Miracle-dz/UniFAR-FTUs huggingface dataset:
[Primary- and revision-reconstruction of the anterior cruciate ligament with allografts: a retrospective study including 325 patients].

UNLABELLED At our institution we have used fresh-frozen allografts for the reconstruction of the anterior and posterior cruciate ligament since 1993. METHOD In this retrospective study we evaluated the clinical outcome of 325 fresh-frozen allografts (bone-patellar-tendon-bone allografts and Achilles-bone-tendon allografts) for primary and revision ACL-reconstruction. Patients (average age 38 years) were operated between 5/1993 and 2/1998 and mean follow-up was 38 (range 24 to 71) months. Clinical evaluation consisted of a case history, an examination, IKDC, Cincinnati knee score (CKS), KT-1000 testing and standardized X-rays. RESULTS Overall subjective rating according to the CKS was more than 82 points for both groups. Objective results according to the IKDC were normal or nearly normal in 75.6 % of primary- and 67.0 % of revision-ACL reconstructions. The stability measured with the KT-1000 showed an average maximum side to side difference of 2.1 mm for primary ACL reconstruction and 2.3 mm for revisioners. The total failure-rate (= rerupture-rate + laxity-failures) was 13.7 % for primary and 15.0 % for revision ACL reconstructions. CONCLUSION Given the increased failure-rate, autograft tissue remains our graft of first choice for primary ACL-reconstruction. We advise to reserve allografts for revision procedures where suitable autogenous tissues have been previously compromised, where a contraindication for autogenous tissue harvest exists or for multiple ligament surgery. No specific complications were observed with the use of allograft tissue.
The Tasmanian Epilepsy Register – A Community-Based Cohort

Background/Aims: Centralized prescription databases may provide an efficient mechanism for recruitment of community-treated disease. Methods: The Australian federal government agency, the Health Insurance Commission (HIC), invited patients to participate in the Tasmanian Epilepsy Register (TER). Eligible patients included those who received at least one anticonvulsant above a ‘reportable’ price threshold between July 1, 2001 and June 30, 2002. Patients were asked to disclose their medical indication for anticonvulsant treatment with additional demographic and prescription information obtained from the HIC. Results: 7,541 were eligible for recruitment. After two mail invitations over 6 months, 3,375 (46.6%) had responded, but TER enrollment amongst those indicating treatment for epilepsy was 1,180 (78.3%). TER participants were more likely to obtain their prescriptions exclusively from their general practitioner (70.9%) or from combined sources (19.1%) rather than from pediatrician (4.2%), neurologist (1.4%) or general physician (1.0%) sources. Patients were more likely to respond with increasing age (linear trend p < 0.001), when from a higher socioeconomic area (linear trend p < 0.001), or if their prescription was obtained from a neurologist (p < 0.001). Conclusion: The national Australian prescription database represents community-treated epilepsy and provides an effective and efficient method for patient recruitment for clinical epidemiological research.
Intestinal-Type Adenocarcinoma of the Nasal Cavity and Paranasal Sinuses. A Clinicopathologic Study of 6 Cases

The clinical and pathologic features of 6 cases of intestinal-type adenocarcinoma of the sinonasal region are presented. These cases were collected in a 17 year period (1972-1988) and account for less than 4% of malignancies of this region in our records for this period. All of the patients were men aged 48 to 82 years (mean, 54 years). Previous exposure to wood dust was reported in 1 case. Radiographic studies, especially computerized tomography, were of critical importance to delineate the extent of tumors. Nasal obstruction was the most common compliant. Duration of symptoms prior to diagnosis is available in 5 cases and ranged from 5 to 36 months (mean 18 months). Surgical treatment was performed in 4 patients (of palliative type in 2) followed by radiotherapy in 3. Histo-pathology revealed tubulo-papillary (5 cases) and mucinous (1 case) patterns. Follow-up is available in all patients (range 0 to 108 months), 50% of whom are still alive. In our series, only 1 patient has survived more than 5 years. Data pooled from the literature reveal that 53% of patients have experienced local recurrences following therapy, and 60% have died of their disease. Of these deaths, 80% occurred within 5 years of diagnosis.
Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions.

