Miracle-dz/UniFAR-FTUs huggingface dataset:
Does Health Reform Change Femoral Neck Fracture Care? A Natural Experiment in the State of Massachusetts

Objectives: To determine whether hospital processes and hospital quality associated with the care of femoral neck fractures were significantly altered by the implementation of healthcare reform in Massachusetts. Design: Pre-post retrospective study. Setting: Massachusetts Statewide Inpatient Dataset (SID). Patients/Participants: Patients treated for femoral neck fracture (n = 23,485) in the periods prehealth (2003–06) and posthealth reform (2008–10). Intervention: Differences in hospital processes for fracture care and quality measures were assessed for the periods before and after health reform. Outcome Measurements: Differences in hospital processes for fracture care (type of surgical intervention, length of stay, and discharge disposition) and quality metrics [mortality, complications, re-operation, and failure to rescue (FTR)] in the periods before and after health reform were assessed using regression techniques to adjust for differences in case mix and the type of surgical intervention. Results: There were no significant differences in the type of surgical intervention performed prereform and postreform (P = 0.27). After adjustment for case mix and surgical intervention, length of stay was significantly reduced {regression coefficient −0.07 [95% confidence interval (CI), −0.09 to −0.06]} as were the odds of FTR [odds ratio 0.73 (95% CI, 0.59–0.92)]. Discharges to skilled nursing facilities significantly increased in the postreform period [relative risk ratio 1.15 (95% CI, 1.03–1.30)]. Findings associated with FTR were driven by changes in the detection of surveillance sensitive complications. Conclusions: Health reform in Massachusetts led to no clinically meaningful differences in hospital processes for femoral neck fracture care. Although some differences in quality measures were noted, these cannot necessarily be attributed to health care reform. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Introducing mothur: Open-Source, Platform-Independent, Community-Supported Software for Describing and Comparing Microbial Communities

ABSTRACT mothur aims to be a comprehensive software package that allows users to use a single piece of software to analyze community sequence data. It builds upon previous tools to provide a flexible and powerful software package for analyzing sequencing data. As a case study, we used mothur to trim, screen, and align sequences; calculate distances; assign sequences to operational taxonomic units; and describe the α and β diversity of eight marine samples previously characterized by pyrosequencing of 16S rRNA gene fragments. This analysis of more than 222,000 sequences was completed in less than 2 h with a laptop computer.
Relation of NSAIDs to incident AD, change in cognitive function, and AD pathology

Objective: To examine the relation of nonsteroidal anti-inflammatory drugs (NSAIDs) to incident Alzheimer disease (AD), change in cognition, and AD pathology. Methods: Participants were 1,019 older Catholic clergy followed up annually for up to 12 years (mean baseline age = 75.0 years, education = 18.1 years, Mini-Mental State Examination score = 28.5), enrolled in the Religious Orders Study, a longitudinal clinical–pathologic study of aging and AD. Clinical evaluations allowed for AD classification and assessment of global cognition and five cognitive domains. NSAIDs were identified by direct medication inspection at baseline and follow-up evaluations. Neuropathologic data were available on 328 deceased participants. AD pathology was summarized as a global measure and as measures of neuritic plaques, diffuse plaques, and neurofibrillary tangles. We used Cox proportional hazards models and mixed models for incident AD and cognitive decline, respectively, and logistic and linear regression for pathologic outcomes, adjusted for age, sex, and education. Results: Overall, we found no apparent relation of NSAIDs to incident AD (n = 209 cases), change in cognition, or AD pathology. The hazard ratio of incident AD was 1.19 (95% CI 0.87–1.62) comparing those using NSAIDs with those not using NSAIDs at baseline, and 0.84 (95% CI 0.63–1.11) for specific use of aspirin. Findings were similar in analyses in which we considered NSAID use during follow-up. NSAIDs were not related to change in cognition (all p values > 0.14). There was no relation of NSAIDs to global AD pathology or plaques or tangles. Conclusion: These data do not support a strong relation between nonsteroidal anti-inflammatory drugs and Alzheimer disease or cognition. Consistent findings across clinical and pathologic outcomes provide additional confidence in these results.
Coding sequence, genomic organization, and conserved chromosomal localization of the mouse gene Scn11a encoding the sodium channel NaN.

