Miracle-dz/UniFAR-FTUs huggingface dataset:
Functional outcome and complications following PHILOS plate fixation in proximal humeral fractures.

OBJECTIVES Proximal humeral fractures account for approximately 5% of all fractures. New plating techniques have been developed to improve stability. The purpose of this study was to evaluate functional outcome following plate fixation with the Proximal Humeral Internal Locking System (PHILOS) and to analyze potential implant-related complications. METHODS The PHILOS plate was used for internal fixation of displaced proximal humeral fractures in 28 patients (20 females, 8 males; mean age 60.7+/-12.9 years). Fractures were caused by low-energy trauma (fall from standing height) in 21 patients, and by an accident while skiing or cycling in seven patients. Involvement was on the right in 16 cases and on the left in 12 cases. According to the Neer classification, 8, 12, and 8 patients had displaced 2-, 3-, or 4-part fractures, respectively. All patients received a similar physical therapy program following internal fixation with the PHILOS plate. The patients were assessed clinically and radiographically after a mean follow-up of 25.2+/-11.8 months. Functional outcome was assessed using the Constant-Murley score adjusted for age and gender. Range of motion and shoulder abduction strength were measured. The patients were also evaluated with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and a visual analog scale (VAS). Complications during the follow-up period were recorded. RESULTS Twenty fractures (71.4%) healed in good anatomical position. At the end of the follow-up period, the mean Constant-Murley score was 57.9+/-21.7, and the mean age- and gender-adjusted Constant-Murley score was 67.5+/-23.6. The results were excellent or good in 16 patients (57.1%), moderate in one patient (3.6%), and poor in 11 patients (39.3%). The mean DASH and VAS scores were 28.3+/-24.3 and 75.4+/-21.2, respectively. Eleven complications (39.3%) were seen during the follow-up period. Reoperation was required in eight patients (72.3%). Complications included avascular necrosis of the humeral head in two patients (7.2%), subacromial impingement in six patients (21.4%), loosening of a locking head screw in one patient (3.6%), and transiently decreased radial nerve sensation in two patients (7.2%). Subacromial impingement was mainly caused by the superior plate position. CONCLUSION Our results demonstrate that the PHILOS plate provides sufficient fracture stabilization in the treatment of proximal humeral fractures of elderly patients.
HIV Coinfection Predicts Failure of Ledipasvir/Sofosbuvir in Treatment-Naïve Noncirrhotic Patients With HCV Genotype 1

Abstract Background The efficacy of licensed direct-acting antiviral (DAA) regimens is assumed to be the same for hepatitis C virus (HCV)–monoinfected patients (HCV-Mono) and HIV/HCV-coinfected patients (HCV-Co). However, the high sustained viral response (SVR) rates of DAA regimens and the small number of HIV-infected patients included in registration trials have made it difficult to identify predictors of treatment failure, including the presence of HIV. Methods We compared treatment outcomes for ledipasvir/sofosbuvir (LDV/SOF) against HCV G1 in treatment-naïve HCV-Mono and HCV-Co without cirrhosis in a prospective registry of individuals receiving DAAs for HCV. Results Up to September 2017, a total of 17 269 patients were registered, and 1358 patients (1055 HCV-Mono/303 HCV-Co) met the inclusion criteria. Significant differences between HCV-Mono and HCV-Co were observed for age, gender, and G1 subtype distribution. Among HCV-Co, 99.0% were receiving antiretroviral therapy. SVR rates for LDV/SOF at 8 weeks did not differ significantly between HCV-Mono and HCV-Co (96.9% vs 94.0%; P = .199). However, the SVR rate for LDV/SOF at 12 weeks was significantly higher for HCV-Mono than HCV-Co (97.2% vs 91.8%; P = .001). A multivariable logistic regression model including age, sex, liver stiffness, G1 subtype, HCV-RNA, HIV, and treatment duration showed the factors associated with treatment failure to be male sex (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.27–4.91; P = .008) and HIV infection (aOR, 2.23; 95% CI, 1.13–4.38; P = .020). Conclusions The results of this large prospective study analyzing outcomes for LDV/SOF against HCV G1 in treatment-naïve noncirrhotic patients suggest that HIV infection is a predictor of treatment failure in patients with chronic hepatitis C.
Theoretical perspectives on career transitions in sport

