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<s>[INST] context: Rtf: American journal of Roentology, Jan 2000, vol 174, 262-263Explanation:The pulmonary circulation carries deoxygenated blood from the R V across the pulmonary capillary- % bed & returns oxygenated blood via the pulmonary veins. This is a low pressure circuit.The bronchial circulation is a nutritional source for the lung. They branch from the aorta & is at systemic pressure, hence bleed profusely.Rasmussen's aneurysm is the aneurysm of small & medium pulmonary artey branches adjacent a tuberculous cavityDistributed peripherally, beyond the main pul. arteryCaused by granulomatous infiltration of intima & media of the artery by the tuberculous process in the nearby cavityCan cause hemoptysis, sometimes litethreateningTreatment- Pulmonary and bronchial artery embolisationOther causes of hemoptysis in a patient with PTB are1. Tubercular cavity2. Endobronchial tuberculosis3. Brock's syndrome4. Post-tubercular bronchiectasis5. AspergiHoina(funga] ball)6. Scar carcinomaCauses of hemoptysis:Tuberculosis, lung abscess, bronchiectasis, pneumonia, fungal infections (aspergillosis, nocardiosis, blastomycosis)Bronchogenic ca, bronchial adenoma, mets to lung (chorio ea, renal cell ca).Bronchiectasis, bronchial cyst, sequestration lungMitral stenosis. PAH, aortic aneurysm, AVM, pulmonary embolismVasculitis, wegner's, Goodpasture'sBleeding disorders [/INST] question: Rasmussen's aneurysm is seen in: | options: A: Bronchial artery B: Pulmonary C: Vertebral artery D: Internal carotid artery | answer: B </s> |
<s>[INST] context: Recently, we've been talking about how we need better teachers. There's no doubt that a great teacher can help in a student's achievement but here's what some new studies are also showing: We need better parents.
Every three years, the organization called O.E.C.D. organizes exams as part of the Program for International Student Assessment , or PISA, which tests 15-year-olds on their abilities to solve real problems. America's 15-year-olds have not done as well as students in Singapore, Finland and Shanghai in the PISA exams.
To better understand the reasons, the PISA team, starting with four countries in 2006, and then adding 14 more in 2009, went to the parents of 5,000 students. They interviewed them about how they raised their kids and then compared it with the test results for each of those years. Two weeks ago, the PISA team published the main findings of its study:
Fifteen-year-olds whose parents often read books with them during their first year of primary school get much higher scores in PISA 2009 than students whose parents don't often read with them or not at all. Parents' concern for their children is strongly connected with better results in PISA.
According to Schleicher, the leader of the team, just asking your children how their school day was and showing great interest in their learning can help a lot. It is something every parent can do, no matter what their education level.
The study found that getting parents concerned about their children's learning at home is more powerful than parents attending parent-teacher meetings, volunteering in classrooms, taking part in money-raising, and showing up at back-to-school nights.
To be sure, nothing can replace a good teacher. But let's stop putting the whole responsibility on teachers. We also need better parents. Better parents can make teaching more effective . [/INST] question: The study was done in _ countries in total in 2009. | options: A: 4 B: 14 C: 18 D: 40 | answer: C </s> |
<s>[INST] context: Age <55 years, any T, any N, M0 - stage 1 Any T, any N, M 1 - stage 2 Primary tumor (T) Tx = Primary tumor cannot be assessed T0 = No evidence of primary tumor T1 = Tumor <= 2cm in greatest dimension limited to the thyroid T1a = Tumor <= 1 cm in greatest dimension limited to the thyroid T1b = Tumor >1cm but <= 2 cm in greatest dimension limited to the thyroid T2 = Tumor >2cm but <= 4 cm in greatest dimension limited to the thyroid T3 = Tumor >4 cm limited to the thyroid, or gross extrathyroidal extension invading only strap muscles T3a = Tumor >4cm limited to the thyroid T3b = Gross extrathyroidal extension invading only strap muscles (sternohyoid, sternothyroid, thyrohyoid or omohyoid muscles) from a tumor of any size T4 = Includes gross extrathyroidal extension beyond the strap muscles T4a = Gross extrathyroidal extension invading subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve from a tumor of any size T4b = Gross extrathyroidal extension invading preveebral or encasing the aery or mediastinal Vessels from a tumor of any size Regional lymph nodes (N) NX = Regional lymph nodes cannot be assessed N0 = No evidence of locoregional lymph node metastasis N0a = One or more cytologically or histologically confirmed benign lymph nodes N0b = No radiologic or clinical evidence of locoregional lymph node metastasis N1= Metastasis to regional nodes N1a = Metastasis to level VI or VII (pretracheal, paratracheal, or prelaryngeal/ Delphian, or upper Mediastinal) lymph nodes. This can be unilateral or bilateral disease. N1b = Metastasis to unilateral, bilateral, or contralateral lateral neck lymph (levels I, II, III, IV, or V) or retropharyngeal lymph nodes Distant Metastasis (M) M0 = No distant metastasis M1 = Distant metastasis [/INST] question: Mr. Ramu 30 years old male with papillary carcinoma in thyroid with a nodule < 3 cm confined to neck with 2 lymph node palpable in neck along with lung micro-metastasis. How will you stage this according to AJCC 8th edition? | options: A: I B: II C: III D: IV | answer: B </s> |
<s>[INST] context: The lights dimmed,the musical hall grew quiet and out walked the conductor shiny and white and 4 feet and 3 inches tall.
ASIMO, a robot designed by Honda Motor Co., met its latest challenge Tuesday evening: Conducting the Detroit Symphony , in a performance of "The Impossible Dream" from "Man of La Mancha".
"Hello, everyone," ASIMO said to the audience in a childlike voice, then waved to the orchestra. As it conducted, it perfectly mimicked the actions of a conductor,
nodding its head at various sections and gesturing with one or both hands. ASIMO took a final bow to excited shouts from the audience. Later, cellist Yo-Yo Ma joined ASIMO onstage to receive an award for his efforts in music education.
Honda spokeswoman Alicia Jones says it is the first time ASIMO has conducted an orchestra, and it may be the first time any robot has conducted a live performance. But ASIMO has its limits. ASIMO's engineers programmed the robot to mimic Charles Burke, the Detroit Symphony's education director, as he conducted the piece in front of a pianist about six months ago. But it can't respond to the musicians.
"It's not a communicative device. It simply is programmed to do a set of gestures," said Leonard Slatkin, the orchestra's musical director. "If the orchestra decides to go faster, there's nothing the robot can do about it. Hopefully, I keep that under control."
But several musicians also said ASIMO was more realistic than they expected. "The movements are still a little stiff , but very humanlike, much better than I thought," Hutchinson said. [/INST] question: What's the audience's response to ASIMO's performance? | options: A: Disappointed B: Moved C: Excited D: Astonished | answer: C </s> |
<s>[INST] context: There is a boy in my gym class (I'll call him Bill) who has unbearably yellow teeth that almost make everyone feel unpleasant. Recently another boy told Bill that he should "go Ajax" his teeth. Bill was crushed. Had the other boy been thinking, he would have realized that there is a better way to handle such a situation. He could have dealt with it with tact. He could have showed this hurtful truth in a more careful, sensitive way--that's "tact".
If a person isn't sensitive to another's feelings, there is no way he or she can be tactful. Yesterday, my 5-year-old brother proudly announced that he had cleaned the screen on our television set. Unfortunately, he used furniture polish , which produced an oily film on the television screen. My mother smiled and thanked him for his efforts--and then showed how to clean the screen properly. Her sensitivity enables my brother to keep his self-respect. Yet, sensitivity alone does not make tact.
"Tactfulness" also requires "truthfulness". Doctors, for example must be truthful. If a patient has just been disabled in an accident, a tactful doctor will tell the truth--but express it with sensitivity. The doctor may try to give the patient hope by telling them curing techniques under study or about advanced equipment now available. Doctors must use tact with patients relatives as well. Instead of bluntly saying, "Your husband is disabled," a doctor might say, "I'm sorry, but your husband has lost feeling in his legs and..."
Tact should not be confused with trickery. Trickery occurs when a nurse is about to give a patient an injection and says, "This won't hurt a bit." Instead of trickery, the nurse might guarantee the patient that the discomfort of the injection is a small thing compared to the benefits of it. It would also be thoughtful for the nurse to tell the patients about some of these benefits.
Tact is a wonderful skill to have, and tactful people are usually admired and respected. Without tact our society would become an intolerable place to live in. [/INST] question: When told he should "go Ajax" his teeth, Bill probably felt _ . | options: A: surprised B: cheated C: regretful D: painful | answer: D </s> |
<s>[INST] context: How to Study Smarter, Not Harder
Here are some of our favorite study tips that will help any student study smarter, not harder:
Recite As You Study
Reciting--saying things out loud should first take place as you read through each paragraph or section. Test yourself. This will help you to understand as well as learn faster because it is more active than reading or listening. It will also help you to notice your mistakes and the topics you have trouble understanding.
Take Fuller Notes
Notes should be in your own words, brief and clear. They should be tidy and easy to read. Writing notes will help you better than just underlining as you read, since it forces you to rewrite ideas in your own words.
Study the Middle
The best time to review is soon after you've learned something. You are more likely to remember the material at the beginning and the end of the lesson, so make sure you focus on the middle when you review.
Sleep On It
Study before going to bed, unless you are very tired. It's easier to remember material you've just learned after sleeping than after an equal period of daytime activity, because your brain continues to think even after you've fallen asleep.
Combine Memory and Understanding
There are two ways to remember: by memorizing and by understanding. Multiplication tables, telephone numbers, and math formulas are better learned by rote. Ideas are best learned by understanding.
The more ways you have to think about an idea, the more meaning it will have; the more meaningful the learning, the better you can remember it. Pay attention to similarities in ideas and concepts, and then try to understand how they fit in with things you already know. Never be satisfied with anything less than a completely clear understanding of what you are reading. If you are not able to follow the thought, go back to the place where you first got confused and try again. [/INST] question: You can notice your mistakes by _ . | options: A: saying things out aloud B: taking notes C: studying the middle D: sleeping on it | answer: A </s> |
<s>[INST] context: A woman was walking her dog along a beach in New Zealand in late June when she saw something that looked like a white ball in the sand. It turned out to be a young Emperor penguin that was lost. At his age, he should have been close to Antarctic, swimming for fish and playing on the ice floes . But this penguin started swimming north and just kept going.
The penguin attracted a lot of attention in New Zealand. It has been 40 years since an Emperor penguin was last seen there. Researchers at the Department of Conservation were called in. They decided to watch the penguin closely, but not to disturb it in any way. Many New Zealanders came to Peka Peka Beach to look at the elegant penguin. They were careful to keep their dogs away from it so it wouldn't be frightened.
The public nicknamed the animal Happy Feet. Researchers started to notice that Happy Feet didn't seem well. It turns out that he had been eating the sand from the beach, likely thinking it was snow.
The public raised more than 11,000 pounds for an operation to get the sand out of his stomach. The operation was a success, and Happy Feet was taken to a zoo in Wellington, NZ. A group of experts met to decide how to help Happy Feet return to the wild.
Last Sunday, they put him on a boat called the Tangaroa, in a specially built ice-filled box and took him out into the Southern Ocean, southeast of New Zealand. There, they released him into the ocean, which is his natural habitat. He took one last look at his human helpers and then dived into the ocean.
"Emperor penguins spend their first five years at sea," said Peter Simpson of New Zealand's Department of Conservation. " What happens now is up to the penguin."
Happy Feet was fitted with a satellite transmitter so they can monitor his progress using the Internet. So far, the trackers shows that he swam northeast for a little while before getting his bearings and heading south. [/INST] question: Where is the young penguin supposed to appear? | options: A: On the sunny beach B: Near the Antarctic C: Inside the hole in the ice D: In the depths of the ocean | answer: B </s> |
<s>[INST] context: ABC News anchor Peter Jennings died on Aug.7, 2005 at home in New York after a brief battle with lung cancer. ABC News anchors said they hope if anything good can be taken from Jennings' death, it is a great awareness of the dangers of smoking.
"I want to give a message," Barbara Walters said. "If you have kids who are smoking, tell them that we lost Peter."
Lung cancer is the worst killer in America, taking more lives each year than any other cancer, according to the America Cancer Society. About 160,440 Americans die each year of cancer, making up 28 percent of all cancer deaths. More than 87 percent of lung cancers are smoking related.
Dr. Derek Raghavan, director of the Cleveland Clinic' s Taussing Cancer Center , said that once a person stops smoking, he starts getting better. Three to five years after quitting, the possibility of getting lung cancer is reduced by half.
Warning signs of lung cancer can also be mixed with symptoms connected with long-term smoking. The three main warning signs are an increase of coughing that doesn't clear up, coughing up blood and sharp chest pains.
People with those symptoms should see a doctor. Raghavan said there have been promising developments in the treatment of lung cancer, including uses of radiation and surgery and drugs. "But the fact is that stopping smoking is the most important thing we can do," Raghavan said. "There is no treatment that even comes close." [/INST] question: Anchor Peter Jennings died of lung cancer which was possibly caused by _ . | options: A: his bad eating habit B: overmuch work C: long-term smoking D: the old age | answer: C </s> |
<s>[INST] context: Lactose Electrolyte efficient ( CLED) Media
CLED agar is a non- selective differential plating media for the growth and enumeration of urinary tract microorganisms.
It contains
Lactose
Casein peptone
Gelatin peptone
Beef extract
L - cysteine
Bromothymol blue
Agar
Omitting sodium chloride (electrolyte deficient) inhibits the proteus swarming and supports the growth of a great majority of bacteria causing urinary tract infections and as used to differentiate and identify them.
Similarities, between CLED Media & MacConkeys Medium
Both are differential media
Both MacConkey and CLED media differentiates between lactose fermenting & non lactose fermenting
Both CLED MaConkey media inhibits swarming of proteus
Both show greenish colour, matt surface & rough periphery of Pseudomonas colonies
CLED media is preferred over MacConkey's for the culture of coliform and other bacteria from infected urine because -
It has the advantage of supporting the growth of certain Staphylococcus, Streptococci and Candida strain." - Macon & Macgregor, 13th/e [/INST] question: In a patient with UTI, CLED (Cystine, Lactose Electrolyte Deficient) Media is preferred over MacConkey media because - | options: A: It is a differential medium B: It inhibits swarming of Proteus C: Promotes growth of Pseudomonas D: Promotes growth of staph aureus and Candida | answer: D </s> |
<s>[INST] context: Restriction enzyme type II identifies the palindromic sequences on the DNA and cuts the DNA strand at a ceain specific site. Types of Restriction EnzymesRestriction enzymes are traditionally classified into four types on the basis of subunit composition, cleavage position, sequence specificity and cofactor requirements. Type I enzymes are complex, multisubunit, combination restriction-and-modification enzymes that cut DNA at random far from their recognition sequences.Type II enzymes cut DNA at defined positions close to or within their recognition sequences. They produce discrete restriction fragments and distinct gel banding patterns, and they are the only class used in the laboratory for DNA analysis and gene cloning. Type III enzymes are also large combination restriction-and-modification enzymes. They cleave outside of their recognition sequences and require two such sequences in opposite orientations within the same DNA molecule to accomplish cleavage; they rarely give complete digests.Type IV enzymes recognize modified, typically methylated DNA and are exemplified by the McrBC and Mrr systems of E. coli. [/INST] question: Restriction enzyme Type II | options: A: Methylates specific DNA sequences B: Cleaves specific palindromic DNA sequences C: Helps in protein digestion D: Helps in keeping the nascent protein unfolded | answer: B </s> |
<s>[INST] context: Skin and soft tissue infection of S. aureus
Folliculitis – Superficial infection of ostia of hair follicle.
Faruncles (boils) – More extensive painful lesions that tends to occur in hairy moist region of body and extend from hair follicle to become a true abscess, eg. buttock.
Carbuncle – Mostly located in lower neck and are even more severe and painful.
Acute paronychia – MC cause is S.aureus.
Bullous impetigo – Impetigo is most frequently diagnosed bacterial infection.
Ecthyma – It is deeper form of impetigo caused by Staph or Strep.
Cellulitis
Hiradenitis suppurativa - Recurrent follicular infections in region such as axilla.
Sycosis barbae is chronic folliculitis of beard hair follicle.
Remember :
S. aureus is MC cause of surgical wound infection.
Harrison 17/e, p 873
Non - bullous impetigo, cellulitis and erysipelas is caused by Strep. pyogenes more commonly than S.aureus.
Ecthyma gangreosum is caused by Ps. aeruginosa.
Erythma migrans is caused by Borrelia burgordeferi (Tick transmission).
Erythrasma is caused by corynebacterium minutissimus.
Impetigo contagiosa is usually caused by streptococci or mixed infections. – Most cases of impetigo is caused by S.aureus. [/INST] question: Staphyloccus can cause : | options: A: Ecthyma B: Erytharsma C: Tumor D: Impetigo contagioa | answer: A </s> |
<s>[INST] context: The earth is changing. Tomorrow it will be different. All the living things on the earth are changing. Even people are changing, and tomorrow you will be different.
There are many kinds of change, and many different things than cause change. People need to realize the changes, to learn to see them, and to learn what causes change.
Human beings must solve many problems so that they can continue to live successfully. War is one of these problems. Disease and natural _ are problems. Having enough food and energy for the growing number of people in the world is a problem. Most problems can be solved, but some are impossible to solve. The way in which people solve problems affects how long and how well they can live.
As people solve their problems, they change things, and changes often cause new problems for people and for other living things on the earth. Sometimes the new problems seem even worse than the old ones. Human beings will probably never stop having problems to solve. Can you use your imagination to describe a world that has no problems at all ? [/INST] question: The reason why everything is changing is that _ . | options: A: people want them to be changing B: there're many different things that cause them to change C: the living things are changing D: the world is too small | answer: B </s> |
<s>[INST] context: Spring is an inviting season for outdoor activities. But be careful--the warm weather is also a hotbed for viruses and disease.
This March, the influenza A(H7N9) virus hit Shanghai, Anhui, Jiangsu and Zhejiang. It was reported that by April 11 at least 35 people had been infected with the H7N9 virus, and nine of them had died.
The influenza A (H7N9) virus is one type of influenza A H7 viruses. Influenza A H7 viruses normally spread among birds.
This is the first time human infections with H7N9 viruses have been reported in China. Earlier reports were about H5N1 and H1N1.
All the three viruses are influenza A viruses but they are not the same. H7N9 and H5N1 are animal influenza viruses that could infect people. However, H1N1 viruses can be divided into two groups. One group can normally infect people and the other normally infects animals. Also, H1N1 can spread from human to human, but H7N9 probably can't, according to the World Health Organization (WHO).
Most people infected with H7N9 looked like they had the common flu. Some people had bad pneumonia . They suffered from a fever, a cough and shortness of breath.
But don't be afraid - it is not easy to be infected with the virus. One of the possible reasons is close contact with sick poultry waste. People may also be infected through breath, according to National Health and Family Planning Commission.
Here are some tips from the WHO that can protect you from being infected.
Wash your hands with soap and running water before you eat, after you use the toilet, and after touching animals or animal waste.
When coughing or sneezing cover your mouth and nose with a mask ,tissue or a sleeve.