BACKGROUND Controversy over the measles, mumps, and rubella (MMR) vaccine has reduced uptake, raising concerns of a future disease epidemic. AIMS To explore parents' accounts of decision making relating to the MMR vaccine controversy, identifying uptake determinants and education needs. DESIGN OF STUDY Qualitative interviews analysed using the 'framework' approach. SETTING Five general practices in the Leeds area, 2002-2003. METHOD Sixty-nine interviews conducted with parents of children aged between 4 and 5 years, and 12 interviews with primary care practitioners, managers and immunisation coordinators serving participating sites. Participants were interviewed one-to-one in a place of their choice. RESULTS The vaccination decision is primarily a function of parental assessments of the relative acceptability and likelihood of possible outcomes. For most parents the evidence of science and medicine plays little role in the decision. Although local general practitioners and health visitors are trusted information sources, the influence of primary care providers on the vaccination decision is limited by concerns over consultation legitimacy, discussion opportunity, and perceptions of financial and political partiality. Parents and practitioners identify a need for new approaches to support decisions and learning when faced with this and similar healthcare controversies. These include new collaborative approaches to information exchange designed to transform rather than supplant existing parent knowledge as part of an ongoing learning process. CONCLUSION The study identified new ways in which parents and practitioners need to be supported in order to increase understanding of medical science and secure more informed decisions in the face of health controversy.
The incidence and risk of second primary cancers in patients with nasopharyngeal carcinoma: a population-based study in Taiwan over a 25-year period (1979-2003).

BACKGROUND Very few reports are available on the incidence and risk of second primary cancers in nasopharyngeal carcinoma (NPC) cases, and most of these are single-institution reviews with relatively small case numbers and short follow-up. PATIENTS AND METHODS A population-based study was conducted. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second cancers among 23 639 individuals with initial diagnoses of NPC. RESULTS We found a 24% increased risk of second cancers in NPC patients compared with the general population [SIR = 1.24, 95% confidence interval 1.15-1.33]. Elevated SIRs were observed in the following second primary cancers: oral/pharyngeal, salivary gland, sarcoma, skin and leukemia/lymphoma. The cumulative incidence >10 years was 3.26%. The risk was higher in younger patients, especially those <40 years old. After diagnosis of second cancers, the median survival time was 1.7 years. CONCLUSIONS This is the largest population-based study to date from a high-incidence area. We found that NPC is associated with an increased risk of second malignancies, which had a negative impact on the survival of patients who survived NPC.
Accuracy of acute otitis media diagnosis in community and hospital settings

Aim: To evaluate the accuracy rates of acute otitis media (AOM) diagnosis in the community by analyzing the initial AOM diagnosis (according to information from the referral letters to the Pediatric Emergency Department [PED]) among children with AOM diagnosis confirmed by tympanocentesis at PED. Methods: A descriptive, retrospective study conducted during the year 2000, including 590 children aged 0–48 mo diagnosed with AOM at PED. AOM was confirmed by tympanocentesis. We defined: (1) simple AOM as <3 or <4 episodes during the last 6 or 12 mo, respectively; (2) complicated AOM as 3 or 4 episodes during the last 6 or 12 mo, respectively, and/or not improving with antibiotics. Results: 571 (96.8%) were <24 mo of age; 355 (60%) were Arab Bedouins and 235 (40%) Jews. Seventy‐three pediatricians, 57 general practitioners and 27 family practitioners provided referral letters. Information on disease severity was available in 471/590 (79.8%) patients, of whom 320 (68%) had simple and 151 (32%) complicated AOM. Three hundred and sixty‐five (62%) of 590 patients were accurately diagnosed by referring physicians, more frequently in patients with complicated than simple AOM ( p<0.001). Diagnostic accuracy was similar among physician specialties ( p=0.33) and ethnic groups ( p=0.11). Multivariable logistic regression analysis showed that complicated AOM, adjusted for age, sex, ethnic origin, and physician specialty, was the only predictive factor for accurate AOM diagnosis (odds ratio 4.0, p<0.001).
An evaluation of the Bausch & Lomb Zywave aberrometer

