Miracle-dz/UniFAR-FTUs huggingface dataset:
Forewings match the formation of leading-edge vortices and dominate aerodynamic force production in revolving insect wings

In many flying insects, forewings and hindwings are coupled mechanically to achieve flapping flight synchronously while being driven by action of the forewings. How the forewings and hindwings as well as their morphologies contribute to aerodynamic force production and flight control remains unclear. Here we address the point that the forewings can produce most of the aerodynamic forces even with the hindwings removed through a computational fluid dynamic study of three revolving insect wing models, which are identical to the wing morphologies and Reynolds numbers of hawkmoth (Manduca sexta), bumblebee (Bombus ignitus) and fruitfly (Drosophila melanogaster). We find that the forewing morphologies match the formation of leading-edge vortices (LEV) and are responsible for generating sufficient lift forces at the mean angles of attack and the Reynolds numbers where the three representative insects fly. The LEV formation and pressure loading keep almost unchanged with the hindwing removed, and even lead to some improvement in power factor and aerodynamic efficiency. Moreover, our results indicate that the size and strength of the LEVs can be well quantified with introduction of a conical LEV angle, which varies remarkably with angles of attack and Reynolds numbers but within the forewing region while showing less sensitivity to the wing morphologies. This implies that the forewing morphology very likely plays a dominant role in achieving low-Reynolds number aerodynamic performance in natural flyers as well as in revolving and/or flapping micro air vehicles.
Proprioceptive Neuromuscular Facilitation Improves Balance and Knee Extensors Strength of Older Fallers

Falls are one of the major problems for elderly people and proprioceptive exercises have been suggested as an alternative in rehabilitation and preventive programs. The purpose of this study was to investigate the influence of a proprioceptive neuromuscular facilitation (PNF) exercise program on balance, knee extension and flexion isometric torque, and knee extension rate of force development (RFD). Fourteen older faller subjects (>60 years) were equally assigned into two groups: a control group (CG: ) and a training group (TG: ). The PNF training program was performed for 10 weeks on TG, with a frequency of three times per week. Patients were assessed before and after the PNF program, with respect to balance (Berg Balance Scale score—BBS), knee maximal isometric extension and flexion torque, knee extensor RFD, and knee extensors and flexors neuromuscular activation level and coactivation level around the knee. After 10 weeks, balance () and knee extension torque () were improved in TG while no differences were found for CG. These improvements were mainly attributed to central nervous system adaptations, since no differences were found for neuromuscular activation level and coactivation.
Free breathing three‐dimensional gradient echo‐sequence with radial data sampling (radial 3D‐GRE) examination of the pancreas: Comparison with standard 3D‐GRE volumetric interpolated breathhold examination (VIBE)

To evaluate the diagnostic performance of free breathing three‐dimensional gradient echo‐sequence with radial data sampling (radial 3D‐GRE) in MR imaging of the normal and diseased pancreas, using standard 3D‐GRE for comparison in cooperative patients, and to perform a preliminary assessment in noncooperative patients.
Bio-functionalized MWCNT/hyperbranched polyurethane bionanocomposite for bone regeneration

The proper fabrication of biomaterials, particularly for purposes like bone regeneration, is of the utmost importance for the clinical success of materials that fulfill the design criteria at bio-interfacial milieu. Building on this aspect, a polyurethane nanocomposite (PNC) was fabricated by the combination of rapeseed protein functionalized multi-walled carbon nanotubes (MWCNTs) and vegetable-oil-based hyperbranched polyurethane. Biofunctionalized MWCNTs showed incredible biocompatibility compared to pristine MWCNTs as ascertained via in vitro and in vivo studies. PNC showed enhanced MG63 cell differentiation ability compared to the control and carboxyl functionalized MWCNT-based nanocomposite, as postulated by alkaline phosphatase activity together with better cellular adhesion, spreading and proliferation. Consequently, a critical-sized fracture gap (6 mm) bridged by the sticky PNC scaffold illustrated rapid bone neoformation within 30–45 d, with 90–93% of the defect area filling up. Histopathological studies demonstrated the reorganization of the normal tibial architecture and biodegradation of the implant. The subsequent toxicological study through cytokine expression, biochemical analysis and hematological studies suggested non-immunogenic and non-toxic effects of PNCs and their degraded/leached products. Their excellent bio-physiological features with high load-bearing ability (49–55.5 Mpa), ductility (675–790%) and biodegradability promote them as the best alternative biomaterials for bone regeneration in a comprehensive manner.
Elastic fibers and amyloid deposition in vascular tissue

