Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of a residency program's experience with a one-week emergency medicine resident rotation at a medical liability insurance company.

INTRODUCTION The authors' residency program implemented a one-week rotation at the office of a medical liability insurance company. Residents examined 30 closed malpractice claims cases and sat in on settlement discussions. OBJECTIVE To review the residents' evaluations of their experiences and to determine whether this was a worthwhile addition to the emergency medicine (EM) residency curriculum. METHODS This was a five-year retrospective study that reviewed residents' annual evaluations from 1994 to 1999 regarding the medical liability rotation. A five-point scale was used to score specific categories in the rotation and an open-ended section was used to collect general comments. RESULTS A total of 179 resident evaluations were reviewed. The quality of teaching ranked in the 80th percentile, the clinical caseload ranked in the 85th percentile, and level of responsibility ranked in the 79th percentile for all EM rotations. Specific comments included "All MDs should do this in their training"; "Quite an eye opener"; and "Good exposure to legal aspects of EM. " CONCLUSIONS Overall, EM residents found the one-week rotation to be invaluable and a good learning experience. This rotation ranked above average when compared with all of our other EM residency rotations.
The prevalence of abnormal echocardiographic findings in a sample of urban adult population.

BACKGROUND Echocardiography has emerged as the test of choice for the evaluation of cardiac diseases. AIM To assess the prevalence of a spectrum of cardiac abnormalities detected by echocardiography in a representative sample of an urban adult population. METHODS Transthoracic echocardiography was performed in a random sample of 511 men (47%) and women (53%) aged 48-76 years selected from population registers in Krakow. Body surface area (BSA) was used to adjust echocardiographic parameters for variations in body size. Disease history and cardiovascular risk factors were assessed in all patients. RESULTS Men smoked more frequently than women and had higher blood pressure and triglycerides and lower high density lipoprotein cholesterol. The most common finding was increased left ventricular (LV) end-diastolic diameter (EDd) (37%), followed by mitral (32%), aortic (24%), or tricuspid (17%) regurgitations, LV posterior wall (24.1%) and interventricular septum (17.5%) thickening, increased indexed LVEDd (23%), increased left atrial diameter (LAd; 15.7%), reduced LV ejection fraction (LVEF; 15.3%), segmental wall motion abnormalities (13.9%), increased indexed LAd (8.8%), dilation of the ascending aorta (8%), enlargement of the right ventricle (RV) (2%) and elevation of RV systolic pressure (0.6%). When adjusted for main cardiovascular risk factors and the presence of coronary artery disease, male sex was associated with a higher prevalence of enlargement of LV (LVEDd/BSA): OR = 1.8 (1.1-2.9), dilation of ascending aorta (aortic diameter/BSA): OR = 2.7 (1.3-5.8), and LA (LA/BSA) = OR 2.7 (1.3-5.6), as well as a decrease of LVEF: OR = 3.6 (1.9-6.5). CONCLUSIONS Approximately a quarter of urban adults aged 48 to 76 can be expected to have some abnormalities on echocardiographic examination. Some of these abnormalities such as aortic dilation, LA enlargement, LV enlargement and decreased LVEF are more frequently found in males than in females, even after adjustment for BSA, main cardiovascular disease risk factors, and the presence of coronary artery disease. The use of raw instead of indexed LAd and LVEDd over estimates the prevalence of LA and LV enlargement.
Results of the BRD CAP project: progress toward identifying genetic markers associated with BRD susceptibility

Abstract The Bovine Respiratory Disease Coordinated Agricultural Project (BRD CAP) is a 5-year project funded by the United States Department of Agriculture (USDA), with an overriding objective to use the tools of modern genomics to identify cattle that are less susceptible to BRD. To do this, two large genome wide association studies (GWAS) were conducted using a case:control design on preweaned Holstein dairy heifers and beef feedlot cattle. A health scoring system was used to identify BRD cases and controls. Heritability estimates for BRD susceptibility ranged from 19 to 21% in dairy calves to 29.2% in beef cattle when using numerical scores as a semi-quantitative definition of BRD. A GWAS analysis conducted on the dairy calf data showed that single nucleotide polymorphism (SNP) effects explained 20% of the variation in BRD incidence and 17–20% of the variation in clinical signs. These results represent a preliminary analysis of ongoing work to identify loci associated with BRD. Future work includes validation of the chromosomal regions and SNPs that have been identified as important for BRD susceptibility, fine mapping of chromosomes to identify causal SNPs, and integration of predictive markers for BRD susceptibility into genetic tests and national cattle genetic evaluations.
Effects of collagen tripeptide supplement on skin properties: A prospective, randomized, controlled study

