Miracle-dz/UniFAR-FTUs huggingface dataset:
Promoting the development of doctoring competencies in clinical settings.

BACKGROUND AND OBJECTIVES This UME-21 project was developed to promote a variety of clinical competencies during a 12-week medicine clerkship for third-year students. METHODS The clerkship is divided into three 4-week rotations--two inpatient rotations and one outpatient rotation. During each rotation, students select a competency, review the module about that competency on the clerkship Web site, and perform a literature search. Learning exercises prompt students to ask their preceptor to model and discuss the performance of the competency on at least one patient and to provide feedback on their performance at least twice. At the end of each rotation, students are required to write about what they learned from the articles they read, write a critical analysis of their performance of the competency on one patient, and complete an evaluation questionnaire. This report is based on the results from the students' evaluation questionnaire. RESULTS At the end of the first six rotations, 120 students completed 330 evaluations of the course (93% response rate). The most frequently selected competency modules were behavior modification and patient education. In 81.5% of the evaluations, students felt that there was at least moderate improvement in their ability to perform the selected competency during the rotation. By the end of the rotation, in 85.3% of the evaluations, students indicated that they were confident performing the competency most or almost all of the time. Observing the preceptor was the component of the curriculum most often rated as helpful (59.1%), followed by literature review (57.9%), reviewing the Web site module (45.2%), and observation and feedback by the preceptor (32.7%). CONCLUSIONS Based on student reports, the approach described in this paper appears to be a promising way to teach important doctoring competencies in a clinical setting.
An assessment of prostatectomy for benign urinary tract obstruction. Geographic variations and the evaluation of medical care outcomes.

IN MAINE, the efforts of practicing urologists to understand how their clinical decisions contribute to the striking variations in rates of prostatectomy from one community to another led to a critical evaluation of the theories under See also pp 3010 and 3018. lying the decision to operate. Specific aspects of our work have been described elsewhere. 1-3 The purpose of this report is to provide an overview of the prostatectomy assessment project—its background and relevance, the methods used, the principal findings and recommendations—and to comment on the applicability of the approach to the evaluation of other common medical practices. BACKGROUND The project was an initiative of the Maine Medical Assessment Program, 4,5 an ongoing program sponsored by the Maine Medical Association to respond to the small-area variations in medical practice patterns seen among Maine communities. Striking geographic variations in use are characteristic of many operations, diagnostic procedures, and causes of
Collision technique

Commonly encountered yet not widely appreciated sources of error in the study of motor nerve conduction velocities of the median and ulnar nerves include (1) spread of stimulating current to the nerve not under study, (2) recording a volume conducted potential from distant muscles, and (3) presence of anomalous crossover in the forearm between the median and ulnar nerves. Under these circumstances, it is desirable to block impulses in one nerve without affecting those in the other. This can be achieved simply by collision if a second stimulus is delivered distally to the nerve not being tested.
Evaluating Dependency based Package-level Metrics for Multi-objective Maintenance Tasks

Role of packages in organization and maintenance of software systems has acquired vital importance in recent research of software quality. With an advancement in modularization approaches of object oriented software, packages are widely considered as re-usable and maintainable entities of objectoriented software architectures, specially to avoid complicated dependencies and insure software design of well identified services. In this context, recently research study of H. Abdeen on automatic optimization of package dependencies provide composite frame of metrics for package quality and overall source code modularization. There is an opportunity to conduct comprehensive empirical analysis over proposed metrics for assessing their usefulness and application for fault-prediction, design flaw detection, identification of source code anomalies and architectural erosion. In this paper, we examine impact of these dependency optimization based metrics in wide spectrum of software quality for single package and entire software modularization. Our experimental work is conducted over open source software systems through statistical methodology based on cross validation fault-prediction and correlation.We conclude with empirical evidence that dependency based package modularization metrics provide more accurate view for predicting fault-prone packages and improvement of overall software structure. Thus, application of these metrics can help the developers and software practitioners to insure proactive management of the source code dependencies and avoid design flaws during software development.
Exploring The Galaxy Mass-Metallicity Relation at 3

