Miracle-dz/UniFAR-FTUs huggingface dataset:
Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

CONTEXT Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. OBJECTIVE Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. DESIGN Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. MAIN OUTCOME MEASURES Knowledge of ACGME core competencies. RESULTS Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1-10 vs > 10), and number of rotations taught per year (1-6 vs 7-12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10-12 rotations per year) were more likely to provide competency-based teaching. CONCLUSION Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies.
Learners mood detection using Convolutional Neural Network (CNN)

This research concerns about classroom learners mood detection in learning process which is believed to be an important thing to increase learning process effectiveness. Convolutional Neural Network (CNN), a branch of deep learning architectures and a part of Machine Learning, was used as a method in this research. The experiments were conducted through several stages such as face detection, image improvement and model formation. There are 660 images used as training data and the classification process result showed a good result. The accuracy average result was considered as a good result by using 4 layers of CNN i.e. 2 convolutional layers and 2 subsampling layers. Based on the experiments result, the system needs to be developed further by adding more specific data class and training data.
A Collaborative Approach to Combine Multiple Learning Methods

This article deals with the design of a hybrid learning system. This system integrates different kinds of learning methods and gives a set of class hierarchies as the result. The classes in these hierarchies are very similar. The method occurrences compare their results and automatically refine them to try to make them converge towards a unique hierarchy that unifies all the results. Thus, the system decreases the importance of the initial choices made when initializing classification algorithm (the choice of the method and its parameters) and to solve some of the limitations of the methods used such as an imposed number of classes, non-hierarchical result, or the size of the hierarchy found.
Editorial: what can be done when infliximab stops working in ulcerative colitis? Authors' reply

We thank Boyapati et al. for their interesting comments regarding our recent article. 2 Dealing with a loss of response to infliximab is often awkward, in terms or deciding whether to intensify infliximab therapy or to switch to an alternative. While infliximab dose intensification restores clinical response in 60–90% of patients in the short term, only 35–47% of the responders will remained in remission at 12 months. In that setting, the economic burden of dose intensification could be useless since patients will have to switch to another treatment sooner or later. On the other hand, a significant proportion of patients who respond to dose intensification will be able to go back to a standard dose of 5 mg/kg (59% of the patients in our study). Furthermore, the efficacy of a second anti-TNF after secondary failure of infliximab has been shown to be poor in Crohn’s disease. We agree with Boyapati et al. that loss of response was not defined adequately. In our study, it was defined according to physician global assessment. However, the vast majority of patients presented with high partial Mayo score [median partial score of 7 (95% confidence interval 6–8)] and all of them had active disease according to this previous score assessment. 7 We fully agree that therapeutic drug monitoring is a cornerstone in the management of patients who lose response to infliximab and is currently lacking in our study. Indeed, it has been shown that infliximab could be consumed by the inflammatory burden, immunogenicity of the drug, and faecal loss. However, time is not on our side when loss of response occurs, and it is often difficult to wait for the results of therapeutic drug monitoring to decide whether infliximab therapy should be intensified. New assays that provide a real-time assessment of the anti-TNF trough levels and the presence of anti-drug antibodies are needed for a personalised drug optimisation strategy.
The Genetic and Cellular Basis of Autosomal Dominant Polycystic Kidney Disease—A Primer for Clinicians

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic disorders worldwide. In recent decades, the field has undergone a revolution, starting with the identification of causal ADPKD genes, including PKD1, PKD2, and the recently identified GANAB. In addition, advances defining the genetic mechanisms, protein localization and function, and the identification of numerous pathways involved in the disease process, have contributed to a better understanding of this illness. Together, this has led to a better prognosis, diagnosis, and treatment in clinical practice. In this mini review, we summarize and discuss new insights about the molecular mechanisms underlying ADPKD, including its genetics, protein function, and cellular pathways.
Epidermal growth factor inhibits ceramide‐induced apoptosis and lowers ceramide levels in primary placental trophoblasts

