Miracle-dz/UniFAR-FTUs huggingface dataset:
Return to play after surgery for isolated unstable syndesmotic ankle injuries (West Point grade IIB and III) in 110 male professional football players: a retrospective cohort study

Objectives To evaluate time to return to play following surgical stabilisation of isolated unstable syndesmosis injuries in a cohort of professional male football players. Methods All professional football players undergoing surgery for isolated unstable syndesmosis injury (West Point grade ≥IIB) at a specialised Orthopaedic and Sports Medicine Hospital were followed up until return to play (minimum ≥6 months). Players with a stable syndesmosis, injuries older than 6 weeks, concomitant medial or lateral malleolar fracture or previous ankle surgery were excluded. During rehabilitation, time required to return to sports-specific rehabilitation, team training and first match play, were recorded. Results Between January 2012 and December 2017, a total of 110 male professional football players were included. The mean time required to begin on field rehabilitation was 37±12 days, while the mean time to return to team training was 72±28 days. The first official match was played on average 103±28 days postoperatively. Multivariable analysis revealed that the severity of injury, the concomitant presence of talar cartilage injury and the age of the player were significantly associated (p<0.00001) with time to return to on field rehabilitation, team training and match play. Conclusion In this cohort of professional football players, surgical stabilisation of isolated unstable syndesmosis injuries (West Point grade ≥IIB) allowed for relatively quick return to play. High grade injury (West Point grade III), concomitant cartilage injury and greater age were associated with longer return to play times. Level of evidence Longitudinal observational cohort study (level II).
Virtual Faces Evoke Only a Weak Uncanny Valley Effect: An Empirical Investigation With Controlled Virtual Face Images

The uncanny valley (UV) hypothesis suggests that increasingly human-like robots or virtual characters elicit more familiarity in their observers (positive affinity) with the exception of near-human characters that elicit strong feelings of eeriness (negative affinity). We studied this hypothesis in three experiments with carefully matched images of virtual faces varying from artificial to realistic. We investigated both painted and computer-generated (CG) faces to tap a broad range of human-likeness and to test whether CG faces would be particularly sensitive to the UV effect. Overall, we observed a linear relationship with a slight upward curvature between human-likeness and affinity. In other words, less realistic faces triggered greater eeriness in an accelerating manner. We also observed a weak UV effect for CG faces; however, least human-like faces elicited much more negative affinity in comparison. We conclude that although CG faces elicit a weak UV effect, this effect is not fully analogous to the original UV hypothesis. Instead, the subjective evaluation curve for face images resembles an uncanny slope more than a UV. Based on our results, we also argue that subjective affinity should be contrasted against subjective rather than objective measures of human-likeness when testing UV.
Validation of the Withdrawal Assessment Tool-1 in Adult Intensive Care Patients.

BACKGROUND The Withdrawal Assessment Tool-1 (WAT-1) has been validated for assessing iatrogenic withdrawal syndrome in critically ill children receiving mechanical ventilation, but little is known about this syndrome in critically ill adults. OBJECTIVE To evaluate the validity and reliability of the WAT-1 in critically ill adults. METHODS A prospective, observational, open-cohort pilot study of critically ill adults receiving mechanical ventilation and regular administration of opioids for at least 72 hours. Patients were assessed for withdrawal twice daily on weekdays and once daily on weekends using the WAT-1 after an opioid weaning episode. The presence of iatrogenic withdrawal syndrome was evaluated once daily using modified Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) criteria. All evaluations were blinded and performed independently. The criterion validity of the WAT-1 and the interrater reliability for WAT-1 and DSM-5 evaluations were determined. RESULTS During 8 months, 52 adults (median age, 51.5 years) were enrolled. Eight patients (15%) had at least 1 positive assessment during their intensive care unit stay using the DSM-5, compared with 19 patients (37%) using the WAT-1. The overall sensitivity of the WAT-1 was 50%, and its specificity was 65.9%. Agreement between WAT-1 and DSM-5 assessments was poor (κ = 0.102). The interrater reliability for the WAT-1 was 89.1% and for the DSM-5 was 90.1%. CONCLUSION Despite showing reliability, the WAT-1 is not a valid tool for assessing the presence of iatrogenic withdrawal syndrome in adults.
Immunohistochemical evaluation of Cajal-like cells and Caveolin-1 levels at ureteropelvic junction obstruction.

