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<s>[INST] context: * The findings of dyspnea, elevated JVP and pedal oedema are suggestive of right sided CHF * Parasternal heave and palpable S2 indicates pulmonary aery hypeension * This also explains why lungs are clear since pulmonary oedema is absent in PAH * Reduced RV compliance in RVH leads to elevated JVP and oedema in feet * The reason for dyspnea is less pulmonary flow due to PAH. Echo for mitral stenosis Useful for diagnosis as PAH is seen in long standing MS ELISA For HIV Useful for diagnosis of Group 1 PAH Urine and stool for Schistosoma Useful for diagnosis of Group 1 PAH WHO classification of PAH Group 1 Idiopathic PAH HIV Poal Hypeension (Schistosomiasis) Drugs Connective tissue disorders Pulmonary veno-occlusive disease Group 2 Pulmonary aery hypeension due to left hea disease Group 3 PAH due to lung disease like COPD, interstitial lung disease Group 4 PAH due to secondary thromboembolism with occlusion of proximal or distal pulmonary aeries Group 5 PAH due to Hematological disorders: Myeloproliferative disorders Systemic disorders: Sarcoidosis, Langerhans cell histiocytosis Metabolic disorders: glycogen storage disorders Miscellaneous: Tumor embolization [/INST] question: A patient came with dyspnea, elevated JVP and edema in the feet. Lungs are clear. There is a parasternal heave and S2 is palpable in the pulmonary area. Which one of the following is LEAST helpful in determining etiology? | options: A: Echo for mitral stenosis B: Anti-endomysial antibody estimation C: ELISA for HIV D: Urine/stool examination for Schistosoma ova | answer: B </s> |
<s>[INST] context: I walked up to the counter. Behind it was a lady with glasses on the tip of her nose and gray hair on her head.
"Excuse me," I said. She looked up. "You're that Clements kid," she said. "I' m Miss Bee. Come closer and let me get a look at you." She pushed her glasses up her nose. "I can describe you to the police if something goes missing from the store."
"I' m not a thief!" I was shocked. I was seven too young to be a thief!
"From what I can see you're not much of anything. But I can tell you've got potential." She went back to reading her newspaper.
"I need to get these." I said, holding up my list. "So? Go get them." Miss Bee pointed to a sign on the screen door. "I'm not your servant, so I suggest you get yourself a basket and start filling."
I visited Miss Bee several times a week that summer. Sometimes she short-changed me. Other times she overcharged. "That can of beans is only twenty nine cents" I corrected her one afternoon. I had watched the numbers change on the cash register closely, and Miss Bee had added 35 cents. She didn't seem embarrassed. She just looked at me over her glasses and fixed the price.
But she ever let me declare victory. All summer long she found ways to play tricks on me. No sooner had I learned how to pronounce bicarbonate of soda and memorized its location on the shelf than Miss Bee rearranged the shelve and made me hunt for it all over again.
One day before I left, she said, "I know what you think of me, but I don't care! Each of us is put on this earth for a reason. I believe my job is to teach every child I meet life lessons. When you get older you'll be glad our paths crossed!" Glad I met Miss Bee?Ha! The idea was absurd...
Until one day my daughter asked me to finish her math problems. "If I do it for you how will you ever learn to do it yourself?" I said. Suddenly, I remembered the lady Miss Bee. [/INST] question: The girl felt _ when Miss Bee implied she could be a thief. | options: A: surprised B: shocked C: puzzled D: annoyed | answer: B </s> |
<s>[INST] context: Devices used foroxygen therapy Performance of these devices can be described according to 1. Themaximum oxygen concentrationachievable to be delivered to the patient, and the reliability/ variability with which the devices do that. Looking at the reliability and variability of oxygen delivery to the patient we can divide these pieces of equipment intofixed performance or variable performance devices. This means that the achieved inspired oxygen concentration is either more dependent on thepatient'speak inspiratory flow rate (PIFR)(variableperformance devices) or less so (fixedperformance devices). Fixed performance devices These devices deliver a fixed inspired oxygen concentration to the patient, independent of the PIFR. Even at the time of PIFR no random entrainment of room air will occur to unpredictably alter the FiO2 with this equipment. Devices in this group include: SS Venturi mask Thereisentrainment of room air with these devices, but it is fixed and not dependent on the patient's PIFR. Therefore the resulting delivered FiO2 is also constant. SS Non-rebreather facemask A reservoir bag supplies 100% oxygen and makes up for the deficit which occurs during times when the patient's PIFR is higher than the oxygen supply flow to the mask (usually around 20 L/min from an oxygen wall or tank source). Aflap valveon the mask prevent or at least reduce entrainment of room air. These masks do not achieve a perfect seal with the patient's face, sosomeroom air entrainment still occurs. FiO2 up to 70-80% can be achieved. SS Anesthetic facemask(with an anesthetic breathing circuit) These masks form a complete seal around the patient's airway so no entrainment of room air can occur. The delivered oxygen concentration is the same as in the gas mixture supplied to the mask (assuming no rebreathing occurs in the anesthetic breathing cicuit). We have also listed thePatil-Syracuseand theendoscopy maskunder this heading. Both of these devices allow instrumentation with a fiberoptic scope while maintaining a seal to the face with the mask. 2. Variable performance devices These devices deliver a variable inspired oxygen concentration to the patient, which depends on the PIFR. Depending on a patient's inspiratory effo (tidal volume, 'speed' of inspiration and respiratory rate) the PIFR can often exceed the flow rate at which oxygen or an oxygen/air mixture is supplied by the device, meaning that at the time of PIFR more or less entrainment of room air occurs, altering the resulting FiO2 in an unpredictable fashion Devices in this group are: SS Nasal cannulas Simple facemask/ 'Hudson' mask [/INST] question: Which of the following can delivery 100% oxygen | options: A: Venturi mask B: Anesthetic face mask C: Hudson mask D: Non - rebreather face mask | answer: B </s> |
<s>[INST] context: Living in a culture that is different from your own can be both an exciting and challenging experience. The following are six cultural differences between China and the US to help promote mutual understanding.
Chinese people do not have the same concept of privacy as Americans do. They talk about topics such as ages, income or marital status, which Americans think is annoying and disturbing.
Family
In China, elders are traditionally treated with great respect while the young are cared for. In America, the goal of the family is to encourage independence, particularly that of the children. Unlike the Chinese, older Americans seldom live with their children.
Friends
Chinese people have different meanings to define friends. Just hanging out together time to time is not friendship. Friendship means lifelong friends who feel it deeply necessary to give each other whatever help might seem required. Americans always call people they meet friends, so the definition of friends is general and different. There are work friends, playing friends, school friends and drinking friends.
Money
As is well known,the Chinese like to save. They are always conservative when they are planning to spend money. It is different in the US, where far fewer families are saving money for emergencies and education than their Chinese counterparts
Education
Chinese people value education and career more than Americans, who in turn put more emphasis on good character and faith.
Team VS Individual
Basically China values the community and the US values the individual. If you achieve something in the US, it's because you are great. While in China, if you achieve something it's because the team, or family, or company is great. Everything you do gets attributed to the greater whole, while in America individual merits are celebrated. [/INST] question: Which is the most appropriate word to show the first cultural difference ? | options: A: Privacy B: Income C: Age D: Marriage | answer: A </s> |
<s>[INST] context: Hemothorax: Causes
trauma (most common)
tumor
tuberculosis
Diagnosis is made by needle aspiration of pleural fluid.
Harrison writes that for making a diagnosis of hemothorax, the pleural fluid hematocrit should be > 50% of the peripheral blood.
Chest X rays are taken to assess the presence and extent of pleural cavity collection (blood or simple plural fluid)
a supine position with horizontal x-ray beam (k/a decubitus position) is better than an erect film, as about 400-500 ml of blood may be hidden by diaphragm on upright chest x-ray.
Management of hemothorax
Most of the hemothorax can be t/t effectively with a large bore chest tube drainage and in most of the cases the bleeding stops as the lungs re-expands.
A small number of cases will require thoracotomy
continued bleeding
a significant blood clot has formed.
Currently, most hemothoraces requiring more than simple tube drainage can be managed with Videothoracoscopy. Thoracotomy may be needed only if more extensive exposure is needed to manage an active source of bleeding or if extensive decortication of the lung is necessary. [/INST] question: About hemothorax -a) Seen in choriocarcinomab) Supine posture is better than erect posturec) Needle aspiration may be needed for diagnosisd) Thoracotomy is always done | options: A: ab B: bc C: acd D: abc | answer: D </s> |
<s>[INST] context: Have you ever wanted to stop eating something sweet but you just couldn't ?Is the first thing you do wehn you get home from schol to look in the biscuit tin ?Can you eat a huge bar of chocolate all by yourself ?Can you say "no"to sweets at parties ?If you can't ,thenn there is a reason ...perhapos you are a sugar addict !Does that sound funny ?Well ,doctors say that people who eat sweets regularly can easily becoame addicted to sugar .What's more ,most sugar addicts don't even realize that they are addicted !Sugar addiction is serious becauase it can really _ your health .doctors say that we should eat food which is healthy such as fresh fruits and vegetables,and that we shouldn't eat a lot of sugar ,fat or fast food .But sugar addicts can't follow this advice .They know they must stop eating sweet food,bu htey can't .
So what can you do if you think you are ddced o he taste of sugar?Well here is some advice :
Eat some fresh fruits when you really want something sweet to eat .
Cut down son sweet foo lowly .Don't try to stp eating it at once
You have to tell your parents ,If they know ,they will help you. [/INST] question: What does the nderlined word "damage"mean ? | options: A: be kind to B: be good ofr C: be harmful to D: be sorry for | answer: C </s> |
<s>[INST] context: Company: KinderCare
Location: US-TX-College Station
Base Pay: 600$ ,.
Employee Type: Full-Time Employee
Industry: Education-Teaching-Management
Job Type: Education
Required Education: 2 Years Degree
Required Experience: At Least 1 Year
Jobs So Desirable, We Hate To Call It Work... Looking for a great opportunity and the chance to make a difference? KinderCare Learning Centers is the leading for-profit provider of early childhood educational services and care in the country with nearly 120,000 children enrolled. KinderCare's training is the key to providing high quality education and care for children 6 weeks to 12 years old. We are looking for devoted, responsible, and creative people for full-time and part-time positions at our centers located in College Station and Bryan, TX. REQUIREMENTS
Successful applicants will possess a High School diploma or GED, and at least 1 year of childcare experience. You must also have 12 credits in Early Childhood Education or be now enrolled in ECE classes and possess 6 credits in ECE.
We offer a wonderful work environment! If you have previous education and/or experience in childcare and a love for children, we want to hear from you! Salary goes with experience and position.
KinderCare offers a comprehensive benefits package, a competitive salary, and childcare discount. KinderCare is an Equal Opportunity Employer.
To apply, please contact us at:
Kinder Care Learning Centers
1711 Village Drive
College Station, TX 77840
Fax: (979) 696-6616
Email: [ Click here for email ] www. kindercare. corn [/INST] question: From the ad above, it seems that the company wants _ . | options: A: nurses B: managers C: trainees D: teachers | answer: D </s> |
<s>[INST] context: Shanghai Air & Hotel with Transfers/One Day Hangzhou City Tour(PK0482737SHA06)
Package Inclusive
*Return Air Tickets
*2 Nights Accommodation
*Return Airport Transfers
*One Day Hangzhou City Tour
Booking Period:29 Jan 2015 to 31 Dec 2015
Travel Period:29 Jan 2015 to 31 Dec 2015
ONE DAY HANGZHOU CITY TOUR
It is a city rich with history and culture,spanning back over 2000 years.With its inviting views and outstanding scenery,the area soon became popular with artists,poets and painters seeking inspiration in this little bit of paradise.
Our first stop is Six Harmonies Pagoda.You will get to visit the charming museum and snap some photos in front of this architectural marvel that was built in the Song Dynasty.
Next stop will be a visit to Meijiawu Tea Village,for a traditional tea ceremony and its significance to Chinese culture.
After lunch,the beautiful view of West Lake is going to greet us.We will have a cruise across West Lake to experience peace and serenity like no place else in the Shanghai area.The unforgettable scenery includes Three Pools Mirroring the Moon,Bai and Su Causeways,Solitary Hill,and Leifeng Pagoda,etc.The boat ride ends at Viewing Fish at Flower Harbor.We will have the chance to walk along on Su Causeway,and feed the fish in the Red Fish Pond to pray for the good luck.
Pickup Time:Between 7:30 a.m.--8:30 a.m.
Duration:10 hrs
2--WAY SHANGHAI PUDONG INTERNATIONAL AIRPEIRT TRANSFERS
Transfer between Shanghai Pudong International Airport(PVG) to your hotel is provided by mini bus.On arrival,you will be met by our driver after custom clearance.
Should you require further assistance,please contact our hotline:+86 21 6322 3855 [/INST] question: What service will you get from One Day Hangzhou City Package Tour? | options: A: Round-trip air tickets B: One day accommodation C: Free food service D: Force-shopping | answer: A </s> |
<s>[INST] context: When the two tiny ducklings were caught by the sharp jaws of a larger German shepherd, they must have thought _
But as luck would have it for the frightened wild ducklings that had lost their mother, the dog that helped them out of the bushes had only their best interests at heart.
Duke, a one-year-old German shepherd, found the two ducklings hidden in long grass next to his owner's workplace on the edge of the Thronybank Industrial Estate in Dalkeith.
And despite the natural instincts of a hunter, the dog gently took them in its mouth and carried them back to his blanket, putting them down where it was warm and even washing them clean with his tongue.
The ducklings will be looked after by staff at the center until they are old enough to be released into the wild.
"This dog is a modern day Rin Tin Tin,( The world's most famous German shepherd dog) and to pick them up in his mouth without harming them is quite something. "To them try and wash them is just amazing behavior." said one of the staff. [/INST] question: Duke is the _ of the German shepherd. | options: A: name B: owner C: friend D: trainer | answer: A </s> |
<s>[INST] context: Amyloid deposits appear similar by light and electron microscopy, but actually represent a heterogeneous population of proteins that have a common teiary structure forming a beta-pleated sheet. Questions about the type of amyloid seen in different disease states are orites on examinations. Here are two tables to help you out: Systemic amyloidosis: Chronic active diseaseAA amyloid from serum amyloid- associated (SAA) protein from liver (choice A)Myelomas and related diseasesAL amyloid from immunoglobulin light chain (choice B)Chronic hemodialysisBeta2 microglobulin (related to high plasma levels) (choice C)Nephropathic hereditary forms (familial Mediterranean fever)AA amyloid from SAA (choice A)Cardiomyopathic hereditary forms (senile systemic amyloidosis)Prealbumin/transthyretin Neuropathic hereditary syndromesPrealbumin/transthyretin Localized amyloidosis: Senile cardiac amyloidosisAtrial natriuretic peptide-related fibrilsCerebral amyloid in Alzheimer disease, Down syndromeCerebral amyloid in Alzheimer disease, Down syndromeMedullary carcinoma of thyroidCalcitonin precursors (choice D)Isolated, massive, nodular deposits (skin, lung, urogenital tract)AL from light chains (choice B) [/INST] question: A 55-year-old men is diabetic and has a long history of renal failure. He is currently waiting for an organ for transplant and has been on hemodialysis in the interim. If this man develops amyloid deposits around his joints, they are likely to be composed of which of the following substances? | options: A: Amyloid-associated protein B: Amyloid light chains C: Beta2 microglobulin D: Calcitonin precursors | answer: C </s> |
<s>[INST] context: The Chinese word "Shanzhai" means a small mountain village, but now it becomes an accepted name for fakes , after "Shanzhai Cell-phones" produced by small workshops in southern China became popular in the mainland market over the past two years.
Besides "Shanzhai" electronic products, there are "Shanzhai" movies, "Shanzhai" stars and even a "Shanzhai" Spring Festival Gala , a copy of the 25-year-old traditional show presented by CCTV on Chinese Lunar New Year's Eve.
"Shanzhai" has become a culture of its own, meaning anything that imitates something famous.
In Chongqing, "Shanzhai" version "Bird's Nest" and "Water Cube" woven by farmers with bamboo attract wide attention from tourists. Both are copies of the famous Olympic buildings in Beijing.
A literature critic said that taking the "Shanzhai" Gala as an example, when the traditional CCTV program becomes less and less attractive to the audience, the"Shanzhai" version appears timely to attract people. "Although it is often connected with poor techniques and operation, 'Shanzhai' culture meets the psychological needs of common people and could be a comfort to their minds," he said.
To the mainstream culture, the rise of "Shanzhai" culture is a challenge and a motivation . People believe different kinds of cultures developing together is a perfect situation and it is for the public to choose. [/INST] question: The Chinese word "Shanzhai" may have started with _ . | options: A: Spring Festival Gala B: electronic products C: fake cell-phones D: Olympic buildings | answer: C </s> |
<s>[INST] context: Ingestion of glucose results in secretion of a "gut factor" into the blood that subsequently increases insulin secretion by b cells. The most likely candidate for this action is the intestinal peptide known as gastric inhibitory peptide (GIP), which obviously was named for its effects on the stomach. GIP secretion is increased during ingestion of glucose and the blood level produced is sufficient to stimulate insulin secretion. Because of this effect on insulin secretion, GIP is sometimes referred to as glucose-dependent insulinotropic peptide. Activation of the sympathetic innervation to the pancreas inhibits insulin secretion an a2-adrenergic mechanism. Hence, any sympathetic reflexes activated during ingestion of glucose would decrease insulin secretion. While paracrine release of somatostatin by D cells in the islets does inhibit insulin secretion by b cells, there is no reason to suspect that intravenous versus ingested glucose would have a differential effect on somatostatin release. The same holds true for glucagon secretion by a cells. Fuhermore, glucagon has a paracrine effect to increase insulin secretion. [/INST] question: Two normal, healthy subjects volunteer for a study on insulin secretion. In Patient 1, blood glucose is increased to 150 mg/dL by direct intravenous infusion. In Patient 2, blood glucose is increased to 150 mg/dL by ingestion of oral glucose. The peak plasma insulin concentration produced in Patient 1 is 70 uU/mL while in Patient 2, it is 95 uU/mL. Which of the following best explains the higher insulin concentration in Patient 2? | options: A: Ingested glucose activates a sympathetic reflex that increases b cell release of insulin B: Ingested glucose increases duodenal secretion of gastric inhibitory peptide (GIP), increasing b cell release of insulin C: Intravenous glucose increases islet cell secretion of somatostatin, inhibiting b cell release of insulin D: Intravenous glucose increases islet cell secretion of glucagon, inhibiting b cell release of insulin | answer: B </s> |
<s>[INST] context: For several days I saw little of Mr. Rochester. In the morning he seemed very busy with business, and in the afternoon gentlemen from the neighborhood called and sometimes stayed to dine with him. When his foot was well enough,he rode out a great deal.
During this time,all my knowledge of him was limited to occasional meetings about the house, when he would sometimes pass me coldly,and sometimes bow and smile. His changes of manner did not offend me,because I saw that I had nothing to do with the cause of them.
One evening,several days later,I was invited to talk to Mr.Rochester after dinner. He was sitting in his armchair, and looked not quite so severe,and much less gloomy,There was a smile on his lips, and his eyes were bright, probably with wine. As I was looking at him,he suddenly turned,and asked me,"Do you think I am handsome,Miss Eyre?
The answer somehow slipped from my tongue before I realized it: "No,sir."
"Ah, you really are unusual! You are a quiet, serious little person, but you can be almost rude."
"Sir, I'm sorry. I should have said that beauty doesn't matter,or something like that,"
"No,you shouldn't! I see,you criticize my appearance,and then you stab me in the back! You have honesty and feeling. There are not many girls like you. But perhaps I go too fast. Perhaps you have awful faults to counterbalance your few good points.
I thought to myself that he might have too. He seemed to read my mind,and said quickly,"Yes,you're right. I have plenty of faults. I went the wrong way when I was twenty-one,and have never found the right path gain. I might have been very different. I might have been as good as you,and perhaps wiser. I am not a bad man,take my word for it,but I have done wrong. It wasn't my character,but circumstances which were to blame. Why do I tell you all this? Because you're the sort of person people tell their problems and secrets to,because you're sympathetic and give them hope."
It seemed he had quite a lot to talk to me. He didn't seem to like to finish the talk quickly,as was the case for the first time.
