Miracle-dz/UniFAR-FTUs huggingface dataset:
Perceived Classroom Responsibility Climate Questionnaire: A new scale.

BACKGROUND Given the lack of measuring instruments, we aimed to develop and validate a scale to assess the classroom responsibility climate fostered by the teacher and the students in different school subject lessons. METHOD 810 students from all secondary education years agreed to participate. Data were obtained from three different subjects: Mathematics (n = 240; 118 female, 13.10 ± 1.07 years), Spanish Language and Literature (n = 318; 169 female 13.37 ± 1.03 years) and Physical Education (n = 252, 112 female, 13.23 ± .99 years). The first version of the questionnaire underwent a three-phase refining process: a) Assessment by experts (n = 8), b) Pilot study one (n = 100) to assess comprehensive adequacy, and c) Pilot study two (n = 300), an exploratory factor analysis. RESULTS The instrument consists of two factors: climate generated by the teacher and by the students. Confirmatory factor analyses showed that all fit indices were acceptable. CONCLUSION The instrument presented adequate convergent, discriminant and concurrent validity and completes other existing tools, being suitable for use in the different secondary school subjects to assess the responsibility climate produced by the teacher and students.
Deep Learning for Chest Radiograph Diagnosis in the Emergency Department.

BackgroundThe performance of a deep learning (DL) algorithm should be validated in actual clinical situations, before its clinical implementation.PurposeTo evaluate the performance of a DL algorithm for identifying chest radiographs with clinically relevant abnormalities in the emergency department (ED) setting.Materials and MethodsThis single-center retrospective study included consecutive patients who visited the ED and underwent initial chest radiography between January 1 and March 31, 2017. Chest radiographs were analyzed with a commercially available DL algorithm. The performance of the algorithm was evaluated by determining the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity at predefined operating cutoffs (high-sensitivity and high-specificity cutoffs). The sensitivities and specificities of the algorithm were compared with those of the on-call radiology residents who interpreted the chest radiographs in the actual practice by using McNemar tests. If there were discordant findings between the algorithm and resident, the residents reinterpreted the chest radiographs by using the algorithm's output.ResultsA total of 1135 patients (mean age, 53 years ± 18; 582 men) were evaluated. In the identification of abnormal chest radiographs, the algorithm showed an AUC of 0.95 (95% confidence interval [CI]: 0.93, 0.96), a sensitivity of 88.7% (227 of 256 radiographs; 95% CI: 84.1%, 92.3%), and a specificity of 69.6% (612 of 879 radiographs; 95% CI: 66.5%, 72.7%) at the high-sensitivity cutoff and a sensitivity of 81.6% (209 of 256 radiographs; 95% CI: 76.3%, 86.2%) and specificity of 90.3% (794 of 879 radiographs; 95% CI: 88.2%, 92.2%) at the high-specificity cutoff. Radiology residents showed lower sensitivity (65.6% [168 of 256 radiographs; 95% CI: 59.5%, 71.4%], P < .001) and higher specificity (98.1% [862 of 879 radiographs; 95% CI: 96.9%, 98.9%], P < .001) compared with the algorithm. After reinterpretation of chest radiographs with use of the algorithm's outputs, the sensitivity of the residents improved (73.4% [188 of 256 radiographs; 95% CI: 68.0%, 78.8%], P = .003), whereas specificity was reduced (94.3% [829 of 879 radiographs; 95% CI: 92.8%, 95.8%], P < .001). ConclusionA deep learning algorithm used with emergency department chest radiographs showed diagnostic performance for identifying clinically relevant abnormalities and helped improve the sensitivity of radiology residents' evaluation.Published under a CC BY 4.0 license.Online supplemental material is available for this article.See also the editorial by Munera and Infante in this issue.
Rapid ocean acidification and protracted Earth system recovery followed the end-Cretaceous Chicxulub impact

