Miracle-dz/UniFAR-FTUs huggingface dataset:
Mini clinical evaluation exercise: validity and feasibility evidences in literature

Clinical skills assessment has a very important role in Health Professions Education. However, the basic requirements of its reliability and validity have not been achieved or taken much care of. A mini Clinical Evaluation Exercise (mini-CEX) is approximately a twenty minute encounter, during which a trainee performs focused history taking and physical examination of a patient in a real setting while the faculty assessor observes. After a discussion on the diagnosis and management plan for the patient, the faculty assesses the trainee using the mini-CEX evaluation form and provides feedback. Based on the literature review mini-CEX is found to be a valid and reliable assessment strategy for clinical competence. It has shown to be content valid and differentiates well between different performance levels for both postgraduate and undergraduate trainees. The results are fairly reliable on four or more encounters with the standard error of measurement being very small. The mini-CEX scores have shown to be criterion valid and have sufficient desired educational impact on trainees. Overall, mini-CEX is found to be a fairly valid and feasible assessment strategy for clinical skills justifying its use for both under-graduate and post-graduate education.
Stress and coping in forensic community mental health nurses: Demographic information and qualitative findings

Occupational stress and burnout in nurses is now well documented. Community mental health nursing has been shown to be particularly stressful. The field of forensic psychiatry has in recent years seen the emergence of the role of the forensic community mental health nurse (FCMHN). There is little documented evidence about these nurses or their experience and perceptions of the work they do. This study forms part of a larger study investigating the levels and sources of stress and burnout among this group of nurses. Preliminary findings suggest that, as a group, FCMHNs are an experienced group of nurses with an average 15 years or more in psychiatric nursing. They tend to occupy higher grades and are almost equally made up of men (53.8%) and women (46.2%). The majority are happy with life in general, do not use maladaptive coping strategies, have good job security (67.1%), feel supported by their manager (87.2%) and carry an average caseload of 13.15 patients. Caseload issues and organisational issues were reported as the most stressful elements of work. Peer support and good supervision were the main coping strategies reported. Consideration for training and reducing the isolation of FCMHNs as they expand into new areas with increased risk of role ambiguity is indicated.
The role of social cognitive theory in farm-to-school-related activities: implications for child nutrition.

BACKGROUND Farm-to-school (FTS) programs are gaining attention for many reasons, one of which is the recognition that they could help stem the increase in childhood overweight and obesity. Most FTS programs that have been evaluated have increased students' selection or intake of fruits and vegetables following the incorporation of FTS components. However, the wide range of activities that are typically part of FTS programs make it difficult to pinpoint which components have the greatest potential to improve students' health behaviors. Within the field of nutrition education, theory-based interventions that target the key underlying factors influencing health behavior offer the most promise. METHODS We review existing research on dietary health impacts and implications of 3 key FTS-related activities and explore the component activities of FTS in terms of their potential to address the key constructs of social cognitive theory (SCT)--which is a current best practice in the field of nutrition--suggesting that FTS programs incorporating a diverse set of activities appear to be most promising. RESULTS We find that components of FTS programs incorporate many of the key theoretical constructs in SCT, and show that FTS programs have great potential to facilitate movement toward desired dietary changes. However, it is unlikely that a set of activities in any one current FTS program addresses multiple constructs of the theory in a systematic manner. CONCLUSION More intentional inclusion of diverse activities would likely be beneficial. Future research can test these assertions.
Contribution of amygdala pathology to comorbid emotional disturbances in temporal lobe epilepsy

