Miracle-dz/UniFAR-FTUs huggingface dataset:
Preparing for palliative medicine; evaluation of an education programme for fourth year medical undergraduates

Prompted by directives from the GMC, ‘care of the dying’ is identified as ‘core curricula’ for undergraduate medical education. However, there are many technical and interpersonal challenges faced in learning the practice of palliative medicine. Accordingly, the design and delivery of education programmes need to be both carefully considered and evaluated. Using Bandura’s Social Cognitive Theory as a driver, appropriate methodology for evaluating a novel education programme in palliative medicine was drafted. A pre- and post-survey of an education programme and palliative care placement for fourth year medical undergraduate students from Liverpool University (n = 216) was completed using a composite questionnaire containing; i) Self-efficacy in Palliative Care Scale (SEPC) and ii) Thanatophobia Scale. Both scales have shown reliability and validity within the sample population. Additionally, a randomly selected Focus Group was conducted to provide qualitative information on the students’ experience. A total of 139 pre- and post-questionnaires (64%) were completed. Analysis identified significant improvements in perceived efficacy (SEPC Communication t = −16.41, P < 0.001; SEPC Patient Management t = −22.31, P < 0.001; SEPC Multidisciplinary Teamwork t = −15.56, P < 0.001). Significant improvements in thanatophobia were also recorded (z = −7.51, P < 0.001) although some interesting anomalies were noted. This study demonstrates that considered and appropriately structured clinical education has been shown to significantly improve students’ belief in their ability to practice palliative medicine and to improve their attitude towards care. In accordance with the study’s theoretical driver, it is reasonable to propose that the engaged active learning will have a positive effect on the future care of dying patients.
Magnetic resonance imaging and developmental outcome following preterm birth: review of current evidence

Preterm birth is associated with an increased risk of developmental difficulties. Magnetic resonance imaging (MRI) is increasingly being used to identify damage to the brain following preterm birth. It is hoped this information will aid prognostication and identify neonates who would benefit from early therapeutic intervention. Cystic periventricular white matter damage has traditionally been associated with abnormal motor developmental and cerebral palsy, but its presence on MRI does not preclude normal cognitive development. This has led to increasing interest in the identification of diffuse periventricular white matter damage with conventional and sophisticated MRI. However, the correlation between these appearances and developmental outcome remains unclear. Measurements of the size, volumes, and growth rates of many regions of the brain, such as the corpus callosum, ventricular system, cortex, deep grey matter, and cerebellum, are all also altered following preterm birth, but there is insufficient evidence to use this data in the clinical setting. This article is a review of the current evidence on MRI and developmental outcome, suggesting possible indications for the use of MRI following preterm birth.
Proactive Management of the Equine Athlete

Simple Summary The athletic career of a horse is relatively short. Career length can be positively influenced by the trainer and the age at which the horse starts competition. There are opportunities for a team approach of health professionals and changes in management to improve functional/competition life. The ability to improve the tolerance of the tissue to exercise load via the introduction of early exercise, which reflects the horse’s evolutionary cursorial lifestyle, could provide a proactive mechanism to attenuate injury risk. Abstract Across many equestrian disciplines the median competition career of a horse is relatively short. One of the major reasons for short career length is musculoskeletal injury and a consistent variable is the trainer effect. There are significant opportunities within equestrian sport for a holistic approach to horse health to attenuate musculoskeletal injury. Proactive integration of care by health professionals could provide a mechanism to attenuate injury risk and the trainer effect. However, the limited data available on current exercise regimens for sport horses restricts interpretation of how management and exercise volume could be modified to reduce injury risk. Early exercise in the juvenile horse (i.e., pre weaning) has a positive effect on stimulating the musculoskeletal system and primes the horse for an athletic career. The early introduction to sport competition has also been identified to have a positive effect on career length. These data indicate that management systems reflecting the cursorial evolution of the horse may aid in attenuating loss from sport due to musculoskeletal injury.
Influenza coinfection and outcomes in children with complicated pneumonia.