This chapter outlines theoretical perspectives on career transitions in sport. Models that have been employed to explain this phenomenon will initially be delineated, including theories of social gerontology, thanatology, and human adaptation to transition. This will be followed by an outline of a conceptual model of sports career transition (Taylor & Ogilvie, 1998). This model focuses on how the causes of career transition, developmental experiences of the athlete, and coping resources affect the quality of adjustment to career transitions in sport. Theoretical Perspectives on Career Transitions in Sport The sport-scientific community has made an effort to conceptualize the career transition process ever since a debate emerged regarding the incidence of distress experienced by retiring athletes. Numerous investigations have been made into athletic career termination, with various explanatory frameworks being employed to explain the phenomenon. Theorists have, however, predominantly made parallels between career transitions in sport and social gerontological models of aging, thanatological models of death and dying, and models of human adaptation to transition. Social Gerontological Models Gerontology, as a scientific field of study, has been defined as the systematic analysis of the aging process (Atchley, 1991). This academic discipline consists of biological, social, and psychological subdivisions, with social gerontology concentrating on the mutual interaction between society and the aged. In its broadest sense, social gerontology attempts to explain the lives and activities of those who appear to age successfully. Numerous gerontological orientations, therefore, have been utilized to explain the general process of retirement from the labor force. Sport theoreticians have suggested that several models of social gerontology are applicable in the study of transitions in sport (e.g., S. H. Lerch, 1981; McPherson, 1980; Rosenberg, 1981). In an attempt to understand the problems and processes confronted by retiring athletes, the career transition process has been compared to the following social gerontological perspectives: activity theory, subculture theory, disengagement theory, continuity theory, social breakdown theory, and social exchange theory.
Intravaginal cleansing among women attending a sexually transmitted infection clinic in Kingston, Jamaica.

OBJECTIVES Although common worldwide, intravaginal cleansing is associated with poor health outcomes. We sought to describe intravaginal cleansing among women attending a sexually transmitted infection (STI) clinic in Jamaica. METHODS We examined intravaginal cleansing ("washing up inside the vagina", douching, and products or materials used) among 293 participants in a randomized trial of counselling messages at an STI clinic in Kingston. We focussed on information on intravaginal cleansing performed in the 30 days and three days preceding their baseline study visit. We describe reported cleansing behaviours and used logistic regression to identify correlates of intravaginal cleansing. RESULTS Fifty-eight per cent of participants reported intravaginal cleansing in the previous 30 days, and 46% did so in the three days before baseline. Among those who cleansed in the previous 30 days, 88% reported doing so for hygiene unrelated to sex, and three-fourths reported generally doing so more than once per day. Soap (usually with water) and water alone were the most common products used for washing; commercial douches or detergents were reported infrequently. Intravaginal cleansing in the three days before the baseline visit was positively associated with having more than one sex partner in the previous three months (adjusted odds ratio [AOR], 1.9; 95% CI, 1.1, 3.2), and negatively associated with experiencing itching in the genital area at baseline (AOR, 0.6; 95% CI, 0.4, 1.0). CONCLUSIONS A large proportion of women attending STI clinics in Jamaica engage in frequent intravaginal cleansing, indicating a need for clinicians to discuss this topic with them accordingly.
Age Dependent White Matter Lesions and Brain Volume Changes in Healthy Volunteers

