Miracle-dz/UniFAR-FTUs huggingface dataset:
The educational value of autopsy in a residency training program.

BACKGROUND Historically, the autopsy has been an indispensable educational tool. Over the past several decades, however, the national autopsy rate has declined and the educational role of autopsy in modern medicine is being questioned. OBJECTIVE To assess the educational value of autopsy attendance in an internal medicine residency program. METHODS We performed a retrospective review of all autopsies performed on the general internal medicine teaching service between October 1996 and September 1998. Premortem and postmortem diagnoses were determined and compared and attending physician surveys were reviewed. RESULTS Eighty-eight deaths occurred during the study period. Twenty-nine (33%) patients underwent autopsy. All autopsies were observed by the primary team and the attending physician completed an autopsy survey on each patient. An unexpected pathological diagnosis directly contributing to death was detected in 10 (34%) patients at autopsy. Additional unexpected pathological diagnoses were discovered in 23 (79%) cases. Attending physician surveys revealed that all 10 unexpected diagnoses contributing to death were observed by the primary team at the time of autopsy. Autopsy attendance was rated as a valuable educational experience in 27 cases (93%). CONCLUSION Autopsy is a valuable educational tool and autopsy attendance should remain an integral part of internal medicine residency training.
Youth participation in child welfare decision making: A focused ethnography

Youth Participation in Child Welfare Decision Making: A Focused Ethnography Astraea Augsberger This dissertation examines youth participation in child welfare decision-making in the context of permanency planning family team conferences held in New York City. It explores the factors that influence youth attendance and participation in decision-making opportunities. It also examines the strategies conference facilitators use to engage youth in decision-making in permanency planning family team conferences. The study employed a focused ethnography design, characterized by relatively short-term field visits, intensive data collection and intensive data analysis. Data collection included observations of permanency planning family team conferences, followed by in-depth interviews with young people and conference facilitators. Grounded theory conventions for data analysis, including initial coding, focused coding, theoretical coding, and analytic memos, were used. Data analysis focused on gaining a deeper understanding of how youth are incorporated into decision-making procedures, including a comparison of youth and conference facilitators’ perceptions and experiences. It also explored the specific strategies facilitators used to engage youth in decision-making at the family team conference. The study findings demonstrate that youth attendance and participation in child welfare decision-making opportunities are influenced by the degree of relationship between youth and agency staff. Youth in the study valued workers who provided them with a combination of instrumental and emotional support. Factors that facilitated the development of a positive relationship with agency staff included, case continuity, nonjudgmental listening, establishing trust, and transcending roles. Regarding facilitator engagement strategies, findings revealed two very different facilitation styles: adult centric and youth centric. Adult centric facilitation placed adults at the center of decision making by failing to engage youth, silencing the youth voice, adopting the adult narrative, and going through the motions. Youth centric facilitation placed youth at the center of decision making by establishing trust, encouraging youth to speak, adapting the youth narrative, and demonstrating genuine care and concern. The facilitation styles are demonstrated through case illustrations and examples. The study’s policy and practice implications, limitations and areas of further research are presented.
Urinary lithogen risk test: usefulness in the evaluation of renal lithiasis treatment using crystallization inhibitors (citrate and phytate).

OBJECTIVES This paper presents the results of a test to globally determine the urinary risk factor of calcium stone formation in the evaluation of treatments using crystallization inhibitors, such as citrate and phytate. METHODS Three groups of active calcium oxalate stone-formers have been selected. The lithogen urinary risk was determined using a specially designed disposable test before any medical treatment. After evaluation group I did not receive any treatment, group II was treated with potassium citrate and group III with a phytate-rich dietary complement. When 15 days had elapsed, the test to evaluate the risk of urinary calcium stone formation was applied again to the three groups. The main lithogenic biochemical parameters of each tested urine were also determined before and after treatment. RESULTS An important number of calcium oxalate stone-formers with high urinary risk factor (positive test) became negative after medical treatment (52% of the citrate-treated patients and 50% of the phytate-treated patients), but only 7% of the untreated patients (1 patient) showed a decrease in their urinary risk factor for calcium stones (negative test) after 15 days had elapsed. When the treatment was not effective, in an important number of cases, the urine contained high levels of calcium or showed pH values greater than 6.5. CONCLUSION From the obtained results it can be concluded that the test is useful to evaluate the efficacy of a given renal lithiasis medical treatment, and also the efficacy of the treatment of calcium oxalate renal lithiasis using crystallization inhibitors, such as citrate and phytate, in an important number of cases.
Expected Return and Conditional Asset Pricing: A New Testing Approach

