Miracle-dz/UniFAR-FTUs huggingface dataset:
[Efficacy and safety of fondaparinux versus enoxaparin for preventing venous thromboembolism after major orthopedic surgery: a meta-analysis].

OBJECTIVE To systematically review the efficacy and safety of fondaparinux and enoxaparin in the prevention of venous thromboembolism (VTE) after major orthopedic surgery. METHODS The MEDLINE, EMbase, the Cochrane Library, CNKI, CBM, VIP and Wanfang databases (from their establishment to October, 2012) were searched for randomized controlled trials (RCTs) comparing the effects of fondaparinux and enoxaparin in preventing VTE after major orthopedic surgery. The related journals and conference papers were manually searched. The outcome measurements were the incidence of total VTE, deep venous thrombosis (DVT), symptomatic VTE, pulmonary embolism (PE), major bleeding and any other adverse event. The quality of literatures was evaluated and the data were extracted for meta-analysis. RESULTS Five RCTs involving 7611 patients were included pertaining to major knee surgery (1 RCT), hip fracture surgery (2 RCTs) and total hip arthroplasty (3 RCTs). The incidences of total VTE and DVT were significantly lower in fondaparinux group than in enoxaparin group [RR=0.52, 95%CI (0.40,0.67), P<0.00001; RR=0.49, 95%CI (0.42, 0.58), P<0.00001]. The incidence of symptomatic VTE was similar between the two groups [RR=1.52, 95%CI (0.80,2.88), P=0.20]. Fondaparinux was associated with a significantly increased incidence of major bleeding compared to enoxaparin group [RR=1.55, 95%CI (1.14,2.12), P=0.006], but the mortality rates were comparable between the two groups [RR=0.93, 95%CI (0.63,1.37), P=0.72]. CONCLUSION Compared with enoxaparin, fondaparinux can reduce the risk of postoperative VTE and do not increase the mortality rate following major orthopedic surgery though with an increased risk of major bleeding.
Malreduction of the Tibiofibular Syndesmosis in Ankle Fractures

Background: Diagnosis and reduction of syndesmosis injuries in ankle fractures can be challenging. Previous studies have demonstrated that standard radiographic measurements used to evaluate the integrity of the syndesmosis are inaccurate. The purpose of this study was to determine the adequacy of standard postoperative radiographic measurements in assessing syndesmotic reduction compared to CT and to determine the prevalence of postoperative syndesmotic malreduction in a patient cohort. Methods: Twenty-five patients with ankle fractures and syndesmotic instability who had open reduction and syndesmotic fixation were evaluated. All patients had a standard radiographic series postoperatively followed by a CT scan. Radiographic measurements were made by three observers to determine the tibiofibular relationship. Axial CT scan images were judged for quality of reduction of the syndesmosis by measuring the distance between the fibula and the anterior and posterior facets of the incisura. Differences between the anterior and posterior measurements of more than 2 mm were considered incongruous. Results: Six patients (24%) had evidence of postoperative diastasis using the radiographic criteria, four of whom had evidence of malreduction on postoperative CT scan. Conversely, 13 patients (52%) had incongruity of the fibula within the incisura on CT scan (average 3.6 mm, range 2.0 to 8.0 mm), only four of whom had one or more abnormal radiographic measurements. In 10 (77%) of the 13 malreductions seen on CT scan, the posterior measurement was greater, indicating that internal rotation or anterior translation of the fibula may have occurred. Sensitivity of radiographs was 31% and the specificity was 83% compared to CT. Conclusions: Many syndesmoses were malreduced on CT scan but went undetected by plain radiographs. Radiographic measurements did not accurately reflect the status of the distal tibiofibular joint in this series of ankle fractures. Furthermore, postreduction radiographic measurements were inaccurate for assessing the quality of the reduction. Although we did not seek to correlate functional outcomes, the known morbidity of postoperative syndesmotic malreduction should lead to heightened vigilance for assessing accurate syndesmosis reduction intraoperatively.
Ophthalmological manifestations in patients with Leigh syndrome

