Miracle-dz/UniFAR-FTUs huggingface dataset:
A learner-centered technique and clinical reasoning, reflection, and case presentation attributes in athletic training students.

CONTEXT Providing opportunities to develop clinical decision-making skills, including clinical reasoning, is an important aspect of clinical education. The learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan management, and selecting an issue for self-directed study (SNAPPS) is used in medicine to express clinical reasoning. OBJECTIVE To investigate the effects of SNAPPS on the clinical reasoning, reflection, and 4 case presentation attributes (length, conciseness, case summary, and expression of clinical reasoning) in athletic training students. DESIGN Randomized controlled clinical trial. SETTING Three undergraduate programs accredited by the Commission on Accreditation of Athletic Training Education. PATIENTS OR OTHER PARTICIPANTS We randomly assigned 38 athletic training students (17 men, 21 women; age = 21.53 ± 1.18 years, grade point average = 3.25 ± 0.31) who had completed at least 1 year of clinical education and all orthopaedic evaluation coursework to the SNAPPS group or the usual and customary group using a stratification scheme. INTERVENTION(S) The SNAPPS group completed four 45-minute clinical reasoning and case presentation learning modules led by an investigator to learn the SNAPPS technique, whereas the usual and customary group received no formal instruction. Both groups audio recorded all injury evaluations performed over a 2-week period. MAIN OUTCOME MEASURES Participants completed the Diagnostic Thinking Inventory and Reflection in Learning Scale twice. Case presentations were analyzed for 4 attributes: length, conciseness, case summary, and expression of clinical reasoning. RESULTS Case presentations were longer (t18.806 = -5.862, P < .001) but were more concise (t32 = 11.297, P < .001) for the SNAPPS group than for the usual and customary group. The SNAPPS group performed better on both the case summary subscale (t32 = 2.857, P = .007) and the clinical reasoning subscale (t25.773 = -14.162, P < .001) than the other group. We found a time effect for Diagnostic Thinking Inventory scores (F1,34 = 6.230, P = .02) but observed no group effects (F1,34 = 0.698, P = .41) or time-by-group interaction (F1,34 = 1.050, P = .31). The Reflection in Learning Scale scores analysis revealed no group-by-time interaction (F1,34 = 1.470, P = .23) and no group (F1,34 = 3.751, P = .06) or time (F1,34 = 0.835, P = .37) effects. CONCLUSIONS The SNAPPS is an effective and feasible clinical education technique for case presentations. This learner-centered technique provides the opportunity for the expression of clinical reasoning skills.
Symptoms at index admission as predictor for 1‐5 year outcome in schizophrenia

A total of 107 drug‐free schizophrenic patients (76 males and 31 females) were consecutively admitted to an emergency ward and rated for psychotic symptoms by means of 32 items from the Comprehensive Psychopathological Rating Scale (CPRS). They were followed prospectively with ratings of social functioning by use of Strauss‐Carpenter's outcome scale at 1, 3 and 5 years after index admission with the aim of determining possible early symptoms that are predictors of social outcome. In total, 59 of the patients were first admissions and had never been treated. At index admission, no difference was found in total CPRS scores between first‐admission patients and chronic readmitted patients, or between male and female subjects. When subscales for positive symptoms (flights of ideas, feeling controlled, disrupted thoughts, auditory hallucinations, ideas of persecution) and negative symptoms (indecision, withdrawal, reduced speech, lack of appropriate emotions, slowness of movements) from the CPRS were applied, no relationship between the two subscales and outcome scores was found. However, in patients with a duration of the disorder of less than 24 months before index admission, high scores on both negative and positive subscales were significantly correlated with a poor 5‐year outcome. No correlation was found in the group with a duration of illness of more than 24 months before index admission. It is concluded that symptoms at index admission have a predictive value for outcome in schizophrenic patients. Negative symptoms measured by use of a subscale of the CPRS have a predictive value for outcome up to 5 years after index admission, but high scores on both positive and negative symptoms are more strongly associated with a poor outcome. The duration of the symptoms before admission, as well as the kind of neuroleptic treatment given (clozapine vs. classical neuroleptics), seem to be important factors for prediction of outcome. Our data support the view that early negative symptoms in particular have a predictive value for the prognosis in schizophrenia for up to 5 years.
A simple microcontroller based digitizer for differential inductive sensors