The brain of 142 healthy volunteers aged 21 to 80 years were investigated using MR imaging. The number and size of the white matter hyperintensity lesions (WMHL) in the cerebral hemispheres were determined. Furthermore, the volume of the cerebral hemispheres and of the lateral ventricles was measured. An almost linear increase in the number of volunteers with WMHL was seen with aging for males and females. With aging a significant decrease in the volume of the cerebral hemispheres was found for males, and a significant increase in the volume of the lateral ventricles was seen for both males and females. Our results suggest that with aging central atrophy increases more (relatively) than cortical atrophy. No correlation was found between the decreasing volume of the cerebral hemispheres and the increasing number and size of WMHL, nor between the increasing volume of the lateral ventricles and the increasing number and size of WMHL.
The role of risk and benefit perception in informed consent for surgery.

BACKGROUND Informed consent relies on patients' ability to understand risk information. Evidence suggests that people may extract the gist of any risk information to make medical decisions. Existing evidence also suggests that there is an inverse relationship between the perception of risk and the perception of benefit. METHOD Seventy-one patients on the waiting list for carotid endarterectomy (CEA) were surveyed regarding their understanding and recall of the risk and benefit to health of undergoing CEA. Patients were surveyed 1 month after their initial consultation, and a subgroup was surveyed again on the day before their operation. RESULTS Patients' estimates of their baseline risk of stroke without surgery were significantly different from what they had been told by the surgeon. Patients' estimates of stroke risk due to surgery ranged from 0% to 65% (actual local risk 2%). Patients also had unreasonable expectations about the benefit of the operation for their health. Estimates of stroke risk correlated positively with the degree of expected benefit from the operation (r = 0.29, P = 0.05). When resurveyed the day before the operation, patients' perceptions of both risk and benefit had increased significantly. The risk perception data from some patients appeared to contradict some of the predictions of the fuzzy-trace theory. CONCLUSIONS Most patients failed to understand the risks and benefits associated with CEA. Some patients' estimates of stroke risk were actually greater than the perceived potential benefit of surgery in terms of risk reduction. The data also suggested a positive correlation between the degree of perceived benefit and the degree of perceived risk.
Behavioral / Cognitive Multifunctional and Context-Dependent Control of Vocal Acoustics by Individual Muscles X

The relationship between muscle activity and behavioral output determines how the brain controls and modifies complex skills. In vocal control, ensembles of muscles are used to precisely tune single acoustic parameters such as fundamental frequency and sound amplitude. If individual vocal muscles were dedicated to the control of single parameters, then the brain could control each parameter independently by modulating the appropriate muscle or muscles. Alternatively, if each muscle influenced multiple parameters, a more complex control strategy would be required to selectively modulate a single parameter. Additionally, it is unknown whether the function of single muscles is fixed or varies across different vocal gestures. A fixed relationship would allow the brain to use the same changes in muscle activation to, for example, increase the fundamental frequency of different vocal gestures, whereas a context-dependent scheme would require the brain to calculate different motor modifications in each case. We tested the hypothesis that single muscles control multiple acoustic parameters and that the function of single muscles varies across gestures using three complementary approaches. First, we recorded electromyographic data from vocal muscles in singing Bengalese finches. Second, we electrically perturbed the activity of single muscles during song. Third, we developed an ex vivo technique to analyze the biomechanical and acoustic consequences of single-muscle perturbations. We found that single muscles drive changes in multiple parameters and that the function of single muscles differs across vocal gestures, suggesting that the brain uses a complex, gesture-dependent control scheme to regulate vocal output.
In-vivo activity and pharmacodynamics of cefotaxime in combination with vancomycin in fibrin clots infected with highly penicillin-resistant Streptococcus pneumoniae.

