Miracle-dz/UniFAR-FTUs huggingface dataset:
Os Odontoideum: Etiology and Surgical Management

OBJECTIVEOs odontoideum is an independent ossicle of variable size with smooth circumferential cortical margins separated from the foreshortened odontoid peg. The etiology of os odontoideum remains controversial, but there is now emerging consensus on the traumatic etiology of os odontoideum rather than a congenital source. RESULTSWe reviewed the literature of os odontoideum. Patients with this condition can be asymptomatic or present with wide range of neurological dysfunctions. Although the diagnosis of os odontoideum can be made with plain x-rays, further imaging modalities including magnetic resonance imaging and computed tomography angiography have improved the preoperative planning. CONCLUSIONThere is a role for conservative treatment of an asymptomatic incidentally found, radiologically stable, and noncompressive os odontoideum. Conversely, surgery has a definite role in symptomatic cases. The main method of surgical treatment today is posterior decompression after reduction and fusion via independent C1 and C2 instrumentation. Irreducible, persistent anterior compression from os odontoideum can be approached by a transoral route with good results in experienced hands.
Asynchronous functional reactive programming for GUIs

Graphical user interfaces (GUIs) mediate many of our interactions with computers. Functional Reactive Programming (FRP) is a promising approach to GUI design, providing high-level, declarative, compositional abstractions to describe user interactions and time-dependent computations. We present Elm, a practical FRP language focused on easy creation of responsive GUIs. Elm has two major features: simple declarative support for Asynchronous FRP; and purely functional graphical layout. Asynchronous FRP allows the programmer to specify when the global ordering of event processing can be violated, and thus enables efficient concurrent execution of FRP programs; long-running computation can be executed asynchronously and not adversely affect the responsiveness of the user interface. Layout in Elm is achieved using a purely functional declarative framework that makes it simple to create and combine text, images, and video into rich multimedia displays. Together, Elm's two major features simplify the complicated task of creating responsive and usable GUIs.
Measuring the Impact of Communication in Agile Development: A Research Model and Pilot Test

While experience from practice provides evidence for the success of agile development, research lacks behind in explaining and understanding the theoretical enablers of this success. To address this gap, we present a theoretically grounded research model that highlights the role of communication within the project team as a critical success factor. We develop measurement instruments and present findings of a pilot test that we distributed in a medium-sized software development company. The goal of the pilot test is to validate our measurement instruments and to gain first indications of construct validity. We present the results of a confirmatory factor analysis and, in consequence, we reflect on our findings and highlight the implications for future research.
Radial metallicity profiles for a large sample of galaxy clusters observed with XMM-Newton

Aims. We measured radial metallicity profiles for a sample of ≈50 hot, intermediate redshift galaxy clusters, selected from the XMM-Newton archive. Methods. As in our previous paper, we used background modeling rather than background subtraction, and the Cash statistic rather than the χ 2 . This method requires a careful characterization of all background components. We also performed Montecarlo simulations to assess systematic effects. Results. The mean metallicity profile shows a peak in the center, and gently declines out to 0.2 R180. Beyond 0.2 R180 the metallicity is ≈0.2 solar and, at variance with recently published expectations based on simulations, consistent with being flat. We find no evidence of profile evolution from z = 0. 1t oz = 0.3. When comparing our mean profile to those obtained by recent works with BeppoSAX and Chandra, we find remarkable agreement over the entire radial range.
Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. For the SUPPORT investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatmentm.

