Miracle-dz/UniFAR-FTUs huggingface dataset:
Education Becomes Social: The Intersection of Social Media and Medical Education.

Social media has become an integral method of communication for a vast majority of our digitally connected society. Although our patients have raced to join the throngs flooding social media sites and networks, the medical profession as a Blogging A blog (short for “web log”) is an online page or website containing writings and/or other media, often reflections or commentaries, published in reverse chronological order. Among types of social media used in medical education, blogging is the most common tool studied for its outcomes. Blogs have been used to improve learner engagement, stimulate interaction with faculty, maintain students’ humanism and empathy, and enhance collaboration. In 1 study, active participation in a blog-based discussion forum correlated with higher final course grades. Required reflective student blogs during a medicine clerkship heavily
Homocysteine is not associated with global motor or cognitive measures in nondemented older Parkinson's disease patients

Levodopa (L‐dopa) treatment of Parkinson's disease (PD) is associated with elevated homocysteine (Hcy). To examine the relationship between Hcy, methylenetetrahydrofolate reductase polymorphisms (MTHFR: 677C/T; 1298A/C), and B‐vitamins in older PD patients and whether Hcy or MTHFR polymorphisms were associated with clinical measures. MTHFR polymorphisms, B‐vitamin intake, and blood concentrations of Hcy, vitamin B12 and folate, and creatinine were determined and compared between groups (PD and controls). The relationship of Hcy to clinical measures was examined in PD. Among 51 patients [30M/21F, mean age (SD): 71.5 (4.7)] and 50 controls [29M/21F, 71.5 (4.8)], Hcy was higher in PD [13.6 (3.8); controls: 10.5 (2.5), P < 0.0005]. Hcy was associated with B‐vitamin intake [F = 21.7, P < 0.0005], folate level (R = 0.31, P = 0.035), and the interaction of intake with MTHFR 677T (F = 5.2, P = 0.007), but not MTHFR 1298C genotype. Hcy did not correlate with global measures of cognition, mood, or parkinsonism in PD or with dyskinesias, fluctuations, or freezing. Higher vitamin B12 levels were associated with lower dyskinesia risk. Hcy was influenced by PD, MTHFR 677 genotype, and vitamin use, but not by the MTHFR 1298 genotype. There was no clear association with motor or cognitive measures, but dyskinesias were less likely with higher B12. © 2008 Movement Disorder Society
It takes more than agency: Linking support from teaching staff, career engagement, and movement capital among university students

Introduction Career self-management behaviours are key to overcoming the challenges of entry into the labour market. Combining the Conservation of Resources and Career Self-management theories, this study delves into the concept of Career Engagement among Italian University students by examining its relationship with Support from teaching Staff and Movement Capital. We hypothesised a mediation model in which Support from Teaching Staff predicts Career Engagement which, in turn, fosters Movement Capital. As the pandemic led to the adoption of online learning solutions, we also explored whether and how the interaction between teachers and students during online classes moderates the said mediation relationship. Methods and results We collected data from 276 Italian University students through an online questionnaire. Results supported the mediation hypothesis, corroborating the mediating role of Career Engagement. We also observed that this relationship is stronger at medium and higher levels of online interaction between teachers and students. Discussion Findings contribute to existing evidence about the role of Career Engagement in facilitating career resources’ acquisition and extend the understanding of its contextual antecedents in Higher Education contexts. Results also align with the importance attributed to interaction in online learning environments. This work suggests ways to encourage career behaviours in Higher Education and equip prospective labour market entrants with career resources.
Predictors of Compliance Handwashing Practice among Healthcare Professionals

Background: Handwashing compliance among healthcare professionals is the most important recommended practice to combat hospital-associated infections. However, compliance rates with handwashing practices remain low, particularly among physicians. Objectives: The purpose of this study was to determine the application status of handwashing information given withinthecontextofinfectioncontrolmeasuresinpracticeareas;andalsotodeterminetheneedforinclusionofmore in-depth information about handwashing and identifying the predictors for handwashing compliance in relation to knowledge, behaviour, beliefs, and attitude by healthcare professionals. Methods:Thisstudywasacross-sectionalsurvey.Thetargetpopulationwasallhealthcareprofessionals,including physicians, nurses and technicians, working in large acute-care hospitals in Amman, Jordan. However, medical and nursing students were excluded. Results: The results showed a predictive model of five predictors which were significantly related to self-reported handwashing:beliefsaboutoutcomes,attitude,referentbeliefs,controlbeliefsandskinassessment.Thesefactorshave a comparable power in the prediction of self-reported handwashing. Attitude, control beliefs and skin assessment had relatively higher prediction effects (B=0.406, P <0.001), (B=0.296, P <0.000), (B=0.523, P <0.000), respectively, compared with intention (B=-0.233, P=0.102) and years of experience (B=-0.078, P=0.576). Conclusion: The results of this study have important implications for improving healthcare professionals' compliance with handwashing through continuous education for those providers to reinforce and educatethem about the concepts of universal precautions and guidelines of infection control.
A new method for hemorrhoid surgery: experimental model of diode laser application in monkeys.

