Miracle-dz/UniFAR-FTUs huggingface dataset:
The art of engaging TBL sessions: Perspectives of medical students

We read with great interest, the article by Malik AS and Malik RH (2021) communicating tips for conducting online Team-Based Learning (TBL) sessions. As UK clinical medical students during the COVID-19 pandemic, we appreciate the interaction provided by TBL at a time of social isolation. We would like to draw upon our personal experiences and provide additional tips for facilitating TBL sessions. Whilst tip 4 suggests the initial use of Multiple-Choice Questions (MCQs), our Faculty used ten True/False questions. We support this approach as it tests understanding of core factual content from pre-reading materials. Following private answer submissions from each team, students were given their score with another opportunity to change answers, but were not told which answers were incorrect, thus honing decision-making skills. Facilitators then tested understanding through case-based discussions and MCQs in ‘knockout round’ polls, identifying the highest-scoring student. Group scores were also cumulatively added over the year, providing an alternative to Mentimeter for grading. In line with previous studies (Morawo et al. 2020), such competitive quizzes incentivised student engagement and enhanced retention. Although we agree with the vital elements of TBL mentioned in tip 2, using three different platforms may prove difficult to manage. Our Faculty delivered sessions for over 150 students using Zoom and Google packages. Students were sent a QR code to a Google Slides presentation containing questions, enabling access on a separate browser tab or device. Activating microphones and video cameras replicated face-to-face discussions. Answers were submitted via the chat box or Google Forms, illustrating successful conduction of sessions using fewer platforms. Whilst TBL offers ample opportunities for facilitatorstudent discussions, students may hesitate to openly ask questions or ‘appeal’. We recommend using the blank whiteboard on Zoom as an effective way of anonymously raising concerns and providing feedback. To conclude, we value the impact of synchronous TBL in enhancing interpersonal skills and educating students amidst placement disruptions. We thank Malik and Malik for their tips and hope our reflections contribute towards conducting future engaging TBL sessions.
Co-existing sickle cell anaemia and inflammatory bowel disease: case report and review of the literature

ABSTRACT Sickle cell anaemia (SCA) is a chronic haemolytic anaemia associated with vaso-occlusive painful crises which may affect several systems including the gastro-intestinal system, resulting in abdominal pain. The concurrence of inflammatory bowel disease and haemoglobinopathy is rare. No previously reported concurrent cases of both SCA and ulcerative colitis (UC) in sub-Saharan Africa were found in the literature. A 16-year-old girl with concurrent SCA and UC is presented. She was admitted to University College Hospital, Ibadan with a 1-year history of recurrent peri-umbilical pain and bloody stools. These symptoms were mainly attributed to SCA at the referring hospital, and she was managed for chronic tropical diarrhoea without a remarkable clinical response. This case illustrates the concurrent presentation of SCA and ulcerative colitis which led to the missed and delayed diagnosis of ulcerative colitis.
Evolution of the magnetic hyperfine field profiles in an ion-irradiated Fe60Al40 film measured by nuclear resonant reflectivity.

Nuclear resonant reflectivity (NRR) from an Fe60Al40 film was measured using synchrotron radiation at several grazing angles near the critical angle of total external reflection. Using laterally resolved measurements after irradiation with 20 keV Ne+ ions of gradually varying fluence of 0-3.0 × 1014 ions cm-2, the progressive creation of the ferromagnetic A2 phase with increasing ion fluence was confirmed. The observed depth selectivity of the method has been explained by application of the standing wave approach. From the time spectra of the nuclear resonant scattering in several reflection directions the depth profiles for different hyperfine fields were extracted. The results show that the highest magnetic hyperfine fields (∼18-23 T) are initially created in the central part of the film and partially at the bottom interface with the SiO2 substrate. The evolution of the ferromagnetic onset, commencing at a fixed depth within the film and propagating towards the interfaces, has been directly observed. At higher fluence (3.0 × 1014 ions cm-2) the depth distribution of the ferromagnetic fractions became more homogeneous across the film depth, in accordance with previous results.
Bold Behavior Is Associated with Genes That Regulate Energy Use but Does Not Covary with Body Condition in Food-Restricted Snails