This paper presents a simple digitizer suitable for differential variable inductive/reluctance sensors. The proposed scheme uses two digital I/O pins, a counter and a comparator of a microcontroller and obtains a digital output directly proportional to the measurand which is sensed using a differential variable inductive/reluctance sensor possessing either a linear or an inverse transfer characteristic. The scheme uses a ratio-metric approach in the computation and hence the output is less sensitive to variation in the parameters such as excitation voltage, reference voltage, offset of the comparator, etc. A prototype of the proposed system has been built and tested using standard variable inductors that emulated a differential inductive sensor following an inverse characteristic. The output recorded was linear across the full range and worst-case error noted was less than 0.3 %. For the prototype developed, the time taken to complete a measurement was 200 μs. The prototype digitizer has been interfaced with a commercially available LVDT and tested. The worst-case error observed in this test was 0.77%. Also, the same digitizer has been employed to get a digital readout from a differential variable reluctance based displacement sensor. The worst-case error was less than 0.83%. The test results establish the efficacy of, the simple and cost effective, scheme developed.
Overexpression of cellular glutathione peroxidase rescues homocyst(e)ine-induced endothelial dysfunction

Homocyst(e)ine (Hcy) inhibits the expression of the antioxidant enzyme cellular glutathione peroxidase (GPx-1) in vitro and in vivo, which can lead to an increase in reactive oxygen species that inactivate NO and promote endothelial dysfunction. In this study, we tested the hypothesis that overexpression of GPx-1 can restore the normal endothelial phenotype in hyperhomocyst(e)inemic states. Heterozygous cystathionine β-synthase-deficient (CBS(−/+)) mice and their wild-type littermates (CBS(+/+)) were crossbred with mice that overexpress GPx-1 [GPx-1(tg+) mice]. GPx-1 activity was 28% lower in CBS(−/+)/GPx-1(tg−) compared with CBS(+/+)/GPx-1(tg−) mice (P < 0.05), and CBS(−/+) and CBS(+/+) mice overexpressing GPx-1 had 1.5-fold higher GPx-1 activity compared with GPx-1 nontransgenic mice (P < 0.05). Mesenteric arterioles of CBS(−/+)/GPx-1(tg−) mice showed vasoconstriction to superfusion with β-methacholine and bradykinin (P < 0.001 vs. all other groups), whereas nonhyperhomocyst(e)inemic mice [CBS(+/+)/GPx-1(tg−) and CBS(+/+)/GPx-1(tg+) mice] demonstrated dose-dependent vasodilation in response to both agonists. Overexpression of GPx-1 in hyperhomocyst(e)inemic mice restored the normal endothelium-dependent vasodilator response. Bovine aortic endothelial cells (BAEC) were transiently transfected with GPx-1 and incubated with dl-homocysteine (HcyH) or l-cysteine. HcyH incubation decreased GPx-1 activity in sham-transfected BAEC (P < 0.005) but not in GPx-1-transfected cells. Nitric oxide release from BAEC was significantly decreased by HcyH but not cysteine, and GPx-1 overexpression attenuated this decrease. These findings demonstrate that overexpression of GPx-1 can compensate for the adverse effects of Hcy on endothelial function and suggest that the adverse vascular effects of Hcy are at least partly mediated by oxidative inactivation of NO.
Guidelines for a minimum acceptable protocol for the construction of complete dentures.

