Miracle-dz/UniFAR-FTUs huggingface dataset:
Operative Management of Ankle Fractures in Patients with Diabetes Mellitus

Background: Multiple studies have documented increased risks associated with treatment of ankle fractures in patients with diabetes mellitus. We reviewed our results in the largest series to date of this complex patient group to determine the frequency of complications. Methods: Eighty-four patients with diabetes had open reduction and internal fixation using standard fixation techniques for acute, closed ankle fractures. The 51 men and 33 women had an average age was 49.3 (22 to 77) years. The average followup was 4.1 years (11 to 97 months). Seventy-five fractures were closed and nine were open. Thirty-nine patients used insulin and 45 used oral hypoglycemics or diet for control of their diabetes. Diabetic complications, including nephropathy, hypertension, peripheral vascular disease, and neuropathy were evaluated. The management of diabetes, fracture classification, and presence of diabetic complications were assessed with chi-square, ANOVA, and univariate logistic regression to determine the presence of statistical significance for these factors. Results: Twelve of the 84 patients developed postoperative complications. Ten patients developed infections (eight deep and two superficial). Four of 12 patients with preoperative evidence of peripheral neuropathy developed Charcot arthropathy. Ten of 12 patients who had absent pedal pulses preoperatively developed complications (p < 0.0001) and 11 of 12 patients with peripheral neuropathy had complications (p < 0.0001). A trend towards complications was noted with nephropathy (two of five patients) and hypertension (nine of 12 patients). Open fractures, insulin dependence, patient age, and fracture classification had no significant effect on outcome. Conclusions: Most patients with diabetes can undergo open reduction and internal fixation of acute ankle fractures without complications. Patients with absent pedal pulses or peripheral neuropathy are at increased risk for complications.
Neural correlates of Italian nominal compounds and potential impact of headedness effect: An ERP study

An event-related potential (ERP) technique was used to investigate the way in which noun–noun compounds are processed during a lexical decision task with Italian speakers. Reaction times and error rates were higher for compounds than for noncompounds. ERP data showed a more negative peak in the left anterior negativity (LAN) component for compounds. These results are compatible with a dual-route model that posits not only whole-word access for compounds but also an activation of decomposed representations of compound constituents. A final result relates to head position, which in Italian compounds could be on either the left- or the right-hand side of the word. While behavioural analysis did not reveal a difference between left- and right-headed compounds, a difference was found with the P300 component. The role of the compound head as a crucial information-bearing component is discussed.
The Down-Regulation of HLA-DM Gene Expression in Rheumatoid Arthritis Is Not Related to Their Promoter Polymorphism1 2

HLA-DM molecule, a class II-like heterodimer, is a critical factor of HLA class II-dependent Ag presentation. It acts as a molecular chaperone and also functions as a peptide editor favoring the presentation of high-stability peptides. Thus, it appears to skew the peptide repertoire presented to T cells. Variation in HLA-DM expression has considerable effect on Ag presentation and regulation of these genes is likely to be a prerequisite to prevent autoimmunity. In this study, rheumatoid arthritis (RA) was chosen as a model of human autoimmune disease since its genetic susceptibility is known to be associated with the HLA-DR and -DM components. We described a limited nucleotide polymorphism in the HLA-DM promoters with functional impact on basal transcriptional activity and IFN-γ induction as assessed in vitro. However, no difference of allele frequencies was found between controls and RA patients. Despite of this lack of association, expression of HLA-DM molecules was also investigated. Interestingly, an underexpression of HLA-DM transcripts and protein was shown in peripheral blood B cells from RA patients compared with controls or inflammatory arthritis patients. This underexpression does not affect HLA-DR genes and is responsible for a decrease of the DM:DR ratio in RA patients. This specific HLA-DM down-regulation is likely to have important consequences on Ag presentation and could participate in the autoimmune process in RA.
Higher resolution in localizationmicroscopy by slower switching of a photochromic protein

