Miracle-dz/UniFAR-FTUs huggingface dataset:
CONTINUING EDUCATION

Continuing Education has been described as the “longest and arguably most important phase of medical education”(1). This could equally be applied to all disciplines within health care. This component of a practitioner’s career is viewed by some as an integral part of their professional development, constantly attempting to improve and refine their skills and knowledge, with the aim of improving their level of patient care. Others may view this phase as unnecessary and intrusive on their valuable time.
Effects of Glucose and Starch on Lactate Production by Newly Isolated Streptococcus bovis S 1 from Saanen Goats

When ruminants are fed high-concentrate diets, Streptococcus bovis proliferates rapidly and produces lactate, potentially causing rumen acidosis. Understanding the regulatory mechanisms of the metabolism of this species might help in developing dietary strategies to alleviate rumen acidosis. S. bovis strain S1 was newly isolated from the ruminal fluid of Saanen dairy goats and then used to examine the effects of glucose and starch on bacterial metabolism and gene regulation of the organic acid-producing pathway in cultures at a pH of 6.5. Glucose or starch was added to the culture medium at 1 g/liter, 3 g/liter (close to a normal range in the rumen fluid), or 9 g/liter (excessive level). Lactate was the dominant acid produced during the fermentation, and levels increased with the amount of glucose or starch in a dose-dependent manner (P < 0.001). The production of formate and acetate in the fermentation media fluctuated slightly with the dose but accounted for small fractions of the total acids. The activities of lactate dehydrogenase (LDH) and -amylase ( -AMY) increased with the starch dose (P < 0.05), but the -AMY activity did not change with the glucose dose. The relative expression levels of the genes ldh, pfl (encoding pyruvate formate lyase), ccpA (encoding catabolite control protein A), and -amy were higher at a dose of 9 g/liter than at 1 g/liter (P < 0.05). Expression levels of pfl and -amy genes were higher at 3 g/liter than at 1 g/liter (P < 0.05). The fructose 1,6-diphosphate (FDP) concentration tended to increase with the glucose and starch concentrations. In addition, the S. bovis S1 isolate fermented glucose much faster than starch. We conclude that the quantities of glucose and soluble starch had a major effect on lactate production due to the transcriptional regulation of
Evolving practice patterns and attitudes toward hormone therapy of obstetrician-gynecologists

Objective: The objective of this study was to examine the opinions and prescribing practices of obstetrician-gynecologists regarding hormone therapy (HT) and the results from the Women's Health Initiative. Design: Surveys were sent to 2,500 randomly selected American College of Obstetrics and Gynecology fellows during December 2004 to March 2005; their responses are compared with those from a survey conducted in November to December 2003. Results: Respondents remained skeptical of the combined HT results (49.1% did not find the results convincing). Compared with the 2003 survey, men were more skeptical (58.8% did not consider the findings convincing in 2004 vs 53.4% in 2003, P = 0.045), and women were somewhat less skeptical (39.5% did not consider the findings convincing in 2004 vs 45.3% in 2003, P = 0.056). There was less skepticism about the estrogen-only trial, although 4 of 10 did not find the results convincing. Men were more skeptical than women; a majority of men disagreed with the decisions to stop the trials. Physicians who completed their residency more recently were more likely to accept the trial results. Respondents reported a reduction in HT prescription practice relative to the year 2000, but 62.7% reported they did not expect their prescribing practices to change further in the near future. The proportion of respondents who considered alternative therapies to HT as viable treatment options increased between 2003 and 2004 (37.1% vs 28.1%, P < 0.001). There was strong support for the use of HT for vasomotor symptoms, vaginal dryness, and osteoporosis, but most physicians did not consider HT useful for cardiovascular disease or dementia. Conclusions: Many obstetrician-gynecologists continue to express skepticism about the results and conduct of the Women's Health Initiative trials. The survey could not determine the reasons for skepticism.
Taking risky opportunities in youthful content creation: teenagers' use of social networking sites for intimacy, privacy and self-expression

