Miracle-dz/UniFAR-FTUs huggingface dataset:
The modified Dunn procedure for unstable slipped capital femoral epiphysis: a multicenter perspective.

BACKGROUND The modified Dunn procedure has rapidly gained popularity as a treatment for unstable slipped capital femoral epiphysis (SCFE), but limited data exist regarding its safety and efficacy. The purpose of this study was to present results and complications following this procedure in a large multicenter series. METHODS We reviewed the outcomes of all patients who had been treated with the modified Dunn procedure by five surgeons from separate tertiary-care institutions. All slipped capital femoral epiphyses were defined as unstable according to the Loder criteria. Patients with less than one year of follow-up and those with an underlying endocrinopathy or syndrome were excluded. All surgical procedures were performed by pediatric orthopaedic surgeons who had specific training in the modified Dunn procedure. Operative reports, outpatient records, and follow-up radiographs were used to determine the demographic information, type of fixation, final slip angle, presence of osteonecrosis, and any additional complications. Standardized surveys were administered to determine the pain level (0 to 10 scale), satisfaction (0 to 100 scale), function (modified Harris hip score, 0 to 91 scale), and activity level (UCLA [University of California Los Angeles] activity score, 0 to 10 scale) at time of the most recent follow-up. RESULTS Twenty-seven patients (twenty-seven hips) with a mean of 22.3 months (range, twelve to forty-eight months) of follow-up met the inclusion criteria. Four patients (15%) had broken implants at three to eighteen weeks after surgery and required revision fixation. Seven patients (26%) developed osteonecrosis at a mean of 21.4 weeks (range, ten to thirty-nine weeks), with each surgeon having at least one case of osteonecrosis. The mean slip angle at the time of the most recent follow-up was 6° (95% confidence interval, 2° to 11°). Patients who did not develop osteonecrosis had significantly better clinical results compared with those who developed osteonecrosis, as demonstrated by a lower mean pain score (0.3 compared with 3.1, p = 0.002), higher level of satisfaction (97.1 compared with 65.8, p = 0.001), higher modified Harris hip score (88.0 compared with 60.0, p = 0.001), and higher UCLA activity score (9.3 compared with 5.9, p = 0.031). CONCLUSIONS This largest reported series of unstable slipped capital femoral epiphyses treated with the modified Dunn procedure demonstrated that the procedure is capable of restoring anatomy and preserving function after a slip but that implant complications and osteonecrosis can and do occur postoperatively.
Effective Use of Information Sources for Breast Cancer Care: Interplay of Mass Media and Interpersonal Channels

In health communication research studies, there have been various qualitative and quantitative studies on breast cancer. However, there is paucity of research investigations on the influence of information sources used in media awareness campaigns on breast cancer care among women in Nigeria. This study, therefore, investigated the influence of media awareness campaigns on breast cancer care among women in South-West Nigeria. This study was anchored on two theories: agenda setting theory and diffusion of innovation theory. It employed survey design, which made use of the questionnaire to achieve the objectives of the study. The total number of subjects examined in this study was 600 questionnaire respondents. The multi- stage sampling and simple random sampling techniques were used to select the questionnaire respondents in Lagos, Oyo and Ekiti States. Three hypotheses were tested using cross tabulation and correlation analysis to determine the strength, nature and direction between variables. The findings revealed that the majority of the respondents (98.8%) were aware of breast cancer but many of these respondents were not sufficiently knowledgeable of the disease. It also reveals that information sources such as mass media and interpersonal channels are crucial health communication carriers for breast cancer interventions. It was suggested that mass media messages should be incorporated as key machineries in media awareness campaigns for improving breast cancer care among women. This is essential because mass media messages can produce positive changes or prevent negative changes in health-related behaviours of women in South-West Nigeria.
Impact of perioperative allogeneic and autologous blood transfusion on acute wound infection following total knee and total hip arthroplasty.