The amygdala contributes to the generation and propagation of epileptiform activity in temporal lobe epilepsy (TLE). Ictal symptoms such as fear, dreamy states (déjà vu, memory flashbacks, experiential hallucinations), epigastric auras, or sympathetic outflow with cardiovascular changes are often linked to a seizure focus in the amygdala. However, the amygdala may also play a role in comorbid anxiety, depression, and other psychiatric symptoms experienced in the interictal phase, especially in pharmacoresistant TLE. The few studies available on TLE‐related alterations in surgical amygdala specimens indicate loss of both excitatory spiny projection neurons as well as interneurons in nuclei with a cortex‐like architecture, which may influence mechanisms of feedforward and feedback inhibition. Studies of the human amygdala indicate global alterations in the density of AMPA/kainate, metabotropic glutamate, γ‐aminobutyric acid type A (GABAA), muscarinic M2 and M3, serotonergic 5‐HT1A, and adrenergic α1 receptors. Also, amygdala GABAergic and neuropeptide Y (NPY) systems affected in human TLE are both involved in antiepileptic and anxiolytic effects. Experimental and human positron emission tomography studies indicate changes in amygdala serotonergic, NPY Y1 receptor, neurokinin, and opioid systems in emotional disturbances in TLE. Of particular interest is the reduction in amygdala volume in conjunction with ictal fear, seizure focus in the amygdala, and amygdala and hippocampal sclerosis in TLE patients. In contrast, patients with interictal depression often have an intact or even enlarged amygdala and a negative MRI associated with amygdala hypometabolism, which can be associated with limbic autoimmune encephalitis. These findings suggest a differential role of TLE‐related amygdala changes in ictal and interictal emotional disturbances. © 2015 Wiley Periodicals, Inc.
Knowledge of AIDS and Sexual Practices of Young Female Hawkers in Truck and Bus Stations in Ibadan, Nigeria

This study explored the AIDS knowledge and sexual practices of 228 young female hawkers in four bus and truck stations in Ibadan, Nigeria. Fifty-one percent did not know that a girl could become pregnant during her first sexual encounter; 71.7 percent and 65.6 percent knew of the sexual and perinatal routes of transmission of HIV infection, respectively. However, a large proportion believed that the virus could spread through sharing eating utensils (60.4 percent) and toilets (59 percent) with infected persons. Forty-two percent had ever had sex; only 16.1 percent used a condom during the first episode of sex, 83.9 percent did not. Sixty-two percent of sexually experienced hawkers were sexually active in the three months preceding the survey. The frequency at which they had sexual intercourse during the period ranged from one to six times. Thirty-two percent of these sexual encounters were protected from pregnancy, 68 percent were not. Half (50 percent) of those who took a precaution to prevent pregnancy reported that their partners used a condom, few received injectable contraceptives (5 percent) others took analgesics, purgatives, and self-made concoctions (45 percent). Four percent of sexually active subjects were raped in the course of trading in the stations. We propose appropriate recommendations to address risky sexual practices.
Educators' Perspectives of Collaboration With Pediatricians to Support Low-Income Children.

BACKGROUND Educational and healthcare systems operate in silos. Few studies explore educators' perspectives of collaboration with pediatricians or cross-system solutions for school-identified concerns. We sought to investigate educators' viewpoints of collaboration with pediatricians. METHODS We conducted semistructured, qualitative interviews with full-time teachers, vice-principals, and principals, who worked with low-income first- or second-grade students. Interviews explored which students were concerning to educators, educators' experiences with collaboration, and barriers and facilitators of collaboration. Interview transcripts were analyzed with modified grounded theory. RESULTS We interviewed 12 teachers and 3 principals/vice-principals. Students' socioemotional problems were a foremost concern. Effective collaboration with pediatricians was not typical. Participants described not knowing they could communicate with pediatricians or that collaboration was often limited or unidirectional. Respecting boundaries of parental privacy and maintaining parental trust emerged as potential barriers. Some participants described negative experiences with pediatricians and reflected on societal perceptions of doctors and teachers, which could affect the development of relationships. Participants recognized potential benefits to collaboration, including gaining a holistic understanding of a child's health and home life. CONCLUSIONS Educators perceived collaboration with pediatricians as inadequate. More developed and tested programs that foster collaboration between schools and pediatricians are needed to support low-income youth.
Angiotensin II and oxidative stress in the failing heart.

