Miracle-dz/UniFAR-FTUs huggingface dataset:
Using Computer and Internet-based Resources to Teach Health Care Planning and Administration in an Undergraduate Medical Program

Summary Objective: We describe the teaching methods, involving computer and Internet-based resources, used in the “Administration and Planning in Health Care” course of the undergraduate medical program at the Federal University of Rio Grande do Sul. Method: Description on how the curriculum guidelines for the undergraduate medical education in Brazil have been implemented at this university. The guidelines specify that graduates should be skilled and knowledgeable in health care administration and management, understand the market dynamics of health care services, and be prepared to contribute to the development of health policy. Results: A required 60-hour course provides students with an opportunity to learn about the structure, planning and administration of the Brazilian and of other health care systems, and their roles, as health care professionals, within those systems. The course is also intended to allow students to develop the minimal skill set required for manipulation of health care data available from national and international databases, and to use the Internet as a source of information in health care. The curriculum includes: Module 1 – basic computer skills, an introduction to networks as an infrastructure for management, the use of spreadsheets and databases for data processing and system modelling, retrieval of Internet-based health data and on-line bibliographic searches; Module 2 – health system financing and service quality management, using a university hospital as a case study; and Module 3 – a comparison of the Brazilian public health care system (SUS) with other national health systems resulting in a term paper formatted for journal submission and presented at a simulated conference at the end of the course. Conclusion: Progressive shift in emphasis from theory to practice in this course has resulted in better development of the skill set required for the students.
Comparative inclined plane tests on silicone and EPDM elastomers under DC

The paper presents comparative inclined plane test results of high temperature vulcanized silicone rubber and EPDM elastomers filled with alumina trihydrate to 25 wt% under DC. Both the initial tracking voltage and the constant voltage test methods are employed to evaluate the relative tracking/erosion resistance of both elastomers. While insignificant differences between the tracking/erosion resistance of the two elastomers is observed, earlier failure occurs under -DC. A recognizable distinction is also found between the failure pattern and the corresponding dry-band arcing current. Shorter non-conduction periods in the leakage current are observed on the silicone rubber elastomer prior to failure, a result that indicates stable discharge activity, which is more evident under +DC than under -DC. Imbedded in the stable dry band arcing current are transient leakage current pulses due to probable ionization activity, which can be seen to enhance the intensity of the discharge. In contrast, intermittent dry band arcing current is found to be dominant for the EPDM elastomer.
Radiography of a normal fault system by 64,000 high‐precision earthquake locations: The 2009 L'Aquila (central Italy) case study

We studied the anatomy of the fault system where the 2009 L'Aquila earthquake (MW 6.1) nucleated by means of ~64 k high‐precision earthquake locations spanning 1 year. Data were analyzed by combining an automatic picking procedure for P and S waves, together with cross‐correlation and double‐difference location methods reaching a completeness magnitude for the catalogue equal to 0.7 including 425 clusters of similar earthquakes. The fault system is composed by two major faults: the high‐angle L'Aquila fault and the listric Campotosto fault, both located in the first 10 km of the upper crust. We detect an extraordinary degree of detail in the anatomy of the single fault segments resembling the degree of complexity observed by field geologists on fault outcrops. We observe multiple antithetic and synthetic fault segments tens of meters long in both the hanging wall and footwall along with bends and cross fault intersections along the main fault and fault splays. The width of the L'Aquila fault zone varies along strike from 0.3 km where the fault exhibits the simplest geometry and experienced peaks in the slip distribution, up to 1.5 km at the fault tips with an increase in the geometrical complexity. These characteristics, similar to damage zone properties of natural faults, underline the key role of aftershocks in fault growth and co‐seismic rupture propagation processes. Additionally, we interpret the persistent nucleation of similar events at the seismicity cutoff depth as the presence of a rheological (i.e., creeping) discontinuity explaining how normal faults detach at depth.
A clinical analysis of surgical treatment for spontaneous spinal infection.