OBJECTIVE To determine the impact of influenza coinfection on outcomes for children with complicated pneumonia. DESIGN Retrospective cohort study. SETTING Forty children's hospitals that contribute data to the Pediatric Health Information System. PARTICIPANTS Children discharged from participating hospitals between January 1, 2004, and June 30, 2009, with complicated pneumonia requiring a pleural drainage procedure. MAIN EXPOSURE Influenza coinfection. MAIN OUTCOME MEASURES Intensive care unit admission, receipt of mechanical ventilation, receipt of vasoactive infusions, receipt of blood product transfusions, in-hospital death, readmission within 14 days of hospital discharge, hospital length of stay, and cost of hospitalization. RESULTS Overall, 3382 of 9680 children with complicated pneumonia underwent pleural fluid drainage; 105 patients (3.1%) undergoing pleural drainage had influenza coinfection. A bacterial pathogen was identified in 1201 cases (35.5%); the most commonly identified bacteria were Staphylococcus aureus in children with influenza coinfection (22.9% of cases) and Streptococcus pneumoniae in children without coinfection (20.0% of cases). In multivariable analysis, influenza coinfection was associated with higher odds of intensive care unit admission and receipt of mechanical ventilation, vasoactive infusions, and blood product transfusions as well as higher costs and a longer hospital stay. Children with influenza coinfection were less likely to require readmission, although there was a trend toward higher odds of mortality for patients with coinfection. In a subanalysis stratified by bacteria, outcomes remained worse for coinfected children in the subgroups of children with S aureus and with no specified bacteria. CONCLUSIONS Influenza coinfection occurred in 3.1% of children with complicated pneumonia. Clinical outcomes for children with complicated pneumonia and influenza coinfection were more severe than for children without documented influenza coinfection.
Economic Determinants of Intertemporal Variation in the Aggregate Earnings-Returns Relation: The Role of Inflation, Risk Premium and Real Output News Components of Aggregate Earnings

Prior research documents a negative contemporaneous relation between earnings changes and stock returns at the aggregate level. We find that the aggregate earnings-returns relation turns significantly positive in recent years (1992-2013). As explanations for that shift, we test over-time shifts in the properties of firm-level earnings and the magnitude of inflation rates. To do so, we use the Bureau of Economic Analysis’ (BEA) corporate profits series as an alternative measure of aggregate earnings, because it is unaffected by changes in GAAP measurement rules and is adjusted for changes in price levels. While changes in both aggregate GAAP earnings and the BEA’s corporate profits series exhibit a significant negative (positive) relation with aggregate returns in the 1970-1991 (1992-2013) period, changes in aggregate GAAP earnings have incremental explanatory power for aggregate returns beyond the BEA’s corporate profits measure in the 1992-2013 period. Additional analysis reveals that such incremental explanatory power stems from GAAP earnings’ inclusion of non-operating items. We also find that a shift over time in inflation, as well as in the proportion of loss-making firms, contribute to inter-temporal variation in the aggregate earnings-returns relation. The effect of changes in the properties of GAAP earnings and inflation rates over time on the aggregate earnings-returns relation is new to the literature.
Essays on Dynamic Macroeconomics and Risk Attitudes.

