were mainly seen in borderline tuberculoid (PB group) and in borderline lepromatous patients. Recent silent neuropathies were seen at first examination and during treatment in 1.4% of the pB and 4.1% of the MB patients. During surveillance only a few silent neuropathies were seen. If all severe RR, severe erythema nodosum leprosum and silent neuropathies at the start of, during and after treatment were added together, then 53% of the borderline lepromatous and 42% of the lepromatous patients had or developed one or another serious complication in need of steroid treatment.
A one-stage dorsal free-graft urethroplasty for bulbar urethral strictures.

OBJECTIVE To report the use of one-stage dorsal free-graft urethroplasty to reduce the incidence of urethrocele. PATIENTS AND METHODS From 1990 to 1994, 20 men (age range 21-86 years) underwent a one-stage dorsal free-graft urethroplasty of bulbar urethral strictures (iatrogenic in 12, traumatic in three, inflammatory in three and unknown in two). All patients except one had been treated previously by optical urethrotomy from one to 14 times. RESULTS Temporary fistulae were detected on post-operative urethrography in three patients with particularly long grafts, but they all resolved spontaneously. Within a mean follow-up of 46 months, only one patient had a short recurrent stricture, which was treated successfully by optical urethrotomy. Two patients complained of post-voiding dribbling, but radiographic studies never showed graft weakening and the urinary flow rate was always > 14 mL/s. CONCLUSION Free skin grafts can be applied successfully to the dorsal aspect and by doing so the complications of urethral reconstruction can be reduced.
Comparison of Ticagrelor Pharmacokinetics and Pharmacodynamics in STEMI and NSTEMI Patients (PINPOINT): protocol for a prospective, observational, single-centre study

Introduction The most common classification of acute myocardial infarction (AMI) is based on electrocardiographic findings and distinguishes ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Both types of AMI differ concerning their epidemiology, clinical approach and early outcomes. Ticagrelor is a P2Y12 receptor inhibitor, constituting the first-line treatment for STEMI and NSTEMI. According to available data, STEMI may be associated with lower plasma concentration of ticagrelor in the first hours of AMI, but currently there are no studies directly comparing ticagrelor pharmacokinetics or antiplatelet effect in patients with STEMI versus NSTEMI. Methods and analysis The PINPOINT study is a phase IV, single-centre, investigator-initiated, prospective, observational study designed to compare the pharmacokinetics and pharmacodynamics of ticagrelor in patients with STEMI and NSTEMI assigned to the invasive strategy of treatment. Based on an internal pilot study, the trial is expected to include at least 23 patients with each AMI type. All subjects will receive a 180 mg loading dose of ticagrelor. The primary end point of the study is the area under the plasma concentration-time curve (AUC(0–6)) for ticagrelor during the first 6 hours after the loading dose. Secondary end points include various pharmacokinetic features of ticagrelor and its active metabolite (AR-C124910XX), and evaluation of platelet reactivity by the vasodilator-stimulated phosphoprotein assay and multiple electrode aggregometry. Blood samples for the pharmacokinetic and pharmacodynamic assessment will be obtained at pretreatment, 30 min, 1, 2, 3, 4, 6 and 12 hours post-ticagrelor loading dose. Ethics and dissemination The study received approval from the Local Ethics Committee (Komisja Bioetyczna Uniwersytetu Mikołaja Kopernika w Toruniu przy Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy; approval reference number KB 617/2015). The study results will be disseminated through conference presentations and peer-reviewed journals. Trial registration number NCT02602444; Pre-results.
Adult post‐infectious thalamic encephalitis: acute onset and benign course

We report on two young patients with an encephalitic syndrome and bilateral thalamic lesions following a presumably viral or mycoplasma respiratory tract infection with the main clinical symptoms of organic psychosis in the first and a prolonged amnestic syndrome and ataxia in the second case. Four months later the patients had recovered clinically and the thalamic lesions had resolved on magnetic resonance imaging in one case and almost completely in the other. We interpret the patients’ illness as rare cases of a post‐infectious acute thalamic encephalitis in adults. The cases and their relationship to possible post‐infectious autoimmune inflammatory or toxic pathophysiological mechanisms are discussed and a review of the literature is provided.
Hearing Loss and Hearing Protection Use Among Midwestern Farmers

