Miracle-dz/UniFAR-FTUs huggingface dataset:
Enhancing Physician Assistant Psychiatry Interviewing Skills Using Standardized Patients

Introduction The aim of this pilot study was to assess whether supplemental psychiatry training in the didactic year increases the scores on the Physician Assistant Education Association (PAEA) Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation. Methods Data were obtained from the physician assistant (PA) students on PAEA Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation for a single institution. Then, a comparison was performed for PA students who did not participate in supplemental psychiatry/behavioral health training (Cohort 1/historical control group; n = 62) and PA students who participated in supplemental psychiatric and behavioral health training (Cohort 2/experimental group; n = 63) to determine the effects of the groups. Results An independent t test demonstrated that the experimental group performed significantly better than the control group on both the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation {control group (M = 83.4) and experimental group (M = 86.3; t[117] = 2.8; P < .05)} and the preceptor evaluation {control group (M = 90) and experimental group (M = 92.6; t[112] = 2.1; P < .05)}. In addition, both analyses demonstrated a moderate effect size (End of Rotation examination, d = 0.51; preceptor, d = 0.62). A multiple regression analysis was used to control for age, sex, grade point average (GPA), and training intervention. Age, sex, and GPA were found not to affect the results. However, treatment intervention was statistically significant for both the End of Rotation examination and preceptor evaluation scores. Discussion Supplemental training in behavioral health and psychiatry, which included a standardized patient encounter and an interactive session dedicated to psychiatry interviewing techniques, resulted in students performing better on the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation.
Lysosome-targeted silicon quantum dots theranostics for simultaneous fluorescent imaging and photodynamic therapy

As an emerging treatment method, photodynamic therapy (PDT) has attracted considerable interest due to the characteristics of non-invasiveness, repeatable treatment, high spatiotemporal resolution and few side effects. However, the life span (<40 ns) and diffusion distance (<20 nm) of reactive oxygen species such as singlet oxygen (1O2) in tumor cells are extremely short, which has seriously limited therapeutic efficacy of PDT. The enrichment site of photosensitizers in cancer cells is usually the first site of PDT action, which will not only affect the biological signaling pathway of cancer cell death, but also is closely related to the final therapeutic effect. Therefore, the design and preparation of photosensitizers targeting specific subcellular organelles can directly break the biological function of the organelle and trigger the corresponding cell death signaling pathway, which can significantly improve the efficacy of PDT. Herein, a lysosome-targeted silicon quantum dots (L-Si QDs) was first made by diethylene glycol-mediated synthetic route as a multicolor fluorescent imaging reagents and a new photosensitizer. The as-prepared L-Si QDs exhibit bright fluorescence with excellent pH stability and time stability, excitation-dependent emission, and good biocompatibility. Furthermore, the results of cell experiments showed that L-Si QDs was accumulated in lysosomes after being taken up by cancer cells, and can efficiently produce 1O2 upon 635 nm laser irradiation, which can damage lysosomes, up-regulate cleavage caspase-3, increase Bax release, down-regulate Bcl-2 and induce cell apoptosis finally. This study significantly broadens the biomedical applications of silicon quantum dots and provides excellent nanomaterials candidates for tumor phototherapy.
Estimation d'état, estimation paramétrique et identifiabilité des modèles quasi-LPV

Dans cette these, deux problemes lies aux approches basees sur des modeles pour le diagnostic de defauts et l'estimation du niveau de degradation des equipements dans un bâtiment sont etudies: la conception d'observateurs adaptatifs pour l'estimation de l'etat et des parametres, et l'analyse de l'identifiabilite des parametres. La classe des modeles consideres est celle des modeles quasi-lineaires a parametres variants dans le temps (quasi-LPV) avec parametrisation affine des matrices d'etat. Utilisant l'approche polytopique de Takagi-Sugeno (T-S), deux types d'observateurs sont proposes, un pour des systemes en temps continu et l'autre pour des systemes en temps discret. La structure de Luenberger (correction de la dynamique a l'aide de l'erreur d'estimation de la sortie) est choisie pour la partie d'estimation d'etat de l'observateur pour les deux et leur conception s'appuie sur l'approche de Lyapunov. Pour la partie d'estimation des parametres, une structure originale est proposee en temps continu et une structure proportionnelle-integrale (PI) est utilisee en temps discret. La troisieme contribution presente succinctement une methode d'estimation d'etat et des parametres de facon decouplee. Elle utilise conjointement l'approche de l'espace de parite et un observateur a memoire finie. Pour la quatrieme contribution relative a l'identifiabilite des parametres, les etats du systeme sont tout d'abord elimines en utilisant une approche de type espace de parite. Cela permet d'extraire le `resume exhaustif' du modele qui aide a etablir l'identifiabilite du modele. Tous les resultats sont illustres a l'aide d'exemples
Outcome of Extracorporeal Cardiopulmonary Resuscitation in Pediatric Patients Without Congenital Cardiac Disease: Extracorporeal Life Support Organization Registry Study