BACKGROUND Patients undergoing total hip or knee arthroplasty frequently receive blood transfusions. The relationship between transfusion and the risk of infection following total joint arthroplasty is unclear. In this study, we sought to examine the impact of allogeneic and autologous transfusion on the risk of acute infection following total hip and total knee arthroplasty. METHODS We performed a retrospective study of consecutive primary total knee arthroplasties and total hip arthroplasties. Patients who had a reoperation for suspected infection within three months after the arthroplasty were identified. Differences in risk factors were assessed across transfusion groups: no transfusion, autologous only, and allogeneic exposure (allogeneic with or without additional autologous transfusion). Backward-stepwise logistic regression analysis was used to compare reoperations (as outcomes) between cases with and those without allogeneic exposure. Prespecified covariates were body mass index, diabetes, an American Society of Anesthesiologists (ASA) score of >2, preoperative hematocrit, and total number of units transfused perioperatively. RESULTS We identified 3352 patients treated with a total hip or knee arthroplasty (1730 total knee arthroplasties and 1622 total hip arthroplasties) for inclusion in the study. Transfusion was given in 1746 cases: 836 of them had allogeneic exposure, and 910 had autologous-only transfusion. There were thirty-two reoperations (0.95%) for suspected infection. Between-group risk-factor differences were observed. The mean age and the rates of diabetes, immunosuppression, ASA scores of >2, and bilateral surgery were highest in the allogeneic group, as were estimated blood loss, surgery duration, and total number of units transfused (p < 0.001). In the unadjusted analyses, the rate of reoperations for suspected infection was higher in the cases with allogeneic exposure (1.67%) than in those without allogeneic exposure (0.72%) (p = 0.013). Autologous-only transfusion was not associated with a higher reoperation rate. However, multivariable logistic regression demonstrated that the total number of units transfused (p = 0.011) and an ASA score of >2 (p = 0.008)-but not allogeneic exposure-were significantly predictive of a reoperation. CONCLUSIONS Perioperative allogeneic transfusion was associated with a higher rate of reoperations for suspected acute infection. However, patients with allogeneic exposure had increased infection risk factors. After adjustment for the total number of units transfused and an ASA score of >2, allogeneic exposure was not significantly predictive of a reoperation for infection.
Intraoperative three-dimensional imaging in the treatment of calcaneal fractures.

BACKGROUND Displaced intra-articular calcaneal fractures are frequently treated by open reduction and internal fixation. The usual intraoperative monitoring by means of fluoroscopy does not always provide complete intraoperative information for the surgeon. The aims of this study were to analyze the percentage of patients for whom intraoperative three-dimensional imaging leads to intraoperative revision and whether the avoidance of an intra-articular step or gap influences the clinical outcome. METHODS From August 2001 to June 2009, 377 consecutive, operatively treated calcaneal fractures were identified in a retrospective chart review. The results of the intraoperative three-dimensional scans were analyzed for the rate of and the reason for intraoperative revision. For the clinical evaluation, all patients with Sanders type-II and III fractures who were seen from October 2002 to January 2006 were included. When the outer shape of the calcaneus was successfully restored, the fractures were divided into two groups according to the reduction outcome for all joint surfaces (a step-off or gap of <2 mm or ≥2 mm). RESULTS The intraoperative revision rate was 40.3%. An additional fracture reduction was performed in 19.6% of the patients. Seventy-seven fractures were followed clinically. The American Orthopaedic Foot & Ankle Society (AOFAS) score indicated that postoperative joint surface congruence had a significant influence on clinical outcome, in both the bivariate and the multivariate analysis. The same relationship was shown between the joint surface congruence and the degree of osteoarthritis. CONCLUSIONS In many cases, intraoperative three-dimensional imaging identifies intra-articular incongruence and implants that are not detected by fluoroscopy. Due to the resulting options for better joint surface reconstruction, clinical outcomes may be improved, at times requiring repeat reduction, and posttraumatic osteoarthritis may be reduced.
Gender Differences in Aggression in Children and Adolescents in South Australian Schools

ABSTRACT Violence in Australian schools is perceived to be on the increase and most of this violence is said to be caused by boys. The traditional view is that males are the more aggressive sex. Recent research in Scandinavia (Bjorkqvist, Lagerspetz and Kaukiainen, 1992; Bjorkqvist, Osterman and Lagerspetz, 1994a) however, has questioned this gender polarised view of aggression in suggesting that gender differences may be qualitative rather than quantitative. This paper reports a study of gender and developmental differences in aggression among students in South Australian schools. A modified version of a peer estimation technique, the Direct and Indirect Aggression Scales (Bjorkqvist et al., 1994a), was administered to students across four year levels (years 2, 6, 9 and 11) in two Catholic high schools and four Catholic primary schools. Boys were found to be more physically and verbally aggressive than girls but girls used more indirect aggression at the higher year levels. The practical and research imp.
Race, ethnicity and postoperative pain in pediatric cancer patients: a single-institution retrospective study

