Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers.

BACKGROUND Femoroacetabular impingement is a cause of hip pain in adults and is a possible precursor of osteoarthritis, with the cam type of impingement being the most common. The purpose of this study was to determine the prevalence of cam-type morphology of the hip in asymptomatic patients. METHODS Two hundred asymptomatic volunteers with no prior hip surgery or childhood hip problems underwent magnetic resonance imaging targeted to both hips. The subjects were examined at the time of magnetic resonance imaging for internal rotation of the hips at 90° of hip flexion and for a positive impingement sign. The contour of the femoral head-neck junction was quantified with use of the alpha angle. A value of >50.5° was considered positive for cam morphology. Measurements were performed independently by two musculoskeletal radiologists. RESULTS The mean age of the individuals was 29.4 years (range, 21.4 to 50.6 years); 79% were white, and 55.5% were women. The mean alpha angle anteriorly at the three o'clock position was 40.9° ± 7.0° on the right and 40.6° ± 7.1° on the left, whereas the mean alpha angle anterosuperiorly at the 1:30 position was 50.2° ± 8.0° on the right and 50.1° ± 8.3° on the left. Fourteen percent of the volunteers had at least one hip with cam morphology: 10.5% had an elevated alpha angle on either the right or the left side, and 3.5% had the deformity in both hips. Seventy-nine percent (twenty-two) of twenty-eight individuals who had an elevated alpha angle were men, and 21% (six) were women. Individuals with an elevated alpha angle on at least one side tended to be male (p < 0.001), with 24.7% (twenty-two) of eighty-nine men having cam morphology compared with only 5.4% (six) of 111 women. CONCLUSIONS The prevalence of cam-type femoroacetabular impingement deformity is higher in men as well as in individuals with decreased internal rotation. Defining what represents a normal head-neck contour is important for establishing treatment strategies in patients presenting with prearthritic hip pain.
EFFERENT CONTROL OF THE HUMAN AUDITORY SYSTEM

The effects of auditory efferent activity on peripheral physiology may be examined by presenting broadband noise (BBN) to the contralateral ear during otoacoustic emission (OAE) recordings. The presentation of BBN typically produces a reduction of OAE amplitudes in comparison to a condition without BBN. This is termed contralateral suppression. Limited information exists regarding the effects of contralateral BBN on responses observed at higher levels in the auditory system. The present study employed this paradigm to investigate interactions of attention and laterality on the transient evoked otoacoustic emission (TEOAE), auditory brainstem response (ABR) and cortical auditory evoked potentials (CAEP) P1-N1-P2. TEOAEs were evoked by 60 dB SPL clicks; ABRs and CAEPs were evoked by 60 dB SPL 2.0 kHz tone pips in 15 normally hearing adults. Four conditions were employed for each ear: 1) quiet (no noise); 2) 60 dB SPL contralateral BBN; 3) words (at –3 dB SNR) embedded in 60 dB SPL contralateral BBN while subjects classified words as animal versus food items; 4) words from condition #3 played backwards and embedded in 60 dB SPL contralateral BBN. For TEOAEs: 1) more suppression was evident in the active attention condition than the passive listening conditions and 2)
A preliminary investigation of psychological distress following surgical management of early pregnancy loss detected at initial ultrasound scanning: A trauma perspective

Recent research has focused on the occurrence of anxiety symptoms after miscarriage and has suggested that early pregnancy loss (EPL) should be conceptualised from the perspective of a trauma experience. We hypothesised that women who have perceived warning signs of an EPL will be less psychologically distressed in a 3-week period after this pregnancy loss than women with no prior perceived warning signs. The prevalence of Acute Stress Disorder (ASD), post traumatic stress symptoms, anxiety and depression was assessed in 40 women, who had experienced an EPL approximately 3 weeks beforehand and, with the exception of ASD, this was also investigated at 3-month follow-up. Evidence of psychological distress was expected to decrease over time in all women regardless of whether they had perceived warning signs or not. It was found that the presence of perceived warning signs did not determine levels of psychological distress. We ascertained that the experience of EPL itself increased post traumatic stress symptoms and anxiety, regardless of perceived warning signs of a pregnancy complication. Psychological distress subsided over time with the exception of anxiety, which remained high. The present study supported the conceptualisation of EPL as a trauma experience and, at a more practical level, highlighted a need for routine follow-up care.
Soluble tumor necrosis factor-alpha receptors in young obese subjects with normal and impaired glucose tolerance.

