Miracle-dz/UniFAR-FTUs huggingface dataset:
Normal Macular Thickness in Healthy Indian Eyes Using Spectral Domain Optical Coherence Tomography

PurposeTo determine macular thickness and its variation with age and sex in healthy Indian eyes using Zeiss spectral domain optical coherence tomography (SD-OCT). DesignA prospective, cross-sectional study. MethodsFour hundred healthy adult subjects (≥18 years) underwent macular cube scanning using Zeiss SD-OCT. Macular thickness from all 9 regions of the Early Treatment Diabetic Retinopathy Study map was documented for each subject. Variations in macular thickness by age and sex were determined. ResultsThe mean age of the subjects was 38.05 ± 12.13 (range, 18–78) years. The mean ages in men and women were 39.19 ± 12.16 and 37.13 ± 12.05 years, respectively (P > 0.05). The mean central subfield thickness (CST) of all subjects was 240.40 ± 18.26 &mgr;m, and mean macular thickness was 287.87 ± 18.07 &mgr;m. The mean CST in the right and left eyes were 240.40 ± 18.25 &mgr;m and 239.65 ± 17.73 &mgr;m, respectively (P = 0.55). Males were associated with greater mean CST and mean macular thickness compared with females (P < 0.05). There was an association of mean CST with sex (adjusted r2 = 0.095; P < 0.05) but not with age. Overall, the nasal quadrant was the thickest followed by the superior, inferior, and temporal subfields. ConclusionsThis is the normative data for macular thickness in healthy Indian eyes using Zeiss SD-OCT. This will serve as a baseline for diagnosing and treating macular pathologies in Indian eyes because such data using Zeiss SD-OCT in Indian eyes have previously been lacking.
Superficial siderosis of the central nervous system presenting with hallucination and delusion: A case report

THERE IS ACCUMULATING evidence that patients with autism spectrum disorders (ASD) exhibit reduced thalamus volume. Non-right-handedness has been suggested as a risk factor for ASD. Thus, it may be fruitful to investigate the effect of handedness on thalamus volume in ASD patients. The present study was approved by the Ethics Committee of the Niigata University School of Medicine. All participants and their parents provided written informed consent. The participants were 32 Japanese male patients between 6 and 20 years of age, who met the DSM-IV criteria for autistic disorder (n = 10), Asperger’s disorder (n = 12) or pervasive developmental disorder not otherwise specified (n = 10). Each participant was assessed using the childhood autistic rating scale – Tokyo version, the Wechsler Intelligence Scale for Children – Third Edition or the Wechsler Adult Intelligence Scale – Revised, and the Edinburgh Handedness Inventory. Details of the procedure for magnetic resonance image acquisition and brain volume measurements have been described elsewhere. Right and total thalamus volumes were significantly smaller in non-right-handed patients than in right-handed patients (Table 1). The present results provided preliminary evidence for reduced thalamus volume in non-right-handed male patients with ASD. One might speculate that non-righthandedness confers susceptibility to ASD, perturbing developments of structure and function in the thalamus. Although there were no significant differences in age, IQ, autistic symptoms or intracranial volume between handedness groups, we could not exclude the possible confounding effects of these factors. Further large-scale studies should be carried out to confirm these preliminary findings.
Defining heterogeneity within bacterial populations via single cell approaches

Bacterial populations are heterogeneous, which in many cases can provide a selective advantage during changes in environmental conditions. In some instances, heterogeneity exists at the genetic level, in which significant allelic variation occurs within a population seeded by a single cell. In other cases, heterogeneity exists due to phenotypic differences within a clonal, genetically identical population. A variety of mechanisms can drive this latter strategy. Stochastic fluctuations can drive differential gene expression, but heterogeneity in gene expression can also be driven by environmental changes sensed by individual cells residing in distinct locales. Utilizing multiple single cell approaches, workers have started to uncover the extent of heterogeneity within bacterial populations. This review will first describe several examples of phenotypic and genetic heterogeneity, and then discuss many single cell approaches that have recently been applied to define heterogeneity within bacterial populations.
Intermediate filament dynamics: What we can see now and why it matters

The mechanical properties of vertebrate cells are largely defined by the system of intermediate filaments (IF). As part of a dense network, IF polymers are constantly rearranged and relocalized in the cell to fulfill their duty as cells change shape, migrate, or divide. With the development of new imaging technologies, such as photoconvertible proteins and super‐resolution microscopy, a new appreciation for the complexity of IF dynamics has emerged. This review highlights new findings about the transport of IF, the remodeling of filaments by a process of severing and re‐annealing, and the subunit exchange that occurs between filament precursors and a soluble pool of IF. We will also discuss the unique dynamic features of the keratin IF network. Finally, we will speculate about how the dynamic properties of IF are related to their functions.
The use of ‘dementia care mapping’ as a method of evaluating care received by patients with dementia – an initiative to initiative to improve quality of life

