Miracle-dz/UniFAR-FTUs huggingface dataset:
Contemporary trends in the immediate surgical management of renal trauma using a national database

BACKGROUND The National Trauma Data Bank was used to analyze open surgical management of renal trauma during the first 24 hours of hospital admission, excluding those who were treated with conservative measures. A descriptive analysis of initial management trends following renal trauma was also performed as a secondary analysis. METHODS With the use of the National Trauma Data Bank, patients with renal injuries were identified, and Abbreviated Injury Scale (AIS) codes were stratified to a corresponding American Association for the Surgery of Trauma (AAST) renal injury grade. Trends in initial management were assessed using the following initial treatment categories: observation, minimally invasive surgery, and open renal surgery. Analysis of initial open surgery was further examined according to etiology of injury (blunt vs. penetrating), type of open renal surgery, concomitant abdominal surgery, patient demographics, and time to surgery. RESULTS A total of 9,002 renal injuries (0.3%) were mapped to an AAST renal grade. Of these, 1,183 patients underwent open surgery for their renal injury in the first 24 hours. There were 773 penetrating and 410 blunt injuries within this cohort. The majority of surgical patients sustained a high-grade renal injury (AAST Grades 4–5, 64%). The overall nephrectomy rate in the first 24 hours was 54% and 83% for the penetrating and blunt groups, respectively. While the overall nephrectomy rate for AAST Grade 1 to 3 renal injuries in the first 24 hours was low (1.8%), the nephrectomy rate was higher in the setting of an exploratory laparotomy (30%). Of those undergoing renal surgery in the first 24 hours, 86% had concomitant surgery performed for other abdominal injuries. Mean time from emergency department presentation to surgery was less for penetrating trauma. CONCLUSION Of the patients requiring open surgery for renal trauma within 24 hours of admission, nephrectomy is the most common surgery. Continued effort to reduce nephrectomy rates following abdominal trauma is necessary. LEVEL OF EVIDENCE Epidemiologic study, level III.
Ultrasound based techniques for treatment of chronic Wounds : A comprehensive review of therapeutic efficacies and clinical considerations

Ultrasound (US) waves have emerged as a promising alternative or adjunctive strategy for chronic wounds. However, the clinical efficacy of these techniques for different chronic wounds is still not fully understood and standard guidelines on the allowed doses and possible side-effects should be determined. This paper aimed to comprehensively review the therapeutic efficacies and clinical considerations of US based techniques for chronic wounds. The databases of PubMed (1985-2016), EMBASE (1985-2016), Web of Sciences (1985-2016), and Google Scholar (1980-2016) were searched using the set terms. The obtained results were screened for the title and abstract by two authors and the relevant papers were reviewed for further details. Despite of rigorous evidence on the therapeutic efficiency of US in chronic wounds, no definite dose-response existed on the clinical trials of US wave applications. However, there is a consensus on the spatial average temporal average dosage in the range of 0.5 W/cm2 to 3 W/cm2 with significant therapeutic outcomes and minimum adverse effects. The available data showed the therapeutic efficacy of US techniques for chronic wounds. However, further in vitro and clinical trials are needed to shed more light on the exact dose-response of US techniques for different wounds.
The association between the serum levels of uric acid and alanine aminotransferase in a population‐based cohort

Elevated serum uric acid levels reflect and also cause both oxidative stress and insulin resistance and are frequently observed in patients with the metabolic syndrome. A strong association exists between the metabolic syndrome and non‐alcoholic fatty liver disease (NAFLD). Therefore, we aimed to test the association between uric acid and elevated alanine aminotransferase (ALT), as a surrogate for NAFLD, using real‐world data.
Prevention of breast cancer: current state of the science and future opportunities