Significance Debate lingers over what caused the last mass extinction 66 million years ago, with intense volcanism and extraterrestrial impact the most widely supported hypotheses. However, without empirical evidence for either’s exact environmental effects, it is difficult to discern which was most important in driving extinction. It is also unclear why recovery of biodiversity and carbon cycling in the oceans was so slow after an apparently sudden extinction event. In this paper, we show (using boron isotopes and Earth system modeling) that the impact caused rapid ocean acidification, and that the resulting ecological collapse in the oceans had long-lasting effects for global carbon cycling and climate. Our data suggest that impact, not volcanism, was key in driving end-Cretaceous mass extinction. Mass extinction at the Cretaceous–Paleogene (K-Pg) boundary coincides with the Chicxulub bolide impact and also falls within the broader time frame of Deccan trap emplacement. Critically, though, empirical evidence as to how either of these factors could have driven observed extinction patterns and carbon cycle perturbations is still lacking. Here, using boron isotopes in foraminifera, we document a geologically rapid surface-ocean pH drop following the Chicxulub impact, supporting impact-induced ocean acidification as a mechanism for ecological collapse in the marine realm. Subsequently, surface water pH rebounded sharply with the extinction of marine calcifiers and the associated imbalance in the global carbon cycle. Our reconstructed water-column pH gradients, combined with Earth system modeling, indicate that a partial ∼50% reduction in global marine primary productivity is sufficient to explain observed marine carbon isotope patterns at the K-Pg, due to the underlying action of the solubility pump. While primary productivity recovered within a few tens of thousands of years, inefficiency in carbon export to the deep sea lasted much longer. This phased recovery scenario reconciles competing hypotheses previously put forward to explain the K-Pg carbon isotope records, and explains both spatially variable patterns of change in marine productivity across the event and a lack of extinction at the deep sea floor. In sum, we provide insights into the drivers of the last mass extinction, the recovery of marine carbon cycling in a postextinction world, and the way in which marine life imprints its isotopic signal onto the geological record.
Characterization of Equine Parvovirus in Thoroughbred Breeding Horses from Germany

An equine parvovirus-hepatitis (EqPV-H) has been recently identified in association with equine serum hepatitis, also known as Theiler’s disease. The disease was first described by Arnold Theiler in 1918 and is often observed with parenteral use of blood products in equines. However, natural ways of viral circulation and potential risk factors for transmission still remain unknown. In this study, we investigated the occurrence of EqPV-H infections in Thoroughbred horses in northern and western Germany and aimed to identify potential risk factors associated with viral infections. A total of 392 Thoroughbreds broodmares and stallions were evaluated cross-sectionally for the presence of anti-EqPV-H antibodies and EqPV-H DNA using a luciferase immunoprecipitation assay (LIPS) and a quantitative PCR, respectively. In addition, data regarding age, stud farm, breeding history, and international transportation history of each horse were collected and analysed. An occurrence of 7% EqPV-H DNA positive and 35% seropositive horses was observed in this study cohort. The systematic analysis of risk factors revealed that age, especially in the group of 11–15-year-old horses, and breeding history were potential risk factors that can influence the rate of EqPV-H infections. Subsequent phylogenetic analysis showed a high similarity on nucleotide level within the sequenced Thoroughbred samples. In conclusion, this study demonstrates circulating EqPV-H infections in Thoroughbred horses from central Europe and revealed age and breeding history as risk factors for EqPV-H infections.
Effect of Fibrinogen Concentrate vs Cryoprecipitate on Blood Component Transfusion After Cardiac Surgery: The FIBRES Randomized Clinical Trial.