Traditional tests of conditional asset pricing models are performed under the assumption of rational expectations and presume that the use of realized returns as a proxy for expected returns is acceptable. This paper turns the tables and asks what realized returns we would observe, given the pricing model. Based on this idea, we develop a new approach for testing conditional asset pricing models. The new approach implies a testable model that links the realized returns to changes in the risk-free rates, expected dividends and risk premium. This approach is used to test the Merton (1973, 1980) model and a long-standing risk-return trade-off puzzle: the price of market risk, lambda, has often turned out to be small, even negative and often insignificant. The empirical model implied by the new approach suggests that estimating lambda requires that we take into account changes in the conditional variance and its long-term persistence. We compare the price of market risk estimates from the new and the traditional testing approaches. We use both conventional measures of variance, such as (asymmetric) GARCH estimates as well as new measures based on forward-looking option market implied volatilities and MIDAS estimation. Tests are conducted using US stock market data. The re-sults give strong support for the new testing approach; the lambda estimates from the new approach are consistently significant, positive, more stable, and higher than those estimated using the traditional approach.
Ignoring Memory Hints: The Stubborn Influence of Environmental Cues on Recognition Memory

Recognition judgments can benefit from the use of environmental cues that signal the general likelihood of encountering familiar versus unfamiliar stimuli. While incorporating such cues is often adaptive, there are circumstances (e.g., eyewitness testimony) in which observers should fully ignore environmental cues in order to preserve memory report fidelity. The current studies used the explicit memory cueing paradigm to examine whether participants could intentionally ignore reliable environmental cues when instructed. Three experiments demonstrated that participants could volitionally dampen the directional influence of environmental cues on their recognition judgments (i.e., whether influenced to respond “old” or “new”) but did not fully eliminate their influence. Although monetary incentives diminished the mean influence of cues on responses rates, finer grained individual differences analysis, as well as confidence and RTs analyses, demonstrated that participants were still systematically influenced. These results demonstrate that environmental cues presented at test remain a potent influence on recognition decisions and subjective confidence even when ostensibly ignored.
Comparison of Yoga versus Physical Exercise on Executive Function, Attention, and Working Memory in Adolescent Schoolchildren: A Randomized Controlled Trial

Purpose: Executive function, attention, and memory are an important indicator of cognitive health in children. In this study, we analyze the effect of yoga and physical exercise on executive functioning, attention, and memory. Methods: In this prospective two-armed randomized controlled trial, around 802 students from ten schools across four districts were randomized to receive daily 1 h yoga training (n = 411) or physical exercise (n = 391) for 2 months. Executive function, attention, and memory were studied using Trail Making Test (TMT). Yoga (n = 377) and physical exercise (n = 371) students contributed data to the analyses. The data were analyzed using intention-to-treat approach using Student's t-test. Results: There was a significant increase in numerical TMT (TMTN) values within yoga (t = −2.17; P < 0.03) and physical activity (PA) (t = −3.37; P < 0.001) groups following interventional period. However, there was no significant change in TMTN between yoga and PA groups (t = 0.44; P = 0.66). There was a significant increase in alphabetical TMT (TMTA) values within yoga (t = 6.21; P < 0.00) and PA groups (t = 1.19; P < 0.234) following interventional period. However, there was no significant change in TMTA between yoga and PA groups (t = 3.46; P = 0.001). Conclusion: The results suggest that yoga improves executive function, attention, and working memory as effectively as physical exercise intervention in adolescent schoolchildren.
A Comparative Study of Self-Regulation in Substance Dependent and Non-Dependent Individuals

