Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk Factors for Blood Transfusion With Primary Posterior Lumbar Fusion

Study Design. Retrospective cohort study. Objective. To identify factors associated with blood transfusion for primary posterior lumbar fusion surgery, and to identify associations between blood transfusion and other postoperative complications. Summary of Background Data. Blood transfusion is a relatively common occurrence for patients undergoing primary posterior lumbar fusion. There is limited information available describing which patients are at increased risk for blood transfusion, and the relationship between blood transfusion and short‐term postoperative outcomes is poorly characterized. Methods. The American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP) database was used to identify patients undergoing primary posterior lumbar fusion from 2011 to 2013. Multivariate analysis was used to find associations between patient characteristics and blood transfusion, along with associations between blood transfusion and postoperative outcomes. Results. Out of 4223 patients, 704 (16.7%) had a blood transfusion. Age 60 to 69 (relative risk [RR] 1.6), age greater than equal to 70 (RR 1.7), American Society of Anesthesiologists class greater than equal to 3 (RR 1.1), female sex (RR 1.1), pulmonary disease (RR 1.2), preoperative hematocrit less than 36.0 (RR 2.0), operative time greater than equal to 310 minutes (RR 2.9), 2 levels (RR 1.6), and 3 or more levels (RR 2.1) were independently associated with blood transfusion. Interbody fusion (RR 0.9) was associated with decreased rates of blood transfusion. Receiving a blood transfusion was significantly associated with any complication (RR 1.7), sepsis (RR 2.6), return to the operating room (RR 1.7), deep surgical site infection (RR 2.6), and pulmonary embolism (RR 5.1). Blood transfusion was also associated with an increase in postoperative length of stay of 1.4 days (P < 0.001). Conclusion. 1 in 6 patients received a blood transfusion while undergoing primary posterior lumbar fusion, and risk factors for these occurrences were characterized. Strategies to minimize blood loss might be considered in these patients to avoid the associated complications. Level of Evidence: 3
Maus-tratos: estudo através da perspectiva da delegacia de proteção à criança e ao adolescente em Salvador, Bahia

This cross-sectional study describes the occurrences of maltreatment recorded over three years (1997-1999) in a Brazilian Police Department for the Protection of the Child and the Adolescent. Socio-demographic and physical data of victims, aggressors and denouncers were investigated in a sample consisting of 2073 cases. The victims were aged between 0-18 years, of which 56.1% were girls. Data were entered into EPI INFO 2000 software and analyzed using descriptive statistics and chi-square test to determine significant differences (p<0.05). All manifestations of abuse, except physical abuse, tend to occur more frequently in females, and tend to be more prevalent in the 11-to-15 year-old subgroup. Physical abuse was the most common offense (64.7%). Injuries of face and jaw were found in 65.3% of the cases. Most of the aggressors were males (71.8%). There was a positive correlation between gender (female) and sexual abuse. Physical violence against boys was more intensive, as indicated by the presence of more severe body lesions. Health professionals should increase their diagnostic skills and raise the awareness of their communities to take action for reducing the incidence and the impact of violence upon children and adolescents.
Total Shoulder Arthroplasty or Hemiarthroplasty: A Comparison of Complication Rates in the English National Health Service

Background There is debate regarding the benefit of glenoid resurfacing in shoulder arthroplasty. The present study aimed to compare the complication rates of total shoulder arthroplasty (TSA) and hemiarthroplasty (HA). This is the first study to compare complication rates on a national scale. Methods Data were extracted from the Hospital Episode Statistics database for patients who underwent planned TSA or HA between 2005 and 2008 in the English National Health Service. Medical and surgical complications, as well as 18-month revision rates, were analysed for the whole cohort (9804 patients). A subset of 939 with longer follow-up was examined for 5-year revision rates. Results The 18-month revision rate was significantly higher in the TSA group (3.03% versus 1.76%; odds ratio = 1.75; 95% confidence interval = 1.33 to 2.28) but, at 5 years, there was no difference (3.85% versus 3.67%; odds ratio = 0.95; confidence interval = 0.46 to 1.91). The overall in-hospital 90-day mortality rate was 0.43%. There were no significant differences in 30-day readmission, wound complication and reoperation rates. The incidence of medical problems was low. Conclusions Despite concerns regarding osteolysis around the glenoid component after TSA, the present study reports no significant differences in complication rates between the groups at 5 years. However, the controversy surrounding glenoid resurfacing is likely to continue.
Local Offices of Emergency Preparedness (LEMA) Belief in Disaster Mythology: What Has Changed and Why?

