Miracle-dz/UniFAR-FTUs huggingface dataset:
Tennis elbow: its course, natural history, conservative and surgical management.

In a series of 1,000 patients with tennis elbow or medial or lateral epicondylitis, adequate follow-up was obtained on 339 patients. Of these, 278 responded to conservative therapy and thirty-nine were operated on. Tears of the extensor or flexor tendon were seen in twenty-eight patients. Resection of the torn or scarred portion of the tendon and suture, if feasible, gave generally satisfactory results.
Are adolescents being screened for sexually transmitted diseases? A study of low income African American adolescents in San Francisco

Objectives: To determine the proportion of sexually experienced African American adolescents who report having been screened for sexually transmitted diseased (STDs), and to determine the proportion who report having been screened for STDs among those adolescents who have had a preventive primary healthcare visit in the past 2 years. Methods: A telephone survey of a population based sample of African American 12–17 year old adolescents residing in a low income San Francisco neighbourhood with a high prevalence of STDs. Results: Of the 302 adolescents surveyed, 118 (39%) reported a history of sexual intercourse. Of these, 26% of the males and 59% of the females had been screened for an STD in the previous 12 months. 31% of the males and 63% of the females had been screened for an STD in the previous 24 months. Of the 93 participants who had had a preventive primary care visit since their first episode of sexual intercourse, 26% of the males and 60% of the females had been screened for an STD in the previous 24 months. Conclusions: Sexually experienced African American adolescents in San Francisco are being screened for STDs at rates well below that recommended by current clinical guidelines. A low rate of screening was found even in those adolescents who had been seen for a preventive primary care visit since they first had sex. This suggests that the preventive primary care visit is not being used to its full potential as an opportunity to screen and treat adolescents for STDs. Capitalising on this opportunity to screen may increase the number of STDs diagnosed and, thus, decrease rates of STDs in this population.
Effect of the Feeding T-Junctions in the Performance of Planar Waveguide Slot Arrays

An improved analysis procedure for planar waveguide slot arrays has been devised to evaluate the effect of the feeding T-junctions on the radiated far field. The T-junctions have been modelled as five-port networks. A hybrid matrix has been derived for each five-port network by analyzing the interaction between a T-junction and the slot couplers next to it with a method of moments (MoM) procedure. Then, the hybrid matrices have been properly inserted in the array equivalent circuit. The results of our model have been compared to those of a commercial software and with measured data, showing a very good agreement.
Homozygosity for human leucocyte antigen‐C ligands of KIR2DL1 is associated with increased risk of relapse after human leucocyte antigen‐C‐matched unrelated donor haematopoietic stem cell transplantation

Human leucocyte antigen (HLA)‐C molecules regulate the function of natural killer cells and may be subdivided into two groups, C(1) and C(2), based on their specificity for inhibitory killer immunoglobulin‐like receptors. We analysed the impact of the HLA‐C genotype on outcome of HLA‐C‐matched unrelated donor haematopoietic stem cell transplantation (URD‐HSCT) recipients. HLA‐C(2) homozygous patients (n = 18) had lower probability of overall survival (P = 0·01) and disease‐free survival (P = 0·02), resulting from increased relapse rate (P = 0·02) when compared with both HLA‐C(1) homozygous (n = 43) and HLA‐C(1),C(2) heterozygous (n = 50) subgroups. Patients lacking HLA‐C(1) should, therefore, be considered at increased risk of relapse following HLA‐C‐matched URD‐HSCT.
Posterior Occipitocervical Fusion: A Preliminary Report of a New Technique

A new technique for occipitocervical fusion is described. The fixation of the upper cervical spine with plates and screws avoids the possible disadvantages of the commonly used wiring technique. By the establishment of a rigid fixation between the occiput and upper cervical spine with a combination of plates and screws, especially with transarticular atlantoaxial screw fixation, reliable, multidirectional, and immediate stability is achieved. The clinical picture and analysis of 14 patients with a variety of pathologies of the upper cervical spine is presented. The satisfactory outcome and solid bony fusion in all 14 patients and the absence of severe complications encourages the continued use of this technique of occipitocervical fusion.
Clinical and molecular characterization of Wilson disease in Spanish patients