OBJECTIVE Detailed here is an experimental model in monkeys of a new approach to treat hemorrhoids using a diode laser. BACKGROUND DATA Hemorrhoids are a common source of pain and suffering. Endovascular laser therapy for variceal veins is a method that potentially could be used in the treatment of hemorrhoids. There is currently no such method described in the literature. MATERIALS AND METHODS Hemorrhoids were induced in monkeys by ligation of the inferior hemorrhoidal vein, similar to their cause in humans. After the piles were identified, laser fibers were introduced into them, and they were irradiated with laser energy (810 nm at 1-2 W in 1-sec pulses of 1-2 J each, for a total fluency of 4-10 J). RESULTS The piles were completely reduced, and histological examination performed 10 d post-surgery showed reduction of the dilated vessels and complete healing. The laser energy was not delivered directly into the veins, but instead to the surrounding submucosal interstitial tissue, effectively reducing the hemorrhoids. CONCLUSION The diode laser energy delivered into the hemorrhoids led to their complete resolution. Further clinical trials using this protocol must be carried out to determine its applicability to human hemorrhoids.
Effects of nonsocial and circumscribed interest images on neural mechanisms of emotion regulation in autistic adults

Introduction Emotion dysregulation is commonly reported among autistic individuals. Prior work investigating the neurofunctional mechanisms of emotion regulation (ER) in autistic adults has illustrated alterations in dorsolateral prefrontal cortex (dlPFC) activity, as well as concurrent atypical patterns of activation in subcortical regions related to affect during cognitive reappraisal of social images. Whereas most research examining ER in autism has focused on regulation of negative emotions, the effects of regulating positive emotions has been generally understudied. This is surprising given the relevance of positive motivational states to understanding circumscribed interests (CI) in autism. Methods Accordingly, the purpose of this study was to use fMRI with simultaneous eye-tracking and pupillometry to investigate the neural mechanisms of ER during passive viewing and cognitive reappraisal of a standardized set of nonsocial images and personalized (self-selected) CI images. Results The autistic group demonstrated comparatively reduced modulation of posterior cingulate cortex (PCC) activation during cognitive reappraisal of CI images compared to viewing of CI, although no eye-tracking/pupillometry differences emerged between-groups. Further, the autistic group demonstrated increased PCC connectivity with left lateral occipital and right supramarginal areas when engaging in cognitive reappraisal vs. viewing CI. Discussion In autistic adults, CI may be differentially modulated via PCC. Considering the documented role of the PCC as a core hub of the default mode network, we further postulate that ER of CI could potentially be related to self-referential cognition.
A follow‐up study on 6‐[18F]fluoro‐L‐dopa uptake in early Parkinson's disease shows nonlinear progression in the putamen

Sixteen subjects with de novo Parkinson's disease (PD) underwent three 6‐[18F]fluoro‐L‐dopa (Fdopa) positron emission tomography (PET) scans during a follow‐up time of 5 years (mean ± SD 5.5 ± 0.4 years) to study the progression of striatal dopaminergic hypofunction. Throughout the study, the smallest Fdopa uptake values were found in the dorso‐caudal part of the putamen contralateral to the side with dominant motor symptoms. The rate of decline in Fdopa uptake in the contralateral putamen was faster in the beginning of the disease and slowed down as the disease progressed. The annual decline in Fdopa influx constant (Ki, unit × 10−3 min−1) was on average 0.5 during the first 2 years and 0.2 during the subsequent 3 years (P = 0.002) in the contralateral putamen. In caudate, the rate of decline in Fdopa values was slower than in the putamen and did not change significantly during the follow‐up time, annual decline in the contralateral caudate being 0.1 between baseline and 2 years and 0.3 between 2 and 5 years (P = 0.4). These results suggest that progression of putaminal dopaminergic hypofuncion in PD follows a nonlinear pattern at least in the contralateral side being faster in the beginning of the disease. © 2009 Movement Disorder Society
Motor patterns in Parkinson's disease: A data‐driven approach

To identify patterns of motor disturbances in Parkinson's disease (PD) and evaluate their relation with other PD domains. A cohort of 399 PD patients was randomly divided into two samples. Factors within the motor section of the SPES/SCOPA were identified by exploratory factor analysis on data from the first sample and next tested by confirmatory factor analysis in the second sample. Relations with other PD domains were evaluated by regression analyses. A four factor model was found to be valid. This included a tremor, a bradykinetic‐rigid, and two axial factors. One axial factor (“rise”, “gait”, “postural instability”) was associated with age and cognition, while the other axial factor (“freezing”, “speech”, “swallowing”) was related to dopaminergic medication and complications of therapy. Both other factors showed no relevant associations with demographic and clinical characteristics. The identification of motor factors and their relation with other domains of the disease may help to elucidate the mechanisms responsible for these associations and provide an objective base for further research on subtypes in PD. © 2009 Movement Disorder Society
Effects of meloxicam and rofecoxib on psychomotor performance: A randomized, double-blind, placebo-controlled cross-over study

