Miracle-dz/UniFAR-FTUs huggingface dataset:
Reliability of a 360-Degree Evaluation to Assess Resident Competence

Massagli TL, Carline JD: Reliability of a 360-degree evaluation to assess resident competence. Am J Phys Med Rehabil 2007;86:845–852. Objective:To determine the feasibility and psychometric qualities of a 360-degree evaluation of physical medicine and rehabilitation (PM&R) residents’ competence. Design:Nurses, allied health staff, and medical students completed a 12-item questionnaire after each PM&R resident rotation from January 2002 to December 2004. The items were derived from five of the six competencies defined by the Accreditation Council for Graduate Medical Education (ACGME). Results:Nine hundred thirty evaluations of 56 residents were completed. The alpha reliability coefficient for the instrument was 0.89. Ratings did not vary significantly by resident gender. Senior residents had higher ratings than junior residents. A reliability of >0.8 could be achieved by ratings from just five nurses or allied health staff, compared with 23 ratings from medical students. Factor analysis revealed all items clustered on one factor, accounting for 84% of the variance. In a subgroup of residents with low scores, raters were able to differentiate among skills. Conclusion:Resident assessment tools should be valid, reliable, and feasible. This Web-based 360-degree evaluation tool is a feasible way to obtain reliable ratings from rehabilitation staff about resident behaviors. The assignment of higher ratings for senior residents than junior residents is evidence for the general validity of this 360-degree evaluation tool in the assessment of resident performance. Different rater groups may need distinct instruments based on the exposure of rater groups to various resident activities and behaviors.
La adquisición de terceras lenguas: multilingüismo aditivo y substractivo

El presente trabajo pretende ofrecer una aproximacion a las peculiaridades de los procesos de adquisicion de una lengua extranjera adicional en un entorno bi/multilingue. Nuestra labor parte de una revision de las conclusiones mas relevantes de los estudios sobre las ventajas cognitivas de los aprendientes bi- y multilingues, incluyendo dos estudios recientes sobre el uso de los tiempos de pasado del espanol por arabofonos tunecinos de la propia autora y concluyendo, asimismo, con una serie de reflexiones acerca del proceso de adquisicion del espanol como L3 por los tunecinos, particularmente aquellos aspectos relacionados con el efecto de los conocimientos linguisticos previos y la experiencia de aprendizaje anterior.
Symposium on ‘ Assessment of nutritional status in disease and other trauma ’ Disease and malnutrition in British hospitals

The development of disease may be accompanied by the loss of appetite, metabolic changes leading to tissue wasting and, in some cases, intestinal malfunction associated with the impaired absorption of nutrients. Thus, in many patients there is an inadequate supply of nutrients which, in combination with the influence of inflammatory mediators, leads to tissue wasting and defective organ function. This process is characterized by the term malnutrition. Unfortunately, satisfactory tools for the measurement of malnutrition in the clinical context are not yet available. Reliance is placed on structural change determined by anthropometry. Laboratory markers such as the concentration of serum proteins and immunological indices are influenced by other factors, not least of which is the activity of the disease process. Consequently, many of these variables reflect the severity of illness rather than the degree of nutritional depletion (Sitges-Serra & Franch-Arcas, 1995). Impaired organ function may precede measurable changes in structure (Lopes et al. 1982; Jeejeebhoy, 1988). Whereas there are some clinical measurements of function, such as muscle dynamometry (Webb et al. 1989), the variability and lack of specificity for nutritional depletion limit their value in nutritional assessment, although they do correlate with increased surgical risk. Malnutrition is common in hospital patients (Bistrian et al. 1974; Bastow et al. 1983a; Larsson et al. 1990; McWhirter & Pennington, 1994). There is a lack of awareness of the importance of the problem amongst clinical staff (McWhirter & Pennington, 1994; Lennard-Jones et al. 1995). Consequently it escapes recognition in the majority of affected patients (Hill et al. 1977; McWhirter & Pennington, 1994). Many malnourished patients are deprived of treatment from which they may benefit and increasing nutritional depletion is common during hospital stay. The effect of malnutrition on the patient and the outcome of disease is significant and sometimes fatal. Reduced muscle strength and stamina affects muscles of respiration as well as muscles of locomotion (Arora & Rochester, 1982). Reduced immune function (Hill, 1992; Animashaun & Heatley, 1994) exposes the patient to increased risk of infection. Increased surgical mortality has long been recognized in the malnourished patient. Techniques for nutritional support are now available for the prevention or treatment of malnutrition. Reversal of nutritional depletion may not be possible in all patients, especially in patients who are stressed on account of sepsis, bums, or trauma, at least until the underlying disease process has been treated or controlled (Askanazi et al. 1980). Even
Antibodies to gp120 and PD-1 Expression on Virus-Specific CD8+ T Cells in Protection from Simian AIDS