OBJECTIVE The purpose of the study was to determine the clinical effects of anterior radical debridement on a series of patients with spontaneous spinal infection. METHODS We retrospectively analyzed the clinical characteristics of 32 patients who underwent surgical treatment from January 2000 to December 2005 in our department. The average follow-up Period was 33.4 months (range, 6 to 87 months). Thirty-two patients presented with the following : 23 cases with pyogenic spondylitis, eight with tuberculous spondylitis and one with fungal spondylitis. The indications for surgery were intractable pain, failure of medical management, neurological impairment with or without an associated abscess, vertebral destruction causing spinal instability and/or segmental kyphosis. RESULTS The study included 15 (46.9%) males and 17 (53.1%) females ranging in age from 26 to 75 years (mean, 53.1 years). Diabetes mellitus (DM) and pulmonary Tbc were the most common predisposing factors for pyogenic spondylitis and tuberculous spondylitis. Staphylococcus aureus (13%) was the main organism isolated. The most prevalent location was the lumbar spine (75%). Changes in the pain score, Frankel's classification, and laboratory parameters demonstrated a significant clinical improvement in all patients. However, there were recurrent infections in two patients with tuberculous spondylitis and inappropriate debridement and intolerance of medication and noncompliance. Autologous rib, iliac bone and allograft (fibular) were performed in most patients. However, 10 patients were grafted using a titanium mesh cage after anterior radical debridement. There were no recurrent infections in the 10 cases using the mesh cage with radical debridement. CONCLUSION The findings of this study indicate that surgery based on appropriate surgical indications is effective for the control of spinal infection and prevention of recurrence with anterior radical debridement, proper drug use and abscess drainage.
A double-blind, randomized, placebo-controlled study of pimobendan in dogs with dilated cardiomyopathy.

A double-blind, randomized, placebo-controlled study was conducted to examine the effect on heart failure class and survival of pimobendan, an oral calcium-sensitizing inodilator, in dogs with dilated cardiomyopathy (DCM). Pimobendan (0.3-0.6 mg/kg body weight/d) or placebo was administered to English Cocker Spaniels (CSs; n = 10) and Doberman Pinschers (DPs: n = 10) that had DCM in addition to background therapy of furosemide, enalapril, and digoxin. Addition of pimobendan to standard triple therapy was associated with a significant improvement in heart failure class, regardless of breed (P < .02, Mann-Whitney rank sum test). Overall, 8 of 10 animals in the pimobendan-treated group, and 1 of 10 animals in the placebo group improved their heart failure status by at least I modified New York Heart Association functional class after initial stabilization (P = .005, Fisher's exact test). Pimobendan had no significant effect on survival in the CSs (P = 0.77, log-rank test), but DPs treated with pimobendan had significantly longer survival times compared with placebo (P < .02, log-rank test), with a median survival time of 329 days in the pimobendan group compared with 50 days in the placebo group, and a hazard ratio of 3.4 (95% confidence interval 1.4-39.8). Pimobendan resulted in significant improvement in heart failure class when added to standard therapy in this group of dogs with DCM, and may have contributed to improved survival in DPs.
Rotavirus gastroenteritis in Finnish children in 2006–2008, at the introduction of rotavirus vaccination

Abstract Rotaviruses (RV) are major causative agents of acute gastroenteritis (AGE) requiring hospitalization in children; RV hospitalizations may be largely eliminated by universal mass vaccination with RV vaccine. We conducted a hospital-based prospective survey of AGE in children over 2 RV epidemic seasons, from 2006 to 2008, when the coverage of RV vaccination in Finland increased to 35% of the birth cohort. RVs were detected by reverse transcription polymerase chain reaction (RT-PCR). In the first season, only 38% of AGE cases were RV-positive, and the onset of the RV season was delayed. Type G1P[8], RVs accounted for 40%, G2P[4] for 19%, G3P[8] for 2%, G4P[8] for 2% and G9P[8] for 38%. In the second season, 63% of AGE cases were RV-positive: G1P[8] accounted for 73%, G2P[4] for only 3%, G3P[8] for 4%, G4P[8] for 13%, and G9P[8] had almost disappeared. G2P[4] RV did not become predominant at the coverage level of 29% of G1P[8] human RV vaccine. RV-associated hospitalizations were seen in children up to the age of 9 y. This study forms the epidemiological background for the follow-up of the impact of universal RV vaccination in Finland introduced in 2009.
The extrathyronine actions of iodine as antioxidant, apoptotic, and differentiation factor in various tissues.