Purpose: The Bausch & Lomb Zywave uses Shack‐Hartmann aberrometry to determine wavefront aberrations of the human eye and provide an estimate of refractive error. We investigated the effect of pupil size on the repeatability and validity of refractive errors estimated by the Zywave and the repeatability of higher‐order aberrations.
Design of a Tunable Single-Polarization Photonic Crystal Fiber Filter With Silver-Coated and Liquid-Filled Air Holes

A tunable single-polarization filter is designed by filling high index liquid into the silver-coated air holes of photonic crystal fiber and the polarization characteristics are analyzed utilizing the finite element method. Results show that the filter can be used to realize, to our best knowledge, the filtering of an incoming signal at 1310 and 1550 nm bands simultaneously in two orthogonal polarization states with narrowband of full width half maximum only 9 nm (at 1550 nm bands). The confinement losses of unwanted polarized mode can reach up to 53.1 and 305.1 dB/cm at the two aforementioned communication windows, with other polarized mode losses as low as 0.8 and 2.4 dB/cm, respectively. For a propagation distance of 1 mm, the crosstalk of x- or y-polarized (x- or y-pol) mode can reach a value of 45.4 and –262.9 dB at 1310 and 1550 nm bands, and the 20 dB bandwidth at 62 and 133 nm. By adjusting the silver-coated air hole diameter, the silver layer thickness, or the filling liquid, the filtering wavelength can be precisely tuned in a broad band range, from 1351 to 1931 nm of x-pol and from 1208 to 1392 nm of y-pol, covering almost all the communication wavelength.
Axel rover NanoDrill and PowderDrill: Acquisition of cores, regolith and powder from steep walls

This paper describes development and testing of low-mass, low-power drills for the Axel rover. Axel is a two-wheeled tethered rover designed for the robotic exploration of steep cliff walls, crater walls and deep holes on earth and other planetary bodies. The Axel rover has a capability to deploy scientific instruments and/or samplers in the areas of interest to scientists currently inaccessible by conventional robotic systems. To enable sample recovery, we developed two drills: NanoDrill for acquisition of 25 mm long and 7 mm diameter cores and PowderDrill for acquisition of either in situ regolith/soil or drilled cuttings from depths of up to 15 mm. Both drills have been successfully tested in laboratory in limestone and sandstone rocks and on-board the Axel rover in the Mars Yard at NASA JPL. The drills managed to acquire limestone and sandstone cores and powder, with an average power of less than 5 Watts. The penetration rate of the NanoDrill was ~2 mm/min and of the PowderDrill it was ~9 mm/min. After sample acquisition, both drills successfully ejected of the acquired samples (cores and powder).
Influence of Diabetes Mellitus and Glycaemic Control on the Characteristics and Outcome of Common Infections

The aim of the present study was to elucidate the effect of diabetes and metabolic control on the presentation, sources, pathogens and outcome of common infections. Of 515 patients admitted to three departments of internal medicine because of a suspected acute infection, 132 (26 %) had diabetes mellitus. Osteomyelitis was diagnosed in 3 % of the diabetic patients and in 1 % of patients without diabetes, and infection of the extremities in 7 % and 0 %, respectively (p = 0.003). Klebsiella sp. caused 24 % of urinary tract infections in diabetic patients, versus 13 % in patients without diabetes (p = 0.1). The percentage of Staphylococcus aureus infections in diabetic patients was 10 % versus 5 % in non‐diabetic patients (p = 0.06). The gross mortality rate in the diabetic patients was 10 %, and in patients without diabetes, 12 %. In patients without fatal underlying disorders, mortality in the diabetic patients was 10 % (2 % in patients with glycosylated haemoglobin (GHb) lower than median, and 17 % in patients with GHb higher than median) and in the non‐diabetic patients 4 % (p = 0.04). Five factors were independently and significantly related to mortality in diabetic patients: acute respiratory distress (very large odds‐ratio [OR]), coma (OR 3.8, 95 % confidence interval [CI] 1.0–14.3), GHb above the median (OR 3.3, 95 % CI 1.8–6.2), the interaction between GHb and absence of a severe underlying disorder (OR 12.0, 95 % CI 2.9–50.7) and duration of diabetes (OR of 1.072 for 1‐year increment, and 1.42 for a 5‐year increment). Choice of empiric antibiotic treatment in diabetic patients with suspected bacterial infection should take into account the preponderance of Klebsiella sp. and Staphylococcus aureus infections. The present results favour an association between poor glycaemic control and a fatal outcome of infectious diseases in diabetic patients.
Characterization of a naturally occurring ecotropic receptor that does not facilitate entry of all ecotropic murine retroviruses