ABSTRACT We compared the relative efficacies against simian immunodeficiency virus (SIV) challenge of three vaccine regimens that elicited similar frequencies of SIV-specific CD4+ and CD8+ T-cell responses but differed in the level of antibody responses to the gp120 envelope protein. All macaques were primed with DNA plasmids expressing SIV gag, pol, env, and Retanef genes and were boosted with recombinant modified vaccinia Ankara virus (MVA) expressing the same genes, either once (1 × MVA) or twice (2 × MVA), or were boosted once with MVA followed by a single boost with replication-competent adenovirus (Ad) type 5 host range mutant (Ad5 h) expressing SIV gag and nef genes but not Retanef or env (1 × MVA/Ad5). While two of the vaccine regimens (1 × MVA and 1 × MVA/Ad5) protected from high levels of SIV replication only during the acute phase of infection, the 2 × MVA regimen, with the highest anti-SIV gp120 titers, protected during the acute phase and transiently during the chronic phase of infection. Mamu-A*01 macaques of this third group exhibited persistent Gag CD8+CM9+ effector memory T cells with low expression of surface Programmed death-1 (PD-1) receptor and high levels of expression of genes associated with major histocompatibility complex class I (MHC-I) and MHC-II antigen. The fact that control of SIV replication was associated with both high titers of antibodies to the SIV envelope protein and durable effector SIV-specific CD8+ T cells suggests the hypothesis that the presence of antibodies at the time of challenge may increase innate immune recruiting activity by enhancing antigen uptake and may result in improvement of the quality and potency of secondary SIV-specific CD8+ T-cell responses.
Fixed effects in the formation of a composite line of beef cattle: I. Experimental design and reproductive performance.

Red Angus (RA) dams were mated to Charolais (C) or Tarentaise (T) sires to produce crossbred (F1) progeny. Members of the F1 generation, differing in breed direct effects, were mated to produce an F2 generation with an expected breed composition of 1/2 RA, 1/4 C, and 1/4 T. Two breed groups within the F2 generation differing in breed maternal effect ([C x RA] x [T x RA] and [T x RA] x [C x RA]) were identified separately. These breed groups were crossed to produce an F3 generation and, likewise, the two resulting F3 generation breed groups were crossed to produce an F4 generation. No distinction was made among breed groups subsequent to the F3 generation. Pregnancy rates averaged 90.9% over 11 yr, with 82.0% of cows exposed weaning a calf. Among formative generations of this composite population, F2 had greatest pregnancy, calving, and weaning rates. Age of dam significantly affected pregnancy rate, calving difficulty, and gestation length. Older cows tended to express higher pregnancy rates and longer gestation lengths than did younger cows (P < .01). Males calves had a 1.7% greater weaning rate than female calves (P < .05), but matings producing male calves had longer gestation lengths (P < .05) and were 8.5% more likely to experience calving difficulty (P < .01). Individual breed additive effects (calves from C or T sires mated to RA dams) were important for calving difficulty only (P < .05), where C-sired matings experienced greater calving difficulty. Differences between C x RA and T x RA dams, indicative of maternal breed additive effects, were not detected. (ABSTRACT TRUNCATED AT 250 WORDS)
Study of Sphenoid Sinus Anatomy in Relation to Endoscopic Surgery