Background Studies have suggested racial and ethnic-based disparities in the intensity of postoperative pain experienced by patients. The objective of this study was to compare the peak and average post-anesthesia care unit (PACU) pain intensity scores of children of non-Hispanic (NH) White race to those of children of other racial/ethnic groups. Methods Single-institution retrospective study of children (≤18 years) who had undergone cancer-related surgical procedures from June 2016 through April 2022. Multivariable logistic regression was used to assess the association between race/ethnicity and the peak and average PACU pain intensity scores. Results Of the 1,009 unique patients, 74 (7.3%) were Asian, 93 (9.2%) were NH-Black, 310 (30.7%) were Hispanic/Latino, 51 (5.1%) identified as “Other” race (NH-Other), and 481 (47.7%) were NH-White. The median age [interquartile range (IQR)] was 13.7 years (IQR, 8.2–16.6), and 517 (51.2%) were female. In the multivariable analysis, the association between race/ethnicity and a peak PACU pain score greater than 3 was not significant (p = 0.062 for overall effect of race). However, upon comparing the peak PACU pain scores of children of other racial/ethnic groups to NH-White children, NH-Black children were 50.1% less likely than NH-White children to have a peak PACU pain score greater than 3 (odds ratio [OR], 0.499, 95% confidence interval [CI], 0.304–0.818; p = 0.006). Patient race/ethnicity was not associated with an average PACU pain score greater than 3 (p = 0.778). In the sub-group analysis of children who had undergone orthopedic or open abdominal surgeries, the proportions of children with peak and average PACU pain scores which were greater than 3 were not significantly different across racial/ethnic groups (p = 0.250 and p = 0.661, respectively). Conclusions In this retrospective study of children who had undergone cancer-related surgery, NH-Black children had significantly lesser odds than NH-White children of having a peak PACU pain score of moderate or severe intensity. However, in the sub-group analysis of children who had undergone orthopedic or open abdominal procedures, peak and average PACU pain scores were not significantly different across racial/ethnic groups.
Sero Status Disclosure and Condom use among Plwhas on Art in Assela Town Health Facilities, Oromiya Region

Background: HIV Status disclosure and sexual behavior of PLWHAS is vital for HIV prevention efforts and the couple’s health in the context of accelerated highly active antiretroviral therapy. Therefore it is essential to see serostatus disclosure and sexual behavior of PLWHAs who are taking ART as this has implication for prevention of HIV epidemic. Objective: To assess sero status disclosure and condom use among PLWHAs who are on ART in Assela town health facilities, Arsi Zone, Oromiya Region. Methodology: institution based cross sectional study was conducted using both quantitative and qualitative methods from February to April 2013 among 324 PLWHAs who are taking ART from Assela town health institutions. Structured and pretested questionnaire was used for data collection of qualitative part and semi-structured questionnaire was used for qualitative part. Result: More than half of the participants 167 (51.5%) were females. The majority 264 (81.5%) were married. Over all 94.1% of the respondents had disclosed their HIV positive result to their regular partner. Knowledge of partners’ sero status, prior discussion about HIV, type of relationship with partner, living in the same home and duration of HIV test were determinants of sero status disclosure. The proportion of consistent condom use in this study was (60.8%) and the main reason reported for not using condom were partner’s refusal (37.4%). Prior discussion about HIV test, duration since ART started, history of condom use and sex of respondent were found to be determinants of consistent condom use. Conclusion: Although the magnitude of HIV positive status disclosure to regular partner found in this study was encouraging, lack of disclosure by a minority resulted in a limited ability to engage in preventive behaviors. Therefore HIV prevention programs and organizations working on HIV should further enhance disclosure and condom use using different mechanisms like mass health education and face to face counseling.
Management of thoracic insufficiency syndrome in patients with Jarcho-Levin syndrome using VEPTRs (vertical expandable prosthetic titanium ribs).

BACKGROUND Jarcho-Levin syndrome represents a spectrum of clinical and radiographic irregularities including abnormal vertebral segmentation or formation defects, rib deformities, and short-trunk dwarfism. These abnormalities cause reduced thoracic capacity for lung development, resulting in thoracic insufficiency syndrome. In the present study, we reviewed outcome measures related to scoliotic curve correction, thoracic growth, and respiratory function following VEPTR treatment in patients with Jarcho-Levin syndrome. METHODS Twenty-nine patients with Jarcho-Levin syndrome, subclassified as spondylocostal dysostosis (SCD) or spondylothoracic dysplasia (STD), were treated with VEPTR expansion thoracoplasty and followed for at least two years since the initial implantation. Spinal and respiratory measures were collected prior to the initial VEPTR implantation, immediately after implantation, and at the most recent follow-up. RESULTS VEPTR treatment was associated with improved clinical respiratory function and with increases in thoracic height (by 50% in the SCD group and 42% in the STD group) and thoracic width (by 37% in the SCD group and 28% in the STD group). VEPTR treatment resulted in scoliosis curve correction (improvement in the Cobb angle of 41% [22°] in the SCD group and 26% [3.7°] in the STD group) and in improved thoracic symmetry in patients with SCD. Patients with SCD displayed increased lumbar lordosis, and both groups of patients developed increased thoracic kyphosis approaching normal. CONCLUSIONS VEPTR treatment improved thoracic symmetry, controlled spinal deformity, and was associated with improved clinical respiratory function.
Swallowing Rehabilitation after Stroke

