Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving students’ sexual history inquiry and HIV counseling with an interactive workshop using standardized patients

Sexual history and HIV counseling are essential clinical skills. Our project’s purpose was to evaluate a standardized patient (SP) educational intervention teaching third-year medical students sexual history taking and HIV counseling. A 4-hour SP workshop was delivered to one-half of the class. Four weeks later, all students engaged in an SP examination including one station on assessing sexual history taking and HIV counseling. Workshop participants scored one standard deviation higher on sexual history and HIV counseling items than nonparticipants. Our sexual history and HIV counseling curriculum was associated with students asking more thorough sexual histories and providing more HIV counseling.
Awareness of human papillomavirus infection, testing and vaccination in midwives and midwifery students in Greece

Summary Midwives play an important role in the implementation of cervical cancer screening. We assessed the knowledge of human papillomavirus (HPV) infection and of its relationship with cervical cancer in 107 midwives and 29 graduating midwifery students. The majority of midwives (78.5%) were aware that a viral infection causes cervical cancer, whereas only 48.3% of the students knew this (p = 0.003). Only one midwife (0.9%) was not aware of HPV infection compared with 10.3% of the students (p = 0.029). Midwives were also more knowledgeable of the relationship between HPV infection and cervical cancer and of the availability of a vaccine against HPV infection (p = 0.005 and p < 0.0001, respectively). In conclusion, Greek midwives have a satisfactory level of knowledge about cervical cancer and HPV infection, in contrast to midwifery students. It is important to better educate midwifery students in order to facilitate the incorporation of HPV testing and vaccination in clinical practice.
Renin-Angiotensin System Inhibitors and Kidney and Cardiovascular Outcomes in Patients With CKD: A Bayesian Network Meta-analysis of Randomized Clinical Trials.

BACKGROUND There is much uncertainty regarding the relative effects of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in populations with chronic kidney disease (CKD). STUDY DESIGN Systematic review and Bayesian network meta-analysis. SETTING & POPULATION Patients with CKD treated with renin-angiotensin system (RAS) inhibitors. SELECTION CRITERIA FOR STUDIES Randomized trials in patients with CKD treated with RAS inhibitors. PREDICTOR ACE inhibitors and ARBs compared to each other and to placebo and active controls. OUTCOME Primary outcome was kidney failure; secondary outcomes were major cardiovascular events, all-cause death. RESULTS 119 randomized controlled trials (n = 64,768) were included. ACE inhibitors and ARBs reduced the odds of kidney failure by 39% and 30% (ORs of 0.61 [95% credible interval, 0.47-0.79] and 0.70 [95% credible interval, 0.52-0.89]), respectively, compared to placebo, and by 35% and 25% (ORs of 0.65 [95% credible interval, 0.51-0.80] and 0.75 [95% credible interval, 0.54-0.97]), respectively, compared with other active controls, whereas other active controls did not show evidence of a significant effect on kidney failure. Both ACE inhibitors and ARBs produced odds reductions for major cardiovascular events (ORs of 0.82 [95% credible interval, 0.71-0.92] and 0.76 [95% credible interval, 0.62-0.89], respectively) versus placebo. Comparisons did not show significant effects on risk for cardiovascular death. ACE inhibitors but not ARBs significantly reduced the odds of all-cause death versus active controls (OR, 0.72; 95% credible interval, 0.53-0.92). Compared with ARBs, ACE inhibitors were consistently associated with higher probabilities of reducing kidney failure, cardiovascular death, or all-cause death. LIMITATIONS Trials with RAS inhibitor therapy were included; trials with direct comparisons of other active controls with placebo were not included. CONCLUSIONS Use of ACE inhibitors or ARBs in people with CKD reduces the risk for kidney failure and cardiovascular events. ACE inhibitors also reduced the risk for all-cause mortality and were possibly superior to ARBs for kidney failure, cardiovascular death, and all-cause mortality in patients with CKD, suggesting that they could be the first choice for treatment in this population.
Free and bound plasma leptin in normal weight and obese men and women: relationship with body composition, resting energy expenditure, insulin‐sensitivity, lipid profile and macronutrient preference