OBJECTIVES: To describe the use of extracorporeal cardiopulmonary resuscitation (ECPR) in pediatric patients without congenital heart disease (CHD) and identify associations with in-hospital mortality, with a specific focus on initial arrest rhythm. DESIGN: Retrospective cohort study using data from pediatric patients enrolled in Extracorporeal Life Support Organization (ELSO) registry between January 1, 2017, and December 31, 2019. SETTING: International, multicenter. PATIENTS: We included ECPR patients under 18 years old, and excluded those with CHD. Subgroup analysis of patients with initial arrest rhythm. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We identified 567 patients: neonates (12%), infants (27%), children between 1 and 5 years old (25%), and children over 5 years old (36%). The patient cohort included 51% males, 43% of White race, and 89% not obese. Most suffered respiratory disease (26%), followed by acquired cardiac disease (25%) and sepsis (12%). In-hospital mortality was 59%. We found that obesity (adjusted odds ratio [aOR], 2.28; 95% CI, 1.21–4.31) and traumatic injury (aOR, 6.94; 95% CI, 1.55–30.88) were associated with greater odds of in-hospital mortality. We also identified lower odds of death associated with White race (aOR, 0.64; 95% CI, 0.45–0.91), ventricular tachycardia (VT) as an initial arrest rhythm (aOR, 0.36; 95% CI, 0.16–0.78), return of spontaneous circulation before cannulation (aOR, 0.56; 95% CI, 0.35–0.9), and acquired cardiac disease (aOR, 0.43; 95% CI, 0.29–0.64). Respiratory disease was associated with greater odds of severe neurologic complications (aOR, 1.64; 95% CI, 1.06–2.54). CONCLUSIONS: In children without CHD undergoing ECPR, we found greater odds of in-hospital mortality were associated with either obesity or trauma. The ELSO dataset also showed that other variables were associated with lesser odds of mortality, including VT as an initial arrest rhythm. Prospective studies are needed to elucidate the reasons for these survival differences.
Timely assessment of 5-year relative survival for patients with thyroid cancer from Taizhou, eastern China: a period analysis

Background While timely assessment of long-term survival in thyroid cancer patients is critical for assessing early detection and screening programs for thyroid cancer, those data are sorely lacking in China. We aimed to timely and accurately assess the long-term survival of thyroid cancer patients in eastern China. Methods Patients diagnosed with thyroid cancer during 2004–2018 from four cancer registries in Taizhou, eastern China were included. The 5-year relative survival was estimated by period analysis and stratified by sex, age at diagnosis, and region. The 5-year RS of thyroid cancer patients during 2019–2023 was also predicted using the model-based period analysis. Results During 2014–2018, the overall 5-year relative survival of thyroid cancer patients was 87.7%, 91.2% for women and 79.4% for men. The 5-year RS decreased along with increasing age at diagnosis, decreasing from 94.9% for age <45 years to 81.3% for age >74 years, while 5-year RS was higher in urban areas than in rural areas (93.2% vs. 86.1%). The 5-year RS for thyroid cancer patients improved greatly between 2004–2008 to 2014–2018. The predicted overall 5-year RS could reach 91.4% over the upcoming 2019–2023 period. Conclusion We provided, for the first time in China using period analysis, the most up-to-date 5-year RS for thyroid cancer patients from Taizhou, eastern China, which has important implications for timely evaluation on early detection and screening programs for patients with thyroid cancer in eastern China.
Diallyl trisulfide inhibits gastric cancer stem cell properties through ΔNp63/sonic hedgehog pathway

