Miracle-dz/UniFAR-FTUs huggingface dataset:
Developing an OSTE to Address Lapses in Learners’ Professional Behavior and an Instrument to Code Educators’ Responses

Purpose. To develop an instrument for measuring medical educators’ responses to learners’ lapses in professional behavior. Method. In 1999, at the Indiana University School of Medicine, a 22-item checklist of behaviors was developed to describe common responses used by educators responding to learners’ lapses in professional behavior. Four medical students were trained to portray lapses in professional behaviors. These students and seven clinical observers trained to categorize behaviors as present or absent. Interrater reliability was assessed during 18 objective structured teaching evaluations (OSTEs). Videotaped OSTEs were coded twice at a one-month interval for test–retest reliability. Items were classified as low, moderate, or high inference behaviors. Script realism and educator effectiveness were assessed. Results. Educators rated OSTE scripts as realistic. Raters observed an average of 6 ± 2 educator behaviors in reaction to learners’ lapses in professional behavior. Educators’ responses were rated as moderately effective. More experienced educators attempted more interventions and were more effective. Agreement was high among raters (86% ± 7%), while intraclass correlation coefficients decreased with increasing inference level. From videotaped OSTEs, raters scored each behavior identically 86% of the time. Conclusions. Accurate feedback on educators’ interactions in addressing learners’ professionalism is essential for faculty development. Traditionally, educators have felt that faculty's responses to learners’ lapses in professional behavior were difficult to observe and categorize. These data suggest that educators’ responses to learners’ lapses in professional behavior can be defined and reliably coded. This work will help provide objective feedback to faculty when engaging learners about lapses in professional behavior.
Increase of surface solar irradiance across East China related to changes in aerosol properties during the past decade

Previously, it was widely documented that an overall decrease in surface solar radiation occurred in China at least until 2005, in contrast to the general background of ‘global brightening’. Increased anthropogenic aerosol emissions were speculated to be the source of the reduction. In this study, we extend the trend analysis to the most recent decade from 2005–2015 and find that surface solar radiation has shifted from ‘dimming’ to ‘brightening’ over East China, with the largest increase over the northeast and southeast parts. Meanwhile, satellite and ground observation both indicate a reduction in aerosol optical depth (AOD) during the same period, whereas no significant trends in cloud amount show up. Detailed analysis using co-located radiation and aerosol observation at the XiangHe station in North China suggests that both AOD and single scattering albedo (SSA) changes contribute to the radiation trends. AOD reduction contributes to the increase of direct solar radiation, also decreasing the diffuse radiation, while the increase of SSA serves to increase the diffuse fraction. Simple calculations using a radiative transfer model confirm that the two effects combined explain changes in the global solar radiation and its components effectively. Our results have implications for potential climate effects with the reduction of China’s aerosol emissions, and the necessity to monitor aerosol composition in addition to its loading.
Asymmetry of Gains and Losses: Behavioral and Electrophysiological Measures