‘Dementia care mapping’(DCM) is a method of assessing care standards as received by dementia victims. Through the application for this tool, shortcomings in care practice can be highlighted in the hope of achieving improvements. The method was employed by the Elderly Mentally Ill (EMI) unit of a National Health Service trust in South Wales. Baseline evaluations were undertaken on each of the EMI wards containing dementia patients, and reports delivered to the appropriate members, of staff. Mean care scores for the unit as a whole were found to lie in the ‘good’ category, as defined by the method. Staff training in the underlying principles of DCM will be followed by re-evaluations of care standards to evaluate the outcome of the attempts made to engender improvements.
Longitudinal integrated clerkships*

Abstract There is increased interest in longitudinal integrated clerkships (LICs) due to mounting evidence of positive outcomes for students, patients and supervising clinicians. Emphasizing continuity as the organizing principle of an LIC, this article reviews evidence and presents perspectives of LIC participants concerning continuity of care, supervision and curriculum, and continuity with peers and systems of care. It also offers advice on implementing or evaluating existing LIC programs.
Twelve tips on writing a discussion case that facilitates teaching and engages learners

Abstract The authors share twelve practical tips on writing a case that engages learners in active learning and discussion. They first advise that, during the initial preparation of the case, authors should (1) identify the case goals and objectives, and (2) identify the level of the learners. When writing the case, authors should (3) use active and colorful language; (4) use patients’ own descriptions rather than medical language; (5) allow the learners to interpret data themselves; (6) allow for natural discovery rather than presenting information chronologically; and (7) be realistic about interruptions in patient care. In addition, case authors should pay attention to methods that enhance discussion by (8) creating barriers to diagnostic or treatment options; (9) promoting questions and discussion over answers; (10) using cues to assure discussion flow and knowledge exploration; and (11) omitting details or inserting informational distractors. Finally, well-crafted questions are essential during the case presentation to engage learners in higher-order thinking; and to (12) stimulate curiosity and reflection.
Phonological fluency is uniquely impaired in Japanese‐speaking schizophrenia patients: Confirmation study

In alphabet‐based language‐speaking patients with schizophrenia, category fluency is disproportionately disturbed as compared with phonological fluency. Deficits in category and phonological fluency observed in Japanese patients, however, were similar. The aim of the present study was to replicate these findings by modifying the task to minimize the influence of lack of motivation and concentration in the patients. Similar deficits were found in both types of fluency in Japanese patients. Patients who speak Japanese have deficits in phonological fluency, compared with patients who speak alphabet‐based languages, suggesting that the pattern of impairment in verbal fluency in schizophrenia is dependent on the specific language system.
Minimum 2‐year follow up of sex reassignment surgery in Brazilian male‐to‐female transsexuals

general fatigue were resolved after a switch to blonanserin. Hypoglycemia was not detected on Day 167 following a 75-g OGTT. Her auditory hallucinations and persecutory delusions were improved (BPRS score: 21), therefore she was discharged on Day 180. Because complaints of hypoglycemia are similar to the sedative effect of SGA, clinicians may overlook hypoglycemia in patients with schizophrenia. We previously reported another case of hypoglycemia induced by quetiapine. In that case, replacement of quetiapine with perospirone improved the symptoms of hypoglycemia but asymptomatic hypoglycemia was still present upon repeat OGTT. In the current case, a switch to blonanserin improved not only the symptoms of hypoglycemia but also hypoglycemia itself upon repeat OGTT. Because blonanserin is a new antipsychotic, its effect on glucose metabolism has not been established. However, this report suggests that a switch to blonanserin may be useful when hypoglycemia induced by SGA occurs.
Hold on to your friends: Dedicated chaperones of ribosomal proteins

Eukaryotic ribosomes are assembled from their components, the ribosomal RNAs and ribosomal proteins, in a tremendously complex, multi‐step process, which primarily takes place in the nuclear compartment. Therefore, most ribosomal proteins have to travel from the cytoplasm to their incorporation site on pre‐ribosomes within the nucleus. However, due to their particular characteristics, such as a highly basic amino acid composition and the presence of unstructured extensions, ribosomal proteins are especially prone to aggregation and degradation in their unassembled state, hence specific mechanisms must operate to ensure their safe delivery. Recent studies have uncovered a group of proteins, termed dedicated chaperones, specialized in accompanying and guarding individual ribosomal proteins. In this essay, we review how these dedicated chaperones utilize different folds to interact with their ribosomal protein clients and how they ensure their soluble expression and interconnect their intracellular transport with their efficient assembly into pre‐ribosomes.
Sudden cardiac death due to quetiapine overdose