Gastric cancer is one of the deadliest malignant tumors, and half of the patients develop recurrences or metastasis within 5 years after eradication therapy. Cancer stem cells (CSCs) are considered to be important in this progress. The sonic hedgehog (SHH) pathway plays an important role in the maintenance of gastric CSCs characteristics. The p63 proteins are vital transcription factors belonging to the p53 family, while their functions in regulating CSCs remain unclear. The preventive effects of dietary diallyl trisulfide (DATS) against human gastric cancer have been verified. However, whether DATS can target gastric CSCs are poorly understood. Here, we investigated the role of ΔNp63/SHH pathway in gastric CSCs and the inhibitory effect of DATS on gastric CSCs via ΔNp63/SHH pathway. We found that ΔNp63 was upregulated in serum‐free medium cultured gastric tumorspheres compared with the parental cells. Overexpression of ΔNp63 elevated the self‐renewal capacity and CSC markers' levels in gastric sphere‐forming cells. Furthermore, we found that ΔNp63 directly bound to the promoter region of Gli1, the key transcriptional factor of SHH pathway, to enhance its expression and to activate SHH pathway. In addition, it was revealed that DATS effectively inhibited gastric CSC properties both in vitro and in vivo settings. Activation of SHH pathway attenuated the suppressive effects of DATS on the stemness of gastric cancer. Moreover, DATS suppression of gastric CSC properties was also diminished by ΔNp63 upregulation through SHH pathway activation. These findings illustrated the role of ΔNp63/SHH pathway in DATS inhibition of gastric cancer stemness. Taken together, the present study suggested for the first time that DATS inhibited gastric CSCs properties by ΔNp63/SHH pathway.
Arithmetical Knowledge and Arithmetical Definability: Four Studies

by Sean Walsh The subject of this dissertation is arithmetical knowledge and arithmetical definability. The first two chapters contain respectively a critique of a logicist account of a preferred means by which we may legitimately infer to arithmetical truths and a tentative defense of an empiricist account. According to the logicist account, one may infer from quasi-logical truths to patently arithmetical truths because the arithmetical truths are representable in the logical truths. It is argued in the first chapter that this account is subject to various problems: for instance, the most straightforward versions seem vulnerable to various counterexamples. The basic idea of the alternative empiricist account considered in chapter two is that complicated arithmetical truths like mathematical induction may be inferred by way of confirmation from less complicated quantifier-free arithmetical truths. The notion of confirmation here is understood probabilistically, and responses are given in this chapter to several seeming problems with this importation of probability into arithmetic. The final two chapters are concerned with arithmetical definability in two different settings. In the third chapter, the interpretability strength of the arithmetical and hyperarithmetical subsystems of second-order Peano arithmetic is
Ruxolitinib-based regimen in children with primary hemophagocytic lymphohistiocytosis

Primary hemophagocytic lymphohistiocytosis (pHLH) is a rare immune disorder and hematopoietic stem cell transplantation (HSCT) is the only potentially curative treatment. Given the high pre-HSCT mortality of pHLH patients reported in the HLH-2004 study (17%), more regimens to effectively control the disease and form a bridge with HSCT are needed. We conducted a retrospective study of pHLH children treated by ruxolitinib (RUX)-based regimen. Generally, patients received RUX until HSCT or unacceptable toxic side-effect. Methylprednisolone and etoposide were added sequentially when the disease was suboptimally controlled. The primary end point was 1-year overall survival. Twenty-one pHLH patients (12 previously treated and 9 previously untreated) were included with a median follow-up of 1.4 years. At last follow-up, 17 (81.0%) patients were alive with a 1-year overall survival of 90.5% (95% confidence interval: 84.1-96.9). Within the first 8 weeks, all patients had an objective response, of which 19 (90.5%) achieved complete response (CR) and two (9.5%) achieved partial response (PR) as a best response. Seventeen (81.0%) patients received HSCT, of which 13 (76.5%) had CR, three (17.6%) had PR and one (5.9%) had disease reactivation at the time of HSCT. Fifteen (88.2) patients were alive post-HSCT. Notably, eight (38.1%) patients received zero doses of etoposide, suggesting the potential of RUX-based regimen to reduce chemotherapy intensity. Patients tolerated RUX-based regimen well and the most frequently observed adverse events were hematologic adverse events. Overall, RUX-based regimen was effective and safe and could be used as a bridge to HSCT for pHLH children.
The importance of prevalence and pre-test probability on the microbiological diagnosis of SARS-CoV-2: the case of Spain in 2020