Asymmetry of Gains and Losses: Behavioral and Electrophysiological Measures Diego Gonzalo Flores Garnica Department of Psychology, BYU Doctor of Philosophy The purpose of this research was to explore the effects of small monetary or economic gains and/or losses on choice behavior through the use of a computerized game, and to determine gain/loss ratio differences using both behavioral and electrophysiological measures. Participants (N=53) played the game in several 36 minute sessions. These sessions operated with concurrent variable-interval schedules for both rewards and penalties. Previously, asymmetrical effects of gains and losses have been identified through cognitive studies, primarily due to the work of nobel laureates Daniel Kahneman and Amos Tversky (1979). They found that the effect of a loss is twice (i.e., 2:1) that of a gain. Similar results have been observed in the behavioral laboratory as exemplified by the research of Rasmussen and Newland (2008), who found a 3:1 ratio for the effect of losses versus gains. The asymmetry of gains and losses was estimated behaviorally and through event-related brain potentials (ERPs) and the cognitive (Kahneman and Tversky) and behavioral (Rasmussen and Newland) discrepancy elucidated. In the game, the player moves an animated submarine around sea rocks to collect yellow coins and other treasures on the sea floor. Upon collecting a coin, one of three things can happen: The player triggers a penalty (loss), the player triggers a payoff (gain), or there is no change. The behavioral measures consisted in counting the number of clicks, reinforces, and punishers and then determining ratio differences between punished (loss) and no punished condition (gain) conditions. The obtained gain/loss ratio corresponded to an asymmetry of 2:1. Similarly ratio differences were found between male and female, virtual money and cash, risk averse versus risk seeking, and generosity versus profit behavior. Also, no ratio difference was found when players receive information about other player’s performances in the game (players with information versus players without information). In electroencephalographic (EEG) studies, visual evoked potentials (VEPs) and ERPs components (e.g., P300) were examined. I found increased ERP amplitudes for the losses in relation to the gains that corresponded to the calculated behavioral asymmetry of 2:1. A correlational strategy was adopted that sought to identify neural correlates of choice consistent with cognitive and behavioral approaches. In addition, electro cortical ratio differences were observed between different sets of electrodes that corresponded to the front, middle, and back sections of the brain; differences between sessions, risk averse and risk seeking behavior and sessions with concurrent visual and auditory stimuli and only visual were also estimated.
The role of parents’ sense of coherence in irregular meal pattern and food intake pattern of children aged 10–11 in Finland

Background: Among adults, a stronger sense of coherence (SOC) seems to promote a better coping with strain and is associated with healthier behaviours, including eating patterns. The parents’ SOC may also have a wider effect on the health behaviour of their children. The aim of this study is to determine whether there are associations between parents’ SOC and the eating patterns of their children and if this can be explained by mediating factors. Methods: Cross-sectional. In 2006, 1268 (response rate 79%) 10- and 11-year-old children in southern Finland, in a classroom situation, filled in a questionnaire assessing meal pattern and food frequency intake. Parents, 816 (response rate 64%), filled in a questionnaire assessing SOC (13 items) and eating patterns. Matching data were found from 772 child–parent pairs. χ2 tests, factor analysis, univariate analysis of variance and logistic regression analyses were used as statistical methods. Results: A weaker parental SOC was associated with children’s irregular meal pattern (p = 0.004), more frequent intake of energy-rich foods (p = 0.002) and less frequent intake of nutrient-rich foods (p = 0.051). Mediating factors, such as availability and accessibility of fruit and vegetables at home, parent’s nutrition knowledge, parents’ own fruit and vegetable intake and an irregular meal pattern, explained the association between parents’ SOC and children’s intake of nutrient-dense foods, but not the association with energy-rich foods. Conclusions: Parents’ weaker SOC was associated with children’s unhealthier eating patterns. More research is needed on the associations between parents’ SOC and other health-related behaviours in their children.
How Do Shocks to Bank Capital Affect Lending and Growth?

We examine bank capital shocks using a recent new approach based on non-normal errors in vector autoregressive models. Using a sample of 14 European economies over January 2004 through March 2018 we identify two distinct classes of bank capital shocks, capital tightening shocks, and bank profitability shocks. We find that both bank capital shocks frequently lead to changes in lending volume and interest rates for new loans. In contrast to some recent similar studies, we find less evidence for impact on production. Bank capital shocks have further effects on the substitution between the bank and market-based financing and on credit allocation across different borrower sectors. Policymakers may find these results useful when considering counter-cyclical adjustments to the bank capital requirements.
Gallium arsenide augments antigen processing by peritoneal macrophages for CD4+ helper T cell stimulation.

