Search

Gollop-Wolfgang complex is defined as the presence of a distal bifid femur and tibial hemimelia with or without hand ectrodactyly. The condition commonly presents with several skeletal abnormalities and internal organ congenital defects. We hereby report a case with a classical presentation of Gollop-Wolfgang complex.

OVERVIEW The following README contains: i) the raw count matrix relative to all nuclei of the dataset, called “filtered_feature_bc_matrix”; ii) the cell cycle genes lists (G2/M and S phase specific markers) named “cycle_gene”; iii) the markers gene lists used to generate the Dot Plots for the All_cells and Neuronal clustering (glial and neuronal markers); iv) the instruction to set up an R environment (R version 4.1.2) and to install R Studio on a Windows/macOS operative systems; iii) the instructions to install Seurat 3.2.3 along with all its dependencies; iv) the software code used to generate all the plots and figure as showed in the manuscript. SYSTEM REQUIREMENTS The following analysis can be performed on a standard computer with sufficient RAM to support the in-memory operation required by Seurat 3.2.3. The installation of Seurat 3.2.3 and all its dependencies have been tested on both Windows (version 10 64-bit ) and macOS (Big Sur version 11.6.1) operating systems. ALL PACKAGES and DEPENDENCIES R version 4.1.2 (2021-11-01) Platform: x86_64-apple-darwin17.0 (64-bit) Running under: macOS Monterey 12.2.1 Matrix products: default LAPACK: /Library/Frameworks/R.framework/Versions/4.1/Resources/lib/libRlapack.dylib locale: [1] en_US.UTF-8/en_US.UTF-8/en_US.UTF-8/C/en_US.UTF-8/en_US.UTF-8 attached base packages: [1] stats graphics grDevices utils datasets methods base other attached packages: [1] dplyr_1.0.8 scales_1.1.1 RColorBrewer_1.1-2 viridis_0.6.2 viridisLite_0.4.0 ggplot2_3.3.5 Matrix_1.3-4 [8] biomaRt_2.50.3 Seurat_3.2.3 loaded via a namespace (and not attached): [1] BiocFileCache_2.2.1 plyr_1.8.6 igraph_1.2.11 lazyeval_0.2.2 splines_4.1.2 [6] listenv_0.8.0 scattermore_0.8 GenomeInfoDb_1.30.1 digest_0.6.29 htmltools_0.5.2 [11] fansi_1.0.2 magrittr_2.0.3 memoise_2.0.1 tensor_1.5 cluster_2.1.2 [16] ROCR_1.0-11 limma_3.50.1 remotes_2.4.2 globals_0.14.0 Biostrings_2.62.0 [21] matrixStats_0.61.0 prettyunits_1.1.1 colorspace_2.0-3 blob_1.2.2 rappdirs_0.3.3 [26] ggrepel_0.9.1 crayon_1.5.0 RCurl_1.98-1.6 jsonlite_1.8.0 spatstat_1.64-1 [31] spatstat.data_2.1-2 survival_3.2-13 zoo_1.8-9 glue_1.6.2 polyclip_1.10-0 [36] gtable_0.3.0 zlibbioc_1.40.0 XVector_0.34.0 leiden_0.3.9 future.apply_1.8.1 [41] BiocGenerics_0.40.0 abind_1.4-5 DBI_1.1.2 miniUI_0.1.1.1 Rcpp_1.0.8 [46] xtable_1.8-4 progress_1.2.2 reticulate_1.24 bit_4.0.4 rsvd_1.0.5 [51] stats4_4.1.2 htmlwidgets_1.5.4 httr_1.4.2 ellipsis_0.3.2 ica_1.0-2 [56] pkgconfig_2.0.3 XML_3.99-0.9 farver_2.1.0 uwot_0.1.11 dbplyr_2.1.1 [61] deldir_1.0-6 utf8_1.2.2 tidyselect_1.1.2 labeling_0.4.2 rlang_1.0.2 [66] reshape2_1.4.4 later_1.3.0 AnnotationDbi_1.56.2 munsell_0.5.0 tools_4.1.2 [71] cachem_1.0.6 cli_3.2.0 generics_0.1.2 RSQLite_2.2.10 pacman_0.5.1 [76] ggridges_0.5.3 stringr_1.4.0 fastmap_1.1.0 goftest_1.2-3 bit64_4.0.5 [81] fitdistrplus_1.1-6 purrr_0.3.4 RANN_2.6.1 KEGGREST_1.34.0 sceasy_0.0.6 [86] pbapply_1.5-0 future_1.24.0 nlme_3.1-153 mime_0.12 xml2_1.3.3 [91] compiler_4.1.2 rstudioapi_0.13 plotly_4.10.0 filelock_1.0.2 curl_4.3.2 [96] png_0.1-7 spatstat.utils_2.3-0 tibble_3.1.6 stringi_1.7.6 lattice_0.20-45 [101] vctrs_0.3.8 pillar_1.7.0 lifecycle_1.0.1 BiocManager_1.30.16 lmtest_0.9-39 [106] RcppAnnoy_0.0.19 data.table_1.14.2 cowplot_1.1.1 bitops_1.0-7 irlba_2.3.5 [111] httpuv_1.6.5 patchwork_1.1.1 R6_2.5.1 promises_1.2.0.1 KernSmooth_2.23-20 [116] gridExtra_2.3 IRanges_2.28.0 parallelly_1.30.0 codetools_0.2-18 MASS_7.3-54 [121] assertthat_0.2.1 withr_2.5.0 sctransform_0.3.3 S4Vectors_0.32.3 GenomeInfoDbData_1.2.7 [126] mgcv_1.8-38 parallel_4.1.2 hms_1.1.1 grid_4.1.2 rpart_4.1-15 [131] tidyr_1.2.0 Rtsne_0.15 Biobase_2.54.0 shiny_1.7.1 SOFTWARE INSTALLATION GUIDE 1. R version 4.1.2 for Windows and for macOS can be downloaded at: https://cran.rstudio.com/. 2. All packages used can be installed running the following command install.packages() from R console. 3. Seurat 3.2.3 and all its dependencies can be installed running the following command line: remotes::install_version("Seurat", version = "3.2.3"). 4. A typical installation time on a “normal” desktop computer is around 15-20 minutes. INSTRUCTION FOR USE/EXPECTED OUTPUT/EXPECTED RUN TIME All the instructions to install and run the code on the data provided in this folder are in the document “SCRIPT.txt”. The expected outputs of the code are: 1) “NEURONS_markers.csv”; 2) Figure 5;3) Supplementary Figure12. Expected run time is about 10 min for all the analyses.

