Miracle-dz/UniFAR-FTUs huggingface dataset:
P-R-A-C-T-I-C-A-L: a step-by-step model for conducting the consultation in general practice.

BACKGROUND It has been shown that when patients are unable to express all their major concerns, they are less likely to follow the physician's prescribed treatment plan and they are less satisfied. On the other hand, the GP has a limited amount of time to elicit all the appropriate information and must ask certain questions about the biological aspects of the illness in order to carry out her professional responsibilities. By acting in a patient-centred way, first enabling the patient to express himself, the GP can make maximum use of patients' ability for problem formulation and solution. METHODS We describe a model, for which the mnemonic, P-R-A-C-T-I-C-A-L, will help the practitioner to remember its nine steps. The model uses a chronological succession of strategies during the consultation that balances the voices of medicine and the lifeworld. In overview, the GP takes the patient, step by step, first through an exploration and clarification of his views of the illness, then expands the problem by further examination (e.g. the physical examination), a negotiation about the final model of the illness that includes both diagnosis and management, a discussion of the treatment plan, and finally a moment of reflection to prepare for the next visit.
How the topic of homosexuality is taught at U.S. medical schools

In 1991 the authors surveyed all U.S. medical schools to assess both the number of curriculum hours devoted to the topic of homosexuality and the instructional strategies employed in its academic treatment; responses were sought from faculty with responsibility for teaching the topic (mostly directors of medical student education in psychiatry). Of the 126 schools, 82 (65%) responded. The mean number of hours reported was 3 hours and 26 minutes, with significant differences based on geographic region. The most frequently cited strategy was lectures in human sexuality, followed distantly by panel presentations and meetings with gay men or lesbians (both health care providers and others). To enhance sensitivity and comfort with gay and lesbian issues and to counter stereotypic responses, the authors propose that the topic of homosexuality be wholly integrated throughout the curriculum.
Implementing a web‐based oncology protocol system in Australia: evaluation of the first 3 years of operation

Background: EviQ is a web‐based oncology protocol system launched across Australia in 2005 (http://www.eviq.org.au). We evaluated eviQ use at the point‐of‐care and determined the factors impacting on its uptake and routine use in the first three years of operation.
Overcoming Barriers to Pneumococcal Vaccination in Patients With Pneumonia

Inpatient pneumococcal vaccination remains underutilized, and little data exist to guide hospital personnel in improving their performance. The authors report their experience with a stepwise program to improve vaccination assessment rates for hospitalized patients with community-acquired pneumonia. They assessed barriers to vaccination and applied a stepwise educational and intranet-based decision support implementation program for hospitalized patients with community-acquired pneumonia. Preintervention vaccination rates were 0%. Primary nursing and physician barriers were assessed. An educational intervention increased vaccination assessment rates to 35%, a nursing decision-support tool to 42%, and approval of a standing order policy to 96%. For patients older than 65 years, vaccination assessment rates increased 33%, 67%, and 100%, respectively. An educational program combined with a decision support tool and a standing order policy can improve vaccination assessment rates to high levels. This study suggests that a multidimensional intervention is required to improve compliance with inpatient vaccination best clinical practices.
The effects of supplementation with lutein and/or zeaxanthin on human macular pigment density and colour vision

Background: Both yellow‐blue (YB) discrimination thresholds and macular pigment optical density (MPOD) measurements in the eye exhibit large variability in the normal population. Although it is well established that selective absorption of blue light by the macular pigment (MP) can significantly affect trichromatic colour matches, the extent to which the MP affects colour discrimination (CD) sensitivity remains controversial.
Decoupling and decorrelation of two closely spaced monopoles for optimum MIMO capacity

In this work it is shown by simulations and measurements that a decoupling network can be used resulting in low correlation between two closely spaced antennas and increases the total received power of the antenna system. Two possible circuits for an antenna separation of 0.21 lambda are proposed operating at the center frequency of 2.45 GHz.
An Approach for Measuring Semantic Similarity between Words Using Multiple Information Sources

Semantic similarity between words is becoming a generic problem for many applications of computational linguistics and artificial intelligence. This paper explores the determination of semantic similarity by a number of information sources, which consist of structural semantic information from a lexical taxonomy and information content from a corpus. To investigate how information sources could be used effectively, a variety of strategies for using various possible information sources are implemented. A new measure is then proposed which combines information sources nonlinearly. Experimental evaluation against a benchmark set of human similarity ratings demonstrates that the proposed measure significantly outperforms traditional similarity measures.
Use of endoscopic ultrasonography in small pancreatic cancer.