Gallium arsenide (GaAs) suppresses numerous immunologic functions of leukocytes at distal locations from the exposure site. The effect of direct GaAs exposure on peritoneal cells was examined by i.p. administration of the chemical. No alteration in the frequency of various cell lineages, including macrophages, B cells, CD4+ and CD8+ T cells, and granulocytes, occurred within the peritoneal population from GaAs-exposed mice. The ability of macrophages to function as antigen-presenting cells (APC) by processing a panel of soluble protein antigens was investigated by the stimulation of antigen-specific helper T cell hybridomas to secrete interleukin-2. On a per cell basis, GaAs-exposed macrophages were more efficient than vehicle control cells in activating the T cells with all native antigens examined. GaAs exposure increased the expression of major histocompatibility complex class II molecules, which are recognized by these T cells, on the surface of macrophages. However, the level of T cell activation with peptide fragments of the antigens, which do not require processing, was not enhanced with GaAs-exposed cells as APC. In contrast, the capability of latex bead-exposed macrophages to function as APC was comparable to that of vehicle control cells, suggesting that GaAs modulatory effects were not merely due to phagocytosis of particles. These findings suggest that direct GaAs exposure augments antigen processing, but not presentation, by macrophages perhaps by activating the cells, which may contribute to the immunotoxicity and inflammatory reaction caused by respiratory exposure to GaAs.
Xenohormesis mechanisms underlying chemopreventive effects of some dietary phytochemicals

A wide variety of phytochemicals present in our diet, including fruits, vegetables, and spices, have been shown to possess a broad range of health‐beneficial properties. The cytoprotective and restorative effects of dietary phytochemicals are likely to result from the modulation of several distinct cellular signal transduction pathways. Many dietary phytochemicals that are synthesized as secondary metabolites function as toxins, that is, “phytoalexins,” and hence protect plants against insects and other damaging organisms and stresses. However, at the relatively low doses consumed by humans and other mammals, these same toxic plant–derived chemicals, as mild stressors, activate adaptive cellular response signaling, conferring stress resistance and other health benefits. This phenomenon has been referred to as xenohormesis. This review highlights the xenohormesis mechanisms underlying chemopreventive effects of some dietary chemopreventive phytochemicals, with special focus on the nuclear transcription factor erythroid 2p45 (NF‐E2)–related factor 2 (Nrf2) as a key player.
Peripheral venous and arterial lactate agreement in septic patients in the Emergency Department: a pilot study

Lactate measurements are routinely used in sepsis for prognostication and for guiding treatment. Although venous lactate measurements have widely been used, most studies have used arterial lactate (A-LACT). The interchangeability between the measurements is debatable. This pilot study aimed to investigate whether an agreement exists between peripheral venous lactate (PV-LACT) and A-LACT with respect to sepsis in the Emergency Department (ED). PV-LACT lactate and A-LACT measurements were taken from a convenience sample of 37 patients presenting to a tertiary hospital ED between November 2010 and August 2011. The agreement between the paired measurements was assessed using Bland–Altman analysis. The mean difference between the measurements (venous–arterial) was 0.54 mmol/l, with 95% limits of agreement of −0.11 to 1.18 mmol/l. This pilot study demonstrates the potential use of PV-LACT as a substitute for A-LACT measurement in septic ED patients. However, further definitive investigation is needed to support widespread clinical adoption of peripheral venous lactate.
Problematic Integration in Pregnancy and Childbirth: Contrasting Approaches to Uncertainty and Desire in Obstetric and Midwifery Care

The experience of pregnancy is often accompanied by uncertainties with which mothers somehow have to cope. Uncertainty may be related to the health of the mother or baby, or how labor will be experienced, as well as longer-range issues, such as financial concerns and worries about being a good parent. Drawing on Babrow's (1992, 2007) PI (problematic integration) theory, this article explores the struggles that pregnant mothers face and the role that their practitioners play in these dilemmas. Particularly, this project examines obstetricians and midwives in an effort to discern how these providers differ in their confrontation of mothers' uncertainties.
Educational mismatch and the earnings distribution