Previous studies have shown that sodium channel alpha-subunit NaN is preferentially expressed in small-diameter sensory neurons of dorsal root ganglia and trigeminal ganglia. These neurons include high-threshold nociceptors that are involved in transduction of pain associated with tissue and nerve injury. In this study, we show that mouse NaN is a 1765-amino-acid peptide that is predicted to produce a current that is resistant to tetrodotoxin (TTX-R). Mouse and rat NaN are 80 and 89% identical at the nucleotide and amino acid levels, respectively. The Scn11a gene encoding this cDNA is organized into 24 exons. Unlike some alpha-subunits, Scn11a does not have an alternative exon 5 in domain I. Introns of the U2 and U12 spliceosome types are present at conserved positions relative to other members of this family. Scn11a is located on mouse chromosome 9, close to the two other TTX-R sodium channel genes, Scn5a and Scn10a. The human gene, SCN11A, was mapped to the conserved linkage group on chromosome 3p21-p24, close to human SCN5A and SCN10A. The colocalization of the three sodium channel genes supports a common lineage of the TTX-R sodium channels.
The utilization of casein and amino acids by Streptococcus sanguis P4A7 in continuous culture.

Streptococcus sanguis P4A7 was grown in glucose limited conditions in continuous culture at pH 7.0 in a chemically defined medium containing either free amino acids or casein as the organic nitrogen source. Apart from aspartate and threonine, which were poorly utilized at the higher dilution rates, all amino acids in the free-amino-acid medium were utilized to various extents. At the higher dilution rates, aspartate actually increased in concentration, probably due to deamidation of asparagine. The amino acid most utilized at all dilution rates was arginine, with up to 99% of the amino acid being consumed. Both casein and its alpha s1-casein fraction supported growth at a level only slightly lower than that obtained with the free-amino-acid medium, provided that either cysteine or thioglycollate was present. With the exception of tyrosine, nearly all of the amino acyl residues of alpha s1-casein were utilized to some degree. In general, the higher the concentration of each amino acid in the medium (whether free or as part of alpha s1-casein) the higher the extent of utilization by S. sanguis P4A7. Only 50% of the arginyl residues (0.16 mM) of alpha s1-casein were utilized compared with 99% of free arginine (1.5 mM) under similar conditions, suggesting that only 50% of the alpha s1-casein arginine was accessible to the organism. (ABSTRACT TRUNCATED AT 250 WORDS)
Persaeus on Prodicus on the Gods’ Existence and Nature

Cet article analyse le probleme de l’« atheisme » pretendu de Prodicos. Un re-examen des sources a notre disposition et, surtout, une nouvelle reconstruction des temoignages fournis par le Sur la piete de Philodeme, dont l’un est consacre a la theologie du stoicien Persaios, demontre que Prodicos n’etait pas un athee mais un critique virulent de la conception traditionnelle des dieux.
Effect of Aging on Intracellular Ca2+, pHi, and Contractilit During Ischemia and Reperfusion

BackgroundTo investigate the effect of aging on myocardial ischemic and reperfusion injury, cytosolic calcium (Ca2+), intracellular pH (pHi), and mechanical performance were measured in isolated perfused rabbit hearts. Methods and ResultsHearts of mature (4-5-month-old) and aged (28-38-month-old) rabbits were loaded with 10, uM of fura-2 or 2′,7′-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF) and subjected to 30 minutes of normothermic ischemia and reperfusion. Cytosolic Ca2+ levels ([Ca2+]) during the nonbeating ischemic period and end-diastolic Ca2+ levels ([EDCa2+]) during reperfusion were determined from the fura-2 fluorescence ratio of emission at 510 nm during excitation at 340 and 380 nm. pH; was obtained from the ratio of emission at 530 nm during excitation at 450 and 490 nm. [Ca2+] of the mature group (n=8) increased from 188±19 nM (mean±SEM) to 373±32 nM during ischemia, and that of the aged group (n=7) increased from 242±17 to 465±20 nM. The rise of [Ca2+] of the aged group was significantly greater (p<0.05) than that of the mature group. Immediately after reperfusion, [EDCa2+ in both groups returned to the preischemic level. pHi decreased to the same extent (from 7.2 to 6.7) during ischemia and returned to preischemic values during reperfusion. The mature group recovered 84±3% of left ventricular peak pressure after ischemia, whereas the aged group recovered only 554±3% (p<0.005). Functional recovery was inversely correlated to the increase of [Ca2+] during ischemia (r=0.66). ConclusionsAged hearts exhibit greater accumulation of [Ca2] during ischemia and less functional recovery after ischemia than mature hearts. The greater rise of [Ca2+] in aged hearts is not a result of the difference of buffering capacity for ischemia-induced acidosis.
Excess adhesive flash upon bracket placement. A typodont study comparing APC PLUS and Transbond XT.