Despite significant progress in breast cancer treatment, mammary tumours still represent the second most frequent cause of cancer-related death in women in the US, with > 211,000 new cases in 2005; however, an expanding range of options for early diagnosis and more reliable risk assessment offers new alternatives for disease control by cancer prevention. Completed large studies with the classical selective estrogen receptor modulator (SERM) tamoxifen have demonstrated that preventing breast cancer pharmacologically is now possible. Novel SERMs, aromatase inhibitors and gonadotropin-releasing hormone agonists targeting hormonal pathways are being tested in clinical trials, revealing the potential for dramatic reductions in tumour incidence with minimal side effects; however, SERMs and aromatase inhibitors are effective only against estrogen receptor-positive tumours, thus chemopreventive drugs targeting other critical signalling pathways (such as retinoids, selective COX inhibitors and tyrosine kinase inhibitors) may provide a means to prevent estrogen receptor-negative breast cancer. In the future, hormonal and estrogen receptor-independent agents may be combined to prevent the development of all mammary tumours. This article reviews the current and novel strategies for breast cancer prevention.
Intergenerational Occupational Mobility in Great Britain and the United States Since 1850: Comment †

Using historical census and survey data, Long and Ferrie (2013) found a significant decline in social mobility in the United States from 1880 to 1973. We present two critiques of the Long-Ferrie study. First, the data quality of the Long-Ferrie study is more limiting than the authors acknowledge. Second, and more critically, they applied a method ill-suited for measuring social mobility of farmers in a comparative study between 1880 and 1973, a period in which the proportion of farmers dramatically declined in the United States. We show that Long and Ferrie's main conclusion is all driven by this misleading result for farmers.
Assessment of quality of survival in children with medulloblastoma and cerebellar astrocytoma

To determine the quality of survival for children with posterior fossa tumors, comprehensive neuropsychological, behavioral, and academic assessment and physician ratings of functional status were obtained on 15 brain tumor patients (ages 6–19 years) at a median of 20 months postdiagnosis. More than 50% of the children (whether irradiated or not) experienced major problems in academic, motor, sensory, cognitive, and emotional function. All but two children were reported by teachers to be “slow workers,” and four of 15 patients were able to maintain their school work in regular classes. Although 80% of the patients were rated by physicians as having “excellent” or “good” functional status, no relationship was found between these global ratings and psychometric measures. Although the affected site was the posterior fossa, deficits also involved higher cortical function. These findings indicate the need for further evaluation of treatment effects and the provision of intervention for survivors.
Measuring Complications of Cancer Treatment Using the SEER-Medicare Data

Background. The linkage of SEER registry data with Medicare claims allows the longitudinal tracking of health care and outcomes for patients after a cancer diagnosis. One category of outcomes amenable to research using Medicare claims is complications of cancer treatments: the unintentional, adverse side effects or sequelae of interventions used to treat or palliate cancer patients. Research Design. The authors review some of the methods and limitations of using Medicare claims to identify both acute and chronic complications of cancer treatments, and present an original analysis comparing survey-based and claims-based complications following radical prostatectomy for prostate cancer to illustrate some of the potential limitations inherent in using claims for this purpose. Results. Utility of the Medicare claims for identifying postdischarge complications varies by the patient type, the initial treatment used, and any subsequent treatment of complications. For patients undergoing surgical interventions, Medicare claims can be used to identify most acute inpatient complications. However, claims data cannot be used as effectively in the long-term to capture chronic complications, particularly when the complication does not consistently prompt an intervention. Conclusion. Researchers who use the SEER-Medicare–linked database to assess long-term complications of cancer treatments should exercise caution when designing and interpreting studies. Ideally, for studies of most chronic complications of cancer care, validation studies similar to the one performed here would provide valuable additional evidence to assess the credibility of conclusions based on claims data.
Physical and Functional Association between GADD153 and CCAAT/Enhancer-binding Protein β during Cellular Stress*