Amyloid fibrils are associated with a large number of diseases, such as Alzheimer’s dementia and others. Evidence links Alzheimer’s dementia with vascular diseases and only few data connect amyloids and atherosclerosis and aging via deposits in the aortic intima. Recent results demonstrate that some elastin polypeptide sequences are also able to produce amyloid fibers. This finding could have useful implications in the study of amyloids in cardiovascular tissue whose main constituent is elastin. In this review, we have also outlined the main characterizing features regarding the structure of amyloid fibrils. Finally, we describe, as a future perspective, the design of proper inhibitors of amyloid deposition in vascular walls as potential therapeutic drugs.
Whiplash injury and neuro-otological sequelae: An evidence based systematic review

Abstract Objective: Epidemiological data showing an association between whiplash and neuro-otological symptoms have existed for many years; however, despite growing evidence a causal relationship has not been forthcoming. This review aims to identify whether evidence exists to substantiate a pathophysiological link between whiplash and its presumed neuro-otological consequences. Study design: A literature search was performed in accordance with ‘the literature search process: guidance for NHS researchers’, using the search terms ‘whiplash’, ‘vertigo’, ‘hearing loss’, ‘dizziness’, ‘tinnitus’, ‘hyperacusis’. This was augmented using citation linking. Results: No evidence was found that satisfactorily proved a pathophysiological link, but there was evidence to support several plausible theories. For hearing loss and tinnitus/hyperacusis these include auditory processing disorders (APD) secondary to cerebral hypoperfusion due to stimulation of cervical nociceptive afferents; and Eustachian tube dysfunction secondary to temporomandibular joint dysfunction. For vertigo/dizziness they include ‘cervical dizziness’ secondary to damage to vestibulocollic/cervicocollic reflexes, osteoarticular tendon sensors/cervical neuromuscular spindles with resulting proprioceptive dysfunction and discordance with visual input; central or peripheral vestibular pathology; and psychosocial factors. Conclusions: The results highlight the multifactorial, biopsychosocial nature of whiplash. Although the largest contributors to neuro-otological symptoms appear to be psychosocial, the results identify promising, if largely theoretical, pathophysiological mechanisms. Unfortunately, much of the work is underpowered and often lacks controls. It therefore creates a need for further research and forms a basis for that research.
The aging motorcyclist: A comparative epidemiologic study on pattern and severity of injury

BACKGROUND The industry statistics demonstrates an increasingly older population is riding motorcycles. This study was designed to identify the orthopedic injuries and their hospital outcome for riders older than 50 years versus younger than 50 years. METHODS We identified all patients who were injured in a motorcycle collision between 2004 and 2009. The charts were reviewed to obtain demographic data, initial injury severity markers, and hospital outcome measures. Radiographs were reviewed and all fractures classified according to the AO/OTA system. Statistical analysis was completed with patients grouped into age <50 years versus ≥50 years with p ⩽ 0.05 determined as significant. RESULTS There were 436 patients who comprised the study population. Older patients had more medical comorbidities at the time of injury (p < 0.001). There was no significant difference between age groups for any initial injury severity markers or fracture complexity. Older patients had a longer average length of stay (p < 0.05), intensive care unit days (p < 0.001), ventilator days (p = 0.001), and rate of complications than younger patients (p < 0.05). Older patients had a significantly higher mortality rate (6.8% vs. 2.4%; p = 0.04). CONCLUSIONS Advanced age demonstrated correlation with prolonged hospital stay and requirement of more aggressive medical care. An increased risk of mortality was demonstrated for the older motorcyclist. However, age alone did not affect the severity or distribution of orthopedic injuries in this study. As the motorcycle riding population ages, it is important to understand the injuries and hospital course of these patients, along with the increased mortality rates and health care expenditure burden which can be expected. (J Trauma. 2012;XX: 000–000. Copyright © 2012 by Lippincott Williams & Wilkins) LEVEL OF EVIDENCE Epidemiological study, level III.
Addition of blood to a phycogenic bone substitute leads to increased in vivo vascularization