PURPOSE To investigate the feasibility of obtaining expert consensus on the prosthodontic principles to be followed when constructing complete dentures, so that any modifications to materials and methods would not sacrifice those principles--a philosophy known as "appropriatech. " These principles would then comprise a Minimum Acceptable Protocol (MAP) for complete dentures. MATERIALS AND METHODS A Delphi survey technique was used that requested yes/no answers to a variety of statements describing the different stages in the construction of complete dentures. Respondents could also provide comments on any aspect of the questionnaire. The statements were then modified in light of the responses and comments received, and recirculated. Three rounds of questionnaires were used, and only statements achieving a 90% or greater consensus were included in the MAP. The respondents were randomly selected by country from the 2004 membership e-mail list of the International College of Prosthodontists. RESULTS Forty-one respondents answered the first questionnaire, 39 the second, and 36 the third. The 75 statements in the first questionnaire were gradually reduced as consensus was reached, and eventually 18 statements remained with 90% or greater agreement. CONCLUSION Even though expert opinion is regarded as the lowest level of evidence, there are no other methods available to derive such a protocol, and the Delphi technique was useful in obtaining the consensus. This MAP could now be used to help assess clinical techniques that attempt to reduce time and costs while producing a quality service-in other words, which will conform to the philosophy of appropriatech.
Host gastric Lewis expression determines the bacterial density of Helicobacter pylori in babA2 genopositive infection

Background and aims: We tested if host gastric Lewis antigens and the babA2 genotype of Helicobacter pylori correlated with clinicohistological outcome. Methods: We enrolled 188 dyspeptic patients (45 with duodenal ulcer, 45 with gastric ulcer, and 98 with chronic gastritis) with H pylori infection, proved by culture and gastric histology, reviewed by the updated Sydney system. Gastric expression of Lewis (Le) antigens Lea, Leb, Lex, and Ley was determined immunochemically to determine intensity (range 0–3). The corresponding 188 H pylori isolates were screened for babA2 genotype by polymerase chain reaction. Results: All H pylori isolates had a positive babA2 genotype. We identified Lea in 33.5%, Leb in 72.9%, Lex in 86.2%, and Ley in 97.4% of biopsies from these 188 patients. Patients who expressed Leb had a higher H pylori density than those who did not express Leb (p<0.001). Among 139 patients who expressed Leb, H pylori density increased with a higher Leb intensity (p<0.05). Gastric atrophy decreased with Leb intensity and thus resulted in lower H pylori density in the antrum (p<0.05). For the 49 patients without gastric Leb expression, H pylori density was positively related with Lex and Lea expression (p<0.05). Conclusions: Taiwanese H pylori isolates are 100% babA2 genopositive. Gastric Leb as well as Lex intensity may be major determinants of H pylori density. While lacking gastric Leb expression, Lex and Lea were closely related to H pylori colonisation.
Risk factors for venous thromboembolism in hospitalized patients with acute medical illness: analysis of the MEDENOX Study.

BACKGROUND There is limited information about risk factors for venous thromboembolism (VTE) in acutely ill hospitalized general medical patients. METHODS An international, randomized, double-masked, placebo-controlled trial (MEDENOX) has previously been conducted in 1102 acutely ill, immobilized general medical patients and has shown the efficacy of using a low-molecular-weight heparin, enoxaparin sodium, in preventing thrombosis. We performed logistic regression analysis to evaluate the independent nature of different types of acute medical illness (heart failure, respiratory failure, infection, rheumatic disorder, and inflammatory bowel disease) and predefined factors (chronic heart and respiratory failure, age, previous VTE, and cancer) as risk factors for VTE. RESULTS The primary univariate analysis showed that the presence of an acute infectious disease, age older than 75 years, cancer, and a history of VTE were statistically significantly associated with an increased VTE risk. Multiple logistic regression analysis indicated that these factors were independently associated with VTE. CONCLUSIONS Several independent risk factors for VTE were identified. These findings allow recognition of individuals at increased risk of VTE and will contribute to the formulation of an evidence-based risk assessment model for thromboprophylaxis in hospitalized general medical patients.
Who Collaborative Study: assessment of depressive disorders

SYNOPSIS In the context of an ongoing WHO research programme in depression, a total of 573 patients consulting psychiatrists in Canada, Iran, Japan and Switzerland were assessed with the WHO/SADD schedule which proved to be a simple and reliable instrument for standardized recording of clinical data. The results indicated that the ‘average’ depressive patients seeking care in culturally different settings have many clinical features in common. A screening instrument, developed in the same study, has been shown to be effective in selecting depressive patients among in- and out-patient populations.
Aging and the use of perceptual and temporal information in source memory tasks.

