Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving Resident Well-Being During Shiftwork: Are Casino Shifts the Answer?

PURPOSE The objective of this study is to quantitatively evaluate the well-being of residents doing casino shifts compared with those doing standard overnight shifts while working in an academic pediatric emergency department. METHODS A randomized prospective survey study was performed over a period of 1 year on all residents who were scheduled to complete a 28-day block. Each block (28-day period) within the year was designated as either a "standard" or "casino" block. The standard overnight shifts were scheduled from midnight to 0800 hours, and casino shifts occurred from either 2000 to 0400 hours (casino A) and 0400 to 1200 hours (casino B). Participating residents were asked to complete both a preblock and postblock survey. The primary outcome was defined as differences in resident well-being as assessed by the brief resident wellness profile (BRWP). A mood faces graphical rating item to assess overall mood was used as a secondary outcome measures as well as a 10-item survey based on World Health Organization domains for quality of life and adapted to reflect completion of shiftwork. RESULTS A total of 124 (90%) of 138 residents completed the study and were included in the analysis. No significant difference in resident well-being measured by BRWP between those in the standard and casino shift groups (17 ± 2.5 for preblock standard and 16.9 ± 2.8 for casino, P = 0.904; 17.1 ± 2.7 for postblock standard and 17.2 ± 3.1 for casino, P = 0.817), or in the relative change of the BRWP preblock and postblock between the 2 groups (standard, 0.35 ± 2.7; casino, 0.29 ± 3.0; P = 0.926). No significant difference in the mood faces rating scale scores or the 10-item postblock survey was found. CONCLUSIONS In the first study examining the effects of casino shifts on trainees, we found no effect of standard overnight versus casino shifts on their well-being. This counters the benefits previously seen in emergency department consultant staff and highlights the need for more studies specifically in trainees.
Cue combination used to update the navigator's self-localization, not the home location.

This study investigated when the Bayesian cue combination of piloting and path integration occurs in human homing behaviors. The Bayesian cue combination was hypothesized to occur in estimating the home location or self-localization. In Experiment 1, the participants learned the locations of 5 objects (1 located at the learning position) in the presence of distal landmarks before walking a 2-leg path without viewing the landmarks and objects. At the end of the path, the participants indicated the original locations of the objects in 4 cue conditions: (a) path integration only, (b) landmarks only where the participants were disoriented and the landmarks reappeared, (c) both path integration and the reappearing landmarks, and (d) path integration and conflicting landmarks rotated 45°. The participants' heading, position, and homing estimations were calculated. The ratio of the length of the second leg to that of the first leg was manipulated to be 0.5, 1, or 2. The results showed evidence of the Bayesian cue combination for heading estimates in all leg ratios, and for homing estimates in a small leg ratio (0.5) but not in a large leg ratio (2). The following experiments replicated the results of the Bayesian cue combination for heading but not for homing estimates for the large leg ratio (2) when participants did a typical homing task without learning the locations of objects (Experiment 2) and when proximal landmarks replaced distal landmarks (Experiments 3-4). These findings suggest that the Bayesian cue combination occurs in self-localization prior to homing. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Amamentação: como e por que promover

Resumo A promocao do aleitamento materno deve ser vista como uma acao prioritaria para a melhoria da saude e da qualidade de vida das criancas e de suas familias. As estrategias de promocao da amamentacao devem variar de acordo com a populacao, sua cultura, seus habitos, suas crencas, sua posicao socio-economica, entre outras caracteristicas. No entanto, de fundamental importância em qualquer estrategia, e a conscientizacao da importância do aleitamento materno. Essa revisao procura contribuir para essa conscientizacao entre os profissionais de saude, mostrando as evidencias epidemiologicas da importância do leite materno para a saude da crianca e da mae. Sao enfatizados o impacto da amamentacao na mortalidade, na morbidade, no estado nutricional das criancas e no espacamento entre os nascimentos. Num segundo momento, sao discutidas algumas atividades promotoras do aleitamento materno, com enfase nos programas educativos (educacao dos profissionais de saude, das gestantes, das puerperas e da populacao em geral). Mudancas nas rotinas hospitalares, comunicacao de massa, normas para comercializacao de alimentos para lactentes, protecao da mae que trabalha e acoes de base comunitaria sao tambem abordadas. J. Pediatr. (Rio). 1994; 70 (3) 138-151: aleitamento materno, leite humano, promocao da saude, educacao em saude.
Dental professionals' knowledge, attitudes, and practice behaviors related to human papillomavirus vaccination.

