Miracle-dz/UniFAR-FTUs huggingface dataset:
Comment on: How much basic science content do second-year medical students remember from their first year?

It was interesting to see the focus on simulation-based teaching in the recent issue of Medical Teacher. As final year medical students at the University of Bristol, we have experienced a curriculum emphasizing simulation teaching throughout our training. Of particular interest was the article by Eppich et al. (2018) exploring the need for telephone communication training. Typically, our simulation sessions involve immersive manikin-based clinical scenarios which are concluded by simulating telephone communications with a senior colleague. Peer discussion reveals that prior to this, students are often unsure of how to effectively communicate information clearly and concisely. From the results of their analysis, this appears to be common, and we feel fortunate to have received training in how to engage effectively with other clinicians over the telephone. Integrating this into simulation sessions has been of utmost benefit as it allows students to voice their concerns and perceived areas of weakness ahead of time, creating structured learning objectives to be addressed. Allowing students to practice conversations with a facilitator, usually a clinical teaching fellow who is known to the student creates an environment of trust and support, avoiding potential tensions that may arise from a trial-and-error approach associated with learning on the job. Scenarios are followed by a debrief, during which feedback on communication is given with explicit learning points identified and discussed. This allows students to further familiarize themselves with their strengths and weaknesses and allows opportunities to ask questions outside the time-pressured environment of the wards. Any conversational interruptions are addressed which, as mentioned, are often manifestations of “disguised” feedback. Discussion provokes students to recognize this pattern of behavior, enabling recognition of further learning opportunities in future conversations. Having had opportunities to practice these skills in a variety of scenarios we feel more confident in our ability to communicate effectively as junior doctors. It would be interesting for future research to compare experiences across different programs and establish how such training has been implemented, and whether students experience beneficial effects or not.
IFN-γR2 is strongly expressed on endothelial cells of gingival tissues from patients with chronic periodontitis

Abstract Chronic periodontitis (CP) is characterized by gingival inflammation and bone destruction. It has been reported that interferon-gamma (IFN-γ) levels are high in CP patients; however, the IFN-γ receptor (IFN-γR) has not been studied in gingival tissue from these patients. Objective: To evaluate IFN-γ levels and IFN-γR expression in gingival tissue biopsies from chronic periodontitis patients compared with healthy subjects (HS). Material and Methods: Gingival tissues were obtained from all study subjects, CP (n = 18) and healthy subjects (HS) (n = 12). A tissue section of each study subject was embedded in paraffin blocks to determine the expression of IFN-γ R (IFN-γR1 and IFN-γR2) through immunohistochemistry. Another section of the tissue was homogenized and IFN-γ was measured by the ELISA technique. Results: No significant differences were found in the IFN-γR1 expression within the cell layers of the gingival tissue of the study groups. When analyzing the IFN-γR2 expression it was found that IFN-γR2 is strongly expressed in the endothelial cells of CP patients when compared to HS (p<0.05). IFN-γ concentrations in the gingival tissue were significantly higher in CP patients than in HS. No significant correlation between IFN-γ levels and the expression of IFN-γR1 and IFN-γR2 was found. However, a positive correlation between IFN-γ levels and clinical parameters [probing depth (PD) and clinical attachment level (CAL)] was found. Conclusion: The study of IFN-γR expression in gingival tissue samples from patients with CP showed an increase only in the IFN-γR2 chain in endothelial cells when compared to HS.
Dysregulation of FTX/miR‐545 signaling pathway downregulates Tim‐3 and is responsible for the abnormal activation of macrophage in cirrhosis

Accumulating evidence has suggested the involvement of miR‐545 and long noncoding RNA (lncRNA) FTX in a wide range of diseases. Therefore, this study aimed to investigate the molecular mechanism underlying the function of miR‐545 and lncRNA FTX in hepatitis B virus (HBV)‐related cirrhosis.
Prevalence and factors associated with fat-soluble vitamin deficiency in adolescents.