OBJECTIVE To compare c-kit-positive interstitial Cajal-like cells (ICC) and Caveolin-1 protein levels as a pacemaker and signaling molecules, on ureteropelvic junction (UPJ) specimens, between two groups of pediatric patients with and without ureteropelvic junction obstruction (UPJO). METHODS We evaluated the UPJ specimens of 45 pediatric patients operated between 2005- 2012 retrospectively. Group 1 included 37 patients who underwent dismembered pyeloplasty due to UPJO. Eight patients underwent nephrectomy by the other reasons (renal tumor, trauma etc) and had normal UPJ were accepted as Group 2. The specimens were examined immunohistochemically with CD117 and Caveolin-1 antibody. According to the total number of ICC; 0-5 cells were accepted as a few (1), 610 cells as moderate (2), and > 10 as many (3). According to the staining intensity of Caveolin-1 at muscle tissue, a subjective evaluation was performed as; mild staining (1), moderate staining (2) and strong staining (3). RESULTS The mean value of ICC distribution was calculated 1.37 ± 0.54 in Group 1 and 2.13 ± 0.64 in Group 2 (p = 0.003), and the median value of ICC distribution was found 1 [1-3] in Group 1 and 2 [1-3] in Group 2 (p = 0.008). Median values for the intensity of staining with Caveolin-1 were found 2 [1-3] in the Group 1, and 2.5 [2-3] in the Group 2 (p = 0.025). CONCLUSIONS A decrease in ICC and Caveolin-1 levels support that there may be a relationship between ICC and Caveolin-1 for UPJO associated with signal transduction and peristalsis in urinary system.
Physical Activity Interventions: Effects on Well-Being Outcomes in Older Adults

A corpus of literature has documented the benefits of physical activity to well-being and quality of life in older adults. However, this relationship has frequently been studied in the context of health-related quality of life (HRQL), as opposed to global quality of life, and in clinical populations. While meta-analyses in this area provide strong evidence of a positive effect of physical activity on HRQL in these populations, systematic evidence is lacking in relation to well-being and global quality of life in healthy older adults. A small number of randomized controlled trials suggest physical activity benefits global quality of life; however, additional research using the global conceptualization of well-being is needed to confirm these findings. There is strong evidence, on the other hand, of a positive influence of physical activity on the proposed antecedents of HRQL and global well-being, including self-related function, or psychological states (i.e., depression, anxiety, self-esteem, positive affect, self-efficacy), and cognitive function (e.g., executive function, working memory) in older adults. Despite this, less is known about the: (1) modes and doses of physical activity that most effectively improve self-related function, cognitive function, HRQL, and well-being; (2) mechanisms of change in well-being outcomes due to increased physical activity; and (3) mediating roles of self-related function, cognitive function, and HRQL in the broader relationship between physical activity and well-being. In this chapter, we present current evidence of physical activity’s effects on well-being and its correlates, HRQL, self-related function, and cognitive function. We also highlight limitations in this evidence base and provide recommendations for future research.
Use of varenicline and nicotine replacement therapy in people with and without general practitioner-recorded dementia: retrospective cohort study of routine electronic medical records