OBJECTIVES In Arizona, human papillomavirus (HPV)-related cancers are declining, with the exception of oropharyngeal cancer (OPC). HPV-related OPC is largely caused by persistent infection with oncogenic HPV strains, many of which the 9-valent HPV vaccine offers protection. Little is known about dental professionals' willingness to promote the HPV vaccine to prevent OPC. The current study assessed Arizona dental professionals' knowledge, attitudes, willingness, and current practice behaviors related to HPV vaccine promotion. Responses between dentists and hygienists were also compared. METHODS A convenience sample of 711 dentists and hygienists attending a regional conference were recruited and asked to complete a 34-item survey assessing knowledge and attitudes about HPV, the HPV vaccine, HPV-related OPC, and their willingness to promote and administer the HPV vaccine. Fisher's exact tests and Mann-Whitney U tests were used for data analysis. RESULTS Most respondents answered HPV knowledge questions correctly but did not know HPV-related OPC has a more favorable prognosis than other head and neck cancers. Dentists were more confident discussing and recommending the HPV vaccine. Both dentists and hygienists were willing to refer patients to their non-dental primary care providers for vaccination; however, they were less confident in administering the vaccine if it fell within their scope of practice. They reported willingness to receive training to recommend the vaccine. CONCLUSIONS Given the willingness of respondents to receive training related to HPV vaccine communication, future research should develop and test talking points and communication training to aid dentists and hygienists in their promotion of the HPV vaccine.
Neonate gut colonization: The rise of a social brain

The human gut microbiota constitutes an integral part of human physiology, playing an important role in maintaining health, and compositional or functional changes in intestinal microbiota may be associated with the emergence of several chronic diseases. Animal and human studies have shown that there is a dynamic cross‐talk between intestinal microorganisms and brain networks which has an impact on neurodevelopment and may be extremely critical in shaping human social behavior.
The AP‐1 pathway; A key regulator of cellular transformation modulated by oncogenic viruses

Cancer progression is critically associated with modulation of host cell signaling pathways. Activator protein‐1 (AP‐1) signaling is one such pathway whose deregulation renders the host more susceptible to cancer development. Oncogenic viruses, including hepatitis B virus, hepatitis C virus, human papilloma virus, Epstein‐Barr virus, human T‐cell lymphotropic virus type 1, and Kaposi's sarcoma‐associated herpes virus, are common causes of cancer. This review discusses how these oncoviruses by acting through various aspects of the host cell signaling machinery such as the AP‐1 pathway might affect oncoviral tumorigenesis, replication, and pathogenesis. The review also briefly considers how the pathway might be targeted during infections with these oncogenic viruses.
Astaxanthin: How much is too much? A safety review

Astaxanthin (AX)‐containing preparations are increasingly popular as health food supplements. Evaluating the maximum safe daily intake of AX is important when setting dose levels for these products and currently, there are discrepancies in recommendations by different regulatory authorities. We have therefore conducted a review of approved dose levels, clinical trials of natural AX, and toxicological studies with natural and synthetic AX. Recommended or approved doses varied in different countries and ranged between 2 and 24 mg. We reviewed 87 human studies, none of which found safety concerns with natural AX supplementation, 35 with doses ≥12 mg/day. An acceptable daily intake (ADI) of 2 mg as recently proposed by European Food Safety Authority was based on a toxicological study in rats using synthetic AX. However, synthetically produced AX is chemically different from natural AX, so results with synthetic AX should not be used in assessing natural AX safety. In addition, few safety studies have been conducted in either humans or animals with synthetic AX. We therefore recommend the ADI for natural AX to be based only on studies conducted with natural AX and further studies to be conducted with synthetic AX (including human clinical trials) to establish a separate ADI for synthetic AX.
Utilizing the Cholecystagogue, Ensure Plus, Results in Similar Hepatobiliary Scintigraphy Study Results and Patient Outcomes Status Post Cholecystectomy, in Comparison With Sincalide.