Long-duration gamma-ray bursts (GRBs) provide a premier tool for studying high-redshift star-forming galaxies thanks to their extreme brightness and association with massive stars. Here we use GRBs to study the galaxy mass-metallicity (M*-Z) relation at z~3-5, where conventional direct metallicity measurements are extremely challenging. We use the interstellar medium metallicities of long-duration GRB hosts derived from afterglow absorption pectroscopy (Z~0.01-1 solar), in conjunction with host galaxy stellar masses determined from deep Spitzer 3.6 micron observations of 20 GRB hosts. We detect about 1/4 of the hosts with I-band absolute magnitudes, M ~ -21.5 to -22.5 AB mag, and place a limit of M>-19 mag on the remaining hosts from a stacking analysis. Using a conservative range of mass-to-light ratios for simple stellar populations (with ages of 70 Myr to ~ 2 Gyr), we infer the host stellar masses and present the galaxy mass-metallicity measurements at z ~ 3-5 (~ 3.5). We find that the detected GRB hosts, with M* ~ 2e10 solar masses, display a wide range of metallicities, but that the mean metallicity at this mass scale, Z~ 0.1 solar, is lower than measurements at z<3. Combined with stacking of the non-detected hosts (with M*<4e9 solar masses and Z<0.03 solar), we find evidence for the existence of an M*-Z relation at z ~ 3.5 and continued evolution of this relation to systematically lower metallicities from z ~ 2.
Transcription Activation In Vitro by the Bradyrhizobium japonicum Regulatory Protein FixK2

ABSTRACT In Bradyrhizobium japonicum, the N2-fixing root nodule endosymbiont of soybean, a group of genes required for microaerobic, anaerobic, or symbiotic growth is controlled by FixK2, a key regulator that is part of the FixLJ-FixK2 cascade. FixK2 belongs to the family of cyclic AMP receptor protein/fumarate and nitrate reductase (CRP/FNR) transcription factors that recognize a palindromic DNA motif (CRP/FNR box) associated with the regulated promoters. Here, we report on a biochemical analysis of FixK2 and its transcription activation activity in vitro. FixK2 was expressed in Escherichia coli and purified as a soluble N-terminally histidine-tagged protein. Gel filtration experiments revealed that increasing the protein concentration shifts the monomer-dimer equilibrium toward the dimer. Purified FixK2 productively interacted with the B. japonicum σ80-RNA polymerase holoenzyme, but not with E. coli σ70-RNA polymerase holoenzyme, to activate transcription from the B. japonicum fixNOQP, fixGHIS, and hemN2 promoters in vitro. Furthermore, FixK2 activated transcription from the E. coli FF(−41.5) model promoter, again only in concert with B. japonicum RNA polymerase. All of these promoters are so-called class II CRP/FNR-type promoters. We showed by specific mutagenesis that the FixK2 box at nucleotide position −40.5 in the hemN2 promoter, but not that at −78.5, is crucial for activation both in vivo and in vitro, which argues against recognition of a potential class III promoter. Given the lack of any evidence for the presence of a cofactor in purified FixK2, we surmise that FixK2 alone is sufficient to activate in vitro transcription to at least a basal level. This contrasts with all well-studied CRP/FNR-type proteins, which do require coregulators.
Congestive Heart Failure: Early Recognition of Congestive Heart Failure in the Primary Care Setting

&NA; Approximately 400,000 patients in the United States are newly diagnosed with congestive heart failure each year. The vast majority of these patients will not survive 5 years. Symptoms that indicate a decline in patient status often go unrecognized by providers. Early identification of insidious changes and prompt intervention can improve cardiac function and decrease the incidence of acute episodes and repeated hospitalizations. Nurse practitioners in the primary care setting are often called upon to manage these patients. By understanding the physiological changes as they occur and the underlying etiology, management is enhanced.
Glutathione S-transferase-pi overexpression is closely associated with K-ras mutation during human colon carcinogenesis.