Objective The adipose‐borne hormone leptin circulates in free and protein‐bound forms but little information is available about their biological significance. Free leptin (FL) levels are related to changes in fat mass, whereas bound leptin (BL) appears to be associated with resting energy expenditure (REE). Our aim was to assess FL and BL levels in normal weight and obese subjects and correlate them with metabolic and nutritional variables.
The Impact of Social Work Environment, Teamwork Characteristics, Burnout, and Personal Factors Upon Intent to Leave Among European Nurses

Objectives: Europe's nursing shortage calls for more effective ways to recruit and retain nurses. This contribution aims to clarify whether and how social work environment, teamwork characteristics, burnout, and personal factors are associated with nurses' intent to leave (ITL). Methods: Our sample comprises 28,561 hospital-based nurses from 10 European countries. Different occupational levels have been taken into account: qualified registered nurses (n = 18,594), specialized nurses (n = 3957), head nurses (n = 3256), and nursing aides and ancillary staff (n = 2754). Results: Our outcomes indicate that ITL is quite prevalent across Europe, although we have found some differences across the countries depending on working conditions and economic situation. Quality of teamwork, interpersonal relationships, career development possibilities, uncertainty regarding treatment, and influence at work are associated with nurses' decision to leave the profession across Europe, notwithstanding some country-specific outcomes. A serious lack of quality of teamwork seems to be associated with a 5-fold risk of ITL in 7 countries. As far as personal factors are concerned, our data support the hypothesized importance of work–family conflicts, satisfaction with pay, and burnout. A high burnout score seems to be associated with 3 times the risk of ITL in 5 countries. Conclusions: To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.
Firms' energy demand and the role of energy taxes: Elasticities estimation of industrial firms in Italy

In this paper we investigate interfuel substitution in the Italian industrial sector using a micro-dataset and a micro-simulation model for firms. According to our estimates there are significant differences between small and large firms. Energy demand of main energy products is not very responsive to relative price changes in the case of firms under 250 workers, whereas higher (negative) own elasticities have been estimated for larger firms, suggesting that price signals are most effective in the latter case. Most of the cross-price elasticities have positive signs, confirming that there is room for a change in energy product mix, which may also be stimulated by a careful excise tax rate design.
Effect of Reflow Profiles on the Board Level Drop Reliability of Pb-Free (SnAgCu) BGA Assemblies

The mechanical reliability of BGA assemblies is sensitive to the intermetallic compounds that are formed at the solder/base metal interfaces. With Pb-free assembly using SnAgCu solder alloys, the reflow temperatures are higher and may degrade the performance of the BGA assemblies compared to tin-lead. In this study, BGA packages with Sn3.8Ag0. 7Cu solder balls and either Ni/Au or Cu substrates were assembled to printed circuit boards with Cu pads protected with organic solderability preservative using a standard Pb-free solder paste of the same composition. The reflow profile variables investigated were peak temperature and number of reflow excursions. A subset of the assemblies were subjected to 4-point dynamic bend at high strain rate (>5/sec) to determine the effect of the reflow variables on the board level drop reliability. BGAs with Ni/Au substrates showed improved performance with increasing peak reflow temperature, while those with Cu substrates demonstrated the opposite. There were weak trends seen with number of reflows for both substrates. The intermetallic compound layer development due to the reflow variables is also covered.
Is there potential for learning in amusia? A study of the effect of singing intervention in congenital amusia

Congenital amusia is a neurodevelopmental disorder of musical perception and production. Much research has focused on characterizing the deficits within this special population; however, it is also important from both a psychological and educational perspective to determine which aspects of the disorder may be subject to change because this will also constrain theorizing about the nature of the disorder, as well as facilitating possible future remediation programs. In this small‐scale study, a professional singing teacher used a broad‐brush intervention approach with five individuals diagnosed with congenital amusia. The compensatory elements were designed to enhance vocal efficiency and health, singing technique, musical understanding, pitch perception, and production. Improvements were observed in most individuals in perception, indexed via the Montreal Battery for the Evaluation of Amusia scale subtest and in the vocal performance of familiar songs. The workshop setting gave a unique opportunity for observation and discussion to inform further investigations of this disorder.
Rapid assessment of childhood disabilities through key informant approach.