The local emergency management directors (n=54) from a midwestern state (USA) were surveyed to determine how accurately they understood behavioural response to disaster, which disaster myths they most often believed, and if education, disaster experience, and EMS work experiences were associated with a more accurate understanding of the behavioural response problems commonly encountered during a disaster. The respondents performed better on a disaster knowledge scale than did their predecessors a decade and a half earlier, which suggests that education and training have had an encouraging impact. However, they averaged only a 65 per cent (the equivalent of a “D”) on the disaster knowledge scale. They continued to believe that citizens will panic and behave irrationally in other ways, that survivors will not prepare or know what to do, and that the initial damage, injury and death estimates are very accurate. On the other hand, they understood that survivors, EMS workers, and others usually behave altruistically in numerous ways. Education, training and experience were found to be associated with a more accurate perception of the behavioural response to disaster. A response rate of 61 per cent was attained after two mailings.
Fibrous proteins: At the crossroads of genetic engineering and biotechnological applications

Fibrous proteins, such as silk, elastin and collagen are finding broad impact in biomaterial systems for a range of biomedical and industrial applications. Some of the key advantages of biosynthetic fibrous proteins compared to synthetic polymers include the tailorability of sequence, protein size, degradation pattern, and mechanical properties. Recombinant DNA production and precise control over genetic sequence of these proteins allows expansion and fine tuning of material properties to meet the needs for specific applications. We review current approaches in the design, cloning, and expression of fibrous proteins, with a focus on strategies utilized to meet the challenges of repetitive fibrous protein production. We discuss recent advances in understanding the fundamental basis of structure‐function relationships and the designs that foster fibrous protein self‐assembly towards predictable architectures and properties for a range of applications. We highlight the potential of functionalization through genetic engineering to design fibrous protein systems for biotechnological and biomedical applications. Biotechnol. Bioeng. 2016;113: 913–929. © 2015 Wiley Periodicals, Inc.
MicroRNA-221 Regulates Hypertrophy of Ligamentum Flavum in Lumbar Spinal Stenosis by Targeting TIMP-2

Study Design. A study of lumbar ligamentum flavum (LF). Objective. The aim of this study was to identify LF hypertrophy related microRNAs (miRNAs) expression profile and to investigate the role of miRNAs in the development of LF hypertrophy in lumbar spinal stenosis (LSS). Summary of Background Data. Although histologic and biologic literature on LF hypertrophy is available, the pathomechanism is still unknown. Accumulating evidence suggests that microRNAs (miRNAs) participate in many physiologic processes, including cell proliferation, differentiation, and fibrosis, but the role of specific miRNAs involved in LF hypertrophy remains elusive. Methods. An initial screening of LF tissues miRNA expression by miRNA microarray was performed using samples from 10 patients and 10 controls, respectively. Subsequently, differential expression was validated using qRT-PCR. Then, functional analysis of the miRNAs in regulating collagens I and III expression was carried out. Western blotting and luciferase reporter assay were also used to detect the target gene. In addition, the thickness of the LF at the level of the facet joint was measured on axial T1-weighted magnetic resonance images. Results. We identified 18 miRNAs that were differentially expressed in patients compared with controls. Following qRT-PCR confirmation, miR-221 was significantly lower in LF tissues of patients than controls. The LF was significantly thicker in patients than that in controls. Bioinformatics target prediction identified tissue inhibitors of matrix metalloproteinase (TIMP)-2 as a putative target of miR-221. Furthermore, luciferase reporter assays demonstrated that miR-221 directly targets TIMP-2 and affects the protein expression of TIMP-2 in fibroblasts isolated from LF. Of note, miR-221 mimic reduced mRNA and protein expression of collagens I and collagen III in fibroblasts isolated from LF. Conclusion. The downregulation of miR-221 might contribute to LF hypertrophy by promoting collagens I and III expression via the induction of TIMP-2. Our study also underscores the potential of miR-221 as a novel therapeutic target in LSS. Level of Evidence: 3
Influence of the Number of Cervical Fusion Levels on Cervical Spine Motion and Health-Related Quality of Life

