Miracle-dz/UniFAR-FTUs huggingface dataset:
Airway Obstruction following Palatoplasty: Analysis of 247 Consecutive Operations

Objective and Methods: Between February 1987 and September 1997, 247 patients underwent primary repair of a cleft of the secondary palate by one surgeon, using the double-opposing Z-plasty (Furlow) technique. This retrospective study reviews perioperative and postoperative airway compromise among these patients. The purposes of this study were to identify factors associated with airway obstruction following palatoplasty and to analyze the management of those patients. Although infants experiencing airway problems following Wardill-Kilner and Von Langenbeck palatoplasty have been described, airway complications in a group of Furlow repair patients has not been previously reported. Results: Fourteen patients (5.7%) had airway problems. The average age of these patients was 18 months, which was not significantly different from those without airway problems. Airway obstruction occurred as late as 48 hours after the completion of surgery. Twelve of the 14 patients had severe airway compromise requiring continued postoperative intubation, reintubation, or tracheostomy (one). There were no deaths. Thirteen of the 14 patients with postoperative airway problems (93%) had other congenital anomalies in addition to clefting, a named congenital disorder, or both. Seven of those 13 had Pierre Robin sequence. In contrast, only 40 of the 233 patients without airway problems (17%) had additional congenital anomalies or named disorders. Presence of other congenital anomalies was associated with a significantly increased risk of airway obstruction (p 5 .005). Conclusion: Patients with cleft palate with the Pierre Robin sequence or other additional congenital anomalies had an increased risk of airway problems following palatoplasty. Awareness of this risk permits identifying those patients prior to surgery so that they can be monitored and managed appropriately, minimizing the likelihood of major complications or death.
Epoetin-alpha reduces red blood cell transfusions (RBC) in high-risk breast cancer patients with adjuvant dose-dense, sequential chemotherapy with epirubicin (E), paclitaxel (T) and cyclophosphamide (C) (ETC)

613 Background: Dose-dense chemotherapy improves DFS and OS in breast cancer patients but leads to a higher number of RBC transfusions. We analyzed the influence of Epoetin-alpha in dose-dense sequential chemotherapy with ETC on the amount of blood transfusions and median Hb value during treatment. Methods: From 12/98 until 4/03, 1284 pts were recruited for a multi-center phase-III trial. Breast cancer pts with at least 4 involved axillary lymph nodes and below 65 years of age were eligible. In the standard arm, pts received 4 courses of conventionally dosed epirubicin/cyclophosphamide (90/600mg/m2) followed by 4 courses of paclitaxel (175 mg/m2) at 3 weeks interval (q3wks). In the experimental arm, pts were given three courses each of epirubicin (150mg/m2), paclitaxel (225mg/m2) and cyclophosphamide (2500mg/m2) (ETC) (q2wks). A second randomization ± Epoetin-alpha was performed (150 IU/kg/sc three times weekly). Results: In 05/04, 1143 (98%) pts were fully evaluable. Risk factors were equally distributed.
Functional Analysis of Cleft Lip and Palate Patients with Modified Rakosi Method

Objective: The aim of this study was to investigate the mandibular functions of patients with cleft lip and palate (CLP) by means of modified Rakosi Functional Analysis and to test whether there was a risk of tendency to temporomandibular joint disorder when compared with Angle Class I non-CLP patients. Design: Fifteen patients with unilateral CLP with a mean age of 12.2 6 1.91 years and randomly selected 15 Angle Class I orthodontic patients with a mean age of 10.5 6 2.01 years as a control group. None of the subjects had complaint of symptoms of temporomandibular joint disorder in their histories. All subjects were evaluated using modified Rakosi Functional Analysis method in accordance with a scoring system of the findings. Main Outcome Measures: Intraand extracapsular clinical functional surveys were taken. A Mann-Whitney U test was used to evaluate the differences between the CLP and non-CLP groups. Results and Conclusion: There was a significant difference (p , .01) between the distributions of the total scores of the two groups. A significant difference (p , .05) in right lateral movement was also observed between the two groups. However, there were no significant but borderline differences in clicking, crepitus, and maximum mouth opening findings between the two groups. Because these results do not explain the reason for the aforementioned differences, further studies seem essential.
Validation of the Tswana Versions of the Roland-Morris Disability Questionnaire, Quebec Disability Scale and Waddell Disability Index

