Miracle-dz/UniFAR-FTUs huggingface dataset:
Radiological and clinical details of major adult limb fractures in a teaching hospital, AAU, Ethiopia.

Background: This prospective study done at Addis Ababa University, Medical Faculty, Department of Radiology, Tikur Anbessa Hospital was aimed at determining the causes, magnitude, radiological and Clinical patterns of major limb fractures in adults in a half- year period from March to August 2007.In Addis Ababa University, fractures are managed both conservatively and operatively, but for lack of implants or expertise, patient which should have been treated surgically are managed conservatively and stay very long (average hospital stay of 11 days) in the Hospital. Such knowledge helps to plan on the management of the fractures and resource-recruitment. Methods: This was a half-year cross-sectional higher institution based study of 422 adult patients with major fracture/s on the limbs. The study included all the major limb trauma patients who attended the 'surgical' and orthopedic Emergency department of T.A. U.H and had fracture at the same time. Data collection related to radiological variables was done by the research team to help reduce inter observer measurement variability. “Difficult” patterns were discussed further. Results: During the study period there were a total of 422 orthopedic adult patients who sustained a major fracture of their limbs. Mean age was 35 years with a male to female ratio was 3:1. Pathological fractures were encountered only in two (0.5%) patients. Nearly half (202, 48%) of the traumatic fractures were due to road traffic accidents. The highest frequency of fracture occurred on the femur (68, 15%), tibiofibular bones (63, 14%) and the humerus (61, 13.5%). A little less than half (44.1%) half of the femur fractures were in the proximal one-third and about half of the tibiofibular fractures were in the distal third. Transverse fracture pattern was seen in about half of the fractures. Compound fracture occurred in 90 (21.3%) of the cases. Thirty four (7.6) of the fractures involved the hand and only 13 (2.9%) involved the foot bones. Conclusion: The very high proportion of closed long bone shaft fractures in a center with limited number of beds compels short Hospital stay using efficient operative fixations, including SIGN interlocking nails, plates and other implants. Road traffic accidents (RTAs) were responsible for almost half of the fractures. Machine injuries and fall injuries were second and third respectively. As the proportions and patterns of the leading causes of adult traumatic fractures remained steadily high over the many years (other similar studies published by the author on this journal), due mutisectorial attention should be emphasized once again to dwindle their burden
Paramedic empathy levels : results from sevenAustralian universities

Purpose Evidence suggests that improved empathy behaviours among healthcare professionals directly impacts on healthcare outcomes. However, the ‘nebulous’ properties of empathic behaviour often means that healthcare profession educators fail to incorporate the explicit teaching and assessment of empathy within the curriculum. This represents a potential mismatch between what is taught by universities and what is actually needed in the healthcare industry. The objective of this study was to assess the extent of empathy in paramedic students across seven Australian universities. Methods A cross-sectional study using a paper-based questionnaire employing a convenience sample of first, second, and third year undergraduate paramedic students. Student empathy levels were measured using a standardised self-reporting instrument: Jefferson Scale of Physician Empathy – Health Profession Students (JSPE-HPS). Findings A total of 783 students participated in the study of which 57% were females. The overall JSPE-HPS mean score was 106.74 (SD=14.8). Females had greater mean empathy scores than males 108.69 v 103.58 (p=0.042). First year undergraduate paramedic mean empathy levels were the lowest, 106.29 (SD=15.40) with second years the highest at 107.17 (SD=14.90). Value The overall findings provide a framework for educators to begin constructing guidelines focusing on the need to incorporate, promote and instil empathy into paramedic students in order to better prepare them for future out-of-hospital healthcare practice.
A Qualitative Analysis of Implementing EvidenceNOW to Improve Cardiovascular Care

Purpose: The Heart of Virginia Health care (HVH) was a regional cooperative under the EvidenceNOW initiative to assist primary care practices in implementing evidence-based cardiovascular care and building capacity for quality improvement. The HVH implementation team included individuals from multiple universities, quality improvement organizations, and consulting firms. The goal of this study was to understand HVH team member viewpoints on the challenges, strengths, and lessons learned in each phase of the project. Methods: Qualitative methods were used to facilitate reflection on the implementation and dissemination of the EvidenceNOW initiative in Virginia. In-depth interviews were conducted at the end of the project with 22 HVH team members. A nonparticipant, multidisciplinary research team completed thematic analysis of interview transcripts. Results: Positive attributes of the HVH initiative included diverse team member skills and areas of expertise, a well-received kick-off event, and a comprehensive set of practice improvement resources. Major challenges included recruiting primary care practices, varying types and capabilities of electronic health records, and working with practices at different transformation stages, with different objectives for participating and involvement in other government initiatives. Conclusions: Study findings provide insights for future dissemination research and implementation of evidence-based practices in primary care. Challenges experienced in project development can result in a domino effect that could change the project timeline, type of practices recruited for study participation, resource allocation, and planned activities for quality improvement. Effectiveness of external quality improvement support may depend on practice engagement, preexisting organizational structures and processes, availability of resources, and length and continuity of practice facilitation.
The Dietary Management of Patients with Irritable Bowel Syndrome: A Narrative Review of the Existing and Emerging Evidence