En las cirugias radicales del pasado, la definicion precisa de las hendiduras de los senos paranasales fueron de importancia limitada. En los ultimos anos, el abordaje transesfenoidal de la hipofisis y las relaciones del seno esfenoidal han tenido en la practica y en el estudio de la anatomia quirurgica, un significativo incremento. Para definir mejor esta anatomia, 20 senos esfenoidales fueron disecados en cadaveres para revelar importantes relaciones anatomicas, dimensiones, volumen y neumatizacion del seno esfenoidal. Los resultados de este estudio son discutidos con referencia particular para la anatomia quirurgica del seno esfenoidal. Los resultados tambien apuntan hacia la posibilidad de variaciones raciales, en terminos de relaciones del seno esfenoidal con la arteria carotida interna y el nervio optico, en la poblacion de la India
Evidence from Polygene Mapping for a Causal Relationship between Potato Tuber Dormancy and Abscisic Acid Content

In previous studies polygene mapping of a backcross population derived from haploid potato (Solanum tuberosum) and a diploid wild species (Solanum berthaultii) showed at least eight quantitative trait loci (QTLs) associated with tuber dormancy. The same population was mapped for abscisic acid (ABA) content in tubers so that any QTLs identified could be compared with those detected previously. At least three distinct loci on three chromosomes (2, 4, and 7) were associated with variation in ABA content. One of the QTLs was detected only as a main (single locus) effect, and two QTLs were found through two-locus interaction analysis (epistasis). Interaction between QTLs at markers TG234 (chromosome 2) and TG155 (chromosome 4) explained 20% of total phenotypic variance for this trait. The interaction closely resembled one previously detected for dormancy, suggesting an association between high ABA content and long tuber dormancy. Although relationships between ABA level and dormancy could be demonstrated through polygene mapping, there was no indication of a relationship between these traits when they were subjected to a conventional correlation test. This illustrates the usefulness of polygene mapping as a tool to identify possible associations between hormone levels and plant development.
Penelitian Kualitatif: Komunikasi, Ekonomi, Kebijakan Publik dan Ilmu Sosial Lainnya

Buku ini mengetengahkan semua hal yang berkaitan pendekatan kualitatif dalam bingkai penelitian. Dimulai dengan sejarah intelektual, runtutan paradigma dan teori serta berbagai pemikiran dan gaya berpikir yang memengaruhinya, sampai perkembangan dan berbagai permasalahan seputar pelaksanaan di lapangan. Semua penjelasan dalam buku ini diharapkan dapat menghadirkan filsafat ilmiah yang mendasarinya dan tema, fokus serta langkah pelaksanaan di lapangan. Tema utama edisi kedua ini, antara lain: 1. Pengantar penelitian kualitatif 2. Masalah dan berbagai topik penelitian kualitatif 3. Desain penelitian kualitatif (substansi dan cara mengkonstruksinya) 4. Realitas sosial dan kaitannya dengan data kualitatif 5. Metode pengumpulan data dan pelaksanaan penelitian kualitatif 6. Strategi analisis data kualitatif 7. Penulisan laporan dan karya ilmiah kualitatif
Resistance to apoptosis in circulating alpha/beta and gamma/delta T lymphocytes from patients with systemic sclerosis.

OBJECTIVE T cell activation plays a pivotal role in the immunopathogenesis of systemic sclerosis (SSc). Lymphocyte processes are tightly controlled by molecules activating either proliferation or programmed cell death (apoptosis). We investigated whether an imbalance in apoptotic function, increasing the survival rate of autoreactive cells, may lead to persistent autoreactive phenomena. METHODS We studied peripheral a/b and g/d T lymphocytes of 22 patients with SSc and 22 healthy controls for their spontaneous and stimulated (phytohemagglutinin, dexamethasone) apoptotic rate and surface phenotype including expression of Fas (CD95) and Bcl-2, determined by flow cytometry. sFas and sFas ligand in sera and supernatants were measured by ELISA. Caspase-3 activation in response to agonistic anti-Fas Mab treatment was assessed. RESULTS Lymphocytes of SSc patients showed a significant decrease in the percentage of apoptotic cells over time, in both unstimulated and stimulated cultures, compared to controls. We observed no difference between patients and controls, in stimulated or unstimulated cells, in the phenotypic expression of apoptotic cells, including surface Fas. SSc T cells were less susceptible to undergoing apoptosis after anti-Fas stimulation. We observed a significant decrease of apoptotic cells from stimulated culture of isolated SSc g/d T cells. Serum levels of sFas in SSc patients were significantly higher compared to controls. Similar data were obtained in the supernatants of stimulated and unstimulated cultures. By contrast, sFas ligand was always reduced. Bcl-2 expression in SSc was significantly elevated. A significant decrease in caspase-3 activity was detected in SSc patients after treatment by agonistic anti-Fas antibody. CONCLUSION Resistance to apoptosis is present in a/b and g/d T cell lymphocyte subsets of patients with SSc, and several pathways seem to be connected in this setting.
Predictors of response and relapse in a cohort of adults with thrombotic thrombocytopenic purpura‐hemolytic uremic syndrome: a single‐institution experience