In spite of recent progress of body imaging diagnostics, such as ERCP, angiography, CT and conventional echosonography, the diagnosis of small pancreatic cancer is still restricted. Conventional US has progressed dramatically; however, intestinal gas or body wall often prevents the demonstration of deeper organs, such as the pancreas head and tail. The development of endoscopic ultrasonography has enabled us to demonstrate clearer imaging of the pancreas head and tail. From May 1980 to December 1983, we have used three types of ultrasonic endoscopy (Olympus and Aloka Co. Ltd.) with sector scan transducer (5.0 MHz or 7.5 MHz) and have examined 118 cases, containing 32 cases of pancreatic diseases. Among 15 cases of pancreatic cancer, 13 were demonstrated by type III (3 cases under 20 mm in size, 1 case between 20 to 30 mm, 9 cases over 30 mm). The scope was introduced into the upper G.I. tract in the same way as in conventional endoscopy. After the balloon tip of the scope was filled with water, scanning was started , having the balloon properly in contact with the duodenal or gastric wall. Cancerous lesions of the pancreas were clearly shown as a low echo mass in all cases. Each size of the lesions measured by EUS corresponded well to the resected specimens. Compared with other diagnostics, such as ERCP, CT, angiography and conventional US, EUS was the most useful method for detection of small pancreatic cancer under 20 mm in size.
The Effects of Narrative Perspectives and Gender Similarity to a Victim on Sympathy and Support for Aid to People in Need

An online experiment was conducted among a convenience sample of college students (N = 219) to explore the effects of narrative perspectives (first-person vs. third-person) and gender similarity to a victim on sympathy and support for aid to people in need. To be specific, the study examined the influence of telling a story of an abused woman from a first-person perspective as opposed to a third-person perspective on participantsi¯ sympathetic reactions and their support for aid to abused women while considering the moderating role of gender similarity between the victim and participants. The results of structural equation modeling showed the anticipated positive effects of gender similarity to the victim on sympathy and support for the aid. Gender similarity to the victim also interacted with narrative perspectives to influence support for the aid through affecting sympathy aroused for the victim. Specifically, telling the victimi¯s experience from first-person as opposed to third-person perspectives had little impact on sympathy and the support among female participants but increased sympathy and, therefore, the support among male participants. These findings shed light on how media portrayals of human suffering can increase aid to people in need. More importantly, they suggest how to call forth help via the media from people who are not normally inclined to support aid to those in need.
Pharmacologic Treatments Effective in Both Generalized Anxiety Disorder and Major Depressive Disorder: Clinical and Theoretical Implications

Objective: To review the efficacy of anxiolytics (alprazolam and azapirones) in major depressive disorder (MDD) and that of antidepressants in generalized anxiety disorder (GAD), thereby exploring the possible theoretical and clinical implications of this efficacy. Method: A Medline literature search was performed for the period January 1980 to September 1997 of randomized, double-blind comparison studies between anxiolytics and antidepressants in the acute treatment of adult patients with either MDD or GAD. Results: Alprazolam, at doses double those generally recommended for anxiety disorders, appears to be as effective as tricyclic antidepressants (TCAs) in the acute treatment of mild to moderate MDD. Alprazolam was also found to have a more rapid onset of action than do TCAs, particularly for the improvement of anxiety, somatization, and insomnia. Two azapirones (buspirone andgepirone) also have demonstrated a modest acute antidepressant effect in preliminary studies, albeit only in a depressed outpatient sample with considerable anxiety at baseline. Finally, various antidepressant drugs (imipramine, trazodone, paroxetine) were shown to have, at the least, comparable efficacy to benzodiazepines (BZDs) in the acute treatment of GAD. Conclusions: The nonspecificity of treatment response suggests that GAD and MDD are 1) different expressions of a similar disorder with a common neurobiological substrate, 2) discrete diagnostic entities that respond to independent pharmacological effects of the same drugs, or 3) a combination of the two (heterogeneity hypothesis). The most relevant clinical finding is the efficacy of antidepressants in the acute treatment of GAD.
Genotype relative‐risks and association tests for nuclear families with missing parental data