Theoretical models about the relationship between food restriction and individual differences in risk-taking behavior (i.e., boldness) have led to conflicting predictions: some models predict that food restriction increases boldness, while other models predict that food restriction decreases boldness. This discrepancy may be partially attributable to an underappreciation for animals’ complex physiological responses to food restriction. To understand the proximate mechanisms mediating state-dependent boldness, we used freshwater snails (Helisoma trivolvis) to examine the relationships among food availability, body condition, boldness (latency to reemerge from shell and exploration), and mRNA expression of three genes (adenosine monophosphate–activated protein kinase [AMPK], molluscan insulin-like peptide [MIP], and serotonin receptor [5-HT]) involved in maintaining energy homeostasis during periods of moderate food restriction. Latency to reemerge and exploratory behavior decreased over time, but fed snails were bolder than fasted snails, suggesting that food restriction reduces bold behavior. Although food restriction decreased body condition, there was not a relationship between body condition and latency to reemerge from shell. However, expression of MIP was positively correlated with latency to reemerge from shell. Furthermore, AMPK was positively correlated with MIP and negatively correlated with body condition and 5-HT. Therefore, individual differences in physiological responses to food restriction, not overall body condition per se, appear to be more closely associated with state-dependent bold behavior. Finally, snails that experienced a novel assay environment returned to their initial “shy” behavior, suggesting that habituation to the assay environment may contribute to snails expressing bolder behavior over time.
Bilateral renal denervation prevents the development of hypertension during diet‐induced obesity in male rats

What is the central question of this study? What is the role of the renal nerves in the development of obesity, hyperlipidaemia and hypertension during the long‐term feeding of a moderately high‐fat diet in male obesity‐prone rats? What is the main finding and its importance? The renal nerves play a prominent mediatory role, without influencing the establishment of visceral adiposity and atherogenic hyperlipidaemia, in the induction and progression of pressure natriuresis impairment and hypertension during the developmental period of diet‐induced obesity.
Characteristics of Dimensional Psychopathology in Suicidal Patients With Major Psychiatric Disorders and Its Association With the Length of Hospital Stay: Algorithm Validation Study

Background Suicide has emerged as a serious concern for public health; however, only few studies have revealed the differences between major psychiatric disorders and suicide. Recent studies have attempted to quantify research domain criteria (RDoC) into numeric scores to systematically use them in computerized methods. The RDoC scores were used to reveal the characteristics of suicide and its association with major psychiatric disorders. Objective We intended to investigate the differences in the dimensional psychopathology among hospitalized suicidal patients and the association between the dimensional psychopathology of psychiatric disorders and length of hospital stay. Methods This retrospective study enrolled hospitalized suicidal patients diagnosed with major psychiatric disorders (depression, schizophrenia, and bipolar disorder) between January 2010 and December 2020 at a tertiary hospital in South Korea. The RDoC scores were calculated using the patients’ admission notes. To measure the differences between psychiatric disorder cohorts, analysis of variance and the Cochran Q test were conducted and post hoc analysis for RDoC domains was performed with the independent two-sample t test. A linear regression model was used to analyze the association between the RDoC scores and sociodemographic features and comorbidity index. To estimate the association between the RDoC scores and length of hospital stay, multiple logistic regression models were applied to each psychiatric disorder group. Results We retrieved 732 admissions for 571 patients (465 with depression, 73 with schizophrenia, and 33 with bipolar disorder). We found significant differences in the dimensional psychopathology according to the psychiatric disorders. The patient group with depression showed the highest negative RDoC domain scores. In the cognitive and social RDoC domains, the groups with schizophrenia and bipolar disorder scored higher than the group with depression. In the arousal RDoC domain, the depression and bipolar disorder groups scored higher than the group with schizophrenia. We identified significant associations between the RDoC scores and length of stay for the depression and bipolar disorder groups. The odds ratios (ORs) of the length of stay were increased because of the higher negative RDoC domain scores in the group with depression (OR 1.058, 95% CI 1.006-1.114) and decreased by higher arousal RDoC domain scores in the group with bipolar disorder (OR 0.537, 95% CI 0.285-0.815). Conclusions This study showed the association between the dimensional psychopathology of major psychiatric disorders related to suicide and the length of hospital stay and identified differences in the dimensional psychopathology of major psychiatric disorders. This may provide new perspectives for understanding suicidal patients.
Role of Venous Endothelial Cells in Developmental and Pathologic Angiogenesis