OBJECTIVE To determine if use of the oral cholecystagogue, Ensure Plus (EP), in hepatobiliary scintigraphy (HBS) leads to a similar distribution of normal and abnormal gallbladder ejection fractions (GBEFs) versus other historical secondary findings of chronic biliary disease in a similar patient population compared with the conventional cholecystokinin analog, sincalide. The HBS findings analyzed included the GBEF, small bowel transit time, gallbladder fill time, and reversal of the normal gallbladder versus small bowel transit. The secondary objectives were to determine whether patient outcomes were significantly different for EP and sincalide HBS study patients following cholecystectomy, namely, the surgical pathology and patient-reported biliary-type pain. METHODS We reviewed all HBS examinations over a retrospective 34-month period. Data from 446 patients who underwent sincalide or EP HBS with GBEF determination for evaluation of chronic symptoms concerning for biliary etiology met the inclusion criteria. The aforementioned HBS findings and postsurgical patient outcomes were obtained for each patient group. RESULTS Comparing HBS examinations performed with sincalide or EP, no significant differences were noted in the major HBS findings of similar patient populations. Outcomes for the sincalide and EP groups status post cholecystectomy were assessed to determine their sensitivity, specificity, positive predictive value, and negative predictive value. The outcomes assessed were the histopathology and patient-reported amelioration of biliary-type pain. No significant differences were noted. CONCLUSIONS The sincalide and EP cholecystagogues did not lead to significantly different HBS findings for similar patient populations or postcholecystectomy outcomes.
Adult obstructive sleep apnoea: Pathogenesis, importance, diagnosis and imaging

Obstructive sleep apnoea (OSA) is a serious worldwide health problem. Moderate‐to‐severe OSA has been found in up to 50% of men and 25% of women in the middle‐aged population. It results in a fourfold increase in all causes of mortality. The prevalence of OSA is underestimated, partly due to absence of symptoms but also lack of knowledge amongst the population at large as well as sectors of the medical profession. Imaging, performed predominantly by clinicians and research scientists, has been integral to evaluating the anatomical basis of OSA. Increased nasal resistance and a narrowed and elongated oropharynx lead to increased collapsibility of the upper airway, predisposing to airway collapse and apnoea during sleep when there is reduction in tone of the pharyngeal dilator muscles. Unfortunately, a significantly narrowed upper airway is usually ignored by radiologists: it is not part of their reporting ‘check‐list’. The imaging findings in the upper airway that are strongly associated with OSA and its sequelae in various organ systems are discussed. Imaging can strongly suggest OSA; the diagnosis requires a polysomnogram for confirmation. Treatment of moderate‐to‐severe disease is primarily with positive airway pressure applied by a nasal or oral mask which splints the upper airway. Although highly effective, compliance is limited and other treatment modalities are increasingly being utilized.
Sex-Based Differences in Hearing Loss: Perspectives From Non-Clinical Research to Clinical Outcomes.

INTRODUCTION It is estimated over 466 million people worldwide have disabling hearing loss, and untreated hearing loss is associated with poorer health outcomes. The influence of sex as a biological variable on hearing loss is not well understood, especially for differences in underlying mechanisms which are typically elucidated through non-clinical research. Although the inclusion of sex as a biological variable in clinical studies has been required since 1993, sex reporting has only been recently mandated in National Institutes of Health funded non-clinical studies. OBJECTIVE This article reviews the literature on recent non-clinical and clinical research concerning sex-based differences in hearing loss primarily since 1993, and discusses implications for knowledge gaps in the translation from non-clinical to clinical realms. CONCLUSIONS The disparity between sex-based requirements for non-clinical versus clinical research may inhibit a comprehensive understanding of sex-based mechanistic differences. Such disparities may play a role in understanding and explaining clinically significant sex differences and are likely necessary for developing robust clinical treatment options.
Identification of Restless Legs Syndrome Genes by Mutational Load Analysis

