Miracle-dz/UniFAR-FTUs huggingface dataset:
Nickel-titanium rotary instrument fracture: a clinical practice assessment.

AIM To prospectively determine the incidence of nickel-titanium rotary instrument fracture in an endodontic clinical practice setting. METHODOLOGY Eleven second year endodontic residents, using four nickel-titanium rotary instrument systems (ProFile, ProTaper, GTRotary and K3Endo) according to the recommendations of the manufacturers, instrumented 3181 canals in 1403 teeth of 1235 patients, in a dental school post-graduate endodontic clinic, in 1 year. The incidence of instrument fracture was determined based on the number of instruments used. When fracture occurred, data were collected concerning the type, size, taper and prior use of the fractured instruments, the length and location of the fragment within the root canal and the curvature of the canal. RESULTS The overall incidence of instrument fracture was 0.39%. The incidence of fracture for ProFile, ProTaper, GTRotary and K3Endo files was 0.28%, 0.41%, 0.39% and 0.52%, respectively. There was no statistically significant difference between instrument systems. The percentage of teeth in which instruments fractured was 1.9% (0.28% for anterior teeth, 1.56% for pre-molars and 2.74% for molars). A total of 26 instruments fractured, of which 23 had tapers of 0.06 or greater. Most of the fragments were located in the apical third of the root canal, and both the median and mode amongst the fragment lengths were 2 mm. CONCLUSIONS The low incidence of nickel-titanium rotary instrument fracture supports the continued use of these instruments in root canal treatment.
Laparoscopic Repair of Bilateral and Recurrent Hernias

The optimal inguinal hernia repair has been controversial for decades. Since the advent of minimally invasive surgery, laparoscopic techniques have added to the controversy. Laparoscopic hernia repair has been advocated by many experts for the repair of bilateral and recurrent inguinal hernias. This study reviews the experience of a single community-based teaching hospital using the total extraperitoneal (TEP)-approach laparoscopic hernia repair for treating patients with bilateral and/or recurrent inguinal hernias. Since the TEP approach was adopted in June 1993, a total of 457 patients were treated for bilateral (322 patients) and/or recurrent (175) inguinal hernias (40 patients had recurrent and bilateral hernias). A total of 779 hernias were repaired with this technique. The average age of this patient group was 47 years, and there were 413 males and 44 females. Operative time averaged 68.3 minutes per patient, and there were 26 (5.7%) minor complications. There were 2 (0.4%) major complications, an enterotomy and a cystotomy, both early in the series and both in patients with previous lower abdominal surgery. There have been no deaths. With an average follow-up of 30 months (range, 1–60 months), there have been three (0.2%) recurrences. These recurrences were due to technical problems (inadequate mesh coverage), and each was repaired with a laparoscopic transabdominal approach or an anterior open approach. The use of the TEP-approach laparoscopic hernia repair is safe and effective in patients with recurrent and/or bilateral inguinal hernias.
Open Versus Closed Laparoscopy: Yet an Unresolved Controversy.

INTRODUCTION Safe placement of the Verres needle or the primary trocar for establishment of pneumoperitoneum is the most critical step in laparoscopic procedure as it is associated with bowel, bladder and life threatening vascular injuries and embolism. In the last few decades many techniques and guidelines have been introduced to eliminate complications in creation of pneumoperitoneum. Classical closed technique (Verres needle) and the open classic technique (Hasson) are the most commonly used techniques for creation of pneumoperitoneum. AIM To compare the rate of occurrence and nature of complications in open and closed laparoscopy during establishment of pneumoperitoneum in different surgical and gynaecological procedures. MATERIALS AND METHODS This was a comparative study conducted at three hospitals in Dibrugarh district, Assam, India from January 2012 to December 2014. Total 3000 cases were included in the study with 1500 cases of open laparoscopy and 1500 cases of closed laparoscopy. Complications occurring in both the groups were compared by using Fisher's-exact test. RESULTS In closed laparoscopy group minor complications occurred in 80 (5.33%) and major complications in 20 (1.33%) cases. In open laparoscopy group minor complications were observed in 60 (4%) and major complications in 2 (0.13%). The p-value of the difference between the two groups for minor complications was 0.0834 and for major complications was 0.0001(significant). CONCLUSION Open laparoscopy was seen to be better than closed laparoscopy in terms of not only the rate of occurrence of complications but also the nature and severity of the complications. This study is clinically relevant as there is no consensus for a particular method of safe entry in to the peritoneal cavity warranting the need for more research. Open technique can be performed in all cases irrespective of previous operative scar, suspected intra peritoneal adhesions or obesity. Favourable outcome may be achieved in closed technique in cases of normal BMI, absence of postoperative scar in the abdomen, absence of abdominal and genital tuberculosis and pelvic inflammatory disease.
Phase One : Systematic Review of Knowledge and Experience Related Physiotherapists and Patients Perspectives on EHRs