Get a good rest and do exercises, which will help make your body strong enough to stand up to the virus. [/INST] question: What's the name of the influenza virus that hit Shanghai, Anhui, Jiangsu and Zhejiang this March? | options: A: It is the H7N9 virus B: It is the H5N1 virus C: It is the H1N1 virus D: It is A H7 virus | answer: A </s> |
<s>[INST] context: We spent a day in the country, picking wild flowers. With the car full of flowers we were going home. On our way back my wife noticed a cupboard outside a furniture shop. It was tall and narrow. "Buy it," my wife said at once. "We'll carry it home on the roof rack . I've always wanted one like that."
What could I do? Ten minutes later I was PS20 poorer; and the cupboard was tied on the roof rack. It was six feet long and eighteen inches square, quite heavy too.
In the gathering darkness I drove slowly. Other drivers seemed unusually polite that evening. The police even stopped traffic to let us through. Carrying furniture was a good idea.
After a time my wife said, "There's a long line of cars behind. Why don't they overtake, I wonder?" In fact a police car did overtake. The two officers inside looked at us seriously as they passed. But then, with great kindness, they led us through the rush-hour traffic. The police car stopped at our village church. One of the officers came to me.
"Right, sir," he said."Do you need any more help?"
I was a bit puzzled. "Thanks, officer," I said. "You have been very kind. I live just on the road."
He was staring at our car, first at the flowers, then at the cupboard. "Well, well," he said, laughing. "It's a cupboard you've got there! We thought it was something else."
My wife began to laugh. The truth hit me like a stone between the eyes. I smiled at the officer. " Yes, it's a cupboard, but thanks again."I drove home as fast as I could. [/INST] question: In fact the husband _ the cupboard. | options: A: would like very much to buy B: badly wanted C: would rather not buy D: was glad to have bought | answer: C </s> |
<s>[INST] context: It is not often realized that women held a high place in southern European societies in the 10 th and 11 th centuries. As wife, the woman was protected by the setting up of a dowry or decimum. Admittedly, the purpose of this was to protect her against the risk of desertion ,but in reality its function in the social and family life of the time was much more important. The decimum was the wife's right to receive a tenth of all her husband's property. The wife had the right to withhold consent, in all transactions the husband would make, And more than just a right: the documents showed that she enjoyed a real power of decision, equal to that of her husband. In no case did the documents indicate any degree of difference in the legal status of husband and wife.
The wife shared in the management of her husband's personal property, but the opposite was not always true. Women seemed perfectly prepared to defend their own inheritance(,)against husbands who tried to exceed their rights, and on occasion they showed a fine fighting spirit. A case in point is that of Maria, Vivas, a Catalan woman of Barcelona. Having agreed with her husband Miro to sell a field she had inherited, for the needs of the household, she insisted on compensation. None being offered, she succeeded in dragging her husband to the scribe to have a contract duly drawn up assigning her a piece of land from Miro's personal inheritance. The unfortunate husband was obliged to agree, as the contract says, "for the sake of peace." Either through the dowry or through being hot-tempered, the Catalan wife knew how to win herself, within the context of the family, a powerful economic position. [/INST] question: A decimum was_. | options: A: the wife's inheritance from her father B: a gift of money to the new husband C: a written contract D: the wife's right to receive one-tenth of her husband's property | answer: D </s> |
<s>[INST] context: My cat Toto is aging,and as she ages,her body is failing her.Mentally,she seems sharp,but after nearly sixteen years,Toto's hips are causing her obvious trouble.In fact,they make it so that she can't use a litter box effectively.She tries to squat ,but mostly she just pisses out the back end of the box.
I spent the summer working with my vet to find things to help Toto,but nothing works.Since we can't stand the smell of cat urine in the house,two weeks ago I took drastic measures.I _ Toto outside.(She gets to come in while I work,but I put her out for 80%of the day and night.)
Because Toto now lives outside,she eats and drinks outside.I' ve set up a heating pad on the porch.and given her own food and water area nearby.She seems perfectly content with this arrangement except when she's out of food,or she wants to be petted.
Strangely enough,she's been out of food a lot lately."I think another cat is eating Toto's food."I told Kris when I first noticed how quickly she was going through her bowl.
"Actually,"I said a couple of days later,"maybe it's a dog.Whoever is eating Toto's food keeps knocking the bowl over."
But a few days after that,I realized that the food thief probably wasn't even a dog.Whatever the critter was,it was messy. Every morning,Toto's water dish was filled with mud.The food bowl was tipped over and the porch scattered with mud and debris ."I' ll bet it's a coon ,"I told Kris.Though we live in a residential neighborhood not far from Portland,we' ve seen plenty of raccoons in the six years since we moved in.
Today I got to see the cat-food thievery first-hand.Turns out it's not one raccoon-it's a family of four.I was lucky enough to have my camera handy as they performed their daring raid:My favorite part of this video is how Toto simply sits on her heating pad and watches the raccoons eat her food.She isn't bothered at all. [/INST] question: Which of the following about Toto is true? | options: A: She is physically sharp B: She is at least sixteen years old C: She can't use a litter box properly D: She stays outside all the while recently | answer: C </s> |
<s>[INST] context: People usually check whether their keys, wallets and phones are with them before going out . But many people in China now have one more important thing to take -- a face mask . They hope that it can protect them from polluted air.
Since January, many cities in China have seen a lot of foggy days.In Beijing, only five days in January were free of smog . It is dirty air that looks like a mixture of fog and smoke caused mainly by smoke from cars and factories in cities. Poor air has done harm to people's health, especially for children and old people. They fall ill easily and the hospitals are full of the the patients of respiratory problems.
To respond to the air problems, the Chinese government and many Chinese people have started to take action. Beijing announced plans to use cle an fuel in government vehicles and plant trees. It also asked citizens to set off fewer fireworks for celebrations.
Three students from No.4 High School in Beijing wrote a report to advise how to fight the air pollution. They suggested that cars with large emissions should not be allowed to use and factories should be closely watched.
We hope more people will join us in making a difference. With all our efforts , the blue skies will certainly return for good. [/INST] question: People will take _ with them before going out, hoping to protect them from the polluted air. | options: A: keys B: wallets C: phones D: face masks | answer: D </s> |
<s>[INST] context: Best Vacation Home&Rental Deals
$ 240-$350--Ojai, CA: 3-Bedroom Home in Historic Downtown
Providing a ton of value versus Ojai's pricey hotels, this home with patios and a fire pit accommodates up to SIX
Through December
$ 225Lake Arrowhead 2-Nt.Cabin Retreat, Save 65%
Retreat to a cozy cabin in the mountains and discover the great outdoors with this exclusive
Lake Arrowhead deal that saves 65% on regular rates.
Arrive through Dec.18,2015
$ 149 - Colorado Springs: Home for 8 in Historic Downtown
Retreat to this Victorian home with a patio located in the heart of downtown near restaurants, galleries and shops.
Many dates September-December
$ 139 - Nlaui: Apartment for 4 near Beach w/Pool &Parking
This upgraded apartment comes with a parking spot and is within a five--minute walk of
Kamaole Beach.
Through December
$ 189Seattle: Charming Home for 8 Near Downtown
Retreat to a three-bedroom home with large backyard close to both the airport and downtown.
Many dates between September - December
$ 319 Sonoma Wine Country 2-Bedroom Apartment for 4
Stay in a newly-renovated flat that's walking distance to wineries and downtown.
Many dates through 2016; 2-nt. stay required [/INST] question: If you rent Lake Arrowhead, you can_. | options: A: walk on the beach B: visit the galleries C: enjoy the wine D: explore the natural beauty | answer: D </s> |
<s>[INST] context: Stop wasting your time thinking of reasons for your failures. Instead, realize that the seeds of success were planted within you when you were born. Only you have the power to make those seeds grow.
The seeds, and the power to grow them, are contained in the most awesome machine ever created: the human mind. Success is a choice and not a chance. You were born a winner. You were born rich. You can be a success if only you make the right choice.
You cannot be successful without first developing your self-confidence. Your level of self-confidence is always based on the degree of control that you are able to exercise over yourself, and thus over your life. People with low self-confidence are people who do not believe that they have any power, or responsibility for their lives. They are always victims. They are leaves tossed by the winds of chance blown about with any sudden change in the weather.
You can exercise control over your life only to the degree that you believe you are responsible for everything that happens in your life. Failures think that everything happens by accident and chance. Successful people realize that they are responsible.
Everything happens as a result of something. If we can identify the cause, we can control the effect. We are responsible for what we choose to think and believe. One generally rises to the level that one expects. We are responsible for setting our expectations. Our success is dependent upon our level of confidence.
In all areas of your life, whether they are financial, physical, or spiritual, you are responsible. Once you recognize this, accept it, and firmly believe it. You are on the road to success. [/INST] question: People with low self-confidence are compared to leaves because they _ . | options: A: don't have the power to face their lives B: are ready to change their minds C: can't exercise control over themselves D: are easily affected by windy weather | answer: C </s> |
<s>[INST] context: Basic life suppo, more popularly known as CPR, is intended to maintain organ perfusion until definitive interventions can be instituted. The elements of CPR are the maintenance of ventilation of the lungs and compression of the chest. Mouth-to-mouth respiration may be used if no specific rescue equipment is immediately available (e.g., plastic oropharyngeal airways, esophageal obturators, masked Ambu bag). Conventional ventilation techniques during single-responder CPR require that the lungs be inflated twice in succession after every 30 chest compressions. Recent data suggest that interrupting chest compressions to perform mouth-to-mouth respiration may be less effective than a continuous chest compression strategy. Chest compression is based on the assumption that cardiac compression allows the hea to maintain a pump function by sequential filling and emptying of its chambers, with competent valves maintaining forward direction of flow. The palm of one hand is placed over the lower sternum, with the heel of the other resting on the dorsum of the lower hand. The sternum is depressed, with the arms remaining straight, at a rate of approximately100 per minute. Sufficient force is applied to depress thesternum 4-5 cm, and relaxation is abrupt. ref:harrison&;s principles of internal medicine,ed 18,pg no 2247 [/INST] question: In basic life suppo (BLS), suppo is given to which of the following organ- | options: A: Lung B: Hea C: Kidney D: Skeletal muscle | answer: A </s> |
<s>[INST] context: This is a talk by a London taxi driver.
"I've been a taxi driver for nearly ten years. Most London taxi drivers have their own taxis."
"It's a nice job most of time. You meet a lot of people. I always work at night, because there is too much traffic during the day. I live twenty miles outside London and I go to work at 5:30 in the afternoon."
"I usually go home between 2 and 3 in the morning."
"Some very strange things happened late at night .The other day I was taking a woman home from a party .She had her little dog with her. When we got to her house, she found that she had lost her key. So I waited in the car with the dog while she climbed in through the windows."
"I waited and waited. After half an hour of ringing the bell I decided to find out what was going on .I tied the dog to a tree and started to climb in through the window. The next thing I knew was that the police came. They thought I was a thief.
Luckily the woman came downstairs.She must have gone to sleep and forgotten about me and the dog!" [/INST] question: The driver always worked at night because it was easier to _ . | options: A: make money B: drive C: climb in through the window D: meet a lot of people | answer: B </s> |
<s>[INST] context: Active transport
Movement across a membrane from an area of low concentration to high concentration.
Since carriers are involved, it demonstrates MichaelisMenten kinetics.
It is a unidirectional transport that requires energy (ATP).
a. Endocytosis—vacuole formation utilizing plasma membrane and released inside the cell.
May result in degradation.
If vacuole is fused with lysozymes, results in degradation.
(1) Pinocytosis—
internalization of interstitial fluid.
(2) Phagocytosis—
internalization of material and subsequent lysosomal digestion.
(3) Receptor mediated endocytosis—
selective internalization of receptor/ligand complex. Receptor complex may return to surface.
b. Exocytosis—secretory vesicle membrane from within the cell fuses with the plasma membrane, and the contents of the vesicle are released outside the cell.
c. Primary active transport—energy derived from ATP.
Specific carriers are utilized, which are saturable.
(1) Ca2+-ATPase pumps are important active transports in sarcoplasmic reticulum membranes.
(2) Na+K+-ATPase pump is present in all plasma membranes.
- Establishes and maintains a Na+ and K+ gradient by transporting Na+ out and K+ into the cell.
- The Na+ concentration gradient is the force for secondary active transport mechanisms.
d. Secondary active transport—ATP establishes an ionic gradient, which is the driving force (secondary transport).
(1) Na+ gradient established by membrane pumps drive this system.
(2) Protein carriers bind both the substance transported and Na+.
(3) Cotransport systems—Na+ and substance transported move in the same direction.
Examples include:
- Glucose and galactose across GI mucosa and resorption in renal tubule.
- Amino acid transport in GI mucosa and renal tubules.
(4) Countertransport—
- Na+ and transported substance move in opposite directions.
Examples include:
- Na+/H+ exchange (H+ out and Na+ into cells).
- Na+/Ca2+ exchange (Ca2+ out and Na+ into cells) [/INST] question: internalization of material and subsequent lysosomal digestion: | options: A: Pinocytosis B: Phagocytosis C: Receptor mediated endocytosis D: Exocytosis | answer: B </s> |
<s>[INST] context: When traveling, it's important to learn about the customs and etiquette of the global village, What we consider polite behavior at home isn't always accepted outside our borders.Don't be regarded rude or disrespectful on your travels.
Gift giving should be a happy, positive experience.When selecting a present for someone in the Netherlands, don't purchase fancy kitchen knives or scissors.Giving sharp, pointy objects as gifts is considered unlucky.Be careful when presenting flowers to a friend or business partner in Russia.Yellow blooms suggest cheat or a relationship break-up. Traditionally, red carnations are placed on the tombs of the dead.Writing cards or notes while visiting South Korea, be mindful of your pen's ink color.Writing a person's name in red ink traditionally suggests that the person has passed away-an important point to remember when giving a birthday card.
Being early or on time is viewed as being rude, too eager or even greedy in Venezuela.If you are invited over to someone's home for a meal, it's recommended that you arrive 10 to 15 minutes later than the requested time.When having a meal in Egypt, don't use the saltshaker . It's _ to your host to spread salt on your food, which means that you find the meal terrible.Japan is a very polite nation, and their fondness for etiquette extends to the mealtime use of chopsticks.According to Japanese custom, it's considered ill-mannered to point, play with, or stab food with chopsticks.If you're in the middle of eating, use the opposite end of your chopsticks to secure food from a shared plate.Using the end that touches your mouth is extremely offensive , not to mention unhygienic . [/INST] question: When sending a gift to your friend in Netherlands, you should avoid _ . | options: A: sharp knives B: red carnations C: yellow flowers D: long chopsticks | answer: A </s> |
<s>[INST] context: In this mutation, stop codon - UAG is replaced by another stop codon- UAA. So, this is silent mutation. In silent mutations, there is no change in primary structure of protein. OTHER QUESTIONS FREQUENTLY ASKED ON THIS TOPIC: Silent Mutation:The codon containing the changed base codes for the same amino acid.For example, if the serine (Ser) codon UCA is given a different third base, U, to become UCU, it still codes for Ser. This is termed a "silent" mutation. Missense Mutation:The codon containing the changed base codes for different amino acid. For example, if the Ser codon UCA is given a different first base, C, to become CCA, it will code for a different amino acid (in this case, proline ). This is called a "missense" mutation. Nonsense Mutation:The codon containing the changed base become a termination codon. For example, if the Ser codon UCA is given a different second base, A, to become UAA, the new codon causes termination of translation at that point and the production of a shoened (truncated) protein. [/INST] question: If Codon no 302 UAG is replaced by UAA, then this mutation is: | options: A: Missense B: Silent C: Nonsense D: Given information is not sufficient to identify | answer: B </s> |
<s>[INST] context: Many of Nalade Resorts' hotels have Kids Club with special facilities for young children, making holidays more relaxing for parents and undoubtedly more pleasant and interesting for youngsters!
Kids Club in Beau Rivage (9 a.m. to 10 p.m.)
The club has a lovely atmosphere, with a large room for activities and a fenced, grass play-area outside. The qualified hostesses really know how to get on with children, as they look after and entertain youngsters from 3 to 12.
Activities are adapted according to children's ages and talents and include:
*Glass-bottom boat trips to see the brightly colored games
*Drawing and painting
*Making things and a whole host of indoor games
*Learning how to snorkel and water-ski
A baby sitting service is also available on request, for a fee. Children's dinner is served in the main restaurant at 6:30 p.m.
Kids Club in Legends (9 a.m. to 10 p.m.)
Three qualified hostesses entertain youngsters from 3 to 11 years old. For children under 3, a baby sitting service is also available on request, for a fee.
Children's lunch is served between 12:30 and 1:30 p.m. in the main restaurant or in the Kids Club depending on the day. The children have dinner in the main restaurant between 6:30 and 7:30 p.m.
Kids Club in Les Pavillons (9:30 a.m. to 10:00 p.m.)
Friendly, experienced, well-trained staff keep youngsters from 3 to 11 happy and occupied throughout the day and evening. Activities include:
*Learning the local dance, the Sega
*Gathering crabs on the beach by torchlight
*Making things and a whole host of indoor games
*Learning to play a traditional musical instrument
A special children's dinner is served from 6 p.m. to 7 p.m. Baby sitting service can also be provided, for a fee.
Kids Club in Diva
The ideal arrangement for both parents and their youngsters! Qualified staffs look after children aged from 3 to 11 from 9 a.m. to 10 p.m. daily and organize a whole range of activities to keep them busy and happy.
Children have dinner between 6 and 7 p.m. A baby sitting service is also available, for a fee. [/INST] question: If you have a 12-year-old child, you can choose _ for your Family holidays. | options: A: Diva B: Legends C: Beau Rivage D: Les Pavillons | answer: C </s> |
<s>[INST] context: This patient has developed pump failure because of a combination of preexisting coronary aery occlusive disease and high preload following a fluid challenge; afterload remains moderately high as well because of systemic vasoconstriction in the presence of cardiogenic shock. Poor myocardial performance is reflected in the low cardiac output and high PCWP. Therapy must be directed at increasing cardiac output without creating too high a myocardial O2 demand on the already failing hea. Administration of nitroglycerin could be expected to reduce both preload and afterload, but, if given without an inotrope, it would create unacceptable hypotension. Nitroprusside similarly would achieve afterload reduction but would result in hypotension if not accompanied by an inotropic agent. A b-blocker would act deleteriously by reducing cardiac contractility and slowing the hea rate in a setting in which cardiac output is likely to be rate-dependent. Dobutamine is a synthetic catecholamine that is becoming the inotropic agent of choice in cardiogenic shock. As a b1 -adrenergic agonist, it improves cardiac performance in pump failure both by positive inotropy and peripheral vasodilation. With minimal chronotropic effect, dobutamine only marginally increases myocardial O2 demand. [/INST] question: A 59-year-old man with a history of myocardial infarction 2 years ago undergoes an uneventful aoobifemoral bypass graft for aooiliac occlusive disease. Six hours later he develops ST segment depression, and a 12-lead electrocardiogram (ECG) shows anterolateral ischemia. His hemodynamic parameters are as follows: systemic BP 70/40 mm Hg, pulse 100 beats per minute, CVP 18 mm Hg, PCWP 25 mm Hg, cardiac output 1.5 L/min, and systemic vascular resistance 1000 (dyne * s)/cm5 . Which of the following is the single best pharmacologic intervention for this patient? | options: A: Sublingual nitroglycerin B: Intravenous nitroglycerin C: A sho-acting b-blocker D: Dobutamine | answer: D </s> |
<s>[INST] context: Gabriel Garcia Marquez , who was awarded the Nobel Prize for Literature in 1982, passed away at the age of 86 on April 17, 2014. The world paused to remember the cultural giant.