Restless legs syndrome is a frequent neurological disorder with substantial burden on individual well‐being and public health. Genetic risk loci have been identified, but the causatives genes at these loci are largely unknown, so that functional investigation and clinical translation of molecular research data are still inhibited. To identify putatively causative genes, we searched for highly significant mutational burden in candidate genes.
Guidelines for safe transfer of the brain‐injured patient: trauma and stroke, 2019

The location of care for many brain‐injured patients has changed since 2012 following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, and we have included an expanded section on paediatric transfers. We have also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of our recommendations. These guidelines remain a mix of evidence‐based and consensus‐based statements. We have received assistance from many organisations representing clinicians who care for these patients, and we believe our views represent the best of current thinking and opinion. We encourage departments to review their own practice using our suggestions for audit and quality improvement.
Crowdsourcing Morphology Assessments in Oculoplastic Surgery: Reliability and Validity of Lay People Relative to Professional Image Analysts and Experts

Purpose: To determine if crowdsourced ratings of oculoplastic surgical outcomes provide reliable information compared to professional graders and oculoplastic experts. Methods: In this prospective psychometric evaluation, a scale for the rating of postoperative eyelid swelling was constructed using randomly selected images and topic experts. This scale was presented adjacent to 205 test images, including 10% duplicates. Graders were instructed to match the test image to the reference image it most closely resembles. Three sets of graders were solicited: crowdsourced lay people from Amazon Mechanical Turk marketplace, professional graders from the Doheny Image Reading Center (DIRC), and American Society of Ophthalmic Plastic and Reconstructive Surgery surgeons. Performance was assessed by classical correlational analysis and generalizability theory. Results: The correlation between scores on the first rating and the second rating for the 19 repeated occurrences was 0.60 for lay observers, 0.80 for DIRC graders and 0.84 for oculoplastic experts. In terms of inter-group rating reliability for all photos, the scores provided by lay observers were correlated with DIRC graders at a level of r = 0.88 and to experts at r = 0.79. The pictures themselves accounted for the greatest amount of variation among all groups. The amount of variation in the scores due to the rater was highest in the lay group at 25%, and was 20% and 21% for DIRC graders and experts, respectively. Conclusions: Crowdsourced observers are insufficiently precise to replicate the results of experts in grading postoperative eyelid swelling. DIRC graders performed similarly to experts and present a less resource-intensive option. Crowdsourced graders are not as reliable as professional image analysts or experts in analyzing postoperative eyelid swelling photos with reference to a novel postoperative swelling scale.
Incidental Effect of Long-Term Tacrolimus Treatment on Sporadic Vestibular Schwannoma Volume Shrinkage and Clinical Improvement.

OBJECTIVE We describe the effect of long-term tacrolimus delivery on sporadic vestibular schwannoma (VS). PATIENT A 48-year-old woman who was diagnosed a right VS. INTERVENTION Long-term tacrolimus delivery following liver transplant. MAIN OUTCOME MEASURES Clinical examination, audiometric test, and gadolinium-contrasted magnetic resonance imaging. RESULTS During the reported follow-up period, the patient felt hearing improvement especially in noisy environment. This was consistent with a clear audiometric improvement. Over a 26 months follow-up period, we noticed a 50% volume regression and a 40% decrease in the intensity of enhancement of the tumor after gadolinium injection. CONCLUSION Tacrolimus, an immunosuppressant used to prevent rejection in organ transplant, could lead to VS volume shrinkage and hearing improvement. Tacrolimus could be an interesting new therapeutic weapon, especially for VS in Neurofibromatosis type 2.
SHR4z, a novel decoy effector from the haustorium of the parasitic weed Striga gesnerioides, suppresses host plant immunity

