Miracle-dz/UniFAR-FTUs huggingface dataset:
An analysis of explanted pyrolytic carbon prostheses

The clinical results of pyrolytic carbon finger prostheses are currently mixed (Hutt et al., 2012). To date there has been no independent analysis of retrieved pyrolytic carbon prostheses. Twelve explanted pyrolytic carbon components were obtained at revision surgery for wear analysis: five distal and three proximal components from proximal interphalangeal (PIP) joints; two distal and one proximal from metacarpophalangeal (MCP) joints; and one component from a trapeziometacarpal (TM) joint. Implants were removed for either dislocation or failure of fixation. The single TM joint was only implanted for 3 weeks, the other implants for between 1 and 3 years. At operation, there were no macroscopic signs of particulate debris in the soft tissues around any of the failed joint replacements. Excessive volumes of particulate debris should result in dark/black staining of the soft tissues, as occurs with worn titanium implants. The articulating surfaces of the implants were examined using a ZYGO NewView 5000 non-contact profilometer (ZYGO Ltd., Zygo Corporation, Laurel Brook Road, Middlefield, Connecticut, USA), with a resolution of 1 nm to determine the roughness average (Ra) of the surface. A total of 103 Ra measurements were taken, with a minimum of four per component obtained. These quantify the level of damage the surface has sustained and thus how worn a surface has become. Previously such profilometers have been used to examine other types of explanted prostheses, such as knees and hips. In addition to the Ra values, the ZYGO also takes detailed images of the surface, displaying them as 3D maps. The Ra values for each component were averaged and compared against the British Standard for orthopaedic implants, which states that the articulating surfaces of devices made of metal or ceramic should have Ra values < 50 nm (British Standards, 1997). Ra values (Table 1) showed that most of the articulating surfaces of the explanted components were relatively unworn (Ra values < 50 nm). ZYGO images showed light unidirectional scratching on four of the explanted components, but despite this, the Ra values of these components were still low (< 50 nm) showing that this scratching was superficial. No other notable damage was observed on the articulating surfaces of the 12 explanted components. The low Ra values obtained from the ZYGO demonstrated that the articulating surfaces of the explanted prostheses were relatively undamaged, as the values lay within the acceptable range defined by the British Standard for orthopaedic implants. This Letters to the Editor Short Report Letters 469134 JHS0010.1177/1753193412469134The Journal of Hand SurgeryShort report letters 2012
The association of Kienböck’s disease and ulnar variance in the Iranian population

We retrospectively determined the distribution of ulnar variance in 60 patients with Kienböck’s disease. We also measured the ulnar variances in 400 standard wrist radiographs in the normal adult population. The mean ulnar variance of the Kienböck’s group was −1.1 mm (SD 1.7) and the mean ulnar variance of the general population was +0.7 (SD 1.5), which was significantly different. In the Kienböck’s disease group there were 38 (63%) with ulnar negative, 16 (27%) neutral and six (10%) with ulnar positive variance. The preponderance of ulnar negative variance was statistically significant. There was an association between ulnar negative variance and the development of Kienböck’s disease in this study.
Immune Monitoring of Infectious Complications in Transplant Patients: an Important Step towards Improved Clinical Management

ABSTRACT Immune reconstitution following organ transplantation is absolutely critical in preventing infectious complications. However, understanding the kinetics of immune reconstitution and its potential impact on the clinical management of transplant patients remains a significant challenge. Over the last decade, various platform technologies have emerged which have provided important insights into the immune reconstitution kinetics in transplant patients. However, many of these technologies are too complicated and cumbersome to implement in a clinical setting. In this issue of the Journal of Clinical Microbiology, Chiereghin et al. (J. Clin. Microbiol. 56:e01040-17, 2018, https://doi.org/10.1128/JCM.01040-17) report the results of their evaluation of the QuantiFERON-CMV (QFN-CMV) assay to assess human cytomegalovirus (CMV)-specific CD8+ T-cell immunity in heart transplant recipients as a prognostic tool. These studies showed that patients with absence of global immune reactivity in the QFN-CMV assay were at a higher risk of developing CMV after discontinuing antiviral prophylaxis. Furthermore, failure to reconstitute CMV-specific immunity after resolution of the first episode of viremia was associated with viral relapse. These observations, along with other recent clinical studies utilizing the QFN-CMV assay, demonstrate that systematic monitoring of antiviral immunity can be successfully used as a prognostic tool and also to guide changes to the clinical management of transplant patients.
The influence of genetic factors, smoking and cardiovascular diseases on human noise susceptibility

