Miracle-dz/UniFAR-FTUs huggingface dataset:
A Prospective Randomized Clinical Trial Comparing Metal-On-Metal Total Hip Arthroplasty and Metal-On-Metal Total Hip Resurfacing in Patients Less than 65 Years Old

The purpose of this prospective randomised study is to compare the early clinical results of the metal-on-metal hip resurfacing to metal-on-metal THA. Two hundred and ten hips were randomised between August 2003 and January 2006 (191 subjects). One hundred and two hips were implanted with an uncemented titanium tapered stem, and an uncemented titanium acetabular component and 28 mm metal-on-metal bearing (THA group) and 103 hips received a hybrid metal-on-metal surface replacement arthroplasty (SRA group). No significant difference was found with the WOMAC or Merle d'Aubigné-Postel scales. However, a significantly higher activity level was found in the SRA group (UCLA score 6.3 versus 7.1, p= 0.037) and a greater percentage of the SRA patients returned to heavy or moderate activities at one - year postoperatively (72% versus 39%, p=0.007). No patient in either group presented with thigh pain one year after surgery. Both techniques present similar complication rates (0.15). This study supports the theory of better functional recovery in the short-term favouring the SRA when compared to THA. The clear benefit of surface replacement arthroplasty over THA is proximal femoral bone preservation. However, the long term survivorship of the SRA will determine the real value of the theoretical advantage.
Can Western developmental screening tools be modified for use in a rural Malawian setting?

Objective: To create a more culturally relevant developmental assessment tool for use in children in rural Africa. Design: Through focus groups, piloting work and validation, a more culturally appropriate developmental tool, based on the style of the Denver II, was created. Age standardised norms were estimated using 1130 normal children aged 0–6 years from a rural setting in Malawi. The performance of each item in the tool was examined through goodness of fit on logistic regression, reliability and interpretability at a consensus meeting. The instrument was revised with removal of items performing poorly. Results: An assessment tool with 138 items was created. Face, content and respondent validity was demonstrated. At the consensus meeting, 97% (33/34) of gross motor items were retained in comparison to 51% (18/35) of social items, and 86% (69/80) of items from the Denver II or Denver Developmental Screening Test (DDST) were retained in comparison to 69% (32/46) of the newly created items, many of these having poor reliability and goodness of fit. Gender had an effect on 23% (8/35) of the social items, which were removed. Items not attained by 6 years came entirely from the Denver II fine motor section (4/34). Overall, 110 of the 138 items (80%) were retained in the revised instrument with some items needing further modification. Conclusions: When creating developmental tools for a rural African setting, many items from Western tools can be adapted. The gross motor domain is more culturally adaptable, whereas social development is difficult to adapt and is culturally specific.
The Thermal Evolution following a Superburst on an Accreting Neutron Star

Superbursts are very energetic type I X-ray bursts discovered in recent years by long-term monitoring of X-ray bursters and are believed to be due to unstable ignition of carbon in the deep ocean of the neutron star. In this Letter, we follow the thermal evolution of the surface layers as they cool following the burst. The resulting light curves agree very well with observations for layer masses in the range 1025-1026 g expected from ignition calculations and for an energy release ≳1017 ergs g-1 during the flash. We show that at late times the cooling flux from the layer decays as a power law F ∝ t-4/3, giving timescales for quenching of normal type I bursting of weeks, in good agreement with observational limits. We show that simultaneous modeling of superburst light curves and quenching times promises to constrain both the thickness of the fuel layer and the energy deposited.
Effects of a home-based intervention among patients with congestive heart failure discharged from acute hospital care.