Photoswitchable fluorophores play an essential role in super-resolution fluorescence microscopy, including techniques such as photoactivated localizationmicroscopy (PALM). A determining factor in the precision of the images generated by PALM measurements is the photon numbers that can be detected from the fluorophores. Dronpa is a reversibly photoswitchable fluorescent protein that has been successfully used in PALM experiments. The number of photons per switching cycle that can be acquired for Dronpa depends on its off-switching rate, limiting the number of photons that can be recorded. In this study we report our discovery that the tetrameric ancestor of Dronpa, 22G, shows slower switching, and develop a mutant that displays switching kinetics between those of Dronpa and 22G. We show that the kinetics of the photoswitching are strongly related to self-association of the protein, supporting our view of dynamic flexibility as determining in the photoswitching. Similarly we find that higher-resolution PALM images can be acquired with slower-switching proteins due to their higher number of emitted photons per switching cycle.
Contributions of a disulfide bond to the structure, stability, and dimerization of human IgG1 antibody CH3 domain

Recombinant human monoclonal antibodies have become important protein‐based therapeutics for the treatment of various diseases. The antibody structure is complex, consisting of β‐sheet rich domains stabilized by multiple disulfide bridges. The dimerization of the CH3 domain in the constant region of the heavy chain plays a pivotal role in the assembly of an antibody. This domain contains a single buried, highly conserved disulfide bond. This disulfide bond was not required for dimerization, since a recombinant human CH3 domain, even in the reduced state, existed as a dimer. Spectroscopic analyses showed that the secondary and tertiary structures of reduced and oxidized CH3 dimer were similar, but differences were observed. The reduced CH3 dimer was less stable than the oxidized form to denaturation by guanidinium chloride (GdmCl), pH, or heat. Equilibrium sedimentation revealed that the reduced dimer dissociated at lower GdmCl concentration than the oxidized form. This implies that the disulfide bond shifts the monomer–dimer equilibrium. Interestingly, the dimer–monomer dissociation transition occurred at lower GdmCl concentration than the unfolding transition. Thus, disulfide bond formation in the human CH3 domain is important for stability and dimerization. Here we show the importance of the role played by the disulfide bond and how it affects the stability and monomer–dimer equilibrium of the human CH3 domain. Hence, these results may have implications for the stability of the intact antibody.
677TT polymorphism of methylenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in‐stent restenosis

Recent studies have shown that a common mutation (nucleotide 677 C→T) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to a mild rise in plasma homocysteine levels and increase the incidence of coronary artery disease. Therefore, this study was designed to further investigate whether the effects of MTHFR 677 C to T mutation, plasma homocysteine, serum vitamin B12, and folate can influence restenosis after successful coronary stenting.
Characterizing unstructured overlay topologies in modern P2P file-sharing systems

In recent years, peer-to-peer (P2P) file-sharing systems have evolved to accommodate growing numbers of participating peers. In particular, new features have changed the properties of the unstructured overlay topologies formed by these peers. Little is known about the characteristics of these topologies and their dynamics in modern file-sharing applications, despite their importance. This paper presents a detailed characterization of P2P overlay topologies and their dynamics, focusing on the modern Gnutella network. We present Cruiser, a fast and accurate P2P crawler, which can capture a complete snapshot of the Gnutella network of more than one million peers in just a few minutes, and show how inaccuracy in snapshots can lead to erroneous conclusions--such as a power-law degree distribution. Leveraging recent overlay snapshots captured with Cruiser, we characterize the graph-related properties of individual overlay snapshots and overlay dynamics across slices of back-to-back snapshots. Our results reveal that while the Gnutella network has dramatically grown and changed in many ways, it still exhibits the clustering and short path lengths of a small world network. Furthermore, its overlay topology is highly resilient to random peer departure and even systematic attacks. More interestingly, overlay dynamics lead to an "onion-like" biased connectivity among peers where each peer is more likely connected to peers with higher uptime. Therefore, long-lived peers form a stable core that ensures reachability among peers despite overlay dynamics.
The relationship of household routines to morbidity outcomes in childhood asthma.

