Miracle-dz/UniFAR-FTUs huggingface dataset:
Management of unstable elbows following complex fracture-dislocations--the "terrible triad" injury.

Complex fracture-dislocations of the elbow can often be either irreducible or unstable, with an inability to hold the reduction or with the delayed development of subluxation or dislocation. The aim of the present study was to evaluate the etiology of the instability, both osseous and ligamentous, and the results of stabilization with a combination of internal fixation, ligament repair, radial head arthroplasty and, when necessary, hinged external fixation. Figures 1 and 2 represent our formulated protocol and treatment algorithm for elbow fracture-dislocation in this series of thirty-two patients. Fig. 1 Constellation of the “terrible triad” injury and the anatomic structures encountered. LUCL = lateral ulnar collateral ligament, and MUCL = medial ulnar collateral ligament. The so-called terrible triad injury has a history of complicated outcomes as the surgeon attempts to maximize functional range-of-motion goals while maintaining stability1-3. On the basis of previous evaluations of these specific injuries and the recent evolution of surgical protocols, the restoration of congruency and stability coupled with progressive rehabilitation can reliably enhance the functional outcome4-6. Thirty-two consecutive patients with unstable elbow injuries who had been referred to three tertiary centers were prospectively recruited for the present study between 2001 and 2005. Six of these patients had been unsuccessfully managed at outside facilities and had been transferred to our care. The unsuccessful treatments had included attempted closed reduction (four patients), radial head excision (one patient), and open reduction and internal fixation of the proximal part of the ulna (one patient). Fig. 2 Treatment algorithm proposed for the achievement of anatomic fixation and mechanical stability in patients with complex fracture-dislocations of the elbow. EUA = examination under anesthesia, MUCL = medial ulnar collateral ligament, LUCL = lateral ulnar collateral ligament, P/L = posterolateral stability, and ORIF = open reduction and internal fixation. All …
Delayed diagnosis is influenced by the clinical pattern of Crohn’s disease and affects treatment outcomes and quality of life in the long term: a cross-sectional study of 361 patients in Southern Italy

Objectives Three patterns of Crohn’s disease (CD) have been described. Our aim was to investigate for differences in diagnostic delay between patterns of CD, and differences in treatment outcomes, need for surgery and quality of life (QoL). Patients and methods This is a cross-sectional study. First, the data of CD patients observed at our IBD Referral Centre between 2000 and 2009 were analysed. We gathered demographical characteristics and data on the onset of clinical symptoms, progression until diagnosis and treatment. The risk of delayed diagnosis was computed for each pattern. We then asked patients to fill the Inflammatory Bowel Disease Questionnaire (IBDQ). QoL scores of patients receiving a diagnosis within 18 months from the onset of symptoms were matched with those of the remaining patients. Results Three-hundred and sixty-one patients were identified. The mean age of the patients at the onset of symptoms and at diagnosis was 30±14 and 32±14 years. The penetrating pattern showed an association only with perianal symptoms at onset (P=0.0015). The risk of delayed diagnosis was 21, 27 and 59% for inflammatory, stricturing and penetrating patterns. We found a significant difference between penetrating and nonpenetrating patterns (P=0.043). A delayed diagnosis was associated with poorer treatment outcomes, QoL and higher surgery rate. Conclusion Our study suggests a correlation between delayed diagnosis and the CD pattern. The delay in diagnosis between the CD subtypes can influence outcomes and QoL.
Composition of nanoparticles in optical fibers by Secondary Ion Mass Spectrometry

The development of new active optical fibre devices requires materials with « augmented » intrinsic properties, though using luminescent ion (LI) –doped silica as host glass. Optical fibers containing dielectric nanoparticles (DNP) grown by phase separation are proposed. DNP would optimally fully encapsulate LI to produce « engineered » spectroscopic properties. To determine the composition of DNP, Secondary Ion Mass Spectrometry imaging at high spatial resolution is employed. Through the use of this technique, we demonstrate without ambiguity the partition of Mg, P and Er in DNP. By increasing Mg concentration, Si concentration in DNP decreases, which explains the spectroscopic behaviour of Er.
Kinetics and catalytic properties of coenzyme A transferase from Peptostreptococcus elsdenii