Garcia Marquez was born in Colombia, but he spent most of his adult life in Mexico City. As one of the most famous writers, he was widely regarded as "a giant of 20th- century literature." Garcia Marquez wrote in a style called " magical realism ." In such works, people live a daily life in a certain period of time in history. But meanwhile , magical things happen to them.
Garcia Marquez is best known for his 1967 novel, One hundred years of Solitude (<<>> ), which has sold about 50 million copies. It tells the tale of the small and _ town of Macondo which was separated from the outside world- of its founding and its troubled history over a hundred years. The story is a metaphor for the development of Colombia since the 19 century. As Colombian President Juan Manuel Santons said, Garcia Marquez wrote about "the essence of the Latin American beings." [/INST] question: Garcia Marquez was born in _ . | options: A: 1914 B: 1928 C: 1967 D: 1982 | answer: B </s> |
<s>[INST] context: One of the major functions of an iPhone is, of course, to play music. The iTunes app has been designed in such a way as to take advantage of the iPhone's touch screen. But what if you want to listen to music that isn't in your iTunes library, or you want to discover new music without sitting in front of computer?
There are plenty of ways to access music, but not everyone knows what options are available. Either that, or there are so many options that going through all of them is tiring. For these reasons, here we offer a few convenient ways of listening to music on your iPhone without using iTunes.
Stream some radio (Tuneln Radio)
Tunnel Radio provides a quick and easy way to listen thousands of Internet radio stations on your Apple products. In addition to local radio stations, this app compiles more than 40 000 radio stations from around the country. What makes the app special is that it allows you to pause and rewind live radio----pause your station to take a phone call or rewind to replay a favorite song. You can also browse by genre of location, and the app includes plenty of talks, news, sports and weather stations in addition to music.
From desktop to smartphone (QQ Music)
QQ Music seems like obvious choice, and it is. It's a streaming service based on the Tencent technology that is already wildly popular on the Internet and now also offers a (free) app. Through this app you can listen to existing playlists or create new ones based on the patterns of music you like. It works amazingly well and everything can be saved to your QQ account for access from a computer.
What was that song? (Shazam)
Shazam is an innovative and free app that cures your"what was that song?"problem. It happens to all of us : we hear a song (on TV or in a store ), love it, know we have heard it before but just can't remember what it is called . With Shazam you don't need to. Just hold your iPhone up and through its microphone, Shazam will identify the album, artist and song title for you. You can then either purchase the song in iTunes or search it on other apps for streaming. How cool is that? [/INST] question: All of the options are strongly recommended to the users of _ . | options: A: iTunes B: iPhones C: computers D: microphones | answer: B </s> |
<s>[INST] context: 2016 Exhibitions in the British Museum
Sunken cities: Egypt's lost worlds
19 May-27 November 2016
Sainsbury Exhibitions Gallery
AdultsPS16.50, Members/under 16s free
Sunken under the sea for over a thousand years, two lost cities of ancient Egypt were lately rediscovered. Their amazing discovery is transforming our understanding of the deep connections between the great ancient civilizations of Egypt and Greece. Their story is told for the first time in this exhibition.
Francis Towne's watercolours of Rome
21 January-14 August 2016
Room 90/ Open late Fridays
Free, just drop in
Come and experience 18th-century Rome through an astonishing series of watercolours not displayed together since 1805.
Sicily: culture and conquest
21 April-14 September 2016
Room 35
Tickets: AdultsPS10, Members/under 16s free
This exhibition tells Sicily's fascinating stories-from the arrival of the Greeks and other settlers, to the extraordinary period of enlightenment under Norman rule in the 11thto 13thcenturies.
Early British exploration of the classical world
14 March-27 July 2016
Room 90a/ Open late Fridays
Free, just drop in
This small display features a remarkable selection of drawings by British explorers and architects, who discovered and documented some of Sicily's best surviving classical sculpture and architecture. [/INST] question: Which place are Francis Towne's works picture about? | options: A: Egypt B: France C: Rome D: Sicily | answer: C </s> |
<s>[INST] context: In US, the potato is one of the most widely consumed crops. French fries are commonly found in typical American fast-food burger joints and cafeterias. French fries were introduced to the US when Thomas Jefferson served them in the White House during his presidency from 1801 t0 1809. Potato chips are popular with consumers as well.
The humble potato is more than just a kind of food. In many ways it's part of the American pop culture. Let's take a look at some pop culture potatoes.
Mashed Potato dance
The Mashed Potato dance is a craze that began in 1962. The name of the dance came from the song it accompanies, Mashed Potato Time, performed by American R&B singer Dee Dee Sharp. The move vaguely resembles that of the Twist dance style, by Sharp's fellow Philadelphian,
Chubby Checker.
Hot Potato!
Hot Potato! is an action puzzle video game released in 2001. In the game the player must drive a bus and clear the road of alien potato beings. The potato beings are either red or blue; when two like-colored potatoes touch each other, they disappear. .Over the years, Hot Potato! has received mostly positive reception from critics.
Mr. Potato Head
Mr. Potato Head is an American toy invented by George Lerner in 1949. The toy consists of a plastic potato model and a variety of plastic parts like hands, feet, ears and mouths. In 1952, Mr. Potato Head became the first toy advertised on television. This commercial revolutionized marketing and caused a boom that solidified this toy's place in American pop culture. [/INST] question: Which is the newest to the American pop culture? | options: A: French fries B: Mashed Potato dance C: Hot Potato! D: Mr. Potato Head | answer: C </s> |
<s>[INST] context: Neuroblastoma is a cancer often found in the small glands on top of the kidneys (adrenal glands). It can develop in the stomach, chest, neck, pelvis and bones. Children aged five or younger are most commonly affected. Most children with neuroblastoma in Noh America have been treated according to the In the previous COG risk system, each child was assigned to a low-risk, intermediate-risk, or high-risk group (refer to Tables INSS stage. Age. International Neuroblastoma Pathologic Classification (INPC). Ploidy. Amplification of the MYCN oncogene within tumor tissue.[Other biological factors that influenced treatment selection in previous COG studies included unbalanced 11q loss of heterozygosity and loss of heterozygosity for chromosome 1p.[Generally, treatment is based on whether the tumor is classified as low, intermediate, or high risk, as follows: Low risk. For patients with low-risk tumors, the approach is either observation or resection, with chemotherapy restricted to symptomatic patients with low-risk biology. Five-year overall survival (OS) was 97% in a large COG study.[Intermediate risk. For patients with intermediate-risk tumors, chemotherapy is often given before definitive resection, and the number of chemotherapy cycles is based on clinical and tumor biological risk factors and response to therapy. In recent studies, select patients have been observed without undergoing chemotherapy or attempted resection. The 3-year OS rate for intermediate-risk patients was about 96% in a large COG study.[High risk. For high-risk patients, treatment has intensified to include chemotherapy, surgery, radiation therapy, myeloablative therapy and stem cell transplant (SCT), isotretinoin, and immunotherapy, resulting in survival rates of about 50%. Statistically significant improvement in survival was observed in a randomized phase III COG study ( COG Risk-Group Assignment Treatment Options COG = Children's Oncology Group; GM-CSF = granulocyte-macrophage colony-stimulating factor; 131I-MIBG = iodine I 131-metaiodobenzylguanidine; SCT = stem cell transplant. Recurrent Neuroblastoma Locoregional recurrence in patients initially classified as low risk Metastatic recurrence in patients initially classified as low risk Locoregional recurrence in patients initially classified as intermediate risk Metastatic recurrence in patients initially classified as intermediate risk Recurrence in patients initially classified as high risk Recurrence in the central nervous system <a style="box-sizing: border-box; margin: 0px; padding: 0px; border: 0px; font: inherit; veical-align: baseline; color: ; text-decoration-line: none;" href=" therapeutic approaches</a>. Refer robbins 8/e p477 [/INST] question: Spontaneous regression though rare is seen in | options: A: Burkits lymphoma B: Wilms tumor C: Neuroblastoma D: Melanoma | answer: C </s> |
<s>[INST] context: Most Chinese people don't understand why some westerners don't eat meat. In China, to eat meat is a sign of wealth. If a westerner doesn't take a bite of their Peking duck, there is something wrong.
But many people in Europe and America choose not to eat meat or fish -- they are known as vegetarians. In the US alone there are 12 million vegetarians and 19,000 more people stop eating meat every week.
People often become vegetarians in order to lose weight or eat more healthily. A lot of research has shown that vegetarian diets are healthier than the average western diet. Fried chicken may be delicious to eat, but all that extra fat can damage your heart.
There are many other reasons for "turning veggie". It could be that you cannot afford to buy meat. Or maybe you just don't like the taste of it.
A large number of vegetarians choose to give up meat because they believe it is cruel to kill animals for food. They believe many animals are not allowed to live in comfort and, when they are killed, it is carried out in a very painful way.
While some vegetarians are happy not to eat animals, others take it one step further and refuse to eat any animal product. They are known as vegans and will not eat cheese, yoghurt and eggs, or drink milk. Neither will they wear clothes or shoes made from animal skin, such as leather. They say that if it is wrong to kill an animal for food, it is worse to kill it for clothing.
But there are some groups that go even further. Fruitarians believe it is wrong to kill any living plant or animal. Besides refusing to eat meat, they will only eat fruit and vegetables that have not been killed when harvested. This means they cannot take an apple from a tree: they must wait until the apple falls to the ground. Only then can it be considered dead. [/INST] question: A lot of _ choose to give up meat because they believe it is cruel to kill animals for food. | options: A: vegans B: vegetarians C: fruitarians D: researchers | answer: B </s> |
<s>[INST] context: Although most of Pakistanis live in the countryside, still many Pakistanis live in cities. Karachi has over 5 million people and Lahore has over 3 million people. Islamabad was built to be Pakistan's capital. The rich city people live in large, air conditioned houses.
Pakistan has 121,000 miles of roads. Bus services and minibuses are available to the public. The trains are still the most common transport of long-distance travel for Pakistanis. Pakistan also has an airline that operates domestic and international flights.
It is difficult to identify Pakistani food because the country shares food traditions with its neighbour, India. The main difference between Pakistani and Indian food is that Pakistani food is less spicy . Pakistani dishes are often made with yoghurt , which reduces the effect of the hot spices used in cooking.
Wheat is the main food for most of the people. It is eaten in the form of bread named chapattis or roti, together with vegetables in season. Sweet tea, milk, or lassi, a drink made from yoghurt, makes the meal perfect. Those who can afford to buy it eat meat, although in the countryside these are usually festival foods. Goat meat is a favourite. Pakistanis will not eat pork by the way. [/INST] question: Which city is the capital of Pakistan? | options: A: Karachi B: Lahore C: Islamabad D: Bangkok | answer: C </s> |
<s>[INST] context: Argosy Christmas Ship Festival
Seattle
December1--December 23, 2010
The Argosy Christmas Ship Festival is a ship -to -shore holiday celebration that has become a local Northwest tradition . Aboard the Christmas Ship , some of the finest Northwest choirs sing holiday greetings . These performances are broadcast via speakers to bonfire sites and to other boats participating in the parade.
Holiday Island Lights Festival
Friday Harbour , Sand Juan Island
December 1--December 31,2010
An island-wide holiday tradition that includes local businesses decorating contest , a tree lighting ceremony on Dec . 4 with shops staying open until 7:00 pm. On Dec. 11 a Lighted Boat Parade starts the evening , to be followed by the Santa ship coming into Friday Harbor for the children , shops staying open until 7:00 pm . Dec 18-19 Roche Harbor's Christmas Festival begins at 3:00 pm and will include artists booths , Victorian carol singing , story telling , theater and dining.
Christmas Lighting Festival
Leavenworth
December4--December 19,2010
This old -fashioned Lighted Farm Implement parade , which expressed its admiration for the Yakima Valley's agricultural heritage , including entries with up to 35,000 lights decorating the tractor , plow or thresher of your choice ! Pre-parade activities include a Christmas Tree Ceremony and other special entertainment before the parade . Join us and you're sure to enjoy the carolers dressed in traditional clothing as they wander through out the Downtown area .
Holiday with Lights
Federal Way
December 10,2010--January 1, 2011
With over a million twinkling lights displayed throughout the park , your heart will be filled with cheer and the spirit of the season! Holiday light displays, festive music and strolling caroler, visit with Santa , enchanted village rides , and much more.
67Which of the following festivals lasts the longest ?
A. Argosy Christmas Ship Festival
B. Holiday Island Lights Festival
C. Christmas Lighting Festival
D. Holiday with Lights [/INST] question: If you want to attend a Lighted Boat Parade , you should go to _ . | options: A: Seattle B: Leavenworth C: Friday Harbor D: Federal Way | answer: C </s> |
<s>[INST] context: A philosophy professor stood before his class with some items on the table in front of him. When the class began, wordlessly he picked up a very large and empty jar and started to fill it with rocks. He then asked the students if the jar was full. They agreed that it was. So the professor then picked up a box of _ and poured them into the jar. He shook the jar lightly. The pebbles, of course, rolled into the open areas between the rocks. He then asked the students again if the jar was full. They agreed it was. The professor picked up a box of sand and poured it into the jar. Of course, the sand filled up everything else. He then asked once more if the jar was full. The students responded with "Yes."
"Now," said the professor, "I want you to recognize that this jar represents your life. The rocks are the important things - your family, your partner, your health, your children - things that if everything else was lost and only they remained, your life would still be full. The pebbles are the other things that matter - like your job, your house, your car. The sand is everything else. The small stuff." "If you put the sand into the jar first," he continued "there is no room for the pebbles or the rocks. The same goes for your life.
If you spend all your time and energy on the small stuff, you will never have room for the things that are important to you. Pay attention to the things that are critical to your happiness. Play with your children. Take your partner out dancing. There will always be time to go to work, clean the house, and give a dinner party. Take care of the rocks first - the things that really matter. Set your priorities . The rest is just sand." [/INST] question: The professor filled an empty jar with rocks to _ . | options: A: teach a life lesson B: make an experiment C: show the large jar D: recognize the jar | answer: A </s> |
<s>[INST] context: When talking about colds, maybe some people say it is very common. During the cold winter days, many people will complain the cold winter makes them catch a cold, and what they feel upset are not only the headache, cough but also the runny nose. It is so embarrassing when they forget to take a handkerchief or tissue along with them.
Want to stay away from colds? Put on a happy face.
Compared to unhappy people, those who are cheerful and relaxed are less likely to suffer from colds, according to a new study. It's possible that being happy helps the body fight illnesses, say the researchers from New York University.
"It seems that positive feelings may reduce the danger of illness," said the study's chief researcher Sheldon Cohen.
In an earlier study, Cohen found that people who were cheerful and lively caught coughs and colds less often. People _ were also less likely to tell their doctors that they felt ill.
In this study, Cohen has interviewed 193 adults every day for two weeks. During the interviews, the people told researchers that they were given colds by doctors and had to stay alone in a room for six days.
The results showed that everyone in the study was equally likely to get ill. But for people who said they felt happy during the research period, their illness are less serious and lasted for a shorter time.
Cohen believes that when people experience positive feelings, their body may produce a chemical that helps fight illness and disease. So if you are worried about your health, look on the brighter side more often. [/INST] question: What did the study find? | options: A: People who felt happy never got ill B: People's feelings didn't influence their health C: People with good feelings became ill more easily D: People with positive feelings had less serious illnesses | answer: D </s> |
<s>[INST] context: The sudden onset of tachycardia and hypotension indicates an acute process. Since the patient is being mechanically ventilated with positive pressure, he is at increased risk of a bullous rupture from barotrauma, leading to a pneumothorax.
Cardiac arrhythmia could lead to tachycardia and hypotension. Ventricular tachycardia and atrial fibrillation with a rapid ventricular response may cause this from decreased ventricular filling. An ECG would aid in this diagnosis. In the setting of mechanical ventilation, however, a pneumothorax must be excluded first. Bronchial secretions usually have a progressively worsening presentation. Furthermore, the patient would exhibit desaturation, but not necessarily hypotension. Myocardial infarction may lead to cardiogenic shock from failure. However, this would most likely be a bit more progressive and less acute. Infarction must remain high on the differential diagnosis, and the patient may require vasopressors because of the shock. In the immediate setting, the pneumothorax is more likely, given the acuity of onset. Pulmonary embolus is on the differential diagnosis of electromechanical dissociation. This patient's risk of an embolus is increased because of prolonged immobilization. However, the subcutaneous heparin should be adequate prophylaxis against an embolism. [/INST] question: A 56-year-old man has been admitted to the ICU in respiratory distress. An endotracheal tube is placed for mechanical ventilation at a tidal volume of 900 mL, a rate of 12 breaths/min, and FiO2 50%. PEEP is 10 cm of water. Medications include subcutaneous heparin and aspirin. He now develops tachycardia and a blood pressure of 70/palpation mm Hg. Cardiac examination reveals multiple premature contractions. His arterial blood gas reveals a PO2 of 40 mm Hg. Most likely cause of this condition is? | options: A: Cardiac arrhythmia B: Bronchial secretions C: Myocardial infarction D: Pneumothorax | answer: D </s> |
<s>[INST] context: People think of ice cream as an American food. Yet, ice cream really came from Asia. In the late 1200s Marco Polo, the great explorer, is said to have seen rich Asians eating dishes of ice. Camels had brought the ice from distant mountains. Before it was served, the ice had been flavored with fruits.
Marco Polo brought this new dish to Italy, In France cooks changed the ice recipe and made ice cream.
At first, cooks tried to keep the recipe a secret. They wanted it to be a special dish for rich people. By the late 1700s, though, ice cream was sold throughout Europe and America.
Some great Americans loved ice cream. George Washington was the first to buy a special machine for making it. When Thomas Jefferson returned from France, he brought an ice cream recipe home with him. Dolly Madison, wife of President James Madison, also liked ice cream, and she often served it at the White House. Actually, a famous brand of ice cream was even named after her.
In the late 1800s, the ice cream industry began to grow. A way of keeping ice cream frozen had been found, so ice cream makers did not have to worry about ice cream melting anymore. [/INST] question: When did ice cream become well-known in many countries? | options: A: In the 1200s B: In the 1500s, C: In the 1600s D: In the 1900s | answer: D </s> |
<s>[INST] context: <img alt="Enterobius vermicularis lifecycle" src=" /> lifecycle of enterobius vermicularis eggs are deposited on perianal folds <img alt="The number 1" src=" />. Self-infection occurs by transferring infective eggs to the mouth with hands that have scratched the perianal area <img alt="The number 2" src=" />. Person-to-person transmission can also occur through handling of contaminated clothes or bed linens. Enterobiasis may also be acquired through surfaces in the environment that are contaminated with pinworm eggs (e.g. , cuains, carpeting). Some small number of eggs may become airborne and inhaled. These would be swallowed and follow the same development as ingested eggs. Following ingestion of infective eggs, the larvae hatch in the small intestine <img alt="The number 3" src=" /> and the adults establish themselves in the colon <img alt="The number 4" src=" />. The time interval from ingestion of infective eggs to oviposition by the adult females is about one month. The life span of the adults is about two months. Gravid females migrate nocturnally outside the anus and oviposit while crawling on the skin of the perianal area <img alt="The number 5" src=" />. The larvae contained inside the eggs develop (the eggs become infective) in 4 to 6 hours under optimal conditions <img alt="The number 1" src=" />. Retroinfection, or the migration of newly hatched larvae from the anal skin back into the rectum, may occur but the frequency with which this happens is unknown. [/INST] question: Which one of the following does not pass through the lungs - | options: A: Hookworm B: Ascaris C: Strongyloides D: Enterobius vermicularis | answer: D </s> |
<s>[INST] context: Do you want to live a happier, less stressful life? Try laughing for no reason at all. That's how millions of people start their day at Laughter Clubs around the world and many doctors now think that having a good laugh might be one of the best ways to stay healthy.