With technological innovations happening at workplaces, 21st century organizations demand competencies in thinking creatively and critically. These two skills will potentially help prospective employees become confident individuals, concerned citizens, self-directed learners, and active professionals. In this context, it becomes imperative to overhaul the lecture-based and banking model of the traditional pedagogical approach in order to impart such skills among undergraduate and graduate students. To address this issue, a lab-based teaching-learning method focused on problem-solving and design thinking was introduced at OAMK Labs in Finland. This study assesses the efficacy of lab-based learning in enhancing creativity and critical thinking among students from engineering, management, and science backgrounds of Kathmandu University, Nepal. The study was conducted in a workshop setting using a randomized control trial (RCT) where participants were divided into control and treatment groups. Participants in treatment group took part in a design thinking workshop that applied lab-based learning pedagogy, while those in the control group were given some reading material on improving creativity and critical thinking. Standard tests on both critical and creative thinking in a pre- and post-stages were administered to both groups. Data was analyzed using standard Difference-in-Differences technique. The results showed that while the level of critical thinking improved significantly, among the learners in treatment group alone, the creativity level in the post-stage increased significantly among learners in both groups. Results validated the efficacy of lab-based teaching-learning in addressing the need for critical and creative thinking skills among learners. Keywords: critical thinking, creativity, lab based learning, innovation, higher education, Difference-in-Differences

In the last decade, boot camp residency preparatory courses for fourth-year medical students have become increasingly popular in medical schools across the USA; however, the curricular content of these courses varies widely. The authors surveyed internal medicine interns at a large academic medical center regarding clinical and non-clinical topics that would be useful for an internal medicine residency preparatory curriculum. The response rate was 79% (64/81). A rational approach to antibiotics (42%) and electrolyte management (41%) were the most frequent clinical topics and cross-cover (69%) was the most frequent non-clinical topic selected by interns.

Outpatient exam room presentations (OERPs) in resident continuity clinic (RCC) can operationalize competency-based medical education and enhance patient satisfaction. We aimed to assess current OERP use and OERP barriers by surveying internal medicine attendings prior to and following a 4-week pilot of OERPs in RCC. Twenty-six out of an eligible 35 attendings completed the pre-pilot survey. Twenty attendings participated in the pilot and completed the post-pilot surveys. On the pre-pilot survey, 65% (17/26) of participants reported never using OERPs. Attendings’ perception of learner discomfort with OERPs as somewhat of or a significant barrier significantly decreased from pre-pilot to post-pilot (96% (25/26) v. 65% (13/20), p = 0.03). Time, feedback, and sensitive topics were frequently rated as barriers on both the pre-pilot and post-pilot surveys. On the post-pilot survey, most participants reported patient discomfort with OERPs, attending physician discomfort with OERPs, difficulty writing attestations during OERPs, and difficulty teaching during OERPs were not barriers. Additionally, 45% (9/20) reported planning to use OERPs in the future. Despite benefits of OERPs, there are several barriers to OERPs that need to be addressed prior to more routine implementation in resident continuity clinic. Further research should focus on strategies for overcoming barriers and maximizing benefits of OERPs as well as developing a set of OERP best practices to support routine implementation in RCC. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40670-019-00773-7) contains supplementary material, which is available to authorized users.