Objectives: To investigate the effects of meloxicam and rofecoxib on psychomotor performance in young, healthy volunteers. Materials and Methods: This study was conducted in Department of Pharmacology, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq in 2003. Twelve healthy, young males were allocated randomly from college students and participated in a balanced one-period cross-over investigation, with each period separated by a 7-day washed-out period. Participants were asked to perform psychomotor performance (choice reaction time and critical flicker-fusion threshold tests) before and after 2 h of receiving single oral dose of either meloxicam (7.5 mg) or rofecoxib (25 mg). Results: Meloxicam and rofecoxib were statistically significant, differing from placebo in reducing motor and recognition reaction times, respectively, of the objective test used. Both drugs were not significantly different from placebo in critical flicker-fusion frequency thresholds. Conclusion: These results allow the conclusion that the effects of preferential (meloxicam) and highly selective (rofecoxib) cyclo-oxygenase-2 inhibitors showed central effect by improving psychomotor performance, but in different directions.
Glue ear: how good is the information on the World Wide Web?

Abstract Objective: This paper objectively evaluates current information available to the general public related to glue ear on the World Wide Web. Methods: The term ‘glue ear’ was typed into the 3 most frequently used internet search engines – Google, Bing and Yahoo – and the first 20 links were analysed. The first 400 words of each page were used to calculate the Flesch–Kincaid readability score. Each website was subsequently graded using the Discern instrument, which gauges quality and content of literature. Results: The websites Webmd.boots. com, Bupa.co.uk and Patient.co.uk received the highest overall scores. These reflected top scores in either readability or Discern instrument assessment, but not both. Readability and Discern scores increased with the presence of a marketing or advertising incentive. The Patient.co.uk website had the highest Discern score and third highest readability score. Conclusion: There is huge variation in the quality of information available to patients on the internet. Some websites may be accessible to a wide range of reading ages but have poor quality content, and vice versa. Clinicians should be aware of indicators of quality, and use validated instruments to assess and recommend literature.
Prognostic value of mean platelet volume on tinnitus

Abstract Objective: This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume. Methods: This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups. Results: Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm3 in the study group and 7.28 ± 0.56 μm3 in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05). Conclusion: The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.
American Gastroenterological Association Institute Guideline on the Medical Management of Microscopic Colitis.

Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota; McMaster University, Hamilton, Ontario, Canada; and Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Santiago, Chile 75 76 77 78 his document presents the official recommendations
Pet keeping and tobacco exposure influence CD14 methylation in childhood

Several CD14 gene–environment interactions in relation to the development of allergic diseases have been reported, but the underlying biological mechanisms are unclear. We recently showed that CD14 methylation increased during childhood, parallelling a decreased impact of CD14 polymorphisms on soluble CD14 levels. Here, we aim to explore whether environmental stimuli during childhood affects CD14 methylation, thereby providing a biological mechanism through which environment may modulate genetic effect.
A randomized maternal evaluation of epinephrine autoinjection devices

Intramuscular epinephrine (adrenaline) is the first‐line therapy for anaphylaxis and prompt administration improves outcome. In 2011, two epinephrine autoinjectors existed in the United Kingdom, differing in their users' administration method: EpiPen® and Anapen®. We routinely train all families who receive these devices.
The prognosis analysis of organ metastatic patterns in lung large cell neuroendocrine carcinoma: A population-based study

Lung large cell neuroendocrine carcinoma (LCNEC) is a rare and highly aggressive malignancy with a dismal prognosis. This study was designed to depict patterns of distant organ metastatic and to analyze prognosis of LCNEC patients. We gathered data from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. We conducted the Kaplan–Meier method to calculate overall survival (OS) and compare different variables. Cox proportional hazards regression models in univariate and multivariate analyses were employed to further explore prognostic factors. A total of 1335 LCNEC patients were eventually selected from the SEER database, of which 348 patients (26.0%) had single organ metastasis and 197 patients (14.8%) had multiple metastases. Our study indicates that patients with single organ metastasis generally have a poor prognosis, with a median OS of 8 months for both lung and brain metastasis with 1-year survival rates of 33% and 29% respectively. Patients with multiple metastases exhibited the worst prognosis, with a median OS of only 4 months and a 1-year OS of 8%. Multivariate analysis revealed that age, T stage, N stage, chemotherapy and radiation in metastatic patients were independently associated with OS. In conclusion, LCNEC exhibits a high metastatic rate when diagnosed. The most common metastatic organ is the brain in single-site metastatic patients. Patients with single or multiple metastases exhibit a significantly worse prognosis than those with non-organ metastases. In the group of single organ metastases, patients with brain and lung metastases had a better prognosis than those with bone and liver metastases.
Joint population pharmacokinetic modeling of venlafaxine and O-desmethyl venlafaxine in healthy volunteers and patients to evaluate the impact of morbidity and concomitant medication