Study Design. A retrospective study. Objective. To analyze the influence of the number of cervical fusion levels on total cervical motion and health-related quality of life (HRQoL) in patients with solid anterior cervical fusions (ACFs). Summary of Background Data. Few studies have analyzed the degree to which cervical range of motion (ROM) and HRQoL are affected by the number of cervical fusion segments. Methods. We analyzed a cohort of patients who underwent ACF for degenerative disc disease. To assess the clinical outcomes and HRQoL, preoperative, 1- and 2-year postoperative neck and arm pain, visual-analogue scale, neck disability index, and short form-36 were analyzed. Radiographically, C2-7 and C0-2 ROM, C2-7 sagittal vertical axis (SVA), and Kellgren grade of radiographic adjacent segment pathology (RASP) were evaluated. Results. A total of 105 patients (M:F = 46:59, mean age of 51.4 yr) were enrolled. There were 36 patients who underwent single-level ACF (group 1), 41 patients who had a double level ACF (group 2), and 28 patients who underwent ACF involving 3 or more levels (group 3). There was no decrease in C2-7 motion in group 1, a mean 7-degree decrease in group 2, a mean 18-degree decrease in those who underwent a 3-level ACF, and a mean 22-degree decrease after 4-level ACF. The grade of RASP was not influenced by the number of fusion levels. All HRQoL parameters showed no significant correlation between number of fusion levels, cervical ROM, and SVA. Conclusion. Single-level ACF showed no decrease in total cervical motion; multilevel ACF decreased cervical motion by a mean of 7.8 degrees per segment of fusion. Progression of RASP showed no correlation with the number of fusion levels. HRQoLs were not influenced by the number of fusion levels, cervical ROM, or SVA after solid ACF. Level of Evidence: 3
A COMPARATIVE STUDY OF CONTEXTUAL SEGMENTATION METHODS FOR DIGITAL ANGIOGRAM ANALYSIS

This paper presents a comparative study of several well-known and thoroughly tested techniques for the segmentation of textured images, including two algorithms belonging to the adaptive Bayesian family of restoration and segmentation methods, and a novel approach based on the recently introduced concept of the frequency histogram of connected elements (FHCE). The paper first introduces the parameters that define a connected element and then details the sensitivity analysis of these parameters, showing that the grayscale intensity histogram of a digital image is a particular case of the FHCE. The application domain chosen for comparison purposes is the problem of medical images segmentation and, more specifically, as a particularly illustrative case the segmentation of digital angiograms is analyzed in detail. To get a comparative evaluation of FHCE performance, two well-established adaptive or contextual Bayesian segmentation algorithms have been applied to the segmentation of digital angiograms as well. The paper ends with a brief discussion of the comparative performances.
Imaging, Navigation, and Robotics in Spine Surgery.

Spinal technology involves imaging, navigation, and robotics-collectively known as "image-guided therapy. " Imaging coupled with navigation enhances visualization of irregular anatomy, enabling less invasive procedures. With robotics surgeons can perform quicker and safer hand movements with increased accuracy. In the 1890s, X-rays were invented by Roentgen. The first piece of X-ray equipment, the Cryptoscope, would take an image for 15 minutes, with the surgeon placing his hand in front of the beam to guide calibration; radiation exposure for both surgeon and patient was extreme. In the 1950s, fluoroscopy (C-arm) was invented. In the 1970s, computer-assisted tomography (CAT), known as CAT scan, became available; magnetic resonance imaging had its beginnings in the 1980s, and in 1985, the first robotic surgery was performed to obtain a neurosurgical biopsy specimen. The concept of navigation was introduced in the 1990s, and today's niche products for navigation came onto the market in the 2000s.
Cell‐free production and streamlined assay of cytosol‐penetrating antibodies