The first Laughter Club was started in Mumbai, India, in 1995 by Dr. Madan Kataria."Young children laugh about 300 times a day. Adults laugh between 7 and 15 times a day," says Dr. Kataria. "Everyone is naturally good at laughing -- it's the common language. We want people to feel happy with their lives." There are now more than 500 Laughter Clubs in India and over 1,300 in the world.
Many doctors are also interested in the effects of laughter on our health. According to a 5-year study at the UCLA School of Medicine in California, with laughing there is less stress in the body. Laughter improves our health against illness by about 40%.
So what happens at a Laughter Club? I went along to my nearest club in South London to find out. I was quite nervous at the beginning of the class, to be honest, I wasn't interested in laughing with a group of strangers, and I was worried about looking silly. Our laughter teacher told us to clap our hands and say "ho ho ho, ha ha ha" while looking at each other. However, our bodies can't tell the difference between real laughter and unreal laughter, so they still produce the same healthy effects.
Surprisingly, it works! After ten minutes everybody in the room was laughing for real and some people just couldn't stop! At the end of the class I was surprised by how relaxed and comfortable I felt. So if you're under stress, then start laughing. You might be very pleased with the results. [/INST] question: The first Laughter Club was started in _ . | options: A: India B: America C: Britain D: China | answer: A </s> |
<s>[INST] context: A Divine Plan
At a fundraising dinner for a school that serves learningdisabled children, the father of one student delivered a speech that would never be forgotten by those who attended. He began with a question. "Everything God does is done with perfection. Yet, my son, Shay, cannot learn and understand things as other children do. Where is God's plan reflected in my son?"
The audience was stilled by the question. The father continued,"I believe that when God brings a child like Shay into the world, an opportunity to realize the Divine Plan presents itself. And it comes in the way people treat that child."
Then he told the following story:
Shay and I walked past a park where some boys Shay knew were playing baseball. Shay asked,"Do you think they will let me play?"
I knew that most boys would not want him on their team. Shay didn't even know how to hold the bat properly, much less connect with the ball. So I approached one of the boys on the field and asked if Shay could play. The boy looked around for guidance from his teammates. Getting none, he took matters into his own hands and said, "We are losing by six runs . The game is in the eighth inning . He can be on our team and we will try to put him up to bat in the ninth inning."
In the bottom of the eighth inning, Shay's team scored a few runs but was still behind by three. At the top of the ninth inning, Shay put on a glove and played in the outfield.
In the bottom of the ninth inning, Shay's team scored again. They had the potential to win. Would the team actually let Shay bat at this _ and give away their chance to win the game?
Surprisingly, Shay was given the bat. At last, understanding what the boy's intentions had been, the boys from both teams helped Shay win the game for the team and Shay was cheered as the hero.
"That day," said the father softly with tears now rolling down his face,"the boys from both teams helped bring a piece of the Divine Plan into this world." [/INST] question: Why did the father think most of the boys wouldn't let Shay join them? | options: A: Because it was a very important game and they couldn't afford to lose it B: Because they knew Shay was physically disabled C: Because they didn't get on well with Shay D: Because they knew Shay was anything but good at playing baseball | answer: D </s> |
<s>[INST] context: RET protooncogene is a growth factor receptor (receptor tyrosine kinase)
The RET protein is a receptor for the glial cell lined derived neurotrophic factor and structurally related proteins that promote cell survival during neural development.
RET is normally expressed in the following cells
Parafollicular C cells of the thyroid
Adrenal medulla
Parathyroid cell precursors. Point mutation in the RET protooncogenes are associated with the following disorders.
(i) MEN type 2A -
There is point mutation in RET extracellular domain which causes constitutive dimerization and activation leading to:-
Medullary thyroid carcinoma
Adrenal and parathyroid tumours
(ii) MEN type 2B -
Point mutation in the RET cytoplasmic catalytic domain alter the substrate specificity of the tyrosine kinase and leads to:-
Thyroid tumours
Adrenal tumors
(iii) Sporadic Medullary thyroid carcinoma
Somatic rearrangement of the RET gene
(iv) Hirschsprung disease
This is caused by complete loss of RET function. [/INST] question: The expression of the following oncogene is associated with a high incidence of Medullary carcinoma of thyroid - | options: A: P53 B: Her2/neu C: RET proto-oncogene D: Rb gene | answer: C </s> |
<s>[INST] context: Do you know Fei Junlong and Nie Haisheng? Fei Junlong was born in 1965. He is a Chinese astronaut selected as a member of the Shenzhou program. He was born in Jiangsu and joined the People's Liberation Army Air Force in 1982 at the age of 17. And since then he has only returned home six times. As a fighter pilot , he was selected to an astronaut in 1998.
He married Wang Jie in 1991 and has one son.
Nie Haisheng was born in September 1964. He is also a Chinese astronaut selected for the Shenzhou program. He is from Hubei. After graduating from high school he joined the People's Liberation Army Air Force, and became a fighter pilot. In 1998 he was selected for the astronaut program.
He was one of the three astronauts who were in the final group to train for the Shenzhou 5 fight. Yang Liwei was also picked out for the flight, with Zhai Ahigang.
On September 23,2005 it was reported that Zhai and Nie would be one of the three pairs of astronauts who would be in the final training for Shenzhou 6. But in the end, Fei and Nie were chosen, and Zhai missed his chance to space again.
Nie Haisheng got married to Nie Jielin and has an 11-year-old daughter. [/INST] question: When did Nie join the army? | options: A: In 1982 B: In 1998 C: In 1991 D: After his graduation from high school | answer: D </s> |
<s>[INST] context: Plans to expand wind energy into the most scenic parts of Germany are meeting increasing opposition across the country.
Anti-wind campaigners are angry that areas including the forests made famous by the tales of the Brothers Grimm are among the targets for new turbines . For the first time they have formed a national opposition group to _ the expansion. They say the expansion will damage forests and tourism across the country.
Germany has started a massive expansion of renewable energy since the Fukushima nuclear disaster in 2011 in Japan. The government decided to reduce atomic plants and instead increase the opportunities for green power. As a result, solar farms, biogas plants and wind parks are booming. In 2013, 22% of Germany's electricity was generated by renewable energy. Wind has played a major part in this change, making up half of the renewable energy in 2013, and the public has been generally supportive. To date, a majority of the 23,000 wind turbines in the country have been built in the flat northern and eastern parts of the country. But now the focus of expansion is on the areas of dark forest in the central and southern areas of Germany.
One such region is the Rheinhardswald in the northern part of the state of Hesse. This is the home of the magical tales of Sleeping Beauty, Rapunzel and others, made famous in the books of the Brothers Grimm. This scenic place is a magnet, attracting hundreds and thousands of tourists from all over the world. But now there are also plans to build up to 200 turbines in this scenic place!
Ann-Kathrin Blankenberg is a PhD student and an opponent of the plans. "It is not because this is the area of Sleeping Beauty," she says, "I want the green movement, I want green technology, I don't want nuclear power--- but they should be made in the right way and not by destroying the forests."
The campaigners argue that putting wind turbines in this area makes no sense. The wind speeds are low and the area is home to some extremely rare birds including the endangered black stork. Campaigners say building turbines here would be disastrous for the birds. [/INST] question: Which of the following does NOT belong to green power? _ . | options: A: Solar energy B: Wind energy C: Bio-energy D: Atomic energy | answer: D </s> |
<s>[INST] context: Bronchiectasis may be the sequela of a variety of necrotising infections that are either inadequately treated or not treated at all. Primary infection is a paicularly common cause of bronchiectasis. The most widely cited mechanism of infectious bronchiectasis is the "vicious cycle hypothesis," in which susceptibility to infection and poor mucociliary clearance result in microbial colonization of the bronchial tree. Some organisms, such asPseudomonas aeruginosa, exhibit a paicular propensity for colonizing damaged airways and evading host defense mechanisms. Impaired mucociliary clearance can result from inherited conditions such as CF or dyskinetic cilia syndrome, and it has been proposed that a single severe infection (e.g., pneumonia caused byBordetella peussisorMycoplasma pneumoniae) can result in significant airway damage and poor secretion clearance. The presence of the microbes incites continued chronic inflammation, with consequent damage to the airway wall, continued impairment of secretions and microbial clearance, and ongoing propagation of the infectious/inflammatory cycle. Moreover, it has been proposed that mediators released directly from bacteria can interfere with mucociliary clearance. [/INST] question: What is the most likely precursor to bronchiectasis? | options: A: Tuberculosis B: Carcinoma C: Bronchial adenoma D: Necrotising pneumonia | answer: D </s> |
<s>[INST] context: Dear editor,
I am writing to ask what has happened to our young people.They are not as polite or hard-working as my generation(I will give you two examples.
Last Friday, I got on the underground at 9:15 a.m. It was very crowded so there was no free seat.There were some boys sitting on the seats near me.I didn't know why they were not at school.They were talking and laughing loudly. It was difficult for me to read my newspaper with all the noise.At the next stop, a pregnant woman and her daughter got on with lots of shopping bags.I expected the boys to let them sit down.They saw the woman but they did nothing.I had to ask them to give the woman and her daughter seats. They did so but gave me a rude look.
Last Saturday, I had dinner with my friend's family.I was glad to see his children, who I hadn't seen for ten years.During the dinner, I started talking about world politics with the children.It soon became clear that they didn't know much about it.They couldn't tell me the name of the King of Spain or President of Italy.All they knew about was the Internet or which singers were the most beautiful.In my days, students knew the kings, the queens and the presidents of every country in Europe.
I worry about the future of Germany.How could these young people become good workers and parents? They sit around McDonald's after school instead of going to the library like I did at their age.Maybe they have too much money.Perhaps some readers can give us some ideas about what to do with this "lost generation".
Yours sincerely,
Frantz Vogts. [/INST] question: Mr. Vogts writes this letter to the editor to _ . | options: A: show how rude the boys were B: express his worry about his friend's children's future C: show how lazy young people nowadays are D: complain the way some young people acted | answer: D </s> |
<s>[INST] context: Spring is a good time for kite flying -- a popular activity in China. On a sunny day with a good breeze , you'll see hundreds of colorful kites flying in the sky. They have all kinds of shapes like swallows and peaches. Some of the shapes have special meanings. For example, swallows mean good luck and peaches bring you a long life.
The city of Weifang in Shandong is the home of the kite. The city holds an international kite festival in April every year. There are competitions for kite-flying skills and new styles of kites. The most famous is the competition for the "Kite King ". Thousands of kite fans from more than 30 countries visit the city to take part in the competitions, or to just enjoy this colorful event .
The largest kite in the world is a big "octopus ". It's about 1,100 square meters, twice as big as a basketball court. Li Jingyang, a kite fanin Jilin, spent eight months making it in 2008.
The kite was invented by Chinese people over 2,000 years ago. According to historical record, kites were first used by soldiers to send news to their friends. In the Tang Dynasty, flying kites became a popular game played by everyone.
As it was introduced to the West in the ll00s, the kite brought a great influence on Western life.
In 1782, the lightning rod was invented with the help of a kite. Modern aircraft came from kites, too. At the National Air and Space Museum in Washington DC, a board reads: "The earliest man-made aircrafts were the kites and missiles of ancient China." [/INST] question: What activity is very popular in spring? | options: A: Eating peaches B: Feeding swallows C: Flying kites D: Going to competitions | answer: C </s> |
<s>[INST] context: Erica McElrath calls herself " The Happy Lady". And by now, you may have caught her singing and dancing with her mp3 player on any of several city street corners. " I don't want money," said McElrah, 40, of St. Louis. " I come out here to make people smile."
McElrah lost her full-time job in January. Since then, she has spent her days doing what she loves-dancing in the street. Her message to people in hard times: do something that you enjoy, no matter what your circumstances. " Life isn't that bad," she said. " If you're working 40 hours a week, you shouldn't be complaining."
McElrah graduated from parkway Central High School and has spent the past 21 years working as a nursing assistant, She began singing and dancing publicly on her days off a few years ago to help her through the pain of her second divorce.
Her favorite spot is the northwest corner of Chouteau Avenue and South Grand Boulevard near St. Louis University. McElrah's mp3 player is loaded with hundreds of classic rock hits and 80's pop songs, including those by Joe Cocker, Tina Turner, Neil Diamond and Toto. But her favorite artist, by far, is Stevie Nicks.
Videos of McElrah have appeared on YouTube, a video-sharing website on which users can upload, share, and view videos. "People think I'm crazy, but I don't care," She said. " I can dance a little. I just go with the music." Even a rude gesture from a passing motorist doesn't bother her either. " I just smile and wave," she said.
McElrah's show of bravery recently earned her a job opportunity with Liberty Tax Service, which temporarily offered her a job as a dancer Statute of Liberty to promote a new place near Grand Center starting in January.
" Just be happy and do what you love," she said. "The money will come." [/INST] question: At first McElrah began singing and dancing in public in order to _ . | options: A: make a living B: entertain the public C: rise to fame D: encourage herself | answer: D </s> |
<s>[INST] context: It's time to do something for your father - the man who for many people has been an encouragement and support since birth.
The third Sunday of June is Father's Day. The holiday honors not only fathers, but also all men who act as father figures, such as stepfathers, uncles and grandfathers.
The idea of Father's Day came from the love and appreciation of American lady called Sonore Smart Dodd in 1909.
Dodd wanted a special day to honor her father, William Smart. He raised six children by himself on a countryside farm in Washington State after his wife died during the birth of their sixth child.
When Dodd became an adult, she realized the selflessness her father has shown in raising his children as a single parent.
It was her father who did all for his children. In the eyes of his daughter, William Smart was a courageous, selfless and loving man.
Dodd's father was born in June, so she chose to hold the first Father's Day celebration in Washington on June 19th, 1910.
In 1924, US President Calvin Coolidge supported the idea of a national Father's Day. Finally, in 1966, President Lyndon Johnson declared the third Sunday of June as Father's day.
So this is a perfect chance to let your father know what he means to you. To show your love and respect, you need not buy an expensive gift. You can send him a home - made card; You can call him every day; Even you can give him a sweet smile when he comes back from work. All these little things are easy for us to do, but they can show your care and love to your father. [/INST] question: Father's Day always falls on _ . | options: A: the same day every year B: the 3rd Sunday of June C: the last day of June D: June 16thof each year | answer: B </s> |
<s>[INST] context: Summer Holiday Fun 2010 !
The summer holidays are upon us again. Here is our guide to summer holiday fun in Peterborough!
Peterborough Museum
The Age of the Dinosaurs is the museum's main attraction this summer. Get up close to prehistoric creatures via some great hands-on exhibits! Watch out for monsters lurking around every ember! The museum is open from 10:00 am to 5:00 pm Monday to Saturday, and from 12:00 pm to 4:00 pm on Sundays in August.
Call 01733-864663 for details.
Saxon Youth Club
School holiday fun: young people aged 13-19 will be able to produce their own music, compete in sports activities,or try their hand at cooking at Saxon Youth Club,Saxon Community Centre, Norman Road, Peterborough every Monday and Wednesday from 3:00 pm. PLUS an aeroball tournament will take place on Thursday, 12th August between 3:30 pm and 6:30 pm.
Call 01353-720274 for details.
Houghton Mill
Through the Looking Class----a new production of the family favorite on Monday, 30thAugust. Bring rugs or chairs to sit on and a picnic if you wish to eat during the play.Gates open 5:30 pm,performance 6:30 pm--8:30 pm.Tea room will be open until end of the interval. Adult PS10. ChildPS7. Family PS20.
Booking advisable on 0845-4505157.
Farmland Museum and Denny Abbey
Farmland Games: from Wellie Wanging to Pretend Ploughing matches, come and join the Farmland Team. Collect your sporting stickers and create a color1ful rosette that is fit for a winner! No need to book, just turn up between 12:00 pm and 4:00 pm on Thursday, 19th August. Suitable for children aged four and above, each child should be accompanied by an adult and all activities are included in the normal admission price. Tickets Cost:PS7 per child.
For further information, call 01223-810080. [/INST] question: If you are interested in cooking, you can go to _ . | options: A: Peterborough Museum B: Houghton Mill C: Saxon Youth Club D: Farmland Museum | answer: C </s> |
<s>[INST] context: People in Shanghai can quench their thirst with high quality water if the Shanghai Water Authority (SWA) is able to make good on its word. It has vowed to make the city's water match its status as a world class city.
"The current tap water quality meets national standards, but, compared with that of the European Union and the United States, it still needs to be improved." said the SWA's director general, Hang Jiayi.
In other developed countries, water fountains can be found almost everywhere--people do not bother with bottled drinking water.
By 2020, the water of the Huangpu River will be treated to reduce the amount of organic waste in it. Major water works that draw water from the Huangpu will need more treatment facilities to improve the colour, texture, ammonia and nitrogen content before 2010.
These treatment facilities are expected to cost 4 billion yuan, something that could affect the price of water, according to Chen Yin, SWA's deputy director general.
Chen said that replacing water pipes was also a key project. The city's aged pipes are mostly to blame for the bad water quality.
The SWA has started the water facilities renovation work, including the more than 14,000 kilometres of indoor piping, 107,000 tanks on top of the buildings, and more than 6,000 underground facilities.
World Water Day came on March 22, and this year's theme is "Water for the future". Beijing is also drawing up plans during China's Water Week, which runs until March 28.
By 2010, the water for the Shanghai EXPO is to be above World Health Organization standards. And, the people of Beijing will be able to drink their tap water as well. [/INST] question: People in Shanghai can drink their tap water _ . | options: A: by 2020 B: in the first half of this year C: by 2010 D: by 2008 | answer: C </s> |
<s>[INST] context: Here are some famous romantic places in the world that you can't miss.
Paris
The ranking for the "most romantic city" quite rightly leads to Paris. The city of light has long been famous as a city of love. This is definitely the best place for love, wine and food. Paris is rich with history; you can take a walk through the Louvre, go to a cafe across the Champs Elysees, have dinner at the Eiffel Tower or visit the Palace of Versailles.
Venice
Undoubtedly, Venice is the most romantic city of Italy. From the amazing architecture of San Marco Square to the gondolas there, Venice talks about love, romance and passion. The best time to visit Venice is during the annual carnival . A gondola trip through the most magical city in Europe remains unforgettable for everyone.
Vienna
Vienna may well be called the cradle of European culture. The baroque architecture, the historic city opera and typical restaurants create a romantic mood and memorable atmosphere. During the ball season in Vienna, one can enjoy the city's past, the masked waltz and romance.
Prague
Prague is called the heart of Europe. The city, dating from the 9thcentury, is indeed a real architectural wonder. Prague's famous castle is the largest ancient castle in the world, built early in 1257. For a more romantic experience, take your loved ones to the top of the 60-foot observatory and watch the slow sunset over Prague.