1. Starrenburg FC, Bogers JP. How can antipsychotics cause diabetes mellitus? Insights based on receptor-binding profiles, humoral factors and transporter proteins. Eur. Psychiatry 2009; 24: 164–170. 2. Chen CH, Lin TY, Chen TT et al. A prospective study of glucose homeostasis in quetiapine-treated schizophrenic patients by using the intravenous glucose tolerance test. Prog. Neuropsychopharmacol. Biol. Psychiatry 2011; 35: 965–969.
Addressing health workforce inequities in the Mindanao regions of the Philippines: Tracer study of graduates from a socially-accountable, community-engaged medical school and graduates from a conventional medical school

Abstract Developing and retaining a high-quality medical workforce in low-resource countries is a worldwide challenge. The Filipino Ateneo de Zamboanga University–School of Medicine (ADZU-SOM) has adopted a strong focus on socially accountable health professional education (SAHPE) in order to address the shortage of physicians across rural and urban communities in the Western Mindanao region. A cross-sectional survey of graduates from two Philippines medical schools: ADZU-SOM in the Mindanao region and a medical school with a more conventional curriculum, found ADZU-SOM graduates were more likely to have joined the medical profession due to a desire to help others (p = 0.002), came from lower socioeconomic strata (p = 0.001) and had significantly (p < 0.05) more positive attitudes to community service. ADZU graduates were also more likely to currently work in Government Rural Health Units (p < 0.001) or be generalist Medical Officers (p < 0.001) or Rural/Municipal Health Officers (p = 0.003). ADZU graduates were also less likely to work in private or specialist Government hospitals (p = 0.033 and p = 0.040, respectively) and be surgical or medical specialists (p = 0.010 and p < 0.001, respectively). The findings suggest ADZU-SOM’s SAHPE philosophy manifests in the practice choices of its graduates and that the ADZU-SOM can meet the rural and urban health workforce needs of the Western Mindanao region.
Comparison of two methods of energy prescription for obese non‐insulin‐dependent diabetics

Two groups of 15 known obese non-insulin-dependent diabetics were enrolled in a prospective study of weight loss over a 12 week period where energy was prescribed by two different methods. Group A: energy prescribed by a formula to estimate metabolic rate. Group B: energy prescribed by dietitian using a 24 hour dietary recall method. Energy prescribed by the formula was significantly higher than that prescribed by the dietitian (P<0.001). However, energy intake over the period of the study, estimated by three day weighed food intake, was similar in each group. Group A initially over restricted their diet (P<0.05) with a rise to prescribed amount at 12 weeks, whereas, Group B's intake rose after the first four weeks to the level prescribed for Group A, and significantly greater than the original prescription for this group (P<0.05). Both groups lost weight, Group A losing significantly greater amount (P<0.05) despite taking similar amounts of energy. This may be due to Group B underreporting their intake. Diet was prescribed as 55% carbohydrate, 15% protein, 30% fat. However, neither group managed to meet this recommendation, consuming significantly greater amounts of protein than was prescribed. Neither group showed any significant change in fasting blood glucose or fructosamine levels. Energy prescribed by a formula for estimating metabolic rate appears to prescribe energy at a higher level than estimated by a dietitian, which may lead to greater compliance and so improve weight loss.
MAMs are attractive targets for bacterial repurposing of the host cell

Pathogenic bacteria frequently target the endoplasmic reticulum (ER) and mitochondria in order to exploit host functions. ER‐mitochondria inter‐organelle communication is topologically sub‐compartmentalized at mitochondria‐associated ER membranes (MAMs). MAMs are specific membranous microdomains with unique regulatory functions such as lipid synthesis and trafficking, calcium homeostasis, mitochondrial morphology, inflammasome activation, autophagosome formation, and apoptosis. These important cellular processes are all modulated by pathogens to subvert host functions and promote infection, thus it is tempting to assume that pathogenic bacteria target MAMs to subvert these different pathways in their hosts. First lines of evidence that support this hypothesis come from Legionella pneumophila. This intracellular bacterium secretes an effector that exhibits sphingosine‐1 phosphate lyase activity (LpSpl) that seems to target MAMs to modulate the autophagy response to infection. Here we thus propose the concept that MAMs could be targeted by pathogenic bacteria to undermine key host cellular processes.
Has the new Kirkpatrick generation built a better hammer for our evaluation toolbox?