PURPOSE The major purpose of this study was to explore the effect of routines on asthma management and morbidity outcomes for children with asthma and their parents. DESIGN AND METHODS This study is a secondary data analysis in a sample of 150 children, which was originally used for an intervention study. RESULTS Parents who had fewer routines in their homes had lower quality-of-life scores and higher burden of asthma scores when compared to parents in households with more routines. More routines were associated with improved asthma morbidity outcomes as measured by nurse rankings of routines. PRACTICE IMPLICATIONS Assisting families to establish routines may result in improved asthma morbidity outcomes.
Expression of small‐conductance calcium‐activated potassium channels (SK) in outer hair cells of the rat cochlea

Physiological evidence suggests that SK‐type Ca2+‐activated K+ channels participate in ACh‐induced hyperpolarization of OHCs (outer hair cells). Based on the sequences published by Köhler et al. (1996 , Science, 273: 1709), we designed degenerated primers recognizing cDNA subunits of rSK1, rSK2 and rSK3. Using this concensus set of primers, we probed by PCR a rat organ of Corti cDNA library. Two PCR products of 707 base pairs with sequence identical to rSK3 and rSK2 were obtained and cloned to generate RNA probes for in situ hybridization in the rat cochlea. The subunit rSK2 showed hybridization in the organ of Corti, at the location of the OHCs. The expression of rSK2 by OHCs was confirmed by probing with PCR a poly(A) amplified OHC cDNA library. During development, rSK2 hybridization in the organ of Corti was negative at embryonic days E16, E18 and at P0, weak at P4 and stronger from P8 to adulthood. The subunit rSK2 could also be detected in the spiral ganglion from P4 to the adult stage. Contrary to rSK2, the subunit rSK3 did not show specific hybridization in the organ of Corti at the adult stage (P120) and only a weak expression was observed at P10 and P21. Our study demonstrates expression of rSK2 in OHCs. These potassium channels are good candidates to underlie the ACh‐activated K+ currents recorded during patch‐clamp recordings in isolated OHCs. The expression of rSK2 in the cochlear ganglion at the adult stage suggests that SK Ca2+‐activated K+ channels may also participate in the repolarization of the auditory neurons after the action potential and may influence their firing patterns.
Immunohistochemical analysis of a primary ovarian leiomyosarcoma. Case report.

BACKGROUND Primary ovarian leiomyosarcoma is an extremely rare malignant smooth muscle neoplasm. We report a case of a primary leiomyosarcoma of the ovary managed at our institution. CASE REPORT Surgical exploration in a 71-year-old woman revealed a large left adnexal tumor and one separate metastatic implant in one part of the omentum, being classified as a primary ovarian leiomyosarcoma stage III C. The patient was treated with an adjuvant chemotherapy regimen consisting of cisplatin and ifosfamide. The patient remained without any evidence of disease until she died due to apoplexy 14 months after initial surgery. High cellularity, nuclear polymorphism as well as patchy necrosis and large areas of hemorrhage, characterized the tumor. Mitotic activity exceeded 5 mitoses per 10 high-power fields with lots of atypical mitoses. Immunohistochemically, the tumor showed a strong positive staining reaction for muscle actin, alpha-smooth muscle actin and neuron-specific enolase as well as a weak positive reaction for vimentin. Furthermore, immunohistochemistry revealed a positive staining for Ki-67, MMP-1 and MMP-2, and VEGF. CONCLUSION Until recently, prognostic parameters in ovarian leiomyosarcoma have still not been identified. Thus, the prognostic value of different clinicopathological and immunohistochemical parameters, especially Ki-67, MMPs and VEGF, should be proven in additional cases with long-term follow-up.
The prognostic impact of SYT‐SSX fusion type and histological grade in pediatric patients with synovial sarcoma treated according to the CWS (Cooperative Weichteilsarkom Studie) trials

