Miracle-dz/UniFAR-FTUs huggingface dataset:
Sources of Stress for Residents and Recommendations for Programs to Assist Them

Bridging the gap between graduation from medical school and being board eligible in a medical specialty is a lengthy and arduous process. The fact that stress is typical during the residency training period is well-documented in the literature, as are its many situational, professional, and personal sources, which the author reviews: heavy work-load, sleep deprivation, difficult patients, poor learning environments, relocation issues, isolation and social problems, financial concerns, cultural and minority issues, information overload, and career planning issues. Stress can also stem from and exacerbate gender-related issues and problems for significant others, spouses, and family members. The author also describes less commonly documented sources of stress—often overlooked or postponed so long that stresses are inevitable for all concerned. These are associated with residents who perform marginally and in some cases should not have been passed on from medical school, or who are studying specialties not compatible with their skills and personalities, or who foster severe interpersonal problems on the job. Common effects of stress include anxiety, depression, obsessive-compulsive trends, hostility, and alcohol and substance abuse. To respond to the problems that these many stressors present to residents, the Accreditation Council for Graduate Medical Education (ACGME) requires that all post—medical-school medical training programs make assistance services available for all residents. The author outlines essential elements of an assistance program, states how important such problems can be in saving both residents and their institutions needless difficulties and costs, and presents important issues for the consideration of all involved in residents' training.
High altitude exposure impairs sleep patterns, mood, and cognitive functions.

This work evaluated the importance of sleep on mood and cognition after 24 h of exposure to hypoxia. Ten males, aged 23-30 years, were placed in a normobaric chamber simulating an altitude of 4,500 m. Sleep assessments were conducted from 22:00-6:00; all mood and cognitive assessments were performed 20 min after awakening. The assessments were conducted in normoxic conditions and after 24 h of hypoxia. Sleep was reevaluated 14 h after the start of exposure to hypoxic conditions, and mood state and cognitive functions were reevaluated 24 h after the start of exposure to hypoxic conditions. Hypoxia reduced total sleep time, sleep efficiency, slow-wave sleep, and rapid eye movement. Depressive mood, anger, and fatigue increased under hypoxic conditions. Vigor, attention, visual and working memory, concentration, executive functions, inhibitory control, and speed of mental processing worsened. Changes in sleep patterns can modulate mood and cognition after 24 h.
Quantum-well theory of the exchange coupling in magnetic multilayers

Magnetic multilayers are novel man-made materials with great potential for applications, especially in magnetic storage technology. It is observed that the configuration of the magnetic moments of neighboring magnetic layers separated by a nonmagnetic layer can be either ferromagnetic or antiferromagnetic depending on the thickness of the intervening spacer layer. This implies an oscillatory indirect coupling between the layers mediated by itinerant electrons in the spacer layer. It is shown that the physical origin of the effect is quantum-mechanical confinement of electrons in the spacer layer by spin-dependent potentials of the magnetic layers. The confinement can be either complete (bound states) or partial (resonances) depending on the ferromagnet and spacer materials and on the layer orientation. A general method for calculating the interlayer coupling, which is based on a formal analogy with de Haas-van Alphen effect is described and illustrated for specific systems such as Co/Cu(100). It is shown that the oscillation period is directly related to the size and shape of the Fermi surface of the bulk spacer material. It is also shown that the coupling strength is determined by detailed matching of the ferromagnet and spacer bands in the direction perpendicular to the layers. Finally, band mismatch mechanism is invoked to explain the observed trends in coupling strength across the Periodic Table.
Behavioral effects of separate and combined administration of naloxone and d-amphetamine.