Wilson disease (WD) results when specific mutations occur at the ATP7B gene. The presence of mutations in the ATP7B gene was studied in the coding region and the intron–exon boundaries in 15 WD Spanish patients, and their first‐degree relatives when possible. A total of 20 nucleotide sequence changes were detected, 18 missense and two splicing mutations. Six of these variants were classified as disease‐causing mutations, five missense, and one splicing; four of them have been previously described (M645R, A1065P, H1069Q, and 3060 + 5G > T), whereas two were novel (P768L and A990P). No mutation was clearly prevalent, although the H1069Q mutation predominated, nor did a good phenotype–genotype correlation exist. The two new mutations described were manifested as an asymptomatic increase in serum transaminases. The remaining 14 changes were classified as polymorphisms and their potential effects on protein function are discussed. The identification of mutations in the ATP7B gene has allowed a conclusive diagnosis to be made of WD in patients presenting neurological phenotype or neurological of hepatic phenotype, who would otherwise not have been diagnosed using classical criteria. WD patients could start chelating treatment earlier on and possibly modify the natural progression of the disease.
Title Sensitivity of Econometric Estimates to Item Non-response Adjustment Permalink

Non-response in establishment surveys is a very important problem that can bias results of statistical analysis. The bias can be considerable when the survey data is used to do multivariate analysis that involve several variables with different response rates, which can reduce the effective sample size considerably. Fixing the non-response, however, could potentially cause other econometric problems. This paper uses an operational approach to analyze the sensitivity of results of multivariate analysis to multiple imputation procedures applied to the U.S. Census Bureau/NSF‘s Business Research and Development and Innovation Survey (BRDIS) to address item non-response. Multiple imputation is first applied using data from all survey units and periods for which there is data, presenting scenario 1. A scenario 2 involves separate imputation for units that have participated in the survey only once and those that repeat. Scenario 3 involves no imputation. Sensitivity analysis is done by comparing the model estimates and their standard errors, and measures of the additional uncertainty created by the imputation procedure. In all cases, unit non-response is addressed by using the adjusted weights that accompany BRDIS micro data. The results suggest that substantial benefit may be derived from multiple imputation, not only because it helps provide more accurate measures of the uncertainty due to item non-response but also because it provides alternative estimates of effect sizes and population totals.
Serum Calcium and Vitamin D Status of Patients with Sickle Cell Disease in Curaçao

We measured parameters of calcium homeostasis and vitamin D status in HbSS patients (median age 8 years, range 3–19; 8 females, 10 males) and matched HbAA controls living in the tropical island of Curaçao. Serum calcium concentration in HbSS patients [2·32(0·07) mmol/L] was lower (ANCOVA, P = 0·002) than that of HbAA controls [2·44(0·14)]. None of the subjects had hypocalcaemia. There were no differences in serum concentrations of phosphate, total protein, albumin, intact parathyroid hormone (PTH), 25-hydroxyvitamin D [87(27) nmol/L in patients, 86(15) nmol/L in controls) and 1,25-dihydroxyvitamin D. There were no significant relations between PTH and 25(OH)D. We conclude that vitamin D status of HbSS patients in Curaçao is adequate.
TPR‐mediated interaction of RapC with ComA inhibits response regulator‐DNA binding for competence development in Bacillus subtilis

The Bacillus subtilis Rap family of proteins are characterized by protein–protein interaction modules containing the so‐called tetratricopeptide repeats (TPRs). The six TPR motifs of RapC mediate its interaction with the pentapeptide inhibitor PhrC (ERGMT) or with its target protein ComA, a phosphorylation‐dependent response regulator transcription factor for genetic competence. Our results show that RapC interaction with ComA inhibits the response regulator's ability to bind its target DNA promoter but does not affect its phosphorylation state. RapC binds equally well to ComA or to ComA∼P. The PhrC pentapeptide binds to RapC and inhibits its interaction with ComA. The D195 residue in TPR3 and the P263 residue in TPR5 of RapC are critical for the interaction with PhrC as their mutation to asparagine or leucine, respectively, prevents peptide inhibitory activity. The RapC mechanism of regulating ComA activity is a new example of how TPR motifs and their structural organization have been adapted for different specific functions within the B. subtilis Rap family.
Increasing body satisfaction of body concerned women through evaluative conditioning using social stimuli.