The aim of our analysis was the evaluation of the prognostic impact of SYT‐SSX fusion status and histological grading in synovial sarcoma (SS) of children and adolescents in the context of the consistent multimodal treatment strategy of the CWS (Cooperative Weichteilsarkom Studie; Cooperative Soft Tissue Sarcoma Study Group) and in comparison with other risk factors.
Efficacy and Safety of Polyacrylamide Hydrogel for Facial Soft-Tissue Augmentation in a 2-Year Follow-Up: A Prospective Multicenter Study for Evaluation of Safety and Aesthetic Results in 101 Patients

Background: Polyacrylamide (Aquamid) is a nonabsorbable soft-tissue filler. It consists of a polyacrylamide hydrogel. Safety and aesthetic results after injection of polyacrylamide hydrogel for facial soft-tissue enhancement were analyzed in a clinical trial. Methods: In a prospective multicenter study, 251 patients were enrolled for injection of polyacrylamide hydrogel (Aquamid). The results of the first year follow-up have been described previously. One hundred one of 251 initially enrolled patients could be recruited for follow-up 24 months after the first injection. Standardized photographs were taken, and blood and urine samples were collected before treatment and during follow-up visits. Common sites of injection were nasolabial folds, lips, glabella folds, and other sites. The amount of injected gel ranged from 0.2 to 12 ml. Results: A course of 24 months was followed in 101 patients. Results were judged to be good or very good by the investigators in 93 patients. Eighty-six patients judged the aesthetic outcome as satisfactory or very satisfactory. No severe side effects were observed during the 2-year follow-up period. Transient local reactions that resolved spontaneously were detected in several patients. In one case, burning sensations after lip augmentation were reported lasting up to the 24-month follow-up visit. Conclusions: Polyacrylamide hydrogel (Aquamid) yielded satisfying aesthetic results in more than 90 percent of patients. There was no difference in efficacy between 12 and 24 months’ follow-up. No adverse soft-tissue reaction was observed. The study group may be biased, as patients with bad results may have refrained from further follow-up. Long-term follow-up is necessary.
Comparison of electromyographic pattern of sensory experts and untrained subjects during chewing of Mahon cheese

Use of electromyography (EMG) to monitor mastication is a relatively new concept in assessing food physical and sensory properties. Although expert assessment of cheese characteristics is widely used, the effect of training in sensory analysis on mastication patterns, as assessed using EMG is not well known. Nine samples of the same Mahon cheese (60 days ripening) were given to 24 subjects (8 experts, 16 untrained) and EMG recorded for each chewing sequence. Three samples were tested in a single session by each subject, and three sessions carried out on different days. EMG was recorded from four masticatory muscles for each subject. From EMG records the following was extracted: number of chews, chewing time, mean and maximum voltage of EMG bursts (i.e. chews) across chewing sequence, chewing work and chewing rate. No gender bias was found for the EMG parameters considered, therefore, as regards gender, each group was considered to be homogeneous. Variability within-subjects across samples was greater for experts than untrained subjects. Significant differences in chewing time, chewing work and chewing rate were found between the expert and untrained groups. Data analysis of the three sessions showed an influence of cognitive constructs, mediating states, on the chewing process. The experts were found to be goal driven as to their mastication process. Experts showed no significant differences between sessions, untrained subjects were found to vary their EMG output in successive sessions for number of chews, chewing time, mean voltage, and chewing work.
The Outcome of Renal Transplantation in Children Without Prolonged Pre-Transplant Dialysis