Background: Several factors influence the beginning and maintenance of substance use. The purpose of this study was to examine as well as to compare ‘self-regulation’ in both substance dependent and non-substance dependent individuals. Method: In a cross-sectional study 228 (118 substance dependent and 110 with no history of using substance) participants aged 16-55 were recruited. All of the participants were asked to complete the Self-Regulation Inventory (SRI-25) and a demographic characteristics data checklist. Data was analyzed using descriptive statistics (frequency, mean and standard deviation) and the t-test. Results: The results showed significant differences between substance dependent and non- substance dependent groups in all the scales of the self-regulation inventory including positive actions, controllability, expression of feelings and needs, assertiveness, and well-being seeking (p<0.01). Conclusion: Self-regulation and self-control skills in drug dependent individuals are lower than those without substance dependence individuals. It is concluded that substance use may related to a deficiency in self-control and regulation of feelings. Therefore, for prevention and treatment of substance dependence disorder, it is necessary to work out and exploit strategies that include the improvement of self-regulation.
MITOCHONDRIAL DNA PHYLOGEOGRAPHY OF THE POLYTYPIC NORTH AMERICAN RAT SNAKE (ELAPHE OBSOLETA): A CRITIQUE OF THE SUBSPECIES CONCEPT

Abstract Subspecies have been considered artificial subdivisions of species, pattern classes, or incipient species. However, with more data and modern phylogenetic techniques, some subspecies may be found to represent true species. Mitochondrial DNA analysis of the polytypic snake, Elaphe obsoleta, yields well-supported clades that do not conform to any of the currently accepted subspecies. Complete nucleotide sequences of the cytochrome b gene and the mitochondrial control region produced robust maximum-parsimony and maximum-likelihood trees that do not differ statistically. Both trees were significantly shorter than a most parsimonious tree in which each subspecies was constrained to be monophyletic. Thus, the subspecies of E. obsoleta do not represent distinct genetic lineages. Instead, the evidence points to three well-supported mitochondrial DNA clades confined to particular geographic areas in the eastern United States. This research underscores the potential problems of recognizing subspecies based on one or a few characters. Editor: B. Bowen
Influence of tumor size on oncological outcomes of pathological T3aN0M0 renal cell carcinoma treated by radical nephrectomy

Objective To evaluate the prognostic significance of tumor size in pathological T3aN0M0 renal cell carcinoma (RCC) treated by radical nephrectomy. Materials and methods Patients who underwent radical nephrectomy for sporadic RCC with pathological T3aN0M0 RCC at our institution between January 2006 and June 2015 were identified. The entire cohort was divided into two groups according to the cutoff of tumor size obtained from receiver operating characteristic (ROC) curve. Clinicopathological variables were retrospectively collected and compared. Kaplan-Meier analysis and multivariate Cox regression were conducted to evaluate the effect of tumor size on survival outcomes. Results 163 pT3aN0M0 RCC patients were included with a median follow-up period of 31 months. The optimal cutoff for tumor size was 7 cm according to the ROC curve. 90 cases (55.2%) presented tumors which measured 7 cm or less, and 73 cases (44.8%) showed tumor size greater than 7 cm. Patients with larger tumors tended to exhibit higher rates of symptoms and higher Fuhrman grades; they also indicated more necrosis features, and were more likely to invade the collecting system and renal vein. Compared with patients who exhibited tumor size of≤7 cm, those with tumor size>7 cm were associated with shorter estimated five-year cancer-specific survival (CSS, 46.6% versus 75.0%, P = 0.003) and five-year recurrence-free survival (RFS, 35.6% versus 62.7%, P = 0.011). Multivariate Cox analysis revealed that tumor size was retained as an independent factor for CSS (HR = 2.506, 95% CI 1.169–5.373, P = 0.018). Conclusions The tumor size significantly affected the survival outcomes of pT3aN0M0 RCC treated by radical nephrectomy, and a cutoff size of 7 cm can help enhance the prognostic discrimination. Thus, the tumor size may be considered in the future TNM classification of stage pT3a.
Stability During Arboreal Locomotion