A number of studies have reported age differences in memory for the source of information. S.A. Ferguson, S. Hashtroudi, and M.K. Johnson (1992) suggested that older adults do not efficiently use multiple distinctive characteristics of sources to distinguish between sources in source memory tasks. In the study reported here, participants heard information from 2 sources and later decided whether test items had been presented by Source A, by Source B, or were new. The distinctiveness of both perceptual and temporal characteristics of sources were independently manipulated. Older adults benefited more than young adults from multiple distinctive characteristics of sources. These results question the generality of S.A. Ferguson et al.'s hypothesis.
Determinants of chronic disability related to low back pain: Towards an integrative biopsychosocial model

Purpose : Since the early 1990s, numerous prospective studies have been published on the determinants of chronic disability related to low back pain (LBP) of non-specific origin whose human and financial costs are enormous. The significant contribution of psychosocial factors is being increasingly recognized. However, additional efforts are needed to clarify their role and to improve the interventions. The purpose of this theoretical paper is to propose a coherent organization of the medical and psychosocial determinants identified in prospective studies into a conceptual framework. Method : Several models available in the field of pain and disability as well as in health psychology were reviewed. Results : A recent version of the stress coping model was chosen and adapted to the problem. The adapted model suggests that stress, particularly that caused by the pain associated with LBP, could have a negative impact on the outcome either: (1) indirectly through the negative emotional responses that it produces, which can cause biological or behavioural changes; or (2) directly through the biological or behavioural changes, which can in turn negatively affect the emotional response. Conclusions : The proposed biopsychosocial model assumes that LBP-related chronic disability is possibly, in some cases, a stress-related disorder. Its empirical verification in LBP could particularly improve the understanding of the interrelationships between certain variables.
Culture and Enterprise Rent-Seeking: Evidence from Native Place Networks among Officials in China

ABSTRACT Using data on Chinese municipal party secretaries (MPS), we study whether firms prefer to pay more to officials who have a wider native place network. In doing so, we find the state-owned enterprises (SOEs) are more willing to pay for benefits from an official’s native place network. Furthermore, we investigate why firms pay for access to officials who have a wider native place network. On the one hand, as an important political social resource, officials’ native place networks enhance the probability of officials’ promotion. The firm is just buying a “political call option. ” On the other hand, an MPS’s native place network can help firms to have more merger and acquisition activity. Using officials’ native place networks, this article provides a new angle on the effect of traditional culture on rent-seeking by firms.
Description of a new species of Surazomus (Arachnida: Schizomida), with comments on homology of male flagellum and mating march anchorage in the genus

Surazomus saturninoae sp. nov. is described from eastern Amazon. The male has a pentagonal flagellum, similar to those of three other species in the genus. These four species are herein gathered as the arboreus-group of Surazomus. We present a brief synopsis of chaetotaxy description in hubbardiines and several homology proposals for the flagellum of the species in the arboreus-group: the posterior lobes may be homologous to the lateral lobes of hubbardiine species with trilobed flagella; the setal brush with 4–5 setae on the posterior lobe may be composed of one Dl2 seta and enlarged lobular microsetae; the single, median posterior coupling pocket may be homologous to the pair of posterior pockets seen in other hubbardiines; the single, median anterior coupling pocket may be homologous to the pair of pockets on the anterior border of the flagellum seen in other hubbardiines. Based on the morphology of these pockets and the chelicerae within Surazomus, we discuss the anchoring mechanism during the mating march.
Relationships Between Renin, Aldosterone, and 24-Hour Ambulatory Blood Pressure in Obese Adolescents