Objectives Our primary objective was to estimate smoking prevalence and prescribing rates of varenicline and nicotine replacement therapy (NRT) in people with and without general practitioner (GP)-recorded dementia. Our secondary objective was to assess and compare quit rates of smokers with versus without GP-recorded dementia who were prescribed varenicline or NRT for smoking cessation. Design A retrospective cohort study based on the analysis of electronic medical records within the Clinical Practice Research Datalink (2007–2015). Setting 683 general practices in England. Participants People with and without GP-recorded dementia, aged 18 years and have a code indicating that they are a current smoker. Intervention Index prescription of varenicline or NRT (from 1 September 2006). Outcome measures The primary outcomes were smoking prevalence and prescribing rates of varenicline and NRT (2007–2015). The secondary outcome was smoking cessation at 2 years. Results Age and sex-standardised prevalence of smoking was slightly higher in people with GP-recorded dementia than in those without. There were 235 314 people aged 18 years and above prescribed NRT or varenicline. Among smokers with GP-recorded dementia (N=447), 409 were prescribed NRT and 38 varenicline. Smokers with GP-recorded dementia were 74% less likely (95% CI 64% to 82%) to be prescribed varenicline than NRT, compared with smokers without GP-recorded dementia. Compared with people without GP-recorded dementia, people with GP-recorded dementia had consistently lower prescribing rates of varenicline from 2007 to 2015. Two years after prescription, there was no clear evidence for a difference in the likelihood of smoking cessation after prescription of these medications between individuals with and without dementia (OR 1.0, 95% CI 0.8 to 1.2). Conclusions Between 2007 and 2015, people with GP-recorded dementia were less likely to be prescribed varenicline than those without dementia. Quit rates following prescription of either NRT or varenicline were similar in those with and without dementia.
Long-term Risk of Malignancy in Branch Duct Intraductal Papillary Mucinous Neoplasms.

BACKGROUND & AIMS Long-term outcomes of patients with branch-duct intraductal papillary mucinous neoplasms (IPMNs), particularly those after 5 years if surveillance, have not been fully evaluated in large studies. We analyzed incidences of IPMN-derived carcinoma and concomitant ductal adenocarcinoma (PDAC) over 20 years in a large population of patients. METHODS We identified 1404 consecutive patients (52% female; mean age, 67.5 years) with a diagnosis of branch-duct IPMN, from 1994 through 2017, at the University of Tokyo in Japan. Using a competing-risk analysis, we estimated cumulative incidence of pancreatic carcinoma, overall and by carcinoma type. We used competing-risks proportional hazards models to estimate sub-distribution hazard ratios (SHRs) for incidences of carcinomas. To differentiate IPMN-derived and concomitant carcinomas, we collected genomic DNA from available paired samples of IPMNs and carcinomas and detected mutations in GNAS and KRAS by PCR and pyrosequencing. RESULTS During 9231 person-years of follow up, we identified 68 patients with pancreatic carcinomas (38 patients with IPMN-derived carcinomas and 30 patients with concomitant PDACs); the overall incidence rates were 3.3%, 6.6%, and 15% at 5, 10, and 15 years, respectively. Among 804 patients followed more than 5 years, overall cumulative incidence rates of pancreatic carcinoma were 3.5% at 10 years and 12% at 15 years from the initial diagnosis. The size of the IPMN and the diameter of the main pancreatic duct associated with incidence of IPMN-derived carcinoma (SHR, 1.85; 95% CI, 1.38-2.48 for a 10-mm increase in the IPMN size and SHR, 1.56; 95% CI, 1.33-1.83 for a 1-mm increase in the main pancreatic duct diameter) but not with incidence of concomitant PDAC CONCLUSIONS: In a large long-term study of patients with branch-duct IPMNs, we found the 5-year incidence rate of pancreatic malignancy to be 3.3%, reaching 15% at 15 years after IPMN diagnosis. We observed heterogeneous risk factor profiles between IPMN-derived and concomitant carcinomas.
Absence of estrogen receptor beta leads to abnormal adipogenesis during early tendon healing by an up‐regulation of PPARγ signalling

Achilles tendon injury is one of the challenges of sports medicine, the aetiology of which remains unknown. For a long time, estrogen receptor β (ERβ) has been known as a regulating factor of the metabolism in many connective tissues, such as bone, muscle and cartilage, but little is known about its role in tendon. Recent studies have implicated ERβ as involved in the process of tendon healing. Tendon‐derived stem cells (TDSCs) are getting more and more attention in tendon physiological and pathological process. In this study, we investigated how ERβ played a role in Achilles tendon healing. Achilles tendon injury model was established to analyse how ERβ affected on healing process in vivo. Cell proliferation assay, Western blots, qRT‐PCR and immunocytochemistry were performed to investigate the effect of ERβ on TDSCs. Here, we showed that ERβ deletion in mice resulted in inferior gross appearance, histological scores and, most importantly, increased accumulation of adipocytes during the early tendon healing which involved activation of peroxisome proliferator‐activated receptor γ (PPARγ) signalling. Furthermore, in vitro results of ours confirmed that the abnormity might be the result of abnormal TDSC adipogenic differentiation which could be partially reversed by the treatment of ERβ agonist LY3201. These data revealed a role of ERβ in Achilles tendon healing for the first time, thereby providing a new target for clinical treatment of Achilles tendon injury.
Effects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus.

