Miracle-dz/UniFAR-FTUs huggingface dataset:
Design, Dissemination, and Evaluation of an Advanced Communication Elective at Seven U.S. Medical Schools

Purpose To test educational methods that continue communication training into the fourth year of medical school. Method The authors disseminated and evaluated an advanced communication elective in seven U.S. medical schools between 2007 and 2009; a total of 9 faculty and 22 fourth-year students participated. The elective emphasized peer learning, practice with real patients, direct observation, and applications of video technology. The authors used qualitative and quantitative survey methods and video review to evaluate the experience of students and faculty. Results Students reported that the elective was better than most medical school clerkships they had experienced. Their self-confidence in time management and in the use of nine communication skills improved significantly. The most valued course components were video review, repeated practice with real patients, and peer observation. Analysis of student videos with real patients and in role-plays showed that some skills (e.g., agenda setting, understanding the patient perspective) were more frequently demonstrated than others (e.g., exploring family and cultural values, communication while using the electronic health record). Faculty highly valued this learner-centered model and reported that their self-awareness and communication skills grew as teachers and as clinicians. Conclusions Learner-centered methods such as peer observation and video review and editing may strengthen communication training and reinforce skills introduced earlier in medical education. The course design may counteract a “hidden curriculum” that devalues respectful interactions with trainees and patients. Future research should assess the impact of course elements on skill retention, attitudes for lifelong learning, and patients’ health outcomes.
Cutting Edge: Itk-Dependent Signals Required for CD4+ T Cells to Exert, but Not Gain, Th2 Effector Function1

The TCR signals for the release of CD4 effector function are poorly understood. Itk plays an essential role in Th2, but not Th1, responses. However, when Itk is required during Th2 development is unclear. We followed the fate of Itk-deficient T cells during Th2 development in vitro and in vivo using an IL-4/GFP reporter. Surprisingly, a similar frequency of itk−/− CD4+ cells differentiated and committed to the Th2 lineage as wild-type cells. However, Itk-deficient Th2 cells failed to exert effector function upon TCR triggering. Loss of function was marked by defective transcriptional enhancement of Th2 cytokines and GATA3. IL-4 production in itk−/− Th2s could be rescued by the expression of kinase-active Itk. Thus, Itk is necessary for the release, but not gain, of Th2 function. We suggest that the liberation of effector function is tightly controlled through qualitative changes in TCR signals, facilitating postdifferentiation regulation of cytokine responses.
Age‐related changes of regional pulse wave velocity in the descending aorta using Fourier velocity encoded M‐mode

Aortic pulse wave velocity (PWV) is an independent determinant of cardiovascular risk. Although aortic stiffening with age is well documented, the interaction between aging and regional aortic PWV is still a debated question. We measured global and regional PWV in the descending aorta of 56 healthy subjects aged 25–76 years using a one‐dimensional, interleaved, Fourier velocity encoded pulse sequence with cylindrical excitation. Repeatability across two magnetic resonance examinations (n = 19) and accuracy against intravascular pressure measurements (n = 4) were assessed. The global PWV was found to increase nonlinearly with age. The thoracic aorta was found to stiffen the most with age (PWV [thoracic, 20–40 years] = 4.7 ± 1.1 m/s; PWV [thoracic, 60–80 years] = 7.9 ± 1.5 m/s), followed by the mid‐ (PWV [mid‐abdominal, 20–40 years] = 4.9 ± 1.3 m/s; PWV [mid‐abdominal, 60–80 years] = 7.4 ± 1.9 m/s) and distal abdominal aorta (PWV [distal abdominal, 20–40 years] = 4.8 ± 1.4 m/s; PWV [distal abdominal, 60–80 years] = 5.7 ± 1.4 m/s). Good agreement was found between repeated magnetic resonance measurements and between magnetic resonance PWVs and the gold‐standard. Fourier velocity encoded M‐mode allowed to measure global and regional PWV in the descending aorta. There was a preferential stiffening of the thoracic aorta with age, which may be due to progressive fragmentation of elastin fibers in this region. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
A 90nm CMOS Dual-Channel Powerline Communication AFE for Homeplug AV with a Gb Extension