Renin-angiotensin system (RAS) activation and abnormalities of ambulatory blood pressure (ABP) are present in obesity, but relationships between components of the RAS and ABP have not been defined in the young. Anthropometric measurements and 24-h ABP were obtained on 30 obese adolescents with and without type 2 diabetes mellitus. Plasma renin activity (PRA), aldosterone, and other cardiovascular risk factors were measured. Median PRA levels were 2.5 [interquartile range (IQR), 1.7–4.1] ng/mL/h and were higher in the diabetic subjects compared with the nondiabetics. Females had significantly higher PRA than males 3.2 (IQR, 2–4.8) versus 1.8 (IQR, 1.1–2.9) ng/mL/h (p = 0.04) and were more obese. BMI Z score and PRA were significantly correlated (rho = 0.46, p < 0.001). PRA inversely correlated with 24-h systolic ABP (rho = −0.46, p = 0.02) and strongly with 24-h pulse pressure (rho = −0.61, p = 0.001). Aldosterone levels were also correlated with 24-h pulse pressure (rho = −0.46, p = 0.02). In multivariate models, lower PRA was independently associated with 24-h systolic blood pressure. In this study, PRA was positively correlated with BMI, but the relationships between components of the RAS and ABP were inverse. Further studies are needed to define the pathophysiologic relationship between RAS components and blood pressure regulation in obese youth.
3,4‐Methylenedioxymethamphetamine increases interleukin‐1β levels and activates microglia in rat brain: studies on the relationship with acute hyperthermia and 5‐HT depletion

3,4‐Methylenedioxymethamphetamine (MDMA) administration to rats produces acute hyperthermia and 5‐HT release. Interleukin‐1β (IL‐1β) is a pro‐inflammatory pyrogen produced by activated microglia in the brain. We examined the effect of a neurotoxic dose of MDMA on IL‐1β concentration and glial activation and their relationship with acute hyperthermia and 5‐HT depletion. MDMA, given to rats housed at 22°C, increased IL‐1β levels in hypothalamus and cortex from 1 to 6 h and [3H]‐(1‐(2‐chlorophenyl)‐N‐methyl‐N‐(1‐methylpropyl)3‐isoquinolinecarboxamide) binding between 3 and 48 h. Increased immunoreactivity to OX‐42 was also detected. Rats became hyperthermic immediately after MDMA and up to at least 12 h later. The IL‐1 receptor antagonist did not modify MDMA‐induced hyperthermia indicating that IL‐1β release is a consequence, not the cause, of the rise in body temperature. When MDMA was given to rats housed at 4°C, hyperthermia was abolished and the IL‐1β increase significantly reduced. The MDMA‐induced acute 5‐HT depletion was prevented by fluoxetine coadministration but the IL‐1β increase and hyperthermia were unaffected. Therefore, the rise in IL‐1β is not related to the acute 5‐HT release but is linked to the hyperthermia. Contrary to IL‐1β levels, microglial activation is not significantly modified when hyperthermia is prevented, suggesting that it might be a process not dependent on the hyperthermic response induced by MDMA.
Live, Attenuated Simian Immunodeficiency Virus SIVmac-M4, with Point Mutations in the Env Transmembrane Protein Intracytoplasmic Domain, Provides Partial Protection from Mucosal Challenge with Pathogenic SIVmac251

ABSTRACT Attenuated molecular clones of simian immunodeficiency virus (SIVmac) are important tools for studying the correlates of protective immunity to lentivirus infection in nonhuman primates. The most highly attenuated SIVmac mutants fail to induce disease but also fail to induce immune responses capable of protecting macaques from challenge with pathogenic virus. We recently described a novel attenuated virus, SIVmac-M4, containing multiple mutations in the transmembrane protein (TM) intracytoplasmic domain. This domain has been implicated in viral assembly, infectivity, and cytopathogenicity. Whereas parental SIVmac239-Nef+ induced persistent viremia and simian AIDS in rhesus macaques, SIVmac-M4 induced transient viremia in juvenile and neonatal macaques, with no disease for at least 1 year postinfection. In this vaccine study, 8 macaques that were infected as juveniles (n = 4) or neonates (n = 4) with SIVmac-M4 were challenged with pathogenic SIVmac251 administered through oral mucosa. At 1 year postchallenge, six of the eight macaques had low to undetectable plasma viremia levels. Assays of cell-mediated immune responses to SIVmac Gag, Pol, Env, and Nef revealed that all animals developed strong CD8+ T-cell responses to Gag after challenge but not before. Unvaccinated control animals challenged with SIVmac251 developed persistent viremia, had significantly weaker SIV-specific T-cell responses, and developed AIDS-related symptoms. These findings demonstrate that SIVmac-M4, which contains a full-length Nef coding region and multiple point mutations in the TM, can provide substantial protection from mucosal challenge with pathogenic SIVmac251.