The explosion in social networking sites such as MySpace, Facebook, Bebo and Friendster is widely regarded as an exciting opportunity, especially for youth.Yet the public response tends to be one of puzzled dismay regarding a generation that, supposedly, has many friends but little sense of privacy and a narcissistic fascination with self-display. This article explores teenagers' practices of social networking in order to uncover the subtle connections between online opportunity and risk. While younger teenagers relish the opportunities to recreate continuously a highly-decorated, stylistically-elaborate identity, older teenagers favour a plain aesthetic that foregrounds their links to others, thus expressing a notion of identity lived through authentic relationships. The article further contrasts teenagers' graded conception of `friends' with the binary classification of social networking sites, this being one of several means by which online privacy is shaped and undermined by the affordances of these sites.
Survival by Machine: The Psychological Stress of Chronic Hemodialysis

The prolongation of life by artificial means is a compelling topic for the physician who treats patients with chronic hemodialysis. This paper discusses the stresses, losses, and restrictions which dialysis imposes upon the patient, his family, and other caretakers. Examples of psychological reactions to such circumstances are given and major conflictual problems are described. The role of dependency and independence in chronic illness, the use of denial as a major defense mechanism, alterations in body image, attitudes towards life and death are all discussed in terms of the psychological reactions to the stress of hemodialysis. The problem of suicide is illustrated with a variety of forms it takes in these special patients who depend upon mechanical devices for their very existence. Some of the moral, ethical and economic problems of patient selection for hemodialysis are indicated and briefly examined.
Effects of the level and duration of feeding restriction on carcass components of broilers

Abstract. The effects of the restriction of the advised daily feed intake (ADFI) during 1 or 2 weeks on broiler body weight (BW) and carcass composition were studied. A total of 150 1-day-old male broilers (Ross-308) were randomly allotted to a control and four experimental treatments with three replicates per treatment. Broilers were subjected to a feeding restriction equal to 75 and 50 % of ADFI, either for a 7- or a 14-day period, between the 7th and 14th and 7th and 21th day of age, respectively. The BW and carcass composition were determined on day 42. From the findings, neither of the two levels of restriction nor the two time intervals had significant effects (P > 0.05) on the BW or breast and leg weight and proportion, liver and most of the body components. However, the feeding treatments show a tendency (P = 0.078) to influence the BW, with birds fed 75 % of ADFI for 14 day being heavier than the control group. For eviscerated carcass weight, an effect (P = 0.002) was observed, with birds fed 75 % of ADFI for 14 day having heavier carcasses (P 0.05). From our results, it can be concluded that the applied feeding restrictions have a neutral or slightly beneficial effect on broiler growth traits and carcass composition.
[Characterization of Pasteurella species isolated from man].

Fifty-four clinical isolates of Pasteurella are classified into different taxa. P. multocida subsp.multocida is more frequently encountered than other subspecies of P. multocida. P. canis is only identified from wounds inflicted by animals. The frequency of isolation of different species and subspecies is comparable with that observed from animal isolates. The distribution of the strains in the capsular types is different according to the origin, human or animal, of the strains.
Sensenbrenner syndrome (Cranioectodermal dysplasia): Clinical and molecular analyses of 39 patients including two new patients