OBJECTIVE Many women show weight and body concerns that leave them vulnerable to body dissatisfaction, lowered self-esteem, psychological distress, and eating disorders. This study tested whether body satisfaction could be increased by means of evaluative conditioning. DESIGN In the experimental condition (n = 26), women with low and high body concern completed a conditioning procedure in which pictures of their bodies were selectively linked to positive social stimuli (pictures of smiling faces). Pictures of control bodies were linked to neutral or negative social stimuli (neutral and frowning faces). In a control condition (n = 28), low and high body concerned women underwent a procedure in which pictures of their own body and of control bodies were randomly followed by positive, neutral, and negative social stimuli. MAIN OUTCOME MEASURES Changes in body satisfaction and self-esteem before and after the conditioning task. RESULTS Women with high body concern demonstrated an increase in body satisfaction and global self-esteem when pictorial representations of their own bodies were associated with positive stimuli that signaled social acceptance. CONCLUSION A simple conditioning procedure increased body satisfaction in healthy, normal weight women who were concerned about their shape and weight.
GnRH agonists before surgery for uterine leiomyomas. A review.

OBJECTIVE To clarify whether preoperative treatment with gonadotropin-releasing hormone (GnRH) agonists offers substantial advantages to patients undergoing conservative or definitive surgery for uterine leiomyomas. STUDY DESIGN A review of data from the most recent English-language literature. RESULTS Inducing amenorrhea in patients with heavy menorrhagia and severe sideropenic anemia before both conservative and definitive surgery for uterine fibroids raises hemoglobin and hematocrit values to within the normal range, limits homologous blood transfusions and enables operations to be scheduled with the patients in better condition. A temporary 30-50% reduction in mean uterine volume theoretically may convert an abdominal into a vaginal hysterectomy in "borderline" cases or sometimes allow a transverse instead of longitudinal abdominal incision. No trial has yet demonstrated "clinically" significant reductions in operating time, operative blood loss or postoperative morbidity in patients undergoing myomectomy or hysterectomy after a course of GnRH agonists as compared with those operated on immediately. There seems insufficient scientific evidence to justify the routine use of GnRH agonists before myomectomy at laparotomy, except possibly in the case of extremely bulky uteri. GnRH agonist treatment before hysteroscopic myomectomy induces endometrial thinning, reduces bleeding and mucous debris, and decreases the diameter of submucous leiomyomas, improving visibility and limiting operating time and fluid intravasation. CONCLUSION The available data seem to support the use of GnRH agonist treatment before surgery for uterine leiomyomas in selected circumstances. Administration of GnRH agonist for only two or three months preoperatively seems to achieve all the advantages of this treatment, limiting side effects and cost.
Genetic behavior of the methicillin resistance determinant in Staphylococcus aureus

The cotransformation frequency of mecC5 with pur-102 using Staphylococcus aureus C5 deoxyribonucleic acid was found to be approximately 45%. However, in cotransduction studies, there was a 15% cotransduction of purine prototrophy and methicillin sensitivity but, in the reciprocal cross, no purine-prototrophic plus Mecr cotransductants were obtained (frequency less than 0.06%). The data support the hypothesis that the mec determinant resides on an inserted deoxyribonucleic acid sequence in S. aureus and that there is no allelic equivalent in sensitive cells.
Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols.