"Don't be afraid of me,Miss. Eyre,"He continued. "You don't relax or laugh very much,perhaps because of the effect Lowood school has had on you. But in time you will be more natural with me,and laugh,and speak freely. You're like a bird in a cage. When you get out of the cage,you'll fly very high. Good night." [/INST] question: At the beginning Miss Eyre's impressions of Mr. Rochester were all except _ | options: A: busy B: sociable C: dull D: changeable | answer: C </s> |
<s>[INST] context: Explanation:Criteria for screeningThe test must satisfy the criteria of acceptability; repeatability and validity.Simplicity; safety, rapidity; ease of administration and cost are other considerations.Acceptability: Test should be acceptable to the people or whom it is aimed. In general, tests that are painful. discomforting or embarrassing (e.g.. rectal or vaginal examinations) are not likely to be acceptable to the population in mass campaigns.Repeatability: The test must give consistent results when repeated more than once on the same individual or material, under the same conditions.Validity (accuracy): The term validity refers to what extent the test accurately measures which it purports to measure. In other words, validity expresses the ability of a test to separate or distinguish those w!ho have the disease from those who do not.It has two components: Sensitivity and specificitySensitivity: It has been defined as the ability of a test to identify correctly all those who have the disease that is "true positive".Specificity: It is defined as the ability of a test to identify correctly those who do not have the disease, that is, "true negatives".The disease to be screened should fulfill following criteria:Prevalence should be highThere should he latent period / asymptomatic periodNatural history should be adequately knownFacility should be available for confirmationEffective treatment [/INST] question: Which of the following is not considered for selecting a screening test? | options: A: Disease burden B: Physician's Knowledge of the disease C: Cost of the test D: Treatment efficacy | answer: B </s> |
<s>[INST] context: (Refer: AAP Committee on Infectious Diseases)
"Women with tuberculosis who have been treated appropriately for two weeks or more and who are not considered contagious may breastfeed.
Breastfeeding and ATT drugs
The American Academy of Pediatrics Recommendation
Women with tuberculosis who have been treated appropriately for two weeks or more and who are not considered contagious may breastfeed.
No toxicity has been reported from this small concentration in breast milk.
Pyridoxine deficiency may cause seizures in the newborn.
Supplemental pyridoxine should be administered to infants on INH or whose mother is taking the drug.
Breastfeeding may be discouraged in women who are yet to commence treatment at the time of delivery and those who are still actively excreting the bacillus while coughing.
It may also be discouraged as part of a prevention of mother to child transmission in HIV coinfection and women with tuberculosis of the lactiferous ducts or glands in the absence of evidence of congenital tuberculosis, isoniazide (10 mg/kg/day) should be commenced at birth and continued for six months in infants. [/INST] question: Breastfeeding should be avoided by a mother on AT for how many weeks? | options: A: 1 B: 2 C: 3 D: 4 | answer: B </s> |
<s>[INST] context: Miep Gies, the woman who hid the Dutch girl Anne Frank's diary from the Nazis to become one of the world's most-read books, died after a brief illness at the age of 100.
It was Gies who guarded Anne's diary, and presented it to the girl's father, Otto, when he returned from the Auschwitz concentration camp at the end of World War II--the only one of his family to survive.
In her diary, Anne Frank wrote about her teenage life hiding from the Nazis in Amsterdam from 1942 to 1944, when the Nazi police discovered her and her family's hiding place. The diary, first published in 1947, has been translated into 70 languages.
Anne Frank expressed a great wish to live on after death. Miep Gies saw it as her duty to help in making this happen.
Born in Vienna in 1909, Gies moved to the Netherlands at the age of 11. In 1933, she began working for Otto Frank at his trading company. At great risk to her own safety, she and four other helpers brought food and supplies to the Frank family hiding in a secret office building for more than two years.
When she turned 100, _ . "I'm not a hero," she said. " It wasn't something I planned in advance. I simply did what I could to help."
Every day she received letters from all over the world with questions about her relationship with Anne Frank and her role as a helper. Gies received many honors for her role, including from the Netherlands, Germany and Israel. [/INST] question: When did Miep Gies move to the Netherlands? | options: A: In 1909 B: In 1920 C: In 1933 D: In 1947 | answer: B </s> |
<s>[INST] context: There are a great number of people in the world while few people are great.I think there is probably only one great person out of 10,000 at best,and most probably much less than that.
The reason why there are only few of them is that most people do not pay the price of greatness.There are so many people who want to be great,why only very few of them actually pay the price? The answer to the question explains the difference between the almost 100% people who want to be great and the much less than 0.01% who actually be so.The reason is that the road to greatness is full of pains.
Greatness requires sacrifices and there is no sacrifice without pain.The kind of sacrifices required for greatness is the ones that make the process continuously painful for long time.If you only want to be good it may be painful just every now and then,and many people can still handle it.But being great is a total difference.The pain is much deeper and it is continuous,so very few people can endure this kind of pain.Most people naturally choose things that bring pleasures to them.It's unnatural to choose pain over pleasure,let alone doing it continuously for long time.But that's what I believe is the secret to greatness: The secret to greatness is choosing pain over pleasures continuously for long time. [/INST] question: If one person only wants to be good,what will he/she face? | options: A: Occasional pains B: Continual work C: Constant pains D: Various difficulties | answer: A </s> |
<s>[INST] context: One fine day, an old couple around the age of 70, walked into a lawyer's office. Obviously, they were there to file a divorce. Lawyer was very puzzled, after having a chat with them, he got their story.
This couple had been quarreling all their 40 over years of marriage nothing ever seemed to go right. They hang on because of their children, afraid that it might affect their up-bringing. Now, all their children have already grown up, have their own family, there's nothing else the old couple have to worry about, all they want is to lead their own life free from all these years of unhappiness from their marriage, so both agree on a divorce.
While they were signing the papers, the wife told the husband. " really love you, but I really can't carry on anymore, I'm sorry."
"It's OK, I understand." said the husband. Looking at this, the lawyer suggested a dinner together, just three of them, wife thought, why not, since they are still going to be friends.
At the dining table, there was a silence of awkwardness .
The first dish was roasted chicken, immediately, the old man took the drumstick for the old lady. "Take this, it's your favorite."
Looking at this, the lawyer thought maybe there's still a chance, but the wife was frowning when she answered. "This is always the problem, you always think so highly of yourself, never thought about how I feel, don't you know that I hate drumsticks?"
Little did she know that, over the years, the husband had been trying all ways to please her, little did she know that drumsticks were the husband's favorite.
Little did he know that she never thought he understood her at all, little did he know that she hated drumsticks even though all he wanted was the best for her.
That night, both of them couldn't sleep, toss and turn , toss and turn. After hours, the old man couldn't take it anymore, he knows that he still loves her, and he can't carry on life without her, he wants her back, he wants to tell her, he is sorry, he wants to tell her, "I love you."
He picks up the phone, started dialing her number. Ringing never stops. He never stop dialing.
Little did she remember, he had heart problems.
The next day, she received news that he had passed away. She rushed down to his apartment, saw his body, lying on the couch still holding on to the phone. He had a heart attack when he was still trying to get through her phone line.
As sad as she could be, She would have to clear his belongings and she saw this insurance policy, dated from the day they got married, beneficiary is her. Together in that file there's this note:
"To my dearest wife, by the time you are reading this, I'm sure I'm no longer around, I bought this policy for you, though the amount is only $1,000,000 I hope it will be able to help me continue my promise that I have made when we got married, I might not be around anymore, I want this amount of money to continue taking care of you, just like the way I will if I could have lived longer. I want you to know I will always be around, by your side. I love you." [/INST] question: The old couple went into a lawyer's office to_. | options: A: have a chat with him B: make an appointment for dinner C: ask for help D: tell him their story | answer: C </s> |
<s>[INST] context: Has a doctor ever given you a note to take to the chemist for some medicine? Are you able to read the note easily? Some doctors write clearly , but most doctors do not. Chemists have more chances to read doctors' notes, but sometimes doctors write so badly that even the chemist can't read them.
One day a lady wrote to a doctor inviting him to have dinner at her house. The doctor wrote an answer, but he didn't write clearly and the lady couldn't read it.
"What shall I do?" she said to her husband, "I don't know whether he is coming or not. I don't want to give him a telephone call and say that I can't read his writing."
Her husband thought a moment, then he had an idea.
"Thank you," said his wife. "That's a very good idea."
She went to the chemist's shop and gave the doctor's note to the chemist. The chemist looked at it very carefully. Then he said politely, "Could you wait a moment, madam?" He went to the back of the shop. After a few minutes he returned carrying a large bottle. He gave the bottle to the lady and said, "Three times a day and one spoonful at a time." [/INST] question: It isn't _ for us to read the notes written by most doctors. | options: A: right B: pleased C: easy D: difficult | answer: C </s> |
<s>[INST] context: If you are looking for a creative solution to a piece of work or a school assignment,don't lock yourself up in a quiet room.
A new study suggests that moderate background noise is a better spur to creative thinking than the sound of silence,Time magazine reported.
A paper published in the Journal of Consumer Research says that the perfect working environment should buzz with a little noise.
Researchers found that test subjects were at their most creative when background noise was measured at 70 decibels,the level one might find in a busy coffee shop.
A nearly silent environment(50 decibels)was too quiet. Turning up the volume to 85 decibels (a jackhammer tearing up the pavement outside your building) was counterproductive-the noise became a distraction.
The researchers asked 65 students at the University of British Columbia,Canada,to perform various creative tasks while noises recorded at a roadside restaurant were played in the background.
In one experiment,scientists asked participants to brainstorm ideas for a new type of mattress . Test subjects had the most successful discussions when the noise in the background was noticeable but not too loud.
While a quiet environment may make it easier to read a book. the authors of the study say that moderate background noise creates just enough of a distraction to force people to think more imaginatively, without breaking their focus so completely that they can't think at all.
Should we all head for Starbucks to get creative? Not necessarily.
Researchers found limited work time surrounded by the low-level noise of a coffeehouse is what really stimulates creativity.
Equally, working in a care environment isn't good for everybody. The productivity boost was most obvious among those who were naturally creative to begin with. [/INST] question: The recommended level of background noise is _ . | options: A: 50 decibels B: 65 decibels C: 70 decibels D: 85 decibels | answer: C </s> |
<s>[INST] context: What's the most expensive place to station an employee overseas? London? Tokyo? Sao Paulo? Try Luanda, Angola.
That's the finding of a survey by Mercer, the world's largest human resources consulting firm, headquartered in New York City. Two African cities (Luanda, N'Djamena) were in the top 10, along with four (Moscow, Geneva, Zurich, Bern) in Europe, three (Tokyo, Singapore, Hong Kong) in Asia and one (Sydney) in Australia. Switzerland alone has three cities in the top 10.
Mercer's 2013 Cost of Living Survey examined data from 214 cities worldwide, comparing a market basket of over 200 goods and services, including unfurnished luxury two-bedroom apartments or three-bedroom houses, movie tickets, blue jeans, international newspapers, coffee, fast food restaurant meals, gasoline, milk and soda.
If it sounds odd that Angola would be the most expensive, Mercer's Barb Marder explains that"Despite being one of Africa's major oil producers, Angola is a ly poor country yet expensive for expatriates since imported goods can be dear. In addition, finding secure living accommodations that meet the standards of expatriates can be challenging and quite costly."The survey found similar supply issues in N'Djamena, Chad, the other top 10 city in Africa.
Mercer measured locations worldwide against New York, on a U.S. dollar basis, meaning that exchange rate shifts could impact the rankings. For example, although Tokyo is Asia's most expensive city for people who live in a foreign country, the weakening of the Japanese yen against the dollar makes it seem cheaper than it was a year ago. Canada, too, has become a bargain as the U.S. dollar strengthens against the Canadian dollar.
Measurements were taken in March, 2013.
What's the trend in the United States?"Overall, U.S. cities either remain stable in the ranking or have slightly decreased due to the movement of the U.S. dollar against the majority of currencies worldwide,"explains Mercer's Steven Nurney. However, that may change as real estate prices rise nationwide. New York is the nation's most expensive place to station expatriates.
While housing is generally the most important factor in the survey rankings, the survey revealed some other significant differences in prices. For example, you may need a vodka chaser after paying $ 8.29 for a cup of coffee in Moscow, but the same coffee in Managua, Nicaragua would cost only $ 1.54. Expect to pay $ 20.10 for a movie ticket in London, versus $ 5.91 in Johannesburg. [/INST] question: Which of the following cities may be the cheapest for employees overseas? | options: A: Geneva B: Sydney C: Tokyo D: New York | answer: D </s> |
<s>[INST] context: There is a famous saying from the French politician J.A. Brillat-Savarin that goes: "Tell me what kind of food you eat, and I will tell you what kind of man you are." It can be easy to not really think about what you eat. For example, whenever you go into a supermarket to buy a drink, it is all too easy to pick up an ice cream or a piece of chocolate as well. You might not even really want them, but sometimes their bright, nice packaging can be too hard to refuse.
So, in our special food magazine we will show you why you should really pay more attention to what you eat! Food not only influences our health but also our beliefs, customs and personalities.
The first article will look at the way fast food is leading to obesity . The famous cook, Jamie Oliver, has made it his purpose to introduce ideas about healthy eating. In a speech, Jamie Oliver told the world that during the 18 minutes that he gave his speech, four Americans would die because of the food that they ate! Obesity is also a growing problem in China. As China Daily reported in February, the number of obese people under the age of 18 in China has reached 120 million.
Jamie has worked for 10 years to try and fight this problem. Learning about food is important not just because of health problems but also because many people still don't have enough food today. And we know as the improvement of science sometimes we have to face genetically modified food. Don't worry - we'll make you know more about all these topics in our special article!
We'll also tell you something interesting about food. For example, do you know what the largest food on the menu is all over the world? It's the roasted camel and it has been served for several hundred years, often stuffed with chicken, lamb, egg, fish and rice!
Hopefully by the time you finish reading this edition , you'll pay more attention to the food that you eat. As Oliver says, food is something that can help us enjoy our life. It is important that we love it! [/INST] question: Where is J.A. Brillat-Savarin from? | options: A: America B: England C: France D: Australia | answer: C </s> |
<s>[INST] context: The radiograph shows marked enlargement of the central pulmonary aeries with abrupt tapering, or pruning. This finding is consistent with pulmonary aerial hypeension. Although patients with atrial septal defect can develop pulmonary aerial hypeension, in this case, the lungs are markedly hyperinflated consistent with emphysema. In addition, the central pulmonary aeries are typically more markedly enlarged in patients with Eisenmenger physiology. Although chronic pulmonary emboli can result in pulmonary aerial hypeension, the lung volume would not be affected. The hyperinflation of the lungs in this case represents emphysema as the cause of the pulmonary aerial hypeension. Pulmonary venous hypeension occurs when the left ventricle is unable to pump the volume of blood that it receives. This results in elevated left atrial pressures and pulmonary venous hypeension. On chest radiographs, the findings of pulmonary venous hypeension include cephalization of the vasculature and enlargement of the vessels, interstitial and alveolar edema - findings that are not present in this case. The radiograph shows marked enlargement of the central pulmonary aeries with abrupt tapering, or pruning, consistent with pulmonary aerial hypeension. In addition, there is marked hyperinflation of the lung with diminished lung markings, consistent with emphysema. In severe cases of emphysema, there is obliteration of the capillary bed. If the volume of affected lung is large enough, pulmonary aerial hypeension will occur. [/INST] question: You are shown a posteroanterior (PA) and lateral chest radiograph of a 75-year-old woman. What is the MOST likely diagnosis? | options: A: Atrial septal defect B: Chronic pulmonary embolism C: Pulmonary venous hypeension D: Cor pulmonale | answer: D </s> |
<s>[INST] context: Tourism probably started in Roman times. Rich Romans visited friends and family who were working in another part of the Roman Empire. But when the empire broke down,this kind of tourism stopped.
In the early 17th century, the idea of the "Grand Tour" was born. Rich young English people sailed across the English Channel .They visited the most beautiful and important European cities of the time, including Paris in France, and Rome and Venice in Italy. Their tours lasted for two to four years, and the tourists stayed a few weeks or months in each city. The "Grand Tour" was an important part of young people's education--but only for the rich.
In the 18th century, tourism began to change. For example, people in the UK started to visit some towns, such as Bath to" take the waters". They believed that the water there was good for their health. So large and expensive hotels were built in these towns.
In the 19th century, travel became much more popular and faster. When the first railways were built in the 1820s, it was easier for people to travel between towns, so they started to go for holidays by the sea. And some started to have holidays in the countryside as cities became larger, noisier and dirtier.
Traveling by sea also became faster and safer when the first steamships were built. People began to travel more to far away countries.
The 20th century saw cars become more and more popular among ordinary people. Planes were made larger, so ticket prices dropped and more people used them.
Thus tourism grew. In 1949, Russian journalist Vladimir Raitz started a company called Horizon Holidays. The company organizes everything--plane tickets, hotel rooms, even food--and tourists pay for it all before they leave home. The package tour and modern tourist industry was born.
The first travel agency in China was set up as early as 1949.But tourism did not take off until 1978.In 2002,the industry was worth 500 billion yuan and became an important part of China's social development. [/INST] question: In the early times, the travelers _ . | options: A: all came from Roman B: were very young and strong C: had lots of money D: traveled by boat | answer: C </s> |
<s>[INST] context: Holmes said, "Somebody sent a letter with five pips in it from India, and arrived seven weeks later to kill John's uncle. Then they sent five pips from Scotland and arrived three days later to kill John's father. Now they have sent five pips to John from London!"
"The letters are all from sea ports . The writer was on a ship when he wrote the letters," I replied.
"Very good, Watson! And John's enemy is in London already!"
"Well, I hope they won't kill young John," I said.
But they did. The next morning, we read in the newspaper that a policeman found him die near Waterloo station. Holmes was very angry about it.
"He came to me for help and those men murdered him! I'm going to find them, if it's the last thing I do!" he said to me, and he hurried out of the house.
At night, when he came back, he was tired, but pleased, he said, "I know the names of John's enemies! And now I'm going to send them a surprise! This will frighten them!" He took five pips from an orange and put them in an envelope . On it he wrote "S. H. for _ "
"I'm sending the pips to captain James Calhoun. His ship is called the Star. He and his men are sailing back to Georgia, USA."
"How did you find him, Holmes?" I asked.