Supplemental Digital Content is available in the text. Background: Angiogenesis is a dynamic process that involves expansion of a preexisting vascular network that can occur in a number of physiological and pathological settings. Despite its importance, the origin of the new angiogenic vasculature is poorly defined. In particular, the primary subtype of endothelial cells (capillary, venous, arterial) driving this process remains undefined. Methods: Endothelial cells were fate-mapped with the use of genetic markers specific to arterial and capillary cells. In addition, we identified a novel venous endothelial marker gene (Gm5127) and used it to generate inducible venous endothelium-specific Cre and Dre driver mouse lines. Contributions of these various types of endothelial cells to angiogenesis were examined during normal postnatal development and in disease-specific setting. Results: Using a comprehensive set of endothelial subtype-specific inducible reporter mice, including tip, arterial, and venous endothelial reporter lines, we showed that venous endothelial cells are the primary endothelial subtype responsible for the expansion of an angiogenic vascular network. During physiological angiogenesis, venous endothelial cells proliferate, migrating against the blood flow and differentiating into tip, capillary, and arterial endothelial cells of the new vasculature. Using intravital 2-photon imaging, we observed venous endothelial cells migrating against the blood flow to form new blood vessels. Venous endothelial cell migration also plays a key role in pathological angiogenesis. This was observed both in formation of arteriovenous malformations in mice with inducible endothelium-specific Smad4 deletion mice and in pathological vessel growth seen in oxygen-induced retinopathy. Conclusions: Our studies establish that venous endothelial cells are the primary endothelial subtype responsible for normal expansion of vascular networks, formation of arteriovenous malformations, and pathological angiogenesis. These observations highlight the central role of the venous endothelium in normal development and disease pathogenesis.
Whole-genome-based phylogenomic analysis of the Belgian 2016–2017 influenza A(H3N2) outbreak season allows improved surveillance

Seasonal influenza epidemics are associated with high mortality and morbidity in the human population. Influenza surveillance is critical for providing information to national influenza programmes and for making vaccine composition predictions. Vaccination prevents viral infections, but rapid influenza evolution results in emerging mutants that differ antigenically from vaccine strains. Current influenza surveillance relies on Sanger sequencing of the haemagglutinin (HA) gene. Its classification according to World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC) guidelines is based on combining certain genotypic amino acid mutations and phylogenetic analysis. Next-generation sequencing technologies enable a shift to whole-genome sequencing (WGS) for influenza surveillance, but this requires laboratory workflow adaptations and advanced bioinformatics workflows. In this study, 253 influenza A(H3N2) positive clinical specimens from the 2016–2017 Belgian season underwent WGS using the Illumina MiSeq system. HA-based classification according to WHO/ECDC guidelines did not allow classification of all samples. A new approach, considering the whole genome, was investigated based on using powerful phylogenomic tools including beast and Nextstrain, which substantially improved phylogenetic classification. Moreover, Bayesian inference via beast facilitated reassortment detection by both manual inspection and computational methods, detecting intra-subtype reassortants at an estimated rate of 15 %. Real-time analysis (i.e. as an outbreak is ongoing) via Nextstrain allowed positioning of the Belgian isolates into the globally circulating context. Finally, integration of patient data with phylogenetic groups and reassortment status allowed detection of several associations that would have been missed when solely considering HA, such as hospitalized patients being more likely to be infected with A(H3N2) reassortants, and the possibility to link several phylogenetic groups to disease severity indicators could be relevant for epidemiological monitoring. Our study demonstrates that WGS offers multiple advantages for influenza monitoring in (inter)national influenza surveillance, and proposes an improved methodology. This allows leveraging all information contained in influenza genomes, and allows for more accurate genetic characterization and reassortment detection.
Knowledge, Attitudes, and Practices Regarding COVID-19 Among Health Care Workers in Public Health Facilities in Eastern Ethiopia: Cross-sectional Survey Study

Background On March 13, 2020, Ethiopia reported the first confirmed case of COVID-19 in Addis Ababa. COVID-19 is likely to overwhelm an already-fragile health care delivery system and reduce the availability of essential health services. This analysis of data from the Somali Region of Eastern Ethiopia on health care workers’ (HCWs) knowledge, attitudes, and practices regarding the prevention and control of COVID-19 may be used in planning health education programs about the emerging viral disease. Objective This study aimed to investigate the knowledge, attitudes, and practices of HCWs regarding COVID-19 infection. Methods This cross-sectional study was conducted among HCWs in three public health facilities in the Somali Region, Eastern Ethiopia. A self-administered questionnaire was shared with all HCWs working at the public health facilities. A total of 15 knowledge questions were scored as 1 or 0 for correct or incorrect responses, respectively. A total of 14 practice questions were scored on a 3-point scale from 1 (“always”) to 3 (“never”). A total of six attitude questions were rated on a 5-point Likert scale, in a negative dimension, as follows: 1 (“strongly agree”), 2 (“agree”), 3 (“neutral”), 4 (“disagree”), and 5 (“strongly disagree”). Mean scores were calculated and used as a cut point to dichotomize the outcome variables (>13.7 indicated good knowledge, <18.8 indicated good practices, and ≤10.5 indicated favorable attitudes). We used t tests and analyses of variance (ie, F tests) to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results Of the 686 HCWs approached, a total of 434 HCWs responded (63.3% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 13.7 (SD 2.6), and 73.3% (318/434) of participants had sufficient knowledge. The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 18.8 (SD 5.8), and 61.5% (267/434) of the participants practiced precautionary measures to prevent COVID-19. There was a negative correlation between knowledge and attitude scores (r=–0.295, P<.001) and between knowledge and practice scores (r=–0.298, P<.001). Conclusions The overall levels of knowledge and practice were relatively better than the attitude level. This highlights the need to implement strategies that enhance the positive attitudes and safe practices of the HCWs for better containment of the pandemic and supporting of essential health care services.
Taxi drivers and COVID‐19 in Jamaica: Occupationally related income decline and health behaviour

