Miracle-dz/UniFAR-FTUs huggingface dataset:
Low infection rates after 34,361 intramedullary nail operations in 55 low- and middle-income countries

Background The Surgical Implant Generation Network (SIGN) supplies intramedullary (IM) nails for the treatment of long bone fractures free of charge to hospitals in low- and middle-income countries (LMICs). Most operations are reported to the SIGN Online Surgical Database (SOSD). Follow-up has been reported to be low, however. We wanted to examine the pattern of follow-up and to assess whether infection rates could be trusted. Patients and methods The SOSD contained 36,454 IM nail surgeries in 55 LMICs. We excluded humerus and hip fractures, and fractures without a registered surgical approach. This left 34,361 IM nails for analysis. A generalized additive regression model (gam) was used to explore the association between follow-up rates and infection rates. Results The overall follow-up rate in the SOSD was 18.1% (95% CI: 17.7–18.5) and national follow-up rates ranged from 0% to 74.2%. The overall infection rate was 0.7% (CI: 0.6–0.8) for femoral fractures and 1.2% (CI: 1.0–1.4) for tibial fractures. If only nails with a registered follow-up visit were included (n = 6,224), infection rates were 3.5% (CI: 3.0–4.1) for femoral fractures and 7.3% (CI: 6.2–8.4) for tibial fractures. We found an increase in infection rates with increasing follow-up rates up to a level of 5%. Follow-up above 5% did not result in increased infection rates. Interpretation Reported infection rates after IM nailing in the SOSD appear to be reliable and could be used for further research. The low infection rates suggest that IM nailing is a safe procedure also in low- and middle-income countries.
The Effects of Swimming Exercise and Probiotic VSL#3 on Zonulin and Some Inflammatory and Oxidative Parameters in Rats (1)

Moderate exercise stimulates immune system whereas intensive exercise may display immune-suppressive effect associated with the disruption of intestinal barrier. With this study, we tested the effects of moderate and intensive swimming exercises on some cytokines and oxidant variables and zonulin, an intestinal barrier marker, in rats. We also tested possible ameliorative effects of probiotic VSL#3 in both moderate and intensive exercise regimens. Twenty eight rats were randomly divided into 4 equal groups: Control-C, Probiotic-P, Exercise-E, Probiotic+Exercise-PE. The rats in group E and PE underwent moderate swimming exercise for 5 weeks. Following this period, intensive swimming exercise was performed for 5 days. The rats in group C and group P were sedentary. Probiotic VSL#3 was given to group P and PE in the water. At the end of the experiments, serum zonulin, TNF-α, IL-6, IL-10, TGF-β, MDA, and protein carbonyl levels were determined. Evidences obtained from present study indicate that moderate swimming exercise improves barrier integrity of intestine and decreases oxidative stress. During the moderate swimming experiment, probiotic VSL#3 supplementation may also improve inflammatory response. On the other hand, intensive exercise does not led changes in the inflammatory response and oxidative stress, but beneficial responses of moderate exercise on the selected parameters probably disappear due to the intense exercise-induced mild stress.
Rheumatoid arthritis-interstitial lung disease-associated mortality.

RATIONALE Mortality rates from rheumatoid arthritis-associated interstitial lung disease (RA-ILD) are largely unknown. OBJECTIVES We sought to determine mortality rates from rheumatoid arthritis-associated interstitial lung disease in the United States from 1988 through 2004. METHODS Using data from the National Center for Health Statistics, we calculated age-adjusted mortality rates from the deaths of persons with rheumatoid arthritis-associated interstitial lung disease, determined the prevalence of interstitial lung disease in all decedents with rheumatoid arthritis, and compared the age and underlying cause of death in these two cohorts of decedents. MEASUREMENTS AND MAIN RESULTS From 1988 to 2004, there were 39,138,394 deaths in U.S. residents and 162,032 rheumatoid arthritis-associated deaths. Of these deaths, 10,725 (6.6%) met criteria for rheumatoid arthritis-associated interstitial lung. Mortality rates from rheumatoid arthritis fell over the course of this study in both women and men. However, mortality rates from rheumatoid arthritis-associated interstitial lung disease increased 28.3% in women (to 3.1 per million persons in 2004) and declined 12.5% in men (to 1.5 per million persons in 2004). Because the rate of decline in rheumatoid arthritis outpaced rheumatoid arthritis-associated interstitial lung disease in men, the prevalence of rheumatoid arthritis-associated interstitial lung disease increased in both sexes over time. CONCLUSIONS Clinically significant RA-ILD occurs in nearly 10% of the RA population, and is associated with shortened survival and more severe underlying disease. Whereas overall mortality rates for RA have fallen, those associated with RA-ILD have increased significantly in older age groups.
Inheritance, Stability, and Dominance of Cry Resistance in Culex quinquefasciatus (Diptera: Culicidae) Selected with the Three Cry Toxins of Bacillus thuringiensis subsp. israelensis