The use of reliable and valid outcome measures inclinical research as well as clinical practice is very important. Selfreported questionnaires are widely used as outcome measures to assessthe subjective perception of disability caused by low back pain (LBP). The Roland Morris Disability Questionnaire (RMDQ), Quebec DisabilityScale (QDS) and Waddell Disability Index (W DI) have been identifiedas reliable and valid instruments for assessing disability caused by LPBin English speaking patients. The fact that we do not yet have a validatedand published version of the RMDQ, QDS and W DI in a local SouthA frican language was the motivation to undertake this study. The threequestionnaires were translated, back-translated and tested in a final version for use with Tswana speaking subjects. The questionnaires were tested on one hundred respondents, who metthe inclusion criteria, at five hospitals in Tswana speaking areas. Of the one hundred respondents 31 were retested 24 hours later. The Visual A nalogue Pain Intensity Scale (VA S-Pain) and Disability Rating Index (DRI) were used ascorrelation tools. There was moderate correlation between the RMDQ and the DRI (0.74) and the W DI and the DRI(0.63). The correlation between the QDS and DRI was strong (0.85). The RMDQ, QDS and W DI correlated moderatelywith the VA S-Pain (0.63, 0.68 and 0.74, respectively). The RMDQ, QDS and W DI appeared to be internally consistentscales with Cronbach’s alpha values of 0.92, 0.95 and 0.75, respectively. The RMDQ, QDS and W DI showed excel-lent test-retest reliability with intra-class correlation coefficient values of 0.93, 0.91 and 0.84, respectively. The resultssuggest that the Tswana versions of the RMDQ, QDS and W DI validated in this study are easy to understand, validand reliable instruments for the measurement of functional disability caused by LBP in a Tswana speaking population.Therefore these translated instruments may be useful clinical instruments for collecting standardised data on activitylimitations resulting from LBP in a Tswana speaking population.
Foreign-Born Resident Networks and Stock Comovement: When Local Bias Meets Home (Country) Bias

Abstract Foreign migration flows have important stock market consequences. Foreign-born resident networks within U.S. Metropolitan Statistical Areas (MSAs) are associated with excess return comovement between locally headquartered stocks and American Depositary Receipts (ADRs) from countries with ties to the MSA through the network of foreign-born residents. This comovement is hardly due to correlated fundamentals and at least partially driven by correlated trading within members of a common investor base consisting of foreign-born residents. Our evidence has implications for both investors and foreign multinational corporations (MNCs) seeking to reap benefits from cross-listings and is consistent with the notion that foreign-born residents exhibit both local bias and home (country) bias.
Dental Health Indices and Caries Associated Microflora in Children with Unilateral Cleft Lip and Palate

Objective: To investigate the dental health and caries related microflora of children with unilateral cleft lip and palate. Study Group: Sixty children with unilateral cleft lip and palate and matched controls. Outcome Measures: The decayed, missing, and filled teeth and surfaces in both the deciduous and permanent dentitions. The presence of developmental defects and plaque and gingivitis scores were also recorded. Plaque was collected from 25 of the children and their matched controls from three different sites, which were (1) the first approximal site distal to the cleft, (2) a contralateral anterior site, and (3) a remote site. It was cultured for Streptococcus mutans and lactobacilli. Plaque was collected from two sites in the matched controls. Results: There was no significant difference in the caries, plaque, and gingivitis scores between the children with cleft palate and the controls. A greater number of enamel opacities were recorded in the control group, and there was a higher prevalence of enamel discoloration in the children with cleft lip and palate. There was no significant difference in the proportion of S. mutans or lactobacilli at the cleft site, compared with the unaffected site in the study group, although there was an anterior-posterior gradient in the proportion of S. mutans. There was no significant association between the stagnation area at the cleft site and the bacteria associated with dental caries.
Postoperative Epidural Fentanyl Infusion—is the Addition of 0.1% Bupivacaine of Benefit?