Abstract Income and employment are recognised as social determinants of health. Occupationally related exposures and working conditions impact health behaviours. Taxi drivers have been recognised as an occupationally COVID‐19 at‐risk group. COVID‐19 threatens their lives and livelihoods. This study describes self‐reported income changes attributed to the COVID‐19 pandemic among taxi drivers. Associations between percentage change in income and reported prevention practices were ascertained. In May 2020, a cross‐sectional study was done among 282 taxi drivers in the Kingston and St. Andrew Metropolitan Area in Jamaica. Multi‐stage sampling was used to select taxi driver from seven hubs. Data collection utilised a 28‐item questionnaire. Self‐reported income before and during the COVID‐19 pandemic was ascertained and correlations between relative changes in income and COVID‐19 prevention practices were assessed. The median pre‐COVID‐19 monthly income was USD 1,428.57 (IQR = 1,467.26), about USD 51/day. Median monthly income since the COVID‐19 outbreak was USD 500 (IQR = 472.37), about USD 18/day, representing a 65% reduction in income. There was a statistically significant association between the relative change in income and the practice of wearing mask while transporting passengers. Generally, as the relative change (decline) in income increased, reported compliance with mask wearing decreased (Spearman's rho = −0.15, p = 0.02). Taxi drivers have experienced marked decline in income due to the COVID‐19 pandemic, with implications for health practices and the maintenance of desired health behaviours. Authorities should be cognisant of the economic impact and COVID‐related consequences in the taxi industry, as they seek to develop COVID‐19 occupationally related prevention and control programmes.
Mental Logout: Behavioral and Neural Correlates of Regulating Temptations to Use Social Media

Individuals sometimes use social media instead of sleeping or while driving. This fact raises the crucial need for—and challenge of—successfully self-regulating potent social-media temptations. To date, however, empirical evidence showing whether social-media temptations can be self-regulated and how self-regulation can be achieved remains scarce. Accordingly, the present within-participants study (N = 30 adults) provided causal evidence for self-regulation of social-media content and identified a potential underlying neural mechanism. We tested the premise that successful self-regulation requires limiting the mental representation of temptations in working memory. Specifically, we showed that loading working memory with neutral contents via attentional distraction, relative to passively watching tempting social-media stimuli, resulted in reduced self-reported desire to use social media, reduced initial attention allocation toward social-media stimuli (reduced late-positive-potential amplitudes), and reduced online representation of social-media stimuli in working memory (reduced contralateral-delay-activity amplitudes). These results have important implications for successfully navigating a social-media-saturated environment.
Recent progress in research on the gut microbiota and highland adaptation on the Qinghai‐Tibet Plateau

Microbial communities that inhabit the host's intestine influence many aspects of the host's health and bear the adaptive potential to alterations in harsh environments and diets. The Qinghai‐Tibet Plateau represents one of the harshest environments in the world. Preliminary progress has been made in identifying the communities of gut microbes in Indigenous Tibetans and non‐human animals. However, due to the complexity of microbial communities, the effects of gut microbes on the host's health and high‐plateau adaptation remain unexplained. Herein, we review the latest progress in identifying factors affecting the gut microbiota of native Tibetans and non‐human animals and highlight the complex interactions between the gut microbiota, health and highland adaptation, which provides a basis for exploring the correlations between the gut microbiota and clinical indexes in native highland residents and travellers, as well as developing microbiota‐based strategies to mitigate health risks for tourists and treatments for mountain sickness during high‐altitude travel in the future.
Thyroid Hormone Profile and Its Prognostic Impact on the Coronavirus Disease 2019 in Korean Patients

Background Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients. Methods The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones. Results Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P<0.05). Patients in the lowest T3 tertile (<0.77 ng/mL) had higher rates of mechanical ventilation, intensive care unit admission, and death than those in the middle and highest (>1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile. Conclusion Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.