Maldives
There are quiet islands, warm, clear water with excellent visibility, a huge amount of reefs and an incredible diversity of marine life. The Maldives is the place to shoot all those beautiful postcard pictures of couples on a desert beach. Most islands are not more than 1 km in area, with makes them particularly suitable for privacy, honeymoons and love. [/INST] question: The city of light refers to _ . | options: A: Paris B: Venice C: Prague D: Vienna | answer: A </s> |
<s>[INST] context: Education is required and free for every child in the United States. Most children start school by the age of six. They attend eight years of elementary school and four years of high school (or secondary school ).The money for free public schools comes from taxes, and each state is responsible for its own educational system .State legislatures set the educational requirements but leave the management of the schools in the hands of the local communities .Most states require their children to go to school until a certain age. This age varies from 16 to 18 years according to the laws of the individual state. The Federal government contributes funds to the states for additional schools and schools services.
After graduation from high school, a student can start his higher education in two -year college, a four-year college, a university or a specialized professional school----either public or private. Most colleges admit students on the basis of their high-school records. The cost of a college education is expensive in private universities, but it is much less in those supported by states and cities. Many students receive scholarships from the schools, the government, or private foundations and organizations. More than 50 percent of the college students work to help pay their college expenses.
Only 2 percent of the population of the country cannot read and write. [/INST] question: What is the educational system in the United States based on ? | options: A: The Federal government B: Individual school C: Individual state D: Local communities | answer: C </s> |
<s>[INST] context: Would you like to visit Britain one day?--Our country would like to welcome you!
Overseas travel can be expensive. But there are ways of visiting Britain cheaply. We hope that we can give you some good ideas.
When to come?
If you can avoid the busy months --July and August ,your visit may be cheaper. There will be smaller numbers of visitors. British weather is pleasant from April to the end of September. Of course, you can visit it in winter, but it is often dark by 4pm.Many places, such as large houses and castles ,are closed early in winter. However, if you are interested in museums, art galleries or theatres, winter may be a good time to visit.
Be prepared.
If you are a student, it's a good idea to apply for an International Student Identity Card .With this card, you can save a lot of money. You can get the card from your local student travel office, and you can also call (44)-08708-413224 to get it. To get the card, you need to show that you are a student, get a passport photo, and pay a little money. [/INST] question: Which is the most popular time for visitors to Britain? | options: A: July and August B: The winter season C: From April to September D: The vacation season | answer: A </s> |
<s>[INST] context: America has been experiencing the longest economic increase in its history. Incomes have risen, unemployment has fallen, and cities such as New York are bursting with new office buildings.
But just a short walk from Manhattan's skyscrapers, George Brown sits on the side-walk, cooking a lunch of rice and bits of fish over a can of cooking fuel.
Brown is homeless----one of the 2.3 million people in the US who end up on the street.
During the day, Brown collects aluminum cans and sells them for five cents a piece. At night, he sleeps on the street.
"I have been on the street about eight or nine years, something like that," said the 62-year-old former construction worker.
Brown admits he had problems with alcohol and has smoked cocaine. But he said he still wants a more stable housing arrangement. He could afford it just with the money he earns by collecting cans and small pieces of metal, if only truly low-income housing were available.
However, he sees no hope of finding affordable housing in New York.
With the strong economy and unemployment down, beautiful housing is being built to meet demand.
A US report shows rents in New York City rose more than 27 per cent, from $549 to $700 a month.
One of the side effects of the strong economy is that rents have been going up.
The majority of people who experience homelessness really just need some affordable housing help.
But few housing companies are building for the poor. Many small apartments in the city now rent for $1,500 a month or more.
Brown, the homeless New Yorker, said he has a daughter who lives in the city but he rarely sees her. She is angry about his drinking and won't allow it in her house.
Smiling, he said he also has seven grandchildren whom he'd like to see more often. "All I've got to do is _ ," he said. [/INST] question: What kind of life does George Brown lead? | options: A: Stable B: Dangerous C: Hard D: Comfortable | answer: C </s> |
<s>[INST] context: Patients are at increased risk for developing venous thromboembolism after:
Major abdominal surgery
Major orthopaedic surgery
Has sustained major trauma
Has prolonged immobility (>3 days)
These patients need some form of prophylaxis. The prophylaxis can be mechanical or pharmacological.
Prophylaxis for DVT
Mechanical Prophylaxis include :
Early ambulation
It is the simplest method of prophylaxis
It acts by activating the calf pump mechanism
Pneumatic compression devices
It is the most common method of prophylaxis
Pneumatic compresses prevents the stasis by periodically compressing the calves.
Pharmacological Prophylaxis include
Use of unfractionated heparin - Now being replaced by fractionated low molecular weight heparin
Use of fractionated low molecular - Better efficacy than unfractionated heparin
weight heparin - No laboratory monitoring is necessary
Comparison of low molecular weight heparin (LMWH) with mechanical prophylaxis demonstrates superiority of low molecular weight heparin (LMWH) in reduction of the development of venous thromboembolic disease. Prospective trials evaluating LMWH in head injured and trauma patients have also proven the safety of LMWH with no increase in intracranial bleeding or major bleeding at other sites. In addition, LMWH shows significant reduction in the development of venous thromboembolism compared to other methods.
In short, LMWH should be considered the optimal method of prophylaxis in moderate and high risk patients. Even the traditional reluctance to use heparin in high risk groups such as the multiply injured trauma patient and the injured patient must be reexamined, given the efficacy and safety profile of LMWH in multiple prospective trials. [/INST] question: Which of the following is the best way of preventing the development of deep vein thrombosis (DVT) in the postoperative period? | options: A: Early ambulation B: Physiotherapy C: Prophylactic heparin D: Low dose aspirin | answer: C </s> |
<s>[INST] context: Most people heard of Shakespeare and probably know something of his plays. However, not everybody knows much about the life of this world - famous man, except perhaps that he was born in the market town of Stratford - upon - Avon and that he married a woman called Anne Hathaway. We know nothing of his school life.
Nothing certain is known of what he did between the time he left school and his leaving home for London. It is said that he was beaten and even put in prison for stealing rabbits and deer from a neighboring landowner, and because of this he was forced to leave his native place.
Whatever caused him to leave his hometown, the world can be thankful about it. When he arrived in London, he set his foot on the road to farm. It is said that he was without money or friends there at first, but that he made a little money by taking care of the horses of the gentlemen who attended the plays at the theatre. In time, he came to know the doctors in the theatre, and they found him clever. Finally he was invited to join their company. By 1592, he had become one of the three members of a famous company.
From what we know of his later life, it is clear that Shakespeare' s connection with theatre had made him a wealthy man since he wrote the plays, which attracted a good many people. Towards the end of the 16th century he bought a large property in Stratford. No less than eleven of his plays were produced after he went back there. These include the great tragedies Othello, Macbeth and King Lear.
Shakespeare died in 1616. Some years earlier he chose it gravestone . He wrote on the stone that if anyone might remove his body from his grave, he would bring bad luck on him.
It seems strange that he should have had this fear. He might have known how deeply he was respected for the genius he showed in his plays and poems. [/INST] question: Shakespeare was forced to run away from _ . | options: A: London B: Oxford C: Stratford - upon - Avon D: the school of his hometown | answer: C </s> |
<s>[INST] context: By 1938, Europe had been experiencing an increased number of attacks on Jews. With no end in sight, Jewish refugee agencies requested the British government to allow them to bring in only Jewish children under17 years of age. This was to be only temporary, until the situation in their home countries was improved.
Kindertransport, meaning "children transport" in German, was then born. Children from Germany, Austria, Czechoslovakia, Poland and other Nazi-occupied regions were transported to the United Kingdom. There they were either placed with other families or in hostels. Later, it was found that many of these children were the only survivors of their families. Nicholas Winton was among those people who helped to save Jewish children. He managed to rescue 669 children from Czechoslovakia and bring them safely to England. In 1938 around Christmas, 29-year-old Nicky was about to leave for a skiing holiday. Suddenly, Martin Blake, one of his good friends, contacted him from Czechoslovakia, asking him to travel there to help political refugees on the run from the Nazis. And Nicholas agreed.
Nicky spent his entire holiday of 3 weeks in the capital city of Prague where he saw the situation first-hand. Once back in England, he immediately started organizing the evacuation of children from the Czech region. From advertising for the necessary permits, Nicky worked tirelessly. By August 1939, 669 children had been helped by Nicky and his friends. _ , the last group of children due to leave Prague in the beginning of September could not do so-- World War II broke out, and swallowed them up.
Nicky did not discuss his particular task with his wife, Grete. It was only when she found a scrapbook in 1988, with names of the rescued children, their (lost) parents and the foster families that had taken them in, that his heroism came to light. Nicky has received several awards in Britain and the Czech Republic. [/INST] question: Kindertransport aimed to _ . | options: A: help the homeless B: transfer the affected C: stop German attacks D: save Jewish children | answer: D </s> |
<s>[INST] context: In northern China during spring, big sandstorms often make trouble for people. Sandstorms usually happen in spring. They have happened in more than 10 provinces in northern China this year. People in southern China don't have to worry about this kind of bad weather. Most of the sand comes from the north of China. In northern China, lots of places have few trees and don't get much rain. When there aren't many trees, the ground can't keep enough water. Over the years, the ground dries up and turns into sand. When spring comes and the ice melts, the ground becomes loose. Strong winds take the loose sand into the sky. Besides, in northeast China, there is some vast desert.
Sandstorms are bad for people's health. If people breathe in too much sand, they will cough or have serious illnesses. Sandstorms also give farmers lots of problems. Sometimes their sheep get lost in the storms and never come back home. The winds also tear the farmers' houses down.
What can you do to stop sandstorms? Here's a piece of advice. Ask your parents to help you plant some trees in spring. If you see people cutting down too many trees, tell them about the dangers of sandstorms, and ask your government to stop them. [/INST] question: Which of the following is NOT a way to stop sandstorms? | options: A: Plant more trees in spring B: Stop people to cut down too many trees C: Don't stay outside when sandstorms happen D: Tell people about the dangers of sandstorms | answer: C </s> |
<s>[INST] context: Erik Weihenmayer was born with an eye disorder. As a child his eyesight became worse and then, at the age of 13, he lost his sight completely. However, he did not lose his determination to lead a full and active life Erik became an adventurer. He took up parachuting, wrestling and scuba diving. He competed in long-distance biking, marathons and skiing. His favorite sport, thought, is mountaineering. As a young man, Erik started to climb mountains. He reached the summit of Mount McKinley in 1995 and then climbed the dangerous 1000-metre rock wall of EI Capitan. Two years later, while climbing Mount Kilimanjaro in Kenya with his girlfriend, they stopped for a time at 13,000 feet above sea level-in order to get married. In 1999, he climbed Aconcagua, the tallest mountain in South America. And then , on May 25, 2001, at the age of 33, Erik successfully completed the greatest mountaineering challenge of all. He climbed Mount Everest, the highest mountain in the world. Erik invented his own method for climbing mountains. He carries two long poles: one to lean on and the other to test the way ahead of him. The climber in front of him wears a bell to guide him. Erik is a good team member. He does his share of the job, such as setting up tents and building snow walls. Although he could not enjoy the view, Erik felt the excitement of being on the summit of Everest. He hopes that his success will change how people think about the blind. "When people think about a blind person or blindness, now they will think about a person standing on the top of the world. [/INST] question: When was Erik born? | options: A: In 1967 B: In 1995 C: In 1968 D: In 1969 | answer: C </s> |
<s>[INST] context: You might think that whether you choose a blue shirt or a yellow one to wear to work or college makes no difference to your day and those around you. However, an increasing number of experts argue that the colors we choose affect our mood , our career and even our health. Color affects us to a greater degree than most of us realize.
Color is used increasingly by doctors for influencing mood and state of mind, and for various types of medical treatment. Green is a good color if you are not feeling well, and possibly this is why we sometimes give flowers and plants to friends and relatives in hospital. It is also thought that turquoise , a "user-friendly" color, can treat stress and headaches.
Companies use color to encourage us to buy their products. For example, purple, which mixes well with red, is used to show that a company has new ideas and the power to make them happen. Orange and blue are also recommended colors for companies to use, because orange is the color of communication and blue suggests safety. So this could be a particularly good combination. Companies have found that certain colors "speak" to specific age groups. They often use red to attract younger people to their products, for example, as it is lively and more youthful than colors like gold and navy , which older customers seem to prefer.
Wearing different colors can affect how you feel and how others react to you, so it is important to consider this when deciding what to wear in the morning. If you want people to take you seriously, then wearing navy or black is good. Blue would also be helpful for an interview or oral examination because it relaxes you and makes you feel calm. Red gets you noticed by everyone and makes you feel energetic, but be careful, as it can raise your pulse rate and not everyone wants this effect.
So think carefully before you leave the house or visit a friend with a gift. The colors you choose in both cases are a powerful tool. Are you making the right impression-- on yourself and on others? [/INST] question: Turquoise is a color that _ . | options: A: stands for energy B: is good for health C: is popular with young people D: makes the wearer be taken seriously | answer: B </s> |
<s>[INST] context: In early November of 1503,during Christopher Columbus's fourth and final trip to America,his ship was seriously damaged in a storm.Columbus and his men had to live on a small island for several months while they tried to repair their ship and return to Spain.
At first,the local people on the island were very kind to the European visitors,giving them allthe food and clothes they needed to survive.However,as the months passed,the local people became more and more unhappy with their guests,who were tricking and stealing from them.Finally the locals decided to stop helping.Without food or any way to leave the island,Columbus's group was soon in serious trouble.
Luckily for Columbus,he had a book about the stars and planets on his ship.It described the movements of all the objects in the night sky.The book,written by a well-known German scientist,said there would be a total lunar eclipse on the evening of February 29,1504 and how long it would last.
Columbus worked out the difference in time between Germ any and North America.He then had a meeting with the local leaders just before the eclipse would take place.In this meeting,Columbus told them his god was angry because the local people were no longer giving food.So his god would take away the moon to punish them.The moment Columbus finished talking,just as he had planned,the moon began disappearing.
The local leaders grew frightened and quickly agreed to provide Columbus with food and anything else he wanted.But first,Columbus's god had to return the moon.Columbus told them he would have to discuss the idea with his god on his ship.Knowing the moon would stay completely hidden for about 48 minutes,Columbus returned just before the moon began to reappear.From that day on,until they finally left,Columbus and his men no longer had any trouble getting the food they needed. [/INST] question: At first,the local people helped Columbus and his men by _ . | options: A: giving them food B: building a house for them C: repairing their ship D: providing them with a book | answer: A </s> |
<s>[INST] context: Even if you are an experienced backpacker or climber,you need to know what to do if something goes wrong.It is not that Alaska is that much more dangerous than other places.It is no more _ than elsewhere,as long as the proper precautions are taken.So, being prepared is crucial to ensure a safe trip.
First of all,make sure you pack everything you will need for your trip.Even if you are traveling by car,pack clothes and gear for backpacking.Because of the bad weather, cars break down frequently. Pack a survival kit full with:a down coat, boots ,mittens, a hat, snow-pants,sleeping bags,candles,a flashlight,and high-energy food. If you are traveling by car , also pack extra belts, a shovel, and a chain.
If you are camping or hiking,make sure you know how to avoid bears.If you are lost in the wilderness, there is no doubt you will encounter them.
However,there is no need to be nervous.Just take these precautions:make noise as you walk,bears will avoid you;cook your food away from where you sleep,and store your food away from where you sleep,so the bears are not attracted.Both of these should keep the bear away.However,if you do encounter a bear,there are two different schools of thought.One is to make noise and scare the bear away.The other is to stand still and speak softly to get the bear to leave.If you are dealing with a brown bear,you can climb a tree,since it cannot follow.But,black bears can climb.If for some reason the bear attacks,play dead.Try to protect your head and neck,and hopefully the bear will leave its"dead" prey. [/INST] question: Yon should prepare your food away from where you sleep so that _ . | options: A: the bear can't find you by the smell of the food B: you can have a better sleep at night C: the bear can't find out your food easily D: you can protect the food you bring with you | answer: A </s> |
<s>[INST] context: Anti fodrin are directed against muscarinic receptors seen in sjogren. Sjogren&;s syndrome is a late onset chronic systemic autoimmune disease characterized by lymphocytic infiltration and destruction of the salivary and lacrimal glands resulting in dry mouth(xerostomia) and dryness and atrophy of conjunctiva and cornea (keratoconjunctivits sicca). This disease is caused by an immune-mediated inflammation of salivary,lacrimal and sweat glands as Sicca Syndrome or with internal organ involvement. Clinical Types PRIMARY SS - Alone. SECONDARY SS - associated underlying connective tissue diseases (RA / SLE / Scleroderma ) SICCA SYNDROME -- Xerophthalmia + Xerostomia --Internal Organ / Bone C/F * Glandular manifestation Dry mouth (Xerostomia) due to decreased production of saliva by salivary glands * Lacrimal Gland Involvement -- Dryness of eyes causes keratoconjuctivitis sicca. * Burning itchy sensation in the eyes. SKIN MANIFESTATIONS (50% Xeroderma, pruritus and scaling Annular erythema, Papular Erythema including Sweet&;s-like lesions. Raynaud&;s syndrome Hyperglobulinemic Purpura Vitiligo Sweating abnormalities Cutaneous Amyloidosis Alopecia diffuse and generalized Diagnosis SS patients of both primary and secondary Sjogren&;s syndrome have marked hypergammaglobulinemia (IgG>IgA>IgM),ANA(>50c)/0) elevated total protein and sedimentation rate. Anti-Ro and Anti-La Antibodies occur in approximately 60% of patients with Sjogren&;s syndrome * Histolgy of skin shows an absence of sebaceous glands and decrease in the sweat glands. Revised classification criteria for Sjogren&;s Syndrome Ocular symptoms : at least one of - * Dry eyes for more than 3 months * Sensation of sand or gravel in the eyes * Need for tear substitutes more than 3 times a day * Oral Symptoms : at least one of -- * Dry mouth for more than 3 months * Recurrently or Persistently swollen salivary glands * Need liquids to swallow dry food * Ocular Signs --at least one the following two tests positive * Schirmer&;s test * Rose Bengal score 4. Histopathology: in minor salivary glands, focal lymphocytic sialoadenitis (focus score ?A). 5. Salivary gland involvement: a positive result for at least one of the following diagnostic tests: 1 Unstimulated whole salivary flow (1.5 ml in 15 min) 2 Parotid sialography showing punctate, cavitary, or destructive pattern, without evidence of obstruction in the major ducts 3 Salivary scintigraphy showing delayed uptake, reduced concentration 6. Autoantibodies -- Anti Ro and Anti La Criteria For primary SS In patients without any potentially associated disease. primary SS may be defined as follows: a. The presence of any four of the six items is indicative of primary SS, as long as either item 4 (Histopathology) or 6 (Serology) is positive. b. The presence of any three of the four objective criteria items (that is, items 3, 4, 5, 6) For secondary SS In patients with a potentially associated disease. the presence of item 1 or item 2 plus any two from among items 3, 4, and 5 may be considered as indicative of secondary SS Treatment Symptomatic treatment for dryness of eyes -- by lubricating agents such as 0.5% methylcellulose eye drops for 4-5 times daily. Cyclosporine ocular drops Bromhexine 16 mg TDS has been found to increase the lacrimal secretion. Aificial saliva and cyclosporin(2.5-5mg/kg), for xerostomia. Routine dental care Steam inhalation may help dryness of the respiratory tract. ref - Harrisons internal medicine 20th ed pg2560 [/INST] question: Anti fodrin antibodies are positive in | options: A: Sarcoidosis B: Sjogren C: Systemic sclerosis D: Dermatomyositis | answer: B </s> |
<s>[INST] context: Sometimes ideas do not appear when you are concentrating your attention and mysteriously appear when you are not. Modern science recognizes this as a result of incubating the problem in your subconscious , yet can't account for why it occurs.