We studied the antipneumococcal efficacy of cefotaxime and vancomycin alone and a combination of cefotaxime with various dosages of vancomycin in the treatment of prolonged (48 h) experimental fibrin clot infections in rabbits. A clinical pneumococcal strain for which MICs were 2, 0.5 and 0.5 mg/L of penicillin, cefotaxime and vancomycin respectively, was used in this study. Cefotaxime was given iv at a fixed dose of 50 mg/kg and vancomycin iv at 1, 2.5, 5, 10 or 20 mg/kg. Maximal concentrations in clots were (mean +/- S.D.): 2.1 +/- 0.9, 1.1 +/- 0.4, 1.9 +/- 1, 2.3 +/- 1.5, 3.6 +/- 0.4 and 4 +/- 0.3 mg/g, respectively. The mean half-lives of elimination from clots were 2.2 h for cefotaxime and 7 h for vancomycin. We observed the highest bacterial reductions for the highest doses of vancomycin with or without cefotaxime. The combination of intermediate doses of vancomycin with cefotaxime led to higher antibacterial effects than either monotherapy. The low dose of vancomycin gave no significant additional effect compared with cefotaxime alone. The times of regrowth were similar for cefotaxime and cefotaxime-vancomycin 1, and also for vancomycin 10 and vancomycin 20 with or without cefotaxime but were significantly delayed for the combination cefotaxime-vancomycin 2.5 and cefotaxime-vancomycin 5 as compared with vancomycin 2.5 and vancomycin 5. By using a multivariate analysis, we demonstrated that the most important parameters were Cmax (r = 0.43) and AUC (r = 0.58) for cefotaxime alone and Cmax (r = 0.70) for vancomycin alone; none of the tested parameters was found to be significantly correlated with the efficacy of the combinations of cefotaxime and vancomycin. From these findings, and under the experimental conditions used (i.e., relatively low concentrations of cefotaxime), we demonstrated that the in-vivo antibacterial efficacy of the combination of cefotaxime and vancomycin was higher than each monotherapy when the local concentrations of vancomycin were at least 1.9 mg/L.
Depressive symptoms and mortality in lung transplant

Evon DM, Burker EJ, Galanko JA, Dedert E, Egan TM. Depressive symptoms and mortality in lung transplant. Clin Transplant 2010 DOI: 10.1111/j.1399‐0012.2010. 01236.x. © 2010 John Wiley & Sons A/S.
Adding quantitative muscle MRI to the FSHD clinical trial toolbox

Objective: To add quantitative muscle MRI to the clinical trial toolbox for facioscapulohumeral muscular dystrophy (FSHD) by correlating it to clinical outcome measures in a large cohort of genetically and clinically well-characterized patients with FSHD comprising the entire clinical spectrum. Methods: Quantitative MRI scans of leg muscles of 140 patients with FSHD1 and FSHD2 were assessed for fatty infiltration and TIRM hyperintensities and were correlated to multiple clinical outcome measures. Results: The mean fat fraction of the total leg musculature correlated highly with the motor function measure, FSHD clinical score, Ricci score, and 6-minute walking test (correlation coefficients −0.845, 0.835, 0.791, −0.701, respectively). Fat fraction per muscle group correlated well with corresponding muscle strength (correlation coefficients up to −0.82). The hamstring muscles, adductor muscles, rectus femoris, and gastrocnemius medialis were affected most frequently, also in early stage disease and in patients without leg muscle weakness. Muscle involvement was asymmetric in 20% of all muscle pairs and fatty infiltration within muscles showed a decrease from distal to proximal of 3.9%. TIRM hyperintense areas, suggesting inflammation, were found in 3.5% of all muscles, with and without fatty infiltration. Conclusions: We show a strong correlation between quantitative muscle MRI and clinical outcome measures. Muscle MRI is able to detect muscle pathology before clinical involvement of the leg muscles. This indicates that quantitative leg muscle MRI is a promising biomarker that captures disease severity and motor functioning and can thus be included in the FSHD trial toolbox.
Comparative study of the shell development of hard‐ and soft‐shelled turtles