Powerline communications is currently emerging as a strong candidate for in-home multi-media content distribution. Recently, products have become available that support 200Mb/s rates over the existing electrical wiring, which is high enough to allow streaming of multiple high-definition content. HomePlugAV is one such 200Mb/s powerline modem standard. However, for these devices to fully realize the market potential, the total application cost must be reduced and performance enhancements enabling increased network throughput must be made. Currently, HomePlug-AV products require 4 chips to implement the modem function: a processor, an external memory, an AFE, and an external line driver. With this in mind, this work describes an integrated sub-micron CMOS AFE meeting the HomePlug-AV standard, but with additional Gb/s capability. The gigabit AFE was developed for use over phoneline, coax, and powerline. In this paper we focus on its application for powerline communications.
Endoleaks after endovascular abdominal aortic aneurysm repair: what one needs to know

Purpose of review To review the current state of diagnosis, treatment, and outcomes of the different types of endoleaks after endovascular abdominal aortic aneurysm repair (endovascular aneurysm repair, EVAR). Recent findings Endoleaks are the most frequent complication after EVAR, the most common indication for secondary interventions, and the most common cause of rupture after EVAR. Imaging is critical for detecting endoleaks. Type I and III endoleaks require urgent intervention to prevent aneurysm rupture. Intervention for other endoleaks or endotension is indicated if the aneurysm sac continues to grow during follow-up. The majority of endoleaks can be treated with endovascular techniques. Open surgical conversion may be considered if the risk of aneurysm rupture is high and if no endovascular options are available or if they have failed. Summary Endoleaks continue to be a challenge and this article discusses the different treatment options for endoleaks after EVAR. Long-term follow-up after EVAR is required to diagnose and treat endoleaks before they result in aneurysm rupture. The majority of endoleaks can be treated with endovascular techniques, although open surgical interventions may be required in selected patients.
A novel synchronization method designed for single-phase distorted grid

Grid synchronization has always been a great challenge for single-phase gird-connected converters since only one signal is provided and it is beneficial for the control system if grid information is obtained rapidly and accurately. In this paper, a novel quadrature signal generation algorithm and a phase-locked loop based on it are proposed and analyzed. The proposed algorithm functions as two finite impulse response filters that can eliminate most harmonics in the input signal and the introduced phase-locked loop shows great harmonic cancellation ability with transient response less than half a cycle. Analysis, along with simulation and experimental results are presented to verify the feasibility and effectiveness of the proposed quadrature signal generation method and phase-locked loop structure.
Comparison of intracoronary adenosine and isosorbide dinitrate on no-reflow/slow flow during rotational atherectomy

Objective — To compare the effect of intracoronary adenosine and isosorbide dinitrate (ISDN) on no-reflow/slow flow during high-speed rotational atherectomy (HSRA) in patients with complex coronary artery disease (CAD). Methods and results — Medical records from consecutive patients diagnosed with complex CAD between November 2002 and March 2006 who underwent HSRA at the Tri-Service General Hospital, National Defence Medical Centre in Taipei, Taiwan, were included in this study. Patients in the adenosine group (n = 32) received a 50 mg intracoronary adenosine bolus prior to the initiation of burr rotation and during each ablation. Patients in the ISDN group (n = 58) received a 0.5 mg intracoronary ISDN bolus at comparable time points. Angiographic success was achieved in 100% of patients in the adenosine group and 98.3% (57/58) in the ISDN group.The procedural success rates were 96.9% (31/32) in the adenosine group and 89.7% (52/58) in the ISDN group. One patient (3.1%) from the adenosine group and six patients (10.3%) from the ISDN group experienced no-reflow/slow flow (P = 0.414). No in-hospital mortality occurred and target vessel revascularization was unnecessary. Conclusions — Intracoronary administration of either adenosine or ISDN during HSRA appears safe and administration of either agent may be effective in decreasing the incidence of no-reflow/slow flow during HSRA. Further large, prospective, randomized, placebo-controlled trials are required.
Analysis of Risk Factors for Myocardial Infarction and Cardiac Mortality after Major Vascular Surgery