When you quit thinking about a subject and decide to forget it, your subconscious mind doesn't quit working. Your thoughts keep making associations(,). This is why you've experienced suddenly remembering names, getting solutions to problems you've forgotten about, and ideas out of the blue when you are relaxing and not thinking about any particular thing.
You may try solving a problem with your subconscious mind by writing a letter to it. Now let go of the problem. Don't work on it. Forget it. Do something else. This is the incubation stage when much of what goes on occurs outside your focused awareness, in your unconsciousness. Open the letter in two days. The answer might magically pop into your mind.
An advertising agency was under pressure to come up with a marketing campaign. Bert, the creative director, wrote the following letter which he addressed to his subconscious mind.
Secret Expert,
I need to come up with a new marketing program to introduce a new season of television shows. I'm interested in some kind of campaign that will capture the audience's attention more than one time. Is there something people need that we can advertise on? What kind of products, foods and services should we investigate? I need your idea about a fresh approach to advertising.
Thanks, Bert
Bert mailed the letter to himself and when he read what he had written, he got his brainstorm, which was to advertise on "eggs". Somehow an association between "foods", "need" and "fresh approach" inspired the thought of using "fresh eggs to advertise." He arranged to put the ad for the television shows on eggs -- some thirty million.
The consumers look at a single egg at least a few times, when they buy the eggs at the store, when they transfer(,,) them to the refrigerator, and when they crack them open. It's unlike any other ad medium in the world, because you're looking at it while you are using it. [/INST] question: You remember names though you are not thinking about them because your subconscious mind _ . | options: A: stops working B: is still working C: is full of names D: improves your memory | answer: B </s> |
<s>[INST] context: Reiters syndrome/ flies singer-Leroy disease: traid of urethritis , ahritis conjunctivitis Genetic predisposition: hla b 27 Causative organisms: Chlamydia trachomatis Salmonella Campylobacter Yersinia Shigella Clostridium diff iCal eah Clinical features: chronological appearance First manifestations: urethritis,conjunctivitis Ahritis Circulate Balan it is Ahritis: asymmetric , oligoaicular-predilection to lower extremity large joints, enthesitis( inflammation of tendons and ligaments at the sites of inseion into capsule or bone),sacroilitis. Rapid development of massive effusions. Sausage digitis-diffuse swelling of solitary finger or toe Joints: early morning stiffness and pain. Genitourinary: nonspecific urethritis, cervicitis, cystitis, hematuria, hydronephrosis,prostatitis, baholinitis,vaginitis, salpingitis Eye lesions: conjunctivitis,uveitis,iridocyclitis Cutaneous: keratoderma blemorrhagicum-hyper keratotic pustular lesions on erythematous base involving palms and soles.crusted thick horny lesions with thick scales circulate Balanitis-most common irregular moist superficial erosions or ulcers coalesce to form circinate lesions. ulceration over tongue-painless Cardiac: aoic is and hea block Renal- glomerulonephritis Investigations: Elevated acute phase reactants Elevated esr Jointfluid-pseudo sepsis- neutrophils>50000/ul, with reiters cells Radiology: enthesitis with periosteum reaction, asymmetric sacroilitis, spondylitis, non marginal syndesmophytes Conditions to be differentiated from reactive ahritis Treatment Ahritis: Physiotherapy, nsaids,indomethacin is the drug of choice. Dmards-sulfasalazine, methotrexate,hydroxychloroquine,prednisolone,acitretin in hiv patients Biological: infliximab,etanercept Cyclosporine, levamisole,gold,pencillamine. Skin and mucus membranes: topical keratolytis, topical coicosteroids,methotrexate,acetretin Iadvl textbook [/INST] question: drug of choice for HIV patients with reiters disease complaining of ahritis and keratoderma blenorrhagicum | options: A: methotrexate B: Acetretin C: Cyclosporine D: Indomethacin | answer: B </s> |
<s>[INST] context: (Carnitine derivatives) (184-lIarper 28th)* Long chain fatty; acids penetrate the inner mitochondrial membrane as carnitine derivatives (184-Harper 28th)* The inner mitochondrial membrane is impermeable to fatty acids. A specialized carnitine carrier system (Carnitine shuttle) operates to transport activated fatty acids from cytosol to the mitochondria (288.U. Satyanarayan 3rd)* Inhibitor of carnitine shuttle is Malonyl CoATransport of long chain fatty acids (LCFA) in to mitochondriaAfter a LCFA enters a cell, it is converted in the cytosol to its CoA derivative by long chain fatty acyl CoA synthetase (thiokinase) an enzyme of the outer mitochondrial membrane. Because b-oxidation occurs in the mitochondrial matrix, the fatty acid must be transported across inner mitochondrial membrane which is impermeable to CoA. Therefore a specialized carrier transports the long chain acyl group from the cytsol into mitochondrial matrix. This carrier is carnitine and this rate limiting transport process is called the carnitine shuttle* Zellweger syndrome - is caused by the absence of peroxisomes in tissues as a result, the long chain fatty acids can not be oxidasedEntry of short and median chain fatty acids into the mitochondria (192-Lippincotf s 4th)* Fatty acids shorter than 12 carbons can cross the inner mitochondrial membrane without the aid of carnitine or the CPT system {carnitine palmitoyl transferase) once inside the mitochondria, they are activated to their CoA derivatives by matrix enzymes and are oxidized [Note- median chain fatty acids are plendiful in human milk. Because their oxidation is not dependent on CPT-1, it is not subject to inhibition by malonyl CoA)* Medium chain fatty acyl CoA dehydrogenase (MCAD) deficiency is one of the most common inborn errors of metabolism it causes decrease in fatty acid oxidation, resulting in hypoketonemia and severe hypoglycemiaImportant Points* Hormone sensitive lipase activity is inhibited by the hormone Insulin* Two final products in P-oxidation of odd chain fatty acids are- Acetyl coA andpropionyl coA* Maximum absorption of short chain fatty acids produced by bacteria occurs in the colon*** Absorption of long chain FA is greatest in the upper parts of the small intestine* Normal fecal fat excretion is less than 6gm/day more than 6 gm 24 hours indicates malabsorptions* Steatorrhea is defined as stool fat exceeding 7 gm/day* Sudan III is the best for screening but gold standard is quantitative estimation offecal fat* Esterified FA in the form of triacylglycerols serve as the major reserve of the body* Trans Fatty Acids - Classified as unsaturated fatty acids but behave more like saturated fatty acids in the body that is they elevate serum LDL and they increase the risk of CHD** & DM* TFA are formed during the hydrogenation of liquid vegetable oils** Fried foods*** Docosahexaenoid acid (DHA) is particularly needed for development of brain and retina and is supplied via the placenta and milk*** [/INST] question: Long chain fatty acids penetrates in the inner mitochondrial membrane through | options: A: Free fatty acids B: Carnitine derivatives C: Thiokinase D: Malonyl CoA | answer: B </s> |
<s>[INST] context: For medical students, real experience begins not in a classroom but at a teaching hospital. These doctors in training are guided. But sometimes accidents happen and the students get injured.
For example, they might stick themselves with a needle while treating patients. Such needle sticks are common. But a recent study found that medical students often fail to report them. Failing to report an injury like this can be dangerous if a patient, or a medical worker, has an infectious disease.
Researchers at Johns Hopkins University in Baltimore, Maryland, did the study, which involved a survey answered by almost 700 surgeons in training in the United States.
Almost 60% said they had suffered needle stick injuries when they were in medical school. Many said they were stuck more than once. Yet nearly half of those whose most recent incident happened in school did not report it to a health office. If they had, they would have been tested to see if they needed treatment to prevent an infection like HIV or hepatitis.
Most known cases of HIV or hepatitis are reported, but other possible infections often are not. Martin Makary, the lead author of the study, says medical students who are stuck put themselves and others in danger from infectious diseases.
Doctor Makary said, "A needle that goes through the skin needs to be as sharp as possible." Doctors in training may have to do hundreds of stitches in some cases to close the skin after an operation.
Doctor Makary said, "I support using _ tip needles which are considered safer. This needle is still sharp enough to go through body tissue, but it does have a blunt tip, so that if it accidentally goes into my finger, it's much less likely to hurt me."
How common are needle sticks among health care workers? An estimated 600,000 to 800,000 of these and similar injuries are reported each year in the United States. But Doctor Makary says the real number may be much higher.
The study advises doctors to protect their hands by wearing two sets of gloves. It also urges hospitals to establish a special telephone number for medical workers and students to call if they are injured. The idea is for hospitals to send a clear message that there is no reason not to report this kind of accident. [/INST] question: It is dangerous for medical students not to report needle stick injuries because _ . | options: A: they don't know how to treat themselves B: they may meet more needle sticks C: it may cause some diseases D: it may make patients sad | answer: C </s> |
<s>[INST] context: TEENSGIVING in SPRING 2010
Frequently Asked Questions
What is TEENSGIVING?
TEENSGIVING is an exciting yearly event where hundreds of New York City teens gather together annually for a remarkable day of community service. This year, TEENSGIVING in SRING 2010 participants will once again better New York City and impact thousands of lives!
When is TEENSGIVING in SPRING2010?
SUNDAY, APRIL 25, 2010
Where is TEENSGIVING?
All over New York City. Everyone will meet at the 92nd Street Y (92nd and Lexington) at 9:00 AM for the event kick-off. Then, all TEENSGIVING volunteers will disperse across the city to work with our partnering agencies where they will make a HUGE difference and have fun!
Who participates in TEENSGIVING?
Hundreds of teenagers from around the city. Teens come from the 92nd Street Y, various city schools, youth groups, and organizations in the area. In addition, many adult volunteers (aged 21 and older) will donate their time to TEENSGIVING in SPRING 2010.
What projects do participants do at the agencies?
Sample projects include painting park benches, planting gardens, visiting and playing with underprivileged children, assembling craft kits for children in hospitals, assisting at animal shelters, working at soup kitchens, delivering meals and celebrating with families at homeless shelters.
Do I get anything for participating in TEENSGIVING?
Yes! Everybody benefits! Teen volunteers will receive *6 hours* of community service credit, good towards honor society, high school graduation and college application requirements. Adult volunteers will be "thanked" with a light breakfast, a gift certificate for their troubles, and the satisfaction of helping our city's youth contribute to their community. In addition, all teen and adult volunteers will receive a cool TEENSGIVING in SPRING 2010 T-shirt.
This sounds awesome! How do I register for TEENSGIVING in SPRING2010? Interested teens and/or adults should e-mail the TEENSGIVING Coordinator Josh Hyman at [email protected](subjet:TEENSGIVING) to receive more information and to register for this fantastic event!
**Teens can also contact their school's Community Service Advisor**
TEENSGIVING is sponsored by the 92nd Street Y. [/INST] question: TEENSGIVING is an event which is held _ . | options: A: fromtimetotime B: onceeveryyear C: everytwoyears D: twiceayear | answer: B </s> |
<s>[INST] context: When you see the girl for the first time, you may think she is a boy. She is very outgoing . Who is she? Wang Meng, the Chinese top skater.
On the evening of February 26th, 2010, Wang Meng first got to the finishing line in 1 minute and 29.213 seconds in the women's 1000 meters short track speed skating final at the Vancouer Olympic Winter Games . After she succeeded in the 500-meter and 3000-meter races, she won her third gold medal this time. With this one China won four gold medals in the women's short track speed skating. That helped China first win the team gold medal in Winter Olympics history.
Just before the final race Wang Meng caught a bad cold and coughed terribly. With the words of "You can, you can do!" she won at last. She said, "I really feel these three gold medals belong to my team, to China. It was with the help of my team that I won the prize."
Though Wang Meng is only twenty-four, she has been the most successful Chinese skater. Chinese are proud of her and her team. We hope she will be faster in Sochi Olympics in 2014. [/INST] question: China won _ gold medals in the women's short track speed skating. | options: A: 2 B: 3 C: 4 D: 5 | answer: C </s> |
<s>[INST] context: People call the Winter Olympics the White Olympics. At this time, they publish many stamps to mark the great games. The first stamps came out on January 25th, 1932 in the United States for the 3rd White Olympics. From then on , publishing stamps during the White Olympics became a rule.
During the 4th Winter Olympics, people published a group of stamps in November 1936. They drew five rings of Olympics. It was the first time that the rings appeared on the stamps of the White Olympics.
In the 1950s,the stamps of this kind became more colorful. When the White Olympics came, the host countries as well as non-host countries published stamps to mark those games. China also published four stamps in February 1980 when the Chinese sportsmen began to take part in the White Olympics.
In Asia, Japan was the only country to hold the White Olympics. They sold 14,500 million stamps during the Olympics.
People drew different kinds of sports on these small stamps, and they enjoyed the wonderful sports and some excellent players. [/INST] question: The White Olympics and the Winter Olympics _ . | options: A: are the same thing B: are different games C: are not held in winter D: are held in summer | answer: A </s> |
<s>[INST] context: Silica crystals incite a fibrogenic response after inhalation and ingestion by pulmonary macrophages. The greater the exposure to silica dust and the longer the time of exposure, the greater is the lung injury. Silica is a major component of the earth's crust, including sand, which contains the mineral quartz. Mining, manufacturing, farming, and construction/renovation activities generate small silica crystals that can be inhaled, and their buoyancy allows them to be carried to alveoli. There, they are ingested by macrophages, which secrete cytokines that recruit other inflammatory cells and promote fibrogenesis. Carbon monoxide readily crosses the alveolar walls and binds avidly to hemoglobin, but does not injure the lung directly. Ozone, a component of smog, has no obvious pathologic effects. Tobacco smoke leads mainly to loss of lung tissue and emphysema, not to fibrosis. Particulate matter such as wood dust is mainly screened out by the mucociliary apparatus of the upper airways, but may invoke bronchoconstriction. [/INST] question: A 63-year-old man has had progressively worsening dyspnea over the past 10 years. He has noticed a 5-kg weight loss in the past 2 years. He has a chronic cough with minimal sputum production and no chest pain. On physical examination, he is afebrile and normotensive. A chest radiograph shows extensive interstitial disease. Pulmonary function tests show diminished DLCO, low FVC, and normal FEV1/FVC ratio. Increased exposure to which of the following pollutants is most likely to produce these findings? | options: A: Carbon monoxide B: Ozone C: Silica D: Tobacco smoke | answer: C </s> |
<s>[INST] context: The Undersea and Hyperbaric Medical Society (UHMS) currently recognizes hyperbaric oxygen therapy (HBO) as an approved therapy for 13 pathologic entities. These are conditions for which HBO has substantial scientific support demonstrating therapeutic benefit.
Hyperbaric oxygen is currently considered a primary treatment modality for
carbon monoxide poisoning, cerebral arterial gas embolism, osteoradionecrosis, decompression sickness, and clostridial gas gangrene.
It is also considered an adjunctive therapy for
acute exceptional blood loss anemia, acute thermal burns, compromised skin grafts or skin flaps, crush injury, compartment syndrome, necrotizing soft-tissue infections, non-clostridial gas gangrene, radiation tissue damage, refractory osteomyelitis, selected problem wounds, and intracranial abscesses.
Treatment of frostbite injuries with HBO is considered experimental.
The treatment protocol for frostbite includes rapid rewarming, close observation, elevation and splinting daily hydrotherapy, and serial debridements.- Schwartz 9/e p409 [/INST] question: Hyperbaric oxygen is useful in - | options: A: Tetanus B: Gas gangrene C: Frostbite D: Vincent's angina | answer: B </s> |
<s>[INST] context: A child's room is not only a bedroom. You can see computers, mobile phones, televisions, DVD players, Playstation, and other 21st-century toys. Britain's 8 to 16-year-olds have bedroom possessions about PS 3,300.
But they don't just have hi-tech toys . A child's room also has expensive clothes, sunglasses, watches, and sports equipment 40% of children have a room that is a home office, mini cinema, and sports hall . 90% have a TV, and 70% have a DVD player. 60% have a CD player, iPod, or MP3 player. 25% have their own computers.
With so much to do in their bedrooms, it is no surprise that children spend more time there than anywhere else in the house. One girl spends so long on her mobile phone in her room that her parents have to text her to speak to her. Another child goes into his room as soon as he gets home form school and plays on his Playstation until bedtime.
Childred's bedrooms are their kingdoms . Some families hardly do anylhing all together. People eat different meals at different times, and watch different TV programmes in different rooms. [/INST] question: _ of children can work, watch movies and exercise in their rooms. | options: A: 70% B: 60% C: 40% D: 90% | answer: C </s> |
<s>[INST] context: When you get in your car, you reach for it. When you're at work, you take a break to have a moment alone with it. When you get into a lift, you play with it.
Cigarette? Cup of coffee? No, it's the third most addictive thing in modem life, the cell phone. And experts say it is becoming more difficult for many people to _ their longing to hug it more tightly than most of their personal relationships.
The costs are becoming more and more evident, and I don't mean just the monthly bill. Dr. Chris Knippers, a counselor at the Betty ford Center in Southern California, reports that the overuse of cell phones has become a social problem not much different from other harmful addictions: a barrier to one-on-one personal contact, and an escape from reality. Sounds extreme, but we' ve all witnessed the evidence: The person at a restaurant who talks on the phone through an entire meal, ignoring his kids around the table; the woman who talks on the phone in the car, ignoring her husband; the teen who texts messages all the way home from school, avoiding contact with kids all around him. Jim Williams, an industrial sociologist based in Massachusetts, notes that cell - phone addiction is part of a set of symptoms in a widening gulf of personal separation. He points to a study by Duke University researchers that found one-quarter of Americans say they have no one to discuss their most important personal business with. Despite the growing use of phones, e - mail and instant messaging, in other words, Williams says studies show that we don't have as many friends as our parents. " Just as more information has led to less wisdom, more acquaintances via the Internet and cell phones have produced fewer friends," he says.
If the cell phone has truly had these effects, it's because it has become very widespread. Consider that in 1987, there were only l million cell phones in use. Today, something like 300 million Americans carry them. They far outnumber wired phones in the United States. [/INST] question: Cell phone addiction has caused the following effects EXCEPT _ . | options: A: a barrier to personal contact B: fewer friends C: an escape from reality D: a serious illness | answer: D </s> |
<s>[INST] context: I shall never forget the night,a few years ago,when Marion J.Douglas was a student in one of my adulteducation classes. He told us how tragedy had struck at his home,not once,but twice. The first time he had lost his fiveyearold daughter. He and his wife thought they couldn't bear that first loss;but,as he said,"Ten months later,God gave us another little girl and she died in five days."
This double bereavement was almost too much to bear. "I couldn't take it," this father told us,"I couldn't sleep,eat,rest or relax. My nerves were entirely shaken and my confidence gone. "At last he went to doctors;one recommended sleeping pills and another recommended a trip,but neither helped. He said,"My body felt as if it was surrounded in a vice ,and the jaws of the vice were being drawn tighter and tighter." The tension of grief --if you have ever been paralyzed by sorrow,you know what he meant.