Background To describe the ophthalmological manifestations in patients with childhood onset Leigh syndrome (LS) and investigate the correlation between genotypes and phenotypes in patients with LS. Methods Childhood onset LS was clinically and enzymatically confirmed in a total of 63 patients. Among them, 44 patients who underwent ophthalmologic consultation were included in this study. Patients with LS underwent genotyping for the whole genome of mitochondrial DNA and SURF1 mutations. The clinical demographic and ophthalmologic phenotypes were compared between the good prognosis group and the poor prognosis group. Results Strabismus (40.9%) was the most frequently observed ophthalmologic manifestation, followed by pigmentary retinopathy (22.5%), optic atrophy (22.5%), ptosis (15.9%), and nystagmus (13.6%). Thirteen patients were exotropes and five patients were esotropes. The mean exodeviation was 29.6±12.5 prism dioptres (PD) and the mean esodeviation was 24.0±8.9 PD. All patients with esotropia reported disease onset at <1 year old. Among 26 patients older than 4 years, eight (30.8%) patients had better than 0.4 in the best eye was noted. Eyelid ptosis was a main presenting sign in four patients (9.1%). Among these patients, two patients had m.13513G>A mutation in the MT-ND5 gene. Age at onset was 2.47±2.06 years in the good prognosis group and 0.92±0.98 years in the poor prognosis group (p=0.002). Serum lactate peak concentration was 3.23±1.36 mmol/L in the good prognosis group and 4.54±2.31 mmol/L in the poor prognosis group (p=0.051). Conclusions LS is a group of mitochondrial disorders with variable ophthalmologic manifestations, the most frequent being strabismus in this study. Ptosis could be an initial sign in patients with LS and these patients can be easily misdiagnosed as having juvenile myasthenia gravis.
H+‐ATPase AND CATECHOLAMINE TRANSPORT IN CHROMAFFIN GRANULES *

The chromaffin granule is a subcellular organelle within the chromaffin cell of the adrenal medulla in which most of the catecholamines contained within the adrenal medulla are localized and stored prior to release. These organelles can be isolated in large amounts and high purity through the use of isotonic gradients of high-density, low-viscosity supporting materials. ' The membrane and matrix composition of these granules has been studied in great detail (for review, see Reference 2). and is schematically depicted in FIGURE 1. Catecholamine content (2,400 nmol/mg protein] and nucleotide content (800 nmol/mg protein, mostly ATP) constitute 35% of the dry weight of the entire granule. Based on the intravesicular water space, it can be calculated that if catecholamines and ATP measured within the matrix space were free in solution, the apparent concentration would be 0.5 and 0.125 M, respectively. Also found within the matrix space is a high content of ascorbate and chromogranins, a class of large-molecular-weight, acidic proteins whose function is virtually unknown. The membrane of the chromaffin granule maintains one of the lowest proteinlipid ratios (0.45 by weight) found within mammalian membranes, and an extremely high percentage of the lipid (10 to 20%] is comprised of lysophosphatidylcholine. Mai or membrane-associated proteins so far identified are (a) cytochrome b,,, and other respiratory chain components whose physiological significance is not understood: (b) dopamine-p-hydroxylase, which has been extensively investigated and even purified to homogeneity; and (c) an H'4ransporting ATPase.
An overview of the alpha-, beta- and gamma-carbonic anhydrases from Bacteria: can bacterial carbonic anhydrases shed new light on evolution of bacteria?