This article focuses on the interrelationship between educational mismatch and earnings, taking three new approaches. First, we examine decompositions of the mismatch wage gap, finding that characteristics explain less than half of the mismatch penalty. Second, we use unconditional quantile regression to examine the mismatch penalty across the earnings distribution, showing that the penalty shrinks as the position in the earnings distribution increases. Third, we decompose the differentials using quantile decompositions. Different reasons for mismatch show heterogeneity in our results, with larger penalties for being mismatched due to working conditions, location, family, and no available job.
Association Between Urinary Phthalates and Pubertal Timing in Chinese Adolescents

Background Phthalates are synthetic chemicals and ubiquitous environmental contaminants, with hormonal activity that may alter the course of pubertal development in children. Objectives To determine whether exposure to phthalate metabolites is associated with timing of pubertal development in a cross-sectional study of a school-based clustered sample of 503 children from a suburban district in Shanghai, China, who were 7–14 years of age at enrollment (2010 October to November). Methods We analyzed six phthalate metabolites in urine samples by isotope-dilution liquid chromatography tandem mass spectrometry. The associations of exposures to phthalates with pubertal timing of testes, breast, and pubic hair development (represented as Tanner stages) were evaluated using an ordered logistic regression model adjusted for chronological age, body fat proportion (BF%), and parental education. Results In boys, urinary mono-n-butyl phthalate (MBP) levels were negatively associated with testicular volume, and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) levels were negatively associated with pubic hair stages. The odds of being in an advanced stage were decreased by 43%–51%. In girls, mono (2-ethylhexyl) phthalate (MEHP), MEHHP, and MEOHP levels, as well as the sum of these levels, were positively associated with breast stages, and the association was much stronger in girls with high BF%; the odds of being in an advanced stage were increase by 29% to 50%. Conclusions Phthalate metabolites investigated in this study show significant associations with pubertal timing both in boys and in girls, especially among girls with high BF%.
Vascular surgeries in West Africa: Challenges and prospects

Background The field of vascular surgery is evolving in sub-Saharan Africa but the practice is bedeviled by lack of expertise and infrastructure challenges. The consequences are a low volume of operations and a dearth of data. Available data are not representative of the wider picture, therefore, this study was undertaken to evaluate the practice of vascular surgery in a tertiary institution, in the light of the prevailing challenges. Methods Data from all patients with vascular-related pathologies managed in our surgical outpatient clinic and accident and emergency wards were obtained from the clinic and in-patient records from January 2008 to December 2012. Age, sex, diagnosis, treatment, and complications were noted. There were 73 patients comprising 45 (61.6%) males and 28 (38.4%) females. The age range was 1–90 years (mean 43.5 years). Results The pathologies managed included end-stage renal disease (n = 36, 49.3%), nontraumatic and posttraumatic aneurysms (n = 13, 17.8%), vascular trauma (n = 12, 16.4%), peripheral vascular disease (n = 5, 6.9%), congenital vascular malformations (n = 4, 5.5%), and thrombotic diseases (n = 3, 4.1%). Fifty-four (74.0%) surgeries were performed, with a complication rate of 5.5% and 2.7% mortality. Conclusions The practice of vascular surgery in Zaria, Nigeria, is fraught with challenges. The gap created by the dearth of skilled vascular surgeons is filled by competent cardiothoracic surgeons. Infrastructure decay and lack of prostheses limit the number and variety of operable cases. These challenges result in preventable morbidity and mortality.
A Kairomone Based Attract-and-Kill System Effective Against Alfalfa Looper (Lepidoptera: Noctuidae)