Abstract Background: Experimental and clinical trials have indicated that dietary supplements can have beneficial effects on skin health. Objective: We investigated to evaluate the effect of daily collagen peptide (CP) supplement on skin properties. Methods: Thirty-two healthy volunteers were randomized to receive either no supplement (Group A), CP 3 g (Group B), CP 3 g, and vitamin C 500 mg (Group C), or vitamin C 500 mg (Group D) daily for 12 weeks. Skin properties evaluated included hydration, transepidermal water loss (TEWL), and elasticity using a corneometer, tewameter, and cutometer, respectively. Results: Changes from baseline in the corneometer were statistically significant between Groups A and B (p = 0.011) and Groups A and C (p = 0.004). There were statistically significant differences in cutometer from baseline between Groups A and B (p = 0.005) and Groups A and C (p = 0.015). There was no significant difference from baseline in the corneometer and cutometer between Groups B and C. The greatest changes in TEWL from baseline were seen in Group B, and the second greatest changes were seen in Group C. Conclusions: Daily CP supplementation may improve skin hydration and elasticity, but concomitant intake of low-dose vitamin C did not enhance the effect of CP on skin properties.
Randomized trial comparing saquinavir soft gelatin capsules versus indinavir as part of triple therapy (CHEESE study).

OBJECTIVE To compare efficacy and tolerability of saquinavir soft gelatin capsule (SQV-SGC) formulation and indinavir, both given as part of a triple drug regimen containing zidovudine and lamivudine, in HIV-1-infected individuals. DESIGN Randomized, open label, multicentre study. PATIENTS A total of 70 patients who were antiretroviral-naive and who had a CD4 cell count < 500 x 10(6)/I and/or > 10000 HIV RNA copies/ml plasma and/or HIV-related symptoms. Subjects were assigned randomly to zidovudine 200 mg three times per day plus lamivudine 150 mg twice per day plus either SQV-SGC 1200 mg three times per day (SQV-SGC group) or indinavir 800 mg three times per day (indinavir group). Data are presented for all patients up to week 24. RESULTS Mean baseline CD4 cell counts (+/- SE) were 301+/-29 x 10(6) cells/l and 310 +/-43 x 10(6) cells/l in the SQV-SGC and indinavir groups, respectively. The log10 median baseline HIV RNA load was 5.00 copies/ml in the SQV-SGC group and 4.98 copies/ml in the indinavir group. No difference in antiretroviral effect between the treatment arms could be demonstrated. Intention-to-treat analysis (last observation carried forward [LOCF]) at week 24 revealed that RNA levels decreased to < 50 copies/ml in 74.3% of patients in the SQV-SGC group and in 71.4% of the patients in the indinavir group (P = 0.78). In the on-treatment analysis the proportion of patients < 50 copies/ml at week 24 was 88.0% in the SQV-SGC group and 84.6% in the indinavir group (P = 0.725). Intriguingly, the mean increase of CD4 cells in the first 24 weeks was 162+/-20 x 10(6) cells/l in the SQV-SGC group and 89+/-21 x 10(6) cells/l in the indinavir group (P = 0.01), but preliminary data indicate that this difference in CD4 cell count gain may disappear after 24 weeks of treatment. Both regimens were generally well tolerated. CONCLUSION During the first 24 weeks of the study, we found no difference in antiviral potency between the indinavir group and the SQV-SGC group. A significantly higher CD4 response in the SQV-SGC group was observed.
Thrombin generation: phenotypic quantitation