BACKGROUND: Thrombotic thrombocytopenic purpura‐hemolytic uremic syndrome (TTP‐HUS) is a diagnosis of exclusion when a patient presents with the sine qua non findings of thrombocytopenia and microangiopathic hemolytic anemia without an identifiable cause. Although most patients respond to therapeutic plasma exchange (TPE), a significant number of patients relapse. The aim was to determine if clinical, laboratory, and/or treatment features could predict response and/or relapse.
Ethnic differences in vascular responses to aerobic exercise.

UNLABELLED Indigenous populations currently experience greater rates of cardiovascular disease. Although ethnic differences in cardiovascular responses to exercise have previously been identified, these responses among indigenous populations are unknown. PURPOSE This investigation aimed to evaluate the vascular responses to aerobic exercise of Canadian indigenous and European adults. METHODS Twelve age- and sex-matched indigenous and European adults completed a cycle ergometer maximal aerobic power test and submaximal 30 min of 60% maximal aerobic capacity on two separate days. Blood pressure, pulse wave velocity, baroreceptor sensitivity, arterial compliance, vascular resistance, and intima-media thickness were directly measured before and after aerobic exercises. RESULTS Vascular responses to exercise were generally similar between indigenous and European adults including decreases in baroreceptor sensitivity and vascular resistance after maximal exercise. No changes in intima-media thickness, pulse wave velocity, and arterial compliance were observed after exercise in either group. However, after submaximal exercise, only European adults demonstrated reductions in baroreceptor sensitivity (spectral: 9.2 ± 4.3 to 11.5 ± 6.7 ms·mm Hg, P = 0.41, vs 15.8 ± 8.3 m·s to 8.9 ± 5.7 ms·mm Hg, P = 0.02; sequence: 14.6 ± 5.4 to 16.5 ± 11.0 ms·mm Hg, P = 0.48, vs 26.2 ± 10.5 m·s to 15.4 ± 9.4 ms·mm Hg, P = 0.02). Similarly, decreases in blood pressure after exercise were observed only among European adults. CONCLUSIONS Indigenous adults demonstrated vascular responses similar to those demonstrated by European adults, although blood pressure was only observed to decrease among European adults after maximal and submaximal exercise, and baroreceptor sensitivity, after submaximal exercise.
Nonpolymorphic regions of p190, a protein of the Plasmodium falciparum erythrocytic stage, contain both T and B cell epitopes.

Two conserved regions from the genetically polymorphic p190 molecule of the malaria parasite Plasmodium falciparum have previously been expressed in Escherichia coli as separate polypeptides (190.L and 190.M) or as a single fusion protein (190.N). In the present study we investigated whether human B and T lymphocytes recognize these conserved regions. The more amino-terminal region, 190.L (corresponding to residues 188-363 of the encoded protein sequence) reacted preferentially with sera from donors living in a malaria-endemic area. Also, EBV-transformed B cells, from a healthy donor living in a malaria-mesoendemic area, were fused with a human-mouse hybrid line (SPM4-0), yielding two hybridomas whose products recognized both 190.L and the fusion protein 190.N, but not the 190.M polypeptide. A large number of p190-specific T cell clones were obtained from PBMC of a noninfected donor, after in vitro stimulation with the recombinant fusion protein 190.N. The clones reacted with intact, parasite-derived p190, as well as either 190.L or 190.M. Four clones that recognized the more amino-terminal fragment also responded to infected E. According to these results the more amino-terminal conserved sequences of p190 have the requisites to be immunogenic in humans.
High prevalence of overweight and obesity in Saudi Arabia.