Sensenbrenner syndrome, also known as cranioectodermal dysplasia, is a rare multiple anomaly syndrome with distinctive craniofacial appearance, skeletal, ectodermal, connective tissue, renal, and liver anomalies. Dramatic advances with next‐generation sequencing have expanded its phenotypic variability and molecular heterogeneity. We review 39 patients including two new patients, one with compound heterozygous novel mutations in WDR35 and a previously unreported multisutural craniosynostosis that may be a part of Sensenbrenner syndrome. In 14 of 25 (56.0%) patients pathogenic mutations have been identified in 4 different genes that regulate (intraflagellar) cilia transport. We compared Sensenbrenner syndrome to asphyxiating thoracic dystrophy‐Jeune syndrome (ATD‐JS) and other ciliopathies. Our analyses showed that the high anterior hairline, forehead bossing and dolichocephaly (accompanied by sagittal craniosynostosis in more than half of the patients) occur in almost all patients with Sensenbrenner syndrome. Metaphyseal dysplasia with narrow thorax, proximal limb shortness, and short fingers are typical of Sensenbrenner syndrome and ATD‐JS. Respiratory complications have been reported in both syndromes, usually less severe with Sensenbrenner syndrome. Proposed diagnostic criteria for Sensenbrenner syndrome include the distinctive craniofacial appearance, ubiquitous brachydactyly and ectodermal anomalies, and sagittal craniosynostosis. Mild heart defects have been noted, but there have been no atrioventricular canal or heterotaxy defects that are common in Ellis‐Van Creveld syndrome. We anticipate that the steady identification of molecularly defined patients may allow correlation of phenotype and genotype. Additional natural history data will improve genetic counseling and current guidelines. © 2013 Wiley Periodicals, Inc.
Review of orbital exenterations in Korle-Bu teaching hospital.

BACKGROUND Orbital exenteration (OE) is a disfiguring procedure which typically involves removal of the entire contents of the orbit including the periorbita, appendages, eyelids and, sometimes, a varying amount of surrounding skin and bone. It results in devastating functional, aesthetic and psychological losses. DESIGN This study reports an experience of OE in a Teaching Hospital in Accra Ghana. METHOD The records of all patients who underwent OE between November 2005 and October 2009 were reviewed retrospectively. These were cases seen at the orbit and oculoplastic clinic of the eye unit. RESULTS A total of 25 patients underwent OE. Nineteen (76%) of these were for invasive orbital squamous cell carcinomas and six (24%) were for other cases. Only one patient had OE for a benign condition (orbital haemangioma). Four patients had lid sparing procedures. One of these was for a patient with extensive ocular surface squamous cell carcinoma. Five patients had recurrent tumours. Among those patients with squamous cell carcinoma, seven had previous procedures, sometimes multiple before reporting to our clinic. CONCLUSION Orbital exenterations in developing countries are mostly for neglected periorbital and ocular surface malignancies. Educating patients to seek medical attention as soon as they notice a persistent conjunctival growth could prevent this.
Energy-optimal algorithms for computing aggregative functions in random networks

We investigate a family of algorithms minimizing energetic effort in random networks computing aggregative functions. In contrast to previously considered models, our results minimize maximal energetic effort over all stations instead of the average usage of energy. Such approach seems to be much more suitable for some kinds of networks, in particular ad hoc radio networks, wherein we need all stations functioning and replacing batteries after the deployment is not feasible. We analyze also the latency of proposed energy-optimal algorithms. We model a network by placing randomly and independently $n$ points in a $d$-dimensional cube of side-length $n^{1/d}$. We place an edge between vertices that interact with each other. We analyze properties of the resulting graphs in order to obtain estimates on energetic effort and latency of proposed algorithms.
The development and adult structure of the malleus, incus and stapes.

I N a seri es of journa l a rt icles the author' have reported the resul ts of t heir otological t ud ies as pa rts of an inc lu 'ive investigation in to the development, t he normal and pathological structure of the audi tory ossicles and otic cap ule. These report dealt chiefl y \\'ith the follo\\'ing subj ects : the development of t he stapes;2 the developmf'ntal and normal adul t structure of the fi ssula ante fenestram ;3 the aberrant form and pathological contents of t he fi · ula;4 the development of the otic capsule and of the extracapsular t i 'ue . 5 Sub"equently, the original program was extended to includ tho e specia l port ions of t he capsule in \\'hich late histological a lteration regularly occurs; these a re the cochlear aq uedu(·t and periotic duct,6 t he tympan ic wall of t he lateral semi circula r cana l (the region of m gical fene t ration)/ the cranial aperture of the ve t ibula r aqueduct and t he cochlear fe nest ra (oyal wi ndow). 9
C‐MOPP/ABV yields good results in a public hospital population with Hodgkin disease in Brazil

Background. Over the last 15 years, a number of combination chemotherapy regimens have been reported to induce more than 80% complete remissions (CR) in patients with advanced Hodgkin disease (HD). Almost all such studies have been conducted in large institutions from North America and Europe. It remains to be proven, however, that those regimens are equally effective for the larger population of patients with HD who live in very different social conditions in third‐world countries.
Tourniquet Use and Sickle Cell Hemoglobinopathy: How Should We Proceed?