Background Patients undergoing vascular surgical procedures are at high risk for perioperative myocardial infarction (PMI). This study was undertaken to identify predictors of PMI and in-hospital death in major vascular surgical patients. Methods From the Vascular Surgery Registry (6,948 operations from January 1989 through June 1997) the authors identified 107 patients in whom PMI developed during the same hospital stay. Case–control patients (patients without PMI) were matched at a 1×:×1 ratio with index cases according to the type of surgery, gender, patient age, and year of surgery. The authors analyzed data regarding preoperative cardiac disease and surgical and anesthetic factors to study association with PMI and cardiac death. Results By using univariable analysis the authors identified the following predictors of PMI: valvular disease (P = 0.007), previous congestive heart failure (P = 0.04), emergency surgery (P = 0.02), general anesthesia (P = 0.03), preoperative history of coronary artery disease (P = 0.001), preoperative treatment with &bgr;-blockers (P = 0.003), lower preoperative (P = 0.03) and postoperative (P = 0.002) hemoglobin concentrations, increased bleeding rate (as assessed from increased cell salvage;P = 0.025), and lower ejection fraction (P = 0.02). Of the 107 patients with PMI, 20.6% died of cardiac cause during the same hospital stay. The following factors increased the odds ratios for cardiac death: age (P = 0.001), recent congestive heart failure (P = 0.01), type of surgery (P = 0.04), emergency surgery (P = 0.02), lower intraoperative diastolic blood pressure (P = 0.001), new intraoperative ST-T changes (P = 0.01), and increased intraoperative use of blood (P = 0.005). Patients who underwent coronary artery bypass grafting, even more than 12 months before index surgery, had a 79% reduction in risk of death if they had PMI (P = 0.01). Multivariable analysis revealed preoperative definitive diagnosis of coronary artery disease (P = 0.001) and significant valvular disease (P = 0.03) were associated with increased risk of PMI. Congestive heart failure less than 1 yr before index vascular surgery (P = 0.0002) and increased intraoperative use of blood (P = 0.007) were associated with cardiac death. The history of coronary artery bypass grafting reduced the risk of cardiac death (P = 0.04) in patients with PMI. Conclusions The in-hospital cardiac mortality rate is high for patients who undergo vascular surgery and experience clinically significant PMI. Stress of surgery (increased intraoperative bleeding and aortic, peripheral vascular, and emergency surgery), poor preoperative cardiac functional status (congestive heart failure, lower ejection fraction, diagnosis of coronary artery disease), and preoperative history of coronary artery bypass grafting are the factors that determine perioperative cardiac morbidity and mortality rates.
A rapid microassay to evaluate enzymatic hydrolysis of lignocellulosic substrates

Current attempts to produce ethanol from lignocellulosic biomass are focused on the optimization of pretreatment to reduce substrate recalcitrance and the improvement of enzymes for hydrolysis of the cellulose and hemicellulose components to produce fermentable sugars. Research aimed at optimizing both aspects of the bioconversion process involves assessment of the effects of multiple variables on enzyme efficiency, resulting in large factorial experiments with intensive assay requirements. A rapid assay for lignocellulose hydrolysis has been developed to address this need. Pretreated lignocellulose is formed into handsheets, which are then used to prepare small disks that are easily dispensed into microtiter plates. The hydrolysis of cellulose to glucose is estimated using an enzyme‐coupled spectrophotometric assay. Using disks prepared from ethanol organosolv pretreated yellow poplar, it is shown that the assay generates data comparable with those produced by hydrolysis of pretreated yellow poplar pulp in Erlenmeyer flasks, followed by HPLC analysis of glucose. The assay shows considerable time and cost benefits over the standard assay protocol and is applicable to a broad range of lignocellulosic substrates. © 2005 Wiley Periodicals, Inc.
Message-Passing-Based Dynamic Point Selection for Coordinated Multipoint Transmission