BACKGROUND & AIMS In colorectal adenoma and carcinoma, glutathione S-transferase-pi (GSTP1-1) is highly expressed. K-ras mutation is also known to occur frequently in colorectal adenoma and carcinoma, as well as in the putative precursor of adenoma, aberrant crypt foci (ACF). Further, forced expression of v-H-ras in rat liver epithelial cells has been shown to enhance rat pi-class GST expression. The aim of the present study is, therefore, to investigate the causative relationship between GSTP1-1 overexpression and K-ras mutation in these lesions. METHODS Twenty-seven specimens of colorectal carcinoma, 24 of adenoma, and 28 of ACF were examined in this study. The expression of GSTP1-1 or p21(K-ras) was examined by immunohistochemistry. The GSTP1-1 messenger RNA levels were measured by TaqMan reverse-transcription polymerase chain reaction (PCR). K-ras mutation was detected by two-step PCR restriction fragment length polymorphism. v-K-ras transfection to RPMI-4788 colon carcinoma cells was carried out by the lipofection method. Activities of GSTP1-1 promoters containing AP-1 and Sp1 responsive elements in the v-K-ras transfectants were measured by a secreted form of human placental alkaline phosphatase (SEAP) assay. Nuclear protein from these transfectants bound to the GSTP1-1 promoter was analyzed by electrophoretic mobility shift assay (EMSA). RESULTS In human colorectal carcinoma, adenoma, and ACF, close association of increased expression of GSTP1-1 with K-ras mutation was observed. v-K-ras transfectants showed significantly higher SEAP activity than that of mock-transfectant activity. EMSA showed specific interaction of AP-1 with promoter of GSTP1-1. CONCLUSIONS It is highly plausible that GSTP1-1 overexpression in ACF, colorectal adenoma, and carcinoma is induced by K-ras mutation via AP-1 activation.
Comparative analysis of machine learning algorithms along with classifiers for network intrusion detection

Intrusion detection is one of the challenging problems encountered by the modern network security industry. A network has to be continuously monitored for detecting policy violation or suspicious traffic. So an intrusion detection system needs to be developed which can monitor network for any harmful activities and generate results to the management authority. Data mining can play a massive role in the development of a system which can detect network intrusion. Data mining is a technique through which important information can be extracted from huge data repositories. In order to spot intrusion, the traffic created in the network can be broadly categorized into following two categories- normal and anomalous. In our proposed paper, several classification techniques and machine learning algorithms have been considered to categorize the network traffic. Out of the classification techniques, we have found nine suitable classifiers like BayesNet, Logistic, IBK, J48, PART, JRip, Random Tree, Random Forest and REPTree. Out of the several machine learning algorithms, we have worked on Boosting, Bagging and Blending (Stacking) and compared their accuracies as well. The comparison of these algorithms has been performed using WEKA tool and listed below according to certain performance metrics. Simulation of these classification models has been performed using 10-fold cross validation. NSL-KDD based data set has been used for this simulation in WEKA.
Oxygen consumption and gill water flow in the dogfish Scyliorhinus canicula L.

1. Determinations of the standard oxygen consumption of the dogfish Scyliorhinus canicula , by several different methods, gave values in the range of 20-55 c.c. /kg. /hr. at 12°C. 2. When the rate of water flow over the resting fish is increased, there is an increase in oxygen consumption, but no marked change in respiratory frequency at the flow rates studied. An increase of respiratory frequency took place when the P O 2 of the inspired water was reduced. 3. The ventilation volume of the dogfish was measured by collecting the water in chambers after it had passed over the gills. The resting ventilation volume was about 120 c.c. /min./kg. at 12° C. 4. The relationship between the flow across the gills and the imposed hydrostatic pressure gradient (Δ p ) showed a linear relationship. The fish was unable to continue pumping water across the gills against adverse gradients in excess of 0.7 cm. H 2 O. 5. When the flow across the gills was relatively low, utilization of oxygen of at least 70% was observed, but with increasing flow rates this fell to between 40 and 50%.
Initial Assessment of the Effects of Radiation on the Electrical Characteristics of  ${\rm TaO}_{\rm x}$ Memristive Memories

Radiation-induced effects on the electrical characteristics of TaOx memristive (or redox) memory are experimentally assessed. 10 keV x-ray irradiation is observed to cause switching of the memristors from high to low resistance states, as well as functional failure due to cumulative dose. Gamma rays and 4.5 MeV energy protons are not observed to cause significant change in resistance state or device function at levels up to 2.5 Mrad(Si) and 5 Mrad(Si) protons, respectively. 105 MeV and 480 MeV protons cause switching of the memristors from high to low resistance states in some cases, but do not exhibit a consistent degradation. 800 keV silicon ions are observed to cause resistance degradation, with an inverse dependence of resistance on oxygen vacancy density. Variation between different devices appears to be a key factor in determining the electrical response resulting from irradiation. The proposed degradation mechanism likely involves the creation of oxygen vacancies, but a better fundamental understanding of switching is needed before a definitive understanding of radiation degradation can be achieved.
Pharmacotherapy of systemic lupus erythematosus