Arboreal locomotion – traveling on the branches, twigs, and trunks of trees and woody shrubs – is very common among mammals. Most primates, many rodents, marsupials, carnivores, and even an occasional artiodactyl travel on arboreal substrates to forage, escape predators, and acquire shelter. Arboreal supports are usually far enough from the ground that a slip or fall could cause serious injury or death, or deprive the animal of a mate, food, or energy. Thus, stability is of great importance for an animal traveling on arboreal supports. The considerable variation among arboreal supports makes stability during locomotion a mechanical challenge. Supports vary in diameter, slope, compliance, texture, direction (that is, bends or curves in a branch), and number and distribution. Furthermore there may be interaction among these variables; for example, compliance varies with diameter – thinner branches are more compliant than thick branches. Also, the thin branches frequently have leaves that act like sails in the wind, causing even more movement in the substrate. Substrate texture often varies with diameter, where narrow twigs have smoother bark than large branches or trunks. Therefore one might expect a considerable number of morphological, behavioral, and biomechanical mechanisms to enhance stability on arboreal supports. Stability can be divided into two categories: static and dynamic. Static stability is the process by which objects at rest remain stable, i.e., neither move (translation) nor rotate about a point or axis. For example, a table is statically stable because the forces and moments (torques) produced by gravity (weight) are balanced by ground reaction forces and the moments generated by them. One way an animal might remain stable is by not moving and adhering to or gripping the support; this definition is the ultimate example of static stability in an animal. Although this strategy allows no movement, it is nevertheless a valid locomotor strategy for an animal attempting to travel on an arboreal support subjected to a sudden gust of wind or other disturbance (Stevens, 2003). This analysis also applies when the animal walks very slowly, but fails when it walks or runs at considerable speed. Because the distribution of the mass is changing from one instant to the next, the forces and torques necessary to maintain static stability would also change with time. That is, it requires an active control by the nervous system. Because stability is critical, it is very likely that the animal employs both active and passive control (Full et al., 2002). Passive control can be due to dynamic processes of the animal’s body, and is referred to as dynamic stability. For example, a hiker might cross a stream or river by running across a fallen log; the rotation of the limbs around the hips and shoulder
Familial associations of intense preoccupations, an empirical factor of the restricted, repetitive behaviors and interests domain of autism.

BACKGROUND Clinical heterogeneity of autism likely hinders efforts to find genes associated with this complex psychiatric disorder. Some studies have produced promising results by restricting the sample according to the expression of specific familial factors or components of autism. Previous factor analyses of the restricted, repetitive behaviors and interest (RRBI) domain of autism have consistently identified a two-factor model that explains a moderate amount of variance. The identification of additional factors may explain more variance in the RRBI domain and provide an additional component of autism that may help in the identification of underlying genetic association. METHODS We conducted factor analyses of RRBI symptoms with a sample that included verbal subjects meeting full criteria for autism aged 5 to 22 years (n = 245). Among affected sibling pairs (n = 126) we examined the familial aggregation of the identified factors. We also examined the associations of the factors with autism-related personality traits in fathers and mothers (n = 50). RESULTS The previously identified two-factor model - insistence on sameness (IS) and repetitive stereotypic motor behaviors (RSMB) - was replicated in our sample. Next, a second factor analysis that included the item for verbal rituals resulted in a four-factor model - IS, 'simple' RSMB, 'complex' RSMB, and a fourth factor including symptoms associated with intense preoccupations (IP). Of these four, both IS and IP were significantly familial among affected siblings, but only IP was significantly correlated with the broader autism phenotype traits of rigidity and aloofness in fathers. CONCLUSIONS The results support previous evidence for the IS factor, its familiality, and the identification of IP as an additional strong candidate trait for genetic studies of autism.
Impact of Renal Survival on the Course and Outcome of Systemic Lupus Erythematosus Patients Treated With Chronic Peritoneal Dialysis