Coenzyme A (CoA) transferase from Peptostreptococcus elsdenii was purified to homogeneity, and some of its physical and catalytic properties were determined. The native enzyme has a molecular weight of 181,000 and is composed of two alpha subunits (molecular weight, 65,000) and one beta subunit (molecular weight 50,000). Heat treatment of the crude cell extract to 58 degrees C causes proteolysis of the native enzyme and yields a catalytically active enzyme with an approximate molecular weight of 120,000. The native CoA transferase is specific for CoA esters of short-chain alkyl monocarboxylic acids. With acetate as CoA acceptor the enzyme is active with propionyl-, butyryl-, isobutyryl-, valeryl-, isovaleryl,- and hexanoyl-CoA but not with heptanoyl or longer-chain CoA esters. There is no activity with acetoacetyl-CoA or the CoA esters of dicarboxylic acids. Steady-state kinetics indicated that the reaction proceeds via a classical bi-, bi-ping-pong mechanism. Maximal activity is obtained with propionyl- or butyryl-CoA, and both the Vmax and Km decrease as the alkyl chain length of the CoA ester increases. All CoA esters apompetitive inhibitor although it is not active as a substrate. Evidence for an enzyme CoA intermediate was provided by demonstration of an exchange between 14C-free acids (acetate and butyrate) and their corresponding CoA esters and by isolation of a 3H-labeled CoA enzyme after incubation of the enzyme with 3H-labeled acetyl-CoA. Approximately 2 mol of CoA was bound per mol of enzyme.
Auditory neglect.

Auditory neglect was investigated in normal controls and in patients with a recent unilateral hemispheric lesion, by requiring them to detect the interruptions that occurred in one ear in a sound delivered through earphones either mono-aurally or binaurally. Control patients accurately detected interruptions. One left brain damaged (LBD) patient missed only once in the ipsilateral ear while seven of the 30 right brain damaged (RBD) patients missed more than one signal in the monoaural test and nine patients did the same in the binaural test. Omissions were always more marked in the left ear and in the binaural test with a significant ear by test interaction. The lesion of these patients was in the parietal lobe (five patients) and the thalamus (four patients). The relation of auditory neglect to auditory extinction was investigated and found to be equivocal, in that there were seven RBD patients who showed extinction, but not neglect and, more importantly, two patients who exhibited the opposite pattern, thus challenging the view that extinction is a minor form of neglect. Also visual and auditory neglect were not consistently correlated, the former being present in nine RBD patients without auditory neglect and the latter in two RBD patients without visual neglect. The finding that in some RBD patients with auditory neglect omissions also occurred, though with less frequency, in the right ear, points to a right hemisphere participation in the deployment of attention not only to the contralateral, but also to the ipsilateral space.
Attention deficit hyperactivity disorder medications in children with heart disease

Purpose of review Attention deficit hyperactivity disorder (ADHD) is quite common in the general pediatric population, Its incidence is thought to be even higher in the population of patients with congenital heart disease, especially in those patients with complex disease and who have had cardiac surgical interventions early in life. There has been controversy as to the safety of ADHD medications, especially in the latter population of patients. This compendium is meant to review the effects of the ADHD medications and the safety of these medications in patients with either known or undiagnosed congenital heart disease. Recent findings The concern with regard to the use of ADHD medications has been as a result of the reports of sudden unexpected deaths among patients taking stimulant drugs for ADHD. Therefore, the question of whether or not stimulant drugs increase the risk of adverse cardiovascular events has led to a discussion of the appropriate use of these drugs in patients with known cardiovascular disease, as well as a discussion as to the appropriate evaluation in order to identify undiagnosed ‘at-risk’ patients with congenital heart disease or arrhythmias. This article will review and amplify these discussions, as well as the conclusions that have come forth as a result of these discussions. Summary Currently available data suggest that there is no evidence for serious adverse cardiovascular complications in children with known cardiovascular diseases including patients of congenital heart disease who are treated with stimulant medications. Despite this, if the patient does have known cardiac disease, or if the history and physical examination is suggestive of cardiac disease, it is suggested that consultation/evaluation with a pediatric cardiologist occur. It is extremely unlikely that stimulant medications would be contraindicated in almost any condition that falls under this category. However, a few specific cardiac conditions might tailor the choice of the specific ADHD medication. Therefore the coordination of care between the primary care physician, the ADHD medication-prescribing physician, and the pediatric cardiologist may be very important in this circumstance.
Frontotemporal dementia with trans‐activation response DNA‐binding protein 43 presenting with catatonic syndrome