Summary Cowpea (Vigna unguiculata) cultivar B301 is resistant to races SG4 and SG3 of the root parasitic weed Striga gesnerioides, developing a hypersensitive response (HR) at the site of parasite attachment. By contrast, race SG4z overcomes B301 resistance and successfully parasitises the plant. Comparative transcriptomics and in silico analysis identified a small secreted effector protein dubbed Suppressor of Host Resistance 4z (SHR4z) in the SG4z haustorium that upon transfer to the host roots causes a loss of host immunity (i.e. decreased HR and increased parasite growth). SHR4z has significant homology to the short leucine‐rich repeat (LRR) domain of SOMATIC EMBRYOGENESIS RECEPTOR‐LIKE KINASE (SERK) family proteins and functions by binding to VuPOB1, a host BTB‐BACK domain‐containing ubiquitin E3 ligase homologue, leading to its rapid turnover. VuPOB1 is shown to be a positive regulator of HR since silencing of VuPOB1 expression in transgenic B301 roots lowers the frequency of HR and increases the levels of successful SG4 parasitism and overexpression decreases parasitism by SG4z. These findings provide new insights into how parasitic weeds overcome host defences and could potentially contribute to the development of novel strategies for controlling Striga and other parasitic weeds thereby enhancing crop productivity and food security globally.
The vicarious construal effect: Seeing and experiencing the world through different eyes.

That 2 individuals can look at the same stimulus and experience it differently speaks to the power of construal. People's construals are shaped by their idiosyncratic attitudes, belief systems, and personal histories. Eleven studies provide support for and explain the origin of a vicarious construal effect: Considering perspectives one once had but seemingly lost, one ordinarily would have only with more experience, or one would not have had spontaneously, all exerted an assimilative pull on one's ongoing experiences. This means habituation can be slowed or stalled by considering another's fresh perspective (Studies 1-6), desensitization can be preemptively achieved by considering another's stale perspective (Study 5), and the experience of a performance can change by considering how fans or nonfans would see it (Study 7). Blind to the power of construal in defining their experiences, participants believed they were learning about a stimulus's properties or their own underlying preferences, not simply the experience-distorting effects of the perspective manipulations (Studies 6-7). These effects emerged in examinations of positive emotions, negative emotions, interest, and perceptions of humor. The final 2 pairs of studies used causal chain designs to elucidate an underlying mechanism. Trying to understand another's perspective encouraged participants to approach a stimulus by posing different questions or directional hypotheses to themselves (Studies 8a and 9a), which caused participants' own experiences of the stimulus to shift (Studies 8b and 9b). The implications of this account for when considering another's perspective should change one's own experience are detailed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Knowledge, Attitude and Practices Regarding Swine Flu among OPD Attendees of Tertiary Care Hospital, Surat

During an infectious disease outbreak, it is critical to learn as much as possible about the concerns, knowledge, attitudes and behaviour of the public. Such information can be crucial to the improvement of communication efforts by public health officials and clinicians. The aim of this study was to assess the knowledge, attitudes and practices related to influenza A (H1N1) among the OPD patients of Tertiary Care Hospital, Surat. Methods: A hospital based cross sectional study was carried out in the tertiary Care Hospital; 507 participants were selected by convenient sampling method from different OPDs. Results: Majority of participants (71.0 %) have heard about swine flu. Major source of information was friends and relatives (37.3 %) followed by Mass Media. About half of the participants have knowledge of symptoms like cough (55.4 %) and fever (53.1 %); knowledge regarding modes of transmission is average to poor, few participants have misconception that sharing meal (1.2 %) and sexual contact (0.6 %) can transmit swine flu. Knowledge regarding availability of treatment (41 %) and vaccination (12.4 %) is also poor. Use of face mask (46.7 %), avoiding the visit of crowded place (31.8 %), frequent hand washing (18.5 %) during the epidemic were the most known preventive measure among participants. Precautionary measures taken by participants to prevent spread of infection were the use of napkins or handkerchief (51.3 %), use of face mask (29.6 %) and avoiding visit of the crowded place and avoidance of hand shaking (15 %).