BACKGROUND fat-soluble vitamin deficiency may be a health problem not recognized in children and adolescents. OBJECTIVE to estimate the prevalence and factors associated with the deficiency of vitamins A, D and E among adolescent students from Northeastern Brazil. METHODS transversal study with adolescents aged 12 to 19 of both genders. A questionnaire to collect socioeconomic and lifestyle data and food intake was applied to adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of retinol, β-carotene, α-tocopherol and 25-hydroxy vitamin D (25[OH]D). RESULTS the intake of vitamins A (50.3%), E (94.0%) and D (99.8%), as well as α-tocopherol (88.1%), β-carotene (74.1%), 25(OH)D (50.9%) and retinol (46.6%) serum levels were mostly deficient/insufficient. An increased risk of α-tocopherol deficiency was observed in girls (PR = 1.11) and an increased risk of 25(OH)D deficiency was observed in boys (PR = 1.41). An increased likelihood of β-carotene (PR = 1.14) and 25(OH) D (PR = 1.38) insufficiency was observed in overweight individuals. CONCLUSIONS the adolescents had a deficit in the intake and in serum levels of fat-soluble vitamins. The greatest risk of inadequacy was associated with gender and weight excess. However, the behavior of fat-soluble vitamins in adolescents needs further research.
Learning From Non-Acceptance: Design Dimensions for User Acceptance of E-Triage Systems

As of 26 December 2016, seventeen electronic triage systems for disaster triage have been proposed in the ACM, IEEE, and ISCRAM publication databases. Most of these systems have remained inside the laboratory; the rest have disappeared entirely. Responders still prefer to do triage with paper tags from the 1960’s, while no research has been presented on why the proposed e-triage systems have not found acceptance and use in the field. Based on exhaustive literature research and on the findings from the four-year long, EU research project BRIDGE , this paper presents e-triage acceptance dimensions, analyzes the main reasons why proposed systems have been rejected, and guides designers towards upcoming, well-accepted e-triage systems.
Recombinant GII.P16/GII.4 Sydney 2012 Was the Dominant Norovirus Identified in Australia and New Zealand in 2017

For the past two decades, norovirus pandemic variants have emerged every 3–5 years, and dominate until they are replaced by alternate strains. However, this scenario changed in 2016 with the co-circulation of six prevalent viruses, three of which possessed the pandemic GII.4 Sydney 2012 capsid. An increased number of institutional gastroenteritis outbreaks were reported within the Oceania region in mid-2017. This study identified emerging noroviruses circulating in Australia and New Zealand in 2017 to assess the changing dynamics of the virus infection. RT-PCR-based methods, next generation sequencing, and phylogenetic analyses were used to genotype noroviruses from both clinical and wastewater samples. Antigenic changes were observed between the capsid of pandemic Sydney 2012 variant and the two new Sydney recombinant viruses. The combination of these antigenic changes and the acquisition of a new ORF1 through recombination could both facilitate their ongoing persistence in the population. Overall, an increased prevalence of GII.P16/GII.4 Sydney 2012 viruses was observed in 2017, replacing the GII.P16/GII.2 recombinant that dominated in the region at the end of 2016. This shift in strain dominance was also observed in wastewater samples, demonstrating the reliability of wastewater as a molecular surveillance tool.
Protective Immune Responses Generated in a Murine Model Following Immunization with Recombinant Schistosoma japonicum Insulin Receptor

There is a pressing need to develop vaccines for schistosomiasis given the current heavy dependency on praziquantel as the only available drug for treatment. We previously showed the ligand domain of the Schistosoma japonicum insulin receptor 1 and 2 (rSjLD1 and 2) fusion proteins conferred solid protection in mice against challenge infection with S. japonicum. To improve vaccine efficacy, we compared the immunogenicity and protective efficacy of rSjLD1 on its own and in combination with S. japonicum triose-phosphate isomerase (SjTPI), formulated with either of two adjuvants (QuilA and montanide ISA 720VG) in murine vaccine trials against S. japonicum challenge. The level of protection was higher in mice vaccinated only with rSjLD1 formulated with either adjuvant; rSjTPI or the rSjTPI-rSjLD1 combination resulted in a lower level of protection. Mirroring our previous results, there were significant reductions in the number of female worms (30–44%), faecal eggs (61–68%), liver eggs (44–56%), intestinal eggs (46–48%) and mature intestinal eggs (58–63%) in the rSjLD1-vaccinated mice compared with the adjuvant only groups. At 6-weeks post-cercarial challenge, a significantly increased production of interferon gamma (IFNγ) in rSjLD1-stimulated splenic CD4+ T cells was observed in the rSjLD1-vaccinated mice suggesting a Th1-type response is associated with the generated level of protective efficacy.
Real-Time fMRI control of a humanoid robot using two brain Networks simultaneously: a Pilot Study