Noise has a metabolic and mechanical effect on the inner ear and may therefore interfere with gap junction channels, thus disrupting the interaction between cells in the cochlea. Studies have shown that carriers of connexin mutations in genes involved in HI may have some disturbance in auditory function and may be more susceptible to damage caused by, e.g. noises. Furthermore, hair cell damage in the cochlea as a result of noise exposure can also be mediated by reactive oxygen species. Smoking in combination with elevated diastolic blood pressure and presence of the Raynaud's disease (white finger disease) seems to aggravate noise induced hearing loss (NIHL). In the present study we investigated whether interaction between connexin mutations (C×26 and C×30) alone, or in combination with genetic variability in the cochlear antioxidant system (GSTM1 deletion, GSTT1 deletion), could explain differences in human noise susceptibility. Furthermore, smoking habits and cardiovascular factors (hypertension, heart disease and white finger diseases) were correlated with noise susceptibility and interactions between genetic factors. Smoking and cardiovascular factors were analysed and correlated with the differences in noise susceptibility found in a Swedish noise-exposed population. The results revealed that smoking alone seems to increase noise susceptibility, and that null-genotypes for the GSTM1 gene in the protective antioxidant system, who smoke/have ever smoked had an additional risk for NIHL compared to those who do not smoke/have never smoked.
The DASH and the QuickDASH instruments. Normative values in the general population in Norway

We collected population-based normative data for the DASH (disabilities of the arm, shoulder and hand ) and QuickDASH questionnaires in order to determine the co-morbidity to be expected in a group of patients. We also studied the correlation between the two scores. A total of 2000 DASH forms and 800 QuickDASH forms were mailed to 1400 men and 1400 women. They were selected randomly in groups of 200 men and women in each age decade from 20–29 to over 80 years old. A total of 50% of the DASH forms and 56% of the QuickDASH forms were returned (p < 0.005). The mean DASH scores for women rose with age from 5 among those aged 20–29, to 22 among those aged 70–79 and 36 for those over 80. The corresponding mean values for men were 5, 13 and 22. The mean DASH and QuickDASH scores extracted from the DASH forms were very similar in each age decade. Spearman’s correlation coefficient for the two forms was 0.965 for all 992 forms and 0.930 for the 174 forms with scores of 30 or more. There were, however, wide confidence limits for the agreement between scores in individual patients. The high average scores in the general population, particularly among the elderly, should be borne in mind when evaluating scores among patients. The QuickDASH should be preferred to the full DASH as it gives the same information, but is shorter and completed more often.
Reproducibility of radiographic classification of scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist

The aim of this study was to measure inter- and intra-observer agreement on the radiographic classification of scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist. Radiographs of 41 patients with SLAC wrist and 47 patients with SNAC wrist were graded on two separate occasions by four orthopaedic consultants specializing in hand and wrist surgery. Inter-observer agreement was evaluated using the multi-rater kappa value. Landis and Koch criteria were used to assess the level of agreement. Intra-observer agreement was tested by re-grading the radiographs after an interval of 2 to 4 weeks and calculating the weighted kappa value. For SLAC wrist, the inter-observer agreement was moderate (kappa value = 0.59) and intra-observer agreement substantial (kappa value = 0.65). For SNAC wrist, the inter-observer agreement was slight (kappa value = 0.20) and intra-observer agreement was fair (kappa value = 0.29). Radiographic classification of SLAC wrist has moderate reliability and reproducibility, whereas classification of SNAC wrist has limited reliability.
An Off‐Season Preparatory Program for Women Lacrosse Athletes