With advances in information and communication technologies (ICT), changes have been produced in physiotherapy provision. However, low adoption of the new technologies calls attention for better theoretical model and methods for ICT design, which may fulfil the needs of health professionals and their patients. In this work we discuss the framework for designing ICT for physiotherapy context based on some of the results obtained during research on requirements and barriers of electronic health records adoption in physiotherapy. We underscore the importance of considering the context the conditions in social and physical environment as well as end-users internal conditions for requirements elicitation of the healthcare information system. Identification, training and collaboration with champion/leader in the target community may contribute to creation and evolution of knowledge and innovation ecosystem for dynamic progress in designing and developing of ICT tailored to the people’ needs, expectations and values.
Étude des variations respiratoires associées à une activité rythmique des muscles de la mastication durant le bruxisme du sommeil

Background: Sleep Bruxism (SB) is a stereotyped movement disorder characterized by rhythmic masticatory muscle activity (RMMA) and tooth grinding (TG). Recent evidence suggests that SB is associated with sleep micro-arousals and that most RMMA episodes are preceded by physiological changes occurring in sequence, namely, a rise in autonomic sympathetic-cardiac activity followed by a ri se in the frequency of electroencephalographic and suprahyoid muscle activity. In the present study we hypothesize that an increase in respiration also characterizes the onset of SB within the micro-arousal sequence. Methods: Polygraphic sleep recordings of 20 SB subjects without any sleep related breathing disorders were analysed for changes in respiration (i.e. root mean square, area under the curve, peak, peak-to-peak and length) extracted from a nasal cannula signal. Variables were analysed and compared using ANOV A and correlation tests. Results: Measurements of respiration showed significant changes over time. Four seconds before RMMA muscle activity, the amplitude of respiration is already increased (8-23%); the ri se is higher at the onset of the suprahyoid activity (60-82%, 1 second before RMMA); and maximal during RMMA (108-206%) followed by a rapid return to levels preceding RMMA. A positive and significant correlation was found between the frequencies of RMMA episodes and the amplitude of breath (R=0.26; p=0.02). The amplitude of respiratory changes was Il times higher when micro-arousal was associated with RMMA in comparison to micro-arousal alone. Conclusions: To our knowledge, this is the first report showing that RMMA-SB muscle activity is associated with a rise in respiration within micro-arousal.
Some aspects of respiratory metabolism during metamorphosis of normal and DDT-resistant house flies, Musca domestica L.

1. Oxygen consumption follows a U-shaped curve during metamorphosis of normal and DDT-resistant strains of house flies. It is of the same order of magnitude in both strains.2. Cytochrome oxidase activity during metamorphosis also follows a U-shaped curve. There is evidence that changes in oxygen consumption during this process are, in some respects, related to the activity of the oxidase.3. A cyanide insensitive system, possibly flavin, and another cyanide sensitive system, probably tyrosinase, contribute to the total oxygen consumption. The latter system apparently contributes mainly during the early stages of metamorphosis.4. The cyanide insensitive respiration of both strains remains relatively constant throughout development. The resistant strain has twice the cyanide insensitive respiration of the normal strain.5. The DDT-resistant pupae have less cytochrome oxidase activity than normal pupae at all stages except immediately prior to emergence of the adult.6. The pupae of DDT-resistant flies exhibit .
The association between hip dysfunction and lower quarter injuries in long distance runners: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE The objective of this review is to establish the association between hip dysfunction and lower quarter (low back and lower limb) injuries in long distance runners. Specifically the review question is: Are long distance runners with hip dysfunction at risk of lower quarter (low back and lower limb) injuries?
Lupus vulgaris and tuberculosis verrucosa cutis (TBVC)--a clinical, pathological and epidemiological study of 71 cases.