OBJECTIVE Tumor necrosis factor-alpha (TNF-alpha) is a possible link between obesity and impaired glucose tolerance (IGT) and type 2 diabetes. Data about TNF-alpha and soluble forms of its receptors (sTNFR1 and sTNFR2) in IGT are controversial. The aim of the present study was to assess plasma TNF-alpha, sTNFR1, and sTNFR2 levels and to evaluate the relationships with insulin resistance in obese subjects with IGT. RESEARCH DESIGN AND METHODS A total of 104 subjects participated in the present study: 30 obese subjects with IGT (obese-IGT), 32 obese subjects with normal glucose tolerance (obese-NGT), and 42 lean healthy control subjects (control-NGT). Anthropometry and blood biochemical parameters were measured and euglycemic-hyperinsulinemic clamp was performed. RESULTS Obese-IGT subjects were more insulin resistant in comparison with obese-NGT and control-NGT groups; obese-NGT subjects were more insulin resistant than control-NGT. Plasma sTNFR1 and sTNFR2 were markedly higher in both groups of obese subjects in comparison with control-NGT and in the obese-IGT versus obese-NGT group. Plasma sTNFR1 and sTNFR2 were inversely related to insulin sensitivity. Both relationships remained significant after adjustment for age, BMI, waist girth, percent body fat, plasma glucose, insulin, nonesterified fatty acids, cholesterol, and triglycerides. Correlation between sTNFR2 and insulin sensitivity was also present in all the groups analyzed separately, but the correlation between sTNFR1 and insulin sensitivity was present only in the obese-NGT group. CONCLUSIONS Our data suggest that TNF-alpha receptors are increased in obese-IGT subjects and are related to insulin resistance. These findings indicate that the TNF-alpha system might contribute to the development of insulin resistance in glucose-intolerant subjects.
Self-assessed Clinical Leadership Competency of Student Nurses

This article is a report on an endeavor conducted to assess the level of clinical leadership competency of level IV student nurses. Articles on nursing leadership are not new, although it is only until recently that clinical nurse leadership has been featured more prominently in health-related literature (Stanley, 2009). Across the globe, the role of clinicians as leaders of health care is viewed as increasingly important. However, only a short series of articles about clinical leadership are present (Swanwick and Mckimm, 2011). An appraisal on the level of clinical leadership competency can aid in recognizing one's strengths and weaknesses to develop a plan to compensate for one's limitation. With this study, direction and improvements for clinical leadership may be forwarded to student nurses while they are still in the academe. A self-reporting questionnaire was administered to 74 senior student nurses in the College of Nursing, Benguet State University. Questions were asked to quantify the level of clinical leadership competency of the respondents in the five (5) domains of leadership framework, namely: demonstrating personal qualities, working with others, managing services, improving services, and setting direction. The results revealed that, sex is not a factor in the establishment of clinical leadership competency differences. Also, clinical leadership among student nurses is high in all domains of: demonstrating personal qualities, working with others, managing services, improving services, and setting direction. Furthermore, student nurses are highly competent leaders in the clinical area. Finally, student nurses excel most in the 'improving services' domain among the five (5) identified clinical leadership competency subsets. In descending order, it is followed by 'managing services', 'working with others', 'setting direction', and 'demonstrating personal qualities'.
Psychosocial Treatment of Patients With Schizophrenia and Substance Abuse Disorders