OBJECTIVES To evaluate the pain experience of seriously ill hospitalized patients and their satisfaction with control of pain during hospitalization. To understand the relationship of level of pain and dissatisfaction with pain control to demographic, psychological, and illness-related variables. DESIGN Prospective, cohort study. SETTING Five teaching hospitals. PATIENTS Patients for whom interviews were available about pain (n = 5,176) from a total of 9,105 patients in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Patients were interviewed after study enrollment about their experiences with pain. When patients could not be interviewed due to illness, we used surrogate (usually a family member) responses calibrated to patient responses (from the subset of interviews with both patient and surrogate responses). Ordinal logistic regression was used to study the association of variables with level of pain and satisfaction with its control. Nearly 50% of patients reported pain. Nearly 15% reported extremely severe pain or moderately severe pain occurring at least half of the time, and nearly 15% of those patients with pain were dissatisfied with its control. After adjustment for confounding variables, older and sicker patients reported less pain, while patients with more dependencies in activities of daily living, more comorbid conditions, more depression, more anxiety, and poor quality of life reported more pain. Patients with colon cancer reported more pain than patients in other disease categories. Levels of reported pain varied among the five hospitals and also by physician specialty. After adjustment for confounding variables, dissatisfaction with pain control was more likely among patients with more severe pain, greater anxiety, depression, and alteration of mental status, and lower reported income; dissatisfaction with pain control also varied among study hospitals and by physician specialty. CONCLUSIONS Pain is common among severely ill hospitalized patients. The most important variables associated with pain and satisfaction with pain control were patient demographics and those variables that reflected the acute illness. Pain and satisfaction with pain control varied significantly among study sites, even after adjustment for many potential confounders. Better pain management strategies are needed for patients with the serious and common illnesses studied in SUPPORT.
Orandi one-stage urethroplasty using the subcutaneous pedicle graft modification of raatzschLong-term results

Objective: To present long-term results obtained with the Orandi one-stage urethroplasty using a modified technique as described by Raatzsch. Material and Methods: Between 1980 and 1993, Raatzsch urethroplasty was used in our clinic in 202 male patients (average age 50.9 years), 53% of whom had undergone other procedures before, mainly internal urethrotomy. The mean follow-up period was 46.2 months (range 2–156 months). Results: Good or improved results with no need for further surgical intervention were achieved in 128 patients (63.4%); a total of 117 procedures had to be performed in the other 74 patients in order to achieve a satisfactory outcome. The success rate was highest for penile strictures (71.8%). Complications occurred in 24.3% of cases. Conclusions: The Raatzsch modification of Orandi urethroplasty is a simple procedure that yields moderate results on long-term follow-up. Surgeons who operate regularly for urethral stricture should be aware of its long-term results, especially in the treatment of penile strictures.
The Role of Axonopathy in Parkinson's Disease

New genetic and environmental studies of Parkinson's disease have revealed early problems in synaptic function and connectivity indicating that axonal impairment may be an important hallmark in this disorder. Since many studies suggest that axonal dysfunction precedes cell body loss, it is critical to target axons with treatments aimed at preserving "connectivity" as well as to develop and verify "biomarkers" with which to assess disease progression and drug efficacy.
Methylation of avpr1a in the cortex of wild prairie voles: effects of CpG position and polymorphism

DNA methylation can cause stable changes in neuronal gene expression, but we know little about its role in individual differences in the wild. In this study, we focus on the vasopressin 1a receptor (avpr1a), a gene extensively implicated in vertebrate social behaviour, and explore natural variation in DNA methylation, genetic polymorphism and neuronal gene expression among 30 wild prairie voles (Microtus ochrogaster). Examination of CpG density across 8 kb of the locus revealed two distinct CpG islands overlapping promoter and first exon, characterized by few CpG polymorphisms. We used a targeted bisulfite sequencing approach to measure DNA methylation across approximately 3 kb of avpr1a in the retrosplenial cortex, a brain region implicated in male space use and sexual fidelity. We find dramatic variation in methylation across the avrp1a locus, with pronounced diversity near the exon–intron boundary and in a genetically variable putative enhancer within the intron. Among our wild voles, differences in cortical avpr1a expression correlate with DNA methylation in this putative enhancer, but not with the methylation status of the promoter. We also find an unusually high number of polymorphic CpG sites (polyCpGs) in this focal enhancer. One polyCpG within this enhancer (polyCpG 2170) may drive variation in expression either by disrupting transcription factor binding motifs or by changing local DNA methylation and chromatin silencing. Our results contradict some assumptions made within behavioural epigenetics, but are remarkably concordant with genome-wide studies of gene regulation.
Repair of tetralogy of Fallot associated with atrioventricular septal defect