A randomised, double-blind controlled clinical trial was conducted in 90 women scheduled for major abdominal gynaecological oncology surgery to determine the effect of adding 0.1% plain bupivacaine to a thoracic epidural fentanyl infusion. Following combined epidural and general anaesthesia, patients were randomised to receive epidural fentanyl 10 μg/ml, with (group FB) or without (group F) bupivacaine. After an initial 50 μg bolus of fentanyl, infusion rate was adjusted according to need between 2 and 10 ml/hr for 48 hours. The two groups (n = 40) were similar with regard to age, weight and preoperative status. Analgesia both at rest and with movement were significantly better in group FB (P < 0.0001) during the first 24 hours postoperatively, the greatest difference occurring in the 4 to 16 hour period. There was no significant difference between groups from 24 to 48 hours postoperatively. Fentanyl utilisation was significantly lower in group FB (median 41 versus 53 μg/hr, P <0.001), although clinically the fentanyl dose-sparing effect of bupivacaine was small and did not reduce opioid-induced side-effects. There was no significant difference between groups with respect to side-effects or lower limb weakness, although fewer patients in group FB could be mobilised on the morning of the first postoperative day (P <0.01). Nevertherless, all study patients were ambulant by the same afternoon. We concluded that, in this patient population, the addition of 0.1% bupivacaine to a thoracic epidural fentanyl infusion was beneficial in the early postoperative period.
Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 1: Background and Methodology

JONATHAN R. SANDY, M.SC., PH.D., M.ORTH. , F.D. S.R.C.S. (ENG), F.D. S.R.C.S. (EDIN) ALISON C. WILLIAMS, M.SC., M.ORTH. , F.D. S.R.C.S. (ENG) DAVID BEARN, M.SC., M.ORTH. R.C.S. (ENG), F.D. S. (ORTH) R.C.P.S. (GLAS) SUE MILDINHALL, L.R.C.S. L.T. TERRIE MURPHY, L.R.C.S. L.T. DEBBIE SELL, PH.D., F.R.C.S. L.T. JOHN J. MURRAY, C.B. E. , PH.D., F.D. S.R.C.S. (ENG) WILLIAM C. SHAW, M.SC.D. , PH.D., D.ORTH. , F.D. S.R.C.S. (ENG), D.D. O.R.C.P.S. (GLAS)
Causes and pathophysiology of malignant pleural mesothelioma

Malignant pleural mesothelioma (MPM) results from the neoplastic transformation of pleural mesothelial cells. Asbestos exposure is a major risk factor for MPM, but epidemiologic studies demonstrated the occurrence of MPM in populations exposed to other fibers, and an excess of MPM in populations occupationally exposed to man-made vitreous fibers and previously to asbestos. The development of nanotechnologies also raises some concern about the potential health effects of new particles of high aspect ration, such as carbon nanotubes. Toxicological studies investigated the mechanism of asbestos-induced transformation of mesothelial cells, and molecular analyses defined the genomic and physiopathological changes in MPM. These findings allowed identifying some key events accounting for the neoplastic process. This article summarizes the known and suspected causes of MPM, the cellular events and responses of mesothelial cells to asbestos fibers and the alterations of key genes and regulatory pathways involved i.
Host-pathogen interaction during Streptococcus pneumoniae colonization and infection