Abstract Carbonic anhydrases (CAs, EC 4.2.1.1) are metalloenzymes which catalyze a simple but physiologically crucial reaction in all life Domains, the carbon dioxide hydration to bicarbonate and protons: CO2 + H2O ⇔ + H+. These enzymes are involved in many physiologic processes, such as photosynthesis, respiration, CO2 transport, as well as metabolism of xenobiotics. Five different, genetically distinct CA families are known to date: the α-, β-, γ-, δ- and ζ-CAs. α-, β- and δ-CAs use Zn(II) ions at the active site, the γ-CAs are probably Fe(II) enzymes (but they are active also with bound Zn(II) or Co(II) ions), whereas the ζ-class uses Cd(II) or Zn(II) to perform the physiologic reaction catalysis. Bacteria encode for enzymes belonging to the α-, β-, and γ-CA classes. They contain zinc ion (Zn2+) in their active site, coordinated by three histidine residues and a water molecule/hydroxide ion (in the α and γ) or by two cysteine and one histidine residues (in the β class), with the fourth ligand being a water molecule/hydroxide ion. Here we propose that bacterial CAs can be used as markers for understanding the evolution and genetic variability of the Gram-positive and Gram-negative bacteria. We addressed several questions such as: (1) why are α-CAs present only in the genome of Gram-negative bacteria; (2) why are α-CAs not present in all Gram-negative bacteria; (3) why do Bacteria show an intricate pattern of CA gene expression; (4) what are the physiologic roles of such diverse CAs in these prokaryotes. We proposed possible answers to the previous questions. Moreover, we speculated on the evolution of the CA classes (α, β and γ) identified in the Gram-negative and -positive bacteria. Our main hypothesis is that from the ancestral Ur-CA, the γ-class arose first, followed by the β-class; the α-class CAs came last it is found only in the Gram-negative bacteria.
Expression of a human 7S K RNA gene in vivo requires a novel pol III upstream element.

The 5′‐flanking sequences required for expression of a human 7S K RNA gene have been defined by mutant analysis. A ‐111 upstream deletion mutant showed full activity when analysed by in vitro transcription with HeLa cell extracts. In contrast, upon transfection into intact cells, this mutant only revealed a basal level activity of approximately 6% as compared to the wild‐type promoter up to position ‐252. The deleted upstream sequence element acts as a transcriptional activator in vivo, in a strictly position and orientation‐dependent manner. Two octamer‐like binding motifs observed within this upstream sequence were both dispensable for proper function of this RNA polymerase III promoter in vivo. Instead, a detailed analysis of this region identified a CACCC‐box element, together with its surrounding base pairs, as the essential upstream element required for expression of this 7S K RNA gene in vivo. Furthermore, this CACCC‐box is centered within a footprint obtained with HeLa cell nuclear proteins.
The Effectiveness of Planning Control on Urban Growth: Evidence from Hangzhou, China

Urban sprawl presents a serious challenge for sustainable urban land use. Urban planning attempts to guarantee sustainable urban development and proper use of land resources. However, a large gap usually exists between planning and actual development. This paper aims to analyze the evolutionary characteristics of urban form and the spatiotemporal dynamics of urban planning from 1964 to 2013, using the case of Hangzhou, China. We proposed a framework that included remote sensing, landscape metrics, and control effectiveness indexes. The results indicated that urban planning failed to perform effectively in Hangzhou, reflected by the uncontrolled urban sprawl during all the planning periods. The low effectiveness of planning was resulted from multiple factors, including historical economic events that made expansion unexpected, functional orientation of planning which drove fragmented suburbanization, the ineffective methods for forecasting population and land use, and the influences by the market forces. The findings deepen the understanding of the impacts of urban planning, and provide references for making rational urban management decisions and sustainable urban land management.
Retinoblastoma: epidemiologic characteristics.

Abstract Nationwide study of 269 death certificates for United States children with retinoblastoma, 1960–67, revealed a peak in mortality at two to three years of age that was 2 1/2 times greater in Negroes than in whites. Nationally, an estimated 81 per cent of children with the neoplasm survived. Study of 1623 hospital records of children with retinoblastoma revealed an excess of mental retardation: 21 cases observed vs. 4.7 expected. Associated malformations in several cases suggested D-deletion syndrome, which has been described by others in six children with retinoblastoma. In accord with previous studies, radiotherapy was associated with an excess of osteosarcoma, soft-tissue neoplasms or carcinoma of the skin. In addition, 11 children had second primary cancers not attributable to radiotherapy, a seeming excess over normal expectation. The cell types were diverse, but three were osteosarcomas, suggesting an innate susceptibility that may add to the risk of radiotherapy.
The robustness of faecal steroid determination for pregnancy testing Kaimanawa feral mares under field conditions