: We have previously shown that real-time fMRI, despite the low temporal resolution of the BOLD signal, can be used for BCI navigation, using motor-imagery and -execution. Here we leverage the superior spatial resolution of fMRI to implement a BCI paradigm going beyond a single brain network for control, while retaining an intuitive mapping between brain activity and BCI functionality. The experiments simulate non-trivial navigation and item selection tasks by a subject teleop-erating an HRP-4 humanoid-robot. Motor actions are mapped into simple navigation commands inside a room and visual attention is mapped to direct the robot’s arm toward one of three objects placed on a table. When the correct item has been selected, the subject navigates the robot toward the experimenter in order to simulate the delivery of the object. We describe a method based on two parallel classiﬁers, with four and three classes (independent of the ﬁrst four), ofﬂine and real-time classiﬁcation results from a single-subject pilot, performing several times.
Protective Effects of Yinchenhao Decoction on Cholesterol Gallstone in Mice Fed a Lithogenic Diet by Regulating LXR, CYP7A1, CYP7B1, and HMGCR Pathways

The study attempted to elucidate whether lipid genes are closely associated with lipid metabolic abnormalities during the lithogenic time and how Yinchenhao Decoction (YCHD) works on the transcriptions of lipid genes against cholesterol gallstone model. C57BL/6J mice fed on lithogenic diet (LD) were used for model establishment and randomized into 5 groups. All groups received LD for different weeks with isometrically intragastric administration of YCHD or NS. Biochemical tests were measured and liver tissues were harvested for histological and genetic detection. It was found that all groups with increasing LD showed a following tendency of gallstone incidence, bile cholesterol, phospholipids, total bile acid, and cholesterol saturation index (CSI). Conversely, YCHD could significantly normalize the levels of gallstone incidence, bile lipids, and CSI (CSI<1). As lithogenic time progressed, ABCG5, ABCG8, PPAR-α, and ABCB4 were upregulated, and SREBP2, CYP7A1, and CYP7B1 were downregulated, while CYP7A1, CYP7B1, LXR, and HMGCR mRNA were increased 3-fold under the administration of YCHD. It was concluded that abnormal expressions of the mentioned genes may eventually progress to cholesterol gallstone. CYP7A1, CYP7B1, LXR, and HMGCR mRNA may be efficient targets of YCHD, which may be a preventive drug to reverse liver injury, normalize bile lipids, facilitate gallstone dissolution, and attenuate gallstone formation.
Detection and classification of islanding and power quality disturbances in microgrid using hybrid signal processing and data mining techniques

This study presents multi-scale morphological gradient filter (MSMGF) and short-time modified Hilbert transform (STMHT) techniques, respectively, to detect and classify multiclass power system disturbances in a distributed generation (DG)-based microgrid environment. The non-stationary power signal samples measured near the target DG's are processed through the proposed MSMGF and STMHT techniques, respectively, and some computations over them generates the target parameter sets. Depending on the complexity of the overlapping in the target attribute values for different disturbance patterns, fuzzy judgment tree structure is incorporated for multiclass event classification, which proves to be robust for most of the classes. In this regard, an extensive simulation on the proposed microgrid models, subjected to a number of multiclass disturbances has been performed in MATLAB/Simulink environment. The faster execution, lower computational burden, superior efficiency as well as better accuracy in multiclass power system disturbance classification by the proposed judgment tree-based MSMGF and STMHT techniques, respectively, as compared to some of the conventional techniques, is significantly illustrated in the performance evaluation section. Further, as illustrated in this section, the real-time capability of the proposed techniques has been verified in the hardware environment, where the results shown are satisfactory.
Sensing and Reliability Improvement of Electrostatic-Discharge Transient by Discrete Engineering for High-Voltage 60-V n-Channel Lateral-Diffused MOSFETs with Embedded Silicon-Controlled Rectifiers