Antibodies that target intracellular proteins hold great promise in the development of novel therapeutic interventions for various diseases. In particular, antibodies that can cross cellular membranes have potential applications in controlling disease‐related intracellular protein–protein interactions. Given the large number of cytosolic proteins and complicated interactions that are potentially involved in disease development, discovery of antibodies targeting intracellular proteins requires iterative cycles of expression and assessment of candidate antibodies. Because current cell‐based expression methods do not provide sufficient throughput for production and assay of cytosol‐penetrating antibodies, we integrated a cell‐free protein synthesis system designed to provide optimal conditions for production of functional antibodies with a cytosol‐penetration assay. The proposed approach of consolidating cell‐free synthesis and cell‐based assay will substantially expand the capability of discovering and engineering antibodies that can cross the cell membrane and effectively control protein‐mediated cellular functions. Biotechnol. Bioeng. 2016;113: 2107–2112. © 2016 Wiley Periodicals, Inc.
A ROBUST APPROACH OF FUZZY CLUSTERING ON DATA SETS WITH NOISE AND OUTLIERS

In this paper, a new robust fuzzy clustering approach is proposed for better performing principal component analysis (PCA) on function curves and character images that not only have loops, sharp corners, and intersections but also are bound of noise and outlier data. The proposed method is composed of two phases: firstly, input data are clustered using the proposed distance analysis to get good initial cluster centers and a reasonable number of clusters; secondly, the input data are further reclustered by the proposed robust fuzzy c-means (RFCM) based on the results obtained in the first phase to overcome the influence of noise and outlier data so that a good result of principal components can be found. Several function curves and Chinese character images are given to illustrate the effectiveness of the proposed method. Experimental results have demonstrated that the proposed approach works very well on PCA for both curves and images despite the fact that their input data sets may include loops, corners, intersections, noise, and outlier information.
AUTOMATIC MACHINE LEARNING OF KEYPHRASE EXTRACTION FROM SHORT HTML DOCUMENTS WRITTEN IN HEBREW

Keyphrases extracted from documents may save precious time for tasks such as filtering, summarization, and categorization. A few such systems are available for documents written in English. In this paper, we propose a model called LEH_KEY (Learning to Extract Hebrew KEYphrases) that for the first time learns to extract keyphrases for documents written in Hebrew. Firstly, we introduce a relatively high number (15) of baseline extraction methods as opposed to other related systems that use combinations of a low number (two/three) of baseline extraction methods. In contrast, we have investigated various combinations of larger number of baseline methods and various machine learning methods have been tested. The best results have been achieved by a combination of six baseline methods using J48 (an improved variant of C4.5). Our results have been found to be at least of equal quality to those achieved by extraction systems for documents written in English, which are regarded as state-of-the art.
Mold‐casted non‐degradable, islet macro‐encapsulating hydrogel devices for restoration of normoglycemia in diabetic mice

Islet transplantation is a potential cure for diabetic patients, however this procedure is not widely adopted due to the high rate of graft failure. Islet encapsulation within hydrogels is employed to provide a three‐dimensional microenvironment conducive to survival of transplanted islets to extend graft function. Herein, we present a novel macroencapsulation device, composed of PEG hydrogel, that combines encapsulation with lithography techniques to generate polydimethylsiloxane (PDMS) molds. PEG solutions are mixed with islets, which are then cast into PDMS molds for subsequent crosslinking. The molds can also be employed to provide complex architectures, such as microchannels that may allow vascular ingrowth through pre‐defined regions of the hydrogel. PDMS molds allowed for the formation of stable gels with encapsulation of islets, and in complex architectures. Hydrogel devices with a thickness of 600 μm containing 500 islets promoted normoglycemia within 12 days following transplantation into the epididymal fat pad, which was sustained over the two‐month period of study until removal of the device. The inclusion of microchannels, which had a similar minimum distance between islets and the hydrogel surface, similarly promoted normoglycemia. A glucose challenge test indicated hydrogel devices achieved normoglycemia 90 min post‐dextrose injections, similar to control mice with native pancreata. Histochemical staining revealed that transplanted islets, identified as insulin positive, were viable and isolated from host tissue at 8 weeks post‐transplantation, yet devices with microchannels had tissue and vascular ingrowth within the channels. Taken together, these results demonstrate a system for creating non‐degradable hydrogels with complex geometries for encapsulating islets capable of restoring normoglycemia, which may expand islet transplantation as a treatment option for diabetic patients. Biotechnol. Bioeng. 2016;113: 2485–2495. © 2016 Wiley Periodicals, Inc.
Engineered bacteria detect spatial profiles in glucose concentration within solid tumor cell masses