Abstract A chemical lure derived from flowers that are visited by moths attracts male and female alfalfa loopers, Autographa californica (Speyer) (Lepidoptera: Noctuidae). This feeding attractant is dispensed from polypropylene bottles that provide controlled release for several weeks. A killing station was tested in the laboratory, in a screenhouse, and in the field in combination with this lure as an “attract-and-kill” system. Starved alfalfa looper adults (moths) were strongly attracted to the attract-and-kill station in a flight tunnel, and 90.9% of female moths and 87.6% of male moths that contacted the station died. In commercial fields of alfalfa hay, female moths captured in monitoring traps were reduced by 80–93% in plots receiving 125 attract-and-kill stations per hectare. In screenhouse trials using two attract-and-kill stations per screenhouse, oviposition on potted lettuce plants by starved female alfalfa looper moths was reduced by 98.5%. Moths were less likely to be attracted to lures when provided sugar before flight tunnel assays, and oviposition by fed moths was much less affected by attract-and-kill stations in screenhouse trials, compared with starved moths. This method has potential as a means to manage alfalfa looper populations in vegetable and other agricultural crops. However, consideration must be given to competing food and odor sources in the field.
An Investigation of Economic Consequences of Family Control and Audit Quality of Firms: A Case Study of Pakistan

The paper, empirically investigates the impact of family control and audit quality on firmsâ€™ performance, over the period of 2007-2014 for the listed firms at the Pakistan Stock Exchange (PSE), using the Pooled OLS, Fixed effect, and Random effect model. For robustness, the case of reverse causality and cross sectional dependency is taken, using GMM, FGLS and PCSE regression methods. The findings suggest that higher audit quality and the family control are associated with higher firmsâ€™ performance and findings as these particular estimates are robust for alternative estimation techniques. Overall, the results support the argument presented by alignment hypothesis of agency theory, stewardship theory, resource based view of firms, and the socio-emotional wealth theory.
The palliative value of tumor necrosis factor α‐based isolated limb perfusion in patients with metastatic sarcoma and melanoma

Both patients with soft tissue sarcoma (STS) and patients with melanoma have limited treatment possibilities once the tumor has metastasized systemically. In patients with extremity STS or bulky melanoma in‐transit metastases, the local tumor burden may be so problematic that, even in patients with systemically metastasized disease, an amputation may be inevitable. Isolated limb perfusion (ILP) has proven to be an excellent, local, limb‐saving treatment option in patients with locally advanced extremity tumors. In this study, the authors investigated the palliative value of the ILP procedure to avoid amputation in patients who had Stage IV STS and melanoma.
Heart Follows Thyroid

In humans both hyper- and hypothyroidism can have different clinical manifestations. Among these symptoms, there is a numerous group dealing with the cardiovascular system. Thyroid hormones affect the hemodynamic state of organism and regulate expression of some cardiomyocyte structural genes. Thyroid disorders may also contribute to accelerate the underlying heart problems. Unfortunately, since thyroid dysfunction remains undiagnosed, cardiological treatment is not effective enough. In this paper, the authors show and explain the main cardiac consequences of an overactive and underactive thyroid gland. Additionally, some new data about thyroxine application in cardiac remodeling and fetal phenotype creation as a result, are included in this review.
On the resource trade-off of flow update in software-defined networks

In software-defined networks, packet forwarding is performed by installing rules on the switches' flow tables. After the rules are installed, the controller needs to dynamically update the rules during runtime for a variety of reasons including traffic engineering, policy changes, network maintenance, and so on. A single forwarding policy update often consists of rule modifications on multiple switches simultaneously. Since the update process requires moving flows to different paths in a consistent and correct manner, multiple steps are usually involved. Thus, additional resources are needed to handle the flow update to ensure correctness and performance, such as extra bandwidth and flow table entries. In this work, we analyze different existing mechanisms of flow update from their resource utilization perspectives. Specifically, we study the impact of bandwidth and flow table size on the performance of flow update, and their interactions. We provide both qualitative analysis of the tradeoff between these two kinds of resources, and the quantitative simulation results of this trade-off under different realistic network topologies. Our observation is important to the problems related to flow update, based on which we further illustrate its usefulness with three applications.