ATHLETES PARTICIPATING IN less-recognized varsity sports may be less likely to receive proper instruction in strength training and sport-specific conditioning. Strength and conditioning can greatly impact a team’s success, and an improper training regimen may result in less than optimal achievement. Furthermore, the athletes in less-recognized programs may be predisposed to greater risks of injury. McMaster University has established a strength and conditioning program giving all varsity teams the opportunity for sport-specific training regimens designed and implemented by a certified strength and conditioning specialist. Prior to embarking on a program design, a “needs analysis” was performed to determine both the biomechanical and physiological demands of lacrosse. Player interviews, game observations, and a consultation of the literature (11, 14) assisted in this process. Lacrosse is a sport characterized by quick transition, continuous activity, and bursts of high-intensity sprints, and it is physically demanding of both the cardiovascular and musculoskeletal systems. Skilled players displayed quickness, agility, and speed along with high levels of upperand lowerbody strength necessary to ward off and deliver checks. The strength-training emphasis was placed on the leg muscles, primarily the hip and knee extensors, along with the muscles of the abdominal–lower-back complex necessary for an effective transfer of leg forces. The strength and metabolic system requirements were found to be similar to other anaerobic/power sports such as hockey (16), basketball, and soccer (4). These sports are generally trained for with an accentuation on highintensity intervals for conditioning. A limitation of this program was that the strength coach was not able to monitor all of the workouts. In order to compensate, an extensive orientation session was delivered to the team. The initial familiarization included complete exercise instruction, a flexibility session, and a quick theoretical outline to emphasize the rationale behind the training exercises. Several follow-up sessions were conducted, and as much personal contact as possible was maintained with the players to complement the original training instruction. This was extremely important for the teaching of the lifts and plyometrics, both of which are essential components for power development. The team was advised to train with a partner to aid workout compliance and motivation. All resistance training was carried out in the school’s facilities and under the supervision of certified personal trainers to ensure player’s safety and proper exercise technique. Fitness testing was not incorporated because of time and budget constraints. When possible, fitness testing should be conducted at multiple time points throughout the year. Pretraining measures establish baseline levels of conditioning and can be used for motivation and goal setting throughout the off season. Further testing should take place at preseason and midseason interAn Off-Season Preparatory Program for Women Lacrosse Athletes
Population Structure of Invasive and Colonizing Strains of Streptococcus agalactiae from Neonates of Six U.S. Academic Centers from 1995 to 1999

ABSTRACT The purpose of this study was to describe the population structure of group B streptococci (GBS) isolated from infected and colonized neonates during a prospective active-surveillance study of early-onset disease in six centers in the United States from July 1995 to June 1999 and to examine its relationship to bovine strains of GBS. The phylogenetic lineage of each GBS isolate was determined by multilocus sequence typing, and isolates were clustered into clonal complexes (CCs) using the eBURST software program. A total of 899 neonatal GBS isolates were studied, of which 129 were associated with invasive disease. Serotype Ia, Ib, and V isolates were highly clonal, with 92% to 96% of serotype Ia, Ib, and V isolates being confined to single clonal clusters. In contrast, serotype II and III isolates were each comprised of two major clones, with 39% of serotype II and 41% of serotype III isolates in CC 17 and 41% of serotype II and 54% of serotype III isolates in CC 19. Further analysis demonstrates that the CC 17 serotype II and III GBS are closely related to a previously described “ancestral” lineage of bovine GBS. While 120 (93%) of invasive GBS were confined to the same lineages that colonized neonates, 9 (7%) of the invasive GBS isolates were from rare lineages that comprised only 2.7% of colonizing lineages. These results are consistent with those for other geographic regions that demonstrate the highly clonal nature of GBS infecting and colonizing human neonates.
Dynamic Time Warping Averaging of Time Series Allows Faster and More Accurate Classification