Childhood disabilities are a cause of major concern causing significant handicap to the affected children. At least one in ten children are born with or acquire a physical, mental or sensory impairment, 50% of these can be prevented or postponed(l). It is important to detect and manage these disabilities early for interventional measures to have a perceptible impact on the quality of life. Conventional surveys are expensive and take time to conduct. This study was conducted to rapidly identify disabilities among children below 14 years of age using Key informant approach(2).
Repeated ventral tegmental area amphetamine administration alters dopamine D1 receptor signaling in the nucleus accumbens

Neuroadaptations of the mesoaccumbens dopamine (DA) system likely underlie the emergence of locomotor sensitization following the repeated intermittent systemic administration of amphetamine (AMPH). In the nucleus accumbens (NAc), such neuroadaptations include enhanced DA overflow in response to a subsequent AMPH challenge as well as increased sensitivity to the inhibitory effects of D1 DA receptor (D1R) activation and an altered profile of D1R‐dependent induction of immediate early genes (IEGs). Previous results indicate that AMPH acts in the ventral tegmental area (VTA) to initiate those changes leading to sensitization of the locomotor activity and NAc DA overflow produced by systemic administration of this drug. These observations are intriguing, given that acute infusion of AMPH into the VTA does not stimulate locomotor activity or, as we report presently, increase extracellular NAc DA concentrations. Two experiments, therefore, assessed the ability of repeated VTA AMPH to produce adaptations in D1R signaling in the NAc. Rats were administered three bilateral VTA infusions of saline or AMPH (2.5 μg/0.5 μl/side, one every third day). In the first experiment, in vivo extracellular electrophysiological recordings revealed that previous exposure to VTA AMPH enhanced the sensitivity of NAc neurons to the inhibitory effects of iontophoretic application of the D1R agonist SKF 38393. This effect was observed early (2–3 days) and at 1 month of withdrawal, but not after 2 months. Similarly, in the second experiment it was found that the D1R‐dependent induction by AMPH of Fos, FosB, and JunB, but not NGFI‐A, in the NAc was enhanced in rats exposed 1 week earlier to repeated VTA AMPH. These findings indicate that repeated VTA AMPH administration initiates relatively long‐lasting adaptations in D1R signaling in the NAc that may, together with presynaptic adaptations affecting DA overflow, contribute to the expression of locomotor sensitization by this drug. Synapse 45:159–170, 2002. © 2002 Wiley‐Liss, Inc.
Incidence of definite stent thrombosis or in‐stent restenosis after drug‐eluting stent implantation for treatment of coronary in‐stent restenosis: From Western Denmark heart registry

There are limited data on the optimal management of in‐stent restenosis after percutaneous coronary intervention (PCI) with bare metal stent (BMS) or drug‐eluting stent (DES) implantations. We assessed the clinical presentation, the incidence, and prognosis of definite stent thrombosis or restenosis after DES implantation for treatment of restenosis.
Avaliação da qualidade de agrupamentos em grafos