markdownabstract__Abstract__ Streptococcus pneumoniae was discovered by Sternberg and Pasteur in 1880. It took another six years to discover that this microorganism, called the pneumococcus, was the actual cause of bacterial pneumonia . Subsequently, this bacterium has been shown to provoke an impressive number of diseases, which can be roughly classified in respiratory and invasive. Respiratory diseases by S. pneumoniae are sinusitis, otitis media, bronchitis and pneumonia, of which the latter one may be complicated by septicemia . Disseminated invasive infections caused by the pneumococcus include sepsis, meningitis, endocarditis and arthritis. Morbidity and mortality are high both in the developing and the developed world: annually 3 million people die worldwide of pneumococcal infections. Approximately 1 million are children under the age of five years . Risk groups for pneumococcal disease are children younger than 2 years, elderly people and immunocompromised patients . In children, the increased risk for pneumococcal infections is mainly due to a relatively immature immune response to type II T-cell independent (TI-2) antigens such as capsular polysaccharides . In the elderly, the ability of both the innate as well as the adaptive immunity to respond to pneumococcal infection are thought to decline . In addition, higher rates of pneumococcal invasive diseases have been observed among populations such as Alaskan Natives, American Indians and African Americans . Patient groups who are at risk for particular variants of pneumococcal diseases are well defined. For example functional asplenia as in sickle cell disease as well as anatomic asplenia are serious risk factors for pneumococcal sepsis. This is due to the absence or dysfunction of the spleen, which is involved in systemic clearance of S. pneumoniae. In addition, complement deficiency and lower levels of circulating antibodies are thought to contribute to the increased susceptibility to pneumococcal infections in patients with sickle cell disease and other haemoglobinopathies . A relatively new risk group for pneumococcal meningitis are children with a cochlear implantation . Disease in these patients is thought to occur by the presence of a continuum between the outer ear and the inner skull. In general, patients with cerebrospinal fluid leakage, immunodeficiencies, chronic cardiovascular and pulmonary disease, HIV infections and diabetes mellitus are considered at risk for pneumococcal invasive disease.
Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 2: Dentofacial Outcomes and Patient Satisfaction

ALISON C. WILLIAMS, M.SC., M.ORTH. , F.D. S.R.C.S. (ENG) DAVID BEARN, M.SC., M.ORTH. R.C.S. (ENG), F.D. S. (ORTH) R.C.P.S. (GLAS) SUE MILDINHALL, L.R.C.S. L.T. TERRIE MURPHY, L.R.C.S. L.T. DEBBIE SELL, PH.D., F.R.C.S. L.T. WILLIAM C. SHAW, M.SC.D. , PH.D., D.ORTH. , F.D. S.R.C.S. (ENG), D.D. O.R.C.P.S. (GLAS) JOHN J. MURRAY, C.B. E. , PH.D., F.D. S.R.C.S. (ENG) JONATHAN R. SANDY, M.SC., PH.D., M.ORTH. , F.D. S.R.C.S. (ENG), F.D. S.R.C.S. (EDIN)
Self-Perception, Social Skills, Adjustment, and Inhibition in Young Adolescents with Craniofacial Anomalies

This study examines the relationships between self-perception, social skills, overall adjustment, and social inhibition in 45 young adolescents with craniofacial anomalies (CFA). Self-perception, social skills, and inhibition scores are within the normal range while the average adjustment is 1.5 SD below the average. Regression analyses were conducted. Social skills and athletic competence are the best predictors of adjustment and accounted for 73.5% of the variance in adjustment. Adjustment of adolescents is associated with degree of inhibition, with more poorly adjusted adolescents displaying greater inhibition. Self-esteem did not predict to adjustment. The theoretical and clinical implications of these findings are discussed.
Cranio-Orbito-Zygomatic Measurements from Standard CT Scans in Unoperated Crouzon and Apert Infants: Comparison with Normal Controls

Cranio-orbito-zygomatic measurements taken from standard axial computed tomographic (CT) scans of unoperated patients with Crouzon syndrome (6 males, 14 females) and Apert syndrome (6 males, 10 females) under 1 year of age were compared to each other and to normal controls (40 males, 35 females). Fifteen cranio-orbito-zygomatic variables were measured and repeated. Means and standard deviations were computed for each sex, and means were pooled since they were not significantly different. Correlation coefficients for repeat measures (intra-observer error) of each variable showed good reproducibility. Only the lateral orbital wall angle differed between the syndromes (p = .034), suggesting that upper facial differences (as measured by these variables) do not manifest themselves at this young age. All measurements for both syndromes, except one, were outside the 95 percent confidence range for age-matched controls. Measurements taken from standard CT scans provide an objective comparison between specific syndromes and the normal population.
Testing for Interaction between Maternal Smoking and TGFA Genotype among Oral Cleft Cases Born in Maryland 1992–1996