"But thank God,I had one child left--a fouryearold son. He gave me the solution to my problem. One afternoon as I sat around feeling sorry for myself,he asked,'Daddy,will you build a boat for me?' I was in no mood to build a boat;in fact,I was in no mood to do anything. But my son is a persistent little fellow!I had to give in. Building that toy boat took me about three hours. By the time it was finished,I realized that those three hours spent building that boat were first hours of mental relaxation and peace that I had had in months!I realized that it is difficult to worry while you are busy doing something that requires planning and thinking. In my case,building the boat had knocked worry out of the ring. So I determined to keep busy."
"The following night,I made a list of jobs that ought to be done. Scores of items needed to be repaired. Amazingly,I had made a list of 242 items that needed attention. During the last two years I have completed most of them. I am busy so that I have no time for worry."
No time for worry!That is exactly what Winston Church ill said when he was working eighteen hours a day at the height of the war. When he was asked if he worried about his huge responsibilities,he said,"I am too busy. I have no time for worry." [/INST] question: Marion felt his body as if it was caught in a vice because _ . | options: A: he couldn't earn enough money to support his family B: he was suffering from sleeplessness disease C: he couldn't get out of mental pressure D: he felt tired of adulteducation classes | answer: C </s> |
<s>[INST] context: Passage 2
Colin is a twenty-year-old young man. Two years ago, when he finished middle school, he got a job in a store. Usually he works until ten o'clock in the evening. He is very tired when he gets home. After a quick supper he goes to bed and soon falls asleep. His grandma who lives downstairs is satisfied with him.
One day, on his way home, he met Nancy. They were both happy. He asked the girl to his house. She agreed happily. He bought some fruit and drinks for her. And they talked about the school life they spent together, their teachers, classmates and their future . They talked for a long time.
"Have a look at your watch, please," said the girl. "What time is it now?"
"Sorry, something is wrong with my watch," said Colin. "Where's yours?"
"I left it at home."
Colin thought for a moment and found a way. He began to stamp his foot on the floor, "Bang! Bang! Bang!"
The sound woke his grandma up. The old woman shouted downstairs, "It's twelve o'clock in the night, Colin. Why are you still jumping upstairs?" [/INST] question: Colin was _ when he finished middle school. | options: A: seventeen B: twenty C: eighteen D: twenty-two | answer: C </s> |
<s>[INST] context: Refer kDT 7/e 556 Treatment depends on severity Treatment ranges from lifestyle changes and cardiac rehabilitation to medication, stents and bypass surgery. Suppoive care Defibrillation Using an electrical shock to correct a rapid, irregular heabeat and restore the hea's normal rhythm. Oxygen therapy Providing extra oxygen to the lungs of people with breathing problems. Medications Blood Thinners Helps prevent blood clots from forming or helps dissolve existing clots. Hea Medication Helps reduce chest pain or pressure caused by blockages in the aeries of the hea. Narcotic Relieves pain, dulls the senses and causes drowsiness. May become addictive. Beta blocker Slows hea rate and decreases blood pressure. When taken in eye-drop form, it reduces eye pressure. Statin Decreases the liver's production of harmful cholesterol. ACE inhibitor Relaxes blood vessels, lowers blood pressure and prevents diabetes-related kidney damage. Medical procedure Coronary stent and Coronary angioplasty Therapies Cardiac rehabilitation Surgery Coronary aery bypass surgery [/INST] question: Which of the following drug is used in myocardial infarction | options: A: Cocaine B: Pethidine C: Morphine D: Butarphanol | answer: C </s> |
<s>[INST] context: I learned about life from an ant farm.When I was seven years old, my family created one.First, we put clean sand in a thin glass box, and then we waited for the live ants to arrive.Shortly after the chilly ants were dropped into the glass structure, they got to work making tunnels.I was amazed that each one knew exactly what to do.After hours of staring, I realized that the ants had assigned jobs.With my mom ' s help, I kept a diary of what happened each day and named the ants.
One day a tragedy struck the ant farm.The pages of the diary, still wrinkled where tear drops fell, indicate the depth of the tragedy.'I had put my face so close to the structure that I accidentally tipped it over, caving in all the tunnels.Although the ants survived their earthquake, one by one they began to die.I was terrified as I watched them give up their tunnel-building to carry the bodies to a comer of the farm.My mother reported that the ants were dying of "frustration." They simply could not stand the reality that their tunnels had been destroyed.
Although much time has passed, I still think of that ant farm.Mom had hoped it would teach me about the natural world, but it taught me much more.Over the years, I came to realize the ants were a study in the benefits of teamwork.Working together, they were able to create an amazing world for themselves.I also learned that they should be admired for their hard work.Day in and day out, each labored at their task.The ant farm showed that teamwork and perseverance are indeed two key ingredients to success.But there was an even larger lesson that I did not realize until recently: Adversity (, ) is a natural part of life,and must be accepted.Unlike the ants, humans cannot give up when they face disappointment.Unlike the ants, we have to realize that if a tunnel caves in, we just have to build another.Giving up, I say, is not a choice. [/INST] question: The family created an ant farm in a glass box because it was easy _ . | options: A: for the ants to live in B: to get sun light in C: to keep the sand clean D: for the boy to observe | answer: D </s> |
<s>[INST] context: Viruses are the most common cause of pharyngitis in adults. Group-A beta- hemolytic streptococci (Spyogenes) accounts for 50% of pharyngitis cases in children but only 10% of cases in adults. Centor criteria (fever, absence of cough, tonsillar exudate, and tender anterior cervical lymphadenopathy) are widely used to identify patients at risk for group-A streptococcal pharyngitis. Patients with two or three criteria should have a positive rapid streptococcal antigen test or positive throat culture before being given antibiotics. A negative rapid streptococcal antigen test needs to be confirmed by a throat culture. Patients meeting all four Centor criteria should also have either of the previously described confirmatory tests but may be treated empirically while awaiting results. A 10-day course of oral penicillin continues to be the treatment of choice for streptococcal pharyngitis. A 5-day course of azithromycin can be used in penicillin-allergic patients.Trismus, hoarseness, and neck swelling are concerning for more serious infections such as epiglottitis. Runny nose, cough, and myalgia suggest a viral illness such as the common cold. [/INST] question: An 18-year-old woman presents with a 2-day history of sore throat. Which of the following constellation of symptoms and signs is most consistent with group-A streptococcal pharyngitis? | options: A: Fever, anorexia, dysphagia, and hoarseness B: Fever, runny nose, cough, myalgia, and poor appetite C: Fever, no cough, tonsillar exudates, and tender anterior cervical lymphadenopathy D: Fever, cough, pharyngeal erythema, and dysphagia | answer: C </s> |
<s>[INST] context: The 30th Olympics will be held in London soon. More and more people will travel there and watch the games. And it's necessary for the tourists to know the customs there. Here are some tips given by William Hanson, an English manner expert.
* Afternoon tea. The traditional view that the British sit down for an afternoon tea is not popular any more. Few people keep the tradition nowadays.
* Give tips -- but not in a clear way. The British would like to choose a quiet way of saying "thank you" when they get good service. In fact, many British waiters will not mind if you decide not to tip at all.
* Greeting with a kiss. The British aren't like their neighbors in France. They do not greet others with a kiss very often. Many people prefer to shake hands or pat on the back to say " hello" .
* Conversation tips. If you are not sure what you are talking about, end a sentence with the word "mate".
* Don't talk about money. According to Hanson, British people don't like to talk about money and it is rude to do so. Especially, never ask anyone how much money he or she makes a month. [/INST] question: _ British sit down for an afternoon tea now. | options: A: More and more B: Many C: A few D: Few | answer: D </s> |
<s>[INST] context: Cytokeratin 20: *Merkel cell carcinoma (MCC) is a rare, aggressive, primary skin cancer exhibiting neuroendocrine differentiation. oThe histogenesis of MCC is controversial. Possible cells of origin include the epidermal MC, a dermal MC equivalent, a neural-crest- derived cell of the amine precursor uptake and decarboxylation (APUD) system, and a residual epidermal stem cell. oCytogenetic abnormalities are present in 30-47% of MCCs. The most frequent change is loss of heterozygosity due to translocations or deletions of chromosome 1; specifically, 2 distinct regions in the most distal band 1 p36 on the sho arm of chromosome 1are implicated in MCC. Similar abnormalities near this site occur in several neuro cystic tumors, including melanoma, neuroblastoma, and pheochromocytoma. Other abnormalities described in MCC include losses at chromosomes 3, 13, and 22 and paial trisomy 01 chromosomes 1, 11, 18, and X. Unlike neuroendocrine (small cell) carcinoma of the lung, gene amplifications are rare in cutaneous MCC. oCytokeratin 20 is expressed in a dot like paranuclear or crescentic pattern; other low molecular weight (MW) cytokeratin antibodies (E.g., CAM5.2, MNF116), white less specific, react in a similar localization pattern. oElectron microscopic findings are char9- cteristic, revealing a lobulated nucleus that may contain rodlets. The cytoplasm is electron- lucent and contains a prominent Golgi apparatus and numerous ribosomes. Intermediate filaments are numerous and often assume a parallel or whorled arrangement near the nucleus, accounting for the dot like pattern of cytokeratin distribution visualized by immunohistochemistry. Desmosomes may be present. Most diagnostic is the dense core granule (80-120 mn in diameter), the source and the locus of the neuroendocrine peptides. [/INST] question: Merkel cell carcinoma is due to | options: A: Cytokeratin: 7 B: Cytokeratin: 19 C: Cytokeratin: 20 D: Cytokeratin: 18 | answer: C </s> |
<s>[INST] context: A developmental assessment for children under age 3 is an attempt to assess various aspects of the child's functioning, including areas such as cognition, communication, behavior, social interaction, motor and sensory abilities, and adaptive skills. Assessment of the family and the child's environment also provides important contextual information.
Topics covered in this section
This section covers the basic aspects of the general developmental assessment for young children with suspected developmental problems including possible autism. This section focuses on the general approach to the developmental assessment, including some specific components of such an assessment, but does not review information on specific autism assessment instruments.
Basis for guideline recommendations about the general developmental assessment
In the previous section on the use of autism assessment instruments, the guideline recommendations are based on the panel's interpretation of an extensive and systematic review of the scientific literature. The panel did not attempt to systematically evaluate the research evidence on effectiveness of the general developmental assessment methods discussed in this section as this was considered outside the specific scope of the guideline. Therefore, guideline recommendations in this section are based on the consensus opinion of the panel, using its collective knowledge and experience in assessing children with autism. In the panel's opinion, these recommendations reflect appropriate practices for assessing children with possible autism and are generally consistent with the scientific knowledge in this field. [/INST] question: What is the age limit for further developmental assessment in a child not reaching for objects | options: A: 3 months B: 5 months C: 9 months D: 12 months | answer: C </s> |
<s>[INST] context: GREENWICH--Recently, a group of concerned Greenwich residents gathered to discuss how they could help those who may be alone during the holiday season.Armed with plenty of ideas and a sincere desire to do good, this group now refers to themselves as "A Random Act of Kindness".As members of this group, we are to put together a Thanksgiving dinner on Thanksgiving Day that will provide a free meal to those who are alone or can't provide for themselves.This task will require many resources to make it successful.We are gathering a small army of volunteers to devote their time to helping prepare, cook, serve, clean, organize and promote this event.We hope that you can help us.The following is what we have planned to do;
*A 2 - hour free dinner that will take place at the Greenwich VFW with 2 seatings, one from 1 p.m.to 2 p.m.and the other from 2: 30 p.m.to 3: 30 p.m.by reservation only on Thanksgiving Day.
*Amy McPhail and Julie Carroll are accepting names of volunteers as well as food donations for the cause; Amy can be contacted at 692 -7841 for donations and Julie can be contacted if you'd like to volunteer at 884 -0658.
*A bank account has been created through Glens Falls National Bank to accept money donations and checks can be made payable to "A Random Act of Kindness" and sent to Glens Falls National Bank c/o Dan Flynn.
*Ellen Pemrick ( Caterer) .Beth Anthony ( Beth's Cafe) and David Hughes (Glens Falls Hospital) will be consulted to make sure the highest quality of food can be served.
*We are looking to serve between 150 and 250 people at this event.We are serving the following: turkey gravy, mashed potatoes, green beans, cranberry sauce, stuffing rolls, pumpkin pie, apple pie.Beverages will include: milk, water, coffee & apple cider.
If you are interested in donating any of the above items, please drop off your donations at the VFW in Greenwich any evening between November 14 and November 24.If you have any problems dropping any items off during that time, please contact George Perkins at either 692 -2367 or 573 -8115.Any non-perishable food donalions not used for the dinner will be donated to the local Greenwich Food Pantry.
Any help you can provide for us would be gready appreciated.Everyone's generosity to the Greenwich community and its residents is very much appreciated.Reservations for dinner are now being accepted by calling Pal Perkins at 692 -2367 until November 13. [/INST] question: If you want to be a volunteer for this Thanksgiving dinner, you may call _ . | options: A: 884-0658 B: 692-2367 C: 573-8115 D: 692-7841 | answer: A </s> |
<s>[INST] context: Going to school means learning new skills and facts in such subjects as reading, math, science, history, art or music. Teachers teach and students learn, and many scientists are interested in finding ways to improve both the teaching and learning processes.
Some researchers, such as Sian Beilock and Susan Levine, are trying to learn about learning. Beilock and Levine are psychologists at the University of Chicago. Psychologists study the ways people think and behave, and these researchers want to know how a person's thoughts and behavior are related.
In a new study about the way kids learn math in elementary school, Beilock and Levine found a surprising relationship between what female teachers think and what female students learn: If a female teacher is uncomfortable with her own math skills, then her female students are more likely to believe that boys are better than girls at math.
"If these girls keep getting math-anxious female teachers in later grades, _ ," Levine toldScience News. The study suggests that if these girls grow up believing that boys are better at math than girls are, then these girls may not do as well as they would have if they were more confident.
Just as students find certain subjects to be difficult, teachers can find certain subjects to be difficult to learn--and teach. The subject of math can be particularly difficult for everyone. Researchers use the word "anxiety" to describe such feelings: anxiety is uneasiness or worry. (Many people, for example, have anxiety about going to the dentist because they're worried about pain.)
The new study found that when a teacher has anxiety about math, that feeling can influence how her female students feel about math. The study involved 65 girls, 52 boys and 17 first- and second-grade teachers in elementary schools in the Midwest. The students took math achievement tests at the beginning and end of the school year, and the researchers compared the scores.
The researchers also gave the students tests to tell whether the students believed that a math superstar had to be a boy. Then the researchers turned to the teachers: To find out which teachers were anxious about math, the researchers asked the teachers how they felt at times when they came across math, such as when reading a sales receipt. A teacher who got nervous looking at the numbers on a sales receipt, for example, was probably anxious about math.
Boys, on average, were unaffected by a teacher's anxiety. On average, girls with math-anxious teachers scored lower on the end-of-the-year math tests than other girls in the study did. Plus, on the test showing whether someone thought a math superstar had to be a boy, 20 girls showed feeling that boys would be better at math--and all of these girls had been taught by female teachers who had math anxiety.
According to surveys done before this one, college students who want to become elementary school teachers have the highest levels of anxiety about math. Plus, nine of every 10 elementary teachers are women, Levine said.
This study was small, and it's often difficult to see large patterns in small studies, David Geary told Science News. Geary, a psychologist at the University of Missouri in Columbia, studies how children learn math. "This is an interesting study, but the results need to be interpreted as preliminary and in need of replication with a larger sample," Geary said. That means that the results are just showing something that might be happening, but more studies should be done. If more studies find the same trend as this one, then it's possible that a teacher's anxiety over math really is affecting her female students. [/INST] question: Sian Beilock and Susan Levine carried out the new research in order to _ . | options: A: know the effects of teaching on learning B: study students' ways of learning math C: prove women teachers are unfit to teach math D: find better teaching methods for teachers | answer: B </s> |
<s>[INST] context: Mr. and Mrs. Jackson worked in the same workplace. The man was skillful and could make all kinds of parts and repair the machines. The boss liked him and paid him more than his workmates. But he had to give all his money to his wife and she bought the food, clothes and drinks for him. He was angry with her but couldn't say anything. All the men in the workplace were afraid of their wives and they felt sorry for each other.
It was March 8 and all the women had a day off. The men could say all they wanted. They said they had to do all the housework at home but the women always spent much money on their clothes. And they didn't think it was fair that women had their own festival but they didn't. The more they said, the angrier they became. They decided to write a letter to the UN and advised them to rescind the" Women's Day". And they asked Mr. Jackson to do it. The man agreed and began to write it at a table.
Just at that moment when Mr. Jackson finished it, his wife came in. She had left her key in the workplace and came to look for it. The man hurried to hide the letter. But it was too late. She made him hand it to her. Having read it, the woman returned the letter to him and said with a smile, "How can you post it to the UN if I don't supply you the money for buying a stamp?" [/INST] question: Mr. Jackson had to give all his money to his wife because _ . | options: A: he was afraid of her B: she bought all for him C: she needed much money D: he loved her very much | answer: A </s> |
<s>[INST] context: A properly performed interscalene block universally blocks the ipsilateral phrenic nerve. Interscalene Block: Side Effects Diaphragmatic hemiparesis from ipsilateral phrenic nerve block (100% incidence, 25% reduction in pulmonary function) Pneumothorax Permanent neurologic injury Blockade of vagus, recurrent laryngeal, and cervical sympathetic nerves (Horner's syndrome) Epidural or subarachnoid injection Veebral aery injection Severe hypotension and bradycardia (Bezold-Jarisch reflex) The interscalene block is indicated for procedures on the shoulder and proximal humerus as well as the lateral two thirds of the clavicle. The interscalene block can also be utilized for surgery of the arm or forearm; however, the higher incidence of incomplete blockade of the inferior trunk with this technique may provide inadequate analgesia in the ulnar distribution. The patient's positioning and comfo, the surgeon's preferences, and the duration of surgery may necessitate coadministration of a general anesthetic. An interscalene catheter may be inseed for prolonged postoperative analgesia [/INST] question: The most common complication of interscalene block:- | options: A: Phrenic block B: Pneumothorax C: Hypotension D: Horner syndrome | answer: A </s> |
<s>[INST] context: What do you usually do after school? Playing football? Watching TV? Let's see how kids in foreign countries spend their free time?
Mess around with Dress-up Do your parents have any old clothes? See if you can get an old box and start collecting hats, shoes and clothes now! Then, when your friends come over after school,you can play dress-up. See if you can make yourself into a doctor, or a cowboy, or even a spaceman! If you are really clever, you could even put on a show for your family! Let your imagination run wild!
Start a Club Want to learn new things after school? Want to make new friends who aren't in your class? You can get both of them in clubs. In other countries' schools,there are usually all kinds of clubs for kids to join. There is a French club,a student government, a theatre,a choir and a photography club.
Take a photography club as an example. One may learn all the skills about taking photos. For example,you will learn how to choose a camera,how to use the light and how to develop pictures.
One can also make a lot of friends in clubs. It's always good to enjoy your free time with friends, isn't it? [/INST] question: How do kids in foreign countries spend their free time? _ . | options: A: Playing football B: Playing dress-up C: Watching TV D: Having a party in clubs | answer: B </s> |
<s>[INST] context: Old Fossils
Scientists have found what they think is probably the oldest fossil on Earth, a remnant of life from 3.7 billion years ago when Earth's skies were orange and its oceans green.