"Ship's papers," he said, "I've looked at hundreds of them today. Only one ship, the Star, was in the three ports at the right times, this morning the Star left London to sail back to Georgia. I found out that the captain and two of his men, all Americans, weren't on the ship last night, so I'm sure they killed John. When they arrive in America, they'll get the pips and then the police will catch them!" [/INST] question: Holmes was _ about John's death. | options: A: curious B: angry C: crazy D: worried | answer: B </s> |
<s>[INST] context: Jerry was a manager in a restaurant.He was always in a good mood and always had something positive to say.This really made me _ so one day I asked him,"It's hard to be a positive person all of the time.How do you do it?'' Jerry replied ,"Each morning I wake up and sayto myself,"Jerry, you can choose to be in a good mood or a bad mood," and I choose to be in a good mood. Life is all about what you choose.And what you choose leads your life."Several years later,I heard that Jerry left the back door open one morning and was robbed .While trying to stop the thief ,he was shot. I went to see him in the hospital.When I asked him how he was,he replied,"If I were any better,I'd be twins." "Weren't you scared when you were in danger?"I asked."Yes. The doctors kept telling me that I was going to be fine, but in their eyes,I read."He's dead."I knew I needed to take action." "What did you do?" "Well.there was a big nurse asking me if I was allergic to anything."Yes,'I replied ."Bullets !Everyone laughed and I told them: I am choosing to live. Operate on me as if I am alive." Jerry lived thanks to the great doctors ,and also because of his amazing attitude .Attitude ,after all ,is everything. [/INST] question: What kind of person was Jerry? | options: A: He was serious B: He was helpful C: He was allergic D: He was happy and smart | answer: D </s> |
<s>[INST] context: Ketogenesis Repeat,from May 09 Lack of insulin promotes ketogenesis. Insulin prevents ketngenesis. Metabolic Effects of Insulin Insulin is known as hormone of abundance. When there is great abundance of energy-giving foods in the diet, especially excess amounts of carbohydrates, insulin is secreted in large amounts. The net effect of insulin is storage of carbohydrate, protein, and fat. Therefore, insulin is called the hormone of abundance. In the case of excess carbohydrates, it causes them to be stored as glycogen mainly in the liver and muscles. Also, all the excess carbohydrates that cannot be stored as glycogen are conveed under the stimulus of insulin into fats and stored in the adipose tissue. In the case of proteins, insulin has a direct effect in promoting amino acid uptake by cells and conversion of these amino acids into protein. In addition, it inhibits the breakdown of the proteins that are already in the cells. Effect of Insulin on Carbohydrate Metabolism Immediately after a high-carbohydrate meal, the glucose that is absorbed into the blood causes rapid secretion of insulin. The insulin in turn causes rapid uptake, storage, and use of glucose by almost all tissues of the body, but especially by the muscles, adipose tissue, and liver. Insulin promotes liver uptake and storage as glycogen One of the most impoant of all the effects of insulin is to cause most of the glucose absorbed after a meal to be stored almost immediately in the liver in the form of glycogen. Then, between meals, when food is not available and the blood glucose concentration begins to fall, insulin secretion decreases rapidly and the liver glycogen is split back into glucose, which is released back into the blood to keep the glucose concentration from falling too low. The mechanism by which insulin causes glucose uptake and storage in the liver includes several almost simultaneous steps: Insulin inactivates liver phosphorylase, the principal enzyme that causes liver glycogen to split into glucose. This prevents breakdown of the glycogen that has been stored in the liver cells. Insulin increases the activity of the enzyme glucokinase, which is one of the enzymes that causes the initial phosphorylation of glucose after it diffuses into the liver cells. Once phosphorylated, the glucose is temporarily trapped inside the liver cells because phosphorylated glucose cannot diffuse back through the cell membrane. iii. Insulin also increases the activities of the enzymes that promote glycogen synthesis, including especially glycogen synthase, which is responsible for polymerization of the monosaccharide units to form the glycogen molecules. Insulin Promotes Conversion of Excess Glucose into Fatty Acids When the quantity of glucose entering the liver cells is more than can be stored as glycogen or can be used for local hepatocyte metabolism, insulin promotes the conversion of all this excess glucose into fatty acids. These fatty acids are subsequently packaged as triglycerides in very-low-density lipoproteins and transpoed in this form by way of the blood to the adipose tissue and deposited as fat. Insulin also inhibits gluconeogenesis. Insulin Promotes Muscle Glucose Uptake and Metabolism Without insulin muscle membrane is only slightly permeable to glucose. Thus between meals, non-exercising muscles, derive their energy from fatty acids, not on glucose. In the presence of insulin, muscle membrane become permeable to glucose. If the muscles are not exercising after a meal and yet glucose is transpoed into the muscle cells in abundance, then most of the glucose is stored in the form of muscle glycogen instead of being used for energy. The glycogen can later be used for energy by the muscle. Effect of Insulin on Carbohydrate Metabolism in Other Cells Insulin increases glucose transpo into and glucose usage by most other cells of the body (with the exception of the brain cells, as noted) in the same way that it affects glucose transpo and usage in muscle cells. Effect of Insulin on Fat Metabolism Although not quite as visible as the acute effects of insulin on carbohydrate metabolism, insulin's effects on fat metabolism are, in the long run, equally impoant. Long-term effect of insulin lack causes extreme atherosclerosis, often leading to hea attacks, cerebral strokes, and other vascular accidents. Insulin Promotes Fat Synthesis and Storage Fat sparing effect-Insulin has several effects that lead to fat storage in adipose tissue. First, insulin increases the utilization of glucose by most of the body's tissues, which automatically decreases the utilization of fat, thus functioning as a fat sparer. Insulin also promotes fatty acid synthesis. Synthesis of fat in liver-When more carbohydrates are ingested than can be used for immediate energy, are used for fat synthesis. Almost all this synthesis occurs in the liver cells, and the fatty acids are then transpoed from the liver by way of the blood lipoproteins to the adipose cells to be stored. Storage of fat in the adipose Cells. Insulin has two other essential effects that are required for fat storage in adipose cells: Insulin inhibits the action of hormone-sensitive lipase. This is the enzyme that causes hydrolysis of the triglycerides already stored in the fat cells. Therefore, the release of fatty acids from the adipose tissue into the circulating blood is inhibited. Insulin promotes glucose transpo through the cell membrane into the fat cells in exactly the same ways that it promotes glucose transpo into muscle cells. Some of this glucose is then used to synthesize minute amounts of fatty acids, but more impoant, it also forms large quantities of a-glycerol phosphate. This substance supplies the glycerol that combines with fatty acids to form the triglycerides that are the storage form of fat in adipose cells. Therefore, when insulin is not available, even storage of the large amounts of fatty acids transpoed from the liver in the lipoproteins is almost blocked. Insulin Deficiency Increases Use of Fat for Energy Insulin Deficiency Causes Lipolysis of Storage Fat and Release of Free Fatty Acids. In the absence of insulin, hormone-sensitive lipase in the fat cells becomes strongly activated. This causes hydrolysis of the stored triglycerides, releasing large quantities of fatty acids and glycerol into the circulating blood. This free fatty acid then becomes the main energy substrate used by essentially all tissues of the body besides the brain. Insulin Deficiency Increases Plasma Cholesterol and Phospholipid Concentrations. The excess of fatty acids in the plasma associated with insulin deficiency also promotes liver conversion of some of the fatty acids into phospholipids and cholesterol, two of the major products of fat metabolism. This high lipid concentration--especially the high concentration of cholesterol--promotes the development of atherosclerosis in people with serious diabetes. Excess Usage of Fats During Insulin Lack Causes Ketosis and Acidosis. Insulin lack also causes excessive amounts of acetoacetic acid to be formed in the liver cells. Some of the acetoacetic acid is also conveed into 13-hydroxybutyric acid and acetone. These two substances, along with the acetoacetic acid, are called ketone bodies, and their presence in large quantities in the body fluids is called ketosis. In severe diabetes the acetoacetic acid and the I3-hydroxybutyric acid can cause severe acidosis and coma, which often leads to death. Effect of Insulin on Protein Metabolism Insulin Promotes Protein Synthesis and Storage. During the few hours after a meal when excess quantities of nutrients are available in the circulating blood, not only carbohydrates and fats but proteins as well are stored in the tissues; insulin is required for this to occur. The manner in which insulin causes protein storage is not as well understood as the mechanisms for both glucose and fat storage. Some of the facts follow. Insulin stimulates transpo of many of the amino acids into the cells. Among the amino acids most strongly transpoed are valine, leucine, isoleucine, tyrosine, and phenylalanine. Insulin increases the translation of messenger RNA, thus forming new proteins. Over a longer period of time, insulin also increases the rate of transcription of selected DNA genetic sequences in the cell nuclei, thus forming increased quantities of RNA and still more protein synthesis--especially promoting a vast array of enzymes for storage of carbohydrates, fats, and proteins. 4. Insulin inhibits the catabolism of proteins, thus decreasing the rate of amino acid release from the cells, especially from the muscle cells. 5. In the liver, insulin depresses the rate of gluconeogenesis. Because the substrates most used for synthesis of glucose by gluconeogenesis are the plasma amino acids, this suppression of gluconeogenesis conserves the amino acids in the protein stores of the body. In summary, insulin promotes protein formation and prevents the degradation of proteins. Note that: The brain is quite different from most other tissues of the body in that insulin has little effect on uptake or use of glucose. Instead, the brain cells are permeable to glucose and can use glucose without the intermediation of insulin. The brain cells are also quite different from most other cells of the body in that they normally use only glucose for energy and can use other energy substrates, such as fats, only with difficulty.Therefore, it is essential that the blood glucose level always be maintained above a critical level, which is one of the most impoant functions of the blood glucose control system. When the blood glucose falls too low, into the range of 20 to 50 mg/100 ml. symptoms of hypoglycemic shock develop, characterized by progressive nervous irritability that leads to fainting, seizures, and even coma. Summary: Effects of Insulin on various tissues: Liver Increased glycogen synthesis Increased protein synthesis Increased lipid synthesis Decreased ketogenesis Decreased glucose output due to decreased gluconeogenesis, increased glycogen synthesis, and increased glycolysis. Muscle Increased glucose entry Increased glycogen synthesis Increased amino acid uptake Increased protein synthesis Decreased protein catabolism Decreased release of gluconeogenic amino acids Increased ketone uptake Increased K+ uptake Adipose tissue Increased glucose entry Increased. fatty acid synthesis Increased glycerol phosphate synthesis Increased triglyceride deposition Activation of lipoprotein lipase Inhibition of hormone -sensitive lipase Increased K+ uptake [/INST] question: Not done by insulin: | options: A: Glycogen synthesis B: Glycolysis C: Lipogenesis D: Ketogenesis | answer: D </s> |
<s>[INST] context: Many people catch a cold in the spring time and / or fall. It makes us wonder .if scientists can send a man to the moon, why they can't find a cure for the common cold. The answer is easy. There are exactly hundreds of kinds of cold viruses there. You never know which one you will get, so there isn't a cure for each one.
When a virus attacks your body, the body works hard to get rid of it. Blood rushes to your nose and brings congestion with it .You feel terrible because you can't breathe well, but your body is actually "eating" the virus. Your temperature rises and you get a fever, but the heat of your body is killing the virus. You also have a running nose to stop the virus from getting to your cells. You may feel miserable, but actually your wonderful body is doing everything it can to kill the cold.
Different people have different remedies for colds. In the United States and sane other countries, for example, people might eat chicken soup to feel better. Some people take hot baths and drink warm liquids. Other people take medicine to stop the fever, congestion, and running nose.
There is one interesting thing to note - some scientists say taking medicines when you have a cold is actually bad for you. The virus stays in you longer because your body doesn't have a way to fight it and kill it .Bodies can do an amazing job on their own. There is a joke, however, on taking medicine when you have a cold. It goes like this: [/INST] question: The scientists think _ .when someone catches a cold. | options: A: they have many ways to cure the patients B: it's difficult to find a good way to cure the patients C: taking hot baths and drink warm liquids can cure the patients D: people should eat chicken soup to cure themselves | answer: B </s> |
<s>[INST] context: This message is to inform all the children that Santa's post office in Himmelpfort, Germany, is open to receive your holiday wishes. That means you can mail your letters to Santa about 6 weeks sooner than that last year. Santa knows you've been good and wants to make sure he and his helpers receive your wish list earlier.
Eight post offices are organized across Germany to answer all letters children send. This year they plan to receive over 250,000 letters. Though the letters fly from over 80 different countries, Santa and his helpers can understand and make sure to answer all the letters.
In 1984, two children from Berlin sent their wish lists to Himmelpfort after spending vacation there. Their letters were answered by postal employees and later Himmelpfort increased its helpers to meet the needs of increased mail traffic. Year after year, Santa and his crew use an eco-friendly powered vehicle to collect the thousands of letters he receives from young boys and girls. The great news for this year is that if you come to the beautiful town of Himmelpfort, you can drop off your letter and visit Santa in person, from Tuesdays to Thursdays until Christmas Eve.
Santa does not currently have an e-mail, Twitter or a Facebook account. He believes in old-fashioned communication. So get out your paper and write your wish list. Just make sure your letter is clear so you can receive an official response, send your letters to:
Santa
Christmas Post Office
Himmelpfort, Germany 16798 [/INST] question: This year Santa and his helpers _ . | options: A: are eager to receive more wishes B: keep traveling around 80 countries C: are able to receive kids' letters earlier D: answer most of the letters from kids | answer: C </s> |
<s>[INST] context: Good afternoon and welcome to England. We hope that your visit here will be pleasant. Today, I would like to draw your attention to a few of our laws.
The first one is about drinking. Now you may not buy alcohol in this country if you are under 18 years old, nor may your friends buy it for you.
Secondly, noise. Enjoy yourselves by all means, but please don't make unnecessary noise, especially at night. We ask you to respect other people who may wish to be quiet.
Thirdly, crossing the road. Be careful. The traffic moves on the left side of the road in this country. Use the crossing for walking and don't take any chances when crossing the road.
My next point is about rubbish. It is an offence to drop litter in the street. When you have something to throw away, please put it in your pocket and take it home, or put it into a rubbish bin.
Finally, smoking. It is against the law to buy cigarettes or tobacco if you are under 16 years old.
I'd like to finish by saying that if you need any kind of help, you can turn to the police. The police will be pleased to help you. You can call, or directly go to ask any policeman. [/INST] question: Who do you think most probably makes the speech? | options: A: A teacher B: A person who makes laws C: A guide D: An English officer | answer: C </s> |
<s>[INST] context: Mrs. Black is sixty-nine years old. She only has a daughter named Sandra. Mr. Black died twelve years ago. Mrs. Black was very sad and lived in her house alone. Two years ago her daughter had a baby. The young woman was busy all the time and had no time to look after her son James. She asked her mother to live with them.
The old woman had to sell her house and moved there. She was strong and could do all the housework. And the family liked her.
Last autumn Mrs. Black went to do some shopping. A car hit her and her leg was hurt. She had to be in hospital for three months. She couldn't do anything after she came back. At first her daughter was kind to her, but soon she began to be tired of her. The old woman wanted to leave, but she had no money to buy a house and nobody could take care of her. She didn't know what to do.
One morning Mrs. Black broke a plate. It made her daughter angry. She told James to buy a wooden plate for his grandma. That afternoon James came back with two wooden plates. She was surprised and asked, "Why did you buy two plates, son?"
"One is for grandma," answered the boy, "the other is for you! You will also have to use a wooden plate when you're old, I think."
The woman heard this and was sad. She cried for long. Now she is kind to her mother as she was before. [/INST] question: Sandra asked her mother to live with them because _ . | options: A: the old woman lived alone B: she needed her help C: the old woman couldn't look after herself D: the old woman could give her much money | answer: B </s> |
<s>[INST] context: FORBES CHINA's annual celebrity list is based on income and appearances in magazines, newspapers, TV shows and online. Stars from the mainland, Taiwan and Hong Kong are included. And here are some of the winners:
Jay Chou
Taiwan singer, actor and director unveiled his 12th studio album, Opus 12, last December (Another "12''). New flick in the works: The Rooftop, being filmed in Taiwan and the mainland, which he stars in and also directs.
3. Andy Lau
Now in his 50s, the evergreen Hong Kong star of song and film stayed popular last year with the movie Blind Detective. Lau's sixth film with Hong Kong actress Sammi Cheng is in the works.
Jackie Chan
Hong Kong movie industry icon last year released what may be his last action film CZ12, or Chinese Zodiac, which he wrote and directed.
5. Zhang Ziyi
Popular actress had hit romantic comedy last year with My Lucky Star, which she also produced. Appears in this year's star-laden The Grandmaster kung fu movie, directed by Hong Kong's Wong Kar-Wai and also starring Tony Leung.
7. Yang Mi
Actress was named most popular female singer in mainland China last year in a joint CCTV-MTV event. Last year's flicks included Love in the Buff, Beijing Love Story and Wu Dang. Has endorsement deals with Pepsi and cosmetics brand Wetcode.
8. Huang Xiaoming
Actor turned up in several successful films last year, including Love in the Buff, An Inaccurate Memoir and White-Haired Witch. Promotes Baleno, Tissot, Olay.
10. Lin Chi-ling
Taiwan TV hostess, model and actress. Most recent success: romantic comedy Say Yes, which took in more than $30 million in China. [/INST] question: Who is the director of the Grandmaster ? | options: A: Tony Leung B: Wong Kar-Wai C: Zhang Ziyi D: Jackie Chan | answer: B </s> |
<s>[INST] context: The patient describes a typical history for migraine headaches, the second most common cause of headache and most common cause of headache-related disability Simplified Diagnostic Criteria for Migraine Repeated attacks of headache lasting 4-72 h in patients with a normal physical examination, no other reasonable cause for the headache, and: At Least 2 of the Following Features: Plus at Least 1 of the Following Features: Unilateral pain Throbbing pain Aggravation by movement Moderate or severe intensity Nausea/vomiting Photophobia and phonophobia Common triggers include: Lack of sleep or excessive sleep Stress Hormonal fluctuations Alcohol Barometric pressures changes. Pathogenesis: 1) SENSORY SENSITIVITYthat is characteristic of migraine is due to dysfunction of monoaminergic sensory control system in brainstem and hypothalamus 2) TRIGEMINO VASCULAR SYSTEM-Release of vasoactive peptides- eg CGRP. Activation of cells in the trigeminal nucleus results in the release of vasoactive neuropeptides, paicularly calcitonin gene-related peptide (CGRP), at vascular terminations of the trigeminal nerve and within the trigeminal nucleus Clinical application-CGRP receptor antagonists have now been shown to be effective in the acute treatment of migraine.Methysergide was found to antagonize ceain peripheral actions of 5-HT and having anti-inflammation propeies .it is used as the first drug capable of preventing migraine attacks. The triptans are potent agonists of 5-HT1B and 5-HT1D receptors.Triptans arrest nerve signaling in the nociceptive pathways of the trigeminovascular system, at least in the trigeminal nucleus caudalis and trigeminal sensory thalamus, in addition to promoting cranial vasoconstriction, act by vascular target. 3)VASCULAR THEORY- Vasoconstriction of intracranial blood vessels & later on reflex vasodilation of extracranial blood vessels that causes pulsatile headache 4) DOPAMIN HYPERSENSITIVITY-There is dopamine receptor hypersensitivity in migraine patients . [/INST] question: A 24-year-old woman has throbbing left-sided headaches which get worsen with movement and got aggravated by loud noises. She also has nausea along with it. Patient needs a dark quiet room during episodes. Which of the following best explains the pathogenesis of the patient's headache syndrome? | options: A: Diffuse muscular contraction of the neck and scalp B: Disinhibition of the central pacemaker neurons in the posterior hypothalamic region C: Dysfunction of monoaminergic sensory control systems in brainstem and hypothalamus D: Focal cerebral vasodilation in the region of the brain that is the focus of the pain | answer: C </s> |
<s>[INST] context: If you're travelling with kids in London, many London hotels have special services and features to help the family holiday, offering services for kids as well as games, bike hire and free ice cream!
Athenaeum
The five-star Athenaeum is a fantastic family hotel, particularly with the addition of its kids' services. Even before you arrive, they'll be in touch to make sure your kids have their favorite DVDs, treats and anything else to keep them happy. And they can arrange your perfect family activities, from bike hire to theatre tickets.
Chessington Safari Hotel
At Chessington Safari Hotel, kids will love staying in an African adventure-themed room, having breakfast overlooking the animals of the Wanyama Reserve, watching family-friendly movies and getting into the theme park before it opens.
Marjin Apartments
Marlin Apartments operate more than 700 serviced apartments in London Apartments are all within five minutes walk of the Tube (good for tired little legs!) with flat screen TVs, fully equipped kitchen and free Wi-Fi. One or two bedroom family apartments have extra room for fold out beds in the living area too.
Novotel
Novotel's family rooms are designed to accommodate two adults and two children. Accommodation and breakfast are free for under-16s (up to two staying in their parents' room). You can also enjoy a late check-out at 5p.m. on a Sunday, and while you lie in, the kids can entertain themselves with the Cartoon Network.
The Ritz
Kids at The Ritz are treated just as well as their parents, if not better! Children can enjoy computer games and DVDs, free ice cream and their own bathrobes and slippers Under-16s can stay for free in their parents' bedroom, depending on the room type. [/INST] question: If your kids love to see animals, you will choose_. | options: A: Athenaeum B: Chessington Safari Hotel C: Novotel D: The Ritz | answer: B </s> |
<s>[INST] context: Even though orbiters have eyed it from space and landers have rumbled across its surface, Mars still has more secrets to reveal. Two findings emerged this week: the possibility of an active glacier far from the planet's poles and evidence that sulfur--rather than carbon--was the element driving the planet's warmer climate long ago. Both discoveries could force some rethinking about Martian evolution and dynamics--and maybe even provide insights about Earth's past.
The glacier discovery was announced Wednesday by the European Space Agency (ESA). A high-resolution stereo camera aboard ESA's Mars Express spacecraft spotted the feature in a region called Deuteronilus Mensae, located in the mid-north latitudes of the planet. The Mars Express science team drew the preliminary conclusion that the material in the feature is water ice and that it accumulated as recently as 10,000 years ago, probably from an underground source. Other deposits of water ice have been mapped at the martian poles, but they're much bigger and are millions of years old. The find is a surprise because the prevailing view is that any water reaching the martian surface from underground quickly evaporates and eventually drifts into space. Yet all of the physical characteristics of the feature are "consistent with that of a glacier," says geologist and team member Ronald Greeley of Arizona State University in prefix = st1 /Tempe.