The present study aimed to analyze the effects of the addition of blood to the phycogenic bone substitute Algipore® on the severity of in vivo tissue reaction. Initially, Fourier-transform infrared spectroscopy (FTIR) of the bone substitute was conducted to analyze its chemical composition. The subcutaneous implantation model in Balb/c mice was then applied for up to 30 d to analyze the tissue reactions on the basis of specialized histochemical, immunohistochemical, and histomorphometrical methods. The data of the FTIR analysis showed that the phycogenic bone substitute material is mainly composed of hydroxyapatite with some carbonate content. The in vivo analyses revealed that the addition of blood to Algipore® had a major impact on both angiogenesis and vessel maturation. The higher vascularization seemed to be based on significantly higher numbers of multinucleated TRAP-positive cells. However, mostly macrophages and a relatively low number of multinucleated giant cells were involved in the tissue reaction to Algipore®. The presented data show that the addition of blood to a bone substitute impacts the tissue reaction to it. In particular, the immune response and the vascularization were influenced, and these are believed to have a major impact on the regenerative potential of the process of bone tissue regeneration.
Base deficit as a marker of survival after traumatic injury: Consistent across changing patient populations and resuscitation paradigms

BACKGROUND: Damage control resuscitation (DCR) has improved outcomes in severely injured patients. In civilian centers, massive transfusion protocols (MTPs) represent the most formal application of DCR principles, ensuring early, accurate delivery of high fixed ratios of blood components. Recent data suggest that DCR may also help address early trauma-induced coagulopathy. Finally, base deficit (BD) is a long-recognized and simple early prognostic marker of survival after injury. METHODS: Outcomes of patients with admission BD data resuscitated during the DCR era (2007–2010) were compared with previously published data (1995–2003) of patients cared for before the DCR era (pre-DCR). Patients were considered to have no hypoperfusion (BD, >−6), mild (BD, −6 to −14.9), moderate (BD, −15 to −23.9), or severe hypoperfusion (BD, <−24). RESULTS: Of 6,767 patients, 4,561 were treated in the pre-DCR era and 2,206 in the DCR era. Of the latter, 218 (9.8%) represented activations of the MTP. DCR patients tended to be slightly older, more likely victims of penetrating trauma, and slightly more severely injured as measured by trauma scores and BD. Despite these differences, overall survival was unchanged in the two eras (86.4% vs. 85.7%, p = 0.67), and survival curves stratified by mechanism of injury were nearly identical. Patients with severe BD who were resuscitated using the MTP, however, experienced a substantial increase in survival compared with pre-DCR counterparts. CONCLUSION: Despite limited adoption of formal DCR, overall survival after injury, stratified by BD, is identical in the modern era. Patients with severely deranged physiology, however, experience better outcomes. BD remains a consistent predictor of mortality after traumatic injury. Predicted survival depends more on the energy level of the injury (stab wound vs. nonstab wound) than the mechanism of injury (blunt vs. penetrating). LEVEL OF EVIDENCE: IV, therapeutic/prognostic study.
Prescrição de medicamentos para crianças hospitalizadas: como avaliar a qualidade?