BACKGROUND We examined the effect of a home-based intervention (HBI) on readmission and death among "high-risk" patients with congestive heart failure discharged home from acute hospital care. METHODS Hospitalized patients with congestive heart failure and impaired systolic function, intolerance to exercise, and a history of 1 or more hospital admissions for acute heart failure were randomized to either usual care (n=48) or HBI at 1 week after discharge (n=49). Home-based intervention comprised a single home visit (by a nurse and pharmacist) to optimize medication management, identify early clinical deterioration, and intensify medical follow-up and caregiver vigilance as appropriate. The primary end point of the study was frequency of unplanned readmissions plus out-of-hospital deaths within 6 months of discharge. Secondary end points included duration of hospital stay and overall mortality. RESULTS During follow-up, patients in the HBI group had fewer unplanned readmissions (36 vs 63; P=.03) and fewer out-of-hospital deaths (1 vs 5; P=.11): 0.8+/-0.9 vs 1.4+/-1.8 (mean +/- SD) events per patient assigned to HBI and usual care, respectively (P=.03). Patients in the HBI group also had fewer days of hospitalization (261 vs 452; P=.05) and fewer total deaths (6 vs 12; P=.11). Patients assigned to usual care were more likely to experience 3 or more readmissions for acute heart failure (P=.02). Predictors of unplanned readmission were (1) 14 days or more of unplanned readmission during the 6 months before study entry (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.8-16.2), (2) previous admission for acute myocardial ischemia (OR, 3.3; 95% CI, 1.2-9.1), and (3) an albumin plasma concentration of 38 g/L or less (OR, 2.4; 95% CI, 1.2-6.0). Home-based intervention was also associated with a trend toward reduced risk of unplanned readmission (OR, 0.4; 95% CI, 0.2-1.1). CONCLUSION Among a cohort of high-risk patients with congestive heart failure, HBI was associated with reduced frequency of unplanned readmissions plus out-of-hospital deaths within 6 months of discharge from the hospital.
The Spatiotemporal Pattern of Degeneration in the Cerebellum of the Wobbler Mouse

Amyotrophic lateral sclerosis (ALS) is a common neurodegenerative disease that affects motor neurons in the spinal cord and motor cortex. Various mouse models have been used to investigate the progression of the pathology of sporadic and familial ALS. Degeneration in the spinal cord and motor cortex in the Wobbler mouse model of sporadic ALS have been documented, but alterations of the cerebellum during disease progression have not been well characterized. We analyzed neurodegeneration and inflammatory responses in the cerebellar cortex of preclinical (p20), clinical (p40), and late (p60) stages in these mice. We did not identify evidence of neuron cell death, but we observed an inflammatory response detected by IL1B and TNFA expression by quantitative PCR, increased activated microglia and astrocytosis by immunohistochemistry, and ultrastructural abnormalities in the cerebella of Wobbler mice at late stages. These alterations may be caused by protein aggregations and variations in the distribution of cytoskeletal proteins; they might be reflected in the early manifestation of head tremor, which precedes motor deficits in these mice. Thus, we conclude that, in addition to the motor cortex and spinal cord, the cerebellum is affected by neurodegenerative and inflammatory processes in the Wobbler mouse model of ALS.
Effect of Growth Differentiation Factor 5 on the Proliferation and Tenogenic Differentiation Potential of Human Mesenchymal Stem Cells in vitro

The use of growth differentiation factor 5 (GDF-5) in damaged tendons has been shown to improve tendon repair. It has been hypothesized that further improvements may be achieved when GDF-5 is used to promote cell proliferation and induce tenogenic differentiation in human bone marrow-derived mesenchymal stem cells (hMSCs). However, the optimal conditions required to produce these effects on hMSCs have not been demonstrated in previous studies. A study to determine cell proliferation and tenogenic differentiation in hMSCs exposed to different concentrations of GDF-5 (0, 5, 25, 50, 100 and 500 ng/ml) was thus conducted. No significant changes were observed in the cell proliferation rate in hMSCs treated at different concentrations of GDF-5. GDF-5 appeared to induce tenogenic differentiation at 100 ng/ml, as reflected by (1) a significant increase in total collagen expression, similar to that of the primary native human tenocyte culture; (2) a significant upregulation in candidate tenogenic marker gene expression, i.e. scleraxis, tenascin-C and type-I collagen; (3) the ratio of type-I collagen to type-III collagen expression was elevated to levels similar to that of human tenocyte cultures, and (4) a significant downregulation of the non-tenogenic marker genes runt-related transcription factor 2 and sex determining region Y (SRY)-box 9 at day 7 of GDF-5 induction, further excluding hMSC differentiation into other lineages. In conclusion, GDF-5 does not alter the proliferation rates of hMSCs, but, instead, induces an optimal tenogenic differentiation response at 100 ng/ml.
Tuberculosis in Nazilli District Prison, Turkey, 1997-2001.