Dose-response curves for d -amphetamine were determined in the rat for three distinct types of behavior: continuous avoidance responding, locomotor activity and food intake. The effects of d -amphetamine were also evaluated on locomotor activity and food intake in the mouse. d -Amphetamine was tested alone and in combination with naloxone, a specific narcotic antagonist that is almost devoid of agonistic properties. Characteristic amphetamine effects were observed in both species. Avoidance responding and locomotor activity were increased by low doses of d -amphetamine and were disrupted by higher doses. A similar biphasic dose-response curve was generated for food intake in the rat, but d -amphetamine produced only a suppression of food intake in the mouse. Otherwise inactive doses of naloxone significantly and consistently reduced the stimulant effects of d -amphetamine on avoidance responding and locomotor activity in the rat; no consistent drug interactions occurred in the locomotor activity tests in the mouse. There were no interactions between naloxone and d -amphetamine on food intake in either species. However, in the rat, naloxone itself showed pronounced activity in suppressing food intake. The results show that a narcotic antagonist can markedly modify the behavioral effects of a non-opioid psychoactive drug. Furthermore, it appears that some of the actions of naloxone are species dependent.
A test of the acoustic adaptation hypothesis in four species of marmots

Acoustic signals must be transmitted from a signaller to a receiver during which time they become modified. The acoustic adaptation hypothesis suggests that selection should shape the structure of long-distance signals to maximize transmission through different habitats. A specific prediction of the acoustic adaptation hypothesis is that long-distance signals of animals in their native habitat are expected to change less during transmission than non-native signals within that habitat. This prediction was tested using the alarm calls of four species of marmots that live in acoustically different habitats and produce species-specific, long-distance alarm vocalizations: yellow-bellied marmot, Marmota flaviventris; Olympic marmot, M. olympus; hoary marmot, M. caligata; and woodchuck, M. monax. By doing so, we evaluated the relative importance the acoustic environment plays on selecting for divergent marmot alarm calls. Representative alarm calls of the four species were broadcast and rerecorded in each species' habitat at four distances from a source. Rerecorded, and therefore degraded alarm calls, were compared to undegraded calls using spectrogram correlation. If each species' alarm call was transmitted with less overall degradation in its own environment, a significant interaction between species' habitat and species' call type would be expected. Transmission fidelity at each of four distances was treated as a multivariate response and differences among habitat and call type were tested in a two-way MANOVA. Although significant overall differences in the transmission properties of the habitats were found, and significant overall differences in the transmission properties of the call types were found, there was no significant interaction between habitat and call type. Thus, the evidence did not support the acoustic adaptation hypothesis for these marmot species. Factors other than maximizing long-distance transmission through the environment may be important in the evolution of species-specific marmot alarm calls. (c) 1998 The Association for the Study of Animal Behaviour.
Participation of the arcR ACME protein in self-activation of the arc operon located in the arginine catabolism mobile element in pandemic clone USA300

ABSTRACT Staphylococcus aureus pandemic clone USA300 has, in addition to its constitutive arginine catabolism (arc) gene cluster, an arginine catabolism mobile element (ACME) carrying another such cluster, which gives this clone advantages in colonisation and infection. Gene arcR, which encodes an oxygen-sensitive transcriptional regulator, is inside ACME and downstream of the constitutive arc gene cluster, and this situation may have an impact on its activation. Different relative expression behaviours are proven here for arcR ACME and the arc ACME operon compared to the constitutive ones. We also show that the artificially expressed recombinant ArcRACME protein binds to the promoter region of the arc ACME operon; this mechanism can be related to a positive feedback model, which may be responsible for increased anaerobic survival of the USA300 clone during infection-related processes.
Rôle pro-inflammatoire des cellules épithéliales de la conjonctive dans un modèle in vitro de sécheresse oculaire