Summary. An individual's ability to generate thrombin following tissue factor stimulus was evaluated in 13 healthy male donors in a 6‐month study. Thrombin generation in whole blood collected by phlebotomy, contact pathway suppressed by the presence of 100 µg mL−1 corn trypsin inhibitor, was initiated by the addition of 5 pm tissue factor/10 nm phospholipid. Reactions were quenched at 20 min by the addition of an ethylenediaminetetraacetic acid (EDTA), benzamidine, FPRck cocktail. Thrombin generation was determined by an ELISA for thrombin–antithrombin III (TAT) complex formation. Results showed that the levels of TAT observed varied from 245 to 775 nm. Thrombin production was consistent within each individual, CVi = 11.6%, but varied significantly within the group, CVg = 25.2%, and correlated inversely with an individual's clotting time (r = − 0.54, P = 0.07). No correlations were individually observed between TAT and C‐reactive protein, antithrombin III, factors II, V, VII, VIII, IX and X, fibrinogen and prothrombin time. However, computer simulations, which integrated each individual's coagulation factor levels using the Speed Rx method (Hockin et al., J Biol Chem 2002; 277: 18322), predicted maximum active thrombin levels (ranging from calculated values of 220–500 nm) consistent with the empirically determined values. Overall, these data suggest that thrombin generated in whole blood exclusively by tissue factor stimulation can be used as an integrative phenotypic marker to determine an individual's response to a tissue factor challenge.
PARASITE PREVALENCE AND THE SIZE OF HOST POPULATIONS: AN EXPERIMENTAL TEST

Although important in epidemiological theory, the relationship between the size of host populations and the prevalence of parasites has not been investigated empirically. Commonly used models suggest no relationship, but this prediction is sensitive to assumptions about parasite transmission. In laboratory populations, I manipulated the size of Tribolium castaneum flour beetle populations and measured the prevalence and distribution of a parasitic mite, Acarophenax tribolii. I found that parasite prevalence did not vary for a wide range of host population sizes. However, prevalence was lower in populations with less than 40 hosts. This effect cannot be attributed to changes in host population density because host density was held constant among treatments. The reduction in prevalence of small populations below a threshold that I observed is predicted by the extinction debt model, but it is not expected from models of host–parasite interactions that assume density-dependent transmission. The distribution of parasites, measured using Lloyd's patchiness index, was not affected by host population size. The mean crowding of parasites, however, was negatively related with host density. Finally, the prevalence of parasites in large populations did not differ from that found in sets of smaller patches as long as the smaller populations in aggregate were equivalent in size to the large population.
Prony and Polynomial Approximations for Evaluation of the Average Probability of Error Over Slow-Fading Channels

A novel and simple semianalytical method for evaluating the average probability of transmission error for digital communication systems that operate over slow-fading channels is presented. The proposed method applies a sum of exponentials fit known as the Prony approximation to the conditional probability of error. Hence, knowledge of the moment-generating function of the instantaneous signal-to-noise ratio (SNR) at the detector input can be used to obtain the average probability of error. Numerical results show that knowledge of the conditional probability of error at only a small number of points and the sum of only two exponentials are sufficient to achieve very high accuracy; the relative approximation error of the exact average probability of error is less than 6% in most of the cases considered. Furthermore, a piecewise polynomial approximation of the conditional probability of error is investigated as an alternative to the sum of exponentials fit. In this case, knowledge of the partial moments of the instantaneous SNR at the detector input can be used to obtain the average probability of error. Numerical results indicate that, to achieve good accuracy, the method based on the polynomial approximation requires that the product of the polynomial degree and the number of approximation subintervals be larger than 10.
Development of risk reduction behavioral counseling for Ebola virus disease survivors enrolled in the Sierra Leone Ebola Virus Persistence Study, 2015-2016