BACKGROUND: Pediatric patients called "therapeutic orphans" are usually excluded from clinical trials for development of new drugs, which, sometimes, are used empirically. This study evaluates the prescriptions for pediatric inpatients, and proposes criteria for evaluation of the quality of the prescriptions. METHODS: The hospital pharmacist determined the prevalence of drug prescription in five pediatric wards. One day collection of all prescriptions for pediatric inpatients was performed in March, April, May and June 1999, and the data were jointly analyzed. Six criteria were proposed for quality evaluation of the drug prescriptions. The drugs were classified according to the ATC classification index. RESULTS: The prescriptions of a total of 322 patients were collected in the four collection days. The three most common diagnoses were: pneumonia 40.4%, meningitis and meningococcemia 6%, diarrhea and dehydration 6%. The three most prescribed therapeutic classes were: nervous system (N ) 109%, general antiinfectives for systemic use ( J ) 81.9% and respiratory system ( R ) 69,0%. The three most prescribed drugs were: metamizole 88.3%, fenoterol 30.7% and penicillin G 25.0%. The quality evaluation showed 1. an excessive use of the intravenous route, 2. appropriate dose schedule for drugs with narrow therapeutic index, 3. no therapeutic duplication, 4. prescription of unapproved and off-label drugs, 5. frequent potential adverse drug interactions, and 6. prescription of drugs not in the therapeutic formulary of the hospital. CONCLUSION: Very simple measures can improve the quality of the health care of pediatric inpatients as inclusion of adequate drug presentations in the hospital formulary, and a careful evaluation of the need of the intravenous route. This study also shows the hospital pharmacists acting as part of the multidisciplinary health care team.
Analysis of the factors influencing bone graft infection after cranioplasty

BACKGROUND Delayed cranioplasty after decompressive craniectomy was performed using various reconstruction materials and methods. Bone graft infection is a major concern with cranioplasty. This study identified factors that are related to bone graft infection after cranioplasty. METHODS A total of 140 patients underwent reconstructive cranioplasty after decompressive craniectomy between 2000 and 2009. The sample population included 102 male patients and 39 female patients aged 6 years to 76 years, with a mean age of 47.5 years. Autografts were used for cranioplasty when available. Polymethylmethacrylate or customized linear high-density polyethylene was considered when autografts were unavailable. Bone graft infection was defined as the removal of the infected bone graft, and the related factors were evaluated retrospectively. RESULTS Bone graft infection occurred in 11 patients (7.86%). Bone graft infection after cranioplasty was significantly related to the number of operations (p = 0.002), operation time (p = 0.031), and diabetes (p = 0.004). An increased number of operations increased the infection rate from 4.3% to 33%. Infection rates increased rapidly after three times. The infection rate was less than 10% when cranioplasty was completed within 199 minutes. An infection rate greater than 20% was observed when cranioplasty required more than 200 minutes. Other factors, such as graft material, fixation devices, age, sex, the cause of the operation, the interval between craniectomy and cranioplasty, and underlying nondiabetic diseases, did not significantly alter the infection rate. CONCLUSION Short surgical times (<200 minutes) and a lower number of previous operations (less than three times) may decrease the risk of bone flap infection. Careful attention is required when performing cranioplasty, particularly in patients with diabetes. LEVEL OF EVIDENCE Prognostic/therapeutic study, level IV.
The role and value of surgical critical care, an essential component of Acute Care Surgery, in the Affordable Care Act: a report from the Critical Care Committee and Board of Managers of the American Association for the Surgery of Trauma.

Heidi L. Frankel, MD, Karyn L. Butler, MD, Joseph Cuschieri, MD, Randall S. Friese, MD, Toan Huynh, MD, Alicia M. Mohr, MD, Miren A. Schinco, MD, Lena M. Napolitano, MD, L.D. Britt, MD, MPH, Raul Coimbra, MD, PhD, Martin A. Croce, MD, James W. Davis, MD, Gregory J. Jurkovich, MD, Ernest E. Moore, MD, John A. Morris, Jr., MD, Andrew B. Peitzman, MD, Basil A. Pruitt, MD, Grace S. Rozycki, MD, MBA, Thomas M. Scalea, MD, and J. Wayne Meredith, MD, Baltimore, Maryland
A feasibility and efficacy randomised controlled trial of swaddling for controlling procedural pain in preterm infants.