BACKGROUND Seaweed is an important dietary component and a rich source of iodine in several chemical forms in Asian communities. Their high consumption of this element (25 times higher than in Western countries) has been associated with the low incidence of benign and cancerous breast and prostate disease in Japanese people. SUMMARY We review evidence showing that, in addition to being a component of the thyroid hormone, iodine can be an antioxidant as well as an antiproliferative and differentiation agent that helps to maintain the integrity of several organs with the ability to take up iodine. In animal and human studies, molecular iodine (I2) supplementation exerts a suppressive effect on the development and size of both benign and cancerous neoplasias. Investigations by several groups have demonstrated that these effects can be mediated by a variety of mechanisms and pathways, including direct actions, in which the oxidized iodine dissipates the mitochondrial membrane potential, thereby triggering mitochondrion-mediated apoptosis, and indirect effects through iodolipid formation and the activation of peroxisome proliferator-activated receptors type gamma, which, in turn, trigger apoptotic or differentiation pathways. CONCLUSIONS We propose that the International Council for the Control of Iodine Deficient Disorders recommend that iodine intake be increased to at least 3 mg/day of I2 in specific pathologies to obtain the potential extrathyroidal benefits described in the present review.
Identifying Absolute Preferred Retinal Locations during Binocular Viewing

PurposeWe present a new method for identifying the absolute location (i.e., relative to the optic disc) of the preferred retinal location (PRL) simultaneously for the two eyes of patients with central vision loss. For this, we used a binocular eye-tracking system that determines the pupillary axes of both eyes without a user calibration routine. MethodsDuring monocular viewing, we measured the pupillary axis and the angle between it and the visual axis (angle Kappa) for 10 eyes with normal vision. We also determined their fovea location relative to the middle of the optic disc with the MP-1 microperimeter. Then, we created a transformation between the eye-tracking and microperimeter measurements. We used this transformation to predict the absolute location of the monocular and binocular PRLs of nine patients with central vision loss. The accuracy of the monocular prediction was evaluated with the microperimeter. The binocular PRLs were checked for retinal correspondence and functionality by placing them on fundus photographs. ResultsThe transformation yielded an average error for the monocular measures of 0.2 (95% confidence interval, 1.0 to −0.6 degrees) horizontally and 0.5 (95% confidence interval, 1.1 to −0.1 degrees) vertically. The predicted binocular measures showed that the PRLs were generally in corresponding locations in the two eyes. One patient whose PRLs were not in corresponding positions complained about diplopia. For all patients, at least one PRL fell onto functional retina during binocular viewing. ConclusionsThis study shows that measurements of the location of the binocular PRLs relative to the pupillary axes can be transformed into absolute locations.
An evaluation of the automaticity of sensory processing using event-related potentials and brain-stem reflexes.

Selective attention effects on reflexes and evoked potentials are reviewed with the aim of evaluating three theories regarding sensory automaticity. (a) The peripheral-gating theory, which assumes that ignored stimuli can be filtered out soon after transduction, was tentatively rejected because neither auditory-nerve nor retinal potentials are reliably affected by attention. (b) At the other extreme, the assumption that sensory analyses are obligatory and cannot benefit from attentional resources (i.e., strong-automaticity theory) was also rejected, because longer latency components were found to be modifiable by attention. (c) An intermediate theory provides the best fit to present electrophysiological data. The earliest sensory analyses are assumed to be strongly automatic and then, at forebrain levels, there is a transition from strong to weak automaticity (i.e., analyses are obligatory but modifiable by attention). This transition can begin as early as about 15 ms for audition and about 80 ms for vision.
Measuring competition in health care markets.