Meanwhile, in the 21 December issue of Science, a team from HarvardUniversityand the Massachusetts Institute of Technology offers a possible solution for the curious absence of carbon-based minerals on Mars. A buildup of carbon dioxide in the ancient martian atmosphere supposedly produced enough of a greenhouse effect to allow liquid water to flow for a time on the surface. The problem is that such a process should have deposited ample carbon-containing minerals on the planet's surface--something that hasn't been found. So the researchers have come up with a new explanation: Large amounts of sulfur dioxide(SO2) in the atmosphere, the result of early volcanic activity, captured enough heat to allow water to flow. This would explain the plentiful distribution of sulfates among martian minerals. [/INST] question: The main cause of the warm climate on Mars is _ . | options: A: water ice B: carbon C: sulfur D: active glacier | answer: C </s> |
<s>[INST] context: VDRL The history of the patient suggests neurosyphilis. Diagnosis of Neurosvphilis No definitive tool / test exists to establish the diagnosis of neurosyphilis with 100% accuracy. Most of the serological tests used in the diagnosis of syphilis cannot accurately diagnosis neurosyphilis. Hence, the diagnosis of neurosyphilis usually depends on combination of clinical features plus C.S.F. finding and serological tests. C.S.F. findings in syphilis:? - Lymphocytic pleocytosis - Protein is moderately elevated - Glucose is usually normal Among the serological tests - "The VDRL C.S.F. test is the standard serological test for C.S.F. and is considered diagnostic of neurosyphilis". -Since invasion of C.S.F by syphilis stimulates production of antilipoidal antibodies in C.S.F.. VDRL test can be performed on C.S.F. to diagnose neurosyphilis. - The VDRL test is highly specific albeit insensitive for the diagnosis of neurosyphilis. - The sensitivity of VDRL*for neurosyphilis is 30% and specificity is 90%. Specific treponemol tests have proved to be quite inaccurate in the diagnosis of neurosyphilis Why ??? - The antibodies against the specific treponemal antigen have the tendency to cross C.S.F., so enough antibodies may be present in the C.S.F. even before neurosyphilis develops. - Therefore specific treponemal tests have no specificity for neurosyphilis. The CS.F. becomes positive for these tests even when neurosyphilis is not present. Moreover, Specific treponemal tests cannot be used to monitor treatment because? - These tests become positive soon after infection and typically remain positive .for life despite adequate treatment. An impoant point - Like VDRL test RPR test can also be used to monitor the treatment in syphilis but it is not suitable for testing C.S.F., so it cannot he used in neurosyphilis. (Anantnarayan 8/e p.375) [/INST] question: A 24 year old male patient with h/o primary syphilis in the form of genital ulcer & mucocutaneous lesions, presents with features suggestive of neurosyphilis in the form of meningitis for which appropriate treatment was staed. What will you do for monitoring of treatment aEUR' | options: A: Venereal disease Research Laboratory test (VDRL) B: TPI C: FTS-AB D: ELISA | answer: A </s> |
<s>[INST] context: Basic Study Manual (Hardcover): $37.50...... Here are the answers to the questions most often asked by students. Read this book and learn:
*What the three barriers to study are and what to do about them
* What to do if you get tired of a subject you are studying
*Twenty-six simple drills to help you learn how to study easily, rapidly and with full understanding
Buy and read the Basic Study Manual and use it to dramatically improve your ability to study.
Study Skills for Life (Hardcover): $31.99
L. Ron Hubbard's study technology for teenagers opens the door to their future success by giving them advice on how to study and learn. Fully illustrated for easy comprehension.
Learning How to Learn (Hardcover):$24.99
The basics of effective study for 8 to 12-year-olds, fully illustrated. Children who read and apply the materials in this book can regain their liking for study. Get this book for a child you want to see win at his studies!
How to Use a Dictionary Picture Book for Children (Hardcover):$34.90
In spite of billions of dollars spent on "educational research", children are not taught the most basic skills of learning: how to use a dictionary. Written for children 8 to 12-year-old, this fully illustrated book will teach your children:
*How to find words in a dictionary
*The different ways that words are used
*How to use a dictionary to correctly pronounce words
At last, you'll just pay 50% for these books before May 1, 2007. (260 words) [/INST] question: The four books can mostly satisfy_. | options: A: teachers B: children C: adults D: parents | answer: B </s> |
<s>[INST] context: Sailing Through History
A group of 1,309 passengers boarded the MSBalmoralon Sunday, in Southampton, England, on a voyage to retrace the path of theTitanic. TheTitanicwas the biggest ship in the world when it sailed on its ill-fated maiden voyage in 1912. Of the 2,227 passengers and crew aboard, more than 1,500 died. The ship, which was headed to New York City, carried the rich and famous on its first voyage. It also carried immigrants, who were seeking a better life in America.
Relatives of people who sailed on theTitanic, historians, authors and people fascinated by the story of the unsinkable ship, are on theBalmoral. They want to remember the doomed ship and those who died on her first and last voyage. The historic liner had set sail on April 10, 1912, from Southampton. Late at night on April 14, she hit an iceberg. In the early morning hours of April 15, theTitanicsank.
TheBalmoralis followingTitanic's original route from Southampton. First, the modern-day cruise liner docked in the port of Cherbourg, France, where theTitanichad picked up more passengers. On Monday afternoon, theBalmoralstops in Cobh, Ireland, theTitanic's last port of call before sailing to New York.
Balmoralwill then cruise the North Atlantic Ocean to the location whereTitanichit an iceberg that ripped the ship's hull . On Sunday, April 15, at 2:20 a.m.--the time theTitanicwent down--passengers and crew will hold a memorial service. The next two days will be spent in Halifax, Canada, where many victims of the sinking are buried. Then, theBalmoralwill reach its final destination in New York City, whereTitanicwas supposed to dock--but never did.
Until today, several teams of divers have explored the site. They have recovered some items such as dishes and silverware and put them on public display. And more trips are planned to the wreckage in the future. TheTitanicand its passengers and crew have been remembered in books, movies and TV programs. But there's a much more important contribution thatTitanicgave us. After she sank, lawmakers and shipbuilders made ships safer. It took a terrible tragedy to make ship travel safer for all. [/INST] question: How many passengers in Titanic survived at last? | options: A: More than 1500 B: About 1309 C: About 1000 D: Less than 750 | answer: D </s> |
<s>[INST] context: My name is Sue. I want to have a special party to celebrate my 12th birthday. After discussing it with my family, I decided to have a Hello Kitty theme birthday party.
Hello Kitty Birthday Invitations
An invitation in the shape of a skirt is a fun way to invite my friends to the party. My sister, Lisa, will help me make the invitations. My mom tells me to send out the invitations 3~5 weeks before the date of the party. My birthday party is on December 21, so I will send out the invitations before November 24.
Hello Kitty Theme Decorations
The party will be held in our garden. I plan to put some white and pink balloons around the garden. There will be a vase which is full of pink flowers on each table and a small Hello Kitty on each chair.
Hello Kitty Birthday Party Menu
My parents will cook some delicious food. All of them will be named after Hello Kitty's friends, such as Rory and Fifi. I will _ a birthday cake in the shape of a Hello Kitty at Mrs Green'S Cake Store at the beginning of December.
I hope my friends will enjoy themselves at the special party. [/INST] question: Sue will be _ years old. | options: A: 5 B: 12 C: 11 D: 14 | answer: B </s> |
<s>[INST] context: Pseudomyxoma peritonei (PMP) is a clinical condition caused by cancerous cells (mucinous adenocarcinoma) that produce abundant mucin or gelatinous ascites.
The primary tumor appears to arise from the MUC2 expressing goblet cells and most commonly from these cells in the appendix. The K-Ras and p53 genes may be involved in the oncogenesis. It may be diagnosed with a range of conditions.
While the majority of these cases are associated with appendiceal carcinoma other conditions may also be found, including disseminated peritoneal adenomucinosis (DPAM), peritoneal carcinomas, several mucinous tumors (mucinous adenocarcinoma, mucinous cystadenoma, and mucinous cystadenocarcinoma), as well as other disease states
This will result in compression of organs and will destroy the function of colon, small intestine, stomach, or other organs. Prognosis with treatment in many cases optimistic, but the disease is lethal if untreated, with death by cachexia, bowel obstruction, or other types of complications. [/INST] question: Pseudo-myxoma peritonei occur due to? | options: A: Dysgerminoma B: Brenner s tumor C: Theca cell tumor D: Mucinous cystadenosarcoma | answer: D </s> |
<s>[INST] context: Researchers recently found that hackers took control of 300,000 home routers . Once your home router has been controlled, hackers could redirect your network to malicious websites controlled by hi-tech thieves who could then steal your online back details and other sensitive data. However, there are some simple steps you can take to protect your router.
Say no to 12345 passwords
First, never leave your router open without a password and make sure you change both your Wi-Fi and router login password from the default one it comes with. If you use the default password , this could give someone access to the router setup, which could allow them to change your router settings, including viewing any security keys.
Don't broadcast it
Make sure you don't show up in other people's wireless network scans. Know your network name so you can easily enter it into any devices you want to access that network. Other people do not need to know your network name. To prevent outsiders from seeing your network's name and attempting to join your wireless network, turn off broadcasting in your router's settings.
Invite only please
One way you can ensure no one else joins your network without your permission is to enable your router to only allow certain devices to connect, and ban all others. To do that you can filter by media access control (MAC) addresses.
Turn it off
This is a simple piece of advice that can go a very long way in keeping you safe. Simply turn off your router when you're not using your network. If you're at work all day and no one's home, why keep it running?
Build a firewall
The firewall built into your router prevents hackers on the internet from getting access to your PC so it's always worth enabling it to help add an extra layer of security. However, it does nothing to stop people in range of your Wi-Fi signal from getting onto your network - and as said, a router in the wrong place means your Wi-Fi signal could reach pretty far.
For further protection, you should run software firewalls on the individual PCs on your networks. [/INST] question: If you use the default password, _ . | options: A: your home router will be linked to some bad websites B: you will find it's very convenient to surf the Internet C: your home router will be changed for new settings D: you will fail to use your own login password | answer: C </s> |
<s>[INST] context: "An old village woman in her seventies from Zhenjiang Province rented a small house in Shanghai and let visitors to the World Expo live there for free while she slept on a little couch. Her kindness moved _ people." Chinese Premier Wen Jiabao said so at the Expo 2010 Shanghai China on October 31 when it ended.
It is a true story. The heroine of it is Ying Miaofang, an old woman from a village of Zhuji City in Shaoxing of Zhejiang Province. "I rented a house in Shanghai and received more than 330 Expo visitors during three months' time. My house was never empty during that period." Ying told reporters. She also said it was worth helping so many people to visit the Shanghai World Expo and she was praised by Premier Wen.
In the late of last May. Ying Miaofang paid 1,800yuan per month to rent a small house near Changning Road in Shanghai, and spent more money on a new air conditioner, a refrigerator, a TV set and other things. She published her phone number in the newspaper and opened the house for Expo visitors for free on June 23.
Besides providing a free living place., Ying got up very early every morning to buy food, cook breakfast, clean rooms and wash clothes for those guests. Many of her guests wanted to pay some money to her when they left, but she refused. In order to support the Shanghai Would Expo, Ying spent about 20 thousand yuan in all, which could not be regarded as a little money for a woman from a village. [/INST] question: The house cost Ying Miaofang _ yuan during three months. | options: A: 330 B: 1,800 C: 5,400 D: 20,000 | answer: C </s> |
<s>[INST] context: New York, 10 November -- 5:27 pm, yesterday. Biggest power failure in the city's history.
* Thousands of people got stuck in lifts. Martin Saltzman spent three hours between the 21st and 22nd floors of the Empire State Building. "There were twelve of us. But no one panicked. We passed the time telling stories and playing word games. One man wanted to smoke but we didn't let him. Firemen finally got us out."
* "It was the best night we've ever had," said Angela Carraro, who runs an Italian restaurant on 42nd Street. "We had lots of candles on the tables and the waiters were carrying candles on their trays. The place was full -- and all night, in fact, for after we had closed, we let the people stay on and spend the night here."
* The zoos had their problems like everyone else. Keepers worked through the night. They used blankets to keep flying squirrels and small monkeys warm. While zoos had problem keeping warm, supermarkets had problems keeping cool. "All of our ice cream and frozen foods melted," said the manager of a store in downtown Manhattan. "They were worth $ 50,000."
* The big electric clock in the lobby of the Waldorf-Astoria Hotel in downtown Manhattan started ticking again at 5:25 this morning. It was almost on time. [/INST] question: Throughout the period of darkness, Martin Saltzman and the eleven others were _ . | options: A: nervous B: excited C: calm D: frightened | answer: C </s> |
<s>[INST] context: That year, in the local school, there was a new math teacher, as well as some new pupils. One of the new kids was the stupidest child that anyone had ever seen. It made no difference how quickly or how slowly they tried explaining numbers to him; he would always end up saying something enormously stupid. Like two plus two was five, seven times three was twenty-seven, or a triangle had thirty corners...
Before this boy arrived, math lessons had been the most boring of all. Now they were great fun. Encouraged by the new teacher, the children would listen to the pieces of nonsense spouted by the new kid, and they would have to correct his mistakes.
Whenever the new teacher asked questions, the stupid kid would stand up but made the wrong answers, the other students all wanted to be the first to find his mistakes, and then think up the most original ways to explain them. To do this they used all kinds of stuff: sweets, playing cards, oranges, paper planes, etc. It didn't seem like any of _ bothered the new kid.
However,little Lewis was sure that it was bound to make him feel sad inside. Lewis was sure he would see him crying. So,one day, he decided to follow the new kid home after school. On leaving school, the new kid walked a few minutes to a local park, and there he waited for a while, until someone came along to meet him...
It was the new teacher!
The teacher gave the new kid a hug, and off they went, hand in hand. Following from a distance, Lewis could hear they were talking about math. [/INST] question: The math lessons became interesting because of the new teacher's _ . | options: A: creativity B: imagination C: responsibility D: curiosity | answer: A </s> |
<s>[INST] context: Ever thought of moving to a new country? How about starting a new country? Patri Friedman is planning to do just that. He left Google years ago to set up the Seasteading Institute. And his dream is to build seasteads-----floating micro-nations in the middle of the ocean.
So, what will life on a seastead be like? Probably a bit like life on a cruise liner , but much larger, with shops, gyms, swimming pools, schools and other areas. In fact, the early seasteads may actually be specially-rebuilt cruise liners. But as science advances, Friedman believes they'll become more like floating cities, with several hundred people.
Seasteading raises a lot of questions. First of all, how will the new countries make money? The Seasteading Institute has suggested several money-making ideas, including ocean-based theme parks, casinos and fish farming. There's also the questions of safety. With storms, typhoons and pirates , the high seas are a dangerous place. However, the Institute says that it can stand bad weather and prevent crimes with its well-designed systems.
So, is this just a day dream? Well, maybe not. One of the people behind the project is Peter Thiel. He founded PayPal and was one of the first investors in Facebook. So far, he's donated $ 500,000 to the project.
And Friedman isn't wasting any time. He recently announced the creation of the Poseidon Award. This will be given to the first seastead with fifty people. Friedman is hoping to hand out the award in 2015. [/INST] question: Where did Friedman use to work? | options: A: In Facebook B: In Seastead Institute C: In PayPal D: In Google | answer: D </s> |
<s>[INST] context: The shoulder joint is separated from the subacromial bursa by the supraspinatus tendon, which is inseing on the greater tubercle of the humerus. So, if the supraspinatus tendon is ruptured, the synol cavity of the shoulder will be able to communicate with the subacromial bursa. If contrast dye is injected into the cavity of the shoulder joint following a rupture of the supraspinatus tendon, the contrast will flow into the subacromial bursa. This can be observed in imaging studies. You should know this relationship between the supraspinatus tendon and the subacromial bursa!The tendon of infraspinatus also inses on the greater tubercle of the humerus--however, it does not communicate with the subacromial bursa. The middle glenohumeral ligament strengthens the capsule of the shoulder joint. The subscapularis tendon inses on the lesser tubercle of the humerus--it is not near the subacromial bursa. Finally, the tendon of the long head of the biceps originates on the supraglenoid tubercle scapula and travels through the shoulder joint, lying in the inteubercular groove of the humerus. It is not a structure that communicates with the subacromial bursa. [/INST] question: The synol cavity of the glenohumeral joint communicates with the subdeltoid bursa after the rupture of: | options: A: Infraspinatus Tendon B: Middle glenohumeral ligament C: Subscapularis Tendon D: Supraspinatus Tendon | answer: D </s> |
<s>[INST] context: The United States is already one year into a depression That was the news this week from the Na-tional Bureau of Economic Research. The downturn is the longest since a depression that began in 1981and lasted sixteen months.
Economists generally wait for production to shrink for six months in a row before they declare a re-cession. But the bureau, a private group, uses a wider set of information to measure the economy. Thenews only confirmed what many people already knew: that the world's largest economy is weak and maynot recover soon.
Worsening conclitions have led to a big drop in spending, especially on costly products like new cars. Even Japanese automaker Toyota saw its sales fall thirty - four percent in the United States in November from a year ago.
The heads of Chrysler, Ford and General Motors retumed to Congress this week to again ask for federal aid. Congressional leaders denounced them two weeks ago after they came in private jets with no clear plans for saving their industry. This time, the chiefs drove to Washington in fuel- saving hybrid vehicles. And their companies presented detailed restructuring plans. The reguest for aid has risen from twenty-five billion dollars two weeks ago to thirty-four billion in loans and credit lines.
G.M. wants almost half of that, and says it needs four billion dollars this month. It warned that without support it cannot continue to operate.
Ford is in a better position, But the sharing of suppliers means it could be affected if G.M. or
Chrysler fails. Ford is asking for a nine billion dollar credit line in case it needs it.
Chrysler is the smallest and most trouble of America's Big Three. It says it needs a seven billion dollar loan by the end of the month.
Two days of congressional hearings began Thursday in the Senate Banking Committee. The chairman, Democrat Chris Dodd, said he would support helping the automakers for the good of the economy.
But the committee's top Republican, Richard Shelby, continued to express opposition to a bailout .
A main root of the world financial crisis is the weak housing market in the United States. The Trea-sury Department has been under pressure to help troubled homeowners. Now comes news that the depart-ment is developing a plan aimed at reducing interest rates on mortgage loans for some buyers of homes. That could be good for homeowners trying to sell. [/INST] question: Why were the automakers refused for federal aid two weeks ago? | options: A: Because the government had no extra money to help B: Because they didn't have a ciear plan to save their industry C: Because they had wasted too much on costly new cars D: Because they had enough money to save their industry | answer: B </s> |
<s>[INST] context: Ectopic pregnancy results from various factors that interrupt the successful migration of the conceptus to the endometrium. The most impoant risk factors for ectopic pregnancy are history of tubal surgery, including tubal ligation, for prior ectopic pregnancy, infeility history of prior ectopic: increases risk 5 folds in utero diethylstilbestrol (DES) exposure: causes congenital fallopian tube anomalies history of pelvic inflammatory disease, sexually transmitted disease peritubal adhesions: secondary to salpingitis, endometriosis, appendicitis SIN: salpingitis isthmica nodosa infeility: use of A: increases risk of atypical/ non tubal ectopic failed contraception: IUCD, sterilisation, progesterone only contraceptives. PLEASE NOTE IT IS FAILURE OF THESE CONTRACEPTIVE PRACTICES, AND NOT THE CONTRACEPTIVE PRACTICE IN ITSELF Intrauterine device (IUD) use are associated with reduce pregnancies and reduced ectopic rates, however, if there is a failure of the IUD and a pregnancy results, ectopic gestation is more likely as compared to normal population conceiving These are not very clear relations. Many other risk factors, including smoking and multiple lifetime sexual paners, are weakly associated with ectopic pregnancy . [/INST] question: Which of the following factors is not an impoant risk factor for tubal ectopic? | options: A: A history of tubal surgery B: Intrauterine device (IUD) use C: In utero diethylstilbestrol (DES) exposure D: History of pelvic inflammatory disease | answer: B </s> |
<s>[INST] context: Cell injury occurs due to decreased generation of cellular ATP ATP is necessary for Na+--K+ ATPase pump and Ca pump action and many other cellular functions for the existence of the cell THE MORPHOLOGY OF CELL AND TISSUE INJURY It is useful to describe the structural alterations that occur in damaged cells before we discuss the biochemical mecha- nisms that bring about these changes. All stresses and noxious influences exe their effects first at the molecular or biochemical level. Cellular function may be lost long before cell death occurs, and the morphologic changes of cell injury (or death) lag far behind both (Fig. 1-7). For example, myocardial cells become noncontractile after 1 to 2 minutes of isch- emia, although they do not die until 20 to 30 minutes of ischemia have elapsed. These myocytes may not appear dead by electron microscopy for 2 to 3 hours, or by light microscopy for 6 to 12 hours. The cellular derangements of reversible injury can be corrected, and if the injurious stimulus abates, the cell can return to normalcy. Persistent or excessive injury, however, causes cells to pass the nebulous "point of no return" into irreversible injury and cell death. The events that determine when reversible injury becomes irreversible and progresses to cell death remain poorly understood. The clinical rele- vance of this question is obvious; if the biochemical and molecular changes that predict cell death can be identified with precision, it may be possible to devise strategies for preventing the transition from reversible to irreversible cell injury. Although there are no definitive morphologic or biochemical correlates of irreversibility, two phenomena con- sistently characterize irreversibility: the inability to correct mito- chondrial dysfunction (lack of oxidative phosphorylation and ATP generation) even after resolution of the original injury, and profound disturbances in membrane function. As mentioned earlier, injury to lysosomal membranes results in the enzymatic dissolution of the injured cell, which is the culmination of injury progressing to necrosis. As mentioned earlier, different injurious stimuli may induce death by necrosis or apoptosis (Fig. 1-6 and Table Refer robbins 9/e p6 [/INST] question: Cell injury occurs due to | options: A: Decreased cellular ATP generation B: Cytosolic Ca++ C: Membrane damage D: Intracellular K+ | answer: A </s> |
<s>[INST] context: ONE day my 5-year-old daughter, Mini, ran to the window crying: "A Cabuliwallah ! A Cabuliwallah!" In the street below was a Cabuliwallah, passing slowly along. Mini called him loudly but when he looked at her she ran away scared. Shortly after this, the two became friends.