Even though irritable bowel syndrome (IBS) has been known for more than 150 years, it still remains one of the research challenges of the 21st century. According to the current diagnostic Rome IV criteria, IBS is characterized by abdominal pain associated with defecation and/or a change in bowel habit, in the absence of detectable organic causes. Symptoms interfere with the daily life of patients, reduce health-related quality of life and lower the work productivity. Despite the high prevalence of approximately 10%, its pathophysiology is only partly understood and seems multifactorial. However, many patients report symptoms to be meal-related and certain ingested foods may generate an exaggerated gastrointestinal response. Patients tend to avoid and even exclude certain food products to relieve their symptoms, which could affect nutritional quality. We performed a narrative paper review of the existing and emerging evidence regarding dietary management of IBS patients, with the aim to enhance our understanding of how to move towards an individualized dietary approach for IBS patients in the near future.
Effects of stocking density on growth performance, growth regulatory factors, and endocrine hormones in broilers under appropriate environments

Stocking density is an important environment factor that affects the development of poultry farming, which has caused widespread concern. This study was carried out to determine the effects of stocking density on growth performance, growth regulatory factors, and endocrine hormones in broilers under appropriate environments. A total of 144 Arbor Acres male broilers (BW 1000 ± 70 g) were randomly divided into low stocking density (LSD; 6.25 birds/m2), medium stocking density (MSD; 12.50 birds/m2), and high stocking density (HSD; 18.75 birds/m2) groups, with 6 replicates in each group, and raised in 3 environmental chambers (same size) from 29-day-old to 42-day-old, respectively. The trial period lasted for 14 D with 21 ± 1°C and 60 ± 7% relative humidity, wind speed < 0.5 m/s, ammonia level<5 ppm. The results indicated that average daily food intake and average daily gain in HSD group showed significantly lower than other 2 groups (P < 0.05). Besides, the HSD group significantly reduced breast muscle yield, tibial length, tibial width, and tibial weight of broilers (P < 0.05). The HSD group increased the mRNA expression level of myostatin, and reduced the mRNA expression levels of insulin-like growth factor 1 (IGF-1) and myogenic determination factor 1 (P < 0.05). The HSD group significantly reduced the expression of parathyroid hormone-related protein in tibial growth plate (P < 0.05). The HSD group increased the serum corticosterone levels of broilers (P < 0.05), and decreased the serum IGF-1 and thyroxine (T4) levels of broiler chickens (P < 0.05) than other stocking density groups. Moreover, the serum alkaline phosphatase levels were decreased (P < 0.05) with increasing stocking density, whereas there were no significant effects on the serum 3,5,3′-triiodothyronine (T3) concentrations in 3 groups (P > 0.05). In conclusion, under appropriate environments HSD reduced the growth performance of broilers and this negative effect was likely associated with decreased growth of muscle and bone.
Distinct metabolic pathways drive monoterpenoid biosynthesis in a natural population of Pelargonium graveolens

Abstract Pelargonium graveolens is a wild predecessor to rose-scented geranium hybrids prized for their essential oils used as fragrances and flavorings. However, little is known about their biosynthesis. Here we present metabolic evidence that at least two distinct monoterpene biosynthetic pathways contribute to their volatile profiles, namely, cyclic p-menthanes such as (−)-isomenthone and acyclic monoterpene alcohols such as geraniol and (−)-citronellol and their derivatives (referred to here as citronelloid monoterpenes). We established their common origin via the 2C-methyl-d-erythritol-4-phosphate pathway but found no indication these pathways share common intermediates beyond geranyl diphosphate. Untargeted volatile profiling of 22 seed-grown P. graveolens lines demonstrated distinct chemotypes that preferentially accumulate (−)-isomenthone, geraniol, or (−)-citronellol along with approximately 85 minor volatile products. Whole plant 13CO2 isotopic labeling performed under physiological conditions permitted us to measure the in vivo rates of monoterpenoid accumulation in these lines and quantify differences in metabolic modes between chemotypes. We further determined that p-menthane monoterpenoids in Pelargonium are likely synthesized from (+)-limonene via (+)-piperitone rather than (+)-pulegone. Exploitation of this natural population enabled a detailed dissection of the relative rates of competing p-menthane and citronelloid pathways in this species, providing real time rates of monoterpene accumulation in glandular trichomes.
New insights on human essential genes based on integrated analysis and the construction of the HEGIAP web-based platform