OBJECTIVE Measuring competition is increasingly important for analysis of health care markets and policies. Measurement of competition in health care is made complex by the breadth of potential issues under study, by the lack of necessary data, and by rapid changes in health care financing and delivery. This study reviews key issues in the measurement of competition and is designed to familiarize researchers and policymakers interested in competition measurement, but not steeped in its practice, with key concepts, data sources, and ways of adapting measures to fit ongoing changes in health care markets. PRINCIPAL FINDINGS Attention to several key issues will strengthen measurement. Important components of successful measurement are: careful identification of the products and market areas for study; selection of Herfindahl-Hirschman or other indices to fit the issues being considered; consideration of econometric problems, like endogeneity, with common measures; and attention to the ways that current marketplace changes, like growth in managed care, affect the performance of classic measures. Data needed for constructing measures are also frequently scarce, insufficient, or both. Measurement could be improved with access to better data.
Dolutegravir maintains a durable effect against HIV replication in tissue culture even after drug washout.

OBJECTIVES Of the currently approved HIV integrase strand transfer inhibitors (INSTIs), dolutegravir has shown greater efficacy than raltegravir at suppressing HIV-1 replication in treatment-experienced individuals. Biochemical experiments have also shown that dolutegravir has a longer dissociative half-life when bound to HIV integrase than does raltegravir. In order to study the intracellular efficacy of various INSTIs, we asked whether drug removal from INSTI-treated HIV-1-infected cells would result in different times to viral rebound. In addition, we assessed the role of the R263K substitution within the integrase ORF that is associated with low-level resistance to dolutegravir. METHODS HIV-infected MT-2 cells were treated with dolutegravir, raltegravir or a third experimental INSTI (MK-2048) and the drugs were washed out after varying times. Viral replication was monitored by measuring reverse transcriptase (RT) activity in the culture fluids. RESULTS We observed a significantly slower increase in RT activity after the removal of dolutegravir compared with raltegravir or MK-2048. The incubation time before the drug was removed also had an impact on the level of RT activity independently of the drug and virus used. The R263K substitution did not significantly impact on levels of RT activity after drug washout, suggesting that dolutegravir remained tightly bound to the integrase enzyme despite the presence of this mutation. CONCLUSIONS These results suggest that the residency time of INSTIs on integrase is a key factor in the activity of these drugs and that the anti-HIV activity of dolutegravir persists more effectively than that of other INSTIs after drug washout.
Partial splenic embolization for cancer patients with thrombocytopenia requiring systemic chemotherapy

Partial splenic embolization (PSE) has been used to improve hematologic parameters related to hypersplenism. The purpose of this study was to review our institutional experience with PSE for cancer patients with thrombocytopenia because of splenic sequestration precluding the administration of systemic therapy (ST).
Mycophenolate mofetil in idiopathic membranous nephropathy: a clinical trial with comparison to a historic control group treated with cyclophosphamide.