The pharmacological management of systemic lupus erythematosus (SLE) is challenging owing to its unpredictable clinical course, the variable organ system involvement and the lack of clear understanding of disease pathogenesis. The widely used corticosteroids and immunosuppressive drugs, which can control disease activity, have serious, potentially fatal, side effects. In the last decade, a better understanding of lupus pathogenesis has led to the development of biological agents that are directed at biomarkers. However, these biologicals also exert side effects due to infections resulting from completely eliminating immune cells (e.g., B cells) or cytokine signals (e.g., interferon-α) or affecting molecular targets outside the immune system (CD40L on platelets). New biomarker-driven clinical trials are ongoing to evaluate the safety and efficacy of B-cell depletion, blocking of interferon signaling, inhibition of the mTOR pathway, and restoration of glutathione deficiency in lupus T cells.
Design and testing of a cyclic stretch and flexure bioreactor for evaluating engineered heart valve tissues based on poly(glycerol sebacate) scaffolds

Cyclic flexure and stretch are essential to the function of semilunar heart valves and have demonstrated utility in mechanically conditioning tissue-engineered heart valves. In this study, a cyclic stretch and flexure bioreactor was designed and tested in the context of the bioresorbable elastomer poly(glycerol sebacate). Solid poly(glycerol sebacate) membranes were subjected to cyclic stretch, and micromolded poly(glycerol sebacate) scaffolds seeded with porcine aortic valvular interstitial cells were subjected to cyclic stretch and flexure. The results demonstrated significant effects of cyclic stretch on poly(glycerol sebacate) mechanical properties, including significant decreases in effective stiffness versus controls. In valvular interstitial cell-seeded scaffolds, cyclic stretch elicited significant increases in DNA and collagen content that paralleled maintenance of effective stiffness. This work provides a basis for investigating the roles of mechanical loading in the formation of tissue-engineered heart valves based on elastomeric scaffolds.
Temporal and Spatial Mouse Brain Expression of Cereblon, An Ionic Channel Regulator Involved in Human Intelligence

Abstract: A mild form of autosomal recessive, nonsyndromal intellectual disability (ARNSID) in humans is caused by a homozygous nonsense mutation in the cereblon gene (mutCRBN). Rodent crbn protein binds to the intracellular C-terminus of the large conductance Ca2+-activated K+channel (BKCa). An mRNA variant (human SITE 2 INSERT or mouse strex) of the BKCa gene (KCNMA1) that is normally expressed during embryonic development is aberrantly expressed in mutCRBN human lymphoblastoid cell lines (LCLs) as compared to wild-type (wt) LCLs. The present study analyzes the temporal and spatial distribution of crbn and kcnma1 mRNAs in the mouse brain by the quantitative real-time reverse transcriptase–polymerase chain reaction (qPCR). The spatial expression pattern of endogenous and exogenous crbn proteins is characterized by immunostaining. The results show that neocortical (CTX) crbn and kcnma1 mRNA expression increases from embryonic stages to adulthood. The strex mRNA variant is >3.5-fold higher in embryos and decreases rapidly postnatally. Mouse crbn mRNA is abundant in the cerebellum (CRBM), with less expression in the CTX, hippocampus (HC), and striatum (Str) in adult mice. The intracytoplasmic distribution of endogenous crbn protein in the mouse CRBM, CTX, HC, and Str is similar to the immunostaining pattern described previously for the BKCa channel. Exogenous hemagglutinin (HA) epitope–tagged human wt- and mutCRBN proteins using cDNA transfection in HEK293T cell lines showed the same intracellular expression distribution as endogenous mouse crbn protein. The results suggest that mutCRBN may cause ARNSID by disrupting the developmental regulation of BKCa in brain regions that are critical for memory and learning.
TRAIL‐R2: a novel apoptosis‐mediating receptor for TRAIL