This thesis is a collection of three essays in Economics. The first essay concerns the di↵erence in the business cycle volatility of the unemployment rates of high-skill and low-skill workers. I show that from the late 1990s onwards the business cycle volatility of the unemployment rate has been higher for high-skill workers in the United States and thirteen European Union countries. I address this volatility gap with a business cycle model in which firms value skill diversity, each worker supplies a specific variety of skill, and households pay a cost to search and find new jobs. I calibrate the model to United States data and show it can successfully replicate the observed unemployment volatility gap, as well as generate unemployment rates that are substantially more volatile than output. The second paper modifies a standard two-country international business cycle model to allow for a state-dependent risk aversion parameter, and investigates whether key mismatches between the theory and the data can be explained by varying risk aversion. I show that even though the dynamics of the exchange rate are linked with the behavior of the risk aversion parameter, under a reasonable calibration the volatility of the exchange rate is largely una↵ected by how strongly countercyclical risk aversion is. In contrast, I find that the correlation between the movements in the exchange rate and the movements in the consumption ratio is substantially reduced in the presence of countercyclical risk aversion. I show that these results hold under di↵erent assumptions about the behavior of the risk aversion parameter, and under di↵erent assumptions about the household’s preferences over the consumption-leisure bundle. The third essay investigates the relationship between risk taking propensity and economic and health expectations using data from a longitudinal survey conducted in the Tshwane Municipality, South Africa. I find evidence that economic expectations significantly predict risk taking propensity, with better expectations being associated with higher willingness to take risks. The results hold with two di↵erent measurement scales for risk attitudes, and hold under a variety of robustness checks. I find some evidence that health expectations predict risk taking propensity, but the robustness checks fail to confirm the results. The findings highlight a channel through which economic expectations can a↵ect decision making under risk, and I discuss its potential implications for entrepreneurial activity and our understanding of asset bubbles.
Lactation Persistency and its Genetic Evaluation in Cattle—A Review

Lactation persistency, an economically important trait for dairy animal, can be defined as the capacity of a cow to continue milk production at a high level after the peak yield. High persistent cows are expected to have higher lactation production, longer productive life and considered as efficient producers. Moreover, lactation persistency has a great influence on the health, reproduction and feed costs of dairy cows. Different environmental factors viz., season of calving, period of calving, parity, genetic group, age of calving, lactation length, peak yield, were reported to have significant effect on the lactation persistency of dairy cattle. The heritability of lactation persistency varied according to the method of calculation of persistency and the method of heritability estimation. Low positive genetic correlation between persistency and milk yield indicated that selection for increased milk yield would slightly improve persistency. To ensure that cows persistent for milk production have good reproductive performance, it is important to study the relationship between persistency and reproductive traits. Various researchers have reported unfavorable relationship between persistency and reproductive traits. Keywords: Persistent, lactation, productivity, reproductive traits Cite this Article Koloi S, Pathak K, Karunakaran M et al . Lactation Persistency and its Genetic Evaluation in Cattle—A Review. Research and Reviews: Journal of Dairy Science and Technology . 2018; 7(3): 1–8p
Pretreatment with Sodium Fluoride Maintains Dentin Bond Strength of a Two-Step Self-Etch Adhesive after Thermal Stressing.

PURPOSE To evaluate the effect of sodium fluoride and chlorhexidine digluconate on the composite-dentin bond strength of a self-etch adhesive after thermocycling. MATERIALS AND METHODS Eighteen human third molars were prepared to expose a flat dentin surface and were divided into 3 groups (n = 6) according to the 3 cavity cleaning solutions: distilled water, 2% chlorhexidine digluconate (CHX), or 1.23% sodium fluoride (NaF). Solutions were rubbed onto dentin surfaces for 60 s, followed by bonding with Clearfil SE Bond, and a 5-mm-thick composite crown buildup. Bonded teeth were stored in distilled water for 24 h and then longitudinally sectioned to obtain bonded sticks. Half of the specimens were immediately tested in tension at 0.5 mm/min, while the remaining specimens were tested after 60,000 thermal cycles. Data were analyzed using two-way ANOVA and the Holm-Sidak method. RESULTS There was no significant difference between the groups after 24 h (p > 0.05). Thermocycling resulted in significant bond strength reduction for distilled water and CHX (p < 0.05). When 24 h bond strengths were compared to the thermocycling group, NaF maintained its bond strength (p > 0.05), while significant reductions were observed for distilled water and CHX (p < 0.05). CONCLUSIONS Pretreatment with NaF maintained the bond strength of Clearfil SE Bond to dentin after 60,000 thermal cycles, but pretreatment with CHX did not.
Magnetic resonance imaging of superficial cartilage lesions: Role of contrast in lesion detection