Substance abuse among patients with schizophrenia is quite common, with at least half of these individuals having a lifetime diagnosis of a substance abuse disorder. These so called “dual diagnosis” or “co-occurring disorder” patients have an increased utilization of medical and psychiatric services. They are more difficult to treat and usually have a worse prognosis as compared with non-substance abusing patients with schizophrenia. Fortunately, in recent years, the treatment of dually diagnosed patients has significantly improved. It has been established that the best treatment of these patients includes enrollment in an integrated program that treats both mental illness and substance abuse problems simultaneously. Previously, we published an article that reviewed the available psychopharmacological options for treatment of co-occurring disorder patients. This article will focus more on the psychosocial treatment modalities that have been used to reduce the psychiatric morbidity and substance relapse in these patients.
Characteristics of calcaneal osteomyelitis: an unusual and severe form of diabetic foot disease

Background: Osteomyelitis of the calcaneus is an uncommon type of diabetic foot infection considered to have a poor outcome. Little is known about predisposing and prognostic factors, or optimum treatment regimens. Methods: Case records were reviewed of the eight patients with diabetes who presented to our centre during 2011–13 with calcaneal osteomyelitis and a complementary group of 19 patients who presented with heel ulcers but without osteomyelitis. Results: Male sex (6/8 vs. 4/19; p 2 cm2 (8/8 vs. 3/19; p<0.0001) and depth (probing to bone) (6/8 vs. 0/19; p<0.0001) were associated with calcaneal osteomyelitis. We were unable to identify any patient or treatment characteristics in the osteomyelitis group that conferred improved outcome. Outcomes at 30 weeks after presentation were significantly poorer in the osteomyelitis group (ongoing osteomyelitis or amputation 4/8, and death 2/8) than in the ulcer only group (1/19 and 2/19). Conclusions: In patients with diabetes and heel ulcers, calcaneal osteomyelitis is associated with gender, neuro-pathy and large deep ulcers. It is uncommon and has a poor prognosis. We were unable to identify any factors associated with improved prognosis.
The prevalence of defensive orthopaedic imaging: a prospective practice audit in Pennsylvania.

BACKGROUND Defensive medicine has been identified as an area of wasteful health-care spending. Estimates of its prevalence and its contribution to the cost of defensive practices have varied widely. To date, there has been no prospective evaluation of the use of defensive medicine for musculoskeletal conditions. METHODS Members of the Pennsylvania Orthopaedic Society were queried by means of an anonymous, prospective audit of consecutive imaging decisions in their clinical practice. For each image order, respondents recorded the modality, the body region imaged, and whether the imaging was "required for clinical care" or "ordered for defensive reasons. " We evaluated the proportion of images that were ordered defensively, identified demographic differences with use of the chi-square test of independence, and calculated the contribution of defensive imaging to the total cost with use of 2009 Medicare reimbursement rates. RESULTS Seventy-two orthopaedists recorded 2068 imaging decisions made during the day that their practice was audited. Defensive imaging represented 19.1% (396) of the orders and 34.7% ($113,675) of the total cost ($327,414). Magnetic resonance imaging (MRI) represented 48.7% of the defensive orders, and 38.5% (193) of the 501 MRIs were ordered for defensive reasons. The proportion of defensive imaging ordered by orthopaedists who had been sued for medical malpractice within the previous five years was significantly greater than the proportion ordered by those who had not been sued during the same time frame (24.6% compared with 15.1%, p < 0.001). The proportion of defensive imaging ordered by orthopaedists who had been in practice for more than fifteen years was significantly greater than the proportion ordered by those who had less experience (20.8% compared with 17.1%, p = 0.03). CONCLUSIONS In a prospective practice audit of orthopaedists, defensive imaging was found to be both common and costly. Recent litigation experiences and longer duration of orthopaedic practice were independent predictors of an increased use of defensive practices in ordering imaging studies. This real-time audit showed that a large proportion of MRI studies were ordered for primarily defensive medicine reasons.
Bisphosphonates and nonhealing femoral fractures: analysis of the FDA Adverse Event Reporting System (FAERS) and international safety efforts: a systematic review from the Research on Adverse Drug Events And Reports (RADAR) project.