La secheresse oculaire est une pathologie frequente qui peut impacter fortement la qualite de vie des patients. D’origine multifactorielle complexe, elle presente de nombreuses etiologies et son diagnostic est difficile en raison de presentations cliniques variees, en termes de symptomes et de tests cliniques, et en l'absence d'un marqueur specifique. En outre, elle ne beneficie actuellement que d’une seule molecule therapeutique, cependant non curative, la ciclosporine. Devenant un reel probleme de sante publique, la recherche visant a une meilleure comprehension des mecanismes sous-jacents a son apparition reste indispensable. L'etat actuel des connaissances sur la secheresse oculaire reconnait a l'inflammation et a l'hyperosmolarite un role central. Ce travail de these a eu pour objectif d'etudier le comportement pro-inflammatoire des cellules conjonctivales dans un modele in vitro classique de secheresse oculaire induite par une hyperosmolarite saline. Nous avons ainsi montre que les cellules conjonctivales secretent une chimiokine pro-inflammatoire majeure, CCL2/MCP-1, et que cette induction est totalement sous la dependance du facteur de transcription osmoprotecteur NFAT5/TonEBP ainsi que partiellement liee a la voie des MAPKs et de NFκB. Nous avons egalement observe que cette induction etait en partie inhibee par la ciclosporine et la dexamethasone. Nous avons ensuite complete ce travail par l'etude de l'inflammasome a la fois sur ces cellules et sur des monocytes, type cellulaire majeur cible par CCL2, en utilisant differents activateurs classiques dans le modele d’hyperosmolarite. Nos resultats ont montre l’absence d’activation de l’inflammasome par l'hyperosmolarite seule. En revanche, l'hyperosmolarite aurait un role inhibiteur de l’inflammasome dans les monocytes. Ces resultats ouvrent des pistes nouvelles d’exploration afin de mieux comprendre les relations entre monocytes et cellules epitheliales de la conjonctive. Ils nous ont permis d'identifier le role incontournable de cellules epitheliales conjonctivales dans l'apparition ou le maintien de l'inflammation dans la pathologie et de caracteriser certaines voies intracellulaires impliquees dans ce processus, ouvrant de nouvelles perspectives en termes de therapeutiques.
A 2.4 GHz Low Phase Noise In-Phase Coupled Class-C Quadrature VCO in 0.18 $\mu{\rm m}$ CMOS

This letter presents a 2.4 GHz Class-C QVCO using an in-phase coupling topology. The phase noise of the proposed QVCO is effectively reduced by using a lower gate biasing voltage at the cross-coupled pairs and an in-phase coupling technique. A complementary Class-C oscillator is employed to enhance the startup robustness over a temperature range from -25°C to 100°C. A quadrature oscillator, implemented in a 0.18 μm CMOS process, achieves a phase noise lower than -130.7 dBc/Hz at 1 MHz offsets and a frequency tuning range from 2.23 to 2.57 GHz while only consuming 3 mW. The design attains a remarkable figure-of-merit of 193.7 dBc/Hz.
Prospective study of quality of life before and after coronary artery bypass grafting.

OBJECTIVES--Measurement of changes in patients' perceptions of how differing states of health affect their lives and determination of the ability of preoperative variables to predict outcome after coronary artery bypass grafting. DESIGN--Prospective study with completion of questionnaires before coronary artery bypass grafting and at three months, one year, and five years afterwards. SETTING--Regional cardiothoracic centre. PATIENTS--100 Male patients all aged below 60 at the time of operation, who were patients of two cardiothoracic surgeons. MAIN OUTCOME MEASURES--Patients' assessment of their health state in terms of functional capacity and aspects of distress, according to the Nottingham health profile and outcome of operation in terms of changes in symptoms, working life, and daily activities determined by self completed study questionnaires before operation and at three and six months afterwards. RESULTS--Intermediate one year results are reported. The differences between the Nottingham health profile scores before operation and at three months afterwards were significantly different (p less than 0.01), indicating an appreciable improvement in general health state, and at one year compared favourably with those from a normal male population. Analysis of responses to the study questionnaire showed that 65 of 89 patients (73%) were working at one year after operation with a further seven (8%) maintaining that they were fit to work but unable to find employment. The proportion of patients complaining of chest pain fell from 90% (88/98) before grafting to 19% (17/89) at one year after coronary artery bypass grafting, when 91% (81/89) patients maintained that their condition was either completely better or definitely improved. The significant positive factors affecting return to work and home activities were working before operation, short wait for operation, absence of breathlessness, and low physical mobility score in the Nottingham health profile (all p less than 0.001). CONCLUSIONS--Improvements were evident in general health state, symptoms, and activity at three months and one year after coronary artery bypass graft surgery. Interventions likely to influence outcomes included reduction in waiting times for operation; rehabilitation initiatives; and more attention to the quality of information given to patients, their relatives, and the community.
iCALL corpus: Mandarin Chinese spoken by non-native speakers of European descent