O processo de descoberta de grupos de vertices similares e conectados em um grafo, conhecido como agrupamento em grafos ou graph clustering, possui aplicacoes interes-santes em diversos cenarios, tais como biologia, marketing e sistemas de recomendacao.Um dos grandes desaos da area de agrupamentos em grafos e a avaliacao da qualidade dos agrupamentos, que e utilizada para medir a efetividade de algoritmos de agrupa-mento. Existem muitas metricas de qualidade para avaliacao de agrupamentos em grafos, mas nao ha consenso sobre qual delas e melhor adequada para essa tarefa, e amaior parte dos autores na literatura simplesmente assume que uma metrica escolhida e boa o suciente, com pouco ou nenhum interesse em avaliar a forca dessas armacoes. Para melhor compreender a efetividade das metricas de qualidade de agrupamen-tos mais populares apresentadas na literatura, estudamo-las em diferentes cenarios. Descobrimos que essas metricas apresentam fortes tendenciosidades e inconsistencias estruturais que fazem com que a qualidade de seus resultados seja, no minimo, duvi-dosa. Nossos estudos demonstraram que, apesar dessas metricas de qualidade avaliarem corretamente a esparsidade de conexoes entre grupos, elas nao avaliam adequadamente a densidade interna dos mesmos, ignorando informacoes essenciais, como a numero de vertices pertencentes a cada grupo, ou mesmo ignorando, na pratica, metodos de avaliacao de densidade interna devido ao seu alto custo computacional. Tendo isso em mente, propusemos um novo metodo de avaliacao da densidade interna de um dado grupo, um que nao apenas utiliza informacoes mais completas na sua avaliacao de densidade, mas que tambem leva em consideracao as caracteristicas estruturais do grafo de origem. Com esse metodo, a densidade interna de um grupo e avaliada em termos da densidade esperada de grupos similares oriundos do mesmo grafo. Isso difere das outras metricas disponiveis, onde grupos de diferentes grafos sao comparados a partir dos mesmos parâmetros, um comportamento que penaliza redes que sejam naturalmente mais esparsas. Entao, propusemos uma nova metrica de qualidade para agrupamentos em grafos, combinando nossa metrica de avaliacao da qualidade interna e Condutância, uma popular metrica de avaliacao de esparsidade externa. Dessa forma, a metrica proposta avalia as duas principais caracteristicas estruturais esperadas de grupos bem formados. Nossos experimentos mostraram que aa metrica proposta e capaz de penalizar corretamente grupos mal formados que seriam bem avaliados por outras metricas de qualidade presentes na literatura, ao mesmo tempo que concedem boas pontuacoes a grupos bem formados.
Achilles tendinopathy - Part 1: Aetiology, diagnosis and non-surgical management

Non-insertional Achilles tendinopathy is by far the most common condition affecting this strong tendon and the incidence is on the rise due to increasing participation in recreational sports worldwide. Although the exact aetiology of Achilles tendinopathy is poorly understood, recent advances in understanding the pathophysiology of this condition have aided clinicians in developing improved methods of preventing and treating this painful, ubiquitous problem. Several contributing factors have been identified but repetitive microtrauma and inade quate, pathological healing appear to be the main culprits. Diagnosis is clinical but can be aided by the judicious use of imaging in equivocal cases. Activity modification and non-surgical modalities form the mainstay of treatment, with eccentric exercise programmes showing the best outcomes in prospective series. Several other non-surgical modalities exist and many show promising preliminary results. Surgical treatment options are discussed in Part 2 of this review, which will be published in Vol 14 No 4 of this journal.
Quantitative changes in plasma amino acids induced by oral contraceptives.

Plasma samples from 6 regularly menstruating women (ages 20-30) and 7 women (same age range) who had been using Gynovlar (0.05 mg ethinyl estradiol and 3.0 mg norethisterone acetate) were taken to study the effect of oral contraceptives on amino acid concentrations. Samples were drawn from all individuals between days 2 and 5 and again between days 19 and 22 of the same cycle. An additional sample was drawn 1 or 2 days before the new course of tablets in those taking contraceptives. In the control group total plasma amino acid concentration was significantly higher between days 2 and 5 than between days 19 and 22 (p less than 0.01). The corresponding difference in the contraceptive group was also significant (p less than 0.01). In the controls there were significant decreases in concentrations of serine glutamate and ornithine in the second half of the cycle. Among the contraceptors there were also significant decreases in concentrations of proline glycine alanine valine leucine and tyrosine in the second half. In the interval between pill courses however there is a normal plasma amino acid concentration with a significant decrease in plasma glycine. It is apparent that these plasma changes are influenced by both endogenous and exogenous sex hormones but the exact mechanism of action of oral contraceptives on amino acid metabolism is not yet known. It is likely that they influence the activity of enzymes concerned with the metabolism of many free amino acids in both the liver and peripheral tissues.
Genetic polymorphisms of long non-coding RNA GAS5 predict platinum-based concurrent chemoradiotherapy response in nasopharyngeal carcinoma patients