Introduction: Venlafaxine (VEN) is a widely used dual selective serotonin/noradrenaline reuptake inhibitor indicated for depression and anxiety. It undergoes first-pass metabolism to its active metabolite, O-desmethyl venlafaxine (ODV). The aim of the present study was to develop a joint population pharmacokinetic (PPK) model to characterize their pharmacokinetic characters simultaneously. Methods: Plasma concentrations with demographic and clinical data were derived from a bioequivalence study in 24 healthy subjects and a naturalistic TDM setting containing 127 psychiatric patients. A parent-metabolite PPK modeling was performed with NONMEM software using a non-linear mixed effect modeling approach. Goodness of fit plots and normalized prediction distribution error method were used for model validation. Results and conclusion: Concentrations of VEN and ODV were well described with a one-compartment model incorporating first-pass metabolism. The first-pass metabolism was modeled as a first-order conversion. The morbid state and concomitant amisulpride were identified as two significant covariates affecting the clearance of VEN and ODV, which may account for some of the variations in exposure. This model may contribute to the precision medication in clinical practice and may inspire other drugs with pre-system metabolism.
In vivo tumor detection in small animals by hematoporphyrin-mediated fluorescence imaging.

OBJECTIVE Noninvasive in vivo imaging of human tumors implanted in mice provides a reliable and economic tool for the investigation of tumor progression and metastasis and of the effectiveness of the antiblastic drugs on them. The purpose of this study is to report on the performance achievable by the well-known and extensively investigated HP-FRI (HematoPorphyrin (HP)-mediated Fluorescence Reflectance Imaging) when a high-quality image-acquisition device is used. BACKGROUND DATA Previous articles of ours showed that HP-FRI still represents a useful, simple and reliable optical imaging technique to detect surface tumors. Therefore, it is particularly suitable to be used in combination with other imaging modalities in a multimodal imaging system endowed with diagnostic capabilities much better than each separate modality. MATERIALS AND METHODS Six-week-old Crl:CD-1 nude mice were subcutaneously inoculated with tumor cells. Tumor-bearing mice were irradiated in vivo by a frequency-doubled pulsed Nd:YAG laser (lambda = 532 nm). A cooled CCD digital camera recorded fluorescence light emitted by HP injected in mice through a cut-on long-wavelength pass filter. RESULTS The system we developed allows in vivo imaging of surface tumors on small animals with a large field of view, high photometric sensitivity, adequate space resolution, and short measurement time. The estimated spatial resolution is 730 microm for a fluorescence source placed about 0.5 mm under the mouse skin. The first exploration of the capabilities of this HP-FRI setup on few mice shows that it allows the detection of (a) both types of investigated tumors, (b) early stage and late stage but visually unrecognizable tumors, (c) the gross structure of tumors, and (d) the discrimination of necrotic and nonnecrotic tumor regions.
The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy.

BACKGROUND & AIMS The management of inflammatory bowel disease (IBD) poses a particular challenge during pregnancy because the health of both the mother and the fetus must be considered. METHODS A systematic literature search identified studies on the management of IBD during pregnancy. The quality of evidence and strength of recommendations were rated using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. RESULTS Consensus was reached on 29 of the 30 recommendations considered. Preconception counseling and access to specialist care are paramount in optimizing disease management. In general, women on 5-ASA, thiopurine, or anti-tumor necrosis factor (TNF) monotherapy for maintenance should continue therapy throughout pregnancy. Discontinuation of anti-TNF therapy or switching from combination therapy to monotherapy may be considered in very select low-risk patients. Women who have a mild to moderate disease flare while on optimized 5-ASA or thiopurine therapy should be managed with systemic corticosteroid or anti-TNF therapy, and those with a corticosteroid-resistant flare should start anti-TNF therapy. Endoscopy or urgent surgery should not be delayed during pregnancy if indicated. Decisions regarding cesarean delivery should be based on obstetric considerations and not the diagnosis of IBD alone, with the exception of women with active perianal Crohn's disease. With the exception of methotrexate, the use of medications for IBD should not influence the decision to breast-feed and vice versa. Live vaccinations are not recommended within the first 6 months of life in the offspring of women who were on anti-TNF therapy during pregnancy. CONCLUSIONS Optimal management of IBD before and during pregnancy is essential to achieving favorable maternal and neonatal outcomes.