SETTING Nazilli District Prison, Turkey. OBJECTIVE To evaluate the tuberculosis situation in a Turkish prison. DESIGN Data obtained between 1997 and 2001 during the systematic annual tuberculosis screening programme undertaken in Nazilli District Prison were evaluated retrospectively. The screening programme consisted of yearly miniature chest radiography, and clinical and bacteriological evaluation of prisoners with abnormalities. Active tuberculosis cases among prisoners diagnosed passively at any time during the period were also studied. RESULTS Over the 5-year period, 99.8% of the prisoners were screened. The mean point prevalence of tuberculosis in Nazilli District Prison was 341 per 100,000 prisoners. The total number of active tuberculosis cases was 13; five were symptomatic, of whom three were detected during screening. The remaining eight cases were determined only by screening. Treatment outcomes were treatment completion for six cases and cure for seven cases. CONCLUSION Because tuberculosis prevalence is high among prisoners, it is necessary to continue screening for tuberculosis in prison in addition to passive case-finding activities. Treatment success is satisfactory in Nazilli District Prison. Screening of prison staff, contact examination and preventive approaches need further investigation.
Implications of Insights from Behavioral Economics for Macroeconomic Models

The last 20 years, the importance of a number of behavioral features has been widely accepted within economics, and they are now regularly included in standard macro models. Where has this development led us? I argue that the insights from behavioral economics have led to important progress in our understanding of macroeconomic phenomena. One of the most important is the effect of fairness considerations on wages and employment relationships. Another important insight is that most or all individuals are affected by various behavioral features, which should be taken into account in the design of saving plans and pension schemes. A third insight is that plausible macro models provide large scope for important effects of sentiments and psychological factors. Future research should follow different routes, like incorporating behavioral features in standard models, improving estimated empirical models, and learning from case studies and historical episodes.
Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society Clinical Practice Guideline.

OBJECTIVE The objective is to provide guidelines for the evaluation and treatment of adults with GH deficiency (GHD). PARTICIPANTS The chair of the Task Force was selected by the Clinical Guidelines Subcommittee of The Endocrine Society (TES). The chair selected five other endocrinologists and a medical writer, who were approved by the Council. One closed meeting of the group was held. There was no corporate funding, and members of the group received no remuneration. EVIDENCE Only fully published, peer-reviewed literature was reviewed. The Grades of Evidence used are outlined in the Appendix. CONSENSUS PROCESS Consensus was achieved through one group meeting and e-mailing of drafts that were written by the group with grammatical/style help from the medical writer. Drafts were reviewed successively by the Clinical Guidelines Subcommittee, the Clinical Affairs Committee, and TES Council, and a version was placed on the TES web site for comments. At each level, the writing group incorporated needed changes. CONCLUSIONS GHD can persist from childhood or be newly acquired. Confirmation through stimulation testing is usually required unless there is a proven genetic/structural lesion persistent from childhood. GH therapy offers benefits in body composition, exercise capacity, skeletal integrity, and quality of life measures and is most likely to benefit those patients who have more severe GHD. The risks of GH treatment are low. GH dosing regimens should be individualized. The final decision to treat adults with GHD requires thoughtful clinical judgment with a careful evaluation of the benefits and risks specific to the individual.
Gastrointestinal and Liver Involvement in Falciparum Malaria