This letter develops a dynamic point selection strategy for coordinated multipoint transmission using a message-passing approach. The dynamic determination of the best transmit point for individual users with the objective of the sum-rate maximization can be cast as a bipartite b-matching problem, the computational cost of which, however, becomes quickly intractable with the increasing number of users. Therefore, this letter develops a message-passing algorithm that solves this computationally demanding challenge. Simulation results show that the proposed algorithm outperforms existing greedy-style approaches and provides a very efficient solution for the maximal sum-rate configuration.
Computer vocabulary training in kindergarten children with special needs

The aim of the present study was to determine whether vocabulary training on a computer can enhance vocabulary learning of young children with special needs and whether the task-on-behaviour of these children differed when story reading was carried out by the teacher or by the computer. An experimental group (n=9) listened to a story read to them by the computer and played additional computer vocabulary games during three 20-min sessions. The control group (n=9) had the same story read to them by a teacher and then followed the normal school curriculum. The results showed that children with special needs were equally able to keep their attention on the story when it was read to them by the computer as when it was read to them by the teacher. For vocabulary growth, the intervention showed positive effects. The children from the experimental group learned more experimental words between the pre-test and retention test than the children in the control group. The study shows that a group of kindergarten children with special needs can enhance their vocabulary by working with a computer program without human intervention.
Involvement of RNA2-encoded proteins in the specific transmission of Grapevine fanleaf virus by its nematode vector Xiphinema index.

The nepovirus Grapevine fanleaf virus (GFLV) is specifically transmitted by the nematode Xiphinema index. To identify the RNA2-encoded proteins involved in X. index-mediated spread of GFLV, chimeric RNA2 constructs were engineered by replacing the 2A, 2B(MP), and/or 2C(CP) sequences of GFLV with their counterparts in Arabis mosaic virus (ArMV), a closely related nepovirus which is transmitted by Xiphinema diversicaudatum but not by X. index. Among the recombinant viruses obtained from transcripts of GFLV RNA1 and chimeric RNA2, only those which contained the 2C(CP) gene (504 aa) and 2B(MP) contiguous 9 C-terminal residues of GFLV were transmitted by X. index as efficiently as natural and synthetic wild-type GFLV, regardless of the origin of the 2A and 2B(MP) genes. As expected, ArMV was not transmitted probably because it is not retained by X. index. These results indicate that the determinants responsible for the specific spread of GFLV by X. index are located within the 513 C-terminal residues of the polyprotein encoded by RNA2.
Coiling of Very Large and Giant Basilar Tip Aneurysms: Midterm Clinical and Angiographic Results

BACKGROUND AND PURPOSE: The purpose of this study was to report the midterm clinical and angiographic results of coiling of very large (>15 mm) and giant basilar tip aneurysms. MATERIALS AND METHODS: Between January 1995 and October 2005, 44 very large and giant basilar tip aneurysms in 44 patients were coiled. There were 13 men (30%) and 31 women (70%) with a mean age of 51.4 years (median, 51 years; range, 34–72 years). Mean aneurysm size was 19.6 mm (range, 15–30 mm). Of 44 aneurysms, 33 (75%) had ruptured. Of 11 unruptured basilar tip aneurysms, 7 were incidentally discovered, 1 was additional to another ruptured aneurysm, and 3 were symptomatic by mass effect. RESULTS: Procedural mortality was 2/44 (4.6%, 95% confidence interval (CI), 0.4%–16%) and morbidity 1/44 (2.3%, 95% CI, 0.01%–13%). Of 33 patients with ruptured aneurysms, mean clinical follow-up was 5.2 years (range, 0.5–11.5 years). Two patients had a rebleeding from the coiled basilar tip aneurysm leading to death in 1 patient and to dependency in the other patient (annual rebleeding rate, 1.1%) One other patient died 2 years later of progressive brain stem compression. Mean angiographic follow-up in 41 of 42 surviving patients was 3.1 years. Nineteen aneurysms reopened and were coiled for a second time. Of these, 9 repeatedly reopened with time and were repeatedly coiled up to 6 times. Additional treatments were without complications. CONCLUSION: Coiling of very large and giant basilar tip aneurysms is associated with reasonably low morbidity. Although additional treatment during follow-up is frequently necessary, rebleeding is uncommon.
Enamel hypoplasia of primary canine: Its prevalence and degree of expression