Catatonia is a clinical syndrome characterized by symptoms such as immobility, mutism, stupor, stereotypy, echophenomena, catalepsy, automatic obedience, posturing, negativism, gegenhalten and ambitendency. This syndrome occurs mostly in mood disorder and schizophrenic patients, and is related to neuronal dysfunction involving the frontal lobe. Some cases of frontotemporal dementia (FTD) with catatonia have been reported, but these cases were not examined by autopsy. Here, we report on a FTD case which showed catatonia after the first episode of brief psychotic disorder. At the age of 58, the patient had a sudden onset of disorganized behavior and meaningless speech. Psychotropic drugs were effective for catatonic symptoms. However, after remission apathy, hyperorality, socially inappropriate behavior, hoarding, and an instinctive grasp reaction appeared and persisted. Brain MRI showed significant atrophy of the bilateral fronto‐temporal lobes. A neuropathological examination revealed extensive trans‐activation response DNA‐binding protein 43 (TDP‐43) positive neurocytoplasmic inclusions and dystrophic neurites in the brain, including the cerebral cortex, basal ganglia, and brainstem. Pathological diagnosis was frontotemporal lobar degeneration (FTLD) with TDP‐43 (FTLD‐TDP) type C, which was also confirmed by the band pattern of C‐terminal fragments of TDP‐43 on western blotting of sarkosyl‐insoluble fractions extracted from the frozen brain. Dysfunction of the thalamus, globus pallidus, supplementary motor area, amygdala and cingulate cortex have been said to be related to the catatonic syndrome. In this case, these areas were affected, showing abnormal TDP‐43‐positive structures. Further studies are expected to confirm further clinical ‐ pathological correlations to FTLD.
Impact of short evidence summaries in discharge letters on adherence of practitioners to discharge medication. A cluster-randomised controlled trial

Background: International concern about quality of medical care has led to intensive study of interventions to ensure care is consistent with best evidence. Simple, inexpensive, feasible and effective interventions remain limited. Objective: We examined the impact of one-sentence evidence summaries appended to consultants’ letters to primary care practitioners on adherence of the practitioners to recommendations made by the consultants regarding medication for patients with chronic medical problems. Design: Cluster-randomised trial. Setting: Secondary/primary care interface (urban district hospital/referral practices). Participants: 178 practices received one or more discharge letters with evidence summaries. The 66 practices in the intervention group provided feedback on 172 letters, and the 56 practices in the control group provided feedback on 96 letters. Results: Appending an evidence summary to discharge letters resulted in a decrease in non-adherence to discharge medication from 29.6% to 18.5% (difference adjusted for underlying medical condition 12.5%; p = 0.039). Among the five possible reasons for discontinuing discharge medication, the evidence summaries seemed to have the largest impact on budget-related reasons for discontinuation (2.6% in the intervention versus 10.7% in the control group (p = 0.052)). Most clinicians (72%) were enthusiastic about continuing receiving evidence summaries with discharge letters in routine care. Conclusions: The one-sentence evidence summary is a simple, inexpensive, well-accepted intervention that may improve primary care practitioners’ adherence to evidence-based consultant recommendations.
Conformation of the Equine Skull: A Morphometric Study

There is a lack of an established method for quantifying equine skull morphology. This study proposes a method that is valid for use on both live and deceased horses. A total of nine head measurements (skull length, cranial length, nasal length, ratio of cranial:nasal length, cranial width, zygomatic width, mandibular depth, nasal profile area, cranial profile area) and six indices (skull index, cranial index, nasal index, mandibular index, nasal profile index, cranial profile index) were recorded from 30 horses from a variety of breeds whilst the soft tissues of the head were intact. A line was drawn level with the palpable notches caudal to the caudal lacrimal process of each orbit to estimate the suture line of the nasal and frontal bones and distinguish between the neurocranium and splanchnocranium. There were positive correlations between many of the head measurements. This method also illustrated significant differences in the skull morphology of three breeds (Arabians, thoroughbreds and standardbreds).
Closed versus Open Innovation: Evolution or Combination?