Abstract Tetralogy of Fallot, when associated with atrioventricular septal defect permitting shunting at ventricular level, represents a complex cyanotic congenital malformation. Experience with surgical repair is limited, and results vary considerably. Between 1984 and 1996, we repaired 14 consecutive patients with this combination seen in our center. Their ages ranged from 8 months to 21 years (median 7.4 years). Six (42.9%) had Down's syndrome. In eight patients the correct diagnosis was made using echocardiogra phy alone. In the remaining six patients, who had previously-constructed arterial shunts and/or suspected pulmonary arterial stenosis, catheterization and angiocardiography were also performed. The repair consisted of double patch closure of the septal defect, reconstruction of two atrioventricular orifices, and relief of pulmonary stenosis at all levels. In five patients with a hypoplastic pulmonary trunk, a monocusp transannular patch (four patients) or an allograft (one patient) was used for restroration of continuity from the right ventricle to the pulmonary arteries. Patch enlargement of one or both pulmonary arteries was necessary in five patients. One patient (7.1%) died early, and another late. The twelve surviving (85.8%) patients have been followed for 1.2–12.5 years after surgery (median 4.9 years, mean 5.9 ± 3.9 years). During the follow-up, reoperation was necessary for repair of residual ventricular septal defect and pulmonary regurgitation in two patients, and closure of an atrial septal defect and alteration to left atrioventricular valvar regurgitation in one patient. Seven patients are in class I of the New York Heart Association, four in class II, and one in class III. Tetralogy of Fallot associated with atrioventricular septal defect can be corrected with low mortality and good long-term results. Residual lesions, however, have a tendency to progress, especially when seen in combination. After surgery, all patients need long-term close follow-up.
Inequality in 30-day mortality and the wait for surgery after hip fracture: the impact of the regional health care evaluation program in Lazio (Italy).

OBJECTIVE INTERVENTIONS that address inequalities in health care are a priority for public health research. We evaluated the impact of the Regional Health Care Evaluation Program in the Lazio region, which systematically calculates and publicly releases hospital performance data, on socioeconomic differences in the quality of healthcare for hip fracture. DESIGN Retrospective cohort study. SETTING and participants We identified, in the hospital information system, elderly patients hospitalized for hip fracture between 01 January 2006 and 31 December 2007 (period 1) and between 01 January 2009 and 30 November 2010 (period 2). MAIN OUTCOME MEASURES We used multivariate regression models to test the association between socioeconomic position index (SEP, level I well-off to level III disadvantaged) and outcomes: mortality within 30 days of hospital arrival, median waiting time for surgery and proportion of interventions within 48 h. RESULTS We studied 11 581 admissions. Lower SEP was associated with a higher risk of 30-day mortality in period 1 (relative risk (RR) = 1.42, P = 0.027), but not in period 2. Disadvantaged people were less likely to undergo intervention within 48 h than well-off persons in period 1 (level II: RR = 0.72, P < 0.001; level III: RR = 0.46, P < 0.001) and period 2 (level II: RR = 0.88, P = 0.037; level III: RR = 0.63, P < 0.001). We observed a higher probability of undergoing intervention within 48 h in period 2 compared with the period 1 for each socioeconomic level. CONCLUSION This study suggests that a systematic evaluation of health outcome approach, including public disclosure of results, could reduce socioeconomic differences in healthcare through a general improvement in the quality of care.
Neoadjuvant Chemotherapy in Malignant Pleural Mesothelioma