ABSTRACT Mendelian crosses were used to study the mode of inheritance of Cry toxin resistance in a Culex quinquefasciatus Say (Diptera: Culicidae) colony (CqAB11A) that evolved insecticide resistance under laboratory selection with a deletion mutant of Bacillus thuringiensis subsp. israelensis de Barjac lacking the Cyt1Aa toxin component but containing its three major Cry toxins, Cry4Aa, Cry4Ba, and Cry11Aa. High levels of resistance were observed to Cry toxins. F1 offspring of reciprocal crosses to a sensitive colony showed intermediate levels of resistance with no maternal effect, indicating autosomal inheritance. Dose—response data for backcross offspring deviated significantly from the monofactorial model when tested with Cry4Aa + Cry4Ba + Cry11Aa, Cry4Aa + Cry4Ba, or Cry11Aa. However, tests with Cry11Ba from B. thuringiensis subsp. jegathesan (Seleena, Lee, Lecadet) fit the monofactorial model. Dominance of F1 offspring was calculated at different concentrations of Cry-toxin suspensions and, as reported for other Cry-resistant Culex, generally decreased as concentration increased. A subset of colony CqAB11A was reared without selection pressure for 18 generations with little change in susceptibility, indicating a highly homozygous population. Consistent with reports for other Cry-resistant Culex, the data show these mosquitoes evolved resistance to B. thuringiensis Cry toxins at multiple loci in response to selection pressure and that cross-resistance to Cry11Ba was conferred by one of those loci.
Peripheral blood mononuclear cells serve as a possible extrahepatic site for hepatitis C virus replication.

Hepatitis C virus (HCV) is thought to have a strong tropism for hepatic tissue but also replicative intermediates are found in extrahepatic tissues suggesting active viral replication in these cells. The aim of the study is to confirm that HCV can infect and replicate in the peripheral blood mononuclear cells (PBMCs) as one of the possible sites of extrahepatic hepatitis C virus replication during the natural course of infection which may serve as a source of virions causing reinfection. Reverse transcriptase Polymerase chain reaction (RT-PCR) for detection of positive and negative strands of HCV-RNA in PBMCs was done for 30 patients with chronic HCV infection admitted to Ain Shams University Hospitals and the results were compared with those from 20 healthy controls matched in age and sex. Our results revealed statistically significant association between both HCV-RNA positive strand and negative strand and both serum HCV-RNA and HCV-Antibody (Ab) (P<0.01). Moreover the association between the presence of HCV positive- and negative-strand RNA in PBMCs was statistically significant (P<0.01). Finally the correlation between HCV positive and negative stranded RNA in PBMCs and extrahepatic complications was statistically significant (P<0 .01). In conclusion our results support previous observations indicating that HCV can infect PBMCs. This is reflected by a higher frequency of extrahepatic complications and diseases associated with chronic HCV infection.
Awareness and knowledge of mother-to-child transmission of HIV among mothers attending the pediatric HIV clinic, Kano, Nigeria.