The activation of sphingomyelinase and the subsequent generation of ceramide are emerging as important components of signaling pathways leading to apoptosis. The combination of tumor necrosis factor‐α (TNF‐α) and interferon‐γ (IFN‐γ) induces apoptosis of primary placental trophoblasts in vitro. This apoptosis is inhibited completely by cotreatment with epidermal growth factor (EGF). We therefore examined the role of sphingomyelinase and ceramide in trophoblast apoptosis and how this may be influenced by EGF. Exogenous C16‐ceramide (20 μM) and acid sphingomyelinase induced trophoblast apoptosis, an effect abrogated completely by cotreatment with 10 ng/ml EGF. Neutral sphingomyelinase also increased ceramide levels but did not induce apoptosis. Treatment with EGF alone decreased cellular ceramide levels. This decrease could be blocked by cotreatment with the acid ceramidase inhibitor N‐oleoylethanolamine (OE). OE alone increased ceramide levels and induced apoptosis that could not be blocked by cotreatment with EGF. In contrast, the alkaline ceramidase inhibitor D‐MAPP, although it also increased ceramide levels, did not induce apoptosis nor did it affect TNF‐α/IFN‐α‐induced cell death. These results implicate sphingolipids as important mediators in trophoblast apoptosis and suggest that the antiapoptotic properties of EGF can in part be explained by its control of ceramide concentrations in trophoblasts. J. Cell. Physiol. 180:263–270, 1999. © 1999 Wiley‐Liss, Inc.
Ballistocardiography based on optical fiber sensors

Ballistocardiography (BCG) is a non-invasive method for measuring the reaction force of the human body to the ejection of blood at each cardiac cycle. It is now being the subject of renewed research interest due to recent technological advancement in the field of sensors. In this paper, we summarize our work on BCG with optical fiber sensors for various applications in the past 6 years. These include wearable BCG and non wearable BCG. In the non wearable BCG, there are bed based BCG, chair based BCG and standing BCG for various applications including measurements of heart rate, respiratory rate, sleep monitoring, cuff-less blood pressure measurement and perioperative pediatric vital signs monitoring. We report the first novel application of microbend fiber sensor for simultaneous measurements of heart rate, respiratory rate and body posture/position.
Adaptive Multicast Key Management for Tactical Networks

Secure and efficient multicast communication is an important area of research for tactical networks. Such forms of communication are essential for efficient collaborative planning, command and control, and situational awareness based applications. In order to realize secure group communication on the battlefield, secure multicast routing must be available and the necessary cryptographic keys must be distributed to the current group members. The routes must be maintained and the keys must be distributed, despite changes in network node position, network topology, communication channel performance, and other factors which affect network connectivity and performance. This paper presents an efficient algorithm, for secure group key management called one-way function chains extended (OFC/X). It is specifically designed for use in dynamic, mobile, ad hoc networks such as tactical networks. We present analytical results comparing the bandwidth performance of OFC/X with other multicast keying algorithms that have appeared in literature. We also compare the energy consumption of OFC/X during member deletion with these algorithms in ad hoc networks. We found that all other keying algorithms use at least 30 percent more energy than OFC/X and that the LKH algorithm, requires between 3 and 4 times the energy of OFC/X while using slightly over twice the bandwidth
Molecular diversity of native rhizobia trapped by five field pea genotypes in Indian soils