Controversy in the literature exists over whether or not it is beneficial to maintain a patient on dialysis for a prolonged time before transplantation. Because no data exist comparing children who have had prolonged dialysis before transplantation to those who have none, we reviewed the charts of all children transplanted at the Children's Hospital of The Cleveland Clinic Foundation. Of those, we selected three groups for analysis: group one (n=12) consisted of patients who had had less than or equal to 10 weeks of dialysis before transplantation (6.8 ± -2.2 weeks, ± = SD); group two (n=21) were patients who had had more than 10 weeks of dialysis (142 +±-148 weeks). Both groups had two years of follow-up data. Group three (n=13) consisted of patients who had had less than two years of follow-up (18.7 ±/-7 months) but no dialysis before transplantation. There were no differences in mode of dialysis between groups one and two nor in the type of transplant (living-related donor vs. cadaveric). Significantly, the patients in group three received more cyclosporine A and less anti-lymphocyte globulin than the other two groups (p< 0.05). Patients in group two received more transfusions (11.9 ± 14.3) than patients in group one (4.0± 2.7) and group three (3.5 ± 7.3). There were no differences in number of patients who experienced at least one rejection episode among the three groups. Although the mean serum creatinine concentration at two years of follow-up was higher in group two (3.6 ± -3.9 mg/dl), this was not significantly different from group one (1.7 ± -0.7 mg/dl) or group three (1.9 ± -0.5, n=7). Sixty-three percent of patients in group one, 60% of patients in group two and 91 % in group three had functioning allografts at two years follow-up. Although there may be other considerations, our data do not indicate any increase in rejection or decrease in graft survival in children who do not receive prolonged dialysis.
Measurement of compliance with naltrexone in the treatment of alcohol dependence: research and clinical implications.

BACKGROUND Medication compliance is a critical issue in pharmacotherapy. This study evaluated the clinical utility of the Medication Event Monitoring System (MEMS), a newer method for monitoring medication compliance, compared with pill count, a traditional measure, in a sample of patients treated for alcohol dependence with naltrexone. METHOD Ninety-three outpatients meeting DSM-III-R criteria for alcohol dependence participated in a 10-week open-label study of naltrexone. They were provided with naltrexone, 50 mg daily, and concurrent counseling. Measures of medication compliance and drinking during treatment were collected every 2 weeks. RESULTS Pill count yielded a significantly (p < .001) higher estimate of compliance (87.6%+/-18.1%) than the MEMS (80.4%+/-20.6%). However, the estimate of compliance obtained with the MEMS was more consistently correlated with treatment outcome (percentage of days abstinent, percentage of heavy drinking days, and mean alcohol amount consumed per drinking occasion) than the pill count compliance rate. In addition, classification of the sample into compliant and less compliant groups using the MEMS data yielded groups that differed more clearly on drinking outcomes than did stratification on the basis of pill count. CONCLUSION In pharmacotherapy research, the MEMS may provide more reliable and valid information about subjects' medication compliance than pill count. Clinically, information obtained with the MEMS could be used to provide feedback to patients about their pill-taking behavior to enhance compliance and overall outcome of therapy.
Pipelle endometrial sampling. Sensitivity in the detection of endometrial cancer.

OBJECTIVE To evaluate the sensitivity of the Pipelle endometrial suction curette in the detection of endometrial carcinoma in patients with known endometrial cancer. STUDY DESIGN A study was conducted using patients with known endometrial cancer undergoing a hysterectomy as part of a formal staging procedure. Endometrial biopsies were performed prior to each surgical procedure. Biopsy results were compared to the hysterectomy specimen for specimen adequacy and final histologic diagnosis. RESULTS The Pipelle biopsy was adequate for analysis in 63 of 65 patients (97%). Malignancy was detected by biopsy in 54 of 65 patients, for a sensitivity of 83 +/- 5% (mean +/- SD). Of the 11 patients with false negative results, 5 had tumors present in only an endometrial polyp. Three of the 11 patients had disease localized to < 5% of the surface area of the endometrium. CONCLUSION The Pipelle endometrial suction curette is an effective office device for evaluating patients at risk of endometrial cancer; however, tumors localized to a polyp or small area of endometrium may go undetected.