The development of a new method for testing the association of genetic markers with disease is presented. This approach is applicable when sampling nuclear families with one or more affected siblings and when neither, one, or both parents are missing marker genotype data. All siblings, affected and not affected, are used to probabilistically infer the missing parental marker data. A likelihood ratio statistic, which treats marker allele frequencies as nuisance parameters, is presented to test whether all marker relative risks are equal to one (i.e., no marker association). This approach offers a solution to test for marker associations when parents are difficult to obtain. © 1997 Wiley‐Liss, Inc.
Nasopharyngeal Carcinoma in the Pediatric Age Group: The Northern Israel (Rambam) Medical Center Experience, 1989-2004

Nasopharyngeal carcinoma (NPC) is rare in children, accounting for less than 1% of all malignancies. Radiation therapy has been the mainstay of treatment of many years, but to improve survival, the use of chemotherapy has been advocated. This is a retrospective analysis of 13 patients less than 20 years of age treated for NPC the Rambam Medical Center during 1989 to 2004. Eight boys and five girls with a median age of 14.5 years (range 10-19) were included. Median follow up (including patients who died) was 6.15 years (range 1-15 years). Duration of symptoms was 1 to 24 months (median 5 months). Of the 13 patients, one patient had stage I, 6 had stage III, 5 had stage IV-A, and 1 had stage IV-B disease. Ten patients (77%) had undifferentiated carcinoma (WHO type III) and three patients (23%) had nonkeratinizing carcinoma (WHO type II). Most of the children received two or three courses of neoadjuvant multiagent chemotherapy consisting of cisplatin and 5-FU, followed by radiotherapy with doses in excess of 60 Gy. One child received concomitant chemoradiation. Ten of the 13 patients (77%) are alive without disease 6 years after diagnosis (range 1-15 years). One patient developed local and distant metastases 1 year after diagnosis and is currently receiving combined radiochemotherapy. Two patients died. Overall survival was 84%; event-free survival was 77%. Nine patients (69%) developed moderate to severe long-term complications. Pediatric NPC is curable by combined radiation and chemotherapy, with doses of radiation in excess of 60 Gy. Long-term follow-up is important for early detection of second malignancies as well as for radiation-induced endocrinologic deficiencies and other normal tissue complications.
Markers of the progression of complications in patients with type 2 diabetes: a one-year longitudinal study.

Hyperglycemia induces tissue damage and complications by mechanisms that produce advanced glycation end-products (AGEs) and inflammation.To investigate the factors associated with the progression of complications in Type 2 diabetes patients.We recruited 157 patients (110 women and 47 men) with diabetes for more than 5 years who were non-smokers and did not have current infections or chronic diseases. Patients were grouped according to neuropathy, nephropathy, and retinopathy status: without (I), slight or moderate (II), and severe complications (III). We measured glucose, lipids and HbA1c, low molecular weight AGEs (LMW AGEs), high sensitivity C-reactive protein (CRP), TNF-α, IL-6, and malondialdehyde (MDA). Patients were re-evaluated 1 year later.Patients were 52.2±6.8 years old with 11.0±4.9 years since diagnosis. After 1 year, circulating AGEs increased (p<0.0001) and eGFR decreased (p<0.0007) in groups II and III. IL-6 and MDA decreased in groups I and II. CRP (p<0.029) and AGEs (p<0.0001) increased in group II. At baseline in group I, TNF-α levels were higher (p<0.002) in patients who later developed complications. In group II, TNF-α levels (p<0.015) and microalbuminuria (p<0.00004) were higher in patients whose complications progressed. Logistic regression analysis showed that complication progress was significantly associated with log(albuminuria) (p<0.004) and log(TNF-α) (p<0.008). In the total group, AGEs were associated with age (p<0.024) and HbA1c (p<0.026). Our results suggest that baseline TNF-α is an important predictor of complication progression in Type 2 diabetes patients. AGEs also increased during the deterioration of renal function after 1 year of follow-up observation.
Computed Tomography for the Diagnosis and Evaluation of the Severity of Community-acquired Pneumonia in the Elderly.