Five pea cultivars; HFP 4, HVP 3–5, HFP 9426, Jayanti and Hariyal, being grown in CCS Haryana Agricultural University farm were used to isolate native rhizobia. Selected 54 rhizobia, from all cultivars, were authenticated as rhizobia by plant infectivity test. Along with nodulation, symbiotic effectiveness in terms of symbiotic ratios showed wide range of effectiveness of pea rhizobia from 1.11 to 5.0. DNA of all the 54 rhizobia was extracted and amplified by PCR, using ERIC and 16S rDNA primers. Dendrogram based on ERIC profiles of these 54 rhizobia showed the formation of 13 subclusters at 80% level of similarity. Dendrogram based on RFLP of 16S rDNA by three restriction endonucleases; Msp I, Csp 6I and Rsa I; also formed 13 subclusters at 80% level of similarity. However, positioning of subclusters was different from that of ERIC based dendrogram. Majority of the isolates i.e. 64.8% by ERIC profiles and 44.4% by RFLP of 16S rDNA formed one cluster. Isolates from same nodule were not 100% similar. Considering each cluster representing a rhizobial genotype, both techniques used to assess molecular diversity indicated the presence of 13 genotypes of field pea rhizobia in CCS Haryana Agricultural University farm soil. Two pea rhizobial genotypes were able to nodulate all the five pea cultivars. Furthermore, high strain richness index (0.43–0.5) of field pea rhizobia was observed by both the techniques. (© 2011 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Predisposing gene for early-onset prostate cancer, localized on chromosome 1q42.2-43.

There is genetic predisposition associated with >=10% of all cancer of the prostate (CaP). By means of a genomewide search on a selection of 47 French and German families, parametric and nonparametric linkage (NPL) analysis allowed identification of a locus, on chromosome 1q42.2-43, carrying a putative predisposing gene for CaP (PCaP). The primary localization was confirmed with several markers, by use of three different genetic models. We obtained a maximum two-point LOD score of 2.7 with marker D1S2785. Multipoint parametric and NPL analysis yielded maximum HLOD and NPL scores of 2.2 and 3.1, respectively, with an associated P value of . 001. Homogeneity analysis with multipoint LOD scores gave an estimate of the proportion of families with linkage to this locus of 50%, with a likelihood ratio of 157/1 in favor of heterogeneity. Furthermore, the 9/47 families with early-onset CaP at age <60 years gave multipoint LOD and NPL scores of 3.31 and 3.32, respectively, with P = . 001.
Overview of the impact of Typhoid and Paratyphoid fever. Utility of Ty21a vaccine (Vivotif®)

Summary Cases of diarrhoeal disease number from 1.7 to 5 billion per year worldwide. One of the main causes of diarrhoeal disease is typhoid fever, which is a potentially life-threatening multi-systemic illness. According to the most recent estimates, a total of 26.9 million typhoid fever episodes occurred in 2010. The geographical distribution of the disease differs widely; in developed countries, the incidence rate per 100,000 per year varies from < 0.1 to 0.3, and the disease mainly affects people who travel to endemic areas located in low- and middle-income countries. Low- and middle-income countries are mainly affected owing to the lack of clean water and proper sanitation. In the fight against this plague, prevention is fundamental, and vaccination against typhoid is an effective measure. Vivotif® is an oral live attenuated vaccine which contains a mutated strain of Salmonella (Ty21a) and reproduces the natural infection. The vaccine was first licensed in Europe in 1983 and in the US in 1989, and over the years it has proved efficacious and safe. It is indicated for adults and children from 5 years of age upwards. Specifically, in the most developed countries, vaccination is suggested for highrisk population groups and particularly for international travellers to destinations where the risk of contracting typhoid fever is high. It must also be borne in mind that international travel is increasing. Indeed, international tourist arrivals totalled 1,184 million in 2015 and, on the basis of current trends, international travel is expected to grow by 3-4% in 2017. Vivotif® appears to be a powerful means of disease prevention, the importance of which is highlighted by the spread of antibiotic-resistant strains of Salmonella typhy (S. typhi).
Effectiveness and residual activity comparison of granular formulations of insect growth regulators pyriproxyfen and s-methoprene against Florida mosquitoes in laboratory and outdoor conditions.