Excised patellar cartilage phantoms with artificial surface lesions were imaged in a 2 g/dl albumin solution to determine the effect of cartilage/fluid contrast on detection of early degenerative change. Surface lesions consisted of full‐thickness holes, superficial grooves, and coarse abrasion. Phantoms were imaged with a T1‐weighted fast low‐angle shot (FLASH) and T2*‐weighted dual‐echo in the steady state (DESS) sequence. Although both sequences were able to identify full‐thickness holes, they underestimated the presence of superficial grooves and extent of fibrillation. Despite greater bulk tissue contrast between cartilage and fluid for the FLASH sequence, detection of fibrillation was poorer compared with the DESS images. The results of this study suggest that surface properties of fibrillated cartilage contribute significantly to the insensitivity of magnetic resonance imaging in detecting superficial lesions. In contrast to previous papers suggesting that T1‐weighted spoiled gradient‐echo imaging provides the greatest accuracy for lesion detection, our results indicate that, in the presence of joint fluid, T2*‐weighted imaging increases detection of superficial lesions. J. Magn. Reson. Imaging 1999;10:178–182. © 1999 Wiley‐Liss, Inc.
Prognostic value of cardiac sympathetic nerve activity evaluated by [123I]m-iodobenzylguanidine imaging in patients with ST-segment elevation myocardial infarction

Background Many studies have shown that cardiac sympathetic nerve activity evaluated by [123I]m-iodobenzylguanidine ([123I]MIBG) scintigraphic study during a stable period is useful for determining the prognosis of patients with chronic heart failure. Objective To examine whether results of this imaging method performed 3 weeks after the onset of ST-segment elevation myocardial infarction (STEMI) are a reliable prognostic marker for patients with STEMI. Methods The study analysed findings for 213 consecutive patients with STEMI undergoing [123I]MIBG scintigraphy. The left ventricular (LV) end-diastolic and end-systolic volume and LV ejection fraction (EF) were determined by left ventriculography or echocardiography 3 weeks after the onset of STEMI. The delayed total defect score, heart-to-mediastinum ratio and washout rate (WR) were also determined from [123I]MIBG scintigraphy at the same time. Results Of the 213 patients, 46 experienced major adverse cardiac events (MACE) during the study. The median follow-up period was 982 days. Patients were divided into an event-free group (n=167; 78.4%) and a MACE group (n=46; 21.6%). The LV and [123I]MIBG scintigraphic parameters in the event-free group were better than those in the MACE group. Multivariate Cox regression analyses revealed that WR was a significant predictor of MACE along with oral nicorandil (ATP-sensitive potassium channel opener) treatment and undergoing percutaneous coronary intervention. On Kaplan–Meier analysis, the event-free rate of patients with a WR<40% was significantly higher than that in patients with a WR≥40% (p<0.001). Even when confined to patients with LVEF>45%, WR was a predictor of MACE, pump failure death, cardiac death and progression of heart failure in patients with STEMI. Conclusion WR evaluated by [123I]MIBG scintigraphy 3 weeks after the onset of STEMI is a significant predictor of MACE in patients with STEMI, independent of LVEF.
Etiological factors of infections in diabetic foot syndrome - attempt to define optimal empirical therapy.