The concept of open innovation has attracted great interest from the academic and industrial sectors alike. Despite the ongoing debate, we can see some lack of consistency of its principles. The purpose of this paper is to set out a conceptual reflection on the foundations of innovation and its process and discuss new proposals from the literature on open innovation. We question whether this concept is really a new model, or if it is nothing more than a recent combination, sponsored by academics. We have examined Chesbrough’s six principles of open innovation, showing how they are based on a false dichotomy that opposes necessarily closed innovation to open innovation. We show how this new paradigm lacks conceptual clarity confusing innovation with innovation process, resurrecting the linear view, and ignoring many earlier studies. We hope to contribute to the discussion on innovation management and to enrich understanding for all concerned.
Applying ISO 9001 and CMMI in Quality-Oriented Knowledge Management for Software Process Improvement

ISO 9001 Quality Management System (QMS) and Capability Maturity Model Integration (CMMI) are quality management technologies, which can be applied to the software industry. This paper adopts these two management technologies to improve software process quality. ISO 9001 stresses the importance of building a QMS complying with the ISO guidelines of documation. CMMI stresses the importance of building a process improvement model following the CMMI documentation guidelines. In addition, knowledge management (KM) technology transforms these quality-related documents into valuable knowledge that can be utilized effectively and efficiently throughout the entire software organization. The objective of this paper is to apply and integrate ISO 9001 and CMMI in a quality-orientated knowledge management system for software process improvement (SPI). Focusing on the combined approaches and methodologies, the software process of a real software company is analyzed for designing a web-based prototyping quality-orientated KM system. The main functional modules of the system include creating, archiving, querying and managing the ISO and CMMI based quality system document. With the prototyping system, this paper confirms the benefits and synergies of the quality system for software development and process improvement. This paper also provides the transformation guidelines from ISO 9001 to CMMI for software companies to enhance the quality-orientated knowledge management of software processes.
Creutzfeldt‐Jakob disease in a patient with a cadaveric dural graft

We report a 26-year-old woman with Creutzfeldt-Jakob disease (CJD) who had received cadaveric dural material 33 months before the onset of neurologic symptoms. This is the fourth case in which a dural graft was the putative source of the CJD agent. All four cases had the grafting before changes in the sterilization procedure adopted in 1987 to inactivate the CJD agent.
Influence of Control Data on Diffusion Tensor Imaging in Cervical Spondylotic Myelopathy

*Correspondence: Kevin Yuqi Wang, Department of Radiology, Baylor College of Medicine, One Baylor Plaza Houston, TX 77030, USA, Tel: 713-798-6362; Fax: 713-7988359; E-mail: yuqiw@bcm.edu Received Date: 27 Feb 2017 Accepted Date: 13 Mar 2017 Published Date: 28 Mar 2017 Citation: Wang KY, Idowu O, Izbudak I. Influence of Control Data on Diffusion Tensor Imaging in Cervical Spondylotic Myelopathy. Remed Open Access. 2017; 2: 1047.
Vitamin C supplement intake and postmenopausal breast cancer risk: interaction with dietary vitamin C.

BACKGROUND Experimental and epidemiologic studies have yielded conflicting results on the relation between vitamin C intake and breast cancer risk. OBJECTIVE We investigated the relation between vitamin C supplement intake and breast cancer risk while considering dietary vitamin C intake. DESIGN Between 1995 and 2008, 2482 invasive breast cancer cases occurred in 57,403 postmenopausal women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective cohort during 581,085 person-years. We estimated vitamin C intake from foods with the use of a validated food-frequency questionnaire that was sent to subjects in 1993-1995 and vitamin C supplement use via questionnaires sent in 1995, 2000, 2002, and 2005. Multivariable HRs (95% CIs) for primary invasive breast cancer were estimated with the use of Cox regression models. All statistical tests were 2-sided. RESULTS Vitamin C supplement use (ever compared with never) was not associated with breast cancer risk overall; it was associated with higher breast cancer risk in women in the fourth quartile of vitamin C intake from foods (HR: 1.32; 95% CI: 1.04, 1.67) but not in other quartiles of dietary vitamin C intake (P-interaction = 0.03). CONCLUSIONS We observed that vitamin C supplement use was associated with increased postmenopausal breast cancer risk in women with high vitamin C intake from foods. Our data suggest a potential U- or J-shaped relation between total vitamin C intake and postmenopausal breast cancer risk that deserves further investigation.
Temporal Trends in Long-Term Survival and Cure Rates in Esophageal Cancer: A SEER Database Analysis