BACKGROUND The epidemiological aspects and diagnostic problems encountered in a rural set up are largely unknown. The present study on cutaneous tuberculosis encompassing clinical, pathological and epidemiological aspects was undertaken at Rajah Muthiah Medical college and Hospital (RMMC&H), a teaching hospital mainly catering to the health needs of a predominantly rural population from villages and hamlets around Chidambaram, a taluq headquarters, located in Cuddalore district ofTamil Nadu. MATERIAL AND METHODS During the period of study, 5744 cases (82%) of pulmonary tuberculosis and 1261 (18%) of extra-pulmonary tuberculosis were encountered. Cutaneous tuberculosis accounted for 117 (1.67%) of tuberculosis cases. RESULTS Of the seventy-one patients with cutaneous tuberculosis, 39 had lupus vulgaris and 32 with TBVC. Lupus vulgaris was more prevalent with male pre-ponderance. The maximum incidence was seen in the second decade of life. Both LV and TBVC showed a male pre-ponderance, M:F ratio being 3:2 and 2:1 in LV and TBVC respectively. A majority of patients with LV (27 cases; 69.2%) and TBVC (31 cases; 96.8%) manifested with a single site of involvement. Lower extremities were more commonly involved among patients hailing from poor economic strata who were not habituated to the use of footwear while working out doors. Over crowding was also a contributing factor. The relationships between BCG vaccination and Mantoux test with cutaneous tuberculosis, association with pulmonary tuberculosis in addition to the underlying predisposing socio-economic factors are discussed.
The validity of classical trajectory and perturbative quantal methods for electron-impact ionization from excited states in H-like ions

To test the validity of classical trajectory and perturbative quantal methods for electron-impact ionization of H-like ions from excited states, we have performed advanced close-coupling calculations of ionization from excited states in H, Li2+ and B4+ using the R-matrix with pseudo states and the time-dependent close-coupling methods. Comparisons with our classical trajectory Monte Carlo (CTMC) and distorted-wave (DW) calculations show that the CTMC method is more accurate than the DW method for H, but does not improve with n and grows substantially worse with Z, while the DW method improves with Z and grows worse with n.
The Bases of Goal Setting in the Self-regulation of Hypertension

We apply a new methodology to investigate goal setting by hypertensive patients that uncovers the reasons why people have a goal to manage hypertension or not (e.g. to reduce/maintain one’s current blood pressure). The reasons are found to consist of superordinate goals in support of one’s focal hypertension goal and the hierarchical mental network underlying the superordinate goals. We show that, not only do such superordinate goals influence patients’ beliefs, feelings and decisions, but the relationships among superordinate goals are particularly efficacious in the formation of beliefs and attitudes, as well as intentions to self-regulate hypertension and actual efforts in doing so. Hypotheses were tested on a sample of 219 patients at a university-based hypertension clinic.
Approximation Algorithms for Min-k-Overlap Problems Using the Principal Lattice of Partitions Approach