High-voltage n-channel lateral-diffused metal-oxide-semiconductor field-effect transistor (nLDMOS) components, fabricated by a TSMC 0.25-μm 60-V bipolar-CMOS-DMOS (BCD) process with drain-side embedded silicon-controlled rectifier (SCR) of the n-p-n-arranged and p-n-p-arranged types, were investigated, in order to determine the devices’ electrostatic discharge (ESD)-sensing behavior and capability by discrete anode engineering. As for the drain-side n-p-n-arranged type with discrete-anode manners, transmission–line–pulse (TLP) testing results showed that the ESD ability (It2 value) was slightly upgraded. When the discrete physical parameter was 91 rows, the optimal It2 reached 2.157 A (increasing 17.7% compared with the reference sample). On the other hand, the drain-side SCR p-n-p-arranged type with discrete-anode manner had excellent SCR behavior, and its It2 values could be increased to >7 A (increasing >281.9% compared with the reference DUT). Moreover, under discrete anode engineering, the drain-side SCR n-p-n-arranged and p-n-p-arranged types had clearly higher ESD ability, except for the few discrete physical parameters. Therefore, using the anode discrete engineering, the ESD dissipation ability of a high-voltage (HV) nLDMOS with drain-side SCRs will have greater effectiveness.
Algorithm for realisation, parameter analysis, and measurement of pipelined separable 3D finite impulse response filters composed of Givens rotation structures

: A novel algorithm for the realisation of an orthogonal digital system performing three-dimensional filtering for a separable transfer function is presented in this study. The algorithm is based on a state-space approach and consists of synthesis and implementation algorithms. A structure composed of Givens rotators and delay elements is obtained. A coordinate rotation digital computer algorithm has been used to implement Givens rotators in a pipelined structure. The obtained structure has been realised on a field-programmable gate array (FPGA) chip and its performance has been evaluated. It achieved good finite precision, good sensitivity of filter amplitude to filter coefficients, less noise, better impulse response, and less FPGA chip occupation. To verify the obtained results, they have been compared to the results obtained using a direct-form structure consisting of adders, multipliers, and delay elements.
Where am I in virtual reality?

It is currently not well understood whether people experience themselves to be located in one or more specific part(s) of their body. Virtual reality (VR) is increasingly used as a tool to study aspects of bodily perception and self-consciousness, due to its strong experimental control and ease in manipulating multi-sensory aspects of bodily experience. To investigate where people self-locate in their body within virtual reality, we asked participants to point directly at themselves with a virtual pointer, in a VR headset. In previous work employing a physical pointer, participants mainly located themselves in the upper face and upper torso. In this study, using a VR headset, participants mainly located themselves in the upper face. In an additional body template task where participants pointed at themselves on a picture of a simple body outline, participants pointed most often to the upper torso, followed by the (upper) face. These results raise the question as to whether head-mounted virtual reality might alter where people locate themselves making them more “head-centred”.
Primary pulmonary sarcoma – long-term treatment outcomes and prognostic factors

Introduction Primary pulmonary sarcoma (PPS) is a rare type of non-epithelial malignant tumour of the lungs. Lung sarcomas are usually of metastatic character, originating from the primary tumour located in another organ. Pathomorphological diagnosis is difficult and therefore definitive diagnosis is usually determined after surgical treatment. Five-year survival of radical operated patients is 42–69%. Aim To evaluate prognostic factors in PPS. Material and methods Twenty-two patients who underwent surgical treatment between 1994 and 2009 were analysed. Results Ten types of sarcomas were identified. All 22 analysed patients underwent operations and in 14 (63.6%) cases it was R0 resection (pneumonectomies, lobectomies, non-anatomical resections). In 8 out of 22 patients a locally advanced form was identified. Median overall survival (OS) in the group of all patients was 22 months, 5- and 10-year OS was 27% and 18% respectively, whereas in patients who underwent non-anatomical lung resections it was 80% and 60% respectively with median OS of 213 months. Overall survival was dependent on gender, completeness of treatment and size of tumour. Haemoptysis was a poor prognostic factor. Primitive neuroectodermal tumour was a type of sarcoma with a negative effect on progression-free survival. No impact of age, type of sarcoma, degree of histological malignancy, stage or adjuvant treatment on OS was noted. Conclusions Primary radical surgical resection prolongs patient survival. Patients with tumours larger than 5 cm and men have worse prognoses. Future studies conducted on larger groups of patients diagnosed with PPS are necessary.
Anti‐influenza activity of berberine improves prognosis by reducing viral replication in mice