The use of tourniquets for upper and lower extremity operative procedures is controversial in patients with sickle cell hemoglobinopathies. The authors used Ovid and MEDLINE®, PubMed, and CINAHL® to detect English-language reports of any surgical procedure where a tourniquet was used on a patient with sickle cell disease or trait. Four papers met the search criteria and were reviewed. These studies included 96 patients with hemoglobin SS, SC, and sickle cell trait (AS). The investigations differed in tourniquet type, perioperative care, operative procedure, and patient genotype distribution. Twelve of 96 sickle cell patients (12.5%) experienced postoperative complications (8 SS/SC and 4 AS) detailed in two of the four studies. Nonetheless, the available limited evidence suggests that with proper perioperative management and necessary precautions, tourniquets can be used with relative safety in most patients with sickle cell disease.
Does Identification of the Causal Organism of Corneal Ulcers Influence the Outcome?

Purpose To investigate whether identification of the causal organism in corneal ulcers influences their outcome. Methods We retrospectively studied 114 patients, 72 males and 42 females aged 6–89 years, admitted to this eye clinic during the years 1994–2000 on account of an infectious corneal ulcer. Their examination included a detailed history, visual acuity measurement, and biomicroscopy in everyday follow-up. The ulcers were classified according to their severity and outcome. We assessed the cases where cultures had been done, reviewed the results, and searched for a possible correlation between the outcome and the fact of culturing the ulcer and identifying the causal organism. Results Of the 114 corneal ulcers studied, 23 were mild, 49 moderate, and 42 severe. Fifty (44%) had not been cultured, but 64 ulcers (56%) had been cultured, with a positive result in 37 cases (58%), Staphylococcus and Pseudomonas species being the most common organisms found. In moderate and severe ulcers, there was a tendency to a higher proportion of successful outcome for cultured ulcers, but with no significant correlation. Conclusions Despite a tendency towards favorable results in culture-positive corneal ulcers, the influence of the detection of the organism on their outcome has not been proved. The role of the initial broad-spectrum antibiotic therapy remains important.
An imbalance between the excretion of thromboxane and prostacyclin metabolites in pulmonary hypertension.

BACKGROUND Constriction of small pulmonary arteries and arterioles and focal vascular injury are features of pulmonary hypertension. Because thromboxane A2 is both a vasoconstrictor and a potent stimulus for platelet aggregation, it may be an important mediator of pulmonary hypertension. Its effects are antagonized by prostacyclin, which is released by vascular endothelial cells. We tested the hypothesis that there may be an imbalance between the release of thromboxane A2 and prostacyclin in pulmonary hypertension, reflecting platelet activation and an abnormal response of the pulmonary vascular endothelium. METHODS We used radioimmunoassays to measure the 24-hour urinary excretion of two stable metabolites of thromboxane A2 and a metabolite of prostacyclin in 20 patients with primary pulmonary hypertension, 14 with secondary pulmonary hypertension, 9 with severe chronic obstructive pulmonary disease (COPD) but no clinical evidence of pulmonary hypertension, and 23 normal controls. RESULTS The 24-hour excretion of 11-dehydro-thromboxane B2 (a stable metabolite of thromboxane A2) was increased in patients with primary pulmonary hypertension and patients with secondary pulmonary hypertension, as compared with normal controls (3224 +/- 482, 5392 +/- 1640, and 1145 +/- 221 pg per milligram of creatinine, respectively; P less than 0.05), whereas the 24-hour excretion of 2,3-dinor-6-keto-prostaglandin F1 alpha (a stable metabolite of prostacyclin) was decreased (369 +/- 106, 304 +/- 76, and 644 +/- 124 pg per milligram of creatinine, respectively; P less than 0.05). The rate of excretion of all metabolites in the patients with COPD but no clinical evidence of pulmonary hypertension was similar to that in the normal controls. CONCLUSIONS An increase in the release of the vasoconstrictor thromboxane A2, suggesting the activation of platelets, occurs in both the primary and secondary forms of pulmonary hypertension. By contrast, the release of prostacyclin is depressed in these patients. Whether the imbalance in the release of these mediators is a cause or a result of pulmonary hypertension is unknown, but it may play a part in the development and maintenance of both forms of the disorder.
Metabolic Derangements in Lichen Planus - A Case Control Study.