OBJECTIVE We herein assessed the utility of computed tomography (CT) for the diagnosis and ascertainment of the severity of community-acquired pneumonia (CAP) in the elderly. METHODS The utility of CT compared with chest radiography (CR) for the diagnosis of CAP was prospectively studied among elderly inpatients with clinical symptoms and signs indicative of CAP at the Department of Respiratory Medicine in Nissan Tamagawa Hospital during the one-year period from January 2013 to December 2013. Additionally, we evaluated whether the findings of CT were useful as predictive factors related to the mortality rate associated with CAP. RESULTS One hundred and forty-two patients, 65 years of age or older, were surveyed upon hospital admission for suspected CAP. Of the 142 patients included, 127 (89.4%) had pneumonic infiltration diagnosed by CT, however, CR could not recognize pneumonic infiltration in 9.4% (12/127) of these patients. In 127 CAP-positive patients, bilateral pneumonic infiltration was more frequently detected by CT in non-survivors than survivors (79.0% vs. 53.7%; p <0.05). By a multivariable analysis to determine the prognostic factors related to mortality from CAP, oxygen desaturation showed the greatest odds ratio among the other predictive factors, followed by comorbid neoplastic disease, blood urea nitrogen ≥21 mg/dL, male gender, and bilateral pneumonic infiltration diagnosed by CT. CONCLUSION We herein demonstrated that CT was superior to CR for diagnosing and evaluating the severity of CAP in elderly patients.
SpiC is required for secretion of Salmonella Pathogenicity Island 2 type III secretion system proteins

Replication of Salmonella typhimurium in host cells depends in part on the action of the Salmonella Pathogenicity Island 2 (SPI‐2) type III secretion system (TTSS), which translocates bacterial effector proteins across the membrane of the Salmonella‐containing vacuole (SCV). We have shown previously that one activity of the SPI‐2 TTSS is the assembly of a coat of F‐actin in the vicinity of bacterial microcolonies. To identify proteins involved in SPI‐2 dependent actin polymerization, we tested strains carrying mutations in each of several genes whose products are proposed to be secreted through the SPI‐2 TTSS, for their ability to assemble F‐actin around intracellular bacteria. We found that strains carrying mutations in either sseB, sseC, sseD or spiC were deficient in actin assembly. The phenotypes of the sseB‐, sseC‐ and sseD– mutants can be attributed to their requirement for translocation of SPI‐2 effectors. SpiC was investigated further in view of its proposed role as an effector. Transient expression of a myc::SpiC fusion protein in Hela cells did not induce any significant alterations to the host cell cytoskeleton, and failed to restore actin polymerization around intracellular spiC– mutant bacteria. However, the same protein did complement the mutant phenotype when expressed from a plasmid within bacteria. Furthermore, spiC was found to be required for SPI‐2 mediated secretion of SseB, SseC and SseD in vitro. An antibody against SpiC detected the protein on immunoblots from total cell lysates of S. typhimurium expressing SpiC from a plasmid, but it was not detected in secreted fractions after exposure of cells to conditions that result in secretion of other SPI‐2 effector proteins. Investigation of the trafficking of SCVs containing a spiC– mutant in macrophages revealed only a low level of association with the lysosomal marker cathepsin D, similar to that of wild‐type bacteria. Together, these results show that SpiC is involved in the process of SPI‐2 secretion and indicate that phenotypes associated with a spiC‐ mutant are caused by the inability of this strain to translocate effector proteins, thus calling for further investigation into the function(s) of this protein.
CD4+CD8+TCRlow thymocytes express low levels of glucocorticoid receptors while being sensitive to glucocorticoid‐induced apoptosis