They started to hang out together, laughing and talking. Mini's new friend would give her raisins and almonds , spending the little money he had on her.
The two of them enjoyed joking together. The Cabuliwallah, who was called Rahmun, would say: "Well, little one, when are you going to the father-in-law's house?" Mini did not understand this and was puzzled.
One morning, I heard uproar in the street, and saw Rahmun being led away by the police. There were bloodstains on his clothes. I gathered that a neighbor had owed Rahmun money for a shawl but had falsely denied having bought it, and that in the course of the quarrel Rahmun had struck him. On a charge of murderous assault , Rahmun was sentenced to jail.
Time passed, and he was not remembered. Mini grew up and we were making arrangements for her wedding. I was sitting in my study when someone entered. It was Rahmun, the Cabuliwallah, released from prison.
Barely recognizable now, he asked to see Mini and said that all those years ago she had reminded him of his own daughter in Kabul. It was his belief that Mini was still the same. He had pictured her running to him calling "Cabuliwallah!". He had imagined that they would laugh and talk together. In fact, he had brought her, wrapped up in paper, a few almonds and grapes.
The two were reunited but Mini had grown up. She now understood the meaning of the word "father-in-law," and when he made this joke once more she flushed up at the question. He could not revive their old friendship.
When Rahmun left, I gave him a bank note, saying: "Go back to your own daughter, and may the happiness of your meeting bring good fortune to my child!"
Having made this present, I had to give up the electric lights and the military band I had intended for the wedding and the ladies in the house were disappointed. But to me the wedding feast was all the brighter for the thought that in a distant land a long-lost father met again with his child.
Adapted from Tagore's short novel The Cabuliwallah [/INST] question: Which of the following is TRUE about Mini and Rahmun's friendship? | options: A: They felt close to each other at first sight B: The author didn't like Mini making friends with Rahmun C: Rahmun liked Mini more when the author often bought fruits from him D: Though not understanding all Rahmun's jokes, Mini liked hanging out with him | answer: D </s> |
<s>[INST] context: When I worked as a waitress in Chicago, US, my coworkers and I would sigh whenever we heard someone with a foreign accent coming into our restaurant. We knew what it meant to serve a non-American: no tip. We would work just as hard as we always did, but we might not get paid.
Americans have an unspoken rule about tipping: they give tips to almost everyone who offers them a service of some kind. Americans tip their waiters, barbers and taxi drivers. An appropriate tip is between 15 and 20 percent of the amount charged for the service (But the charge for the tip doesn't appear on the bill. The customer is expected to add it himself/herself.) Tipping less than this sends a message to your waiters that you think they've done a bad job serving you. And to leave no tip at all is simply unacceptable.
It's not that American waiters are greedy. In many countries, waiters are paid a salary for their work. They'll earn money even if no one comes into the restaurant. This system offers much more safety for waiters than the American version. In the US, waiters know that a night without customers means a night without pay.
Some countries include a tip for waiters - a "service charge" - on the bill itself. Since the tip is included with the other charges, waiters don't need to worry about people forgetting to tip. But in the US, waiters do not receive a salary, and service charges only appear on bills when there are six or more customers at the table.
Since almost all American customers are familiar with the system, they know to add a tip without being told. But visitors to the US may expect waiters to be paid a salary, or think that the tip is included on the bill.
So much as we waiters loved hearing stories about other places from our foreign customers, we were always nervous when they got ready to leave the restaurant. We were never sure what to expect. [/INST] question: If you order $200 worth of food, which of the following is a proper total payment? | options: A: $200 B: $215 C: $220 D: $230 | answer: D </s> |
<s>[INST] context: One of the most exciting and attractive fields of work today is the fashion industry. Some of the most well-known people in this industry are the fashion designers with unbelievable financial Kingdoms. But most of the clothes that you wear have been designed by people that the world has never heard of. Although these unknown fashion designers will never make a very large amount of money as their famous workmates, most still would not think of changing their careers. They are doing what they love.
If you spend hours looking through fashion magazines and like making your own clothes, a career as a fashion designer might be right for you. You do not have to go to design school to become a fashion designer, but many people who want a career in this field do. One of the most famous places to study is the Fashion Institute of Technology in New York City. It is located in the heart of the "garment" district on Eighth Avenue, also known as Fashion Avenue.
Becoming a fashion designer is not just a matter of classroom education. Students know that they cannot just leave school and start designing on their own. Many think that they need at least four years' experience working for someone else after they graduate. The best schools encourage students to work closely with the fashion industry while they are still studying.
You need ambition and hard work to get a career in fashion. Students often work 12 hours a day. They are encouraged to have realistic ambitions and not to expect success overnight, if ever. Success means finding a job in the fashion industry and more years of hard work. [/INST] question: In order to have a career in fashion design, one had better _ . | options: A: look through magazines B: go to New York City C: study in a design school D: graduate from high school | answer: C </s> |
<s>[INST] context: As you probably know, J.Paul Getty was one of the richest and moat successful American industrialists in history.Quite ambitious from an early age, Getty made his first million at age 23 in 1916.He later went on to found the Getty oil company, In 1957, Fortune magazine named him the richest living American and in 1966, the Guinness Book of Records named him as the world's richest private citizen.
Although he is highly regarded by vast numbers of people for his financial success, as a younger man, his drive to acquire power and money had a _ l impact on other aspects of his life, particularly in his relationships with women.He was, at one point quoted assaying "A lasting relationship with a woman is only possible if you are a business failure." He married five times, having children with four of these wives.He couldn't seem to keep a marriage going for very long.His obsession with having a fortune and power alienated each of his wives, eventually driving them away. His marriage with his first wife Jeanette lasted for only three years, with Allene for two years, Adolphine, four years, Ann, four years, and finally Louise, nineteen years.
Perhaps as a young man, Getty was willing to pay whatever price for financial success.Yet Paul came to feel some regret in regard to his life priorities as he approached his later years when he Wrote: "I hate and regret the failure of my marriages.I would gladly give all of my millions for just one lasting marriage success."
At the end of Getty's life, all of the wealth that he had got meant very little to him.It was only then that he became wise enough to understand what really mattered most.Despite all of his accomplishments, he died with great regret.
It' s a sad story and a cautionary tale for those of us who may have chosen to make career building our highest priority , thereby ignoring our relationships.Like any other living organism, relationships require care and attention in order to grow.Even the strongest relationships will he damaged, if there is not enough care. [/INST] question: J.Paul Getty's marriage that lasted for the longest time was with _ . | options: A: Ann B: Adolphine C: Allene D: Louise | answer: D </s> |
<s>[INST] context: The Great Fire of London started in the very early hours of 2 September 1666. In four days it destroyed more than three-quarters of the old city, where most of the houses were wooden and close together. Over one hundred people became homeless, but only a few lost their lives.
The fire started on Sunday morning in the house of the King's baker in Pudding Lane. The baker, with his wife and _ , was able to get out through a window into the roof. A strong wind blew the fire from the bakery into a small hotel next door. Then it spread quickly into Thames Street. That was the beginning.
By eight o' clock three hundred houses were on fire. On Monday nearly a kilometer of the city was burning along the River Thames. Tuesday was the worst day. The fire destroyed many well-known buildings, old St Pauls and the Guildhall among them.
Samuel Pepys, the famous writer, write about the fire, "People threw their things into the river. Many poor people stayed in their houses until the last moment. Birds fell out of the air because of the heat ."
The fire stopped only when the King finally ordered people to destroy hundreds of buildings in the path of the fire. With nothing left to burn, the fire became weak and finally died out.
After the fire, Christopher Wren, the architect , wanted a city with wider streets and fine new houses of stone. In fact, the streets are still narrow, but he did build more than fifty churches, among them the mew St Pauls.
The fire caused great pain and loss, but after it London was a better place: a city for the future and not just of the past. [/INST] question: The fire began in _ . | options: A: a hotel B: the palace C: Pudding Lane D: Thames Street | answer: C </s> |
<s>[INST] context: It's 2035. You have a job ,a family and you' re about 40 years old ! Welcome to your
future life.
Getting ready for work, you pause in front of the mirror. "Turn red," you say. Your shirt changes from sky blue to deep red. Tiny pre-programmed electronics are rearranged in your shirt to change its color1. Looking into the mirror, you find it hard to believe you're 40. You look much younger. With amazing advances in medicine, people in your generation may live to be 150 years old. You ' re not even middle-aged!
As you go into the kitchen and prepare to pour your breakfast cereal into a bowl, you hear, "To lose weight, you shouldn't eat that," from your shoes. They read the tiny electronic code on the cereal box to find out the nutrition details. You decide to listen to your shoes. "Kitchen, what can I have for breakfast?" A list of possible food appears on the counter as the kitchen checks its food supplies.
"Ready for your trip to space?" you ask your son and daughter. In 2005 only specially trained astronauts went into space -- and very few of them. Today anyone can go to space for day trips or longer vacations. Your best friend even works in space. Handing your children three strawberries each, you add, "The doctor said you need these for space travel." Thanks to medical advances, vaccination shots are a thing of the past. Ordinary foods contain specific vaccines. With the berries in their mouths, the kids head for the front door.
It's time for you to go to work. Your car checks your fingerprints and unlocks the doors. " My office. Autopilot. "you command. Your car drives itself down the road and moves smoothly into traffic on the highway. You sit back and unroll your e-newspaper. The latest news downloads and fills the viewer. Looking through the pages, you watch the news as video film rather than read it. [/INST] question: What changes the color1 of your shirt? | options: A: The mirror B: The shirt itself C: The counter D: The medicine | answer: B </s> |
<s>[INST] context: The Australian continent is a land like no other. Its animals, plants and landscapes have evolved over one thousand years, and there are about a million different natural species in Australia. More than 80 per cent of the country's plants and animals are unique to prefix = st1 /Australia, along with most of the fish and almost half the birds.
Australia has more than 140 species of marsupials ,including koalas, wombats and the Tasmanian devil, now found only in the Australian wilderness. More than 750 species of birds have been recorded in Australia, 350 of which are found nowhere else in the world. Among them are the kookaburra, the rainbow lorikeet and fairy penguins. There are also 55 differernt species of macropods--the kangaroo family--native toAustralia. They vary greatly in size and weight, ranging from half a kilogram to 90 kilograms.
The country has been making every effort to protect its natural heritage. Despite the large size of the continent, the majority of Australians live on the coast and in major cities--around 75 per cent of Australia's population lives in city areas.
Australia is the driest continent on earth. Its center has one of the lowest rainfalls in the world and about three-quarters of the land is dry. These dry areas extend from the large central deserts to the western coast. Soils in these areas are very poor compared to other deserts. This has given Australians a great challenge.They have to make the best use of the variety of regions to meet the competing demands of agriculture, economy and conservation. [/INST] question: Wombats and the Tasmanian devil are the names of_. | options: A: plants B: animals C: places D: people | answer: B </s> |
<s>[INST] context: This x-ray shows a bilateral diffuse miliary nodular pattern involving both lung fields with no loss of volume. Characteristically, miliary nodules are less than 4 mm in size. They are generally noncalcified and diffuse and are seen in many conditions, such as TB/fungal infections/pneumoconiosis and ceain malignancies such as melanomas/thyroid cancer. Larger, more confluent lesions can be seen in alveolar sarcoid, Wegener's granulomatosis, and metastatic disease. The clinical hints that aid diagnosis include: An occupational history without constitutional symptoms. X-ray that looks worse than the patient's complaints, as in sarcoidosis. History of thromboembolic disease or sepsis, as in septic emboli or pulmonary infarcts. These are generally seen in the lower lung zones. * History of ahritis; may suggest rheumatoid nodules. Presence of eosinophilia in the peripheral smear with fleeting infiltrates; provides clue for pulmonary infiltrates with eosinophilia (PIE) syndrome, in which case history of travel or use of medications/drugs may be helpful and a stool exam may aid in the diagnosis. Immune-compromised patients may have oppounistic infections such as herpes or CMV This elderly patient has all the stigmata of chronic illness. Although the PPD skin test and sputum studies are negative (seen in about 30% of cases), the history and CXR are consistent with miliary TB. Hyponatremia and hypercalcemia are common findings in TB. In this age group sarcoidosis is unlikely. In the absence of occupational exposure, silicosis is also unlikely. Bone marrow aspirate may be positive for TB culture in 60% of patients with miliary TB, and aspiration is a logical step in the diagnostic evaluation. CT scan will not aid fuher in the diagnosis, and thyroid function tests will be normal unless there is clinical evidence of hypo- or hypehyroidism. Open lung or thoracoscopic biopsy is always diagnostic. [/INST] question: A 71-year-old man is seen with low-grade fever, generalized malaise, and a run-down feeling. He has lost weight and shows stigmata of chronic illness. There is no history of occupational exposure. On physical examination, vital signs are as follows: pulse 110 bpm; temperature 99degF; respirations 19/min; blood pressure 90/60 mm Hg. On exam, the man is frail and appears cachectic with temporal wasting. Other aspects of his physical exam are unremarkable. Laboratory data: Hb 10 g/dL; Hct 30%; MCV 90; WBCs 3000/uL; differential normal; BUN 19 mg/dL; creatinine 1.0 mg/dL; sodium 129 mEq/L; potassium 5.0 mEq/L; ABGs (RA): pH 7.42, PCO2 35 mm Hg, PO2 58 mm Hg. Spirometry: FVC 60% of predicted; FEV1 60% of predicted. PPD skin test is negative (0 mm); induced sputum for AFB smear is negative. Chest radiograph is shown below.What is the most likely diagnosis? | options: A: Silicosis B: Miliary TB C: Metastatic thyroid carcinoma D: Sarcoidosis | answer: B </s> |
<s>[INST] context: (2 Reverse transcriptase inhibitors + 1 Protease inhibitors) (1124-H) (1197-1201-300-CMDT-09) (1190- H17th)Currently licenced drugs for the treatment of HIV infections fall into three categories: those that inhibit the viral reverse transcriptase enzyme: those that inhibit the viral protease enzymes, and those that interfere with viral entry (1124-H)Reverse transcriptase inhibitors include(i) Nucleoside analogues - Zidovudine, Zalcitabine, Didanosine, Zalcitabine, Stavudine, Lamivudine, abacavir, and emtricibine(ii) Nucleotide analogues - tenofovirNon-nucleoside reverse transcriptase inhibitors - nevirapine, delavirdine and efavirenzProtease inhibitors (PIs) Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir, Fosamprenavir, Lopinavir, AtazanavirEntry inhibitors (Fusion inhibitors) - Enfuvirtide* The combination of Zidovudine, Lamivudine and indinavir was the first "triple combination" shown to have a profound effect on HIV replication (1134-H)Symptomatic HIV disease or asymptomatic disease and CD4 < 200/pL or asymptomatic disease and special circumstances | Best first line treatment{CombivirEfavirenz Common altemativeregimens once a day regimens |||||* Tenofovir +Lamivudine +Efavirenz Tenofovir +Efavirenz +Afazanavir +Ritonavir + | | Intolerance to regimen Progression of disease or viral load does not decrease by > 0.5 log with initiation of treatment or increase of viral load by > 0.5 log while on treatmentLow pill burden regimens Combivir +Neviripine Trizivir | Change to alternative first line regimens High potency regimens| | Perform resistance testing and change to a regimen with three drugs to which the patient is not resistant. If possible Combivir +Lopinavir withRitonavir Approach to antiretroviral therapy [/INST] question: Treatment of AIDS include | options: A: 3 Reverse transcriptase inhibitors B: 2 Reverse transcriptase inhibitors + 1 Protease inhibitors C: 2 Reverse transcriptase inhibitors + 2 Protease inhibitors D: 3 Reverse transcriptase inhibitors + 1 Protease inhibitors | answer: B </s> |
<s>[INST] context: Classification of hepatitis
In the new classification system of Hepatitis, Grading refers to the assessment of necroinflammatory activity.
Chronic hepatitis represents a series of liver disorders of varying causes and severity in which hepatic inflammation and necrosis continue for at least 6 months.
Earlier chronic hepatitis was categorized into three types depending upon histopathological features. These are
Chronic persistent hepatitis
Chronic lobular hepatitis
Chronic active hepatitis
Now, this categorization has been replaced by more informative classification based upon a combination of clinical serological and histological variables.
Now the classification is based upon —
It's cause
Its histologic activity or grade
It's a degree of progression or stage
(a) Classification by cause —
In this, the hepatitis is classified according to the cause - such as viral hepatitis, autoimmune hepatitis, drug-associated hepatitis.
(b) Classification by Grade —
This classification is based upon an assessment of necroinflammatory activity.
An assessment of following histological features is made on liver biopsy -
Periportal necrosis
Piecemeal necrosis
Bridging necrosis
Portal inflammation
(c) Classification by stage —
This classification is based upon the degree of fibrosis.
It reflects the levels of progression of the disease.
Staging is based upon the degree of fibrosis as follows
0 = No fibrosis
1= Mild fibrosis (limited to portal tract)
2 = Moderate fibrosis (Portal and periportal fibrosis)
3 = Severe fibrosis including bridging fibrosis
4 = Cirrhosis [/INST] question: Regarding Chronic Viral Hepatitis - | options: A: Hepatitis A virus infection is a common cause in children B: Morphological classification into Chronic Active Hepatitis and Chronic Persistent Hepatitis are important C: Fatty change is pathognomic of Hepatitis C virus infection D: Grading refers to the extent of necrosis and inflammations | answer: D </s> |
<s>[INST] context: Topic: "Enjoy Worldwide privileges with BOC cards" 5% cash rebate from UnionPay credit card issued by Bank of China
Time: April 1, 2014 to February 28, 2015
Customer: Personal credit cards with card number starting with "62" and with the UnionPay logo on the card
Details:
Payments with business cards, corporate cards or transactions through third-party platform (PAYPAL, Alipay and the internet banking payment and Kuai payment supported by Alipay) are not eligible for the promotion.
The promotion is applicable to online shopping payments to appointed business partners only, and all the transactions need to be completed via UnionPay online. Amazon (U.S.) personal credit cards with card number starting with "62" and with the UnionPay logo on the card are eligible for the promotion.
As the promotion has no pre-defined upper limit on the number of transactions, all transactions meeting the criteria above will enjoy the cash rebate. The value of eligible transactions will be the settlement amount in RMB according to the UnionPay system.
All single transactions of RMB 500 or more with payment made by UnionPay credit card issued by Bank of China (card number starting with '62') via UnionPay online platform will enjoy a 5% cash rebate, capped at RMB 100 per card per month.
Cardholders will receive the cash rebate within 90 calendar days after every promotion period. If the cardholder has any questions on the amount of rebate, please contact Bank of China Credit Card Customer Care Hotline(4006695566)within 30 calendar days since receiving the rebate; if no question is raised within 30 calendar days, the bank with deem the client agreeable to the amount of rebate. The date of cash rebate arriving in client's account could be later than the date described above due to force majeure that is not unforeseeable.
Only transactions made with specified credit cards to appointed business partners will be eligible for the cash rebate promotion; in case of refund, no cash rebate will be made. At the same time, Bank of China reserve the right to recall any unqualified cash rebate already made.
Cardholders will need to ensure no late payment, card freeze or other abnormal occasions during the promotion period, otherwise the cardholder will not be eligible for the promotion.