INTRODUCTION An association between psoriasis and metabolic syndrome has been established in previous studies. Lichen Planus (LP) is also a chronic inflammatory disease morphologically related to psoriasis and few studies have shown association of metabolic derangements in LP. AIM To study the association of metabolic derangements in LP. MATERIALS AND METHODS A prospective case control study was undertaken for a period of one year. Age and sex matched patients of LP and other non-inflammatory diseases were taken as cases and controls respectively. Data on height, weight, lipid profile and fasting blood glucose levels were collected for all the patients. Body Mass Index (BMI) was calculated. RESULTS A total of 80 patients were recruited, 40 cases and 40 controls. The mean values for all the lipid and glucose parameters were high in cases as compared to controls with significant p-values. CONCLUSION In the present study metabolic derangements were seen in patients with LP.
Multiple roles of ephrins in morphogenesis, neuronal networking, and brain function.

Cell-to-cell communication during development and plasticity is controlled to a large extent by signaling events downstream of receptor tyrosine kinases (RTKs). Most RTKs bind soluble ligands, which are often produced at a distance from the RTK-expressing cells, and therefore these interactions typically mediate long-range communication. Eph receptors (or Ephs), instead, bind membrane-bound ephrin ligands expressed by neighboring cells and mediate short-range cell-to-cell communication. The influence of ephrin–Eph interaction on cell behavior depends on the cell type, but can in most cases be interpreted as repulsion of neighboring cells or of cellular processes, such as the neuronal growth cone. However, in some cases ephrin–Eph activation can have the opposite effect, that is, increased adhesion/attraction. One subclass of ephrins, the ephrinB ligands, are transmembrane proteins with intrinsic (so-called reverse) signaling properties (for review, see Kullander and Klein 2002). This complicates the interpretation of functional assays and genetic phenotypes, because manipulations intended to eliminate forward receptor function often have consequences for reverse signaling as well. This review summarizes the diverse biological roles of ephrins and Ephs in embryonic development, including patterning and morphogenetic processes of the nervous and vascular systems, and in the adult, such as synaptic plasticity. We further touch upon more recent observations on ephrin functions in neurogenesis, nervous system regeneration, and tumorigenesis. Our focus is on, but is not restricted to, recent findings using genetically amenable systems.
Lower Eyelid Malposition following Orbital Fracture Surgery: A Retrospective Analysis Based on 198 Surgeries

The aim of this study is to analyze the development of lower eyelid malposition following reconstruction of orbital fractures, in relation to the incisions used for access. A total of 198 surgical orbital floor reconstructions were performed in 175 patients between 2001 and 2011. Preoperative and postoperative presence of lower eyelid malposition of patients was reported. The types of incision used for access were as follows: approach via laceration (4.5%), via preexisting scar (16.2%), infraorbital (40.9%), subciliar (23.7%), transconjunctival (13.1%), and transconjunctival with lateral canthotomy (1.5%). The incidence of ectropion development following surgery was 3.0% and the incidence of entropion development following surgery was 1.0%. The highest rate of ectropion (11.1%) was seen using an approach via a laceration, followed by approach via a scar (6.3%). Our conclusion is that the transconjunctival incision without a lateral canthotomy has a low complication rate, provides adequate exposure, and leaves no visible scar.