The turtle shell provides a fascinating model for the investigation of the evolutionary modifications of developmental mechanisms. Different conclusions have been put forth for its development, and it is suggested that one of the causes of the disagreement could be the differences in the species of the turtles used – the differences between hard‐shelled turtles and soft‐shelled turtles. To elucidate the cause of the difference, we compared the turtle shell development in the two groups of turtle. In the dorsal shell development, these two turtle groups shared the gene expression profile that is required for formation, and shared similar spatial organization of the anatomical elements during development. Thus, both turtles formed the dorsal shell through a folding of the lateral body wall, and the Wnt signaling pathway appears to have been involved in the development. The ventral portion of the shell, on the other hand, contains massive dermal bones. Although expression of HNK‐1 epitope has suggested that the trunk neural crest contributed to the dermal bones in the hard‐shelled turtles, it was not expressed in the initial anlage of the skeletons in either of the types of turtle. Hence, no evidence was found that would support a neural crest origin.
Iterative PIV interrogation for complex wall-bounded flows

The strategy of the iterative PIV algorithm is discussed with the aim of investigating transitional wall-bounded flows. It is proposed to start the algorithm with a coarse prediction of the large-scale tangential velocity gradient to eliminate its negative effect. A window correlation with image deformation technique is then iteratively conducted to capture the fluctuating flow structures. Synthetic particles are created based on the DNS result of a typical hypersonic transitional boundary layers to evaluate the performance of the algorithm. Effects of several parameters, including the mean tangential displacement gradient, particle diameter, particle density and background noise on the level on the evaluation, are systematically investigated. Four methods to initially predict the near-wall flow are compared, including the directly-used window correlation with image deformation (WC) (Scarano 2002 Meas. Sci. Technol. 13 R1–19), the WC method with static particles added in the solid region (Zhu et al 2013 Meas. Sci. Technol. 24 125302), the image gradiometry method (Nguyen et al 2009 Proc. 6th Int. Symp. on Turbulence and Shear Flow Phenomena (Seoul, Korea, 2009)) and the newly-proposed joint-translation-shear correlation method method. The results show that, compared with the other three approaches, the performance of the new method is greatly enhanced for evaluating the dynamical flow properties, even if the displacement gradient is very high. Finally, experimental data on artificially disturbed boundary layers from a low-speed and a high-Mach-number wind tunnel are used to evaluate the new method, which is able to evaluate the mean and instantaneous velocity fields in both cases.
A taxonomy of medically unexplained symptoms.

Medically unexplained symptoms (MUS) are common in people’s personal experience and in general and specialist medical practice [1–3]. MUS have been the recipients of a number of epithets: psychosomatic syndromes and symptoms; conversion disorders; somatoform disorders; functional somatic syndromes and symptoms; and so forth. Medically unexplained symptoms is among the better descriptive terms, because it brings honest ignorance to the fore and states simply that there is a number of symptoms and syndromes that present as phenomena for which health professionals at present can find no medical cause on the basis of physical examination or investigation. Medically unexplained symptoms are mysterious with respect to their etiologies. As scientists we want to understand them and to be able to say that the causes of occurrences of MUS are so and so. As with any other phenomenon we wish to explain, we then need two things: First, we need a taxonomy of the phenomenon we wish to explain (or understand). A taxonomy gives us a map of the dependent variable(s), and points to the pockets of variance we have to account for. Is there an agreed or derivable taxonomy of medically unexplained symptoms from our current knowledge? Second, once we can see the taxonomy of the target phenomenon—MUS is this case—we must ask: do we have the necessary constructs to explain the occurrences of medically unexplained symptoms? The first question will be addressed in this editorial. For a discussion of the second question—at least from a psychological viewpoint—the study by Kirmayer et al. [4] is highly recommended. The most obvious taxonomic question is whether we are dealing with one or many phenomena when it comes to describing medically unexplained symptoms. Because they share a terminological umbrella—MUS—this might lead us to think there are aspects of etiologic overlap. However, just because they are brought under the coverall term of MUS it cannot be dictated that they share sources of variance. On the other hand, the fact that many different medically unexplained symptoms are seen by different medical specialists could lead us invalidly to separate them