SIGNIFICANCE Despite recent medical advances, cardiovascular disease and heart failure (HF) continue to be major health concerns, and related mortality remains high. As a result, investigation of the mechanisms involved in the development of HF continues to be an active field of study. RECENT ADVANCES The renin-angiotensin system (RAS) and its effector molecule, angiotensin (Ang) II, affect cardiac function through both systemic and local actions, and have been shown to play a major role in cardiac remodeling and dysfunction in the failing heart. Many of the downstream effects of AngII signaling are mediated by elevated levels of reactive oxygen species (ROS) and oxidative stress, which have also been implicated in the pathology of HF. CRITICAL ISSUES Inhibitors of the RAS have proven beneficial in the treatment of patients at risk for and suffering from HF, but remain only partially effective. ROS can be generated from several different sources, and the oxidative state is normally tightly regulated in the heart. How AngII increases ROS levels and causes dysregulation of the cardiac oxidative state has been the subject of considerable interest in recent years. FUTURE DIRECTIONS A better understanding of this process and the mechanisms involved should lead to the development of more effective HF therapies and improved outcomes.
Emerging role of protein-protein transnitrosylation in cell signaling pathways.

SIGNIFICANCE Protein S-nitrosylation, a covalent reaction of a nitric oxide (NO) group with a critical protein thiol (or more properly thiolate anion), mediates an important form of redox-related signaling as well as aberrant signaling in disease states. RECENT ADVANCES A growing literature suggests that over 3000 proteins are S-nitrosylated in cell systems. Our laboratory and several others have demonstrated that protein S-nitrosylation can regulate protein function by directly inhibiting catalytically active cysteines, by reacting with allosteric sites, or via influencing protein-protein interaction. For example, S-nitrosylation of critical cysteine thiols in protein-disulfide isomerase and in parkin alters their activity, thus contributing to protein misfolding in Parkinson's disease. CRITICAL ISSUES However, the mechanism by which specific protein S-nitrosylation occurs in cell signaling pathways is less well investigated. Interestingly, the recent discovery of protein-protein transnitrosylation reactions (transfer of an NO group from one protein to another) has revealed a unique mechanism whereby NO can S-nitrosylate a particular set of protein thiols, and represents a major class of nitrosylating/denitrosylating enzymes in mammalian systems. In this review, we will discuss recent evidence for transnitrosylation reactions between (i) hemoglobin/anion exchanger 1, (ii) thioredoxin/caspase-3, (iii) X-linked inhibitor of apoptosis/caspase-3, (iv) GAPDH-HDAC2/SIRT1/DNA-PK, and (v) Cdk5/dynamin related protein 1 (Drp1). This review also discusses experimental techniques useful in characterizing protein-protein transnitrosylations. FUTURE DIRECTIONS Elucidation of additional transnitrosylation cascades will further our understanding of the enzymes that catalyze nitrosation, thereby contributing to NO-mediated signaling pathways.
Thioredoxin and thioredoxin reductase in relation to reversible S-nitrosylation.

SIGNIFICANCE Nitric oxide (NO) regulates a diverse range of cellular processes, including vasodilation, neurotransmission, and antimicrobial and anti-tumor activities. S-nitrosylation with the formation of S-nitrosothiols (RSNOs) is an important feature of NO signaling regulating protein function. In mammalian cells, glutathione (GSH), S-nitrosoglutathione reductase (GSNOR), and thioredoxin (Trx) have been identified as the major protein denitrosylases. RECENT ADVANCES Human cytosolic/nuclear Trx1 in the disulfide form can be nitrosylated at Cys73 and transnitrosylate target proteins, including caspase 3. Thus, similar to GSH, which by forming S-nitrosoglutathione (GSNO) can transnitrosylate proteins, Trx can either denitrosylate or nitrosylate proteins depending on its oxidation state. CRITICAL ISSUES In this review, we discuss the regulation of cellular processes by reversible S-nitrosylation and Trx-mediated cellular homeostasis of RSNOs and S-nitrosoproteins. FUTURE DIRECTIONS Functions of RSNOs in vivo and their pharmacological uses have not yet been fully studied. Further investigations on the role of Trx systems in relation to biologically relevant RSNOs, their functions, and the mechanisms of denitrosylation will facilitate the development of drugs and therapies. Antioxid. Redox Signal. 18, 259-269.
Changes in Electrophysiological Parameters After Surgery for the Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common condition, affecting mostly females. Nerve conduction studies are performed routinely for the diagnosis of carpal tunnel syndrome. Surgical intervention for release of the median nerve at the carpal tunnel is the treatment of choice. Few studies have looked at the improvement in the electrophysiological parameters after carpal tunnel release. This study compared the distal motor and sensory latencies, motor and sensory amplitudes, and sensory conduction velocities of the median nerves across the carpal tunnel in patients with the carpal tunnel syndrome preoperatively and postoperatively at 18 and 42 weeks, respectively. The results showed improvement in all the studied variables, except the distal sensory latency, 18 weeks after the surgery, whereas the distal sensory latency improved only at 42 weeks postoperatively. These findings denote the differential affection of the sensory and motor fibers in the carpal tunnel syndrome and confirm the value of nerve conduction studies in the evaluation of patients who do not improve or who have recurrence of their symptoms after carpal tunnel release.
Adolescent Forensic Psychiatry