GADD153, a ubiquitously expressed member of the CCAAT/enhancer-binding protein (C/EBP) family is induced by a wide variety of growth-arresting and DNA-damaging agents. Functionally, GADD153 has been postulated to act as a dominant-negative regulator of C/EBPs. Therefore we sought to gain evidence for interactions between GADD153 and other C/EBPs during cellular responses to stress. In this report we have demonstrated that treatment of rat pheochromocytoma PC12 cells with sodium arsenite leads to enhanced expression of C/EBP-β and GADD153 (rowth rrest and NA amage inducible gene 153) but not other C/EBPs. Coimmunoprecipitation experiments provided evidence for the formation of endogenous GADD153-C/EBP-β complexes in arsenite-treated cells. Additional experiments were performed to determine the role of such complexes in regulating GADD153 expression. Previous studies in our laboratory demonstrated that the GADD153 promoter contains a C/EBP binding site through which other C/EBPs interact to transactivate GADD153 expression in liver hepatoma cells. Here, we demonstrate that extracts prepared from arsenite-treated PC12 cells likewise show increased amounts of factors capable of binding to the GADD153-C/EBP site and that these complexes are comprised at least in part of C/EBP-β. Forced expression of C/EBP-β was found to be capable of transactivating the GADD153 promoter in PC12 cells cotransfected with plasmids expressing a GADD153 reporter gene and C/EBP-β protein. However, overexpression of GADD153 inhibited the transactivation of the GADD153 promoter by C/EBP-β. These findings provide evidence for an autoregulatory loop in which stress-induced GADD153 feeds back to attenuate GADD153 expression during the cellular response to stress.
A standardized manual tender point survey. I. Development and determination of a threshold point for the identification of positive tender points in fibromyalgia syndrome.

OBJECTIVE To (a) develop a standardized tender point examination protocol [Manual Tender Point Survey (MTPS)] as a diagnostic procedure to evaluate the tender point (TP) criterion for fibromyalgia syndrome (FM) and (b) determine a threshold point for positive TP. METHODS A standardized MTPS consisted of standardized components including (a) location of the survey sites, (b) patient and examiner positioning, (c) order of examination, (d) pressure application technique, and (e) pain severity rating scores [0 (no pain) - 10 (worst pain)]. Seventy patients with FM and 70 with chronic headache were examined using the MTPS protocol. RESULTS A pain severity score of 2 (i.e., 0-1 = negative) was found to be an optimal threshold point for identifying positive TP, with sensitivity of 88.57% and specificity of 71.43%. These results are comparable to the sensitivity and specificity of the 1990 multicenter study. CONCLUSION The MTPS provides a step-by-step, standardized TP examination protocol, which is sensitive and specific in discriminating patients with FM from patients with chronic headache.
Effect of Employee Stock Ownership Plans (ESOPs) on the performance of Small business in Karachi

This paper examines the impact of employee stock ownership plans on the overall performance of the organizations. From the five decades literature, the conceptual underpinning formed includes variables of interest namely; employees' motivation, job commitment, employees' turnover, and productivity/profitability of the firms. The paper follows positivist philosophy with deductive approach to gain numerical significance. Total 280 respondents targeted using combination of probability (random) sampling and non-probability (convenience and snowball) sampling techniques. The statistical tests, which are used to test the hypotheses, are regression and correlation. Results showed that they exists statistically significant correlation between ESOPs and overall performance of the organization. Interestingly, the nature of relationship is positive but the strength is moderate to weaker. Employees' turnover has moderate positive significant correlation (r=. 541, p
Dermatitis herpetiformis and bone mineral density: analysis of a French cohort of 53 patients

BackgroundThe characteristics of patients with dermatitis herpetiformis (DH) in France is poorly documented. Furthermore, the risk of fractures and bone mineral density (BMD) in DH remain under-described, and recommendations for systematic screening for osteoporosis in DH are lacking.ObjectivesTo describe the characteristics of DH in a large French cohort and evaluate the association between BMD and features of osteoporosis.Materials and methodsPatients were recruited from the French Association of Gluten Intolerants (AFDIAG) and a single university dermatology department. A telephone questionnaire was used to record features of DH, history of fractures, calcium intake, treatment, and the gluten-free diet (GFD). Serum calcium and 25(OH) vitamin D3+D2 levels, as well as BMD, were measured.ResultsWe included 53 patients (27 men) with a median age of 49 years (range: 23-86). Median disease duration before inclusion was 14 years (range: 2-55); 51 patients (96%) were adherent to a GFD and had no digestive symptoms. Overall, 18 (34%) had a history of fractures; 16 high-velocity (traumatic) and two low-velocity (nontraumatic). Mean BMD, measured in 48 patients, was normal (femoral neck: 0.956 ± 0.210 g/cm2; lumbar spine: 1.091 ± 1.199 g/cm2). In all, 18 patients (38%) had osteopenia and one (2%) osteoporosis. T-score for bone density did not differ with and without fractures. Calcium intake and serum calcium level were normal in all patients.ConclusionScreening for osteoporosis does not appear to be mandatory for DH patients with good adherence to a GFD and without digestive symptoms or additional risk factors of osteoporosis.
Mexiletine in the Treatment of Diabetic Neuropathy