In a newly melted part of Greenland, Australian scientists found the leftover structure from a community of microbes that lived on an ancient seafloor. Based on their analysis of the fossils, the researchers determined that they are 220 million years older than those discovered in Western Australia, which were 3.48 billion years old.
The discovery shows life may have formed quicker and more easily than once thought, about half a billion years after Earth formed. And that may also give hope for life forming elsewhere, such as Mars, said study co-author Martin VanKranendonk of the University of New South Wales and director of the Australian Center for Astrobiology. "It gives us an idea how our planet evolved and how life gained a foothold," VanKranendonk said.
Scientists had thought it would take at least half a billion years for life to form after the molten Earth started to cool a bit, but this shows it could have happened quicker, he said. That's because the newly found fossil is far too complex to have developed soon after the planet's first life forms, he said.
In an outcrop of rocks that used to be covered with ice and snow which melted after an exceptionally warm spring, the Australian team found stromatolites , which are layered structures that are often produced by a community of microbes. The stromatolites were about 1 to 4 centimeters high.
"It is like the house left behind made by the microbes," VanKranendonk said. "Scientists used the layers of ash from volcanoes and tiny zircon with uranium and estimated that they date back to 3.7 billion years ago."
The dating seems about right, said Abigail Allwood, a NASA astrobiologist who found the previous oldest fossil, from 3.48 billion years ago, in Australia. But Allwood said she is not completely convinced that what VanKranendonk's team found once was alive. She said the evidence wasn't conclusive enough that it was life and not a geologic quirk .
"It would be nice to have more evidence, but in these rocks that's a lot to ask," Allwood said in an email. [/INST] question: What is Abigail Allwood's attitude towards the newly found fossil? | options: A: Neutral B: Sceptical C: Objective D: Supportive | answer: B </s> |
<s>[INST] context: The Cambridge Science Festival Curiosity Challenge
Dare to Take the Curiosity Challenge!
The Cambridge Science Festival (CSF) is pleased to inform you of the sixth annual Curiosity Challenge. The challenge invites, even dares school students between the ages of 5 and 14 to create artwork or a piece of writing that shows their curiosity and how it inspires them to explore their world.
Students are being dared to draw a picture, write an article, take a photo or write a poem that shows what they are curious about. To enter the challenge, all artwork or pieces of writing should be sent to the Cambridge Science Festival, MIT Museum, 265 Mass Avenue, Cambridge 02139 by Friday, February 8th.
Students who enter the Curiosity Challenge and are selected as winners will be honored at a special ceremony during the CSF on Sunday, April 21st. Guest speakers will also present prizes to the students. Winning entries will be published in a book. Student entries will be exhibited and prizes will be given. Families of those who take part will be included in the celebration and brunch will be served.
Between March 10th and March 15th, each winner will be given the specifics of the closing ceremony and the Curiosity Challenge celebration. The program guidelines and other related information are available at: http://cambridgesciencefestival.org. [/INST] question: Who can take part in the Curiosity Challenge? | options: A: School students B: Cambridge locals C: CSF winners D: MIT artists | answer: A </s> |
<s>[INST] context: Dorsiflexion of foot Compament syndrome (CS) occurs whenever increased tissue pressure in a myofascial compament compromises blood flow to the muscles and nerves within that compament, resulting in tissue and nerve damage. The compaments of the lower leg and the volar forearm are paicularly prone to developing elevated compament pressures.Two types of CS have been identified, acute and chronic.Acute CS typically occurs subsequent to a traumatic event, most commonly fractures. Symptoms worsen acutely, and irreversible nerve injury and muscle necrosis occur within hours.Chronic CS (also known as chronic exeional CS, exeional CS, recurrent CS, or subacute CS) is a recurrent syndrome that occurs with exercise or work.Relevant Anatomy There are 4 osteofascial compaments of leg enclosed by the unyielding deep fascia and separated from each other by the bones of die leg and interosseeous membrane and by the anterior and posterior intermuscular septa. Each ofthe compaments is "sealed" spaces containing muscles, aeries, and nerves.Anterior or extensor compamento Dorsiflexor muscles of the ankle and footTibialis anterior- Extensor digitorum longus- Extensor hallucis longus- Peroneus teiuso Anterior tibial aery - Commonly injured in lateral tibial plateau fractureso Deep peroneal nerve - Provides sensation to the first dorsal web spaceLateral compamento Peroneus (fibularis) brevis and peroneus (fibularis) longus - Plantar flexor and eveor muscles of the foot o Superficial peroneal nerve - Provides sensation to the dorsum of the footDeep posterior compamento Plantar flexor and phalangeal flexor muscles- Tibialis posterior- Flexor digitorum longus (FDL)- Flexor hallucis longus(and Popliteus, which acts on the,knee joint)o Posterior tibial and peroneal aerieso Posterior tibial nerve - Provides sensation to the sole of the footSuperficial posterior compamento Plantar flexor muscles of the foot- Gastrocnemius- Plantaris- Soleuso Sural nerveAcute compament syndromes are medical emergencies that may require immediate surgical treatment. Acute compament syndromes are usually the result of a traumatic incident. The swelling from the contusion causes the increased pressure in the compament. These injuries are most often seen in the emergency room and are not athletic injuries.Chronic CS is seen more often in the athletic community. Diagnosing this injury is one of exclusion. A complete examination should rule out medial tibial stress syndrome, stress fractures, and Achilles tendon injuries.The athlete presents with pain that is present during weight bearing training. Activities such as running, stair climbing, and jumping are the most common offenders.There will be pain on passive stretch of the muscles of the compament.So in the: Deep posterior compament syndrome- there will be pain on passive dorsiflexion of the foot and on toeextension (since muscles in the deep post compament are plantar flexors and phalangeal flexors )Anterior compament syndrome- there will be pain on passive plantar flexion of the foot and toe flexion.Lateral compament syndrome- there will be pain on passive foot inversion.Superficial posterior compament syndrome- pain is on passive dorsiflexion of foot.Definitive diagnosis of a chronic CS can be made with an intracompamental pressure test. A catheter is inseed into the offending compament to measure its pressure.Once the diagnosis is confirmed with a positive compament measurement, a treatment course is to be chosen. Conservative treatment is the first option. Rehabilitation should include: low impact cross training, flexibility training, appropriate strength training for weakened muscles, and/or the use of ohotics to correct biomechanical abnormalities.If conservative treatment fails, surgical intervention in the next step. Afasciotomy is the procedure of choice. [/INST] question: Which passive movement causes pain in deep posterior compament syndrome? | options: A: Foot abduction B: Dorsiflexion of foot C: Plantar flexion of foot D: Foot adduction | answer: B </s> |
<s>[INST] context: Imagine when you are sailing an ocean for the first time, you see a big fish swimming near your ship. You might be scared, and worried about whether it will turn over your ship for a meal. In fact, it is not a fish at all, but a gentle giant whale.
Whales are not fishes but mammals . Their body temperature stays the same, and does not change with the temperature of their environment. They breathe air, so they have to come out of the water to get oxygen. Thus, they cannot afford to fall into a sleeping state for too long, since they need to be awake in order to breathe. It is thought that only half of their brains sleep at a time, so that whales are never completely asleep. Females give birth to the young. They have hair. Although they are not covered in hair or fur like many mammals, whales have some bristles , usually on their heads.
Whales are highly social animals with complex languages and intelligence. They communicate with each other using romantic sounds, called "whale songs". Being so large and powerful, these sounds are also loud.
Whales are endangered as a result of whaling from the eleventh century to the twentieth. It has attracted the attention of environmentalists and some measures have been taken to protect whales. [/INST] question: How many aspects show that whales are mammals? | options: A: One B: Two C: Three D: Four | answer: D </s> |
<s>[INST] context: A man claiming to be a pastor apparently tried to stiff a waiter on a tip, explaining that his work for God allowed him not to leave one.
A photo of the receipt, posted to Reddit.com, shows a bill for $34.93 with an automatic 18 percent gratuity (or $6.29) added above a blank space for an additional tip.
"I give God 10%," the diner wrote on the receipt, scratching out the automatic tip. "Why do you get 18?" He then wrote "Pastor" above his signature, and an emphatic "0" where the additional tip would be. (The automatic gratuity, however, had already been added to the total.)
The Reddit user who submitted the image explained in the comments section that the receipt was part of a total bill for a party of 20, which is why the gratuity was automatically added.
"Parties up to eight ... may tip whatever they'd like, but larger parties receive an automatic gratuity," the server wrote. "It's in the computer; it's not something I do."
The server added: "They had no problem with my service, and told me I was great. They just didn't want to pay when the time came."
Scribbling notes on receipts has become something of a trend. Earlier this month, the manager of a North Carolina Red Robin surprised an overdue pregnant woman by comping her meal.
"Once seated, a manager came up to us and started talking," the woman's husband told Consumerist. "He was extremely friendly and jokingly asked my wife if this was her last meal before heading to the hospital."
When the check came, a note from the manager next to her portion of the bill read: "MOM 2 BEE GOOD LUC."
"It was a pleasant surprise and made my tired-of-being-pregnant wife a little more cheery," the man said. [/INST] question: What did the pastor mean by saying, "I give God 10%. Why do you get 18?" | options: A: He was bargaining with the waiter B: He didn't mean to pay the gratuity at all C: God gave him the privilege not to pay a gratuity D: The gratuity had already been paid by his friends | answer: B </s> |
<s>[INST] context: FROM 1964 to 1978, Dazhai, with a population of 500, was the most famous village in China. Millions of Chinese came to the Shanxi village to visit its terraced fields and "splendid" irrigation systems.
It was not until 1978 when Guo Fenglian, head of the village, paid a visit to the US that China's model village found how far it had fallen behind those in developed countries.
"I was astonished at their modern equipment in harvesting, which could even separate big tomatoes with small ones," said Guo. "American farmers' life quality also impressed me a lot. Every day they had two cups of milk, which is something we don't have even in our wildest dreams."
"We have to learn their advanced technology and administration for our own development," said then first Deputy Prime Minister Deng Xiaoping who was planning China's reform and opening up policy then. "Through opening our doors, we would not only take advantage of foreign funds , but also create job opportunities and cultivate talents."
In 1978 Japanese electricity giant Panasonic came to China as the first foreign business to invest here and its success attracted other world brands into exploring the Chinese market. So far China has for 15 years taken in the world's second biggest foreign investment, following the US, to help set the country in a fast growth.
However, China's 30-year road of reform was not always smooth. Doubts on the reform began to rise at the end of the 1980s as many people worried the country would turn to capitalism .
"The criterion for our judgment is whether it helps develop socialist productive forces, whether it helps increase the overall national strength of a socialist country, and whether it brings about better living standards," said Deng.
"China's reform and opening up is a unique success story. It has brought benefit to both China and the world," said William Keller, chief manager of a Swiss pharmaceutical company. [/INST] question: Guo Fenglian was _ at the sight of the modern equipment in harvesting when she visited the US in 1978. | options: A: shocked B: delighted C: excited D: attracted | answer: A </s> |
<s>[INST] context: Multiple myeloma is a plasma cell neoplasm commonly associated with lytic bone lesions, hypercalcemia, renal failure, and acquired immune abnormalities. Clinical Features. The clinical features of multiple myeloma stem from (1) the effects of plasma cell growth in tissues, paicularly the bones (2) the production of excessive Igs, which often have abnormal physicochemical propeies; and (3)The suppression of normal humoral immunity. Bone resorption often leads to pathologic fractures and chronic pain. The attendant hypercalcemia can give rise to neurologic manifestations, such as confusion, weakness, lethargy, constipation, and polyuria, and contributes to renal dysfunction. Decreased production of normal Igs sets the stage for recurrent bacterial infections. Cellular immunity is relatively unaffected. Of great significance is renal insufficiency, which trails only infections as a cause of death. The pathogenesis of renal failure (Chapter 20), which occurs in up to 50% of patients, is multifactorial. However, the single most impoant factor seems to be Bence-Jones proteinuria, as the excreted light chains are toxic to renal tubular epithelial cells. Ceain light chains (paicularly those of the l6 and l3 families) are prone to cause amyloidosis of the AL type, which can exacerbate renal dysfunction and deposit in other tissues as well. [/INST] question: Comment on the diagnosis for an individual serum alkaline phosphatase normal, PTH normal, Vitamin D3 normal with elevated serum Calcium values? | options: A: Vitamin D intoxication B: Hyperparathyroidism C: Multiple myeloma D: Nutritional rickets | answer: C </s> |
<s>[INST] context: Have you ever had a doctor write you a prescription for three laps around a local trail ? How about a prescription for sit-ups?
These treatments may not be as typical as the drugs that are usually used to treat our problems, but maybe they should be: a new report shows that regular exercise can be just as effective as prescription drugs for patients with depression and anxiety.
"Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger, " said the paper's co-author, Jasper Smith, director of the Anxiety Research and Treatment Program at Southern Methodist University. " Exercise may help patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing."
In a separate study, published in Physical Therapy journal, scientists studied 161 women who' d recently given birth to babies, and decided them into two groups. New mothers tend to develop post-partum depression , and the scientists wanted to find out whether exercise could prevent such problems. One group of women was given specialized exercises as part of an eight-week parenting education program, while the other was given only written education. The physical element seemed to do the trick; the researchers report that the number of women identified as "at risk" for post-partum depression was reduced by half in the exercising group.
Another recent study shows that even when a patient has a chronic illness like cancer or a heart condition, regular exercise can dramatically increase wellbeing by reducing anxiety. Researchers from University of Georgia analyzed 40 clinical trials involving almost 3,000 patients, and found that the patients who reported exercising regularly had a 20% reduction in symptoms of anxiety compared to those who didn't exercise. As a result, they were more likely to follow their recommended treatment plan.
Of course, there are still some situations where prescription drugs are necessary, and we recommend you leave it to your doctor to determine when that may be. But in many cases, the best medicine may simply be to get up off the couch and go for a walk. [/INST] question: Which of the following is the common method to treat depression and anxiety? | options: A: Drug B: Exercise C: Run D: walk | answer: A </s> |
<s>[INST] context: Benign paroxysmal positional veigo (BPPV): It is characterised by veigo when the head is placed in a ceain critical position. There is no hearing loss or other neurologic symptoms. Disease is caused by a disorder of posterior semicircular canal though many patients have history of head trauma and ear infection It has been demonstrated that otoconial debris, consisting of crystals of calcium carbonate, is released from the degenerating macula of the utricle and floats freely in the endolymph The condition can be treated by performing Epley's manoeuvre. The principle of this manoeuvre is to reposition the otoconial debris from the posterior semicircular canal back into the utricle. The manoeuvre consists of five positions. Position 1; With the head turned 45deg, the patient is made to lie down in head-hanging position (DixHallpike manoeuvre). It will cause veigo and nystagmus. Wait till veigo and nystagmus subside. Position 2. Head is now turned so that affected ear is up. Position 3. The whole body and head are now rotated away from the affected ear to a la teral recumbent position in a face-down position. Position 4. Patient is now brought to a Sitting posiition with head st ill turned to the unaffected side by 45deg Position 5. The head is now turned forward and chin brought down 20deg. [/INST] question: Epley's test is used for__________ | options: A: Benign paroxysmal veigo B: Basilar migraine C: Ohostatic hypotension D: Thoracic outlet syndrome | answer: A </s> |
<s>[INST] context: Riding School:
You can start horse-riding at any age. Go riding any day except weekends.
But at 3:30 p.m. on Saturdays, there are 10 kilometers of rides across farmland and open countryside. You will need a riding hat.
Opening Hours: Any weekday: 9:00 a.m.-8:30 p.m.
Phone: (412) 396-6754 Fax : (412)396-6752
Sailing Club:
Our Young Sailor's Course leads to the Stage 1 Sailing qualification . You'll learn how to sail safely. Have fun with other course members.
Opening Hours: Tuesdays: 6:00 p.m.-8:00 p.m.
Phone: (412)396-6644 Fax: (412)396-6644
Watersports Club:
We have a two-kilometer-long river for boat racing and water-skiing. You will learn to drive boats safely and confidently, but must be able to swim. The club is open every day from 9 a.m. to 4 p.m. with lessons all through the day.
Opening Hours: From Monday to Friday: 9:00a.m.-4:00 p.m.
Phone: (412)396-6899 Fax: (412)396-6890
Diving Centre:
Our experienced coaches offer one-month courses in deep-sea diving for beginners. There are two evening lessons a week.
Opening Hours: Monday and Friday: 6:30 p.m.-8:30 p.m.
Phone: (412)396-6312 Fax: (412)396-6706 [/INST] question: Which of the following should you join if you are able to swim and want to enjoy activities that are fast and a bit dangerous? | options: A: Watersports Club B: Driving Centre C: Sailing Club D: Riding School | answer: A </s> |
<s>[INST] context: Opioids Epidural opioid (fentanyl) analgesia is commonly employed as a therapeutic modality in the management of pain during labour. The general perception is that administered drugs remain in the maternal epidural space and do not compromise the respiratory status of the newborn. Contrary to the widely held belief fentanyl diffuses freely from the epidural space into the maternal blood because of its high lipid solubility. Equilibrium is reached within 10-30 min. The drug is freely transpoed across the placenta with a slightly higher concentration in the, fetal compament because of a comparative acidic pH. There is no consensus on the dose of fentanyl causing respiratory depression in the newborn period. However, it appears that neonates are prone to respiratory depression at a lower concentration because of the immaturity of the respiratory centre. According to the Cochrane analysis Morphine, meperidine and fentanyl are the opioids that have been studied the most in labour analgesia research. These opioids as well as newer alternatives, such as nalbuphine have been associated with newborn respiratory depression at bih. - Opioids are known for their high lipid solubility which allows rapid transfer of the drug through the placenta and into the fetus. - The risk of respiratory depression is highest if bih occurs at the time of peak fetal uptake between 1-4 hours after administration of drug to the mother. - Repeated doses of opioids results in significant .fetal exposure and neonatal respiratory depression. Opioids are also used in neonates for pain management - They are the mainstay of pain management in newborn. - In newborns the clearance is diminished and elimination half lives are prolonged as compared to adults because of the immaturity of hepatic cytochrome system of the neonates. - Therefore opioid administration may result in opioid accumulation and respiratory depression. [/INST] question: A new born child developed respiratory depression in neonatal ward. Which of the following drug is the cause aEUR' | options: A: Opioids B: Barbiturates C: Diazepam D: Propofol | answer: A </s> |
<s>[INST] context: A major earthquake rocked Haiti at 4:53 pm local time on Jan.12, 2010, killing possibly thousands of people but no official figure has been released so far.
The quake, which struck about 15km (10 miles) south-west of the capital, Port-au-Prince, was quickly followed by two strong aftershocks. In the space of a minute, numerous buildings fell down. A five-story U.N. building was also brought down by the 7.3 magnitude quake, the most powerful to hit Haiti in more than 200 years according to the U.S. Geological Survey.
As night fell, the whole city is in total darkness. You can see thousands of people sitting in the streets with nowhere to go. There are people running, crying, screaming. Describing the earthquake as a "catastrophe", Haiti's president said the cost of the damage could run into billions.
Haiti became the first independent Caribbean state in the early 19th century. Haiti's location, history and attracting climate once made it a tourist hot place. However, decades of poverty, environmental pollution and violence have left it as the poorest nation in the Americas. It has suffered a lot, including four hurricanes and storms in 2008 that killed hundreds. [/INST] question: The great earthquake happened to the _ of the capital city. | options: A: south-west B: north-west C: south-east D: north-east | answer: A </s> |
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