BACKGROUND Nigeria accounts for about 10% of all HIV/AIDS cases in the world. Globally women constitute 48% of adults infected with HIV; in Nigeria, they constitute 57%. There is an increase in the number of children infected with HIV in recent years as the number of HIV-positive women has increased. However, more than 90% of HIV infections in children aged less than 15 years are due to mother-to-child transmission of HIV. OBJECTIVE To evaluate the awareness and knowledge of mother-to-child transmission of HIV, HIV/AIDS and the methods to prevent mother-to-child transmission of HIV. METHODS This is a descriptive study. The study was carried out at the pediatric HIV clinic of Aminu Kano Teaching Hospital from 1 st July 2006 to 30 th December 2006. Mothers included in the study were mothers in first contact with HIV facilities, which was at our center, before any form of counseling. The instrument used was a questionnaire designed to assess awareness of the mothers about HIV/AIDS, evaluate their knowledge of possible routes of transmission and measures to prevent vertical transmission. The questionnaire was then pre-tested for comprehensibility, appropriateness of language, sensitivity of questions and average duration of administration. RESULTS A total of 164 mothers brought their children for treatment to the pediatric HIV clinic. The level of awareness about HIV/AIDS among mothers was very high (100%), and the main sources of information were radio (48.8%) and television (37.8%). Ninety-one percent of mothers were aware of mother-to-child transmission of HIV. Transplacental route (41%) was the commonly identified route of transmission. The level of knowledge and perceptions of mother-to-child transmission of HIV is inadequate. CONCLUSION There is a need to scale up education about mother-to-child transmission of HIV in our health facilities.
Effective shear stress of graded sediments

A meta‐analysis of fractional mobilization data from 14 sets of experiments, totaling 103 different mixed sand and gravel beds and flow conditions, has been carried out in order to identify an expression for effective shear stress, here defined as the component of bed shear stress that is directly involved in transporting each grain size fraction in graded sediment. In doing so we test the assumption that excess stress should be defined solely in terms of a critical stress rather than effective stress, which exhibits sensitivity to the flow stage. In contrast to the approach which evaluates the size‐distribution effects on motion threshold by comparing inferred transport rates, an alternative approach is utilized which is based on the skill of reproducing the measured, mobilized particle size distribution. A simple equation is developed for mobilization of sediment mixtures, based on a well‐established transport law, and employing a classical “hiding function” approach to the problem of mitigating the bias toward mobilizing fine material in the mixture. We use inverse methods to find the optimal form of the hiding function which provides the best fit with the data. We find that the hiding function is indeed sensitive to the flow and bed composition. On this basis, a simple deterministic equation is proposed for fraction‐specific effective stress, which outperforms the next best existing formula based on critical stress by 34% on aggregate.
Economic evaluation of BDP/formoterol fixed vs two single inhalers in asthma treatment

To cite this article: Brüggenjürgen B, Ezzat N, Kardos P, Buhl R. Economic evaluation of BDP/formoterol fixed vs two single inhalers in asthma treatment. Allergy 2010; 65: 1108–1115.
Induction of USP17 by combining BET and HDAC inhibitors in breast cancer cells

Members of the bromodomain and extra-C terminal (BET) domain protein family and the histone deacetylase (HDAC) enzyme family regulate the expression of important oncogenes and tumor suppressor genes. Here we show that the BET inhibitor JQ1 inhibits proliferation and induces apoptosis of both triple negative and estrogen receptor positive breast cancer cells. Consistent with the critical role of histone acetylation in the regulation of gene expression, treatment with JQ1 or the HDAC inhibitor mocetinostat was associated with global changes in gene expression resulting in suppression of genes involved in cell-cycle regulation. Combining JQ1 with mocetinostat, further decreased cell viability. This synergistic effect was associated with increased suppression of genes essential for cell-cycle progression. Furthermore, we detected dramatic increase in the expression of several members of the ubiquitin–specific protease 17 (USP17) family of deubiquitinating enzymes in response to the combination treatment. Increased expression of USP17 enzymes were able to attenuate the Ras/MAPK pathway causing decrease in cell viability, while, siRNA mediated depletion of USP17 significantly decreased cytotoxicity after the combination treatment. In conclusion, our study demonstrates that co-treatment with BET inhibitors and HDAC inhibitors reduces breast cancer cell viability through induction of USP17.
Plasma Homocysteine Levels and Parkinson Disease: Disease Progression, Carotid Intima-media Thickness and Neuropsychiatric Complications