Recent years have seen significant progress in improving both the efficiency and effectiveness of time series classification. However, because the best solution is typically the Nearest Neighbor algorithm with the relatively expensive Dynamic Time Warping as the distance measure, successful deployments on resource constrained devices remain elusive. Moreover, the recent explosion of interest in wearable devices, which typically have limited computational resources, has created a growing need for very efficient classification algorithms. A commonly used technique to glean the benefits of the Nearest Neighbor algorithm, without inheriting its undesirable time complexity, is to use the Nearest Centroid algorithm. However, because of the unique properties of (most) time series data, the centroid typically does not resemble any of the instances, an unintuitive and underappreciated fact. In this work we show that we can exploit a recent result to allow meaningful averaging of 'warped' times series, and that this result allows us to create ultra-efficient Nearest 'Centroid' classifiers that are at least as accurate as their more lethargic Nearest Neighbor cousins.
Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal joint osteoarthritis: results after minimum 2 years of follow-up

A prospective study was undertaken to assess the outcomes of a series of patients treated using pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis. We analysed the results of this procedure in 27 trapeziometacarpal joints of 25 patients. The mean follow-up interval was 34 months (range 26–52). The study showed that pyrocarbon interpositional arthroplasty provided excellent pain relief and high patient satisfaction. Overall function, according to disabilities of the arm, shoulder and hand (DASH) score, improved from 48 points preoperatively to 14 points at the last follow-up assessment. Key pinch strength recorded in the operated hands was comparable with the results obtained in the contralateral hand and in healthy individuals from the same population. No further operations were performed in the study group. Partial trapeziectomy with pyrocarbon arthroplasty may prove to be a successful option for the treatment of trapeziometacarpal joint osteoarthritis. Further long-term comparative studies are warranted.
Indecision and an Avalanche of Expectations: Challenges Facing Sophomore Resident Assistants

Residence education professionals find themselves hiring more sophomores for resident assistant (RA) positions. Understanding the experience of sophomore RAs is an important step in identifying how this practice impacts student staff and students under their support and supervision. This is a phenomenological study of the experience of sophomore RAs at one private university. Findings suggest that sophomore RAs may require additional supports as they navigate their work.
Fibrinolysis in Critically III Patients

Impaired fibrinolysis may contribute to development of adult respiratory distress syndrome (ARDS). Pathologic increases in endogenous plasminogen activator inhibitor (PAI-1) may blunt normal fibrinolysis and unmask alternate fibrinolytic mechanisms, such as elastase-induced fibrin degradation. We measured PAI-1 and elastase-induced fibrin(ogen) degradation products in 69 critically ill patients in our medical intensive care unit (MICU) and in nine healthy volunteers. Factor VIII-related antigen protein (VIII:Ag), a reported marker of acute lung injury, and alpha-1-protease inhibitor (alpha-1-PI), an acute phase reactant, were also measured. MICU patients included 24 control patients with no known risk of ARDS, 35 patients with risk factors for ARDS including sepsis, pneumonia, aspiration, and shock, and 12 patients with ARDS including two patients from at-risk groups who developed ARDS. Plasma PAI-1 was determined by chromogenic assay, elastase-induced peptides by a new radioimmunoassay, VIII:Ag by immuno.
Hyaluronic acid scaffold for skin defects in congenital syndactyly release surgery: a novel technique based on the regenerative model