This longitudinal study investigated whether renal survival can affect the course and outcome of systemic lupus erythematosus (SLE) patients treated with chronic peritoneal dialysis (PD). Thirty‐five SLE patients, out of 1115 end‐stage renal disease (ESRD) patients treated with chronic PD, were seen between 1990 and 2007 at the Chang Gung Memorial Hospital. Patients were followed up for a mean of 38.8 ± 22.9 months. There were no significant differences between patients with short renal survival (<3 years) and long renal survival (>3 years) for the various demographic variables such as age, sex, PD duration, immunosuppressive drug administration, or exchange system (P > 0.05). Interestingly, before PD, patients with short renal survival had lower serum complement levels than patients with long renal survival (C3, 40.2 ± 14.4 vs 76.3 ± 18.5 mg/dL, P < 0.001; and C4, 14.8 ± 4.7 vs 22.4 ± 8.1 mg/dL, P < 0.05). However, the differences in complement levels between the groups disappeared after PD (C3, 76.5 ± 27.3 vs 84.2 ± 27.8 mg/dL; and C4, 26.7 ± 11.3 vs 22.6 ± 10.8 mg/dL, both P > 0.05). Patients with short renal survival were more likely to have a high peritoneal solute transporter rate (PSTR) than their long renal survival counterparts (χ2‐test, P = 0.02, and AUROC = 0.744 and P = 0.040); however, there were no significant differences for other variables such as cardiothoracic ratio (CTR), Kt/V, residual renal function, exit site infection, and peritonitis (P > 0.05). Finally, Kaplan–Meier analysis revealed that the two groups did not differ in patient and technical survival (P > 0.05). Therefore it was concluded that renal survival might be associated with PSTR, but not with patient and technical survival in SLE patients treated with PD.
The Low Density Lipoprotein Receptor-related Protein Complexes with Cell Surface Heparan Sulfate Proteoglycans to Regulate Proteoglycan-mediated Lipoprotein Catabolism*

It has been proposed that clearance of cholesterol-enriched very low density lipoprotein (VLDL) particles occurs through a multistep process beginning with their initial binding to cell-surface heparan sulfate proteoglycans (HSPG), followed by their uptake into cells by a receptor-mediated process that utilizes members of the low density lipoprotein receptor (LDLR) family, including the low density lipoprotein receptor-related protein (LRP). We have further explored the relationship between HSPG binding of VLDL and its subsequent internalization by focusing on the LRP pathway using a cell line deficient in LDLR. In this study, we show that LRP and HSPG are part of a co-immunoprecipitable complex at the cell surface demonstrating a novel association for these two cell surface receptors. Cell surface binding assays show that this complex can be disrupted by an LRP-specific ligand binding antagonist, which in turn leads to increased VLDL binding and degradation. The increase in VLDL binding results from an increase in the availability of HSPG sites as treatment with heparinase or competitors of glycosaminoglycan chain addition eliminated the augmented binding. From these results we propose a model whereby LRP regulates the availability of VLDL binding sites at the cell surface by complexing with HSPG. Once HSPG dissociates from LRP, it is then able to bind and internalize VLDL independent of LRP endocytic activity. We conclude that HSPG and LRP together participate in VLDL clearance by means of a synergistic relationship.
The Internationalization of Academic Spin-Offs: Evidence from Italy

Despite a growing interest in academic spin-offs (ASOs), research has overlooked the determinants, strategies, and outcomes of their internationalization choices. In this chapter, we review existing literature on the topic of internationalization of ASOs, connecting it to international business and international entrepreneurship literature, identifying relevant theoretical and empirical knowledge gaps. We then carry out a descriptive investigation about the characteristics and internationalization patterns of ASOs in the Italian context, drawing on a survey on 120 companies. Based on the review and our results, we highlight research areas deserving future investigation.