Background During the 2014–2016 West Africa Ebola Virus Disease (EVD) epidemic, the public health community had concerns that sexual transmission of the Ebola virus (EBOV) from EVD survivors was a risk, due to EBOV persistence in body fluids of EVD survivors, particularly semen. The Sierra Leone Ebola Virus Persistence Study was initiated to investigate this risk by assessing EBOV persistence in numerous body fluids of EVD survivors and providing risk reduction counseling based on test results for semen, vaginal fluid, menstrual blood, urine, rectal fluid, sweat, tears, saliva, and breast milk. This publication describes implementation of the counseling protocol and the key lessons learned. Methodology/Principal findings The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol was developed from a framework used to prevent transmission of HIV and other sexually transmitted infections. The framework helped to identify barriers to risk reduction and facilitated the development of a personalized risk-reduction plan, particularly around condom use and abstinence. Pre-test and post-test counseling sessions included risk reduction guidance, and post-test counseling was based on the participants’ individual test results. The behavioral counseling protocol enabled study staff to translate the study’s body fluid test results into individualized information for study participants. Conclusions/Significance The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol provided guidance to mitigate the risk of EBOV transmission from EVD survivors. It has since been shared with and adapted by other EVD survivor body fluid testing programs and studies in Ebola-affected countries.
The quadratic approximation lemma and decompositions of superlative indexes

It was shown in 1976 that a difference in a quadratic function of N variables evaluated at two points is exactly equal to the sum of the arithmetic average of the first order partial derivatives of the function evaluated at the two points times the differences in the independent variables. In the present paper, this result is generalized and the resulting generalized quadratic approximation lemma is used to establish all of the superlative index number formulae that were derived in Diewert [4]. In addition, some new exact decompositions of the percentage change in the Fisher and Walsh superlative indexes into N components are derived. Each component in this decomposition represents the contribution of a change in a single independent variable to the overall percentage change in the index. Finally, these components are given economic interpretations.
Axial Implants in Immediate Function for Partial Rehabilitation in the Maxilla and Mandible: A Retrospective Clinical Study Evaluating the Long-Term Outcome (Up to 10 Years)

Background:There is a need of long-term studies evaluating the outcome of fixed partial rehabilitations (FPR) supported by implants in an immediate function protocol. The aim of this retrospective cohort study was to investigate the long-term outcome of FPR supported by implants placed in immediate function. Methods:One hundred ninety-nine patients were consecutively included, between 1998 and 2010, with 481 implants supporting 213 FPR (maxilla: 87 and mandible: 126). Primary outcome measures were implant and FPR survival rates; secondary outcome measures were marginal bone levels at 5 and 10 years and incidence of mechanical and biological complications. Results:The cumulative implant survival rate was 98.5% and 99.0% after 5 years and 92.7% and 96.7% after 10 years, using the patient and implant as unit of analysis, respectively. No prostheses were lost. Average (SD) marginal bone levels were 1.79 (0.93) and 1.89 mm (0.81 mm) at 5 and 10 years of follow-up. Mechanical complications occurred in 43 patients (21.6%), biological complications occurred in 12 patients (6%), and 16 implants (3.3%) up to the 10 years follow-up. Conclusions:FPR supported by immediate function implants in both jaws is a viable and safe treatment alternative.
Preliminary results of combined application of radioisotopes and biphosphonates in the management of pain associated with osteoblastic-osteolytic bone metastases of breast cancer.

Background. The aim of this study was to evaluate the effectivness of connected therapy using strontium 89 or Sm153 (osteoblastic component) and bisphosphonate therapy (osteolytic component) in the group of breast cancer patients with multiple osteoblastic-osteolytic (mixt) bone metastases. Material and methods. The study included 16 patients with breast cancer and multiple bone painful metastases detected by scintigraphy and by radiogram or CT or MRI (the type of metastases). Each patient received a standard dose of strontium 89 (Metastron) or samarium 153 (Quadramet) combined with intravenous infusion of pamidronate (Aredia) or zoledronate (Zometa). The bisphosphonate therapy was repeated every month. For assessment of therapy effectivness; pain relief (VAS scale), a reduction in analgesic requirements and motor activity (ECOG and Karnofsky scale) were evaluated. The group of 10 patients treated with bisphosphonate only in the same time was observed. Results. We conclude that connected palliative therapy using strontium 89 and bisphosphonates is effective (66-75% "good" and "moderate" response rate) and safe for bone pain palliation in patients with multiple osteoblastic-osteolytic bone metastases from breast cancer. We have observed that the analgesic requirments decreased to 30% of dose on average. The motor activity of the points evaluated according to ECOG scale increased from 3 to 2 and from 50 to 60 to Karnofsky scale. Conclusions. The results of treatment in the group with radioisotope and bisphosphonate were better than in the group treated with bisphosphonates or radioisotope only.
The effects of clinical workload on teaching in the emergency department.