Objectives The aim of this work was to estimate the conditioned probability for the diagnosis of SARS-CoV-2 infection with reverse transcription polymerase chain reaction (RT-PCR), viral antigen rapid diagnostic tests (Ag-RDT), and antibody detection tests depending on the prevalence in the specific healthcare settings in Spain in 2020, and on the pre-test probability (PTP) according to the clinical situation, age and unknown or close contacts of the patient. Material and methods Performance parameters of tests were obtained from literature. Prevalence data and PTP were obtained from Spanish sources and a survey, respectively. The post-test probability is the positive predictive value (PPV) when test is positive. For negative result, we also calculated the probability of having the infection (false negatives). Results For both RT-PCR and viral Ag-RDT, the lowest PPV values were for the population screenings. This strategy proved to be useful in ruling out infection but generates a high number of false positives. At individual level, both tools provided high PPV (≥ 97%) when the PTP values are over 35%. In seroprevalence studies, though the specificity of IgG alone tests is high, under low seroprevalence, false positives cannot be avoided. Total antibodies tests are useful for diagnosis of COVID-19 in those doubtful cases with RT-PCR or Ag-RDT tests being repeatedly negative. Conclusions The interpretating of results depends not only on the accuracy of the test, but also on the prevalence of the infection in different settings, and the PTP associated to the patient before performing the test.
Evolutionary Γ-convergence of gradient systems modeling slow and fast chemical reactions

We investigate the limit passage for a system of slow and fast chemical reactions of mass-action type, where the rates of fast reactions tend to infinity. We give an elementary proof of convergence to a reduced dynamical system on the manifold of fast reaction equilibria. Then we study the entropic gradient structure of these systems and prove an E-convergence result via Γ-convergence of the primary and dual dissipation potentials, which shows that this structure carries over to the fast reaction limit in a thermodynamically consistent way. We recover the limit dynamics as a gradient flow of the entropy with respect to a pseudo-metric.
Isospin Equilibration in Fermi-energy Heavy-ion Nuclear Collisions

The nuclear Equation of State and the density dependence of the asymmetry energy have been explored via heavy-ion collisions of 35 MeV/nucleon Zn,Ni+Zn and Zn+Zn,Ni. The experimental data were collected on the NIMROD-ISiS (Neutron-Ion Multidetector for Reaction Oriented Dynamics with Indiana Silicon Sphere) 4π charged particle detector array coupled with the TAMU Neutron Ball at the Texas A&M University Cyclotron Institute which provides excellent isotopic resolution, event characterization and coverage of charged particles along with eventby-event measurement of neutron multiplicities. The nature of isospin equilibration was examined via the use of the iBUU04 transport model and the Constrained Molecular Dynamics (CoMD) model coupled with the GEMINI statistical decay model. Both models provided insight into the nature of the heavy-ion collisions studied but both models must also be better understood in order to replicate the effects seen in the experimental data. An improved method of experimental impact parameter determination was demonstrated with the CoMD results. Experimental measurements of the isoscaling parameter α, isobaric yield ratio for the A=3 isobar and reconstructed quasi-projectile isospin asymmetry were conducted with respect to the centrality of the collision. A new signature of isospin equilibration was proposed and observed in the experimental data: convergence of the quasiprojectile and quasi-target isospin asymmetries to each other as the interaction time increases. Finally, a direct comparison was made to previous works and found that the reaction systems studied experienced an isospin equilibration of approximately 75%.
Effect of individualised strength and plyometric training on the physical performance of basketball players