AIMS AND OBJECTIVES This study aimed to investigate the feasibility and efficacy of swaddling to control procedural pain among preterm infants. BACKGROUND Swaddling has been recommended for controlling neonatal pain. However, the feasibility for use is uncertain and insufficient evidence is available among preterm infants. DESIGN A two-arm randomised controlled trial with repeated measures. METHOD The study was conducted in a 21-bed neonatal intensive care unit of a regional hospital in Hong Kong. Preterm infants who required heelstick procedure were eligible. Fifty-four preterm infants between 30-37 gestational weeks were randomly assigned to swaddling (n = 27) and control (standard care, n = 27) groups. Pain assessment was performed pre, during, immediate, two, four, six and eight minutes after heelstick procedure using the Premature Infant Pain Profile. RESULTS The mean Premature Infant Pain Profile scores were significantly reduced in the intervention group compared to the control group during, immediate, two, four, and six minutes after the heelstick procedure. The mean changes of heart rate and oxygen saturation in the intervention group were significantly lower than that of the control group at all measured time points. Notably, the swaddled infants quickly resumed to the baseline level at two minutes whereas the control group reached the stable state at an extended period of six minutes. CONCLUSION The findings show that swaddling is feasible and efficacious in controlling pain for heelstick procedure among preterm infants. No adverse effects were observed. RELEVANCE TO CLINICAL PRACTICE This article presents the feasibility and efficacy of swaddling as a non-pharmacological and non-invasive intervention to relieve pain during the heelstick procedures among preterm infants. Swaddling can contribute to control minor procedural pain in neonates as one of the simple, safe, cost effective, humanistic and natural analgesia alternatives.
Knowledge and Practice of Cardiopulmonary Resuscitation Amongst Doctors and Nurses in Benin City, Nigeria

In this study, the knowledge and practice of the 2000 CPR guidelines of doctors and nurses in Benin City, Nigeria was evaluated. This cross sectional study was conducted in six health facilities in Benin City. A structured self administered questionnaire was used to test the knowledge and practice of CPR of 145 doctors and nurses in the selected facilities. Of the 145 respondents who filled the questionnaires, 88(60.7%) were doctors and 57(39.3%) were nurses. There was poor knowledge of CPR amongst the respondents. It was significantly poorer amongst nurses than doctors and better amongst younger respondents. Only 73(50.3%) of the respondents would perform mouth to mouth resuscitation while 17(11.7%) respondents were aware of the 2005 guidelines. The observed poor knowledge of CPR and low awareness of the new 2005 CPR guidelines amongst respondents in this study buttresses the need for regular CPR training of health professionals in Nigeria. Keywords: cardiopulmonary resuscitation, doctors, nurses, knowledge, practice
Clinical predictors of outcome following inflicted traumatic brain injury in children

BACKGROUND The study aimed to determine which acute injury variables were predictors of long-term functional outcome following inflicted traumatic brain injury (iTBI). METHODS A retrospective case review of 35 children with iTBI was performed. After controlling for age at injury and time since injury, the generalized estimation equations method was used to identify acute injury variables that were significantly related to the Glasgow Outcome Scale scores at the initial follow-up assessments. When available, functional sequelae at these and longer-term follow-ups were also examined. RESULTS In bivariate generalized estimation equations analyses, a low Glasgow Coma Scale (GCS) eye component score, a low GCS motor component score, a low GCS verbal component score, need for neurosurgical intervention, seizures in the first week after injury, need for mechanical ventilation for more than 10 days, length of intensive care unit stay of more than 10 days, initial hyperglycemia, and neuroimaging findings of cerebral edema or loss of gray-white matter differentiation were significantly (p ⩽ 0.05) related to having a poor outcome, as defined by their Glasgow Outcome Scale score at the initial follow-up. In multivariable analyses, considering the significant predictors while controlling for age at injury and time since injury, the presence of cerebral edema on neuroimaging (odds ratio, 27.21; 95% confidence interval, 4.40–168.22), and length of intensive care unit stay of more than 10 days (odds ratio, 21.57; 95% confidence interval, 3.09–150.48) were significantly related to having a poor outcome. CONCLUSION Early clinical data following iTBI help predict long-term functional outcome. Further research to support these findings may help delineate acutely after injury which children with iTBI are at risk for a poor prognosis and should be more closely followed up over time. LEVEL OF EVIDENCE Prognostic study, level IV.