LncRNA GAS5 plays a tumor suppressive role in a variety of human cancers and promises to be a novel diagnostic biomarker, therapy target, as well as prognostic biomarker. However, the role of GAS5 in nasopharyngeal carcinoma (NPC) remains elusive. The objective of the present study was to evaluate the effect of single nucleotide polymorphisms (SNPs) in GAS5 on treatment efficacy and toxicity in NPC patients receiving chemoradiotherapy. Three potentially functional SNPs of GAS5 were genotyped in 267 NPC patients and validated in another 238 NPC patients treated with chemoradiotherapy from southern China. Multivariate logistic regression analyses and stratification analyses were used to estimate the association of candidate SNPs and chemoradiotherapy efficacy and toxic reactions. Our results showed that rs2067079 kept a consistent association with severe myelosuppression and severe neutropenia in discovery set (OR=2.403, P=0.009; OR=2.454, P=0.015; respectively), validation set (OR=3.653, P=0.027; OR=4.767, P=0.016; respectively), and combined dataset (OR=1.880, P=0.007; OR=2.079, P=0.005; respectively). rs2067079 CT genotype carriers presented an even more remarkable increased risk of severe myelosuppression (OR=3.878, P=0.003) and severe neutropenia (OR=3.794, P=0.009) in subgroups taking paclitaxel+platinum as concurrent chemoradiotherapy regimen. Besides, we found a gene-does effect of rs6790, with the incidence rate of severe myelosuppression decreased from 23.56% to 17.21% to 10% and the incidence rate of severe neutropenia decreased from 30.4% to 20.9% to 17.1% for rs6790 GG vs GA vs AA genotype carriers. Our results indicate the potential role of lncRNA GAS5 polymorphisms rs2067079 and rs6790 as predictive biomarkers for chemoradiotherapy induced toxic reactions in NPC patients.
Dietary lipid modification of renal disorders and ether phospholipid metabolism.

The formation of arachidonic acid derived eicosanoids, including thromboxane A2 and leukotriene B4, as well as platelet-activating factor (1-O-alkyl-2-acetyl-glycerophosphocholine), has been implicated in various renal pathophysiologies. Alteration of the fatty acid composition of membrane phospholipids in platelets, the glomerulus, and inflammatory cells, and of 1-O-alkyl-2-acyl-glycerophosphocholine (platelet-activating factor precursor) can be attained by dietary lipid modifications (e.g., consumption of fish oil containing n - 3 polyunsaturated fatty acids). These changes have been associated with an attenuation in renal disease progression and modifications in the synthesis and actions-interactions of eicosanoids, cytokines, and platelet-activating factors.
Small‐Sample Inference for Incomplete Longitudinal Data with Truncation and Censoring in Tumor Xenograft Models

Summary. In cancer drug development, demonstrating activity in xenograft models, where mice are grafted with human cancer cells, is an important step in bringing a promising compound to humans. A key outcome variable is the tumor volume measured in a given period of time for groups of mice given different doses of a single or combination anticancer regimen. However, a mouse may die before the end of a study or may be sacrificed when its tumor volume quadruples, and its tumor may be suppressed for some time and then grow back. Thus, incomplete repeated measurements arise. The incompleteness or missingness is also caused by drastic tumor shrinkage (<0.01 cm3) or random truncation. Because of the small sample sizes in these models, asymptotic inferences are usually not appropriate. We propose two parametric test procedures based on the EM algorithm and the Bayesian method to compare treatment effects among different groups while accounting for informative censoring. A real xenograft study on a new antitumor agent, temozolomide, combined with irinotecan is analyzed using the proposed methods.