OBJECTIVE To determine if there is any significant difference in excess adhesive flash (EAF) with the use of APC PLUS adhesive coated appliance system and Transbond XT and if other variables such as side of the mouth, time taken to bond the brackets, the age of the orthodontic specialist, or the years of clinical experience affected the amount of EAF. MATERIALS AND METHODS Twenty orthodontic specialists bonded 20 preadjusted straight wire brackets (Victory, 3M Unitek) on a typodont with a Class I crowded malocclusion in a split-mouth design, with one-half of the brackets bonded with APC PLUS adhesive system and the other half with Transbond XT. The teeth were sputter coated with gold and an image was taken at 32x magnification in a scanning electron microscope (Philips XL30). The resultant tagged image file (TIF) was opened in AnalySIS Pro 3.1 (Soft Imaging System, Munich, Germany) and the area of EAF was measured. RESULTS t-Tests demonstrated that: (1) there was no statistically significant difference in EAF between two adhesives when bonding in different quadrants of dentition; and (2) there was no statistically significant difference in EAF between two adhesives overall. Analysis of variance models demonstrated there were no statistically significant differences found regarding the age of the orthodontic specialists, years of clinical experience, and time in performing the bonding. CONCLUSIONS The addition of a coloring agent to assist in the visualization of the excess adhesive does not reduce the amount of excessive adhesive around orthodontic brackets.
Fertility Outcome After Radical Vaginal Trachelectomy: A Prospective Study of 212 Patients

Objective For treatment in patients with early-stage cervical cancer, radical vaginal trachelectomy (RVT) as a fertility-preserving surgery can be put on a par with radical hysterectomy as to oncologic safety. Our aim was to investigate the fertility concerns and outcome. Methods Prospective collection of fertility data of patients treated with RVT. The data were collected on personal communication, by telephone, or e-mail correspondence. Descriptive statistical analysis was performed. Results Between March 2005 and April 2010, 212 patients were followed up after RVT. Only 76 patients (35.9%) were seeking parenthood currently. Sixty pregnancies occurred in 50 women. Five patients (8.3%) had first-trimester miscarriage, 3 had second-trimester miscarriage (5.0%), 2 patients decided for pregnancy termination (3.3%), and 1 patient (1.7%) had an ectopic pregnancy. Three women (5.0%) delivered prematurely before 28th weeks of gestation, 15 (25.0%) delivered between 28 and 36 weeks, and 27 women (45.0%) reached full term. Four pregnancies are ongoing. Conclusions Preservation of childbearing function is a great advantage for patients with early-stage cervical cancer. Many patients do not seek parenthood immediately. We see no impairment of fertility and have solid data on pregnancy outcome. Premature labor is the main problem in pregnancy after RVT.
Bacteriuria testing by the ATP method as an integral part in the diagnosis and therapy of urinary tract infection (UTI).

Rapid tests for bacteriuria have the highest value, if the test result is available while the patient is with the doctor. At the bacteriological laboratory rapid testing of samples obtained by mail may be cost-effective but is of little clinical value. In a previous study performed at a health care centre using conventional urine culture as a reference the ATP test came out as the most reliable one among several rapid bacteriuria tests. The present study was performed to see how the ATP test could be fitted into the routine of the health care centre. Female patients with UTI symptoms were asked to deliver a urine sample to the health care centre laboratory and to wait for the result before seeing the doctor. After having the symptoms confirmed the doctor based the diagnosis on the ATP value. A low ATP value ruled out UTI and a high ATP value confirmed UTI. In patients with an intermediary ATP value (10-50 nmol/l) a positive nitrite test was used to confirm UTI. Only those patients with intermediary ATP values and negative nitrite test had to wait for conventional urine culture. Thus in most patients the decision on antibiotic therapy or not was based on clinical symptoms and ATP results only. Antibiotics (trimethoprim) were given as single dose or as a conventional 7-day regime in a double-blind comparison. The correlation between the ATP method and conventional culture was good. (ABSTRACT TRUNCATED AT 250 WORDS)
Immunochemical studies of phospholipids. VI. Haptenic activity of phosphatidylinositol and the role of lecithin as an auxiliary lipid.