Objective: To determine whether plasma homocysteine (Hcy) levels are associated with clinical characteristics, neuropsychological and psychiatric manifestations and cardiovascular comorbidity in patients with Parkinson disease (PD). Background: Elevated Hcy levels are linked to atherosclerosis, vascular disease, depression, and dementia. Patients with PD treated with L-dopa have been shown to have elevated Hcy levels. Design/Methods: Idiopathic PD patients were evaluated using the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr stage, Parkinson Psychosis Rating Scale, Beck Depression Inventory, Frontal Assessment Battery, Mini-Mental Status Examination, and several tests for frontal type cognitive functions. Fasting blood samples were collected for the measurement of Hcy, and carotid B-mode ultrasound was performed to measure intima-media thickness of the common carotid arteries. Results: Seventy-two consecutive PD patients (46 men; average age, 68.7 ± 11.6 years; average disease duration, 7.0 ± 4.7 years) were recruited. All but 10 patients were treated with L-dopa. The average level of Hcy was 16.4 ± 7.8 &mgr;mol/L, and 38.9% of the patients had Hcy level above the reference range (>15.0 &mgr;mol/L). The Hcy levels were associated with PD duration as they were with L-dopa treatment duration but were not associated with the parameters of disease severity or with L-dopa dose. The Hcy levels were associated neither with the common carotid intima-media thickness nor with cardiovascular morbidity. No association was found between Hcy and the neuropsychiatric features of PD such as depression, cognitive performance, or psychosis. Conclusions: Hyperhomocystinemia is common in L-dopa-treatedPD patients but was not associated with neuropsychological complications (depression, dementia, and cognitive decline associated with frontal lobe functioning or psychosis), enhanced disease severity, or vascular comorbidity.
Paroxysmal dysarthria and other transient neurological disturbances in disseminated sclerosis.

The alternation of relapse and remission is one of the outstanding characteristics of disseminated sclerosis. Relapse has been defined as 'the appearance of a new symptom . or the return or exacerbation of a previous symptom' (McAlpine, Compston, and Lumsden, 1955). Classically, these symptoms last for days, weeks, or months. Distinct from the true relapse, the 'fluctuation' (Muller, 1949), or 'tempor-ary exacerbation' is also well recognized and has been defined as 'the re-appearance of an old symptom or the exaggeration of an existing symptom for a short period, i.e., minutes, hours, or a few days' (McAlpine et al., 1955). subdivides these attacks into two groups, according (McAlpine, variety as Routine blood tests, and the cerebrospinal fluid pressure and constituents were normal, and the Wassermann reaction was negative. Plain radiography of skull and chest and vertebral angiography showed no abnormality. The electroencephalogram (E.E.G.) showed wide- spread medium theta activity over both hemispheres, and provoked several paroxysms of bilateral, synchronous, high-voltage, 3 per second slow waves.
Gender-Related Differential Effects of Obesity on Health-Related Quality of Life via Obesity-Related Comorbidities: A Mediation Analysis of a French Nationwide Survey

Background—Negative effects of obesity on health-related quality of life (HRQoL) have been reported, especially in women, but the relative contribution of cardiometabolic and other obesity-related comorbidities to such effects remains unclear. Our objective was to model the association by sex between body mass index and HRQoL and to precisely quantify the indirect effects mediated by obesity-related comorbidities. Methods and Results—Data were drawn from the latest French Decennial Health Survey, a nationwide cross-sectional study conducted in 2003 (21 239 adults aged 25–64 years analyzed). HRQoL was measured by the 36-item short-form health survey questionnaire. A mediation analysis based on the counterfactual framework was performed to quantify the proportion of obesity effects on HRQoL mediated by related comorbidities, including cardiometabolic risk factors (diabetes mellitus, hypertension, dyslipidemia) and diseases (ischemic heart disease, cerebrovascular, and peripheral vascular disease), musculoskeletal disorders, and asthma. After multiple linear regression, inverse associations were found between increasing body mass index category and physically oriented and most mentally oriented 36-item short-form health survey dimensions, with evidence of greater effects in women. Mediation analysis revealed that obesity effects were significantly mediated by several comorbidities, more apparently in men (eg, proportion of obesity class II total effect mediated via cardiometabolic factors: general health 27.0% [men] versus 13.6% [women]; proportion of obesity class II total effect mediated via total count of comorbidities: physical functioning 17.8% [men] versus 7.7% [women] and general health 37.1% [men] versus 20.3% [women]). Conclusions—Women have a greater overall impact of obesity on HRQoL, but with proportionally lower effects mediated by cardiometabolic and other obesity-related conditions, suggesting the possible role of other specific psychosocial processes.
Speech perception and lexical effects in specific language impairment