Effectiveness and residual activity tests of granular formulations of 2 insect growth regulators (IGRs), s-methoprene and pyriproxyfen, against laboratory-reared larvae of 5 colonized mosquitoes, Aedes aegypti, Aedes albopictus, Aedes taeniorhynchus, Anopheles quadrimaculatus, and Culex nigripalpus, were conducted in the laboratory and outdoors in plastic tubs. Culex quinquefasciatus was exposed to these two IGRs in the laboratory only. Each IGR formulation was applied at 0.02 and 0.05 ppm active ingredient (Al) against 5 of the 6 mosquito species both in the laboratory and the outdoor evaluations, whereas Cx. quinquefasciatus was exposed to 0.2 and 0.4 ppm AI of s-methoprene, and 0.1 and 0.2 ppm AI of pyriproxyfen in the laboratory. s-Methoprene at 0.02 and 0.05 ppm AI resulted in variable levels (<39-100%) of inhibition of adult emergence in the 5 species monitored for 6 weeks after treatment under both test conditions. Aedes taeniorhynchus was the most susceptible to s-methoprene in terms of initial and residual activity. Culex quinquefasciatus and Ae. albopictus were the most tolerant to s-methopene, with maximum emergence inhibitions amounting to 84% in Cx. quinquefasciatus at 0.4 ppm and 44.3% in Ae. albopictus at 0.05 ppm during the 1st week in the laboratory. Pyriproxyfen at comparable treatment rates to s-methoprene caused very high levels (>80-100% in most cases) of initial and residual emergence inhibitions of the tested species in the laboratory as well as outdoors. In several species, pyriproxyfen induced complete inhibition of adult emergence for several weeks after treatment, even at the lower rate of 0.02 ppm. The World Health Organization has recently recommended the use of pyriproxyfen for the control of some mosquito species at specified rates in certain habitats.
Innate and adaptive immune responses in chronic hepatitis B virus infections: towards restoration of immune control of viral infection

Knowledge of the immunological events necessary to control hepatitis B virus (HBV) infection has accelerated in recent years, but their translation towards therapeutic strategies able to achieve a durable HBV suppression has been challenging. The scenario of how HBV deals with the host immunity is presented and used to discuss how the immune response can be harnessed to potentially achieve infection control.
Homocysteine and methionine metabolism in ESRD: A stable isotope study.

BACKGROUND Hyperhomocysteinemia has a high prevalence in the end-stage renal disease (ESRD) population, which may contribute to the high cardiovascular risk in these patients. The cause of hyperhomocysteinemia in renal failure is unknown, and therapies have not been able to normalize plasma homocysteine levels. Insight into methionine-homocysteine metabolism in ESRD is therefore necessary. METHODS Using a primed, continuous infusion of [2H3-methyl-1-13C]methionine, we measured whole body rates of methionine and homocysteine metabolism in the fasting state in four hyperhomocysteinemic hemodialysis patients and six healthy control subjects. RESULTS Remethylation of homocysteine was significantly decreased in the hemodialysis patients: 2.6+/-0.2 (SEM) vs. 3.8+/-0.3 micromol. kg(-1)x hr(-1) in the control subjects (P = 0.03), whereas transsulfuration was not 2.5+/-0.3 vs. 3.0+/-0.1 micromol. kg(-1) x hr(-1) (P = 0.11). The transmethylation rate was proportionally and significantly lower in the ESRD patients as compared with controls: 5.2+/-0.4 vs. 6.8+/-0.3 micromol. kg(-1) x hr(-1) (P = 0.02). Methionine fluxes to and from body protein were similar. CONCLUSIONS The conversion of homocysteine to methionine is substantially (approximately 30%) decreased in hemodialysis patients, whereas transsulfuration is not. Decreased remethylation may explain hyperhomocysteinemia in ESRD. This stable isotope technique is applicable for developing new and effective homocysteine-lowering treatment regimens in ESRD based on pathophysiological mechanisms.
Regulation of Telomere Homeostasis during Epstein-Barr virus Infection and Immortalization