OBJECTIVES To study the pattern of body weight distribution and the prevalence of overweight and obesity in Saudi Arabia. DESIGN Cross-sectional national epidemiological household survey. SUBJECT 13,177 Saudi subjects, over the age of 15 years. The sample was adjusted for gender, age, regional and residency population distribution. The range and mean of age was similar for male and female subjects (15-95 years, 33 years). MEASUREMENT questionnaire, describing the social, educational and financial status. Measurement of height, weight and calculation of body mass index (BMI). WHO classification was used for defining overweight (BMI 25-30) and obesity (BMI > 30). RESULTS The mean BMI for female subjects was significantly higher than for male subjects, whether for all subjects or subjects of any given age group. There was a progressive increase of BMI for male and female subjects with age, reaching maximum at the 5th decade. The prevalence of overweight among male subjects was significantly higher than for female subjects (29% vs 27%). The prevalence of obesity among female subjects was significantly higher than for male subjects (24% vs 16%). There was a gender variation within each region with respect to the prevalence of overweight with higher prevalence of overweight among male subjects, throughout all the regions, except the Southern region, none of the differences, however, reached significance levels. The prevalence of obesity was significantly higher among female subjects, throughout all the regions. Overweight and obesity were more prevalent among illiterate, high-income subjects who were residing in urban communities. CONCLUSION This epidemiological household survey has shown high prevalence of overweight and obesity among Saudi subjects. The prevalence of obesity among female Saudi subjects was among the highest reported, whether, when using the WHO criteria or the 85th percentile of US subject aged 20-29 years. The increase of prevalence of such conditions among high income subjects would reflect the perception of fatness as sign of affluence among those subjects. As the prevalence of obesity increases with age and considering that the majority of Saudi population are less than 30 years old at the present time, then, one would expect the magnitude of obesity to be even bigger in the near future. There is a need to establish programs for promoting awareness among the population of the health hazards and means of control of obesity.
Clinical Applications of Highly Sensitive Troponin Assays

Cardiac troponin is the biomarker of choice for the diagnosis of acute myocardial infarction. Recent consensus recommendations have adopted a concentration of troponin above the 99th percentile of a healthy population to diagnose myocardial infarction. Until recently, there was no assay capable of achieving recommended precision; however, with the development of “highly sensitive” troponin assays, it is now possible to accurately measure troponin concentrations at and below the current 99th percentile of a healthy population. These assays have enormous potential in not only identifying more patients with acute myocardial infarction, and providing superior risk prediction in those so afflicted, in addition highly sensitive troponins assays may be useful for long-term risk assessment of the patient with coronary disease. In this article, we will review the clinical applications, novel concepts, challenges, and limitations of using highly sensitive troponins assays.
Stressful life events and symptom onset in HIV infection.

OBJECTIVE The authors' goal is to provide basic epidemiologic data on the issue of reactivity to stress and HIV symptom onset by studying the relationship between a broad set of naturally occurring stressor events and HIV natural history in a large longitudinal community sample of HIV-seropositive homosexual men. METHOD Subjects were recruited from a cohort of 1,011 homosexual men enrolled in the Chicago site of the Multicenter AIDS Cohort Study who also participated in the Coping and Change Study. The men were given self-administered questionnaires assessing behavioral, psychological, and psychosocial variables. Relationships between reports of stressful life events and longitudinal biomedical data measuring illness progression were examined. Life events were assessed by reports on the numbers of lovers, friends, and acquaintances who were diagnosed with AIDS or had died of AIDS and by scores on a checklist of 24 more general serious stressor events. The variables indicating progression of illness among initially asymptomatic men were a drop in T-helper lymphocyte percent (CD4%) between pairs of examinations of at least 25% and onset between examinations of thrush and/or fever lasting a minimum of 2 weeks. RESULTS The authors found no evidence that serious stressor events have any meaningful effect on symptom onset indicated by either a drop in CD4% or onset of fever or thrush. CONCLUSIONS There is no need for asymptomatic people with HIV infection to restrict their lives in order to avoid exposure to stressful life experiences or to develop special skills for coping with stress to forestall the progression of HIV illness.