Income tax associated with the cash rebate will be taken care of by the cardholder. Cardholders hold the responsibility to declare the income and settle the tax payment. [/INST] question: How much rebate can I get from a 500 dollars payment? | options: A: About 5RMB B: About 25 RMB C: About 100 RMB D: About 125 RMB | answer: C </s> |
<s>[INST] context: A ie Scabies The diagnosis is scabies, which is characterized by severe itching and diffusely scattered papular and papulo-vesicular lesions which may appear on all pas of body except the face. It is common to find other individuals especially children staying in same house also showing similar features. In infants, eczematization is very common and it leads to exudation and crusting especially on the wrist and ankle. Secondary infection leads to pustule, crust fever and lymphadenopathy. Involvement of palm & soles, duration of < 6 weeks (2 weeks) and presence of same lesions in mother, our the diagnosis of scabies. Scabies Intense itching even in presence of minor physical signs The physical sign are essentially those of eczema & effects of scratching. Vesicles are seen but excoriations and prurigo-like papules are more common. Pathognomic lesion is burrow or run (in stratum corneum); which is a tiny, raised, linear or serpiginous white mark. The best sites to find burrows are palms & interdigital areas of fingers, flexural creases and over the elbows. Other common sites of involvement are - anterior axillary fold, buttock fold, areola of breast, lower abdomen, genitalia, knees, ankle and soles. Head and neck is involved in infants only. Same type of lesion may also present in family members. Positive family or social history Finding of mite or egg by pin or by examining skin scrapings or a skin surface biopsy taken with cynoacrylate glue, confirms diagnosis. Atopic Dermatitis/Infantile Extremely itchy Q, erythematous papular or papulo-vesicular lesions mostly on face and flexures (popliteal fossa, antecubital fossae & wrist) of infant, children, adolescent & young adult * Itching made worse by change in temperature, sundry (rainy season) etc. * Perpetual rubbing & scratiching I/ t excoriation, lichenification, hyperlinear palms & Denny morgan fold (crease lines just below eyes) . * Personal or family h/O of atopy (eg asthama, hay fever, rhinitis, uicariaQ) present Clinical course lasting longer than 6 weeksQ Course marked by exacerbation & remission May be associated with alopecia areate & susceptibility to skin infection Seborrheic Dermatitis Infantile S.D. may be evident within first few weeks of life (usually < 3 months)Q. It involves scalp (cradle cap), face or groin. It is rarely seen in children beyond infancy but becomes evident again during adult life. Lesions are characterized by greasy scales overlying erythematous patches or plaques Reddened itchy patches may become either scaly or crusted & exudative. The most common location is scalp where it may be recognized as severe dandruff Other sites are eyebrows, eyelids, glabella, and nasolabial folds. Scaling of external auditory canal is common & mistaken as fungal infection. Retroauricular areas often become macerated & tender. May be associated with Parkinson's disease, cerbro-vascular accident & HIV infection. Rarely groin, axilla central chest, sub mammary folds & gluteal cleft may also be involved. Impetigo contagiosa Contagious superficial skin infection caused by staph. aureus (mostly) Red, sore areas, which may blister, appear on exposed skin Yellowish gold curst surmounts the lesion It is mostly a disorder of prepubeal children May be associated with glomeruloneprhitis, [/INST] question: A 6 month old infant presented with multiple erythematous papules & exudative lesions on the face, scalp, trunk and few vesicles on palms and soles for 2 weeks. His mother has H/o itchy lesions. The most likely diag is: | options: A: Scabies B: Infantile exzema (atopic dermatitis) C: Infantile sebornheic dermatitis D: Impetigo contagiosa | answer: A </s> |
<s>[INST] context: Make it very clear in mind that the higher affinity of fetal hemoglobin for oxygen is due to the low affinity of HbF for 2,3 - DPG (not due to decreased 2, 3-DPG concentration). HbF does not combine to 2, 3-DPG as avidly as adult hemoglobin.
"Fetal hemoglobin is left - shifted because it has a low affinity for DPG". — Principles of medical physiology
"It is worth noting that DPG does not combine with fetal hemoglobin. That is perhaps one reason why HbF has a greater affinity for oxygen than adult hemoglobin (HbF)". — Understanding of medical physiology
"Fetal hemoglobin binds less 2-3 DPG it has consequently a greater affinity for O2". _ Pediatric physiology
All other textbooks have mentioned the same thing.
So, the high affinity of HbF to O2 is due to the low affinity of HbF for 2, 3 DPG (and not due to decreased 2, 3-DPG concentration).
However, amongst the given options, option a is the best answer here because, although there is no decrease in concentration of 2, 3-DPG, because of low affinity for 2, 3-DPG, HbF behaves as if 2, 3-DPG levels are low.
"Fetal hemoglobin has considerably less affinity for 2, 3-DPG than does adult hemoglobin. In human blood, the affinity of fetal hemoglobin for 2, 3-DPG is only about 40% that of adult hemoglobin. This makes fetal hemoglobin behave as if 2, 3-DPG levels are low; therefore, the oxygen dissociation curve is shifted to the left". — Clinical physiology in childhood [/INST] question: Fetal hemoglobin has a higher affinity for oxygen due to | options: A: Low affinity for 2, 3 DPG B: Reduced pH C: Increased release of carbon dioxide D: Oxygen dissociation curve is shifted to right | answer: A </s> |
<s>[INST] context: Discover
News magazine of science devoted to the wonders and stories of modern science, written for the 41-45 ADBCA
Cover Price: $59.88
Price: $19.95 ($1.66/issue)
You Save : $39.93 (67%)
Issues : 12 issues/12 months
Self
Published by Conde Nast Publications Inc., Selfis a handbook devoted to women's overall physical and mental health. Every issue contains usable articles such as "Style Lab", in which wearable clothes are mixed and matched on non-models and the "Eat-Right Road Map", with tips on how to eat properly.
Cover Price: $ 35.86
Price: $15.00 ($2.5/issue)
You Save: $ 20.86(58%)
Issues: 6 issues/12 months
In Style
In Style is a guide to the lives and lifestyles of the world's famous people. The magazine covers the choices people make about their homes, their clothes and their free time activities. With photos and articles, it opens a door to these people's homes, families, parties and weddings, offering ideas about beauty, fitness and in general, lifestyles. Publisher: The Time Inc. Magazine Company.
Cover Price: $47.88
Price: $23.88($2.38/issue)
You Save: $24.00(50%)
Issues: 10 issues/12 months
Wired
This magazine is designed for leaders in the field of information engineering including top managers and professionals in the computer, business, design and education industries. Published by Conde Nast Publications Inc., Wiredoften carries articles on how technology changes people's lives.
Cover Price : $ 59.40
Price : $ 10.00 ($1.00/issue)
You Save: $49.40(84%)
Issues: 10 issues/12 months [/INST] question: Which of the following magazines is published monthly? | options: A: Discover B: Self C: In Style D: Wired | answer: A </s> |
<s>[INST] context: Oxidation of fatty acid - two pathway Major pathway - beta oxidation -oxidation of fatty acid at beta carbon atom and sequential removal of acetyl COA MINOR PATHWAY - a oxidation and o oxidation Refsum disease - Defect in the alpha-oxidation due to the deficiency of the enzyme phytanic acid alpha-oxidase. Phytanic acid cannot be conveed to a compound that can be degraded by beta-oxidation Cerebral ataxia and peripheral neuropathy Phytanic acid mostly found in plant .its also present in milk and dairy products so this food is restricted in patient of refsum disease Zellweger syndrome is a rare disease characterized by the absence of functional peroxisomes. The long chain fatty acids (C26-C36) are not oxidized. They accumulate in tissues, paicularly in brain, liver and kidney. Hence the disorder is also known as cerebrohepatorenal syndrome. This condition is apparent at bih and is characterized by profound neurologic impairment, victims often dying within a year. Two closely related conditions are neonatal adrenoleukodystrophy and infantile Refsum disease. Zellweger syndrome and these two conditions represent a spectrum of overlapping features, with Zellweger syndrome being the most severe (many proteins affected) and infantile Refsum disease the least severe Dicarboxylic aciduria - characterized by the excretion of C6--C10 o-dicarboxylic acids and by nonketotic hypoglycemia, and is caused by a lack of mitochondrial medium-chain acyl-CoA dehydrogenase. Jamaican vomiting sickness - caused by eating the unripe fruit of the akee tree, which contains the toxin hypoglycin. This inactivates medium and sho-chain acyl-CoA dehydrogenase, inhibiting b-oxidation and causing hypoglycemia. [/INST] question: Defect in alpha oxidation of fatty acid leads to: | options: A: Dicarboxylic aciduria B: Zellweger syndrome C: Jamaican vomiting sickness D: Refsum disease | answer: D </s> |
<s>[INST] context: Millions of young people are writing blogs . Millions of others are reading them. The word "blog" is a short way of saying Web log.
Many popular Web sites now offer free, easy ways to create personal Web pages and fill them with writings and pictures. Web sites called "Face book" and "My Space" are some of the most popular blog sites for young people.
Blogs offer young people a place to show their writings and feelings. They can also be helpful to connect young people with others. But blogs can become dangerous when they are read on the Internet by millions of people all over the world.
Recent studies show that young people often tell their names, age and where they live on the Internet. That may not be safe for them. This personal information puts them in danger when found out by dangerous people who want to hurt them. Students can also get into trouble when they put information about others on their blogs.
As a result, many schools don't allow using blogging web sites on school computers. Many schools have also begun teaching parents about the web sites. Parents should know what their children are doing online and should read their blogs to make sure they are not giving out personal information. One way to keep away from these problems is to use programs so that blogs can be read by "friends only." people can read the website only if they know a secret word chosen by the blogger. [/INST] question: "Face book" and "My Space" are _ . | options: A: school subjects B: computer programs C: school online BBS D: blog sites for young people | answer: D </s> |
<s>[INST] context: United States and Canada are multicultural countries with many national, religious and cultural differences, where people attach great importance to individualism--the uniqueness among people. Teachers value the qualities that make each student special and different. You can see such values through their educational systems. For example, students needn't memorize lots of information. Instead, they work independently and find answers on their own. There are discussions for children to show their own ideas and opinions.
By contrast, people have the same language, history, and culture in most Asian societies. As a result, Asia's educational system reflects society's belief in group goals and purposes rather than individualism. Children in China, Japan, and Korea learn to work together and help one another in assignments. And the teaching methods are often very formal and serious. In class, teachers give lectures while students listen and take notes. Discussion is replaced by reciting rules of information that have been memorized.
These two systems both have advantages and disadvantages. One advantage in Japan is that there is much more math and science than American students learn by the end of high school. In addition, students study more hours each day and more days each year than North Americans do. The difficult system also prepares students for a society that place emphasis on discipline and self-control. However, while memorization is an important learning method in Japanese schools, yet many students admit forgetting much of the information that they have memorized after exams.
On the other hand, the educational system in North American has an advantage that students learn to think for themselves, which prepares them for a society that values creativity. The disadvantage is that when they graduate from high school, they haven't recited as many basic rules and facts as students in other countries have. [/INST] question: People in multicultural countries such as the US or Canada lay more stress on _ . | options: A: team work B: self-control C: discipline D: individualism | answer: D </s> |
<s>[INST] context: A ship was damaged during a storm at sea and only two of the men aboard were able to swim to a small island. Not knowing what else to do, the two survivors decided that they should pray to God.
However, to find out whose prayers were more powerful, they agreed to divide the land between them and stay on opposite sides of the island.
The first thing they prayed for was food. The next morning, the first man saw a tree on his side of the island, and he was able to eat its fruit. But the other man's side of land remained _
After a week, the first man became lonely and decided to pray for a wife. The next day, another ship was damaged and the only survivor was a woman who swam to his side of the island. But on the other side of the island, there was nothing.
Soon the first man prayed for a house, clothes and more food. The next day, like magic, all of these things were given to him. However, the second man still had nothing.
Finally, the first man prayed for a ship so that he and his wife could leave the island, and in the morning he found a ship stopped at his side of the island.
The first man boarded the ship with his wife and decided to leave the second man on the island. As the ship was about to leave, the first man heard a voice from Heaven, "Why are you leaving your partner on the island?"
"My blessings are mine alone since I was the one who prayed for them." The first man answered. " His prayers were all unanswered so he doesn't deserve anything."
"You are mistaken!" the voice said. "He had only one prayer, which I answered. He prayed that all your prayers would be answered." [/INST] question: Why didn't the two men stay together on the island? | options: A: Because they both wanted to live a quiet life B: Because they couldn't get along well with each other C: Because they wanted to test the power of their prayers D: Because they wanted to keep their own life secret from others | answer: C </s> |
<s>[INST] context: The past fifty years or so have seen the gradual disappearing of animals from this earth, fishes from the sea, trees and plants from the land.
Many factors result in this on pleasant phenomenon . Among them, hunting is the main factor that endangers wild life. Some people kill wild life for sport. They take pleasure in collecting heads and hides. Yet others specialize in commercial hunting like killing whales.
Apart from this, the rapidly growing human population threatens wild life on land, too. Towns expand and roads have to be built, so forests are burnt and trees are cut down. It seems that man needs every inch of land within his reach, so he moves on to the natural habitat of wild life. Tigers lions and leopards slowly die off without the food arm shelter that the forests provide.
In addition, rapid urbanization means industrial expansion. Very often, poisonous chemicals, industrial wastes and oil are dumped into the rivers and seas. Fish and birds are threatened.
Man depends greatly on animals for survival. He needs their flesh, hides and furs. Thus, man cannot, to without wild life; or he himself would die out. The public should be made aware that it would be better to shoot the animals with a camera than with a gun. In this way, they can preserve and help wild life to continue living rather than to remove all signs of it.
Man must learn to farm the sea as he does the land. He should control the amount and the frequency of his catch. Man also needs to build reserves, and to pass laws to stop the killing of animals, especially those that are already rare. To keep the present animal kingdom, the least that man can do is to clean the seas and to prevent pollution. [/INST] question: How many causes are mentioned that result in the unpleasant phenomenon? | options: A: 2 B: 3 C: 4 D: 5 | answer: B </s> |
<s>[INST] context: CSDT writes - "Unilateral, spontaneous, serious or serosanguineous discharge from a single duct is usually caused by an intraductal papilloma or rarely, by intraductal cancer."
Mostly the underlying cause is a duct papilloma or duct ectasia, but since the chances of malignancy are high, it must be investigated further. The risk of malignancy increases if an underlying mass is present.
Investigation used are
Mammography - can show any underlying suspicious lesion.
Cytological examination - this may identify malignant cells, but a negative finding does not rule out cancer.
Galactography/Ductography.
The primary indication for ductography is nipple discharge, particularly when bloody.
Ductography though helpful in reaching a diagnosis is not essential since excision of the bloody duct system is indicated regardless of finding.
In this study, a contrast medium is injected into the discharging duct and a mammogram taken. The injected may show an intraductal papilloma as a filling defect surrounded by contrast. Cancers may appear as irregular masses or as multiple intraluminal filling defects, or abrupt obstruction. Duct ectasia or fibrocystic disease may appear as dilated cystic structures.
Ultrasound - may show the presence of an underlying mass or duct ectasia.
The final diagnosis is made by excising the involved duct (Microdochotomy) and any underlying mass if present and subjecting them for a histopathological diagnosis.
Radical duct excision (meaning removal of all lactiferous ducts) is not done. [/INST] question: A 25 year old Female complains of discharge of blood from a single duct in her breast. The most appropriate treatment is : | options: A: Radical excision B: Microdochectomy C: Radical mastectomy D: Biopsy to rule out carcinoma | answer: B </s> |
<s>[INST] context: Chancroid Corimoxazole in Typhoid Initially cotrimoxazole was an effective alternative to chloramphenicol. However, in many areas resistant S. typhi have appeared and now it is seldom used. Cotrimoxazole in chancroid Corimoxazole for 7 days is a 3rd choice inexpensive alternative to ceftriaxone, erythromycin or iprofloxacin. Cotrimoxazole It is a combination of sulfonamide (sulfamethoxazole) and trime- thoprim in the ratio of 1 :5. Cotrimoxazole was claimed to be more effective than either of its components individually in treating bacterial infections. Because of its associated greater incidence of adverse effects including allergic responses its widespread use has been restricted in many countries to very specific circumstances where its improved efficacy is demonstracted. Uses of Cotrimoxazole Upper and lower respiratory tract infections - Exacerbations of chronic bronchitis - For otitis media and sinusitis. - It should never be used for streptococcal pharyngitis. Urinary tract infections -Uncomplicated cystitis in non pregnant women. Especially valuable for chronic and recurrent cases. - Prostatitis (cotrimoxazole is concentrated in goodamounts in prostate) Pneumocystic carinii pneumonia -Drug of choice next to pentamidine for the treatment and prophylaxis of pneumonias caused by Pneumocystic Jirovecci (commonly seen in imtnunocompromised patients including those suffering from HIV/AIDS). Other conditions where cotrimoxazole finds its use. -Listeria monocytogens infections - Meliodosis - Shigellosis - Traveller's diarrhoeas (E. coli, Campylobacter, Shigella, Y. enterocolitica) - Prophylaxis of cerebral toxoplasmosis - Whipple's disease - Salmonella (typhoid) initially it was responsive but now resistant strains have emerged. - Chancroid According to K.D.T. - Cotrimoxaxole can be used in both chancroid and typhoid. According to Harrison (18/e) Cotrimoxazole is used in Typhoid but it is not used in chancroid. Antiobiotic therapy in typhoid Empirical Ceftriaxone Azithromycin Fully susceptible Ciprofloxacin Amoxicillin Chloramphenicol Cotritnoxazole Multidrug resistant Ciprofloxacin Ceftriaxonl Azithromycin Nalidixic acid resistant Ceftriaxone Azithromycin High dose ciprofloxacin Treatment of chancroid Ciprofloxacin Ceftriaxone Azithromycin [/INST] question: Which of the following is not an indication ofcotrimoxazole aEUR' | options: A: >Lower UTI B: >Prostatitis C: >Chancroid D: >Typhoid | answer: C </s> |
<s>[INST] context: If your life is just too busy for the added stress of planning a birthday party, consider having someone else do all the work. There are several great places in Amarillo that would be happy to host the party for you. Here are a few party places for children's birthday parties in Amarillo, Texas.
Jump'n Jive
Jump' n Jive birthday parties are a hit in Amarillo. It is basically a giant indoor playground full of inflatable jumpers and slides. The kids will enjoy pretending to be popcorn, and you'll enjoy not having to plan the activities. It's great exercise and parents may content for wearing out their kids for a good short sleep. They can supply the cake, ice cream, tableware, pizza, good bags and much more. They are located at 7302 W. 34th Street and you can reach them at (806) 367-8954.
Brush With Art
If you've ever found your child color1ing on the wall (or even if you haven't) Brush With Art is a fantastic birthday party place. It is a paint-you-own pottery studio where the guests and your birthday star will enjoy painting items such as a plate, a cup and other items. Brush With Art is located at 1948 Civic Circle in Wolflin Square. You can reach them at (806) 355-7911.
The Amarillo Zoo
Want to celebrate the birthday with monkeys, lions and pot-bellied pigs? The Amarillo Zoo is a great place for a birthday party. The kids will enjoy seeing and talking about the animals. It will definitely provide a memorable experience. It even includes a private encounter with an animal such as a snake or a rabbit. For more details on birthday parties at the Amarillo zoo, call at least 3 weeks in advance at (806)381-7911.
Don Harrington Discovery Center
Want an entertaining birthday party with an educational twist? The Don Harrington Discovery Center is a fantastic place to go. Kids will enjoy interacting with fun exhibits such as a bubble area where you can make giant bubbles. Their birthday parties include the use of a private party room for two hours. It also includes a hands-on activity with a staff person. It definitely makes for a unique, but exciting birthday party. To learn more about their party packages, give them a call at (806)355-9547. The museum's address is 1200 Streit Drive in Amarillo. [/INST] question: We can infer that children attending a Jump'n Jive birthday party will be _ . | options: A: disappointed B: worried C: frightened D: tired | answer: D </s> |
<s>[INST] context: Dear Disney,
Last weekend, the four members of my family spent an enjoyable holiday at the Magic Kingdom - Disneyland. And one event made our visit seem truly magical.
We got to the front of the line at Space Mountain, only to find out that our little daughter Gloria
couldn't take her ice-cream on the ride. We were so excited that we all forgot ice-cream was not allowed on the ride.
Gloria broke into tears and we all had no idea what to do. Then Murphy, one of the staff members, came over. She bent down and told Gloria that she would hold the ice-cream for her and give it to her when she finished the ride. Gloria said, "Promise?" Then she gave Murphy her ice-cream, and she completely enjoyed the ride.
Sure enough, as we walked out the exit, there was Gloria's new friend with "her" ice-cream.
Now you and I both know what happened, because we know that an ice-cream won't last twenty minutes on a summer afternoon in Florida. Murphy knew what time we would get off the ride. she went to the nearest shop and bought a brand-new ice-cream thirty seconds before we walked out the exit. Gloria said, "Thank you," but I'm sure she thought it was the same ice-cream.
We know that _ tried hard to make our visit special. Thanks so much for going above and beyond!
Your fan,
Carmen Rivera [/INST] question: The family's visit to the Magic Kingdom was _ . | options: A: helpful B: awful C: frightening D: enjoyable | answer: D </s> |
<s>[INST] context: Japanese Students Suffer from Pressure
Last April,15-year-old Rei Iwasaki stopped her piano and flute lessons and began to study every day of the week. Her parents paid to send her to a "cram school ."She wanted very much to pass her exams.
In February she did pass an all-day, five-subject examination and entered the high school she hoped to enter.
Thirteen-year-old Akio Yoshiwara wasn't so lucky. Unable to take the pressure of the exams, he hanged himself in February. He left a suicide note which said, "I did my best in this dear life, but it's no good."
Suicides are now a common part of life among students in Japan. The cause is the incredible pressure of the "examination hell."
Even a number of teachers are committing suicide each year. When some students broke windows in a school near Tokyo, the principal blamed himself and wrote the following note: "The incidents were due to the lack of appropriate measures by the principal and I apologize. I am very tired.
The Japanese educational system is much different from the American system. It is perhaps the most regimented school system in any of the industrialized nations.
Boys and girls wear uniforms and go to school six days a week --- 240 days a year compared to 180 in the U.S. Ninety- five percent graduate from high school compared to seventy-five percent in the U.S.