Objective: Infants born in Maryland between June 1992 and June 1996 were used in a case-control study of nonsyndromic oral clefts to test for effects of maternal smoking and a polymorphic genetic marker at the transforming growth factor alpha (TGFA) locus, both of which have been reported to be risk factors for these common birth defects. Design and Setting: Cases were infants with an oral cleft ascertained through three comprehensive treatment centers, with additional ascertainment through a registry of birth defects maintained by the Maryland Health Department. Controls were healthy infants. Medical history information on infants and mothers were collected, along with DNA samples Patients, Participants: Among 286 cases contacted (72% ascertainment), there were 192 nonsyndromic isolated oral clefts (106 M; 86 F) available for this case-control study. Main Outcome Measures: The largest group of 149 Caucasian nonsyndromic cases and 86 controls was used to test for association with maternal smoking and genotype at the Taq1 polymorphism in TGFA. Results: While this modest sample had limited statistical power to detect gene-environment interaction, there was a significant marginal Increase In risk of having an oral cleft If the mother smoked (odds ratio = 1.75, 95%CI = 1.01 to 3.02). We could not demonstrate statistical interaction between maternal smoking and TGFA genotype in this study, however, and the observed increase in the C2 allele among cases was not statistically significant. Conclusions: We could not confirm either the reported association between oral clefts and TGFA genotype or its interaction with maternal smoking. However, these data do show an increased risk if the mother smoked during pregnancy, and this effect was greatest among infants with a bilateral cleft and no close family history of clefts.
The Effects of Client Size and Stress Criteria on Bankruptcy Prediction Models: An Empirical Analysis

This study analyzes the effects of stress level and client size on the power of bankruptcy prediction models. First, four different stress criteria are tested regarding their effectiveness in increasing bankruptcy prediction models’ power These four criteria are: 1. Auditor View Criterion, 2. Altman Z-score Criterion, 3. Zmijewski Probability Criterion, 4.Stock Return Criterion. I find that Criteria 3 and 4 significantly outperform the other two criteria. The model’s performance is even better when I create a new stress criterion by combining Criteria 3 and 4. Secondly, I find that the traditional wisdom that larger firms are generally less likely to go bankrupt does not hold for stressed firms. This study documents a positive relationship between firm size and the probability of bankruptcy for stressed firms, and provides relevant explanations. Third, I hypothesize and find that firm size has a significant impact upon the relationship between the probability of bankruptcy and other bankruptcy predictors. The interaction terms between firm size and other predictors add significant incremental explanatory power to bankruptcy prediction models.
Speech Outcome following Late Primary Palate Repair

Objective: Early palate repair is recommended to minimize the development of disordered speech. We studied the speech outcome of late palate repair in 131 patients. The success of late palate repair is questioned because of the persistence of learned, compensatory misarticulations that are difficult to correct in spite of the establishment of correct palatal anatomy and a competent velopharyngeal mechanism. The objective of this study is to highlight the speech results following late primary repair of the palate. Settings and Design: Retrospective analysis of speech outcomes in 131 patients with cleft lip and palate who underwent primary palate repair after the age of 10 years between November 2000 and December 2004. None of the patients had received supervised institution-based speech therapy. However, all patients were counseled and oriented and demonstrated the correct place and manner of articulation for the phonemes misarticulated by them. Preoperative and 6to 12-month postoperative speech samples were assessed within the parameters of articulation, hypernasality, nasal air emission, and speech intelligibility. Outcome: The analysis indicated improvement in all speech parameters leading to an overall improvement in postoperative intelligibility for most patients. Conclusion: Although definite improvement occurs in all parameters of speech following late primary palate repair, residual speech problems persist in most patients, requiring further evaluation and appropriate treatment.