Malignant pleural mesothelioma (MPM) is a rare and aggressive tumour with a poor prognosis, directly related to chronic inhalation of asbestos fibres. Despite the extraction, import and marketing of the mineral were banned in most of the industrialized nations, the epidemiologic data foresee a sharp rise of MPM incidence and mortality in the next fifteen years because of the long lag time (even 40 years) from exposure to clinical evidence (Marinaccio et al., 2007).
Investigating the use of chronological split for software effort estimation

In previous studies, the authors investigated separately the use of two different types of chronological splits (project-by-project split and date-based split) for assigning projects to training sets and testing sets. The aim of this study is to compare the two types of chronological splits against each other, to see whether either leads to better prediction accuracy. Estimation models were built and evaluated using training and testing sets formed using project-by-project chronological splitting and date-based splitting using two different splitting dates. The authors used 906 projects from the ISBSG Release 10 repository. The authors found no significant differences between the accuracy of models built and evaluated with either of the different splitting methods. However, models built using later splitting dates were more accurate than models built using earlier splitting dates. Different accuracy with different splitting dates suggests that chronological splitting is useful. Therefore the authors recommend that training and testing sets should be formed with regard to chronology, and a date-based split appears sensible for researchers in this field.
Factors influencing biodiversity and distributional gradients in mangroves

Numerous factors affect the distribution of mangrove plants. Most mangrove species are typically dispersed by water-buoyant propagules, allowing them to lake advantage of estuarine, coastal and ocean currents both to replenish existing stands and to establish new ones. The direction they travel depends on sea currents and land barriers, but the dispersal distance depends on the time that propagules remain buoyant and viable. This is expected to differ for each species. Similarly, each species will also differ in establishment success and growth development rate, and each has tolerance limits and growth responses which are apparently unique. Such attributes are presumably responsible for the characteristic distributional ranges of each species, as each responds to the environmental, physical and biotic settings they might occupy. In practice, species are often ordered by the interplay of different factors along environmental gradients, and these may conveniently be considered at four geographic scales-global, regional, estuarine and intertidal. We believe these influencing factors act similarly around the world, and to demonstrate this point, we present examples of distributional gradients from the two global biogeographic regions, the Atlantic East Pacific and the Indo-West Pacific.
AN ELDERLY PATIENT WITH ACUTE TRANSIENT OUTER RETINAL DISRUPTION RESEMBLING BILATERAL MULTIPLE EVANESCENT WHITE DOT SYNDROME.

PURPOSE To report an unusual case of an elderly patient with transient outer retinal disruption resembling bilateral multiple evanescent white dot syndrome. METHODS Observational case report. Fundus photographs, fluorescein angiography, standard and ultra-widefield fundus autofluorescence, and cross-sectional and en face optical coherence tomography were used to characterize and describe the clinical findings. RESULTS A 67-year-old woman presented with decreased vision and floaters in her left eye. Best-corrected visual acuity was 20/20-3 in the right eye and 20/80-2 in the left eye. Funduscopic examination showed small deep white dots and foveal granularity of the left eye corresponding to hyperautofluorescent spots on fundus autofluorescence and ellipsoid zone disruption on spectral domain optical coherence tomography. The asymptomatic right eye had evidence of subretinal deposits on spectral domain optical coherence tomography but was otherwise unremarkable. At 4-week follow-up, the patient noted resolution of her symptoms in the left eye but had developed floaters and blurry vision in her right eye. The left eye showed resolving white spots and ellipsoid zone disruption. However, the right eye had new evidence of white spots corresponding to hyperautofluorescent spots on fundus autofluorescence. Spectral domain optical coherence tomography demonstrated subretinal deposits overlying areas of ellipsoid zone disruption. At 8-week follow-up, the patient was asymptomatic in both eyes with best-corrected visual acuity of 20/20 in both eyes. The hyperautofluorescent spots on ultra-widefield fundus autofluorescence had faded with restoration of ellipsoid zone disruption in both eyes and disappearance of subretinal deposits. CONCLUSION Our case demonstrates multimodal retinal imaging findings resembling multiple evanescent white dot syndrome in an elderly patient. The bilateral presentation, presence of subretinal deposits before symptom onset, and older age of the patient were atypical features for this entity.
Evaluation of surveillance bias and the validity of the venous thromboembolism quality measure.