BACKGROUND Diabetic foot syndrome (DFS) represents one of the most frequent reasons for lower limb amputation in developed countries. In most cases, it is associated with bacterial infection, requiring optimal antibiotic therapy. OBJECTIVES The aim of this study was to identify the most frequent pathogens responsible for infections associated with DFS, establish the optimal protocol of empirical therapy, and ascertain the clinical variables that may determine the choice of the appropriate antibacterial agent. MATERIAL AND METHODS The analysis included hospital records of patients treated at the Department between 2008 and 2010. A total of 102 individuals were identified; their material was cultured and tested for antibiotic susceptibility. RESULTS A total of 199 bacterial strains were isolated. There was a predominance of Gram-positive bacteria, particularly Staphylococcus aureus, Staphylococcus coagulase-negative strains, and Enterococcus faecalis. Of note was the high percentage of E. faecalis infection (16.08%). One can speculate on the potential etiological factors in the case of some bacteria, e.g. patients infected with S. aureus were characterized by higher monocytosis and lymphocytosis as compared to other patients. Analysis of drug susceptibility revealed that ciprofloxacin has the highest (but still only 44%) efficacy of all agents tested as monotherapy, and a combination of piperacillin and tazobactam or amoxicillin and clavulanate with aminoglycosides is particularly beneficial. CONCLUSIONS Staphylococcus spp. predominates amongst the etiological factors of DFS infection; however, the rate of E. faecalis infection is alarmingly high. Monotherapy enables effective treatment in a minority of cases; therefore, at least two-drug protocols should be implemented from the very beginning of the therapy.
Does Sinusitis Play a Pathogenic Role in Primary Acquired Obstructive Disease of the Lachrymal System?

Objectives To investigate the etiopathogenic role of sinus inflammatory disease in primary acquired dacryocystitis and other chronic obstructive diseases of the lachrymal drainage system. Study Design Noninterventional controlled study. Setting Tertiary care center. Subjects and Methods Sixty consecutive patients with primary acquired dacryocystitis and other chronic obstructive diseases of the lachrymal drainage system, selected for endoscopic endonasal dacryocystorhinostomy (DCR) and who had been ordered a preoperative sinus CT scan, had their sinus scans assessed for inflammatory naso-sinusal disease extension, using the modified Lund-Mackay system. A control group of 40 subjects was simultaneously enrolled, as a way to assess the prevalence of sinus disease in the general population. Results Chronic inflammatory sinus disease was found to be no more frequent or more extensive in DCR patients than in controls. Conclusion Chronic sinusitis alone does not seem to be a causative factor to primary acquired chronic obstructive diseases of the lachrymal drainage system.
Secure base representations for both fathers and mothers predict children's secure base behavior in a sample of Portuguese families

Relations between fathers’ and mothers’ representations of attachment (independently assessed using an attachment script representation task) and children's secure base behavior (assessed using the Attachment Q-sort; AQS) were studied in 56 Portuguese families (mean age of child = 31.9 months). Each parent's secure base script representation score predicted AQS security scores for the child with that parent at approximately equivalent degrees of association. However, both parental secure base script scores and AQS security scores were positively correlated across parents. A hierarchical regression predicting AQS security with father from both parent's scriptedness scores and from the AQS score with mother showed a unique, significant influence of father's scriptedness score and the AQS score with mother, but mother's scriptedness score did not uniquely add to the prediction. Difficult temperament was ruled out as a mediator of the cross-parent association for AQS security scores.
Cgrp May Play A Causative Role in Migraine

Calcitonin gene-related peptide (CGRP) has been detected in increased amounts in external jugular venous blood during migraine attacks. However, it is unknown whether this is secondary to migraine or whether CGRP may cause headache. In a double-blind crossover study, the effect of human αCGRP (2 μg/min) or placebo infused intravenously for 20 min was studied in 12 patients suffering from migraine without aura. Headache intensity was scored on a scale from 0 to 10. Two patients were excluded due to severe hypotension and one because she had an infection. In the first hour median peak headache score was 1.0 in the hαCGRP group vs. 0 in the placebo group (P < 0.01). During the following 11 h all patients experienced headaches after hαCGRP vs. one patient after placebo (P = 0.0004). The median maximal headache score was 4 after CGRP and 0 after placebo (P = 0.006). In three patients after hαCGRP, but in no patients after placebo, the delayed headache fulfilled the IHS criteria for migraine without aura. As intravenous administration of hαCGRP causes headache and migraine in migraineurs, our study suggests that the increase in CGRP observed during spontaneous migraine attacks may play a causative role.