Students don't ask questions in class but only listen respectfully to the teachers. And every few year's students are tested to see which school they will enter next. There is stiff competition for the "best" schools.
The result is a well-informed, disciplined student, ideal for factory and company work and excellent at learning specialized skills. But there is little fun in education, little creativity and the incredible pressure of "examination hell." [/INST] question: It's because _ that many Japanese students committed suicide. | options: A: they didn't do their best in their lives B: they were sent to a "cram school" C: of the most regimented school D: they were unable to take the pressure of the exams | answer: D </s> |
<s>[INST] context: By Zhang Youlv (China Daily 09/29/2008)--A manned lunar landing is China's next target when the current three-stage space program ends in the next dacade. "When our manned space program is completed, we will travel even further," Wang Zhaoyao, deputy head of China's manned space program office and Shenzhou VII mission spokesman, told a briefing in Beijing three hours after China's third manned space mission was successfully concluded yesterday.
"After comprehensively analyzing the general trend of the international development of manned space, as well as realities in China, we see a manned lunar landing as a both challenging and tactical field in global hi-tech," he said.
"We believe it necessary for our country to do something in this field," Wang said.
He did not give a specific date for a moon landing. Wang, however, said, "Experts believe this is 'very much needed' for research into relevant (closely connected) technologies to further China's achievements in space."
The 68-hour Shenzhou VII mission featured a 25-minute spacewalk on Saturday.
It was broadcast live and watched by millions throughout the country. The crew's landing at a site in the Inner Mongolia autonomous region was also carried live by national television.
The entire mission was pronounced a complete success.
Wang said the three astronauts, were transported to Hohhot, the region's capital, and would spend the evening there.
"They will return to Beijing this morning," he said.
"During the course of the mission, Russian experts provided strong technical support for the EVA spacesuits. The successful Sino-Russian cooperation for this flight created beneficial conditions for more intensive cooperation between the two sides in the future," Wang said.
The mission's success has paved the way for completing the second stage of the program--building a space station before 2020.
Before that, a space lab will be set up in 2010 with Shenzhou X, the country's next full-crew space journey. [/INST] question: When will China's spaceship land on the moon? | options: A: 2020 B: 2010 C: 2018 D: No specific date | answer: D </s> |
<s>[INST] context: The amyloidoses are a group of acquired and hereditary disorders characterised by extracellular deposition of insoluble proteins . These complex deposits consist of fibrils of the specific protein involved, linked to glycosaminoglycans, proteoglycans and serum amyloid P (SAP). Protein accumulation may be localised or systemic, and the clinical manifestations depend upon the organ(s) affected. The diagnosis of amyloidosis should be considered in all cases of unexplained nephrotic syndrome ,cardiomyopathy and peripheral neuropathy. Diagnosis The diagnosis is established by biopsy, which may be of an affected organ, rectum or subcutaneous fat. The pathognomonic histological feature is apple-green birefringence of amyloid deposits when stained with Congo red dye and viewed under polarised light. Immunohistochemical staining can identify the type of amyloid fibril present. Quantitative scintigraphy with radio-labelled SAP is a valuable tool in determining the overall load and distribution of amyloid deposits DAVIDSON&;S 22nd EDITION;PAGE NO 86 [/INST] question: Conventional site for taking biopsy In secondary amyloidosis is? | options: A: Liver B: Kidney C: Rectum D: Abdominal fat aspirate | answer: D </s> |
<s>[INST] context: This patient has an unexplained pancytopenia. If all three elements (red blood cells, white blood cells, and platelets) are affected, the cause is usually in the bone marrow (although peripheral destruction from hypersplenism can cause pancytopenia as well). In this patient without a history of liver disease or palpable splenomegaly on physical examination, a bone marrow production problem is the most likely culprit. Although B12 deficiency can cause pancytopenia, usually a macrocytic anemia is the most prominent feature; a serum B12 level would be reasonable, but the most productive approach would be to examine the bone marrow. Leukemia can present without leukocytosis (so-called aleukemic leukemia), but the most likely diagnosis would be aplastic anemia. In the elderly patient, myelodysplastic syndrome (MDS) may present with pancytopenia. Decreased levels of erythropoietin can cause decreased RBC production but will not cause pancytopenia. A corticosteroid trial is not warranted until a diagnosis is established. [/INST] question: A 38-year-old woman presents with repeated episodes of sore throat. She is on no medications, does not use ethanol, and has no history of renal disease. Physical examination is normal. Hb is 9.0 g/dL, MCV is 85 fL (normal), white blood cell count is 2000/mL, and platelet count is 30,000/mL. Which of the following is the best approach to diagnosis? | options: A: Erythropoietin level B: Serum B12 C: Bone marrow biopsy D: Liver spleen scan | answer: C </s> |
<s>[INST] context: For every cup of coffee you made, about two spoons of grounds end up in the waste. That doesn't seem like a lot, but just think about the millions of coffees consumed around the world every single day, and you'll see the problem. Sure, some of those coffee grounds are recycled as fertilizer to enrich the soil or beauty products like face masks, but most will be buried into the ground. It was while considering this issue that German product designer Julian Lechner came up with a new way of recycling coffee grounds -- turning them into tableware.
"We were always drinking coffee at university," Lechner remembers. "And that's how I started to wonder. What happens to all that coffee? It was all just getting thrown away." He began consulting with his professors about ways of using coffee grounds to create a solid material.
"We tried combining with a lot of different things," Lechner said, "We even tried sugar. That was close, but basically it was a candy cup. It just kept melting after being used three times." The whole point was to make it last long, so Lechner and his partners went back to the institute to continue their research. Finally, after many failed experiments, they came up with a mix of coffee grounds and a biopolymer that seemed to behave the way Lechner had expected it.
"The moment of knowing the cup would actually stand was super-exciting," he recalls. "It was wonderful to drink that first coffee out of the cup. It proved to be totally worth the wait." And his creation has proven commercially successful, which is just _ . The coffee cups are now present in ten shops across Europe, and the company can hardly keep up with demand, regularly selling out of its stock online.
Lechner will soon launch a larger line of coffee grounds cups and also work on a travel mug. But those are just short-term plans, as Lechner hopes to one day use recycled coffee grounds to create all sort of useful stuff--like sheets and furniture in cafes and restaurants. [/INST] question: What do people do with coffee grounds before Lechner? | options: A: Make products beautiful B: Improve the soil C: Produce drinking cups D: Create solid materials | answer: B </s> |
<s>[INST] context: One night in February 1962, John H. Glenn, Jr. flew overprefix = st1 /Australia. The man in the Mercury capsule was alone, but friendly voices reached him by radio. Over the dark land 100 miles below, he saw sparkling lights. It marked the city of Perth, where people had turned on their lights as a greeting to him.
In Friendship 7, Glenn radioed, "The lights show up very well. Thank everybody for turning them on." His capsule moved on to the east.
"During his three orbits of the earth, Glenn could always reach one of the 18 tracking stations. Some of them were on ships at sea. Others were in theUnited States.
Many of the stations had been built with the help of other countries. These countries allowed Americans to bring in radio equipment and set it up. Without the help of such lands asNigeria, Zanzibar andMexico, there would have been breaks in the worldwide radio network. John Glenn, Jr. was the first American to orbit the earth. For his flight, the tracking network covered 60,000 statute miles . 500 men worked in the stations along the route. Since his flight, the network has grown. Today, it covers more than 100,000 statute miles and has about 100 stations. One-third of these stations are outside theUnited States. [/INST] question: People in the city of Perthturned on lights to _ . | options: A: greet Glenn B: see Friendship 7 C: guide Glenn to land D: celebrate the date of Glenn's flight | answer: A </s> |
<s>[INST] context: June and I were both poor when we were young. At that time, June always said, " If I got rich, I would buy a bigger apartment and a new wardrobe ." Of course, she said this just for fun and she never imagined that she would really become rich.
A few years ago, June was surprised and excited when she came into a fortune from her uncle, who had been single. After receiving it, she made a shopping list. On it she wrote down all the ways she could use to spend the money. Every time I told her not to spend all of the money and to save some, she would always say impatiently , " I know, I know!"
One day, when I was in June's home, she passed a piece of paper to me. "I thought over your suggestion for several nights. I've decided how to use the money. I hope my money will be helpful to those who need help," she said.
I was pleased to hear what she said. Then I took the paper and only saw the two words written by her: Charity and Family. I smiled and played a joke on her, "Don't you want to move to a new apartment? That is what you have been dreaming of."
"Actually, I have been looking forward to it, but now it doesn't seem so important to me anymore," she answered with a smile.
When I was about to put the paper on the table, I found there were still a few words. June had written: and a new wardrobe. [/INST] question: June could get her uncle's fortune because _ . | options: A: her uncle had no children B: she treated her uncle very well C: her uncle didn't get along well with his children D: she was very poor and her uncle wanted to help her | answer: A </s> |
<s>[INST] context: I turned 16 on Friday, but the Driver's License Office in my small hometown was only open on Tuesday, so I had to wait through that extremely long weekend and an endless Monday before going in for my examination.
I came to the Driver's License Office half an hour earlier _ , pacing back and forth on the worn porch waiting for the office to open at eight. I reviewed the driver's manual for the hundredth time. I was ready. I knew the manual backward and forward; I had made an "A" in my driver's training course, and I was a genius behind the wheel.
Finally, the door opened and a weary-looking man in a brown uniform let me in.
"Let me guess. You want to take the driver's test." his voice was not enthusiastic.
"Yes!" I answered in excitement.
"Ok, fill this out, and if you pass we'll go for a drive."
_ . A quick check showed that my paper was perfect.
"Let's get in the car." He tossed me a set of keys, and I slid behind the wheel. Everything was going smoothly as we pulled out of the empty parking lot. I signaled a right hand turn, and we were on a deserted street. This was going to be easy.
"Turn left and go up Young Blood Hill," he ordered. My hometown is in the mountains, and Young Blood Hill was almost vertical . As I eased up the steep hill and came to a stop at the top, I heard the car's engine die. My heart sank. I would have to start it again without rolling back down the hill. I swallowed hard and turned the key; as I moved my foot from the brake, the car began to roll. I suppose I could have rolled all the way back to the bottom except for one thing. There was something behind me which stopped my roll with a rough shake and crash of glass--a police car.
The policeman wrote me a ticket as I looked over the damage, and the man from the Driver's License Office slid behind the wheel. I waited until we had parked before I asked how long a person had to wait before taking the test again. [/INST] question: Why didn't the car roll back to the bottom? | options: A: It hit a police car B: The engine died C: The writer braked it hard D: The man from the Driver's License Office helped make it stop | answer: A </s> |
<s>[INST] context: Losing weight comes with a lot of health benefits--including making your brain sharper.
Yes, it turns out that overweight may damage cognitive functions such as memory and attention. There have been few studies of overweight and cognitive functioning, possibly because it is generally believed that it is not a primary risk cause for poor cognitive performance. Losing weight, therefore, may help improve these mental functions, according to a new research led by John Gunstad, assistant professor of psychology at Kent State University.
Growing evidence suggests that being fat is linked to cognitive deficits . So Gunstad and his team guessed that losing weight might improve mental function. For their study, they measured memory and attention in a group of 150 overweight participants, some of whom had some kind of operation for weight loss and some did not. All of the volunteers completed mental skills tests to assess their abilities of memory and attention at the beginning of the study, and again 12 weeks later. To begin with, about 24% of the patients showed damaged learning and 23% showed signs of poor memory when tested. At the end of the study, those who had lost weight after operation improved their scores into the average or above average range for cognitive functions. Scores for the volunteers who didn't lose weight dropped even further.
The study helped Gunstad to find out whether losing weight had any effect on mental function. Now that he's seen the positive effect that weight loss can have on memory and attention, he says he will next study those who choose to lose weight by the traditional way--eating healthier and getting more active. He expects that losing weight in this way will have a similarly positive effect on the brain. "If we can improve the condition with operations, then we can probably produce the same change with behavioral weight loss as well," he says. [/INST] question: There is less research on overweight and cognitive functions because researchers _ . | options: A: believe overweight only affects our body B: have focused on ways to sharpen people's mind C: do not consider overweight a main cause for low cognitive ability D: are clear about the relation between weight and mental functions | answer: C </s> |
<s>[INST] context: Many thousands of Chinese are studying at schools in the United States. And writer Liel Leibovitz says the students are following an example that began in the eighteen seventies.
Mr. Leibovitz and writer Matthew Miller joined forces to tell the story of the students in their book, "Fortunate Sons." The book says China sent one hundred twenty boys from 1872 to 1875 to America to learn about developments that could help modernize their country.
Mr. Leibovitz got the idea for the book about the boys a few years ago when he was traveling with his wife in China.
Mr. Leibovitz learned that Qing government sent a whole delegation of boys to learn the ways of the West. The goal was for them to return to China and help their country.
The book says the boys received their American training in Massachusetts, New York, New Jersey and Connecticut. It must have been a very good education. Mr. Leibovitz says the first prime minister of the Chinese Republic completed this program. And so did the first engineer to build a large-scale railroad without foreign help. The same was true of the fathers of Chinese education, diplomacy and the Navy.
The book-writers had only to open some boxes containing the writings of these men to learn about them. Their notebooks, journals, letters and postcards were in English. Mr. Leibovitz said he was lucky to have so much information from events that took place long ago.
The students returned to China after about nine years. They no longer spoke Mandarin well enough to answer questions. Police welcomed them home by putting them in jail. The young men were released after about a week. But they were given low-level jobs.
Mr Leibovitz says it took about ten years for them to rise to higher positions. He said their story continues today with large numbers of Chinese studying in the United States. [/INST] question: How many exchange children did Qing government send to America? | options: A: 1872 B: 1875 C: 120 D: 210 | answer: C </s> |
<s>[INST] context: PHACES syndrome (posterior fossa malformations, haemangioma, aerial anomalies, cardiac anomalies and coarctation of the aoa, eye abnormalities, sternal cleft and/or supraumbilical raphe) An association between posterior fossa brain abnormalities and large facial infantile haemangiomas is now well recognized, and there is evidence that the association may occur more commonly in female infants. The facial haemangiomas most characteristically take the form of extensive plaques, that appear to occupy one or more facial dermatomes, and they may initially be mistaken for po-wine stains. They may be either unilateral or bilateral. Ulceration is common. The commonest posterior fossa abnormality is the Dandy-Walker syndrome, but other abnormalities have included arachnoid cyst, cerebellar atrophy with enlarged cisterna magna and fouh ventricle, cerebellar atrophy with vermis agenesis, and agenesis of the corpus callosum. These posterior fossa abnormalities may be reflected clinically by macrocephaly, enlarging head circumference, hemiparesis, developmental delay, or may be found on imaging in the absence of symptoms.Ipsilateral intracranial haemangiomas may also occur; they are generally asymptomatic and appear to regress spontaneously in parallel with associated extracranial lesions. These patients may also have cardiac anomalies, paicularly coarctation of the aoa, pharyngeal or laryngeal haemangioma, a wide variety of eye abnormalities, including glaucoma, and ventral developmental defects, most characteristically sternal clefting or a supraumbilical raphe. [/INST] question: A 1 month old presents with a 2 week history of a red slightly raised plaque on the left forehead, periorbital area and malar cheek with a rim of vasoconstriction around it. The lesion has been thickening each day per mm. What syndrome is likely? | options: A: Cutis Marmorata Telangiectatica Congenita B: Kasabach Merritt Phenomenon C: LUMBAR syndrome D: PHACE syndrome | answer: D </s> |
<s>[INST] context: The Yale Peabody Museum is open:
Monday through Saturday 10:00 a. m. to 5:00 p. M.
Sunday Noon to 5:00 p. m.
The Museum is closed on New Year's Day, Easter Sunday, Independence Day, Thanksgiving Day, Christmas Eve, and Christmas Day.
Admission Fees:
$9.00 Adults
$8.00 Senior citizens 65 years and over
$5.00 Children ages 3 through 18, and college students with ID
$4.00 Group admission
To receive this reduced admission, groups must make a reservation at least 2 weekdays in advance. Group admission is only available with a written confirmation brought to the Museum at the time of the visit.
More attention:
Some halls may be closed to the public on weekday mornings during the academic year for school group programs, so we recommend visiting after 1 p.m. on weekdays or at any time on the weekends.
There is no cafeteria or lunchroom at the Peabody. Information on local eating places is available through our Restaurant Guide or at the Admission Desk in the lobby. Visitors are welcome to picnic on the lawns around the Museum.
Photography with handheld cameras is permitted in exhibition halls for personal use only; photography of The Age of Mammals is prohibited at all times. All other uses require the advance written permission of the Yale Peabody Museum.
Highlights Tours of the Museum are offered at no extra charge every Saturday and Sunday at 12: 30 and 1: 30 p.m. These 45minute tours of the Yale Peabody Museum's exhibition halls are led by one of our specially trained volunteer guides.
The Museum offers free individual admission on Thursday afternoons from 2: 00 to 5: 00 p.m. during the months of September to June.
Admission is free to any individual with a valid Yale ID. Check out a Peabody Museum pass at your local library. A Museum pass will give you $5 off each admission for up to 4 people. Ask for it at your local library. [/INST] question: To visit the museum, a 12yearold six grader should pay _ . | options: A: 4 dollars B: 5 dollars C: 8 dollars D: 9 dollars | answer: B </s> |
<s>[INST] context: A man stopped his car at the door of a flower shop. He planned to order flowers and asked the shopkeeper to deliver them to his mother, who was far away in the man's hometown.
The man saw a little girl crying on the road when he was about to enter the shop. The man asked her: "Why are you crying?"
"I want to buy a rose for my mother, but I haven't got enough money," said the girl.
The man took the girl's hand and entered the flower shop. He first ordered the bouquet for his mother and bought a rose for the girl.
Walking out of the shop, the man asked the girl if she would like a ride home.
"Will you really drive me home?" she asked.
"Of course," the man replied.
"Then drive me to my mother. But the place where my mother lives is very far."
The man drove along the mountain road and finally came to the cemetery .
The little girl put the flower onto a new grave. In order to present a rose to her mother who had passed away a month before, she had gone on a very long journey.
The man drove the girl to her home and then returned to the flower shop. He cancelled the bouquet and bought a big bunch of fresh flowers instead. He drove directly to his mother's home, a five-hour drive from where he was. He would present the flowers to his mother in person. [/INST] question: Whom did the man go to a flower shop to order flowers for? | options: A: His girlfriend B: His mother C: His wife D: A little girl | answer: B </s> |
<s>[INST] context: Vitamins are complex chemical substances found in many foods. The human body needs them for health and growth. The body makes some vitamins, but usually in amounts too small to meet its needs. Other vitamins are not made in the body. These must be supplied. No one knows exactly how all vitamins work. Doctors do know that vitamins have very special uses. One vitamin therefore cannot take the place of another. The steady absence of one vitamin in an otherwise complete diet causes a deficiency disease. Rickets, scurvy, and pellagra are examples of deficiency diseases.
It is best to obtain vitamins by eating the foods in which they occur. There are also pills that contain a single vitamin or a combination of vitamins people should consult their doctors before they take any vitamin pills.
Scientists have discovered about 25 vitamins and their different forms that are very important to human beings and other forms of life. Experts believe that there are many more vitamins to be discovered.
There are two basic groups of vitamins. One group of vitamins dissolves in fat and is therefore called the "fat-soluble" group. Vitamins A, D, E and K are in this group. The other group is known as "water-soluble" vitamins. These vitamins, understandably, dissolve in water. Among this group are Vitamin C and the B group of vitamins.
Vitamin A aids the building and growth of body cells. This vitamin is therefore vital for the growth of children and for good development of babies before birth. Vitamin A is also important for good vision at night. Vitamin B1 is also called thiamine. This vitamin prevents and cures disease. Vitamin B2, called riboflavin, is needed for growth, healthy skin, and for the eyes. Vitamin C, or ascorbic acid, prevents and cures scurvy.
Vitamin D is a group of 10 vitamins that prevents rickets. Scientist believe that Vitamin D3 forms in the skin when the body is exposed to sunlight. Because of this, it is called the "sunshine vitamin". A lack of Vitamin D may lead to bone damage; too much may cause kidney disease.
All of the functions of Vitamin E, also called tocopherol, are not known. It is necessary for reproduction in animals. Vitamin K is necessary for making the blood clot.
The more that is learned about vitamins, the more it is realized how these chemical substances play a part in all aspects of human activity. [/INST] question: Which disease is caused because of the steady absence of one vitamin in the diet? | options: A: Scurvy B: Pellagra C: Rickets D: All of the above | answer: D </s> |
<s>[INST] context: Lingual Artery
The lingual artery arises from the external carotid artery opposite the tip of the greater cornua of the hyoid bone.
Its course is divided into four parts by the hyoglossus muscle.
The first part lies in the carotid triangle. It forms a characteristic upward loop which is crossed by the hypoglossal nerve. The lingual loop permits free movements of the hyoid bone.