BACKGROUND In the United States, hip fracture rates have declined by 30% coincident with bisphosphonate use. However, bisphosphonates are associated with sporadic cases of atypical femoral fracture. Atypical femoral fractures are usually atraumatic, may be bilateral, are occasionally preceded by prodromal thigh pain, and may have delayed fracture-healing. This study assessed the occurrence of bisphosphonate-associated nonhealing femoral fractures through a review of data from the U.S. FDA (Food and Drug Administration) Adverse Event Reporting System (FAERS) (1996 to 2011), published case reports, and international safety efforts. METHODS We analyzed the FAERS database with use of the proportional reporting ratio (PRR) and empiric Bayesian geometric mean (EBGM) techniques to assess whether a safety signal existed. Additionally, we conducted a systematic literature review (1990 to February 2012). RESULTS The analysis of the FAERS database indicated a PRR of 4.51 (95% confidence interval [CI], 3.44 to 5.92) for bisphosphonate use and nonhealing femoral fractures. Most cases (n = 317) were attributed to use of alendronate (PRR = 3.32; 95% CI, 2.71 to 4.17). In 2008, international safety agencies issued warnings and required label changes. In 2010, the FDA issued a safety notification, and the American Society for Bone and Mineral Research (ASBMR) issued recommendations about bisphosphonate-associated atypical femoral fractures. CONCLUSIONS Nonhealing femoral fractures are unusual adverse drug reactions associated with bisphosphonate use, as up to 26% of published cases of atypical femoral fractures exhibited delayed healing or nonhealing.
Deposit Market Competition, Wholesale Funding, and Bank Risk

In this paper we revisit the long debate on the risk effects of bank competition and propose a new approach to the empirical estimation of the relation between deposit market competition and bank risk. Our approach accounts for the opportunity of banks to shift to wholesale funding when deposit market competition is intense. The analysis is based on a unique comprehensive dataset which combines retail deposit rates data with data on bank characteristics and with data on local deposit market features for a sample of 589 U.S. banks. Our results support the notion of a risk-enhancing effect of deposit market competition.
The Impact of Not on Tobacco on Teen Smoking Cessation

This review summarizes end-of-program quit rates from 6 controlled and 10 field-based Not on Tobacco (NOT) evaluations. Approximately 6,130 youth from 5 states and 489 schools participated. Intent-to-treat and compliant quit rates were calculated at 3 months postbaseline (end-of-program). Results from controlled evaluations revealed an aggregate quit rate of 15% and 19%, respectively. The field-based evaluations revealed an aggregate quit rate of 27% and 31%, respectively. NOT youth were two times more likely to quit than comparison youth (OR = 1.94; p = .002; 95% CI 1.267-2.966). This is the first multiyear, multisite review of a teen smoking cessation program reported in the literature and the first longitudinal review of NOT. NOT participants showed consistent, significant positive smoking behavior change across evaluations.
Evaluation of clinical and pathological characteristics of 155 canines with mammary tumours: a retrospective study

En este estudio se evaluaron en forma retrospectiva las caracteristicas clinicas y patologicas de 155 perras con tumores mamarios. 55% de los animales con tumores mamarios eran Poodle (83 pacientes). La edad promedio al momento de la excision del tumor fue de 10,3 ± 0,2 anos, mientras que el tiempo transcurrido entre la deteccion del tumor y tratamiento del paciente fue de 308 ± 38,5 dias. 46 de las 119 perras habian parido al menos una vez y 22 de 59 habian presentado un historial con falsa prenez. Ademas, 2% de los animales habian presentado tumores de origen vulvar o vaginal. 212 tumores fueron removidos quirurgicamente y de ellos, 78,3% eran malignos, 12,3% resultaron benignos, 8% eran cambios hiperplasicos y 1,4% eran tumores no clasificados. No hubo asociacion significativa entre el tipo histopatologico de los tumores mamarios y edad, raza, ubicacion y duracion del tumor, estado reproductivo, historial de prenez o pseudoprenez.
Efficacy and Tolerability of MlC601 in Patients with Mild to Moderate Alzheimer Disease Who Were Unable to Tolerate or Failed to Benefit from Treatment with Rivastigmine