A fibroblast cell line (MDTF) derived from the feral mouse Mus dunni is resistant to infection by Moloney murine leukemia virus (Mo-MuLV), an ecotropic murine leukemia virus (E-MuLV) (M. R. Lander and S. K. Chattopadadhyay, J. Virol. 52:695-698, 1984). MDTF cells can be infected by other E-MuLVs such as Friend MuLV and Rauscher MuLV, which have been demonstrated to use the same receptor as Mo-MuLV in NIH 3T3 cells (A. Rein and A. Schultz, Virology 136:144-152, 1984). We have now shown that the block to Mo-MuLV infection of MDTF cells occurs at the level of the envelope-receptor interaction. We have cloned the ecotropic receptor cDNA from MDTF cells (dRec) and compared its sequence with that of the NIH 3T3 cell receptor (mRec). Although the deduced dRec and mRec proteins differ at only four amino acid residues, we demonstrate that these changes account for the resistance of MDTF cells to Mo-MuLV infection. Our findings suggest that retroviruses in the same receptor class can exhibit different host ranges due to single amino acid differences in their cellular receptor.
Glial influence on nerve fiber formation from rat ventral mesencephalic organotypic tissue cultures

Rat fetal ventral mesencephalic organotypic cultures have demonstrated two morphologically different dopamine nerve fiber growth patterns, in which the initial nerve fibers are formed in the absence of astrocytes and the second wave is guided by astrocytes. In this study, the presence of subpopulations of dopamine neurons, other neuronal populations, and glial cells was determined. We used “roller‐drum” organotypic cultures, and the results revealed that β‐tubulin‐positive/tyrosine hydroxylase (TH)‐negative nerve fibers were present as early as 1 day in vitro (DIV). A similar growth pattern produced by TH‐positive neurons was present from 2 DIV. These neurites grew to reach distances over 4 mm and over time appeared to be degenerating. Thin, vimentin‐positive processes were found among these nerve fibers. As the first growth was retracted, a second outgrowth was initiated and formed on migrating astrocytes. TH‐ and aldehyde dehydrogenase‐1 (ALDH1)‐positive nerve fibers formed both the nonglia‐associated and the glia‐associated outgrowth. In cultures with membrane inserts, only the glia‐associated outgrowth was found. Vimentin‐positive cells preceded migration of NG2‐positive oligodendrocytes and Iba‐1‐positive microglia. Oligodendrocytes appeared not to be involved in guiding neuritic growth, but microglia was absent over areas dense with TH‐positive neurons. In conclusion, in “roller‐drum” cultures, nerve fibers are generally formed in two sequences. The early‐formed nerve fibers grow in the presence of thin, vimentin‐positive processes. The second nerve fiber outgrowth is formed on astroglia, with no correlation to the presence of oligodendrocytes or microglia. ALDH1‐positive nerve fibers, presumably derived from A9 dopamine neurons, participate in formation of both sequences of outgrowth. J. Comp. Neurol. 501:431–442, 2007. © 2007 Wiley‐Liss, Inc.
Some principles of systemic glucocorticoid therapy