We present iCALL , a speech corpus designed to evaluate Mandarin Chinese pronunciation patterns of non-native speakers of European descent, developed at the Institute for Infocomm Research (I 2 R) in Singapore. To the best of our knowledge, iCALL is larger than any reported non-native corpora to date in terms of utterance number, duration, and number of speakers: iCALL consists of 90,841 utterances from 305 speakers with a total duration of 142 hours. The speakers are gender-balanced, from a diverse native language background, and represent a realistic sampling of the adult age of Mandarin learners. The read utterances are phonetically balanced and are of varying lengths (words, phrases, and sentences). The spoken utterances are phonetically transcribed and perceptually rated with ﬂuency scores by trained native speakers of Mandarin. In this work, we share our experience in corpus design, data collection, and human annotation and analyze phonetic and tonal error patterns, in particular their relationship with speaker demographics and utter-ance length. Potential applications of the iCALL corpus include computer-assisted pronunciation training (CAPT), lexical tone recognition, automatic ﬂuency assessment, accent recognition, and accented Mandarin speech recognition.
Heart failure in African Americans: unique etiology and pharmacologic treatment responses.

OBJECTIVES After reading the article, "Heart Failure in African Americans: Unique Etiology and Pharmacologic Treatment Responses," the learner should be able to complete the following quiz and evaluation questions.Accredidation:NMA is accredited by the Accredidation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. NMA designates this continuing medical education activity for one credit hour in category one of the Physician's Recognition Award of the American Medical Association. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. The Journal of the National Medical Association (JNMA) has been approved by the American Academy of Family Physicians (AAFP) as having educational content acceptable for five prescribed credit hours. This article has been approved for one credit hour. Term of approval is from January 1, 2003, through December 31, 2003. Credit may be claimed for one year from date of individual use.Expiration:The quiz must be completed, postmarked and mailed by Feb. 25, 2003, for eligibility to receive continuing medical education credit for this CME activity.
A simulation-based resident-as-teacher program: The impact on teachers and learners.

BACKGROUND Residency training is charged with improving resident teaching skills. Utilizing simulation in teacher training has unique advantages such as providing a controlled learning environment and opportunities for deliberate practice. OBJECTIVE We assessed the impact of a simulation-based resident-as-teacher (RaT) program. DESIGN A RaT program was embedded in an existing 8-case simulation curriculum for 52 internal medicine (IM) interns. Residents participated in a workshop, then served as facilitators in the curriculum and received feedback from faculty. METHODS Residents' teaching and feed back skills were measured using a pre- and post-program self-assessment and post-session and post-curriculum evaluations by intern learners. SETTING/PARTICIPANTS Forty-one second- and third-year residents participated in the study August 2013 to October 2013 at a single center. RESULTS Pre- and post-program teaching skills were assessed for 34 of 41 resident facilitators (83%) participating in 3.9 sessions on average. Partaking in the program led to improvements in resident facilitators' self-reported teaching and feedback skills across all domains. The most significant improvement was in teaching in a simulated environment (2.81 to 4.16, P < 0.001). Interns rated the curriculum highly (81% "excellent," 19% "good") and reported that resident facilitators frequently utilized debriefing techniques covered in the RaT program. CONCLUSIONS Our simulation-based RaT program offered a unique opportunity for deliberate practice of teaching skills in a controlled environment and led to improvements in resident facilitators' teaching and feed back skills. The simulation curriculum, facilitated by residents, was well received by the intern learners. Our program design may serve as a model for the development of simulation curricula and RaT programs within IM residencies.
Pharmacotherapy of major depressive disorder in adolescents