While signaling by either the TCR or glucocorticoid receptor (GR) can induce apoptosis in thymocytes, recent studies have shown that combining these signals results in survival of CD4+CD8+ thymocytes. Although glucocorticoids (GC) in this way may directly affect T cell selection, no data are available addressing GR expression in thymocyte subsets and in individual cellswithin subsets. We studied GR expression by combining immunofluorescence cell surface staining for CD4, CD8 and TCR with intracellular staining of GR in four‐color cytometry. Significant differences of GR expression were observed in various thymocyte subsets, although a homogeneous distribution of GR expression in individual thymocyte subsets emerged. The highest GR expression was found in CD4–CD8–TCR– thymocytes, and decreased during development via the CD4–CD8+TCR– subpopulation into the CD4+CD8+TCRlow subset. Interestingly, the latter population, although expressing less than half the GR density of CD4–CD8–TCR– cells, is the most sensitive subset to GC‐in‐duced apoptosis. Up‐regulation of TCR expression by the CD4+CD8+TCRlow subset to CD4+CD8+TCRhigh cells was accompanied by a parallel increase in GR expression. The latter finding and the presence of a homogeneous distribution of GR in each thymocyte subset provides an experimental basis for the concept that GR can antagonize TCR‐mediated signals at a constant rate relative to TCR expression.
The Genetic Relationship of Progressive Muscular Dystrophy (Duchenne Type) and Mental Retardation

Two hundred and eleven patients with progressive muscular dystrophy (pmd) of the Duchenne type were identified in 135 separate families. The overall incidence of mental retardation in the 211 patients was 20.9 per cent. There was no evidence of a similar increase in the incidence of mental defect among non‐dystrophic siblings.
Pharmacokinetics and linear exposure of AFRESA™ compared with the subcutaneous injection of regular human insulin

Aim: AFRESA™ [Technosphere® Insulin (TI); MannKind Corporation, Valencia, CA], a dry powder preparation of regular human insulin (RHI), utilizes a novel and versatile drug carrier platform that enables pulmonary administration of medications typically administered by injection. The aim of this study was to compare the pharmacokinetic (PK) and pharmacodynamic (PD) parameters of three different inhaled doses of TI with those of subcutaneous (s.c.) RHI.
A Strategic Research Agenda

About 25 years ago, the Nobel laureate Herbert A. Simon and other top Management Science/Operations Research (MS/OR) and Artificial Intelligence (AI) researchers, suggested that an integration of the two disciplines would improve the design of decision making support tools in organizations. The suggested integrated system has been called an intelligent decision-making support system (i-DMSS). In this paper, we use an existing conceptual framework posed to assess the capabilities and limitations of the i-DMSS concept, and through a conceptual meta-analysis research of the Decision Support System (DSS) and MS/OR literature from 1980 to 2004, we develop a strategic assessment of the initial proposal. Such an analysis reveals support gaps that suggest for further development of the initial i-DMSS concept. We offer recommendations for making the indicated improvements in I DMSS design, development, and application.
Determinants of Public Phobia About Infectious Diseases in South Korea

This study investigated the individual and social determinants of the public’s phobia of infectious diseases in South Korea, where collective action was recently fueled by the public phobia over mad cow disease (bovine spongiform encephalopathy [BSE]). Gender-specific multivariate regression was used to compare the public perception of BSE and highly pathogenic avian influenza (HPAI). The analysis results differentiated between the determinants of the phobia for the 2 diseases, BSE and HPAI (N = 1002). As with HIV/AIDS and leprosy, the public fear of HPAI was expressed as a disease phobia that seeks to ensure the social exclusion of infection sources, whereas the fear of BSE was influenced by social and communication factors. Therefore, BSE, unlike previous HPAI, can be rapidly amplified amid the growing distrust in health communication, in which case the social determinants of disease phobia are associated with communicator trust, social values, and political attitude toward diseases rather than disease perception.