Abstract Essential genes are those whose loss of function compromises organism viability or results in profound loss of fitness. Recent gene-editing technologies have provided new opportunities to characterize essential genes. Here, we present an integrated analysis that comprehensively and systematically elucidates the genetic and regulatory characteristics of human essential genes. First, we found that essential genes act as ‘hubs’ in protein–protein interaction networks, chromatin structure and epigenetic modification. Second, essential genes represent conserved biological processes across species, although gene essentiality changes differently among species. Third, essential genes are important for cell development due to their discriminate transcription activity in embryo development and oncogenesis. In addition, we developed an interactive web server, the Human Essential Genes Interactive Analysis Platform (http://sysomics.com/HEGIAP/), which integrates abundant analytical tools to enable global, multidimensional interpretation of gene essentiality. Our study provides new insights that improve the understanding of human essential genes.
Role of fruit juice in achieving the 5-a-day recommendation for fruit and vegetable intake

Abstract Although there is strong evidence that consumption of fruit and vegetables is associated with a reduced rate of all-cause mortality, only a minority of the population consumes 5 servings a day, and campaigns to increase intake have had limited success. This review examines whether encouraging the consumption of fruit juice might offer a step toward the 5-a-day target. Reasons given for not consuming whole fruit involve practicalities, inconvenience, and the effort required. Psychologically, what is important is not only basic information about health, but how individuals interpret their ability to implement that information. It has been argued that fruit juice avoids the problems that commonly prevent fruit consumption and thus provides a practical means of increasing intake and benefitting health through an approach with which the population can readily engage. Those arguing against consuming fruit juice emphasize that it is a source of sugar lacking fiber, yet juice provides nutrients such as vitamin C, carotenoids, and polyphenols that offer health-related benefits. Actively encouraging the daily consumption of fruit juice in public health policy could help populations achieve the 5-a-day recommendation for fruit and vegetable intake.
untreated patients with chronic lymphocytic leukemia Prognostic nomogram and index for overall survival in previously

doi:10.1182/blood-2005-12-051458Prepublished online February 13, 2007;2007 109: 4679-4685€€€€Giles, Farhad Ravandi, Susan Lerner, Hagop Kantarjian and Michael KeatingJorge Cortes, Deborah Thomas, Guillermo Garcia-Manero, Charles Koller, Miloslav Beran, Francis William G. Wierda, Susan O'Brien, Xuemei Wang, Stefan Faderl, Alessandra Ferrajoli, Kim-Anh Do,€
Organ-wide and ploidy-dependent regulation both contribute to cell-size determination: evidence from a computational model of tomato fruit

The development of a new organ is the result of coordinated events of cell division and expansion, in strong interaction with each other. This paper presents a dynamic model of tomato fruit development that includes cells division, endoreduplication and expansion processes. The model is used to investigate the interaction among these developmental processes, in the perspective of a neo-cellular theory. In particular, different control schemes (either cell-autonomous or organ-controlled) are tested and results compared to observed data from two contrasted genotypes. The model shows that a pure cell-autonomous control fails to reproduce the observed cell size distribution, and an organ-wide control is required in order to get realistic cell sizes. The model also supports the role of endoreduplication as an important determinant of the final cell size and suggests a possible interaction through carbon allocation and metabolism.
n-3 Canola oil effectively replaces fish oil as a new safe dietary source of DHA in feed for juvenile Atlantic salmon

Abstract Limited availability of fish oils (FO), rich in n-3 long-chain (≥C20) PUFA, is a major constraint for further growth of the aquaculture industry. Long-chain n-3 rich oils from crops GM with algal genes are promising new sources for the industry. This project studied the use of a newly developed n-3 canola oil (DHA-CA) in diets of Atlantic salmon fingerlings in freshwater. The DHA-CA oil has high proportions of the n-3 fatty acids (FA) 18 : 3n-3 and DHA and lower proportions of n-6 FA than conventional plant oils. Levels of phytosterols, vitamin E and minerals in the DHA-CA were within the natural variation of commercial canola oils. Pesticides, mycotoxins, polyaromatic hydrocarbons and heavy metals were below lowest qualifiable concentration. Two feeding trials were conducted to evaluate effects of two dietary levels of DHA-CA compared with two dietary levels of FO at two water temperatures. Fish increased their weight approximately 20-fold at 16°C and 12-fold at 12°C during the experimental periods, with equal growth in salmon fed the FO diets compared with DHA-CA diets. Salmon fed DHA-CA diets had approximately the same EPA+DHA content in whole body as salmon fed FO diets. Gene expression, lipid composition and oxidative stress-related enzyme activities showed only minor differences between the dietary groups, and the effects were mostly a result of dietary oil level, rather than the oil source. The results demonstrated that DHA-CA is a safe and effective replacement for FO in diets of Atlantic salmon during the sensitive fingerling life-stage.
Failures, Reoperations, and Improvement in Knee Symptoms Following Matrix-Assisted Autologous Chondrocyte Transplantation: A Meta-Analysis of Prospective Comparative Trials