Importance of the field: At any one time, major depressive disorder (MDD) affects 4 – 6% of adolescents. When untreated, MDD leads to a high immediate and subsequent suicide risk, long-term chronicity and a poor psychosocial outcome. Whereas psychotherapy can be effective in mild depression, it seems to be less effective in moderate and severe depression. However, although the use of antidepressants increased markedly during the 1990s, in recent years it has decreased as a result of concerns regarding the emergence of suicidality during antidepressant treatment. Areas covered in this review: Are antidepressants truly effective? What is the relationship between different treatments for depression – psychotherapy and pharmacotherapy – alone or in combination? Can antidepressants increase the risk of suicide in some adolescents? Can antidepressants reduce suicide risk in suicidal adolescents? What the reader will gain: There is evidence that selective serotonin reuptake inhibitors (SSRIs) can improve adolescent depression better than placebo, although the magnitude of the antidepressant effect is ‘small to moderate’, because of a high placebo response. The SSRI with the best rate of response compared to placebo is fluoxetine. The increased risk of suicidality in adolescents, compared to adults, is weak but consistent across most studies. However, epidemiological studies do not support a relationship between use of antidepressants and suicide rate. Take home message: A cautious and well-monitored use of antidepressant medications is a first-line treatment option in adolescents with moderate to severe depression. Low rates of remission with current treatment strategies indicate that further research in both psychotherapy and pharmacotherapy is warranted.
An Explanation of Why Inference Learners Sometimes Appear to Store Prototypical Features

Introduction A range of studies indicate that inference learners and classification learners rely on different knowledge when making post training judgments (e.g. Yamauchi & Markman, 1998). The differences have been argued to be due to inference learners focusing on prototypical features whereas classification learners focus on diagnostic features or exemplars (e.g. Markman & Ross, 2003). This hypothesis will be referred to as the learning paradigm hypothesis (LPH). In the present study an alternative hypothesis, the directed attention hypothesis (DAH), is introduced. DAH suggests that, in previous studies, a confounding variable in the inference learning condition have created the illusion that all stimuli are identical to the prototypes.
To disclose or not: publicness in social networking sites

Purpose – Social networking sites (SNS) are changing the methods of social connectivity – and what it means to be public. Existing literature hints at competing perspectives on how the public nature of these sites impacts users. The question of how the perceived publicness of SNSs influences users' self‐disclosure intentions is debated in the literature, and the aim of this paper is to answer this debate.Design/methodology/approach – This paper theorizes competing perspectives on the role of publicness on self‐disclosure. Competing perspectives are tested using data collected via an online survey.Findings – The study finds support for the perceived publicness of a SNS negatively influencing users' self‐disclosure intentions. Additionally, exploratory analysis of self‐disclosure items ubiquitous to most SNSs found that perceived publicness negatively influences users' intention to self‐disclose items related to users' likes and affiliations.Research limitations/implications – Variables of the study were se.
Evaluation of Headache and Regional Cerebral Flood Flow in Patients With Migraine

Purpose of the Report The aim of this study is to observe the abnormalities of regional cerebral blood flow (rCBF) in migraine patients and to evaluate its relation to the severity of the headache in patients with migraine. Patients and Methods The rCBF imaging was done on 19 patients with migraine and 15 normal controls using single-photon emission computed tomography (SPECT). The abnormal character of cerebral perfusion function was analyzed with Statistical Parametric Mapping (SPM) software, and the headache grade of patients was evaluated with the headache severity measuring scale. Results The results of SPM analysis demonstrated a decreased rCBF on both sides of the frontal and temporal lobes, left parietal lobe, and right occipital lobe (P < 0.001), and increased rCBF focus on the left prefrontal lobe and right temporal lobe (P < 0.001). The headache scores in migraineurs were correlated to the rCBF on the bilateral temporal lobes and right frontal lobe (P < 0.001). Conclusions The migraineurs had lower rCBF at the frontal and temporal lobes, and the lower rCBF was correlated to the degree of headache.