Antiserum against the phosphatidylinositol hapten was obtained in rabbits by injecting a complex of the hapten and methylated bovine serum albumin. The specificity of the antiserum was concerned with the inositol moiety of phosphatidylinositol and was influenced by the ratio of phosphatidylinositol to lecithin. The role of lecithin as an auxiliary lipid in the phosphatidylinositol hapten as well as the cardiolipin hapten was partly explained from observations of the nature of the phospholipase C-treated phospholipid haptens. The lecithin molecule as a whole is indispensable in forming micellar structure of the hapten. However, once the micelle is prepared, the phosphorylcholine moiety of lecithin is no longer necessary, at least in the case of the phosphatidylinositol hapten, and the diglyceride portion of lecithin is important in preserving the micelle already formed. Chemical analysis, reactivity with antisera and binding ability with methylated bovine serum albumin of the enzymetreated phospholipid hapten in comparison with the original hapten supported the above conclusions.
Close Your Eyes and Think of England

Faced with declining fertility rates, media in Britain are reacting with anxiety about cultural annihilation. To look at how nationalism inflects concerns over biological and cultural reproduction, the authors analyze coverage of falling fertility and rising immigration in Great Britain in major newspapers in 2000-2. They find pronatalist appeals to be commonand especially directed at women but varying in how women’s duty to the nation is framed. Appeals characterized as begging, lecturing, threatening, and bribing express different relationships between individual interest and the national good and offer positive and negative views of women. The political leanings of specific newspapers affect how they connect biological reproduction to the cultural threat seen in immigration. Even positive views of women as making rational reproductive choices are tainted by alarmist views of immigration as a threat to national survival.
Parasitism of Immature Stages of Haemaphysalis sulcata (Acari: Ixodidae) on Some Reptiles in Turkey

Abstract: Reptiles may contribute to maintaining tick populations by feeding larvae, nymphs, and adults. The life cycles and tick–host associations of many Turkish ticks are still poorly known, and only 3 ixodid tick species have been reported on 7 reptile species in Turkey. In this study, we performed a tick survey on reptiles in the Southeastern Anatolia Region of Turkey. In 2005, 57 reptiles (52 lizards and 5 snakes) comprising 10 species from 5 families were captured and examined for tick infestation. A total of 427 ticks was collected. The majority of ticks found on lizards was the immature stages of Haemaphysalis sulcata, 420 larvae and 4 nymphs. The only adult ticks recorded on the agamid lizard, Laudakia stellio, were Hyalomma aegyptium (1♂, 2 ♀). The highest tick infestation rate was recorded on specimens of Timon princeps. This study is the first detailed investigation on ticks infesting reptiles in Turkey. To the best of our knowledge, these tick–host associations have never been documented in the literature.
Cell type‐specific chromatin organization of the region that governs directionality of yeast mating type switching

Switching of mating type in Saccharomyces cerevisiae is directional; MATα cells recombine to transfer information from HMRa while MATa cells switch using the silent cassette at HMLα. Genetic analysis recently has defined a 700 bp recombination enhancer ∼29 kb from the left end of chromosome III that is necessary for directionality. The chromatin structure of this region differs strikingly in a‐ and α‐cells. Matα2p organizes a 3.7 kb chromatin domain that opposes interaction of trans‐acting proteins with the enhancer. In a‐cells lacking the α2 repressor, two footprinted regions flank an ∼100 bp section having a unique DNA structure. This structural signature probably reflects interactions of proteins that result in directional mating type switching.
BARRIERS TO CLINICAL DECISION-MAKING IN NURSES IN AUSTRALIA