HEARING LOSS AND HEARING PROTECTION USE AMONG MIDWESTERN FARMERS Josie J. Ehlers, M.P.H. , Ph.D. University of Nebraska, 2018 Supervisor: Chandran Achutan, C.I. H. , Ph.D. Many farmers have noise-induced hearing loss, yet few use hearing protection when working around loud noise. A point source intervention (storing hearing protection devices near sources of noise) was implemented to help farmers overcome accessibility barriers related to using hearing protection. Intervention farmers (n=53) received education and the point source intervention; control farmers (n=36) received education only. During each year of the study, all farmers completed a questionnaire about their perceptions of hearing protection and participated in an audiometric test at their farm. Ambient sound pressure levels were taken during tests. The main objectives of this dissertation were to evaluate if the point source intervention improved farmers’ perceptions about hearing protection and prevented hearing loss. The onsite audiometric test environments were also assessed. The first study evaluated factors that influence farmers’ perceptions about hearing protection. These perceptions improved during the study, specifically those related to barriers, self-efficacy, and intent. Older age was associated with positive perceptions of barriers concerning communication and intention to use hearing protection. Having hearing loss (both perceived and measured) was associated with lower intention of using hearing protection. These findings were similar for both intervention and control groups. The second study, conducting audiometric testing on farms, showed that in most cases ambient noise levels exceeded the American National Institute Standard for audiometric test
Can Serum ICAM 1 distinguish pancreatic cancer from chronic pancreatitis?

Background and aim: Pancreatic cancer is the fourth leading cause of cancer-related death worldwide, with an overall 5-year survival of <5% mainly due to presence of advanced disease at time of diagnosis. Therefore development of valid biomarkers to diagnose pancreatic cancer in early stages is an urgent need. This study concerned the sensitivity and specificity of serum ICAM 1 versus CA 19-9 in differentiation between pancreatic cancer and healthy subjects and acohort of patients with chronic pancreatitis with a focus on assessing validity in diagnosis of early stages of pancreatic cancer. Methods: A cohort of 50 patients with histologically diagnosed pancreatic tumors, 27 patients with chronic pancreatitis, and 35 healthy controls were enrolled. Serum samples for measurement of CA19-9 and I-CAM 1 were obtained from all groups and analyzed for significance regarding diagnosis and disease stage. Results: At a cut off value of (878.5 u/ml) I-CAM 1 had 82% and 82.26% sensitivity and specificity for differentiation between cancer and non-cancer cases, with higher sensitivity and specificity than CA19-9 at different cut offs (CA19-9 sensitivity and specificity ranged from 64-80% and 56.4 – 61.2% respectively). The AUC was 0.851 for I-CAM and 0.754 for CA19-9. Neither of the markers demonstrated significance for distinguishing between early and late cancer stages. Conclusion: ICAM 1 is a useful marker in differentiation between malignant and benign pancreatic conditions, and superior to CA19-9 in this regard. However, neither of the markers can be recommended for use in differentiation between early and late stage pancreatic cancers.
A Review of Instruments Measuring Resilience

The objectives of the study were to evaluate the psychometric properties and appropriateness of instruments for the study of resilience in adolescents. A search was completed using the terms resilience and instruments or scales using the EBSCO database (CINAHL, PreCINAHL, and Academic Search Premier), MEDLINE, PsychINFO and PsychARTICLES, and the Internet. After instruments were identified, a second search was performed for studies reporting the psychometric development of these instruments. Using inclusion and exclusion criteria, six psychometric development of instrument studies were selected for a full review. A data extraction table was used to compare the six instruments. Two of the six instruments (Baruth Protective Factors Inventory [BPFI] and Brief-Resilient Coping Scale) lacked evidence that they were appropriate for administration with the adolescent population due to lack of research applications. Three instruments (Adolescent Resilience Scale [ARS], Connor–Davidson Resilience Scale, and Resilience Scale for Adults) had acceptable credibility but needed further study in adolescents. One instrument (Resilience Scale [RS]) was determined to be the best instrument to study resilience in the adolescent population due to psychometric properties of the instrument and applications in a variety of age groups, including adolescence. Findings of this review indicate that the RS is the most appropriate instrument to study resilience in the adolescent population. While other instruments have potential (e.g., ARS, BPFI) as they were tested in the adolescent and young adult populations, they lack evidence for their use at this time. An evaluation of the review and recommendations are discussed.
Engineering the Japanese encephalitis virus RNA genome for the expression of foreign genes of various sizes: Implications for packaging capacity and RNA replication efficiency