Tumor heterogeneity makes cancer difficult to treat. Many small molecule cancer drugs target rapidly dividing cells on the periphery of tumors but have difficulty in penetrating deep into tumors and are ineffective at treating entire tumors. Targeting both rapidly dividing and slower growing regions of tumors is essential to effectively treat cancer. A cancer drug carrier that penetrates deep into tumors and identifies metabolically activity could supply treatment to those areas based on the local microenvironment. We hypothesized that glucose sensing bacteria could identify sugar gradients in solid tumors. To test this hypothesis, a genetic circuit was designed to trigger expression of a green fluorescent protein (GFP) reporter through the chemotaxis‐osmoporin fusion protein, Trz1, a receptor for sensing glucose and ribose sugars. E. coli equipped with the Trz1‐GFP expression system, were administered to an in vitro model of a continuously perfused tumor tissue that mimics systemic delivery and clearance of bacteria through a blood vessel adjacent to a solid tumor. The level of GFP expressed, per bacterium, was time independent and indicated the glucose concentration as a function of penetration depth within the microfluidic tumors. The measured glucose concentration, correlated (P‐value = 2.6 × 10−5) with tumor cell viability as a function of depth. Mathematical analysis predicted drug delivery by glucose‐sensing bacteria would eliminate a higher percentage of the viable tumor cell population than a systemically administered drug. Glucose‐sensing bacteria could deliver cancer therapies with increased drug penetration and nutrient‐dependent dosing to continuously treat viable regions of cancer tissue that have a higher prevalence for metastatic dissemination. Biotechnol. Bioeng. 2016;113: 2474–2484. © 2016 Wiley Periodicals, Inc.
Kinematic and Kinetic Variations of Below-Knee Amputee Gait

Although many studies have been carried out on prosthetic gait, the main parameters of below-knee amputee (BKA) gait are still poorly understood. The majority of the gait studies of amputees have focused on the temporal and distance variables, whereas kinetics of the gait may reveal more important information. The purpose of this study was to assess the prosthetic gait of transtibial amputees and compare it with the findings of other studies on BKA and able-bodied persons. Five male unilateral traumatic BKA between the ages of 32 and 77 years were tested. Ground reaction force data were combined with simultaneously recorded and subsequently digitized video data of coordinate motion to calculate joint kinetics data. The following variables were compared within the group and with those of nonamputees: linear velocity, relative angles, net moment, power, and work at the hip, knee, and ankle joints. The results of this study indicated that BKA perform a higher than normal hip extension, knee flexion, and ankle dorsiflexion of the unaffected side, whereas having more than normal hip and knee flexion during stance on the affected side. It was also shown that amputees tend to generate little power during push-off of the prosthetic side. Major findings of this study confirmed that BKA perform an asymmetrical gait that is different from those of normal population.
Figures (and Perhaps some Facts) on Police Killing of Civilians in the United States, 1965–1969

Official reports for a 20-year period show that the police killed about five civilians for every officer killed. A study of newspaper reports from 1965–1969 shows that about half of the police and of their victims were young male minorities in urban areas. About a third of the civilians killed were committing misdemeanors when stopped; they tended to have weapons and to use them. The police who killed civilians tended to be on duty, in uniform, and reported that they killed the civilians to defend themselves or to prevent escape.