Miracle-dz/UniFAR-FTUs huggingface dataset:
Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes

Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students’ attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students’ performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students’ performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills.
Cost-effective screening for the metabolic syndrome in patients treated with second-generation antipsychotic medications.

OBJECTIVE Despite concerns about the adverse effects of second-generation antipsychotics on weight regulation and glucose and lipid metabolism, little is known about the relationship between these agents and the metabolic syndrome. Because the metabolic syndrome is more strongly associated with cardiovascular morbidity and mortality than its individual components, attention to the full syndrome is important. The authors' goal was to explore the relationship between second-generation antipsychotics and the metabolic syndrome. METHOD They assessed the prevalence of metabolic syndrome in a nearly consecutive group of 89 acutely admitted psychiatric inpatients treated with at least one second-generation antipsychotic for different psychiatric disorders. Patients' waist circumference and blood pressure were measured as well as their fasting blood glucose and lipid levels. RESULTS Twenty-six (29.2%) of the 89 patients fulfilled criteria for the metabolic syndrome. Presence of the syndrome was associated with older age, higher body mass index, and higher values for each individual criterion of the metabolic syndrome but not with specific diagnoses or antipsychotic treatment regimens. Presence of abdominal obesity was most sensitive (92.0%), while fasting glucose >110 mg/dl was most specific (95.2%) in correctly identifying the presence of metabolic syndrome. Combining abdominal obesity and elevated fasting blood glucose had 100% sensitivity. CONCLUSIONS The measurement of both abdominal obesity and fasting blood glucose is a simple, cost-effective screening test to detect patients at high risk for future cardiovascular morbidity.
Highland settlement evolution in West Perthshire : development and change in the parish of Balquhidder from the fifteenth century to 1851

This thesis is concerned with four leading ideas. These are continuity, persistence, discontinuity, and redundancy, as essential elements of the evolutionary process of human settlement. This requires a dynamic view of history, rather than a periodic one. The research, therefore, focussed upon one parish and traced its evolution from the middle ages into the nineteenth century. The thesis reviews evidence for origins of the social and settlement system before the fifteenth century. Internal local processes of change, and external forces, are examined. Modern theories of the antiquity and influence of great estates, and their subsidiary territorial units, upon the development of rural environments, are examined in relation to the development of land use, tenurial systemst and social organisation. Results indicate the persistence of ancient land divisions, and of cultural characteristics of communities, through periods of significant change. Demographic changes were very important driving forces in the evolutionary process. However, cultural traditions, handed down through generations, tended to inhibit changes, even in the face of economic necessity and land shortage. A destructive negative force operated within an
CCL20 and β-Defensin-2 Induce Arrest of Human Th17 Cells on Inflamed Endothelium In Vitro under Flow Conditions

CCR6 is a chemokine receptor that is expressed at the cell surface of Th17 cells, an IL-17– and IL-22–secreting population of CD4+ T cells with antipathogenic, as well as inflammatory, properties. In the current study, we have determined the involvement of CCR6 in human Th17 lymphocyte migration toward inflamed tissue by analyzing the capacity of its ligands to induce arrest of these cells onto inflamed endothelium in vitro under flow conditions. We show that polarized, in situ-differentiated, skin-derived Th17 clones activated via the TCR–CD3 complex produce CCL20 in addition to IL-17 and IL-22. The latter cytokines induce, in a synergic fashion, the production of human β-defensin (hBD)-2, but neither hBD-1 nor hBD-3, by epidermal keratinocytes. Both CCL20 and hBD-2 are capable of inducing the arrest of Th17 cells, but not Th1 or Th2 cells, on HUVEC in an CD54-dependent manner that is CCR6 specific and independent from the expression of CXCR4, reported to be an alternative receptor for hBD-2. In addition, Ag-specific activation induces a transient loss of CCR6 expression, both at the transcriptional and protein level, which occurs with slow kinetics and is not due to endogenous CCL20-mediated internalization of CCR6. Together, these results indicate that Ag-specific activation will initially contribute to CCR6-mediated Th17 cell trafficking toward and sequestration in inflamed tissue, but that it eventually results in a transitory state of nonresponsiveness to further stimulation of these cells with CCR6 ligands, thus permitting their subsequent migration out of the inflamed site.
Reynolds number dependence of an upper bound for the long-time-averaged buoyancy flux in plane stratified Couette flow