PURPOSE To define prognostic factors for response and long-term outcome for a wide spectrum of osteosarcomas, extending well beyond those of the typical young patient with seemingly localized extremity disease. PATIENTS AND METHODS A total of 1,702 consecutive newly diagnosed patients with high-grade osteosarcoma of the trunk or limbs registered into the neoadjuvant studies of the Cooperative Osteosarcoma Study Group before July 1998 were entered into an analysis of demographic, tumor-related, and treatment-related variables, response, and survival. The intended therapeutic strategy included preoperative and postoperative chemotherapy with multiple agents as well as surgery of all operable lesions. RESULTS Axial tumor site, male sex, and a long history of symptoms were associated with poor response to chemotherapy in univariate and multivariate analysis. Actuarial 10-year overall and event-free survival rates were 59.8% and 48.9%. Among the variables assessable at diagnosis, patient age (actuarial 10-year survival > or = 40, 41.6%; < 40, 60.2%; P =.012), tumor site (axial, 29.2%; limb, 61.7%; P <.0001), and primary metastases (yes, 26.7%; no, 64.4%; P <.0001), and for extremity osteosarcomas, also size (> or = one third, 52.5%; < one third, 66.7%; P <.0001) and location within the limb (proximal, 49.3%; other, 63.9%; P <.0001), had significant influence on outcome. Two additional important prognostic factors were treatment related: response to chemotherapy (poor, 47.2%; good, 73.4%; P <.0001) and the extent of surgery (incomplete, 14.6%; macroscopically complete, 64.8%; P <.0001). All factors except age maintained their significance in multivariate testing, with surgical remission and histologic response emerging as the key prognostic factors. CONCLUSION Tumor site and size, primary metastases, response to chemotherapy, and surgical remission are of independent prognostic value in osteosarcoma.
The "distal-dorsal difference" as a possible predictor of secondary Raynaud's phenomenon.

OBJECTIVE To investigate the possibility that a hand distal-dorsal difference in temperature of greater than 1 degree C (fingers colder than the dorsum) at a room temperature of 30 degrees C is a good predictor of secondary Raynaud's phenomenon (RP). METHODS We imaged the hands of patients with primary Raynaud's phenomenon (PRP) and systemic sclerosis (SSc) using a thermal camera at room temperatures of 23 and 30 degrees C. From these images we measured the distal-dorsal difference in temperature for all fingers excluding the thumbs. At a room temperature of 23 degrees C we also performed a cold challenge test using water at 15 degrees C for 1 min and thermally imaged the rewarming process for 15 min. Several variables were derived from the rewarming curve. The procedure was repeated within 3 days to assess reproducibility. RESULTS The best discriminator between PRP and SSc was found to be a distal-dorsal difference of > 1 degree C at 30 degrees C (p = 0.005). There is reasonable reproducibility when considering groups of patients. However, the intra-subject standard deviations were large, indicating that measurements for the same patient on separate visits may vary considerably. CONCLUSION Our results suggest that the finding of a distal-dorsal difference of > 1 degree C (cold fingers) at 30 degrees C in a patient with RP is specific for underlying connective tissue disease.
Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation.

Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Clopidogrel trial with Irbesartan for prevention of Vascular Events ACTIVE W Trial. The Lancet 2006;367:1903-1912 Study Type: POEM Purpose: Is clopidogrel and aspirin as effective as oral anticoagulation therapy in preventing vascular events in patients with atrial fibrillation at high risk of stroke. Trial Design: Randomized, multicenter, intention-to-treat Drug: clopidogrel 75mg qday plus low dose aspirin (75-100 mg) versus oral anticoagulation (manipulated by investigators to a target INR= 2-3). Study lasted 1.28 years. Patients: n= 6706, mean age = 70, mean BP = 133/79, mean HR = 74, mean BMI = 28.7, 66 % male, 34% female, 60% A. fib > 2 years, 83% history of HTN, 15% history of stroke or TIA, 17% had a MI, 9% had a CABG, 10% with CAD, 21% with DM, 4% PAD, 30% with HF Medications: 77% on oral anticoagulation prior to start of study, 28% aspirin, 3% clopidogrel, 54% ACE, 15% ARB, 57% BB, 19% digoxin, 37% statin Inclusion Criteria: EKG evidence of A. fib and at least one of the following: >/= 75 yoa, Tx of HTN, previous stroke, TIA, or non-CNS embolus, left ventricular dysfunction w/ EF<45% or PAD. Patients 55-74 if none of above present then had to have DM (requiring drug therapy) or CAD. Exclusion Criteria: Prosthetic mechanical heart valve, documented PUD w/in last 6 months, previous ICH, platelets <50 or mitral stenosis. Outcome Events: Primary 1 occurrence of stroke, non-CNS embolism, MI or vascular death; Stroke subdivided into hemorrhagic and ischemic; Severity of stroke was determined using Rankin score and subdural hematomas were classified as ICH and transformation from ischemic stroke to hemorrhagic stroke was not considered ICH.
Low-fluoride Dentifrice and Gastrointestinal Fluoride Absorption after Meals