BACKGROUND Cyclophosphamide can decrease proteinuria and improve renal function in patients with idiopathic membranous nephropathy, but has a high risk of side effects. We studied whether mycophenolate mofetil (MMF) could be a reasonable alternative with fewer side effects. STUDY DESIGN Clinical trial with historic controls. SETTINGS & PARTICIPANTS 32 cases and 32 controls with idiopathic membranous nephropathy and renal insufficiency at multiple centers. For comparison, we selected matched historic controls treated with cyclophosphamide. INTERVENTION MMF, 1 g twice daily, for 12 months versus cyclophosphamide, 1.5 mg/kg/d, for 12 months. Both groups also received intermittent methylprednisolone and alternate-day prednisone. OUTCOMES & MEASUREMENTS Serum creatinine, proteinuria, and side effects during and after treatment. RESULTS Median follow-up was 23 months (range, 11 to 46 months). Median serum creatinine levels were 1.8 mg/dL (159 micromol/L) in both groups at baseline and 1.4 mg/dL (124 micromol/L) in the MMF group versus 1.3 mg/dL (115 micromol/L) in the cyclophosphamide group at 12 months (P = 0.4). Proteinuria values at baseline and 12 months were protein of 8.40 and 1.41 g/d in the MMF group versus 9.19 and 1.13 g/d in the cyclophosphamide group (P = 0.5 at 12 months), respectively. Cumulative incidences of remission of proteinuria at 12 months were 66% in the MMF group versus 72% in the cyclophosphamide group (P = 0.3). Five patients (16%) in the MMF group versus none in the cyclophosphamide group had disease that did not respond to therapy (P = 0.05). Twelve patients (38%) experienced a relapse and 9 patients (31%) were re-treated in the MMF group compared with 4 (13%) and 2 patients (6%) in the cyclophosphamide group (P < 0.01 and P = 0.024, respectively). Side effects occurred in 24 patients (75%) in the MMF group and 22 patients (69%) in the cyclophosphamide group (P = 0.6). LIMITATIONS Nonrandomized control group, short duration of follow-up. CONCLUSIONS A 12-month course of MMF decreased proteinuria and improved renal function in the majority of patients, but did not appear as effective or better tolerated than cyclophosphamide. Long-term data and randomized controlled trials are needed to ascertain the efficacy of MMF in patients with idiopathic membranous nephropathy.
Spatiotemporal Variation and Networks in the Mycobiome of the Wheat Canopy

The phyllosphere is an important habitat for a diverse microbiome and an important entry point for many pathogens. Factors that shape the phyllosphere microbiome and also the co-existence among members and how they affect disease development are largely understudied. In this study we examined the wheat mycobiome by using metabarcoding of the fungal ITS1 region. Leaf samples were taken from four cultivars grown at two locations in Denmark. Samples were taken from the three uppermost leaves and at three growth stages to better understand spatiotemporal variation of the mycobiome. Analysis of read abundances showed that geographical location had a major effect in shaping the mycobiome in the total dataset, but also leaf position, growth stage and cultivar were important drivers of fungal communities. Cultivar was most important in explaining variation in older leaves whereas location better explained the variation in younger leaves, suggesting that communities are shaped over time by the leaf environment. Network analysis revealed negative co-existence between Zymoseptoria tritici and the yeasts Sporobolomyces, Dioszegia, and Cystofilobasidiaceae. The relative abundance of Z. tritici and the yeasts was relatively constant between individual samples, suggesting that fast growing fungi rapidly occupy empty space in the phyllosphere.
Peers at Work: From the Field to the Lab

In an influential study, Mas and Moretti (2009) find that “worker effort is positively related to the productivity of workers who see him, but not workers who do not see him”. They interpret this as evidence that social pressure can reduce free riding. In this paper we report an attempt to reproduce the findings of Mas and Moretti in a lab experiment. Lab experiments have the advantage that they can shut down alternative channels through which workers can influence the productivity of colleagues whom they observe. Although the subjects in our experiment are aware of the productivity of others and although there is sufficient scope for subjects to vary their productivity, we find no evidence of the type of peer effects reported by Mas and Moretti. This suggests that their findings are less generalizable than has been assumed.
Defining acceptable limits for the metrological traceability of specific measurands

Abstract Although manufacturers are compelled by the European IVD Directive, 98/79/EC, to have traceability of the values assigned to their calibrators if suitable higher order reference materials and/or procedures are available, there is still no equivalence of results for many measurands determined in clinical laboratories. The adoption of assays with metrological traceable results will have a significant impact on laboratory medicine in that results will be equivalent across different laboratories and different analytical platforms. The IFCC WG on Allowable Errors for Traceable Results has been formed to define acceptable limits for metrological traceability chains for specific measurands in order to promote the equivalence of patient results. These limits are being developed based on biological variation for the specific measurands. Preliminary investigations have shown that for some measurands, it is possible for manufacturers to assign values to assay calibrators with a measurement uncertainty that allows the laboratory enough combined uncertainty for their routine measurements. However, for other measurands, e.g., plasma sodium, current assays are too imprecise to fulfil limits based on biological variation. Although an alternative approach based on probability theory is being investigated, the most desirable approach would be for industry to improve measurement methods so that they meet clinical requirements.