Nausea and vomiting are common symptoms found in falciparum malaria, particularly in children with high fever. Vomiting may be provoked by antimalarial drug treatment. While diarrhea has been reported from some parts of the world, it appears to be uncommon in others. Although malabsorption of amino acids, sugars, fats, chloroquine and quinine have been documented, in most studies the absorption of oral antimalarials in uncomplicated malaria has been normal in even the most seriously ill patients. In the acute phase of severe falciparum malaria, patients show the greatly reduced absorption of those sugars that rely on mediated mechanisms and unmediated diffusion. Absorption returns to normal in convalescence. Gastric emptying is normal in uncomplicated falciparum malaria. Biopsies of the gut show parasite sequestration in the vascular bed which presumably interferes with the process of absorption. Gastrointestinal permeability is increased during severe and uncomplicated falciparum malaria but reverts to normal in convalescence. Endotoxemia may also originate in the gut. Gram-negative bacteria or endotoxin may shift from the gut lumen; the normal hepatic clearance mechanisms may fail. Hyperbilirubinemia is attributable to intravascular hemolysis of parasitized erythrocytes and to hepatic dysfunction and possibly to an element of microangiopathic hemolysis associated with disseminated intravascular coagulation. Impairment of hepatic function is common in severe malaria. Unfortunately, assessment of uliver functionu by measurement of blood concentrations of bilirubin and liver-related enzymes is notoriously imprecise, particularly in the presence of coexisting hemolysis, Jaundice is more common in adults with severe malaria than in children. The measurable consequences of hepatic dysfunction are coagulation abnormalities resulting from failure of clotting factor syntheses, hypoalbuminemia, and reduced metabolic clearance of many substances, including alanine, lactate, and antimalarial drugs. The biotransformation of drugs, particularly those metabolized by hepatic microsomal enzymes, is reduced in proportion to disease severity. Hepatic blood flow is reduced during acute malaria and is significantly lower in severe malaria than in uncomplicated malaria; it returns to normal during convalescence. Hepatic microsomal metabolism is also apparently slow in severe falciparum malaria but reverts to normal in convalescence. Liver metabolic function does not appear to be significantly affected in uncomplicated malaria.
Spray-dried doxorubicin-albumin microparticulate systems for treatment of multidrug resistant melanomas

As multidrug resistance continues to be a problem in cancer treatment, controlled release delivery systems, such as microspheres, may aid to give a slower release of anticancer drugs into drug resistant tumor cells. In this study doxorubicin microspheres microencapsulated in an albumin matrix were prepared via the spray-drying method and characterized for particle size, content analysis, and release studies. They were then evaluated in vitro using drug resistant murine melanoma tumor cells for uptake and efflux studies. Spray-drying produced a dispersed powder with a mean particle size of 4.91 ± 1.2 µm, 60% product yield, and encapsulation efficiency of 85% and a ζ potential range of 37 to −40 mV. Intracellular doxorubicin concentrations were higher in drug resistant tumor cells treated with microspheres as opposed to solution, and efflux of doxorubicin from the tumor cell was inhibited. Greater cytotoxic effects were seen in tumor cells treated with doxorubicin microspheres versus solution up to and after 3 days. In vivo pharmacokinetic studies conducted in male Sprague–Dawley rats, revealed a plasma-level time curve indicative of a two-compartment model, and showed prolonged half-life of doxorubicin, greater area under the plasma concentration time curve, and increased plasma concentrations of doxorubicin in rats at 8 and 24 h after administration of doxorubicin microspheres.
Prevalence of diabetes mellitus in a Saudi community