We derive an improved rigorous upper bound for the long-time-averaged vertical buoyancy flux for stably stratified Couette flow; i.e. the flow of a Boussinesq fluid (with reference density $\rho_0$, kinematic viscosity $\nu$, and thermal diffusivity $\kappa$) confined between two parallel horizontal plates separated by a distance $d$, which are driven at a constant relative velocity $\uDelta U$, and are maintained at a constant (statically stable) temperature difference leading to a constant density difference $\uDelta \rho$. We construct the bound by means of a numerical solution to the ‘background method’ variation problem as formulated by Constantin and Doering using a one-dimensional uni-directional background. The upper bound so constructed is the best possible bound with the imposed constraints for streamwise independent mean flows that are statistically steady, and is calculated up to asymptotically large Reynolds numbers. We find that the associated (dimensional) upper bound ${\cal B}^*_{\hbox{\scriptsize\it max}}$ on the long-time-averaged and volume averaged buoyancy flux ${\cal B}^*:=\lim_{t \rightarrow \infty} (1/t) \int^t_0 \langle \rho u_3 \rangle g/\rho_{0} {\rm d}\skew2\tilde{t}$ (where $u_3$ is the vertical velocity, $g$ is the acceleration due to gravity, and angled brackets denote volume averaging) does not depend on either the bulk Richardson number $J=g\uDelta \rho d/(\rho_0 \uDelta U^2)$ of the flow, or the Prandtl number $\sigma=\nu/\kappa$ of the fluid. We show that ${\cal B}^*_{\hbox{\scriptsize\it max}}$ has the same inertial characteristic scaling as the (dimensional) mechanical energy dissipation rate ${\cal E}^*_B$, and ${\cal B}^*_{\hbox{\scriptsize\it max}}=0.001267\uDelta U^3/d$ as $\hbox{\it Re}\rightarrow\infty$. The associated flow structure exhibits velocity boundary layers embedded within density boundary layers, with local gradient Richardson numbers $\hbox{\it Ri} =O(\sigma/\hbox{\it Re})\ll 1$ in the vicinity of the horizontal plates. There is a correspondence between the predicted flow structure and the flow structure at a lower Reynolds number associated with the upper bound on the mechanical energy dissipation rate ${\cal E}^*_{\hbox{\scriptsize\it max}}$ in an unstratified fluid. We establish that, for the flow that maximizes the buoyancy flux, the flux Richardson number $\hbox{\it Ri}_f \rightarrow 1/3$ as $\hbox{\it Re} \rightarrow \infty$, independently to leading order of both $\hbox{\it Re}$ and $J$. There is a generic partition of the energy input by the shear into the fluid into three equal parts: viscous dissipation of kinetic energy by the mean flow; viscous dissipation of kinetic energy by perturbation velocities; and vertical buoyancy flux.
Uptake of Mycobacterium avium subsp. paratuberculosis through the Distal Small Intestinal Mucosa in Goats: An Ultrastructural Study

Various pathogens gain access to the intestinal wall via specialized cells, the M cells, found among the follicle-associated epithelial cells overlying the domes of the Peyer's patches. The present study was undertaken to examine the uptake of live Mycobacterium avium subsp. paratuberculosis in the distal small intestine of goat kids. Following laparotomy, distal small intestinal segments of five goats were ligated and injected with bacterial suspension. After 1 hour, the intestinal segments were excised and fixed for light and electron microscopic studies. M. a. paratuberculosis organisms were observed by transmission electron microscopy at locations in the intestinal wall, suggesting transcellular transportation through the M cells. The organisms were present both in the cytoplasm of the M cells and in the cytoplasm of intraepithelial leukocytes found in M-cell pockets. Intercellular bacteria between M cells were occasionally seen. Bacteria were not observed in association with the absorptive epithelium. This study indicates that in goat kids, M. a. paratuberculosis enters the intestinal wall primarily through the M cells in the follicle-associated epithelium of the Peyer's patches.
Layered direct policy search for learning hierarchical skills

Solutions to real world robotic tasks often require complex behaviors in high dimensional continuous state and action spaces. Reinforcement Learning (RL) is aimed at learning such behaviors but often fails for lack of scalability. To address this issue, Hierarchical RL (HRL) algorithms leverage hierarchical policies to exploit the structure of a task. However, many HRL algorithms rely on task specific knowledge such as a set of predefined sub-policies or sub-goals. In this paper we propose a new HRL algorithm based on information theoretic principles to autonomously uncover a diverse set of sub-policies and their activation policies. Moreover, the learning process mirrors the policys structure and is thus also hierarchical, consisting of a set of independent optimization problems. The hierarchical structure of the learning process allows us to control the learning rate of the sub-policies and the gating individually and add specific information theoretic constraints to each layer to ensure the diversification of the sub-policies. We evaluate our algorithm on two high dimensional continuous tasks and experimentally demonstrate its ability to autonomously discover a rich set of sub-policies.
Multiple Intravenous Transplantations of Mesenchymal Stem Cells Effectively Restore Long-Term Blood Glucose Homeostasis by Hepatic Engraftment and β-Cell Differentiation in Streptozocin-Induced Diabetic Mice