W hy would you read a book on adolescent forensic psychiatry? Well, there are a number of reasons, many of which have been well covered by the editors of this book. If you are a child and adolescent psychiatrist (like me), you would find such a book useful in understanding and managing risk posed by adolescents with delinquent behaviours. You would benefit from a framework for assessment—handily provided …
How ABBA may help improve neonatal resuscitation training: Auditory prompts to enable coordination of manual inflations and chest compressions

Resuscitation guidelines recommend 90 chest compressions (CCs) and 30 inflations (INFs) per minute for neonatal cardiopulmonary resuscitation (nCPR). We hypothesised that auditory prompts would help coordinate these actions. Our aim was to investigate the effect of musical prompts during nCPR training on adherence to recommended CC and INF rates and on the quality of delivered INFs.
Alternative Sites for Intraoperative Monitoring of Cranial Nerves X and XII During Intracranial Surgeries

Summary: During intracranial surgeries, cranial nerve (CN) X is most commonly monitored with electromyographic endotracheal tubes. Electrodes on these endotracheal tubes may be displaced from the vocal folds during positioning, and there is a learning curve for their correct placement. Cranial nerve XII is most commonly monitored with electrodes in the dorsum of the tongue, which are also prone to displacement because of their proximity to the endotracheal tube. A retrospective review was conducted of a consecutive series of 83 skull base surgeries using alternative sites for monitoring CN X and XII. On-going (spontaneous) and evoked electromyography (EMG) were obtained from the cricothyroid muscle for CN X and submental genioglossus for CN XII. Stimulation of CN X or XII evoked specific compound motor action potentials from these muscles, and well-defined on-going EMG was observed during tumor resection in the vicinity of CN X and XII. Volume-conducted responses from the adjacent platysma muscle during CN VII stimulation were identified by concomitant responses from the orbicularis oris and oculi. In conclusion, during skull base surgeries, CN X may be monitored with electrodes in the cricothyroid muscle and CN XII with electrodes in the submental genioglossus. These alternative sites are less prone to displacement of electrodes compared with the more commonly used EMG endotracheal tube and electrodes in the dorsum of the tongue. The cricothyroid muscle should not be used when the recurrent laryngeal nerve is at risk.
EEG Patterns in Hypoxic Encephalopathies (Post–Cardiac Arrest Syndrome): Fluctuations, Transitions, and Reactions

Summary: In patients with coma resulting from hypoxic encephalopathy (e.g., after cardiac arrest), the EEG may reflect the severity of brain dysfunction, although the exact relationship among the EEG changes, the extent of neuronal damage, and consequent prognosis is still under study. Many prognostications are based on particular EEG patterns at a time point, such as burst suppression or generalized periodic discharges, but with sequential, repeated, or with prolonged or continuous EEG monitoring, it has become increasingly clear that more information might be gleaned from EEG pattern changes over time. Short-term fluctuations (as opposed to permanent transitions), or preserved reactions to exogenous stimuli, have to be differentiated. This review presents many of the typical postanoxic EEG patterns, along with their evolution over time. This preliminary report illustrates the temporal dynamic changes of EEG over time. It is hoped that it will act as a starting point for prospective and systematic investigation to test whether EEG evolution and transitions add diagnostic and prognostic value.
Factors in the Control of Interdigestive and Postprandial Myoelectric Patterns of Canine Jejunoileum: Role of Extrinsic and Intrinsic Nerves