Importance Excessive bleeding is a common complication of cardiac surgery. An important cause of bleeding is acquired hypofibrinogenemia (fibrinogen level <1.5-2.0 g/L), for which guidelines recommend fibrinogen replacement with cryoprecipitate or fibrinogen concentrate. The 2 products have important differences, but comparative clinical data are lacking. Objective To determine if fibrinogen concentrate is noninferior to cryoprecipitate for treatment of bleeding related to hypofibrinogenemia after cardiac surgery. Design, Setting, and Participants Randomized clinical trial at 11 Canadian hospitals enrolling adult patients experiencing clinically significant bleeding and hypofibrinogenemia after cardiac surgery (from February 10, 2017, to November 1, 2018). Final 28-day follow-up visit was completed on November 28, 2018. Interventions Fibrinogen concentrate (4 g; n = 415) or cryoprecipitate (10 units; n = 412) for each ordered dose within 24 hours after cardiopulmonary bypass. Main Outcomes and Measures Primary outcome was blood components (red blood cells, platelets, plasma) administered during 24 hours post bypass. A 2-sample, 1-sided test for the ratio of the mean number of units was conducted to evaluate noninferiority (threshold for noninferiority ratio, <1.2). Results Of 827 randomized patients, 735 (372 fibrinogen concentrate, 363 cryoprecipitate) were treated and included in the primary analysis (median age, 64 [interquartile range, 53-72] years; 30% women; 72% underwent complex operations; 95% moderate to severe bleeding; and pretreatment fibrinogen level, 1.6 [interquartile range, 1.3-1.9] g/L). The trial met the a priori stopping criterion for noninferiority at the interim analysis after 827 of planned 1200 patients were randomized. Mean 24-hour postbypass allogeneic transfusions were 16.3 (95% CI, 14.9 to 17.8) units in the fibrinogen concentrate group and 17.0 (95% CI, 15.6 to 18.6) units in the cryoprecipitate group (ratio, 0.96 [1-sided 97.5% CI, -∞ to 1.09; P < .001 for noninferiority] [2-sided 95% CI, 0.84 to 1.09; P = .50 for superiority]). Thromboembolic events occurred in 26 patients (7.0%) in the fibrinogen concentrate group and 35 patients (9.6%) in the cryoprecipitate group. Conclusions and Relevance In patients undergoing cardiac surgery who develop clinically significant bleeding and hypofibrinogenemia after cardiopulmonary bypass, fibrinogen concentrate is noninferior to cryoprecipitate with regard to number of blood components transfused in a 24-hour period post bypass. Use of fibrinogen concentrate may be considered for management of bleeding in patients with acquired hypofibrinogenemia in cardiac surgery. Trial Registration ClinicalTrials.gov Identifier: NCT03037424.
Behavioral Finance and Agent-Based Artificial Markets

textabstractStudying the behavior of market participants is important due to its potential impact on asset prices and the dynamics of financial markets. The idea of individual investors who are prone to biases in judgment and who use various heuristics, which might lead to anomalies on the market level, has been explored within the field of behavioral finance. In this dissertation, we analyze market-wise implications of investor behavior and their irrationalities by means of agent-based simulations of financial markets. The usefulness of agent-based artificial markets for studying the behavioral finance topics stems from their ability to relate the micro-level behavior of individual market participants (represented as agents) and the macro-level behavior of the market (artificial time-series). This micro-macro mapping of agent-based methodology is particularly useful for behavioral finance, because that link is often broken when using other methodological approaches. In this thesis, we study various biases commented in the behavioral finance literature and propose novel models for some of the behavioral phenomena. We provide mathematical definitions and computational implementations for overconfidence (miscalibration and better-than-average effect), investor sentiment (optimism and pessimism), biased self-attribution, loss aversion, and recency and primacy effects. The levels of these behavioral biases are related to the features of the market dynamics, such as the bubbles and crashes, and the excess volatility of the market price. The impact of behavioral biases on investor performance is also studied.
Preoperative versus intraoperative image-guided localization of multiple ipsilateral lung nodules.

OBJECTIVES Computed tomography (CT)-guided localization of multiple ipsilateral pulmonary nodules remains challenging. Hybrid operating rooms equipped with cone-beam CT and laser navigation systems have the potential for improving clinical workflows and patient outcomes. METHODS Patients with multiple ipsilateral pulmonary nodules requiring localization were divided according to the localization method [preoperative CT-guided (POCT group) localization versus intraoperative CT-guided (IOCT group) localization]. The 2 groups were compared in terms of procedural efficacy, safety and radiation exposure. RESULTS Patients in the IOCT (n = 12) and POCT (n = 42) groups did not differ in terms of demographic and tumour characteristics. Moreover, the success and complication rates were similar. Notably, the IOCT approach allowed multiple nodules to be almost simultaneously localized-resulting in a shorter procedural time [mean difference (MD) -15.83 min, 95% confidence interval (CI) -7.97 to -23.69 min] and lower radiation exposure (MD -15.59 mSv, 95% CI -7.76 to -23.42 mSv) compared with the POCT approach. However, the total time under general anaesthesia was significantly longer in the IOCT group (MD 34.96 min, 95% CI 1.48-68.42 min), despite a similar operating time. The excess time under anaesthesia in the IOCT group can be attributed not only to the procedure per se but also to a longer surgical preparation time (MD 21.63 min, 95% CI 10.07-33.19 min). CONCLUSIONS Compared with the POCT approach, IOCT-guided localization performed in a hybrid operating room is associated with a shorter procedural time and less radiation exposure, albeit at the expense of an increased time under general anaesthesia.
Targeting Glutathione and Cystathionine β-Synthase in Ovarian Cancer Treatment by Selenium–Chrysin Polyurea Dendrimer Nanoformulation