IMPORTANCE Postoperative venous thromboembolism (VTE) rates are widely reported quality metrics soon to be used in pay-for-performance programs. Surveillance bias occurs when some clinicians use imaging studies to detect VTE more frequently than other clinicians. Because they look more, they find more VTE events, paradoxically worsening their hospital's VTE quality measure performance. A surveillance bias may influence VTE measurement if (1) greater hospital VTE prophylaxis adherence fails to result in lower measured VTE rates, (2) hospitals with characteristics suggestive of higher quality (eg, more accreditations) have greater VTE prophylaxis adherence rates but worse VTE event rates, and (3) higher hospital VTE imaging utilization use rates are associated with higher measured VTE event rates. OBJECTIVE To examine whether a surveillance bias influences the validity of reported VTE rates. DESIGN, SETTING, AND PARTICIPANTS 2010 Hospital Compare and American Hospital Association data from 2838 hospitals were merged. Next, 2009-2010 Medicare claims data for 954,926 surgical patient discharges from 2786 hospitals who were undergoing 1 of 11 major operations were used to calculate VTE imaging (duplex ultrasonography, chest computed tomography/magnetic resonance imaging, and ventilation-perfusion scans) and VTE event rates. MAIN OUTCOMES AND MEASURES The association between hospital VTE prophylaxis adherence and risk-adjusted VTE event rates was examined. The relationship between a summary score of hospital structural characteristics reflecting quality (hospital size, numbers of accreditations/quality initiatives) and performance on VTE prophylaxis and risk-adjusted VTE measures was examined. Hospital-level VTE event rates were compared across VTE diagnostic imaging rate quartiles and with a quantile regression. RESULTS Greater hospital VTE prophylaxis adherence rates were weakly associated with worse risk-adjusted VTE event rates (r2 = 4.2%; P = .03). Hospitals with increasing structural quality scores had higher VTE prophylaxis adherence rates (93.3% vs 95.5%, lowest vs highest quality quartile; P < .001) but worse risk-adjusted VTE rates (4.8 vs 6.4 per 1000, lowest vs highest quality quartile; P < .001). Mean VTE diagnostic imaging rates ranged from 32 studies per 1000 in the lowest imaging use quartile to 167 per 1000 in the highest quartile (P < .001). Risk-adjusted VTE rates increased significantly with VTE imaging use rates in a stepwise fashion, from 5.0 per 1000 in the lowest quartile to 13.5 per 1000 in the highest quartile (P < .001). CONCLUSIONS AND RELEVANCE Hospitals with higher quality scores had higher VTE prophylaxis rates but worse risk-adjusted VTE rates. Increased hospital VTE event rates were associated with increasing hospital VTE imaging use rates. Surveillance bias limits the usefulness of the VTE quality measure for hospitals working to improve quality and patients seeking to identify a high-quality hospital.
Debt Crises: For Whom the Bell Tolls

What a country has done in the past, and what other countries are doing in the present, can feedback for good or for ill in debt markets. We develop a simple model of sovereign bond markets with global investors and endogenous information acquisition about fundamental default probabilities. This model displays hysteresis and contagion in sovereign bond spreads. Small fundamental shocks in one country can induce investors to acquire information, generating price volatility and increased risk premia. These changes may also induce investors to rebalance their portfolio, generating market segmentation and information acquisition in seemingly unrelated economies. Information regimes may persist over time, requiring large improvements in fundamentals to return to more stable bond spread conditions.