Berberine, a natural isoquinoline alkaloid isolated from the berberis species, has a wide array of biological properties such as anti‐inflammatory, antibacterial, antifungal, and antihelminthic effects. We evaluated the antiviral effect of berberine against influenza A/FM1/1/47 (H1N1) in vivo and in vitro. The results showed that berberine strongly suppressed viral replication in A549 cells and in mouse lungs. Meanwhile, berberine relieved pulmonary inflammation and reduced necrosis, inflammatory cell infiltration, and pulmonary edema induced by viral infection in mice when compared with vehicle‐treated mice. Berberine suppressed the viral infection‐induced up‐regulation of TLR7 signaling pathway, such as TLR7, MyD88, and NF‐κB (p65), at both the mRNA and protein levels. Furthermore, berberine significantly inhibited the viral infection‐induced increase in Th1/Th2 and Th17/Treg ratios as well as the production of inflammatory cytokines. Our data provide new insight into the potential of berberine as a therapeutic agent for viral infection via its antiviral activity.
Regaining agency and autonomy: A grounded typology of concealed pregnancy

AIM To explore and understand the experience of concealed pregnancy and develop a framework for practitioners. BACKGROUND Numerous cases of concealed pregnancy resulting in serious outcomes including maternal and perinatal death, newborn abandonment, and neonaticide are reported internationally. Historically concealed pregnancy is associated with oppressive religious cultures where premarital pregnancy was shunned. Concealed pregnancy has traditionally been viewed through a biomedical lens and associated with mental illness but this assertion remains unsubstantiated by robust evidence. DESIGN A Glaserian grounded theory study was undertaken. DATA SOURCES Thirty women were interviewed, between 2014 - 2016, on up to three occasions (46 interviews) and 22 cases of public interest were included as data. METHODS The constant comparative method and theoretical sampling which are the analytical strategies of grounded theory were used to analyse the data and generate the typology. RESULTS Concealed pregnancy is a fearful, life-altering, and traumatic experience. Women with a history of controlling and oppressive relationships characterized by fear respond to a crisis pregnancy by keeping it secret. Many women's relationships were characterized by emotional, mental, sexual, or physical violence. Fear for one's survival is common, may render women unable to access care or support and can be so extreme that a woman may end her own life or give birth alone. CONCLUSIONS This typology of concealed pregnancy is intended to aid understanding the fear, trauma, and complexities associated with concealed pregnancy which is vital if practitioners are to provide sensitive, responsive and non-judgemental care.
Stomatin‐like protein‐2 relieve myocardial ischemia/reperfusion injury by adenosine 5′‐monophosphate‐activated protein kinase signal pathway

Previous studies have shown that stomatin‐like protein‐2 (SLP‐2) could regulate mitochondrial biogenesis and function. The study was designed to explore the contribution of SLP‐2 to the myocardial ischemia and reperfusion (I/R) injury. Anesthetized rats were treated with SLP‐2 and subjected to ischemia for 30 minutes before 3 hours of reperfusion. An oxygen‐glucose deprivation/reoxygenation model of I/R was established in H9C2 cells. In vivo, SLP‐2 significantly improved cardiac function recovery of myocardial I/R injury rats by increasing fractional shortening and ejection fraction. SLP‐2 pretreatment alleviated infarct area and myocardial apoptosis, which was paralleled by decreasing the level of cleaved caspase‐3 and the ratio of Bax/Bcl‐2, increasing the content of superoxide dismutase and reducing oxidative stress damage in serum. In addition, SLP‐2 increased the level of ATP and stabilized mitochondrial potential (Ψm). The present in vitro study revealed that overexpression with SLP‐2 reduced H9C2 cells apoptosis, accompanied by an increased level of ATP, the ratio of mitochondrial DNA/nuclear DNA, activities of complex II and V, and decreased the production of mitochondrial reactive oxygen species. Simultaneously, SLP‐2 activated the adenosine 5′‐monophosphate‐activated protein kinase (AMPK) signaling pathway in myocardial I/R injury rats and H9C2 cells. This study revealed that SLP‐2 mediates the cardioprotective effect against I/R injury by regulating AMPK signaling pathway.