Objective Though multiple high-level comparative studies have been performed for matrix-assisted autologous chondrocyte transplantation (MACT), quantitative reviews synthesizing best-available clinical evidence on the topic are lacking. Design A meta-analysis was performed of prospective randomized or nonrandomized comparative studies utilizing MACT. A total of 13 studies reporting 13 prospective trials (9 randomized, 5 nonrandomized) were included (658 total study participants at weighted mean 3.1 years follow-up, range 1-7.5 years). Results Reporting and methodological quality was moderate according to mean Coleman (59.4 SD 7.6), Delphi (3.0 SD 2.1), and MINORS (Methodological Index For Non-Randomized Studies) scores (20.2 SD 1.6). There was no evidence of small study or reporting bias. Effect sizes were not correlated with reporting quality, financial conflict of interest, sample size, year of publication, or length of follow-up (P > 0.05). Compared to microfracture, MACT had greater improvement in International Knee Documentation Committee (IKDC)-subjective and Knee Injury and Osteoarthritis Outcome Pain Subscale Score (KOOS)-pain scores in randomized studies (P < 0.05). Accelerated weight-bearing protocols (6 or 8 weeks) resulted in greater improvements in IKDC-subjective and KOOS-pain scores than standard protocols (8 or 11 weeks) for MACT in randomized studies (P < 0.05) with insufficient nonrandomized studies for pooled analysis. Conclusions Compared to microfracture, MACT has no increased risk of clinical failure and superior improvement in patient-reported outcome scores. Compared to MACT with standardized postoperative weight-bearing protocols, accelerated weight-bearing protocols have no increased risk of clinical failure and show superior improvement in patient-reported outcome scores. There is limited evidence regarding MACT compared to first-generation autologous chondrocyte implantation, mosaicplasty, and mesenchymal stem cell therapy without compelling differences in outcomes.
Individualized Management of Genetic Diversity in Niemann-Pick C1 through Modulation of the Hsp70 Chaperone System.

Genetic diversity provides a rich repository for understanding the role of proteostasis in the management of the protein fold in human biology. Failure in proteostasis can trigger multiple disease states, affecting both human health and lifespan. Niemann-Pick C1 (NPC1) disease is a rare genetic disorder triggered by mutations in NPC1, a multi-spanning transmembrane protein that is trafficked through the exocytic pathway to late endosomes (LE) and lysosomes (Ly) (LE/Ly) to globally manage cholesterol homeostasis. Defects triggered by > 300 NPC1 variants found in the human population inhibit export of NPC1 protein from the ER and/or function in downstream LE/Ly, leading to cholesterol accumulation and onset of neurodegeneration in childhood. We now show that the allosteric inhibitor JG98, that targets the cytosolic Hsp70 chaperone/co-chaperone complex, can significantly improve the trafficking and post-ER protein level of diverse NPC1 variants. Using a new approach to model genetic diversity in human disease, referred to as Variation Spatial Profiling (VSP), we show quantitatively how JG98 alters the Hsp70 chaperone/co-chaperone system to adjust the Spatial CoVariance (SCV) tolerance and set-points on an amino acid residue-by-residue basis in NPC1 to differentially regulate variant trafficking, stability, and cholesterol homeostasis, results consistent with the role of Bag family co-chaperones in managing the folding status of NPC1 variants. We propose that targeting the cytosolic Hsp70 system by allosteric regulation of its chaperone/co-chaperone based client relationships can be used to adjust the SCV tolerance of proteostasis buffering capacity to provide an approach to mitigate systemic and neurological disease in the NPC1 population.
Heterogeneity of p16 immunohistochemistry and increased sensitivity of RNA in situ hybridization in cytology specimens of HPV‐related head and neck squamous cell carcinoma

Many patients with human papillomavirus (HPV)–related head and neck squamous cell carcinoma (HPV‐HNSCC) initially present with cervical lymph node metastases. Although p16 immunohistochemistry (IHC) is the most commonly used surrogate marker for HPV, however criteria in cytologic material are not well established. The objective of this study was to better characterize p16 IHC in cell blocks of metastatic HPV‐HNSCC, and to evaluate the performance of HPV RNA in situ hybridization (RNA ISH).
Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry.

BACKGROUND The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. METHODS We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. RESULTS A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn's disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. CONCLUSIONS Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response.