ABSTRACT The aims of this study were to examine the effects of eight weeks of individualised force-velocity imbalance (F-Vimb) training on physical performance in basketball players and to analyse the differences in physical performance between two periods of time (four to eight weeks) with this training. Thirty male players (age, 22.8 ± 5.68 years; height, 1.87 ± 0.07 m; body mass, 86.3 ± 11.1 kg) were divided into an intervention group (INT, n = 15), who performed an individualised training based on individual F-Vimb; and a control group (CON, n = 15), who underwent a non-individualised training programme; both groups performed two days/week of intervention and the same pre-season basketball training. At baseline, at four weeks, and at eight weeks of intervention, an assessment was performed including countermovement-jumps, unilateral drop jumps, triple hop test, force-velocity profile, sprint and change of direction (COD). At four weeks, the INT showed improvements in sprint and vertical jumping actions (≥3.76%, ES ≥0.44, p ≤ 0.02). At eight weeks, the INT continued to improve vertical jumping actions (p < 0.05) and showed improvements in horizontal jumping (6.80%, ES = 0.45, p < 0.01) and COD (≥2.99%, ES ≥0.96, p < 0.01). A significant reduction in F-Vimb was observed for INT (ES = 0.77, p = 0.01). In contrast, none of these changes were observed in CON. Thus, an individualised F-Vimb training intervention improved physical performance after eight weeks, with changes in sprint and vertical jump after first four weeks. Basketball coaches should optimise the force-velocity profile and improve the performance in sport-related actions as jumping and changing direction. Highlights An individualised F-Vimb training programme improved sport-specific actions after eight weeks in basketball athletes. Improvements were specific to the orientation worked on, with vertical jumping and sprint actions being the most sensitive to change after just four weeks of individualised F-Vimb intervention. In complex actions such as COD, it would be recommended to optimise the F-V profile, emphasising a vertical force-orientation for at least 8 weeks.
Pan-genome analysis sheds light on structural variation-based dissection of agronomic traits in melon crops.

Sweetness and appearance of fresh fruits are key palatable and preference attributes for consumers and are often controlled by multiple genes. However, fine-mapping the key loci or genes of interest by single genome-based genetic analysis is challenging. Herein, we present the chromosome-level genome assembly of one landrace melon accession (Cucumis melo ssp. agrestis) with wild morphologic features and thus construct a melon pan-genome atlas via integrating sequenced melon genome datasets. Our comparative genomic analysis reveals a total of 3.4 million genetic variations, of which the presence/absence variations (PAVs) are mainly involved in regulating the function of genes for sucrose metabolism during melon domestication and improvement. We further resolved several loci that are accountable for sucrose contents, flesh color, rind stripe and suture using a structural variation (SV)-based genome-wide association study (GWAS). Furthermore, via BSA-seq and map-based cloning, we uncovered that a single gene, (CmPIRL6), determines the edible or inedible characteristics of melon fruit exocarp. These findings provide important melon pan-genome information and provide a powerful toolkit for future pan-genome-informed cultivar breeding of melon.
Hepatitis B viral replication markers and hepatic fibrosis in untreated chronic hepatitis B virus infection with and without HIV coinfection in Zambia

Background: To inform novel therapies, a more nuanced understanding of HIV's impact on hepatitis B virus (HBV) natural history is needed, particularly in high burden countries. Methods: In Lusaka, Zambia, we compared prospectively recruited adults (18+ years) with chronic HBV infection, with and without HIV. We excluded those with prior antiviral treatment experience or HBV diagnosis due to clinical suspicion (rather than routine testing). We assessed HBV DNA levels, hepatitis B e antigen (HBeAg), CD4+ (if HIV coinfection), and liver disease (transient elastography, serum alanine aminotransferase). In multivariable analyses, we evaluated the association of HIV overall and by level of CD4+ count on these markers. Results: Among 713 adults analyzed, median age was 33 years, 63% were male, and 433 had HBV/HIV coinfection. Median CD4+ count was 200 cells/μl. HBV DNA was greater than 2000 IU/ml for 311 (51.0%) and 227 (32.5%) were HBeAg-positive. 15.5% had advanced fibrosis or cirrhosis. HIV coinfection was associated with five-fold increased HBV DNA levels [adjusted geometric mean ratio, 5.78; 95% confidence interval (CI), 2.29–14.62] and two times the odds of HBeAg-positivity (adjusted odds ratio, 2.54; 95% CI, 1.59–4.08). These associations were significant only at CD4+ counts 100–350 and <100 cells/μl. HIV was not associated with markers of fibrosis or ALT. Discussion: HIV's impact on HBV natural history likely depends on the degree and duration of immune suppression. There is strong rationale to monitor HBV DNA in people with HBV/HIV coinfection and immune suppression. A better understanding is needed of mechanisms of increased liver-related mortality in people with HBV/HIV coinfection.