Background and Objectives : Quantifying the prevalence of diabetes mellitus is important to allow for rational planning and allocation of resources. Therefore, we designed this study to determine the prevalence of diabetes among Saudi nationals. Design and Setting : A cross-sectional study among patients attending a primary care clinic in June 2009. Patients and Methods : Patients were interviewed with structured questionnaires to determine the presence of diabetes by questioning for history of the disease, and charts were reviewed to document any diabetic therapies that the patients may have undergone in the past or were undergoing at that time. Results : Of 6024 subjects, diabetes mellitus was present in 1792 (30%) patients. The mean (SD) age of the patients was 55.3 (13.2) years. The prevalence of diabetes was 34.1% in males and 27.6% in females (P<.0001). The mean (SD) age for onset of diabetes in males and females was 57.5 (13.1) and 53.4 (13.1) years, respectively (P<.0001). Females <50 years old had a higher prevalence than males in the corresponding age range-34.1% and 25.1%, respectively (P<.0001). The prevalence of diabetes decreased in patients older than 70 years. The prevalence of body mass index of ≥25 was 72.5%. Among patients with diabetes, the prevalence of body mass index of ≥25 was 85.7% (P<.0001). There was a higher prevalence of obesity (body mass index, ≥25) in females (87.7%) as compared to males (83.1%) (P=.008). Conclusion : The prevalence of diabetes is high among the Saudi population and represents a major clinical and public health problem. A national prevention program to prevent diabetes and address the modifiable risk factors at the community level, targeting high-risk groups, should be implemented soon.
Examining Pre-Service Teachers' Pedagogical Content Knowledge With Regard To Curriculum Knowledge*

One of the components of pedagogical content knowledge is curriculum knowledge. Curriculum contains aims and objectives which belong to the subjects that the teachers will teach and explain the skills that students are supposed to be obtained. Constructivist model was adopted instead of behaviourist model of teaching mathematics with changes in the secondary mathematics program in Turkey in 2005. In this study, we aimed at determining pre-service teachers' curriculum knowledge related to the limit and continuity concept. First, Content Knowledge Questionnaire on the limit and continuity concept was administered to 37 pre-service teachers. According to the results of the questionnaire, four pre-service teachers were selected with different levels of subject matter knowledge. Interviews were conducted with the selected pre-service teachers; their lesson plans of limit and continuity were examined and their micro-teaching was observed. Data obtained shows that the pre-service teachers' curriculum knowledge was limited.
A Sensemaking Approach to Ethics Training for Scientists: Preliminary Evidence of Training Effectiveness

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed.
Presence of fibronectin peptides in saliva of patients with Sjögren's syndrome: a potential indicator of salivary gland destruction.

OBJECTIVE The purpose of this preliminary study was to monitor the degree of destruction of salivary glands in Sjögren disease by the detection of fibronectin peptides in patients' saliva. STUDY DESIGN The sample consisted of 10 subjects divided in 2 groups, one with Sjögren disease and a control group. Saliva samples were submitted to an inmunodetection analysis. In addition, non pathological salivary glands, obtained from 2 subjects who underwent minor oral surgery, were incubated with leukocyte homogenates and analysed to compare the obtained fragments. RESULTS The inmunodetection analysis of Sjögren saliva revealed multiple protein bands, including fibronectin, that were not present in saliva from healthy individuals. The inmunostained bands varied depending on the course of the disease, showing more fibronectin fragments in an active phase. Furthermore, results obtained from the non-pathological glands incubated with leukocyte homogenates were similar to those revealed in saliva from Sjögren patients. CONCLUSION The presence of fibronectin peptides in Sjögren patients' saliva can constitute a method to monitor activity in Sjögren's disease.
The Credibility of Child Witnesses Seen on Closed-Circuit Television

Helen Westcott is Researcher at the NSPCC, London, and worked as Research Assistant on the Child Witness Project at the Polytechnic of East London until recently. Graham Davies is Professor of Psychology at the University of Leicester, and Brian Clifford is Professor of Psychology at the Polytechnic of East London. This article summarises a paper given at the International Conference of Applied Psychology, Kyoto, Japan, July 1990. The research described in this article was made possible by generous financial support from the Police Foundation and the PEL Research Initiative Fund.