Using an identification task, we examined lexical effects on the perception of vowel duration as a cue to final consonant voicing in 12 children with specific language impairment (SLI) and 13 age-matched (6;6–9;6) peers with typical language development (TLD). Naturally recorded CV/t/sets [word–word (WW), nonword–nonword (NN), word–nonword (WN) and nonword–word (NW)] were edited to create four 12-step continua. Both groups used duration as an identification cue but it was a weaker cue for children with SLI. For NN, WN and NW continua, children with SLI demonstrated certainty at shorter vowel durations than their TLD peers. Except for the WN continuum, children with SLI demonstrated category boundaries at shorter vowel durations. Both groups exhibited lexical effects, but they were stronger in the SLI group. Performance on the WW continuum indicated adequate perception of fine-grained duration differences. Strong lexical effects indicated reliance on familiar words in speech perception.
Prediction of the requirement of open reduction for developmental dysplasia of the hip

Objective Closed reduction (CR) is a noninvasive treatment for developmental dysplasia of the hip (DDH), and this treatment is confirmed intraoperatively. This study aimed to develop a preoperative estimation model of the probability of requiring open reduction (OR) for DDH. Methods The study design was cross-sectional by screening all patients younger than 2 years who had attempted CR between October 2012 and July 2016 by a single surgeon. Potential diagnostic determinants were sex, age, side, bilaterality, International Hip Dysplasia Institute (IHDI) grade, and acetabular index (AI). An intraoperative arthrogram was the reference standard. A logistic regression equation was built from a reduced model. Bootstrapping was performed for internal validity. Results A total of 164 hips in 104 patients who met the inclusion criteria were analysed. The prevalence of CR was 72.2%. Independent factors for OR were older age, higher IHDI grade, and lower AI. The probability of OR = 1/[1 + exp − (−2.753 + 0.112 × age (months) + 1.965 × IHDI grade III (0 or 1) + 3.515 × IHDI grade IV (0 or 1) − 0.058 × AI (degrees)]. The area under the curve was 0.79. Conclusion This equation is an objective tool that can be used to estimate the requirement for OR.
92 Area Fumigation with Hydrogen Peroxide Vapor

The ability to safely and reproducibly decontaminate enclosed areas like isolators and rooms is an important consideration to many industrial, research, and healthcare facilities. Traditionally, formaldehyde has been used, but safety and efficacy concerns have highlighted the need for alternative methods. Vaporized Hydrogen Peroxide, as used in STERIS Corporation’s VHP® Technology, is a dry gaseous method that has been used as a reliable alternative for aseptic processing isolators and more recently for room/facility decontamination. In this report the antimicrobial efficacy of VHP Technology has been studied under worst-case test conditions, including the presence of contaminating soils which may be present under certain applications. Geobacillus stearothermophilus spores were verified as being the most resistant organism to the fumigation process while paper was identified as the most resistant material. Efficacy was then verified in the presence of 10% and 50% whole blood, as representative soils to ensure fumigant penetration. Typical VHP fumigation processes in rigid and flexible-walled isolators showed a 6 log10 reduction under these worst-case test conditions. Like other biocides, the microbiocidal activity of vaporized hydrogen peroxide is affected by the presence of soil, but these results confirm that VHP Technology can decontaminate under soiled conditions within a routine decontamination process.
Edge Detection: A Collection of Pixel based Approach for Colored Images

The existing traditional edge detection algorithms process a single pixel on an image at a time, thereby calculating a value which shows the edge magnitude of the pixel and the edge orientation. Most of these existing algorithms convert the coloured images into gray scale before detection of edges. However, this process leads to inaccurate precision of recognized edges, thus producing false and broken edges in the image. This paper presents a profile modelling scheme for collection of pixels based on the step and ramp edges, with a view to reducing the false and broken edges present in the image. The collection of pixel scheme generated is used with the Vector Order Statistics to reduce the imprecision of recognized edges when converting from coloured to gray scale images. The Pratt Figure of Merit (PFOM) is used as a quantitative comparison between the existing traditional edge detection algorithm and the developed algorithm as a means of validation. The PFOM value obtained for the developed algorithm is 0.8480, which showed an improvement over the existing traditional edge detection algorithms.