Ovarian cancer is the main cause of death from gynecological cancer, with its poor prognosis mainly related to late diagnosis and chemoresistance (acquired or intrinsic) to conventional alkylating and reactive oxygen species (ROS)-generating drugs. We and others reported that the availability of cysteine and glutathione (GSH) impacts the mechanisms of resistance to carboplatin in ovarian cancer. Different players in cysteine metabolism can be crucial in chemoresistance, such as the cystine/glutamate antiporter system Xc (xCT) and the H2S-synthesizing enzyme cystathionine β-synthase (CBS) in the pathway of cysteine catabolism. We hypothesized that, by disrupting cysteine metabolic flux, chemoresistance would be reverted. Since the xCT transporter is also able to take up selenium, we used selenium-containing chrysin (SeChry) as a plausible competitive inhibitor of xCT. For that, we tested the effects of SeChry on three different ovarian cancer cell lines (ES2, OVCAR3, and OVCAR8) and in two non-malignant cell lines (HaCaT and HK2). Results showed that, in addition to being highly cytotoxic, SeChry does not affect the uptake of cysteine, although it increases GSH depletion, indicating that SeChry might induce oxidative stress. However, enzymatic assays revealed an inhibitory effect of SeChry toward CBS, thus preventing production of the antioxidant H2S. Notably, our data showed that SeChry and folate-targeted polyurea dendrimer generation four (SeChry@PUREG4-FA) nanoparticles increased the specificity for SeChry delivery to ovarian cancer cells, reducing significantly the toxicity against non-malignant cells. Collectively, our data support SeChry@PUREG4-FA nanoparticles as a targeted strategy to improve ovarian cancer treatment, where GSH depletion and CBS inhibition underlie SeChry cytotoxicity.
Adjuvant therapeutic potential of tonabersat in the standard treatment of glioblastoma: A preclinical F98 glioblastoma rat model study

Purpose Even with an optimal treatment protocol, the median survival of glioblastoma (GB) patients is only 12–15 months. Hence, there is need for novel effective therapies that improve survival outcomes. Recent evidence suggests an important role for connexin (Cx) proteins (especially Cx43) in the microenvironment of malignant glioma. Cx43-mediated gap junctional communication has been observed between tumor cells, between astrocytes and between tumor cells and astrocytes. Therefore, gap junction directed therapy using a pharmacological suppressor or modulator, such as tonabersat, could be a promising target in the treatment of GB. In this preclinical study, we evaluated the possible therapeutic potential of tonabersat in the F98 model. Procedures Female Fischer rats were inoculated with ± 25.000 F98 tumor cells in the right frontal lobe. Eight days post-inoculation contrast-enhanced T1-weighted (CE-T1w) magnetic resonance (MR) images were acquired to confirm tumor growth in the brain. After tumor confirmation, rats were randomized into a Control Group, a Connexin Modulation Group (CM), a Standard Medical Treatment Group (ST), and a Standard Medical Treatment with adjuvant Connexin Modulation Group (STCM). To evaluate therapy response, T2-weighted (T2w) and CE-T1w sequences were acquired at several time points. Tumor volume analysis was performed on CE-T1w images and statistical analysis was performed using a linear mixed model. Results Significant differences in estimated geometric mean tumor volumes were found between the ST Group and the Control Group and also between the STCM Group and the Control Group. In addition, significant differences in estimated geometric mean tumor volumes between the ST Group and the STCM Group were demonstrated. No significant differences in estimated geometric mean tumor volumes were found between the Control Group and the CM Group. Conclusion Our results demonstrate a therapeutic potential of tonabersat for the treatment of GB when used in combination with radiotherapy and temozolomide chemotherapy.
Practice choices of clinical associates: Policy realisation or practical reality?