BACKGROUND Mobile health interventions may support risk factor management and are readily scalable in healthcare systems. We aim to evaluate the efficacy of a text messaging-based intervention to improve glycemic control in patients with coronary heart disease and diabetes mellitus in China. METHODS AND RESULTS The CHAT-DM study (Cardiovascular Health and Texting-Diabetes Mellitus) was a parallel-group, single-blind, randomized clinical trial that included 502 patients with both coronary heart disease and diabetes mellitus from 34 hospitals in China. The intervention group (n=251) received 6 text messages per week for 6 months in addition to usual care. Messages were theory driven and culturally tailored to provide educational and motivational information on glucose monitoring, blood pressure control, medication adherence, physical activity, and lifestyle. The control group (n=251) received usual care and 2 thank you messages per month. The primary outcome was change in glycated hemoglobin (HbA1C [hemoglobin A1C]) from baseline to 6 months. Secondary outcomes were change in proportion of patients achieving HbA1C <7%, fasting blood glucose, systolic blood pressure, LDL (low-density lipoprotein) cholesterol, body mass index, and physical activity from baseline to 6 months. The end points were assessed using analyses of covariance. The follow-up rate was 99%. When compared with control group at 6 months, the intervention group had a greater reduction in HbA1C (-0.2% versus 0.1%; P=0.003) and a greater proportion of participants who achieved HbA1C <7% (69.3% versus 52.6%; P=0.004). Change in fasting blood glucose was larger in the intervention group (between-group difference: -0.6 mmol/L; 95% CI, -1.1 to -0.2; P=0.011), but no other outcome differences were observed. Nearly all participants reported that messages were easy to understand (97.1%) and useful (94.1%). CONCLUSIONS A text message intervention resulted in better glycemic control in patients with diabetes mellitus and coronary heart disease. While the mechanism of this benefit remains to be determined, the results suggest that a simple, culturally sensitive mobile text messaging program may provide an effective and feasible way to improve disease self-management. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials. gov. Unique identifier: NCT02883842.
Comparative Evaluation of Sealing Ability of Biodentine, Smart Dentine Replacement (SDR) and Resin Modified Glass Ionomer Cement (RMGIC) in Cervical Lining Restorations by Dye Extraction Method: An in-Vitro Study

Introduction: The increasing demand for aesthetic procedures, along with the advantage of minimal invasive procedure and bonding to tooth structure has drastically increased the popularity of composite resin restorations.The major disadvantage of resin based materials is polymerization shrinkage that causes microleakage leading to bacterial penetration which results in post-operative sensitivity, marginal discolouration, secondary caries and even restoration loss.To overcome the demerits of Glass ionomer cementsand resin modified GIC, use of flowable resin composite&tricalcium based bioactive restorative material (Biodentine) as an intermediate material in the gingival seat has been suggested to reduce polymerization shrinkage. Aim: To evaluate the sealing efficacy of Biodentine, Smart dentine replacement (SDR) and Resin modified Glass Ionomer cement (RMGIC) at the cervical margins of approximal cavities of posterior teeth. Material and methodology: 30 approximal cavities were prepared on 30 extracted human molars. Teeth were randomly assigned into 3 groups of 10 cavities each: (G1) Biodentine as lining material+ Filtek Z350 XT (light cured composite) as restorative material, (G2) – Smart dentine replacement as lining material+ Filtek Z350 XT (light cured composite) as restorative material, (G3) – Resin modified Glass Ionomer cement+ Filtek Z350 XT (light cured composite) as restorative material as positive control. The material was used according to manufacturer’s instructions. The teeth were thermocycled (5°C to 55°C). The specimens were then sealed with a 1-mm window around the marginal interface with red nail varnish and were immersed in a methylene blue solution for 24 hours. Samples were then immersed in a 69% w/v nitric acid solution for dye extraction test. The amount of dye extracted was directly measured using spectrophotometer. The results were expressed as Absorbance that is amount of dye extracted from each specimen. The data were analysed with the parametric One-way ANOVA test (p<0.05). Results: Statistically significant difference was found between the groups. Group (G1) showed best sealing efficacy than Group (G2 and G3) when used as cervical lining restoration. Conclusion: Within the limits of this in vitro study, microleakage scores were least in those teeth where biodentine was used as cervical lining restorations. Biodentine when used as cervical lining restoration showed good sealing ability as compared to smart dentine replacement (SDR) and Light cured composite.
Mapping of IDUA gene variants in Pakistani patients with mucopolysaccharidosis type 1