Using the RNA replication machinery of Japanese encephalitis virus (JEV), the authors have established and characterized three strategies for the expression of foreign genes. Initially, ≈11 kb genomic RNA was engineered to express heterologous genes of various sizes by preferentially inserting a new cistron at the beginning of the 3′ nontranslated variable region. RNA transfection yielded recombinant viruses that initiated foreign gene expression after infecting permissive cells. JEV was capable of packaging recombinant genomes as large as ≈15 kb. However, larger genome size was inversely correlated with RNA replication efficiency and cytopathogenicity, with no significant change in infectivity. Second, a variety of self-replicating propagation-deficient viral replicons were constructed by introducing one to three in-frame deletions into the ectodomains of all the structural proteins of JEV. These replicons displayed a spectrum of RNA replication efficiency upon transfection, suggesting that remnant transmembrane domains play a suppressive role in this process. Third, the authors generated a panel of stable packaging cell lines (PCLs) providing all three JEV structural proteins in trans. These PCLs efficiently packaged viral replicon RNAs into single-round infectious viral replicon particles. These JEV-based virus/vector systems may provide useful tools for a variety of biological applications, including foreign gene expression, antiviral compound screening, and genetic immunization.
A 1.2V High Linearity Mixer Design

This paper introduces double balance active mixer which is designed by Barrie Gilbert, it shows good characteristics in linearity, gain and isolation. In 1998, Barrie Gilbert present multi-tanh principle with bipolar transistors. So this paper uses the multi-tanh technique to design some new structure in order to improve linearity and gain. First we double the transconductor level with four NMOS transistors, then we tripled the transconductor level with six NMOS transistors, meanwhile we keep the circuit is symmetry. Using Cadence SpectreRF, the circuits show better linearity and gain, yet noise figure increase, so it exists a tradeoff among these parameters of active mixer. In this paper, the circuit simulated in 2.4 GHz down-conversion mixer with 0.18 mum process, IIP3 and ldB compression point achieved 8.5 dBm and 2 dBm, gain is 4 dB, power assumption is 6 mW. Although this new architecture being used in down conversion mixer, it can be applied in up conversion active mixers too.
Cellular immune dysfunction in immune thrombocytopenia (ITP)

Over the past decades, a wealth of information has been reported about the pathogenic features of immune thrombocytopenia (ITP). To this day, however, it is unclear whether the immune abnormalities associated with ITP play causative roles in the disease or are secondary epiphenomena brought on by the inflammatory processes that are associated with the disorder. Like the majority of all autoimmune diseases, ITP is an organ‐specific disease and abnormalities in immune cell types, such as antigen‐presenting cells (APC), T cells and B cells have been shown to play some sort of role in the initiation and/or perpetuation of the disease. This review will discuss recent advances in understanding three immune cells important in ITP pathophysiology: APC, T cells and B cells, and will review how they interact with each other to initiate and perpetuate ITP, particularly the chronic form of the disorder. It will also focus on new data related to the genetics of the disorder and discuss relevant animal models of ITP.
Consistent condom use in relationships between seropositive injecting drug users and sex partners who do not inject drugs

Objectives.To study how condom use in injecting drug users' (IDU) relationships differs according to whether they are HIV-infected, and to whether their sex partner is an IDU. Design and methods.A total of 317 street-recruited IDU were HIV-antibody tested and interviewed about 421 relationships with particular sex partners. Results.Condoms were consistently (100%) used in sex between partners (during the previous 30 days) in 33% of these relationships, and their use was significantly more frequent in relationships of seropositive IDU and in relationships with non-IDU partners. In relationships between seropositive IDU and non-IDU, consistent condom use was reported to be high (68%); this remained unchanged under multivariate controls. Conclusions.Self-reported condom use by IDU in New York, with its relatively mature epidemic, appears to be concentrated where it may most reduce the spread of HIV to non-IDU heterosexuals, i.e., in relationships between infected IDU and non-IDU partners. Differential condom use by serostatus and by partners' drug injection should be incorporated into mathematical models of the HIV epidemic. Causes of the high level of condom use in this subset of relationships may include drug injector altruism and pressure by sex partners; prevention programs should develop ways to use both of these factors to motivate increased condom use.