In this paper we discuss strategies for constructing approximation algorithms for solving theMin-k-cut problem, theMin-k-vertex sharing problem, and their generalization theMin-k-overlap problem. In each case, we first formulate an appropriate submodular function and construct its principal lattice of partitions (PLP) (H. Narayanan,Linear Algebra Appl.144(1991), 179? 216). Applying an elementary strategy on an appropriate subinterval of the PLP yields the approximation algorithms. We give two such strategies. For convenience and greater generality we present our results in terms of bipartite graphs (which may be regarded as representing hypergraphs). We observe that the Min-k-cut problem isNP-Hard(O. Goldschmidt and D. S. Hochbaum,in“Proceedings 29th Annual Symposium on the Foundations of Computer Science,” pp. 444? 451, 1988). Approximation algorithms for the Min-k-cut problem were first given in (H. Saran and V. V. Vazirani,in“Proceedings 32nd Annual Symposium on the Foundations of Computer Science, 1991”). Their algorithms yield a Min-k-cut which is at most 2(1? (1/k)) times worse than the optimal. Our algorithm using the first strategy has a 2(1? (1/n)) factor (times worse than optimal) for both Min-k-cut and Min-k-vertex sharing (1) problems (nis |V(G)|, |E(G)| respectively). For Min-k-vertex sharing (2) this strategy yields aq(1? (1/|E(G)|)) factor, whereqis the maximum degree of a vertex in the graphG. Using a second strategy we are able to obtain a (2? (k? /n? )) factor for the Min-k-cut problem, wherek? =k? k0,n? =n? k0,k0being an appropriate integer defined in the paper. In our approach the chief labor consists in finding a sequence of increasingly coarser partitions (starting with the partition into singleton blocks and ending with the single block partition ofS) called theprincipal sequence. Once this is done the remaining effort is essentiallyO(|S|logS).
Short Note Quantifying Natural Fault Geometry: Statistics of Splay Fault Angles

We propose a new approach to quantifying fault system geometry, using an objective fit of the fault geometry to a test function, specifically here a fault branch. Fitting a Y-shaped object using a cost function to dextral faults in California, we find a number of significant results arising from use of a a systematic, objective, quantitative approach. (1) The largest angle of the branch structure is generally very close to 180°, implying that the branch is a splay fault off the primary through-going fault. (2) The distribution of the smallest angle, the splay angle, has a peak near � 17°, symmetric about the primary fault. (3) These features appear independent of scale. These results are not yet explained by any theory, and they pose new questions and constraints for the physics of fault system formation and behavior. Online Material: Event information and color figures.
The offline spill-over of signing online petitions against companies: A dual pathway model

Purpose The purpose of this paper is to examine cognitive, emotional, and behavioral reactions caused by online petition campaigns against cases of perceived corporate malpractice, while also contributing to the ongoing debate over the spill-over effects of online activism to offline contexts. A dual pathway model is advanced based on the individual’s motivation to help the people affected by irresponsible corporate behavior and punish the deviant corporation. Design/methodology/approach Two studies (USA and UK) are used to gather cross-sectional and longitudinal data, which are analyzed using structural equation modeling. Findings Online petition campaigns relying on the display of victims affected by irresponsible behavior trigger feelings of compassion and anger. While the former leads to campaign support motivated by a desire to help, the latter causes intentions to punish. Intentions to support the petition resulting from this dual pathway influence the actual signing of the petition online and self-reported offline negative word of mouth against the company. Social implications Both identified pathways should be activated by online petition campaigns to increase online support and spreading offline negative word of mouth. To do so, such campaigns need to increase perceptions of unfairness and victim’s similarity, and likeability. Originality/value Scant research has examined the psychological processes that explain the effectiveness of online petition campaigns against businesses and the motivations to sign an online petition and engage in subsequent offline behavior. Implications for businesses are also discussed.
Safety and efficacy profiles of tocilizumab monotherapy in Japanese patients with rheumatoid arthritis: meta-analysis of six initial trials and five long-term extensions

We present safety and efficacy data from Japanese clinical studies on monotherapy with tocilizumab (TCZ), a humanized anti-interleukin 6 receptor monoclonal antibody, in which 601 patients with moderate to severe rheumatoid arthritis, with a total of 2188 patient-years (pt-yr) exposure, were enrolled. The median treatment duration was 3.8 years. The incidence of adverse events (AEs), including abnormal laboratory test results, was calculated as 465.1 per 100 pt-yr. The most common serious adverse events (SAEs) were infections (6.22 per 100 pt-yr). There was no increase in the frequency of AEs or SAEs with long-term treatment. Abnormalities in the laboratory test results, such as increases in lipid parameters or abnormal liver function parameters, were common, but most were mild and there were no SAEs related to them. At baseline, 546 patients (90.8%) were taking corticosteroids; of these, 77.8% were able to decrease their corticosteroid dose during the study period, while 35.2% discontinued corticosteroids altogether. In the patients treated longer than 5 years, 91.3, 73.0, and 51.3% met the ACR20, ACR50, and ACR70 response criteria, respectively, and 59.7% met the DAS remission criterion (DAS28 <2.6) at 5 years. In conclusion, based on these results, TCZ has shown good tolerability and high efficacy during long-term treatment.
Epidermolysis bullosa nevus: an exception to the clinical and dermoscopic criteria for melanoma.