Abstract Background Mucopolysaccharidosis type 1 (MPS1) is a rare debilitating multisystem lysosomal disorder resulting due to the deficiency of α-L-iduronidase enzyme (IDUA), caused by recessive mutations in the IDUA gene. Lack or improper amount of the IDUA enzyme results in the improper metabolism of mucopolysaccharides or glycosaminoglycans (GAGs). These large sugar molecules accumulate in lysosomes within cells leading to different systemic complications. The estimated global incidence of MPS1 is 1:100,000 live births for the Hurler and 1:800,000 for the Scheie phenotypes. Methods Thirteen MPS1-affected children from 12 unrelated cohorts were enrolled. All coding and flanking regions of the IDUA gene were sequenced. Bioinformatics tools were used for data analysis and protein prediction for clinical correlations. Results Six IDUA gene mutations were mapped co-segregating with the recessive pattern of inheritance including a novel variant. A novel missense variant c.908T > C (p.L303P) was mapped in two affected siblings in a cohort in the homozygous form. The variant c.1469T > C (p.L490P) was mapped in five unrelated patients and c.784delC (p.H262Tfs*55) was mapped in three unrelated patients, while mutations c.1598C > G (p.P533R), c.314G > A (p.R105Q) and c.1277ins9 (p.[A394-L395-L396]) were mapped in a single patient each. Conclusions Multisystem disorders and a wide range of clinical presentation impede the evaluation of patients as well as make it difficult to differentiate between different phenotypes of MPS. Early and accurate diagnosis is crucial for the disease management and implementation of an expanded new-born genetic screening program for inborn errors of metabolism including MPS1. We recommend c.784delC (p.H262Tfs*55) and c.1469T > C (p.L490P) as first-line genetic markers for the molecular diagnosis of MPS1 in Pakistan.
Neuroprosthetic Speech: The Ethical Significance of Accuracy, Control and Pragmatics

Abstract: Neuroprosthetic speech devices are an emerging technology that can offer the possibility of communication to those who are unable to speak. Patients with ‘locked in syndrome,’ aphasia, or other such pathologies can use covert speech—vividly imagining saying something without actual vocalization—to trigger neural controlled systems capable of synthesizing the speech they would have spoken, but for their impairment. We provide an analysis of the mechanisms and outputs involved in speech mediated by neuroprosthetic devices. This analysis provides a framework for accounting for the ethical significance of accuracy, control, and pragmatic dimensions of prosthesis-mediated speech. We first examine what it means for the output of the device to be accurate, drawing a distinction between technical accuracy on the one hand and semantic accuracy on the other. These are conceptual notions of accuracy. Both technical and semantic accuracy of the device will be necessary (but not yet sufficient) for the user to have sufficient control over the device. Sufficient control is an ethical consideration: we place high value on being able to express ourselves when we want and how we want. Sufficient control of a neural speech prosthesis requires that a speaker can reliably use their speech apparatus as they want to, and can expect their speech to authentically represent them. We draw a distinction between two relevant features which bear on the question of whether the user has sufficient control: voluntariness of the speech and the authenticity of the speech. These can come apart: the user might involuntarily produce an authentic output (perhaps revealing private thoughts) or might voluntarily produce an inauthentic output (e.g., when the output is not semantically accurate). Finally, we consider the role of the interlocutor in interpreting the content and purpose of the communication. These three ethical dimensions raise philosophical questions about the nature of speech, the level of control required for communicative accuracy, and the nature of ‘accuracy’ with respect to both natural and prosthesis-mediated speech.