Depletion of pancreatic β-cells results in insulin insufficiency and diabetes mellitus (DM). Single transplantation of mesenchymal stem cells exhibits short-term effects in some preclinical studies. Here, we further investigated the long-term therapeutic effects of multiple intravenous MSC transplantations. In this study, multiple human MSC transplantations (4.2 × 107 cells/kg each time) were performed intravenously at 2-week intervals into streptozocin (STZ)-induced diabetic mice for 6 months. Blood sugar, insulin, renal function, cholesterol, and triglyceride levels were monitored. We demonstrated that compared to single intravenous transplantation, which only transiently decreased hyperglycemia, multiple MSC transplantations effectively restored blood glucose homeostasis. Systemic oxidative stress levels were reduced from the seventh week of treatment. From the 11th week, production of human insulin was markedly increased. When MSC transplantation was skipped after blood sugar level returned to normal at the end of 15th week, a sharp rebound of blood sugar occurred, and was then controlled by subsequent transplantations. At the end of 6 months, histopathology examination revealed MSCs specifically engrafted into liver tissues of the recipients. Fifty-one percent of human cells in the recipient liver coexpressed human insulin, especially those surrounding the central veins. Taken together, intravenous MSC delivery was safe and effective for blood glucose stabilization in this preclinical DM model. Multiple transplantations were essential to restore and maintain glucose homeostasis through decreasing systemic oxidative stress in the early stage and insulin production in the late stage. Liver engraftment and differentiation into insulin-producing cells account for the long-term therapeutic effects of MSCs.
Anisotropic mechanosensing by mesenchymal stem cells

Mesenchymal stem cells (MSCs) are a potential source for the construction of tissue-engineered vascular grafts. However, how vascular mechanical forces regulate the genetic reprogramming in MSCs is not well understood. Mechanical strain in the vascular wall is anisotropic and mainly in the circumferential direction. We have shown that cyclic uniaxial strain on elastic substrates causes the cells to align perpendicularly to the strain axis, which is different from that in the vascular wall. To simulate the vascular cell alignment and investigate the anisotropic mechanical sensing by MSCs, we used soft lithography to create elastomeric membranes with parallel microgrooves. This topographic pattern kept MSCs aligned parallel to the strain axis, and the cells were subjected to 5% cyclic uniaxial strain (1 Hz) for 2–4 days. DNA microarray analysis revealed global gene expression changes, including an increase in the smooth muscle marker calponin 1, decreases in cartilage matrix markers, and alterations in cell signaling (e.g., down-regulation of the Jagged1 signaling pathway). In addition, uniaxial strain increased MSC proliferation. However, when micropatterning was used to align cells perpendicularly to the axis of mechanical strain, the changes of some genes were diminished, and MSC proliferation was not affected. This study suggests that mechanical strain plays an important role in MSC differentiation and proliferation, and that the effects of mechanotransduction depend on the orientation of cells with respect to the strain axis. The differential cellular responses to the anisotropic mechanical environment have important implications in cardiovascular development, tissue remodeling, and tissue engineering.
Systematic Reviews and Meta-and Pooled Analyses Maternal Hyperlipidemia and the Risk of Preeclampsia : A Meta-Analysis

Published reports examining lipid levels during pregnancy and preeclampsia have been inconsistent. The objective of this meta-analysis was to test the association between preeclampsia and maternal total cholesterol, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and triglyceride levels measured during pregnancy. We conducted a systematic search for studies published between the index date until July 2013 reporting maternal lipid levels in women with preeclampsia and normotensive pregnant women. Seventy-four studies met all eligibility criteria and were included in the meta-analysis. Weighted mean differences in lipid levels were calculated using a random-effects model. Statistical heterogeneity was investigated using the I statistic. Meta-regression was used to identify sources of heterogeneity. Preeclampsia was associated with elevated total cholesterol, non-HDL-C, and triglyceride levels, regardless of gestational age at the time of blood sampling, and with lower levels of HDL-C in the third trimester. A marginal association was found with LDL-C levels. Statistical heterogeneity was detected in all analyses. Meta-regression analyses suggested that differences in body mass index (weight (kg)/height (m)) across studies may be partially responsible for the heterogeneity in the triglyceride and LDL-C analyses. This systematic review and meta-analysis demonstrates that women who develop preeclampsia have elevated levels of total cholesterol, non-HDL-C, and triglycerides during all trimesters of pregnancy, as well as lower levels of HDL-C during the third trimester.
Maternal Punitive Reactions to Children's Negative Emotions and Young Adult Trait Anger: Effect of Gender and Emotional Closeness