Compared to oral glucocorticoids, ACTH and its physiologically equivalent synthetic derivative, tetracosactrin, have many liabilities and no advantages. They are not therapeutically superior in any disease, a predictable finding since the anti-inflammatory actions of ACTH result entirely from cortisol (hydrocortisone) released from the adrenal cortex. Furthermore, because ACTH and tetracosactrin require parenteral administration, they are inconvenient, markedly more expensive than therapeutically equivalent doses of prednisone or prednisolone, and uncomfortable, commonly causing pain and swelling at injection sites. ACTH and tetracosactrin also have more, rather than fewer, adverse systemic effects. They stimulate adrenal androgen secretion, while oral eorticosteroids, by suppressing ACTH, diminish it. With tetracosactrin and ACTH, therefore, acne, hirsutism, and menstrual irregularities are more common. Furthermore, the glucocorticoid secreted by the adrenals (hydrocortisone) causes greater salt retention than prednisone or prednisolone, producing more oedema and hypertension (Axelrod, 1976). Because absorption from the intramuscular injection site and the adrenal response to corticotrophin are so variable, the glucocorticoid effect is less predictable and the dose less easily regulated than with oral eorticosteroids. Early in the course of these injections the maximum response of the adrenals is about 100 mg of cortisol daily (equivalent to about 25 mg of prednisone), and frequently the output is closer to 60-80 mg of cortisol (15-20 mg of prednisone) (Treadwell & Dennis, 1969). For many diseases these amounts are therapeutically inadequate. After several weeks of injections, the adrenal glands hypertrophy, and a given quantity of ACTH elicits more cortisol secretion than before; this further complicates dose regulation. Another confounding factor in therapy is that 'long-acting' tetracosactrin (depot Synacthen), a preparation adsorbed onto an inorganic zinc complex, in fact lasts only 24-48 h when given in the usual doses of 0 5 2 0 mg (Besser, Butler & Plumpton, 1976; Treadwell & Dennis, 1969). Therefore, to ensure a continuous glucocorticoid effect, daily therapy is necessary. Used once or twice a week, a frequent practice, these injections are an expensive and inconvenient form of intermittent glucocorticoid administration.
Vanishing Price of Decentralization in Large Coordinative Nonconvex Optimization

We focus on nonconvex multi-agent optimization where a large number of participants collaboratively optimize some social cost function and their individual preferences. We focus on the semidecentralized multi-agent best response setting where a central planner attempts to coordinate the agents and each participant pursues self-interest. By studying the duality framework, we provide geometric and analytic characterizations of the duality gap and the price of decentralization. We prove that the nonconvex problem becomes increasingly convex as the problem scales up in dimension. Upon appropriate coordination, the price of decentralization asymptotically vanishes to zero as the number of participants grows. We develop a duality-based coordination procedure for the central planner to adapt the price vector and select a particular best response for each participant. The coordination algorithm is able to induce individual best responses to dynamically converge to an approximate global optimum, regardless of the .
Management of Perforating Colon Trauma Randomization Between Primary Closure and Exteriorization

During a 44 month trial, 268 patients with wounds of the colon were entered into a prospective, randomized, nonblinded study. Consideration for primary closure demanded that: preoperative shock was never profound, blood loss was less than 20% of estimated normal volume, no more than two intra-abdominal organ systems had been injured, fecal contamination was minimal, operation was begun within eight hours, and wounds of colon and abdominal wall were never so destructive as to require resection. Once such criteria had been satisfied, colon wound management was dictated by last digit in the randomly assigned hospital number; odd indicated primary closure; even, exteriorization of the wound or primary closure with protection by a proximal vent. Results obtained in 139 determinant patients eligible for randomization revealed that primary closure (67 patients) had a lower infection rate of the incision (48% vs 57%, p > 0.05) and a still lower infection rate for the abdomen proper (15% vs 29%, p < 0.05) on comparison to the 72 patients with a randomized colostomy. Morbidity otherwise for the randomized colostomy was tenfold greater than if a primary closure had been performed. Average postoperative stay was six days longer (p < 0.01) if a colostomy had been created, exclusive of subsequent hospitalization for colostomy closure; while the total extra cost for management of the colon wound by colostomy was approximately $2,700.00. Although immediate mortalities were identical, one late death occurred following colostomy closure. These data not only confirm the safety of primary closure for colon wounds in selected cases, but also indicate that such should become the preferred method of treatment whenever specific criteria have been met.