BACKGROUND The Bachelor of Clinical Medical Practice (BCMP) programme was introduced in South Africa as a strategy to fill human resource gaps in both the public sector and rural communities. A previous study explored the practice intentions of BCMP students from one university prior to graduation. OBJECTIVES To determine whether the actual practice choices of these BCMP graduates reflect their practice intentions. METHODS A cross-sectional analytical study invited all graduates from the four cohorts of BCMP graduates (N=250) who graduated during the period 2011 - 2014 to complete an online survey. Data were exported and analysed using Stata 13. Chi-square tests of independence were done to explore associations in the data. RESULTS More than 80% of participants were currently employed in the public sector, with over 50% in rural settings. Factors such as where clinical associates spent most of their lives (i.e. where they were born and raised) and bursary obligations influenced their current practice choices. There was no association between gender and rural practice choice. Intention to emigrate was not associated with origin, gender or race. Almost 90% of participants indicated an interest in furthering their studies; 46% of these intended a change in career, with 65% interested in studying medicine. CONCLUSIONS The practice choices of the first four cohorts of this degree were similar to their intended practice choices. Although the policy intentions of public sector employment and rural practice have been met, it is not clear what will happen once bursary obligations are fulfilled. The reasons for increased intentions to change career need further research, as a change of career would countermand gains achieved in implementing the policy.
WOUND INFECTIONS AND CULTURE SENSITIVITY PATTERN IN PEDIATRIC BURN PATIENTS

Objective: To identify common organisms causing burn infection and their antimicrobial sensitivity pattern. Material and Methods: A retrospective study of sixty patients with burn wound infection was carried out at burn unit of Khyber Teaching Hospital Peshawar from September 2006 to August 2007. Children who received burn injuries with signs and symptoms of septicemia were included in this study. Age, sex, percentage of burn wound and etiology of burn wounds was recorded. Culture and sensitivity tests were performed from burn wounds of those patients who were having fever and other features of septicemia by tissue culture of all patients( from infective sites) and their results were noted. Results: Out of sixty patients, fourty were male and twenty were female pediatric burn patients. The most frequent organism isolated was staphylococcus aureus (25%), followed by pseudomonas (21.6%). Other organisms included mix pseudomonas and staphylococcus aureus (23.5%), E-coli (13%), proteus (3%), Klebsiella (3%). All these organisms were resistant to most routine antibiotics. Conclusion: This study highlights that staphylococcus aureus (25%) and pseudomonas (21.6%) are the most common organisms and cefoperazone/sulbactam and imipenem/cilastatin are the most effective empirical therapy in our setup.
CREB activity is required for epidermal growth factor‐induced mouse cumulus expansion

The release of a fertilizable oocyte from the ovary is dependent upon the expansion of the cumulus cells. The expansion requires cooperation between epidermal growth factor (EGF) family peptide‐activated mitogen‐activated protein kinase (MAPK)3/1 and oocyte paracrine factor‐activated‐Sma‐ and Mad‐related protein (SMAD)2/3 signaling in cumulus cells. However, the mechanism underlying (MAPK)3/1 signaling is unclear. In the present study, the EGF‐activation of EGF receptor (EGFR) induced cyclic adenosine 3′,5′‐monophosphate (cAMP) response element‐binding protein (CREB) phosphorylation in cumulus cells, and the interruption of CREB functional complex formation by naphthol AS‐E phosphate (KG‐501) completely blocked the EGF‐stimulated expansion‐related gene expression. EGF‐stimulated phosphorylation of CREB was completely inhibited by MAPK3/1 inhibitor U0126, suggesting that EGF‐activated MAPK3/1 results in the activation of CREB for cumulus expansion. Also, the role of EGF‐stimulated calcium signaling was studied. Calcium‐elevating reagents ionomycin and sphingosine‐1‐phosphate mimicked, but calcium chelators bis‐(o'aminophenoxy)‐ethane‐N,N,N,N‐tetraacetic acid, tetra(acetoxymethyl)‐ester, and 8‐(N,N‐diethylamino)‐octyl‐3,4,5‐trimethoxybenzoate abolished the activity of EGF on CREB phosphorylation, cumulus expansion, and expansion‐related gene expression. Furthermore, EGF‐induced cumulus expansion was inhibited by calmodulin (CaM)‐dependent protein kinase II (CaMKII) inhibitors, KN‐93 and autocamtide‐2‐related inhibitory peptide. However, the inhibition of SMAD2/3 activity by removal of oocyte from cumulus–oocyte complexes did not affect the EGF‐induced CREB phosphorylation, indicating that EGF‐activated CREB is independent of oocyte‐activated SMAD2/3 signaling. Therefore, EGF‐induced CREB activity by MAPK3/1 and Ca2+/CaMKII signaling pathways promotes the expansion‐related gene expression and consequent cumulus expansion.