TRAIL is a member of the tumor necrosis factor (TNF) family of cytokines and induces apoptosis in a wide variety of cells. Based on homology searching of a private database, a receptor for TRAIL (DR4 or TRAIL‐R1) was recently identified. Here we report the identification of a distinct receptor for TRAIL, TRAIL‐R2, by ligand‐based affinity purification and subsequent molecular cloning. TRAIL‐R2 was purified independently as the only receptor for TRAIL detectable on the surface of two different human cell lines that undergo apoptosis upon stimulation with TRAIL. TRAIL‐R2 contains two extracellular cysteine‐rich repeats, typical for TNF receptor (TNFR) family members, and a cytoplasmic death domain. TRAIL binds to recombinant cell‐surface‐expressed TRAIL‐R2, and TRAIL‐induced apoptosis is inhibited by a TRAIL‐R2–Fc fusion protein. TRAIL‐R2 mRNA is widely expressed and the gene encoding TRAIL‐R2 is located on human chromosome 8p22‐21. Like TRAIL‐R1, TRAIL‐R2 engages a caspase‐dependent apoptotic pathway but, in contrast to TRAIL‐R1, TRAIL‐R2 mediates apoptosis via the intracellular adaptor molecule FADD/MORT1. The existence of two distinct receptors for the same ligand suggests an unexpected complexity to TRAIL biology, reminiscent of dual receptors for TNF, the canonical member of this family.
The Preparation of Self-formed PDMS Nanostructures by RIE Etching

In this study, a novel fabrication method of nanostructure by reactive ion etching (RIE) process on PDMS without predefinition of nanopattern is proposed. During etching process, self-formed high-aspect-ratio nanostructure was observed on PDMS surface adjacent to SiO2 area, suggested the provision of nano masks from the SiO2 residue during RIE etching. In tuning the flow rate of working gases (CF4, O2), the distribution of nanostructure can be controlled. Furthermore, it was observed that different species of nanostructures could be fabricated by the selection of mask materials (SiO2, Cu) under RIE etching.
Thrombolysis for Ischemic Stroke in Children: Data From the Nationwide Inpatient Sample

Background and Purpose— Few pediatric reports of thrombolysis exist. We sought to determine national rates of thrombolysis among pediatric ischemic stroke patients using a national database. Methods— Patients between the ages of 1 and 17 years, entered in the Nationwide Inpatient Sample between 2000 and 2003, with International Classification of Diseases codes for ischemic stroke were included in the study. Differences in mean age, gender distribution, ethnicity, secondary diagnoses, medical complications, associated procedure rates, modes of discharge, and hospital costs between pediatric stroke patients receiving and not receiving thrombolysis were estimated. Results— In the United States, between 2000 and 2003 an estimated 2904 children were admitted with ischemic stroke, of which 46 children (1.6%) received thrombolytic therapy. Children who received thrombolysis were on the average older (11 versus 9 years), more likely to be male (100% versus 53.8%), with significantly higher hospital costs ($81 800 versus $38 700). These children were also less likely to be discharged home with higher rates of death and dependency, although differences in clinical severity between the 2 groups was not known. Conclusion— Thrombolysis, though not indicated for patients <18 years of age, is currently being administered to children, with unclear benefit. Larger studies are needed to evaluate the safety and efficacy of this treatment for children.
Summary of best efficient algorithms on cognitive radio cooperative spectrum sensing to improve QoS

Cooperative spectrum sensing (CSS) in cognitive radio (CR) has been widely investigated to be considered as a spectrum scanning mechanism that allows secondary users or cognitive radio users (SUs) to use detected spectrum holes caused by primary users (PUs) absence. This paper focuses on optimality of analytical study on the common soft fusion (SDF) CSS based on different iterative algorithms which confirm low total probability of error and high probability of detection in details. In fact, all steps of genetic algorithm (GA), particle swarm optimization (PSO) and imperialistic competitive algorithm (ICA) will be well mentioned in details and investigated on cognitive radio cooperative spectrum sensing (CRCSS) method. Then, the performance of CRCSS employing GA, POS and ICA based scheme is analyzed in MATLAB simulation to show superiority of these schemes over other conventional schemes in terms of detection and error performance with very less complexity. In addition, the ICA-based scheme also indicates promising convergence and time running performance as compared to other schemes.