OBJECTIVE To prove the efficacy of mexiletine in painful diabetic neuropathy. RESEARCH DESIGN AND METHODS Treatment was provided in three dosages. For pain measurements, a VAS and McGill's verbal rating scale were chosen. Ninety-five patients were included in the study. RESULTS A global assessment of the VAS among patients showed no differences between mexiletine treatment and placebo. The total evaluation (PRIT) of the McGill scale fell just below the level of significance. More specific exploratory evaluations of subclasses of the McGill scale, representing different degrees of pain, gave remarkable differences between mexiletine and placebo in sensory and miscellaneous items. In special subgroups, which were formed according to types and courses of complaints compiled at the beginning of this evaluation, the substantial advantages of the mexiletine treatment were shown with both the VAS and the McGill scale. CONCLUSIONS Evidence strongly indicates that, in particular, those patients with stabbing or burning pain, heat sensations, or formication will benefit most by mexiletine therapy. Concerning the dosage, a medium regimen of 450 mg/day seems to be appropriate. With an increase in the antiarryhthmic dosage level, the efficacy does not rise proportionally. Mexiletine proved to be a safe therapy with negligible side effects at the medium dose range, even < placebo; and remarkably, no cardiovascular side effects were noted. Further studies should avoid global assessments and pay more attention to the variety of complaints and quality of life.
Interface Layers for High-k/Ge Gate Stacks: Are They Necessary?

a Department of Materials Science and Engineering, Stanford University, Stanford, California 94305, USA b Department of Electrical Engineering, Stanford University, Stanford, California 94305, USA c School of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 440-746, South Korea d Materials Science and Engineering, University of Texas at Dallas, Richardson, Texas, 75083, USA
GABAA Receptor M2–M3 Loop Secondary Structure and Changes in Accessibility during Channel Gating*

The γ-aminobutyric acid type A (GABAA) receptor M2–M3 loop structure and its role in gating were investigated using the substituted cysteine accessibility method. Residues from α1Arg-273 to α1Ile-289 were mutated to cysteine, one at a time. MTSET+ or MTSES− reacted with all mutants from α1R273C to α1Y281C, except α1P277C, in the absence and presence of GABA. The MTSET+ closed-state reaction rate was >1000 liters/mol-s at α1N274C, α1S275C, α1K278C, and α1Y281C and was <300 liters/mol-s at α1R273C, α1L276C, α1V279C, α1A280C, and α1A284C. These two groups of residues lie on opposite sides of an α-helix. The fast reacting group lies on a continuation of the M2 segment channel-lining helix face. This suggests that the M2 segment α-helix extends about two helical turns beyond α1N274 (20′), aligned with the extracellular ring of charge. At α1S275C, α1V279C, α1A280C, and α1A284C the reaction rate was faster in the presence of GABA. The reagents had no functional effect on the mutants from α1A282C to α1I289C, except α1A284C. Access may be sterically hindered possibly by close interaction with the extracellular domain. We suggest that the M2 segment α-helix extends beyond the predicted extracellular end of the M2 segment and that gating induces a conformational change in and/or around the N-terminal half of the M2–M3 loop. Implications for coupling ligand-evoked conformational changes in the extracellular domain to channel gating in the membrane-spanning domain are discussed.
Bronchoconstriction Provoked by Exercise in a High-Particulate-Matter Environment is Attenuated by Montelukast