Background: Enamel hypoplasia is a unique lesion showing wide variations in prevalence among populations. The present study aimed to evaluate frequency and degree of expression of enamel hypoplasia of primary canine in populations living in the eastern part of India. Materials and Methods: A prospective cross sectional study was performed in randomly selected 3539 school children. Labial surfaces of all primary canines were examined. The frequency and degree of expression of enamel hypoplasia between different ethnic groups were recorded. Based on the location of the defect on the tooth surfaces, the lesions were divided as prenatal, perinatal, and postnatal according to stage of mineralization. Statistical analysis was carried out using Chi square test. Results: The overall prevalence of primary canine hypoplasia was 10.3%. The mandibular primary canines were significantly (P = 0.03) more frequently affected than maxillary canines among different ethnic groups. The side difference among populations was not significant (P = 0.96) statistically. In 8.5% Bengali population, 7% Rajbangsi population, and 9.4% in other group of population, the defect occurred prenatally. Most of the defects, 64.7% in Bengali, 66.1% in Rajbangsi, and 58.8% in others occurred during perinatal stage of mineralization. The defect occurred postnatally in 26.8%, 26.7%, and 31.8% in Bengali, Rajbangsi, and in other group of population respectively. Conclusion: The overall prevalence of primary canine hypoplasia was 10.3%. The mandibular primary canines were more frequently affected (P = 0.03) than their maxillary counterparts among populations. Most of the defects correspond to perinatal stage of mineralization.
Actions of Neurotensin: A Review of the Electrophysiological Studies a

Three effects of NT were observed on midbrain DA cells. The modulatory effect of NT, that is, the attenuation of DA-induced inhibition, has been most extensively examined. Studies indicate that this effect of NT was not simply due to a nonspecific excitation. NT selectively attenuated DA-induced inhibition without affecting either GABA-induced inhibition or glutamate-induced excitation of the same cells, and the attenuation of DA-induced inhibition could be observed at the doses at which the basal activity of DA cells was not changed by NT. The attenuation of DA-induced inhibition by NT is also unlikely to result from the formation of a DA-NT complex, since neuromedin N, which competes with NT for the same receptor but does not bind to DA, mimicked the effects, and neurotensin(1-11), which forms a complex with DA but is inactive in competing for NT receptors, did not. The similarities between the effects of NT and those of 8-bromo-cAMP and forskolin suggest that intracellular cAMP and protein kinase A may be involved. This suggestion was supported by the findings that IBMX (an inhibitor of phosphodiesterases) potentiated the effect of NT; and SQ22536 (an inhibitor of adenylate cyclase) and H8 (an inhibitor of protein kinase A) antagonized it. Phorbal-12,13-dibutyrate (an activator of protein kinase C) did not mimic the effect of neurotensin, and H7 (an inhibitor of protein kinase C) did not reduce the effect, suggesting that protein kinase C is unlikely to be involved in the modulatory effect of neurotensin. Experiments in vitro indicated that the excitatory effect of NT on DA cells occurred at higher concentrations (> 10 nM) than those needed for producing the modulatory effect. Its persistence during DA receptor blockade by sulpiride suggests that this effect was not entirely mediated by an attenuation of the inhibition induced by endogenously released DA. At even higher concentrations (> 100 nM), a sudden cessation of cell activity preceded by an increase in firing rate was observed. Whether this effect of NT was due to depolarization inactivation or a toxic effect of the peptide at high concentrations remains to be determined. In most other areas studied, the excitatory effect of NT was most commonly observed. In many areas, this excitatory effect was apparently a direct postsynaptic effect of NT. However, different mechanisms may be involved (see Table 1). For example, in some areas NT acted through a decrease in membrane conductance, while in others no change or an increase in the membrane conductance was observed. (ABSTRACT TRUNCATED AT 400 WORDS)