The acquisition of unlimited proliferative potential is dependent on the activation of mechanisms for telomere maintenance, which counteracts telomere shortening and the consequent triggering of the DNA damage response, cell cycle arrest, and apoptosis. The capacity of Epstein Barr virus (EBV) to infect B-lymphocytes in vitro and transform the infected cells into autonomously proliferating immortal cell lines underlies the association of this human gamma-herpesvirus with a broad variety of lymphoid and epithelial cell malignancies. Current evidence suggests that both telomerase-dependent and -independent pathways of telomere elongation are activated in the infected cells during the early and late phases of virus-induced immortalization. Here we review the interaction of EBV with different components of the telomere maintenance machinery and the mechanisms by which the virus regulates telomere homeostasis in proliferating cells. We also discuss how these viral strategies may contribute to malignant transformation.
Aberrant expression of regulatory cytokine IL-35 in patients with systemic lupus erythematosus

Objective This study characterizes an IL-35-mediated regulatory role in patients with systemic lupus erythematosus (SLE). Methods Plasma of SLE patients and healthy controls (HCs) was analyzed for the concentrations of IL-35 and soluble gp130 by using ELISA. mRNA expression of IL-35 subunit (p35 and EBI3) and its receptor (gp130 and IL-12Rβ2) in peripheral blood mononuclear cells (PBMCs) was assessed by RT-qPCR. Flow cytometry was performed to evaluate the number of CD4+CD25highCD127−Treg cells and the expression of IL-35 receptor on the CD4+ helper (Th) cells and CD19+ B cells. Plasma collected from SLE patients and HCs was assayed for cytokine and chemokine expression by Luminex multiplex assay. Results Plasma IL-35 and soluble gp130 levels positively correlated with each other and were significantly higher in patients with severe SLE compared with HCs. Significantly higher levels of inflammatory cytokines/chemokines CCL2, CXCL8, IL-6, interferon (IFN)-γ, IL-10 and IL-17A were observed in plasma of SLE patients than HCs. mRNA levels of IL-35 and its receptor were significantly positively correlated in PBMCs from SLE patients and their levels were higher in SLE than HCs. The increase significantly correlated with changes in SLE Disease Activity Index (SLEDAI) (all p < 0.05). In addition, the number of Treg cells in severe and moderate SLE patients were both significantly lower than HCs, where the ratio of CD4+CD25−effector T cell %/CD4+CD25highCD127−Treg % was found to be significantly higher in severe SLE patients. Furthermore, the expression of gp130 on CD4+ Th cells and percentage of Tregs were positively correlated with each other, and both were negatively correlated with SLEDAI. Conclusion Our findings indicate that high level of plasma IL-35 in active SLE patients expressed with low level of IL-35 receptor (gp130) on CD4+ Th cells. These data raise the possibility that the level of IL-35 expression in SLE patients is not sufficient to induce the production of CD4+CD25highCD127−Tregs, and subsequently suppress the release of inflammatory cytokines and chemokines upon inflammation.
Deep rank-based transposition-invariant distances on musical sequences

Distances on symbolic musical sequences are needed for a variety of applications, from music retrieval to automatic music generation. These musical sequences belong to a given corpus (or style) and it is obvious that a good distance on musical sequences should take this information into account; being able to define a distance ex nihilo which could be applicable to all music styles seems implausible. A distance could also be invariant under some transformations, such as transpositions, so that it can be used as a distance between musical motives rather than musical sequences. However, to our knowledge, none of the approaches to devise musical distances seem to address these issues. This paper introduces a method to build transposition-invariant distances on symbolic musical sequences which are learned from data. It is a hybrid distance which combines learned feature representations of musical sequences with a handcrafted rank distance. This distance depends less on the musical encoding of the data than previous methods and gives perceptually good results. We demonstrate its efficiency on the dataset of chorale melodies by J.S. Bach.