Abstract Airborne ultrafine and fine particulate matter (PM1 from fossil-fueled internal combustion engines may cause abnormal airway narrowing. Because of high PM1 exposure from ice resurfacing machines, the ice-rink athlete is especially vulnerable to PM1 toxicity. The purpose of this study was to evaluate protection by a single dose of montelukast in college ice hockey players following PM1 exposure exercise. Nine male ice hockey players (age 19.3 ± 1.22 yr) performed 4 randomized, double-blinded, high-intensity, 6-min cycle ergometer trials in low [PM1] (2260 ± 500 particles/cm3) and high [PM1] (348,600 ± 121,600 particles/cm3) after placebo or montelukast. Pre- and postspirometry showed similar peak FEV1 (forced expiratory volume in 1 s) falls between placebo and montelukast after low [PM1] trials (14.5 ± 18.06 vs. 9.5 ± 11.75% of baseline, respectively). Peak FEV1 falls after high [PM1] trials were greater for placebo than for montelukast (17.3 ± 9.79% vs. 1.7 ± 5.77% of baseline; p < .0001). High [PM1] FEV1 fall after exercise following montelukast ingestion was less than after exercise following placebo ingestion under high and low [PM1] conditions and after exercise following montelukast ingestion under low [PM1] conditions at 5, 10, and 15 min postchallenge (p < .004, .0006, .009, respectively). Montelukast provided greater protection against bronchoconstriction after exercise during high [PM1] than low [PM1] exposure (∼90% vs. ∼35%), suggesting that bronchoconstriction from PM1 exposure is predominately leukotriene mediated. The precise mechanism of airborne PM1-induced leukotriene-mediated airway narrowing remains unclear.
Flipping an engineering mathematics classroom for a large undergraduate class

Although flipping classroom is not a new idea in education, implementing flipped class is somewhat a new trend. Flipping classrooms involve students in using their textbooks, online materials, and other useful resources before coming to class. Consequently, students can spend valuable class meetings on problem-solving activities instead of lectures. Positive feedback from utilizing the flipped classroom techniques has been reported in several papers. This article presents an attempt to implement the flipped classroom for a large introductory engineering class in multivariable calculus at King Mongkut's Institute of Technology Ladkrabang. The results from implementing the flipped classroom both quantitatively and qualitatively showed a higher performance and more positive feedback when compared to those obtained from this class taught by the same instructor using the traditional classroom format in the previous year.
Edinburgh Research Explorer The Yin and Yang of kidney development and Wilms’ tumours

Wilms’ tumor, or nephroblastoma, is the most common pediatric renal cancer. The tumors morphologically resemble embryonic kidneys with a disrupted architecture and are associated with undifferentiated metanephric precursors. Here, we discuss genetic and epigenetic findings in Wilms’ tumor in the context of renal development. Many of the genes implicated in Wilms’ tumorigenesis are involved in the control of nephron progenitors or the microRNA (miRNA) processing pathway. Whereas the first group of genes has been extensively studied in normal development, the second finding suggests important roles for miRNAs in general—and specific miRNAs in particu-lar—in normal kidney development that still await further analysis. The recent identification of Wilms’ tumor cancer stem cells could provide a framework to integrate these pathways and translate them into new or improved therapeutic interventions.
Missense polymorphism in the human carboxypeptidase E gene alters enzymatic activity

Carboxypeptidase E (CPE) is involved in the biosynthesis of peptide hormones and neurotransmitters, including insulin. One of the features of type 2 diabetes mellitus (T2DM) is an elevation in the proinsulin level and/or proinsulin/insulin molar ratio, suggesting that mutations in proinsulin processing enzymes may contribute to the development of T2DM. We scanned CPE for mutations in a collection of Ashkenazi T2DM families and identified five novel single nucleotide polymorphisms (SNPs). An SNP in the 283rd codon, c.847C>T, changes arginine to tryptophan (R283W). The residue Arg283 is conserved among CPE orthologs as well as most enzymatically active metallocarboxypeptidases. Of the 272 Ashkenazi T2DM pedigrees screened, we found four families segregating R283W. Within these four families, patients who inherited one copy of this variant had much earlier age of onset for T2DM. The R283W CPE protein cleaves peptide substrates with substantially lower efficiencies and is less stable at elevated temperature. In addition, the R283W CPE variant has a narrower pH optimum and is much less active at pH 6.0–6.5, indicating that the R283W CPE variant would be substantially less active than wild type CPE in the trans‐Golgi network and immature secretory vesicles where the enzyme functions in vivo. To summarize, we uncovered a rare non‐conservative missense mutation in CPE and demonstrated that the mutant protein has altered enzymatic properties. We predict that this mutant could cause hyperproinsulinism and diabetes in the homozygous state. Hum Mutat 18:120–131, 2001. © 2001 Wiley‐Liss, Inc.