The current study tested whether young adult's recollected reports of their mother's punitive reactions to their negative emotions in childhood predicted anger expression in young adulthood and whether emotional closeness weakens this association. Further, a three-way interaction was tested to examine whether emotional closeness is a stronger protective factor for young women than for young men. Results revealed a significant three-way interaction (gender × emotional closeness × maternal punitive reactions). For young men, maternal punitive reactions to negative emotions were directly associated with increased anger expressions. Maternal punitive reactions to young women's negative emotions in childhood were associated with increased anger in adulthood only when they reported low maternal emotional closeness. Findings suggest that maternal emotional closeness may serve as a buffer against the negative effects of maternal punitive reactions for women's anger expression in young adulthood.
The effect of oral preexposure prophylaxis on the progression of HIV-1 seroconversion

Objective: To investigate whether oral preexposure prophylaxis (PrEP) alters timing and patterns of seroconversion when PrEP use continues after HIV-1 infection. Design: Retrospective testing of the timing of Fiebig stage HIV-1 seroconversion in the Partners PrEP Study, a randomized placebo-controlled clinical trial of PrEP conducted in Kenya and Uganda. Methods: Specimens from 138 seroconverters were collected every 3 months and when HIV-1 infection was suspected based on monthly rapid HIV-1 tests. Progression of seroconversion was compared between randomized groups (PrEP versus placebo) and per-protocol groups (placebo versus PrEP participants with detectable tenofovir during the seroconversion period) using laboratory assessment of Fiebig stage. Delay in site-detection of seroconversion and association with PrEP drug-regimen resistant virus were assessed using logistic regression. Analysis of time to each Fiebig stage used maximum likelihood estimation with a parametric model to accommodate the varying lengths of HIV-infection intervals. Results: There was a significant increase in delayed site detection of infection associated with PrEP (odds ratio = 3.49, P = 0.044). Delay in detection was not associated with increased risk of resistance in the PrEP arm (odds ratio = 0.93, P = 0.95). Estimated time to each Fiebig stage was elongated in seroconverters with evidence of ongoing PrEP use, significantly for only Stage 5 (28 versus 17 days, P = 0.05). Adjusted for Fiebig stage, viral RNA was ∼2/3 log lower in those assigned to PrEP compared with placebo; no differences were found in Architect signal to cut-off at any stage. Conclusion: Ongoing PrEP use in seroconverters may delay detection of infection and elongate seroconversion, although the delay does not increase risk of resistance.
Periodontal tissue regeneration by recombinant human transforming growth factor-beta 3 in Papio ursinus.

BACKGROUND AND OBJECTIVE Osteogenic proteins of the transforming growth factor-beta superfamily induce periodontal tissue regeneration in animal models, including primates. To our knowledge, no studies have been performed in periodontal regeneration using the transforming growth factor-beta 3 isoform. In the present study, recombinant human transforming growth factor-beta 3 was examined for its ability to induce periodontal tissue regeneration in the nonhuman primate, Papio ursinus. MATERIAL AND METHODS Class II furcation defects were surgically created bilaterally in the maxillary and mandibular molars of four adult baboons. Heterotopic ossicles, for transplantation to selected furcation defects, were induced within the rectus abdominis muscle by recombinant human transforming growth factor-beta 3. Forty days later, the periodontal defects were implanted with recombinant human transforming growth factor-beta 3 in Matrigel as the delivery system, with recombinant human transforming growth factor-beta 3 plus minced muscle tissue in Matrigel, or with the harvested recombinant human transforming growth factor-beta 3-induced ossicles. Sixty days after periodontal implantation, the animals were killed and the specimens harvested. Histological analysis on undecalcified sections measured the area and volume of new alveolar bone and the coronal extension of newly formed alveolar bone and cementum. RESULTS Morphometric analyses showed pronounced periodontal regeneration in experimental defects compared with controls. Substantial regeneration was observed in defects implanted with fragments of heterotopically induced ossicles and with recombinant human transforming growth factor-beta 3 plus minced muscle tissue. CONCLUSION Recombinant human transforming growth factor-beta 3 in Matrigel significantly enhanced periodontal tissue regeneration in the nonhuman primate, P. ursinus.