Abstract Although Kirkpatrick’s original outcome-focused model is widely used to evaluate medical education programs, it is subject to criticism. To combat this criticism and address the complexities of learning environments, the New World Kirkpatrick Model has emerged. This brief article describes key aspects of the New World Kirkpatrick Model for program evaluation. Specifically, it highlights three major criticisms of Kirkpatrick’s original model and discusses the ways in which this new model attempts to rebut them. By doing so, this article hopes to encourage medical teachers to try the New World Kirkpatrick Model in the evaluation of their complex educational programs and investigate its strengths and weaknesses.
Sequence‐specific targeting of chromatin remodelers organizes precisely positioned nucleosomes throughout the genome

Eukaryotic genomes are functionally organized into chromatin, a compact packaging of nucleoproteins with the basic repeating unit known as the nucleosome. A major focus for the chromatin field has been understanding what rules govern nucleosome positioning throughout the genome, and here we review recent findings using a novel, sequence‐targeted remodeling enzyme. Nucleosomes are often packed into evenly spaced arrays that are reproducibly positioned, but how such organization is established and maintained through dramatic events such as DNA replication is poorly understood. We hypothesize that a major fraction of positioned nucleosomes arises from sequence‐specific targeting of chromatin remodelers to generate “founding” nucleosomes, providing reproducible, predictable, and condition‐specific nucleation sites against which neighboring nucleosomes are packed into evenly spaced arrays.
Non‐homologous end joining: Common interaction sites and exchange of multiple factors in the DNA repair process

Non‐homologous end‐joining (NHEJ) is the dominant means of repairing chromosomal DNA double strand breaks (DSBs), and is essential in human cells. Fifteen or more proteins can be involved in the detection, signalling, synapsis, end‐processing and ligation events required to repair a DSB, and must be assembled in the confined space around the DNA ends. We review here a number of interaction points between the core NHEJ components (Ku70, Ku80, DNA‐PKcs, XRCC4 and Ligase IV) and accessory factors such as kinases, phosphatases, polymerases and structural proteins. Conserved protein‐protein interaction sites such as Ku‐binding motifs (KBMs), XLF‐like motifs (XLMs), FHA and BRCT domains illustrate that different proteins compete for the same binding sites on the core machinery, and must be spatially and temporally regulated. We discuss how post‐translational modifications such as phosphorylation, ADP‐ribosylation and ubiquitinylation may regulate sequential steps in the NHEJ pathway or control repair at different types of DNA breaks.
Relative Frequency of Echovirus 30 in Patients Suffering From Enterovirus Meningitis in Ahvaz

Background: Human enteroviruses are members of Picornaviridae family; they are non-enveloped, icosahedral viruses with positive RNA as genome. Echovirus 30 is an important member of enteroviruses that is recognized in outbreaks of enterovirus meningitis. Objectives: The aim of this study was to determine relative frequency of echovirus 30 as an important agent of aseptic meningitis among children referred to Aboozar hospital, Ahvaz, Iran. Patients and Methods: 34 cerebrospinal fluid samples from patients with enterovirus aseptic meningitis, negative bacterial culture, WBC (white blood cell) count > 5x106/mm3, and aseptic meningitis symptoms were entered in the study. These samples were collected in a year between May 2010 and May 2011. RNA of enteroviruses were extracted and investigated for echovirus 30 infection with RT-PCR (reverse transcription polymerase chain reaction) test. Samples also were cultured in RD (rhabdomyosarcoma) cell and positive results were approved by RT-PCR test with enterovirus specific primers. To recognize PCR-product, 440 bp RT-PCR product was sequenced and phylogenic tree was drawn based on Neighbor Joining method with 1000 replication bootstrap. Results: Echovirus 30 infection was not detected in any case. Just one CSF sample grew in RD cell culture. This sample was approved by RT-PCR and sequencing. Positive sample was recognized as coxsackie virus B3. Conclusions: There was no echovirus 30 in Ahvaz because of diverse nature of enteroviruses and several serotypes with various distribution patterns in different geographical regions, and the fact that echovirus 30 is mostly detected in outbreaks rather than endemism. Coxsackie virus B3 was responsible for aseptic meningitis of a child in this study. Based on another study conducted in Tehran, it seems that Coxsackie B viruses are among current agents causing enterovirus aseptic meningitis in Iran. Of course we need to conduct more studies in Ahvaz and other parts of the country to approve this hypothesis.
Building, Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.