BACKGROUND Large acquired melanocytic nevi that occur in patients with epidermolysis bullosa (EB), referred to as EB nevi, may pose a diagnostic challenge because of their clinical and dermoscopic resemblance to melanoma. These unconventional melanocytic nevi have been encountered in all categories of hereditary EB, most of them in childhood. Although some of the reported cases have an alarming clinical appearance that is indistinguishable from melanoma, long-term follow-up has confirmed the benign nature of these rarely encountered melanocytic lesions. The histopathologic patterns of these nevi range from a banal congenital pattern to the problematic persistent pseudomelanoma pattern. OBSERVATION We describe the clinical, dermoscopic, and histopathologic features of a large EB nevus in a toddler. Clinically, the lesion was markedly asymmetrical and irregularly pigmented with foci of stippled pigmentation and scarring, which easily fulfilled the ABCD criteria for melanoma. Accordingly, a false-positive score resulted when dermoscopy was performed. Histopathologically, a pattern of persistent melanocytic neoplasm was observed. In the following 18 months, dynamic changes of the lesion included near-complete disappearance of the pigment, which was replaced by scar, milia, and areas of healing ulcers. CONCLUSION Epidermolysis bullosa nevi are dynamic melanocytic lesions that may simulate melanoma.
Altered amino acid excretion in children with autism

Abstract Autism is a complex and life-long behavioural disorder of unknown aetiology. Recent reports have indicated the involvement of digestive tract dysfunction and possible complications from inadequate nutrition. In this study, 34 autistic children (12 untreated and 22 receiving therapeutic treatments related to digestive function and nutritional uptake) and 29 control subjects (all 5–15 years of age) were investigated to determine whether there were any anomalies in the urinary excretion of amino acids, glucose, sucrose, arabinose and tartaric acid using GC/FID and GC/MS analysis techniques. Significantly lower relative urinary levels of essential amino acids were revealed for both the untreated (mean ± SEM, 32.53 ± 3.09%) and treated (31.98 ± 2.87%) autistic children compared with the controls (37.87 ± 1.50%). There were no significant differences in measured excretions of sugars or tartaric acid. It was concluded that the untreated autistic children had evidence of altered metabolic homeostasis.
Screening for Mutations in ABCC8 and KCNJ11 Genes in Saudi Persistent Hyperinsulinemic Hypoglycemia of Infancy (PHHI) Patients

The autosomal recessive form of persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is associated with mutations in either ABCC8 or KCNJ11 genes. In the present study, we describe the clinical features and results of genetic analysis of 13 Saudi Arabian patients with PHHI. Clinically, most patients presented with infantile seizures and/or developmental delay, with a subset of patients who were also found to have abnormal brain imaging and electrophysiological studies. Interestingly no coding pathogenic mutations were identified in these two genes by direct sequencing. However, two splice variants were identified in ABCC8 gene in two patients, and a large deletion of exons 1-22 of the ABCC8 gene was identified in three patients. Our data shows that large deletions in ABCC8 gene are the common genetic mechanism in the Saudi population.
Papillary fibroelastoma of the left atrium in a 3-year-old boy

A 3 year old boy presented with a cardiac murmur. Except for mildly impaired physical condition that was more likely due to asthmatic bronchitis, he was asymptomatic. Cardiac echocardiography disclosed a large tumor in the left atrium originating from the interatrial septum. The patient was immediately referred to surgery for excision of the tumor. Histological examination of the tumor showed a typical papillary fibroelastoma. The occurrence of a papillary fibroelastoma in a child is a rarity.