Purpose: To assess long-term temporal trends in population-based survival and cure rates in patients with esophageal cancer and compare them over the last 3 decades in the United States. Methods: We identified 62,523 patients with cancer of the esophagus and the gastric cardia diagnosed between 1973 and 2007 from the Surveillance, Epidemiology, and End Results database. Long-term cancer-related survival and cure rates were calculated. Stage-by-stage disease-related survival curves of patients diagnosed in different decades were compared. Influence of available variables on survival and cure was analyzed with logistic regression. Results: Ten-year survival was 14% in all patients. Disease-related survival of esophageal cancer improved significantly since 1973. Median survival in Surveillance, Epidemiology, and End Results stages in local, regional, and metastatic cancers improved from 11, 10, and 4 months in the 1970s to 35, 15, and 6 months after 2000. Early stage, age 45 to 65 years at diagnosis and undergoing surgical therapy were independent predictors of 10-year survival. Cure rate improved in all stages during the study period and were 73%, 37%, 12%, and 2% in stages 0, 1, 2, and 4, respectively, after the year 2000. Percentage of patients undergoing surgery improved from 55% in the 1970s to 64% between 2000 and 2007. Proportion of patients diagnosed with in situ and local cancer remains below 30%. Conclusion: Long-term survival with esophageal cancer is poor but survival of local esophageal cancer improved dramatically over the decades. Complete cure of nonmetastatic esophageal cancer seems possible in a growing number of patients. Early diagnosis and treatment are crucial.
Biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral and oropharyngeal squamous cell carcinoma, with emphasis on smoking, protein p16(INK4a) expression, and HPV status.

The aim of this study is to evaluate the biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral (OSCC) and oropharyngeal (OPSCC) squamous cell carcinoma, with emphasis on smoking, protein p16(INK4a) (p16) expression, and human papillomavirus (HPV) status.The study sample consisted of 48 patients with OSCC and 44 patients with OPSCC. Half of the patients were nonsmokers and the other half were gender-, age- and tumor localization-matched smokers. p16 expression was detected in 17/48 (35 %) OSCCs and in 36/44 (82 %) OPSCCs and HPV DNA was present in 7/48 (15 %) OSCCs and in 35/44 (80 %) OPSCCs. The sensitivity and specificity of p16 expression for HPV DNA presence were 0.74 and 0.88, respectively. The OPSCCs were more frequently basaloid (p < 0.001) while the OSCCs were more frequently conventional (p < 0.000001). The OSCCs were more likely to recur locally and to be the cause of death (p = 0.009 in both parameters). The HPV-positive tumors were more frequently localized in oropharynx, were basaloid SCCs and were p16- and HPV-positive (p < 0.000001 in all 4 parameters). The HPV-negative tumors were more frequently localized in oral cavity (p < 0.000001), more frequently asociated with local, regional and locoregional recurence (p = 0.011, p = 0.019 and p = 0.030, respectively) and with tumor-related death (p = 0.003). There was no significant difference with regard to smoking history (p > 0.05). The survival of patients with HPV-positive tumors was significantly longer (median 112 months; 95% CI 54 - 112 months) than that of patients with HPV-negative tumors (median 17 months; 95% CI 12 - 39 months) (p < 0.001). The HPV status of OSCC/OPSCC is an important biological and prognostic parameter and should be examined in all cases, using PCR or immunohistochemical detection of surrogate marker p16. Smoking itself does not seem to be an important prognostic factor.