Swallowing problems after stroke are common affecting up to 65% of people. In a small proportion of people will have persistent problems. Previously it has only been possible to compensate for these swallowing problems by modifying the swallow or altering the diet. There are now increasing numbers of therapies that show promise in enabling the swallow to be rehabilitated much in the same was as stoke as a whole. "To be able to eat and swallow is important not only for physical, but social and spiritual well wellbeing" Being able to swallow safely will result in the ability to enjoy food such that it is not a chore to keep body and soul together but also a convivial social past time. This joy may be removed following brain injury, in the case of this paper, following stroke. It is accepted that for meaningful recovery of limb function and speech a period of rehabilitation should be undertaken. Swallowing has often been neglected, with an air of nihilism that used to pervade stroke as a whole. This paper is a brief review of accepted and emerging interventions that assist in the rehabilitation of swallowing and the return to oral feeding.
Differential perceptions of teachers and students about the teaching and learning of history at the upper secondary school level

This study sought to examine students’ and teachers’ perceptions of history to determine the different conceptual paradigms that exist in students’ thinking about history. The study employed a mixed-method research design aimed at triangulating quantitative and qualitative data obtained from questionnaires and focus group interviews. Four hundred and thirty-two participants were randomly drawn from selected secondary schools in Tobago and the east/west corridor of Trinidad. Findings of this research revealed a general weakness in student understanding of such concepts as historical evidence, causation, and historical explanation. This is largely because history concepts were taught only incidentally, if at all, at the upper secondary school level.
Recovery and reliable change rates for patients scoring severe on depression, anxiety or impaired functioning in a psychological therapies service: IAPT

Purpose – The NHS Improving Access to Psychological Therapies (IAPT) programme provides access to psychotherapy in England through a stepped care approach for adults with depression and anxiety disorders. This evaluation sought to investigate IAPT recovery and reliable change rates of those who scored severe on depression (PHQ-9), anxiety (GAD-7) or impaired functioning (WASA). The paper aims to discuss this issue. Design/methodology/approach – This evaluation employed a within groups design: a single case evaluation follow-up. Routine service data (from services set-up in 2008-2009 to February 2012) from 25,034 patients treated at four IAPT services was analysed. Findings – The analysis revealed that 29 per cent (n=7,059) of patients were assessed as being in the WASA severe range, 41 per cent (n=10,208) in the PHQ severe range, and 57 per cent (n=14,612) in the GAD-7 severe range; with 14 per cent (n=3,548) in the severe range on all three measures combined. There were significant falls on all three mea.
The emerging academician: The rise of the online adjunct faculty

The use of adjunct faculty has become a mainstay for community colleges and nontraditional programs serving the adult community in both on-campus and online settings. Yet, little is known about online adjunct faculty members—who they are, why they teach, what motivates them and how satisfied they are with their positions. The existing literature compares and contrasts part-time adjuncts to their counterparts—fulltime faculty. However, limited information is available regarding those who teach in virtual environments. This dissertation seeks to fill this gap by providing the results of a study of online adjuncts. The data gathered from this study reveals the demographic profile of this group of faculty members and their overall job satisfaction and motivations to teach within the virtual environment. The results are then compared to findings in the literature of adjuncts who teach in traditional settings. In addition, this study explores the perceptions of adjuncts with respect to an often used label of second-class citizens. The results of this study reveal new strategies to strengthen the commitment of adjunct faculty to virtual institutions, as the data are used to recommend recruitment and retention strategies for attracting qualified individuals based on their self-selected classification types. By cultivating motivated and satisfied adjuncts, educational institutions will strengthen the commitment and dedication of faculty, thereby increasing the length and quality of faculty members’ tenures with their institutions.
EXPLORING MALAYSIAN TRAINEE TEACHERS' ADOPTION OF THE INTERNET AS INFORMATION TOOL

This study reports the usage of three commercial Internet search engines in information seeking among trainee teachers at a teacher training institute in Malaysia. It attempts to investigate the information seeking behavior of the trainees via three Internet search engines (Google, Yahoo and MSN) as gateways to information for research in academic learning using two cohorts of trainee teachers. The study surveyed 166 trainee teachers undergoing a 5-year Bachelor’s Degree program and compares the statistical differences on gender, programs and years of computer technology experiences. The results revealed that there were significant differences between gender for all the three search engines. Furthermore it also indicated that there was a significant difference between TESL and PISMP group for Yahoo and MSN but not for Google. A significant difference was also observed between years of computer technology experiences and the frequency of usage in the case of MSN. Post hoc test revealed a significant difference in the Internet search between those with more than 7 years of experience with those with less than 2 years experience and those between 2-4 years computing experience. The results provide insight into TESL and PPISMP trainee teachers’ use of the Internet search engines as a tool in information seeking when approaching research for their academic learning activities. Implications on the impact of the Internet to the trainee teachers’ academic learning in approaching research needs were discussed.