Aim: To evaluate the efficacy and tolerability of MLC601 in patients with mild to moderate Alzheimer disease (AD). Study Design: This is an open-label pilot study. Place and Duration of Study: It was conducted at three university referral centres in Iran from September 2009 until November 2011. Methodology: One-hundred and twenty four outpatients with mild to moderate AD who had previously failed to tolerate or benefit from treatment with Rivastigmine for 6 months at a dose of 2 to 12 mg per day were switched to a MLC601 regimen of one capsule three times per day for up to 18 months. Outcome measures included adverse events (AEs), withdrawal rate, and changes in the Mini-Mental State Examination (MMSE) and the cognitive subscale of the AD Assessment Scale (ADAS-cog) relative to baseline measurements. Research Article British Journal of Medicine & Medical Research, 3(2): 341-350, 2013 342 Results: Two patients were lost to follow up, and 122 patients completed the 18-month trial. The mean age of the participants was 65.3±6.4 years (range 54-82), and 77 (63.1%) of the participants were female. Improved cognitive function was observed in the first 6 months of the regimen (ADAS-cog=-3.1±10.1; MMSE=1.2±3.0), and the stabilisation of cognitive decline was observed over the remaining 12 months (ADAScog=-1.6±7.6; MMSE=0.8±4.2). AEs were predominantly gastrointestinal and occurred in 7.3% of patients. Conclusions: MLC601 showed good tolerability and promising effects on cognitive function in AD patients during 18 months of treatment.
Minocycline in Active Rheumatoid Arthritis

Objective. To determine the efficacy of minocycline in the treatment of rheumatoid arthritis (RA). Methods. Minocycline (maximal oral daily dose 200 mg) or placebo was administered in a 26-week, randomized, double-blind study to 80 patients with active RA, who were treated or had previously been treated with at least one disease-modifying antirheumatic drug. Results. There were 15 premature discontinuations: 6 (5 taking minocycline) because of adverse effects, 8 (all taking placebo) because of lack of efficacy, and 1 (taking placebo) because of intercurrent illness. There was a statistically significant improvement in the minocycline group over the placebo group. There was a pronounced improvement in laboratory parameters of disease activity; however, improvement in clinical parameters was less impressive. The observed adverse effects attributable to minocycline were mainly gastrointestinal symptoms and dizziness. Conclusion. The results of the present study suggest that minocycline is beneficial and relatively safe in RA patients.
Dealing with Real-Life Challenges: Outcome of a Home-Based Occupational Therapy Intervention for People with Severe Psychiatric Disability

The authors offered home-based occupational therapy integrated into supported or sheltered housing to help individuals with severe psychiatric disability identify their specific needs of engagement in meaningful daily occupations. This study aimed to evaluate the client outcomes in activities of daily living (ADL) ability and health factors following their participation in occupation-centered interventions in home and community settings. Seventeen participants (7 women) between the ages of 27 and 66 years participated in the intervention project based on the Everyday Life Rehabilitation (ELR). The following instruments were administered before and after the intervention and at a 6-month follow-up: Goal Attainment Scaling, Assessment of Motor and Process Skills, Assessment of Social Interaction, Satisfaction with Daily Occupations, ADL-taxonomy with an effort-scale, and the Symptom Check List-90. Pretest, posttest, and follow-up differences in test scores on goal attainment, occupation, and health-related factors indicate that important progress was made. These findings support the use of the ELR intervention and suggest that larger randomized clinical trials are needed.