Research aims: The aim of this study was to examine whether nurses in Australia participated in clinical decision making to the extent they desired. Some factors that could be inhibiting or promoting participation in clinical decision making, namely educational level, occupational orientation (role values), level of appointment and area of practice (medical/surgical) were also examined. Method: A quantitative, correlational study examined the relationship between nurses' occupational orientation, educational level, area of specialty and decision making. T-tests were used to identify significant differences between the decision making nurses say they have and that which they say they want. Major findings: Nurses holding a professional role value participated more in clinical decision making than those holding a paramedical role value. Nurses practising in surgical areas participated less in decision making than those in medical areas. While a higher educational level was not associated with greater participation in clinical decision making, it was linked to wanting more participation in this process. Conclusion: Important issues arising from the study need to be addressed. Nurses who are better educated are not making decisions to the extent to which they aspire. Surgical nurses participated less in decision making than medical nurses and holding professional values can lead to greater decision making participation. (author abstract)
Factors Associated with Erosive Arthritis in Rheumatoid Arthritis and Other Connective Tissue Diseases: A Retrospective Study From a Southern Chinese Population

ObjectiveTo investigate the clinical predictors of erosive arthritis (EA) in patients with rheumatoid arthritis (RA) and other connective tissue diseases. MethodsFour hundred and one consecutive patients with newly diagnosed RA between January 2010 and January 2013 were enrolled in the study. During the study period, 729 consecutive patients with non-RA connective tissue diseases were also included, and a cross-sectional study was performed. Medical records were reviewed. Only those patients with data for 2 years were considered in the analysis (338). ResultsErosive arthritis was noted in 60.4% (204 /338) of patients with RA and occurred early in RA. The multivariate logistic regression analysis indicated that rheumatoid nodules, anemia, and positive anticyclic citrullinated peptide antibody (ACPA) were strongly associated factors for the occurrence of EA in RA patients. Erosive arthritis was also noted in 1.5% of patients with SLE, 5.8% of patients with primary Sjögren syndrome, and 9.1% (3/33) of patients with systemic sclerosis. When compared with patients without EA, high level and prominently higher positive rate of ACPA was found in these patients with EA. On receiver operating characteristic curve analysis, ACPA exhibited a maximum sensitivity with a cutoff value of 1.6 U/mL and 0.6 U/mL for RA and SLE patients, respectively. ConclusionErosive arthritis had a high prevalence in Chinese RA patients and occurred early. Anemia, rheumatoid nodules, and ACPA were associated with EA in RA. Erosive arthritis also could be detected in SLE, primary Sjögren syndrome, and systemic sclerosis. Anticyclic citrullinated peptide antibodies were also associated with EA in these diseases. Intensive monitoring for erosions was recommended for RA patients with a cutoff of ACPA greater than 1.6 U/mL and greater than 0.6 U/mL for SLE patients.
Structural basis of hypoxic pulmonary hypertension: the modifying effect of chronic hypercapnia

Exposure to chronic hypoxia causes pulmonary hypertension and pulmonary vascular remodelling. In chronic lung disease, chronic hypercapnia frequently coexists with hypoxia and is associated with worsening of pulmonary hypertension. It is generally stated that pulmonary hypertension in these conditions is secondary to hypoxic vascular remodelling and that hypercapnia augments this remodelling thus worsening the hypertension. We review recent evidence which shows that although chronic hypoxia causes thickening of the walls of pulmonary arterioles, these changes do not lead to structural narrowing of the lumen by encroachment. Moreover, hypoxia leads to new vessel formation within the pulmonary vasculature and not loss of vessels as formerly thought. Such neovascularization may provide a beneficial adaptation by increasing the area of the gas exchange membrane. These novel structural findings are supported by recent reports that inhibitors of the RhoA pathway can acutely reduce pulmonary vascular resistance in chronically hypoxic lungs to near normal values, demonstrating that structural changes are not the dominant mechanisms underling hypoxic pulmonary hypertension. Chronic hypercapnia inhibits the development of hypoxic pulmonary hypertension, pulmonary vascular remodelling and hypoxia‐induced angiogenesis. This last effect might be maladaptive, as it would prevent the potentially beneficial increase in gas exchange membrane area. These findings suggest that structural narrowing of the vascular lumen of resistance vessels is not the mechanism by which hypoxia and hypercapnia cause pulmonary hypertension in chronic lung disease.