The second part lies deep to the hyoglossus along the upper border of hyoid bone.
It is superficial to the middle constrictor of the pharynx.
The third part is called the arteria profunda linguae, or the deep lingual artery. It runs upwards along the anterior border of the hyoglossus, and then horizontally forwards on the undersurface of the tongue as the fourth part.
In its vertical course, it lies between the genioglossus medially and the inferior longitudinal muscle of the tongue laterally. The horizontal part of the artery is accompanied by the lingual nerve.
During surgical removal of the tongue, the first part of the artery is ligated before it gives any branch to the tongue or to the tonsil. [/INST] question: During surgical removal of the tongue _____ part of the lingual artery is ligated before it gives any branches to tongue or tonsils: | options: A: First B: Second C: Third D: Fourth | answer: A </s> |
<s>[INST] context: LONDON (AP) -- England joins on Sunday the growing list of places that ban smoking in public buildings, taxis and other places including even Buckingham Palace with a tough law.
Pubs, clubs and restaurants will all be smoke-free. Taxi and delivery drivers have been warned that they too could be fined 50 pounds, or about $100, if caught lighting up inside work vehicles.
Experts say the bans have become an irreversible tread because of greatly rising health costs and public uneasiness over second-hand smoke. Some of the strictest smoking bans are in the United States, even though there is no federal anti-smoking policy. New York and Florida have strict bans, while California has certain outdoor smoking bans.
Spain, Italy, Iran, Norway, Sweden, Singapore, South Africa, Uruguay and new Zealand have passed legislation to restrict smoking. France banned smoking in many public places in February and plans to extend the ban to cafes and restaurants next year. Finland is introducing a ban in 2009.
Despite the spread of bans, the World Health Organization predicts a steady rise in tobacco sales. In its Tobacco Atlas, the WHO said that by 2030 there will be "at least another two billion smokers in the world" and an expected decrease in male smokers "will be _ by an increase in female smoking rates, especially in developing countries."
In advance of the English ban, anti-smoking ads have coated bus stops and the British government has subsidized programs to help people quit. The rest of Britain--Scotland, Wales and Northern Ireland --already have smoking bans in place. [/INST] question: Which of the following places may still be smoking areas in England? | options: A: Private houses B: Taxis C: Restaurants D: London clubs | answer: A </s> |
<s>[INST] context: BEIJING - For the first time in decades, Chinese drivers will enjoy a toll-free journey home during the upcoming eight-day holiday, which begins on Sunday.An 820-km drive from Beijing to the coastal city of Dalian takes travelers through four toll stations and costs a total of 380 yuan ( $ 60) in toll fees, while a sleeper train is just 240 yuan.
Amid growing calls, the State Council, or China's cabinet , issued a tollfree road policy in August, allowing passenger cars with seven seats or less to travel forfree on toll roads during four major holidays.The first toll-free holiday will be the upcoming eight-day Mid-Autumn Festival and National Day holiday.
The removal of toll fees will not only make travel cheaper and more convenient, but will also _ the service industry, as people will spend more money on related services, such as food and accommodation.
Hu Fangjun, an expert from the China Academy of Transportation Sciences, said companies funded by the toll fees will lose about 20 billion yuan each year throughout the four extended holidays due to the toll-free policy. However, new revenues earned from increasing spending during the longest holiday season will likely compensate for the losses. The companies that run the toll booths are largely state-owned, while the sector has been named as one of the most profitable in China.
Roads are public. Every citizen has the right to be on the road. The toll-free policy during holidays will give the roads back to the public. and is also a way of returning wealth to the people, which will eventually boost the public's trust toward the government. China's financial revenues have enjoyed rapid growth for decades. The government is capable of offering more welfare to its people. [/INST] question: Cars with _ fails to be included for the policy of toll-free holiday. | options: A: seven seats B: less than seven seats C: no more than seven seats D: more than seven seats | answer: D </s> |
<s>[INST] context: (Carcinoma stomach) (557-Harsh Mohan 6th ,786-Robbin-Pathologic-Basis of disease 8th)Leather bottle appearance termed linitis plastica seen in gastric adenocarcinoma. Breast and lung cancers that metastasize to the stomach may also creat a linitis plastica- like appearanceSCIRRHOUS CARCINOMA (Linitis plastica) - the stomach wall is thickened due to extensive desmoplasia giving the appearance as 'leather-bottle stomach' or 'linitis plastica, The lumen of the stomach is reduced. There are no ulcer but rugae are prominent (mother-of-pearl in appearance)* Gastric carcinoma is most commonly located into region of gastric canal (prepyloric region)**_* Ulcerative carcinoma*** is the most common pattern* Most common complication of gastric cancer is haemorrhage (haematemesis or melaena)* Pre malignant changes in gastric mucosa(i) Hypo or achlorhydria in atrophic gastritis of gastric mucosa with intestinal metaplasia***(ii) Adenomatous (neoplastic) polyp of the stomach(iii) Chronic gastric ulcer (Ulcer-cancer) and its association with achlorhydria(iv) Stump carcinoma in patients who have undergone partial gastrectomy* Superficial spreading or 'early' gastric cancer-confined to the mucosa or sub mucosa (with or without lymph node metastasis) are associated with an excellent prognosis* Trossier's si2n - The metastasis through lymphatic spread presents as left supraclavicular lymphnode enlargement* The depth of invasion and the extent of nodal and distant metastasis at the time of diagnosis remain the most powerful prognostic indicators for gastric cancers (786- Robbins- Basis of disease 8th)* Most common cause of gastric outlet obstruction in India is - Carcinoma stomach*** Sister Mary Joseph nodule (Metastatic involvement of the para umbilical nodes*** is most commonly seen with stomach carcinoma)* Early gastric cancer. Defined as a primary lesion confined to the mucosa and submucosa with or without lymph node metastasis*** There is one dictum that "Anterior ulcer perforates & posterior ulcer bleeds"* Stomach reveal fat-laden cells in post gastrectomy**** Watermelon stomach is seen in Scleroderma* Blood group A is associated with(i) Carcinoma stomach, cervix, salivary gland & pancreas(ii) Pernicious anemia(iii) Thrombosis in OCP users [/INST] question: Linitis plastica is seen in | options: A: Carcinoma of liver B: Carcinoma stomach C: Carcinoma lung D: Carcinoma esophagus | answer: B </s> |
<s>[INST] context: Option 1:is an epidemic form of highly contagious conjunctivitis and is characterized by sudden onset of painful, swollen, red eyes, with conjunctival hemorrhage and excessive tearing. AHC typically is caused by one of two enteroviruses (Coxsackie A24 or enterovirus 70). This disease is transmitted person-to-person usually through contact with contaminated hands or through sharing of contaminated personal-care items. fig:- acute hemorrhagic conjuctivitis Diseases caused by Enterovirus: Enterovirus 68: Pneumonia Enterovirus 70: Acute hemorrhagic conjunctivitis. Enterovirus 71: Pulmonary edema, herpangina, aseptic meningitis, and hand-foot-and mouth disease. Enterovirus 70, 71: Paralysis and encephalitis. Option 2: Acute follicular conjunctivitis is usually associated with: viral (epidemic keratoconjunctivitis, Herpes zoster keratoconjunctivitis, infectious mononucleosis, Epstein-Barr virus infection) chlamydial infections (Inclusion conjunctivitis). Option 3: Hepatitis is caused by hepatotropic virues like Hepatitis A, B, C. Option 4: Epidemic keratoconjunctivitis (EKC) is a viral conjunctivitis caused by a group of adenoviruses. [/INST] question: Enterovirus causes | options: A: Acute hemorrhagic conjunctivitis B: Acute follicular conjunctivitis C: Hepatitis D: Epidemic Keratoconjunctivitis | answer: A </s> |
<s>[INST] context: I'd like to share my unforgettable experience with you. Believe it or not, it was a real happening.
We were on tour a few summers ago, driving through Chicago, when right outside of the city, we got pulled over. A middle-aged policeman came up to the car and was really being troublesome at first. Lecturing us, he said, "You were speeding. Where are you going in such a hurry?" Our guitarist, Tim, told him that we were on our way to Wisconsin to play a show. His way towards us totally changed. He asked, "Oh, so you boys are in a band?" We told him that we were. He then asked all the usual band questions about the type of music we played, and how long
we had been at it. Suddenly, he stopped and said, "Tim, you want to get out of this ticket, don't you?" Tim said, "Yes." So the officer asked him to step out of the car. The rest of us, inside the car, didn't know what to think as we watched the policeman talk to Tim. Next thing we knew, the policeman was putting Tim in the back of the police car he had parked in front of us. With that, he threw the car into reverse , stopping a few feet behind our car. Now we suddenly felt frightened. We didn't know if we were all going to prison, or if the policeman was going to sell Tim on the black market or something. All of a sudden, the policeman's voice came over his loudspeaker. He said, "Ladies and gentlemen, for the first time ever, we have Tim here singing on Route 90." The policeman had told Tim that the only way he was getting out of the ticket was if he sang part of one of our songs over the loudspeaker in the police car. Seconds later, Tim started screaming into the receiver. The policeman enjoyed the performance , and sent us on our way without a ticket. [/INST] question: The policeman stopped the boys to _ . | options: A: put them into prison B: give them a ticket C: enjoy their performance D: ask some band questions | answer: B </s> |
<s>[INST] context: Passage 3
A smile will tell people around you that you are a kind and friendly person. However, many people don't smile because they think they have ugly teeth. For example, one of my classmates, Mike, doesn't have very nice teeth, so that is why he seldom opens his mouth. He even says that he has lost confidence because of his teeth. So it is very important for us to look after our teeth. In fact, a lot of people have this problem. Some people inherit teeth problems from their parents, while others' teeth are damaged because of bad habits, like heavy smoking, eating too much sugar or not brushing teeth often. If your teeth are in bad shape, you should see a dentist and ask for help. They can help improve your teeth and tell you how to take care of them.
Smiling can help you to feel more confidence and make people think of you as a more friendly person. If you want to keep healthy, you should not only smile but also laugh. An Indian doctor called Kataria said that young children should laugh about 30 times a day, while adults should laugh between 7 and 15 times a day. So please take this chance to smile and laugh now. [/INST] question: What has made Mike lose his confidence? | options: A: His bad habit B: His bad teeth C: Not smiling D: Eating too much sugar | answer: B </s> |
<s>[INST] context: A sick little girl is being kept alive thanks to her best friend -- a dog who carries her oxygen tank on his back. Alida's faithful dog companion Mr Gibbs has been specially trained to shepherd the three-year-old, who breathes through a tube most of the time. He follows her closely as she plays in her family's ten-acre land in Louisville, uses the slide or even rides her bike.[:Z*xx*k.Com]
Alida was diagnosed with neuroendocrine hyperplasia of infancy(NEHI)when she was just eight months old. Her rare condition has just eight hundred documented sufferers throughout the world, and causes diseased pieces of the lungs to filter oxygen through extra layers of cells, making it hard or almost impossible to breathe. For Alida and her parents, it meant that even a walk in the park was very difficult because oxygen equipment was too heavy for the youngster to be able to carry herself. As parents, they wanted to do something to help their daughter survive despite having a tube following her all the time. _ found out about "service dogs" from a TV program and realized an animal trained to help the blind could be trained to help Alida. They finally found help in the shape of golden doodle--a retriever crossed with a poodle-dog Mr Gibbs. Now thanks to trainer Ashleigh Kinsley--Alida and Mr Gibbs love nothing more than playing and running around together with the dog acting as Alida's life saver. [/INST] question: What is Mr Gibbs? | options: A: A pet dog B: A policeman C: A doctor D: A firefighter | answer: A </s> |
<s>[INST] context: J.K. Rowling set children's imaginations on fire. Can the creator of Harry Potter do the same for a grown-up audience? The British author will find out on September 27, when more than 2 million hardcover copies of her first novel for adults hit bookstores in the UK and the US, along with the digital edition. Set in a little English town, The Casual Vacancy is about an election held after an unexpected death.
Michael Pietsch, Rowling's US publisher, says the novel reminded him of Dickens "because of the humanity, the humor, the social concerns, the intensely real characters". No magic though, apparently: "This book isn't Harry Potter", says Pietsch. "It is a completely different concern". As with Harry Potter, there are no advance copies for the media, no early reviews. To date, the seven-book series has sold more than 450 million copies worldwide, and it became one of the most successful movie franchises in July 21, 2007.
Back then, fans could buy books at midnight parties hosted by bookstores. But recent years have seen a great challenge for brick-and-mortar bookstores. People are still buying books, indeed more books than in 2007, according to figures released by the Association of American Publishers. But they are reading them in a new format --the e-book. The Harry Potter series just became available digitally for the first time in April. It will be different for The Casual Vacancy, with the publisher _ releasing an e-book. For Rowling fans who once queued up for Harry Potter, this means that instant satisfaction is now only a click away.
Moving from children's books to adult literature is a big transition. Will Rowling's new book be successful? Arthur Levine, the US co-editor of the Harry Potter books, seems confident: "If you read or re-read the Harry Potter books, you can see that Rowling has all the strengths she needs for great success as a fiction writer -you have great characters, an involving plot, a sense of humor and great empathy". [/INST] question: What do the Harry Potter series and The Casual Vacancy have in common? | options: A: They are both intended for children B: They both show the author's great talent C: Their characters both have magical power D: Both of them won't be read on the Internet | answer: B </s> |
<s>[INST] context: How Room Designs Affect Our Work and Feelings
Architects have long had the feeling that the places we live in can affect our thoughts, feelings and behaviors. But now scientists are giving this feeling an empirical(,) basis. They are discovering how to design spaces that promote creativity, keep people focused and lead to relaxation.
Researches show that aspects of the physical environment can influence creativity. In 2007, Joan Meyers-Levy at the University of Minnesota, reported that the height of a room's ceiling affects how people think. Her research indicates that higher ceilings encourage people to think more freely, which may lead them to make more abstract connections. Low ceilings, on the other hand, may inspire a more detailed outlook.
In additions to ceiling height, the view afforded by a building may influence an occupant's ability to concentrate. Nancy Wells and her colleagues at Cornell University found in their study that kids who experienced the greatest increase in greenness as a result of a family move made the most gains on a standard test of attention.
Using nature to improve focus of attention ought to pay off academically, and it seems to, according to a study led by C. Kenneth Tanner, head of the School Design & Planning Laboratory at the University of Georgia. Tanner and his team found that students in classrooms with unblocked views of at least 50 feet outside the window had higher scores on tests of vocabulary, language arts and maths than did students whose classrooms primarily overlooked roads and parking lots.
Recent study on room lighting design suggests than dim light helps people to loosen up. If that is true generally, keeping the light low during dinner or at parties could increase relaxation. Researchers of Harvard Medical School also discovered that furniture with rounded edges could help visitors relax.
So far scientists have focused mainly on public buildings. "We have a very limited number of studies, _ ," architect David Allison says. "How do you take answers to very specific questions and make broad, generalized use of them? That's what we're all struggling with." [/INST] question: What does Joan Meyers-Levy focus on in her research? | options: A: Light B: Ceilings C: Windows D: Furniture | answer: B </s> |
<s>[INST] context: Edda, a Little Valkyrie's First Day of School
Written and illustrated by Adam Auerbach.
32 pp. Christy Ottaviano/Holt. $15.50.
Edda's home is in Asgard, "a land full of magic and adventure." But Edda, the littlest Valkyrie, doesn't have quite enough to do, until her father flies her "all the way to Earth for the first day of school."
The contrast between home and school is hard to get used to (in one, she can ride reindeer; in the other she gazes guinea pig through glass at the classroom). In his first picture book, Auerbach mixes the two worlds perfectly. Children are likely to appreciate the joke.
Planet Kindergarten
By Sue Ganz-Schmitt. Illustrated by Shane Prigmore.
32 pp. Chronicle. $14.99.
After careful preparations and a successful blastoff, a boy finds himself in a very unfamiliar environment. "We're aliens from many galaxies on Planet Kindergarten," he reflects as he sees his very varied classmates for the first time.
Prigmore, who designs for the movie industry, uses black backgrounds and bright colors to give this space adventure visual excitement and humor.
The Smallest Girl in the Smallest Grade
By Justin Roberts. Illustrated by Christian Robinson.
42 pp. Putnam. $18.99.
It makes sense that the author of the long, rhyming lines in "The Smallest Girl in the Smallest Grade" is a children's music performer. The story is about the power of one small person to fight prejudice.
Sally, whom no one ever seems to notice, is "paying super extra special attention" to the "terrible stuff" happening around her. When she decides to take action, she's not alone for long.
And Two Boys Booed
By Judith Viorst.
32 pp. Margaret Ferguson/Farrar, Straus & Giroux. $16.59.
Ever felt quietly confident one minute, and a shaking mess the next? In Viorst's story about determination, a little boy wakes up thinking about singing his song in the class talent show. [/INST] question: Which of the following is true about the book Edda, a Little Valkyrie's First Day of School? | options: A: Edda found it easy to apply herself to the life on earth B: The book was Adam Auerbach's first picture book C: The book was illustrated by Shane Prigmore D: The story of the book was about a little boy's determination | answer: B </s> |
<s>[INST] context: This is a true story. Tristin Saghin enjoyed the movie Black Hawk Down very much,which is about the conflict in Somalia.The battle scenes and the exciting rescues of people who are dying,interested him greatly.
There was just one problem:Tristin was only 9 years old,and it was thought that movie was not for children. When his parents caught him watching it on TV,they made him turn it off,though he had finished his homework and it was not late. Then one day,Tristin and his family were visiting his grandmother in Mesa,Arizona. Tristin's 2yearold sister got out of the house and fell in the backyard pool. Realizing the little girl was missing,the family ran outside,only to find the girl had fallen into the water.
Pulled from the pool and placed on the ground,the child wasn't breathing. The family called the ambulance ,but no one knew how to do first aid. No one,that is,except for Tristin. A scene in Black Hawk Down describes a doctor giving first aid. Tristin remembered it. Then the 9yearold gave first aid to his sister at once and saved her life.
His parents don't stop him seeing the movies he likes any more. Tristin taught himself how to do first aid but he had never thought he could use it to save his little sister's life. Any skill can be used in time,so you should always learn. [/INST] question: Black Hawk Down is a(n) _ . | options: A: war movie B: comedy C: action movie D: love film | answer: A </s> |
<s>[INST] context: The trouble started when Mrs. Cady lost control of her car on a mountain road. The car fell down thirty feet from the road into the water. It rolled over once and landed right side up in the rushing water. All three people, Mrs. Cady, and her two daughters, were wearing their seatbelts. Luckily, nobody was hurt; however, they couldn't leave the car.
The rescue started almost at once. Another driver told the police about the trouble. The police called rescue workers and a truck to pull the car out. The driver of the truck, Paul, arrived first. Immediatedly he took a rope from his truck and began to walk through the rushing water to the car. Then he got caught in the ropes. He went under the water. Mrs. Cady saw him and pulled as hard as she could and brought him to the car door.
Next the other rescue workers arrived. They put on special suits to keep warm. They brought safety ropes, life jackets, and warm blankets . First they pulled the people out of the back window onto the top of the car. Then they swam with each person to the shore . They saved Paul, Mrs. Cady, and the little girls. [/INST] question: Where did the trouble start? | options: A: In the river B: On a mountain road C: Under the water D: In a big city | answer: B </s> |
<s>[INST] context: One afternoon Peter and Jim went out for a bicycle ride. When they passed a place they saw a large area of grass and bushes on fire and a strong wind was blowing the flames towards a village. The firemen had already arrived and were trying to put out the fire. The boys left their bicycles and ran towards the village to see if they could help to fight the fire. On the way they met two firemen.
"Quick, you boys," said one of the firemen. "Come and help us to pull a pump to the stream. We can't beat out the fire. The wind is too strong. The pump is our only hope."
The two boys ran further until they came to a heavy pump. They helped to pull it to a stream not far from the village.
Soon the pump was working well so the boys went to watch the fire. It had already reached the edge of the village. The boys saw that two houses were on fire, and the flames were attacking a third building. Suddenly there was a shout from one of the villagers.
"Keep away!" a voice shouted. "There's paint stored in that building." The boys and villagers moved away quickly. With a loud explosion , the whole building burst into flames, sending clouds of thick black smoke into the sky.
At this time Peter and Jim began to think that the whole village would be burnt to the ground. The firemen had left the burning buildings and were pouring water onto the neighboring houses, trying to stop the fire from spreading. Then the wind died down. A second pump was brought up to help, and the fire was gradually put out.
"It's soon finished," Peter said to his friend. "We must go or we shall get home late." "Yes, come on," agreed Jim, and with a last look at the ruins, they walked back to their bicycles. [/INST] question: Seeing the fire, the boys ran to the village to _ . | options: A: watch it B: ask for help C: help the firemen D: warn the villagers | answer: C </s> |
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