Our aim was to determine the roles of extrinsic and intrinsic (enteric) neural continuity to the jejunoileum in control of postprandial and fasting motility patterns. Four groups of dogs were prepared: control, neurally intact; intrinsic transection, distal duodenal transection to disrupt intrinsic myoneural continuity with jejunum; extrinsic transection, transection of all extrinsic nerves to jejunoileum; and intrinsic/extrinsic transection, disruption of both intrinsic myoneural and extrinsic neural continuity to jejunoileum. Duodenal and jejunal electrodes were placed to monitor motility. After 2 weeks, the dogs were studied while fasting, after meals, and during intravenous infusions of cholecystokinin octapeptide at 0. 5μg/(kg · h) and pentagastrin at 2μg/(kg · h). During fasting, although the migrating motor complex (MMC) occurred in each region, coordination between duodenum and jejunoileum was disrupted in intrinsic/extrinsic transection dogs, but only partially in intrinsic transection dogs. Small meals (50 g of liver) interrupted the duodenal MMC in all groups and the jejunoileal MMC only in control dogs. A larger (500‐g) meal disrupted the MMC in both regions for comparable durations in all groups. Cholecystokinin octapeptide and pentagastrin inhibited the MMC in duodenum and jejunoileum in all groups. Both intrinsic myoneural and extrinsic neural continuity play a role in regional coordination of interdigestive and digestive gut motility. Both hormonal and neural factors (central, enteric) participate in the regulation of onset of postprandial motor patterns.
Stress and Service Use Among Minority Caregivers to Elders with Dementia

Abstract Research indicates that minority caregivers use fewer outside social and medical services than white, European-American caregivers. Qualitative research has shown non-caregiving stressors stemming from family and community environments as affecting burden and service use among minority caregivers. Yet few studies of caregiver service use include multiple groups of minority caregivers, or quantitatively evaluate the influence of non-caregiving stress. Using Pearlin, Mullan, Semple and Skaff's (1990) model of caregiver stress, we examined the relationship of ethnicity, non-caregiving stressors, and other stress-associated variables to service use by African-American, Chinese, and Latino caregivers. A group of white, European-American caregivers served as a reference group. Results show ethnicity, non-caregiving stress, and the dementia-affected elder's impairment level to predict unmet service need. The results also point to the usefulness of a new measure of non-caregiving stress in evaluating service use among minority caregivers.
Candida species extracellular alcohols: production and effect in sessile cells

Cell‐cell signaling alcohol molecules were recently identified in Candida albicans and Candida dubliniensis supernatants. To date, it is not known whether these molecules are produced by other Candida species and their role in biofilm formation is not fully clarified. Herein, Candida parapsilosis and Candida tropicalis extracellular alcohols production by planktonic cultures was analyzed by headspace‐solid‐phase microextraction and gas chromatography‐mass spectrometry. Both these Candida species extracellular media contained E,E ‐farnesol, 1‐dodecanol, 2‐phenylethanol, and isoamyl alcohol but not E ‐nerolidol, as produced by C. albicans and C. dubliniensis. Moreover, the ability of these compounds to regulate C. albicans, C. dubliniensis, C. parapsilosis, and C. tropicalis sessile cells was assessed by adding the alcohols after 3 h of adhesion and 48 h of biofilm formation. After 24 h, biofilms were analyzed in terms of cellular mitochondrial activity and total biomass. E,E ‐Farnesol affected C. albicans and C. dubliniensis. E ‐Nerolidol and 1‐dodecanol elicited C. parapsilosis and C. tropicalis changes in further biofilm development. C. tropicalis was affected by 2‐phenylethanol and isoamyl alcohol triggered changes in C. albicans, C. dubliniensis, and C. tropicalis sessile cells. The results demonstrated that almost all of these alcohols are produced by these Candida species and also evidence the complexity of biofilm formation. (© 2010 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)