A low-fluoride (F) dentifrice has been recommended to reduce the risk of dental fluorosis, but its anti-caries efficacy is questionable compared with that of conventional dentrifices (1000–1100 μg F/g). The tested hypothesis was that conventional dentifrices might be safe if used soon after meals, since food interferes with F absorption. In a crossover, double-blind study, 11 volunteers ingested a dentifrice slurry containing 0 (placebo), 550 (low F), or 1100 μg F/g in 3 gastric content situations: on fasting, or 15 min after breakfast or lunch. F was analyzed in saliva and 24-hour urine samples. The conventional dentifrice ingested after lunch resulted in only 10% higher F absorption than the low-F ingested on fasting. Analysis of the data suggests that the risk of fluorosis could be reduced by the use of either a low-F dentifrice or a conventional dentifrice, if toothbrushing occurred soon after meals.
Amyotrophic lateral sclerosis—Evolutionary and other perspectives

In this study some particular and puzzling aspects of amyotrophic lateral sclerosis (ALS) are discussed, with an emphasis on the role of neocortical evolution. Other issues explored include the nature of the clinical deficit in ALS; anatomical and evolutionary aspects of the neocortex, motor cortex, and corpus callosum; and some discussion as to when ALS begins. In common with other neurodegenerative diseases, ALS may result from dysfunctional neocortical circuitry. It is suggested that the disease starts some years prior to clinical onset, possibly in adolescence, or even earlier, when there is marked alteration of anatomy, physiology, and biochemistry of the neocortex. The failure of naturally occurring animal models of ALS or models that truly replicate the human disease may reflect the unique, continued, and increased neocortical evolution of modern humans. Muscle Nerve 40: 297–304, 2009
Neoadjuvant and adjuvant therapy for surgical resection of hepatocellular carcinoma.

BACKGROUND Hepatocellular carcinoma is a disease of great concern. Surgery is the treatment of choice, but there is still a high recurrence rate after resection. OBJECTIVES To determine the benefits and harms of neoadjuvant and adjuvant therapies compared to surgery alone or surgery and placebo/supportive therapy after curative resection for operable hepatocellular carcinoma. SEARCH STRATEGY We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, Chinese Biomedical Database, and US National Cancer Institute's Physician's Data Query Trials Database until 2005. References of the identified trials were also searched for identifying further trials. SELECTION CRITERIA Randomised and quasi-randomised trials that compared hepatocellular carcinoma patients who were given and not given neoadjuvant/adjuvant therapy as a supplement to curative liver resection. DATA COLLECTION AND ANALYSIS Data were extracted independently by two authors and discrepancies resolved by consensus. The survival and disease-free survival curves were compared using their one, two, three, four, and five-year survival rates, median survival times, and the result of the significance tests (P-values). MAIN RESULTS A total of 12 randomised trials were identified, totaling 843 patients. The size of the randomised clinical trials ranged from 30 to 155 patients. Both preoperative (neoadjuvant) and postoperative (adjuvant), systemic and locoregional (+/- embolisation), chemo- and immunotherapy interventions were tested. Treatment regimens and patients selected were not comparable, so no pooling was done. Only one regimen using preoperative transcatheter arterial chemoembolisation with doxorubicin was similar in two trials. Four of the twelve trials reported survival benefit at five years when given adjuvant or neoadjuvant therapy. Disease-free survival was reported in nine trials, and the estimated hazard ratios show that disease-free survival was significant in two trials at five years. These two trials had not shown a survival advantage, but the recurrence was significantly lower in patients given adjuvant or neoadjuvant therapy. The highest toxicity rate was in a trial using oral 1-hexylcarbamoyl 5-fluorouracil which resulted in 12 out of 38 patients being withdrawn from the trial because of adverse events. AUTHORS' CONCLUSIONS There is no clear evidence for efficacy of any of the adjuvant and neo-adjuvant protocols reviewed, but there is some evidence to suggest that adjuvant therapy may be beneficial offering prolonged disease-free survival. In order to detect a realistic treatment advantage, larger trials with lower risk of systematic error will have to be conducted.