BACKGROUND Academic emergency physicians have expressed concern that increased clinical workload and overcrowding adversely affect clinical teaching. OBJECTIVES To evaluate the influence of clinical workload and attending physicians' teaching characteristics on clinical teaching in the emergency department (ED). METHODS This was a prospective observational study using learner satisfaction assessment tools to evaluate bedside teaching. On days when a research assistant was available, all ED residents and attending physicians were queried. A total of 335 resident surveys were administered over nine months (89% response). Clinical workload was measured by perception and patient volume. Teaching quality and characteristics were rated on ten-point scales. A linear mixed-effects model was used to obtain adjusted impact estimates of clinical workload and teaching attributes on teaching scores while controlling for individual attending physicians' teaching ability and residents' grading tendencies. RESULTS No clinical workload parameter had a significant effect on teaching scores: residents' workload perception (beta estimate, 0.024; p = 0.55), attending physicians' workload perception (beta estimate, -0.05; p = 0.28), patient volume in patients per hour (beta estimate, -0.010; p = 0.36), and shift type (beta estimate, -0.19; p = 0.28). The individual attending physician effect was significant (p < 0.001) and adjusted in each case. In another model, the attending physicians' learning environment established (beta estimate, 0.12; p = 0.005), clinical teaching skills (beta estimate, 0.36; p < 0.001), willingness to teach (beta estimate, 0.25; p < 0.001), and interpersonal skills (beta estimate, 0.19; p < 0.001) affected teaching scores, but the attending physicians' availability to teach had no significant effect (beta estimate, 0.007; p = 0.35). CONCLUSIONS Clinical workload and attending physicians' availability had little effect on teaching scores. Attending physicians' clinical teaching skills, willingness to teach, interpersonal skills, and learning environment established were the important determinants of overall scores. Skilled instructors received higher scores, regardless of how busy they were.
Formation of der(19)t(1;19)(q23;p13) in acute lymphoblastic leukemia

The t(1;19)(q23;p13), which results in a fusion of TCF3 (previously E2A) at 19p13 with PBX1 at 1q23, is one of the most common translocations in acute lymphoblastic leukemia (ALL). It is seen either as a balanced t(1;19) or as an unbalanced der(19)t(1;19); occasional cases with coexisting t(1;19)‐ and der(19)‐positive clones also have been described. Although it generally has been assumed that the unbalanced form arises from the balanced t(1;19) through loss of the derivative chromosome 1 followed by duplication of the normal homologue, this has never been proved. At least two other mechanisms are possible for the formation of the der(19): an initial trisomy 1 followed by translocation and subsequent loss of the der(1) or a rearrangement during the G2 phase of the cell cycle, with the derivative chromosomes 1 and 19 ending up in separate daughter cells. The different alternatives may be distinguished by investigation of markers proximal to the breakpoint in 1q23 because they would be expected to lead to different allelic patterns. Thus, loss of heterozygosity as a result of the presence of uniparental disomy (UPD)—both copies of a chromosome being derived from only one parent—for chromosome 1 would be present in all der(19)‐harboring cases arising via the duplication pathway and in one‐third of cases arising via the trisomy pathway, but in none of the der(19) formed via the G2 pathway. In this study, we used quantitative fluorescence PCR with polymorphic microsatellite markers to investigate chromosomes 1 and 19 in two t(1;19)‐ and four der(19)‐positive ALLs. None of the der(19) cases displayed UPD for chromosome 1, excluding that this aberration arises through the duplication pathway. Because previous findings of cases with coexisting t(1;19) and der(19) clones are difficult to explain if the translocation originated in G2, the present results suggest that an unbalanced der(19) may arise from an initial trisomy 1 followed by t(1;19) translocation and loss of the derivative chromosome 1. © 2004 Wiley‐Liss, Inc.