Syndactyly release may require skin grafting to fill the skin defects, which might lead to complications or poor cosmetic outcomes. A simple graftless technique for syndactyly release with a hyaluronic acid (HA) scaffold used to cover the bare areas is described. Between 2008 and 2011, release of 26 webs in 23 patients was performed. All skin defects were covered with Hyalomatrix® PA. One patient was excluded due to early post-operative infection that required HA scaffold removal before its integration. Web creep, secondary deformities, scar quality, and patient and parental satisfaction were assessed. Mean follow-up of the group of 22 patients was 24 months. There were no secondary deformities and minimal degree of web creep. All patients had close to normal pigmentation and good pliability at the sites of scaffold application. The results confirm the use of a HA scaffold as a promising alternative to skin grafting in syndactyly release surgery.
Association between chronic periodontal disease and cardiovascular risk factor hyperlipidemia

Background: Periodontal disease is one of the major reasons for tooth loss. Accumulating evidence suggests that chronic infections, such as periodontitis, are associated with increased risk for cardiovascular diseases (CVD) possibly through providing a systemic inflammation and found that 25% to 50% increase in risk of CVD for those with periodontitis when compared to those with no or minimal periodontitis. Aim: To evaluate the association between chronic periodontal disease and cardiovascular risk factor such as hyperlipidemia. Materials and Methods: A hospital-based study was conducted among the patients who came to the out-patient department. Fifty subjects including both males and females were selected by systematic random method, and community periodontal index was recorded on all subjects. Subjects were divided in to healthy group (controls) and chronic periodontitis group (cases) based on presence/ absence of loss of attachment. Blood samples were collected from all subjects for the measurement of lipid profile in the serum. Results: Mean total cholesterol values in controls and cases were 190.44 and 200.64, which were not statistically significant between the groups. Mean LDL cholesterol values in controls and cases were 110.96 and 136.64, which were statistically increased in cases (P = 0.003). Mean HDL cholesterol values in controls and cases were 61.60 and 49.28, which were statistically higher in controls (P = 0.041). Conclusion: Chronic periodontitis patients may have high risk of getting cardiovascular diseases since cardiovascular risk factors such as total cholesterol and LDL are associated with periodontitis.
Combined Real-Time PCR and rpoB Gene Pyrosequencing for Rapid Identification of Mycobacterium tuberculosis and Determination of Rifampin Resistance Directly in Clinical Specimens

ABSTRACT Our laboratory has developed a rapid, sensitive, and specific molecular approach for detection in clinical specimens, within 48 h of receipt, of both Mycobacterium tuberculosis complex (MTBC) DNA and mutations within the 81-bp core region of the rpoB gene that are associated with rifampin (RIF) resistance. This approach, which combines an initial real-time PCR with internal inhibition assessment and a pyrosequencing assay, was validated for direct use with clinical specimens. To assess the suitability of real-time PCR for use with respiratory, nonrespiratory, acid-fast bacillus (AFB)-positive and AFB-negative specimens, we evaluated specimens received in our laboratory between 11 October 2007 and 30 June 2009. With culture used as the “gold standard,” the sensitivity, specificity, and positive and negative predictive values were determined for 1,316 specimens to be as follows: for respiratory specimens, 94.7%, 99.9%, 99.6%, and 98.6%, respectively; for nonrespiratory specimens, 88.5%, 100.0%, 100.0%, and 96.9%, respectively; for AFB-positive specimens, 99.6%, 100.0%, 100.0%, and 97.7%, respectively; and for AFB-negative specimens, 75.4%, 99.9%, 98.0%, and 98.4%, respectively. PCR inhibition was determined to be minimal in this assay, occurring in 0.2% of tests. The rpoB gene pyrosequencing assay was evaluated in a similar prospective study, in which 148 clinical specimens positive for MTBC DNA by real-time PCR were tested. The final results revealed that the results of direct testing of clinical specimens by the pyrosequencing assay were 98.6% concordant with the results of conventional testing for susceptibility to RIF in liquid culture and that our assay displayed adequate sensitivity for 96.6% of the clinical specimens tested. Used together, these assays provide reliable results that aid with the initial management of patients with suspected tuberculosis prior to the availability of the results for cultured material, and they also provide the ability to predict RIF resistance in Mycobacterium tuberculosis-positive specimens in as little as 48 h from the time of clinical specimen receipt.