Legumes are alternative protein sources that have been successfully used to develop diverse meatless foods. Although these plant-based products have a lower impact on the environment than equivalent animal-based products, they have lower protein digestibility. Germination could be a useful bioprocess to enhance protein digestibility in legumes, although its effect at different times of seedling development has been little studied in lentils and faba beans. This work investigated the effect of germination time (4 and 6 days after full seed imbibition) on the proteins of three types of Canadian lentils (“gray zero tannin”, G; “caviar black”, B; and “red dehulled”, D) and faba beans (“zero vicin/convicin”, F). Germination increased total nitrogen (4–14% increase) and total levels of some amino acids: Asp in all the sprouts studied; Ser, Pro, Ala, Cys, His and Lys in G; and Met and Tyr in B. A concurrent degradation of the 7S and 11S globulin subunits, the accumulation of peptides below 20 kDa and free essential and non-essential amino acids (4- to 6-fold increase) were observed after germination in all the legumes studied. These effects were attributable to the increased protease activity observed after sprouting. Trypsin inhibitory activity was lower in legume sprouts, except for D, where a small increase was detected. Time, legume type and their interaction showed significant effects on the parameters studied. Germination effects were generally more remarkable at longer stages of seedling development. Among the legumes studied, D showed a differential behavior characterized by a faster protein degradation and release of small peptides, probably due to its higher protease activity as indicated by principal component analysis. These results evidence the positive effects of germination on the protein digestibility of different lentil types and faba beans. The protein quality of plant-based foods could be improved through the selection of legume species with higher germination-induced proteolytic rates and optimized germination times., This research was funded by the University of Saskatchewan, grant “Lentils for Sustainable and Healthy Proteins (Ref. 20196324)”.

This paper aims to analyse labour market trajectories and mobility of immigrants in Spain, in a comparative perspective with the UK and Canada. This approach gives us information about risks and uncertainty, which different working groups are exposed to (Crouch, 2008; 2009)1. Today's interest for labour mobility rests on its importance in the European Employment Strategy and the OECD goals (2009). This two institutions call for a more flexible labour market through a major mobility, thus reducing unemployment, poverty, and providing social upward progression and a better supplydemand adjustment. Hence, it allows workers to improve their occupational and social status, and therefore limiting their risk of poverty. In other words, labour upward mobility brings security, as well as it contributes to reduce risk and uncertainties among workers.

INTRODUCTION: Outpatient exam room presentations (OERPs) in resident continuity clinics could address several current challenges in graduate medical education including increasing patient satisfaction, enhancing patient-centered care, and operationalizing competency-based education through direct observation. The authors’ aim of this study was to explore the positive and negative aspects of OERPs as a precepting model in resident continuity clinics and to develop a list of best practices for medical educators to utilize when conducting OERPs. MATERIALS AND METHODS: The authors defined an OERP as a case presentation and subsequent discussion taking place inside the exam room with the attending physician, resident physician, and patient present. Following a 1-month pilot period of conducting OERPs in internal medicine resident continuity clinics, the authors conducted individual phone interviews and focus groups with internal medicine attendings and residents, respectively. The authors analyzed transcripts using thematic analysis and the constant comparative method. Sixteen attendings participated in individual phone interviews and four resident focus groups averaged five participants per group. RESULTS: Four main topics emerged: (1) effect of OERPs on patient care, (2) effect of OERPs on medical education, (3) barriers to OERPs, and (4) OERP best practices. CONCLUSION: Participants noted both positive and negative effects of OERPs on patient care and medical education. Best practices suggested to maximize these benefits and minimize drawbacks included targeting OERPs to certain types of clinical encounters and employing strategies to preserve the resident physician-patient relationship and resident autonomy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40670-020-01092-y) contains supplementary material, which is available to authorized users.

INTRODUCTION AND OBJECTIVE:Active surveillance for low-risk prostate cancer has increased by 3 fold between 2010-15 in the US. Barriers to undergoing active surveillance include clinical, physician...