Abstract Aims: To investigate the utility of faecal oestrone sulphate (OS) concentrations for detecting pregnancy in mares during behavioural studies of feral horses, in which the collection and preservation of samples is not immediate. Methods: Oestrone sulphate concentrations were measured in fresh dung samples collected from 153 free-roaming Kaimanawa mares throughout the year. In addition, multiple samples were taken from the same pile to investigate the reliability of diagnosis from a single sample, as well as the influence of time until preservation on OS concentrations. Samples were also taken before and after a 10mm simulated rainfall event to test for dilution of OS concentrations by rain. Oestrone sulphate concentrations in all samples were measured using an enzymeimmunoassay. Results: From approximately 150 to 250 days of gestation, OS concentrations were consistently >80 ng/g in mares which subsequently foaled. Mares which did not foal and had low faecal OS concentrations in multiple samples throughout the year had faecal OS concentrations of 31 ±13 ng/g (mean ± s.d.) with an upper 95% confidence limit of 57 ng/g. Mares sampled from 1 week before to 1 month after behavioural oestrus, and that did not foal in the previous and subsequent seasons, had OS concentrations of 37 ± 32 ng/g (mean ± s.d.) with an upper 95% confidence limit of 100 ng/g.The standard error of oestrone sulphate concentrations in multiple samples from the same dung pile ranged from 1 to 37% of the mean. This large within-pile variation, however, did not result in incorrect diagnoses from single samples unless mares were within 18 days of parturition. Keeping samples at ambient temperatures for up to 16 hours did not affect OS concentrations. Simulated rainfall caused a 17% mean reduction in OS concentrations, but did not change pregnancy diagnoses. Conclusions: Faecal OS concentrations > 100 ng/g were indicative of pregnancy in Kaimanawa mares. For mares more than 150 days post-mating, OS concentrations <57 ng/g were indicative of non-pregnancy, while concentrations between 57 and 100 ng/g provided an inconclusive diagnosis. A single sample from each dung pile collected within 16 hours of defecation was sufficient to accurately diagnose pregnancy in mares 150-250 days post conception. Clinical Relevance: Measurement of OS concentrations in dung samples was a reliable and robust indicator of pregnancy status in feral mares 150-250 days post mating. This corresponds approximately to the period from May to August, given the seasonal breeding pattern in this population. This method of determining pregnancy status is suitable for field use in behavioural and demographic studies of wild horse populations.
Attribution in Romance: Reconstructing the oral and written tradition

Abstract The article seeks to demonstrate that the diachrony and synchrony of Romance languages are marked by the coexistence of two major types of adverb with attributive (modifying) function. Both are based on adjectives: Type A takes the unmarked adjective (e.g. Sp. trabajar duro ‘to work hard’), whereas Type B is derived (Sp. trabajarduramente ‘to work hard’). In contrast to studies which focus on -ment(e), the article highlights the neglected synchrony and diachrony of Type A adverbs. Moreover, the diachrony and synchrony of both Type A and Type B are considered as related phenomena that have to be placed at the interface of the oral and the written traditions. A combination of written diachronic data with written and spoken variationist data from the twentieth and twenty-first centuries provides evidence for the reconstruction of the oral and written tradition in Romance.
HIV and ageing: improving quantity and quality of life

Purpose of reviewEvidence-based strategies are needed to address the growing complexity of care of those ageing with HIV so that as life expectancy is extended, quality of life is also enhanced. Recent findingsModifiable contributing factors to the quantity and quality of life in adults ageing with HIV include: burden of harmful health behaviours, injury from HIV infection, HIV treatment toxicity and general burden of age-associated comorbidities. In turn, these factors contribute to geriatric syndromes including multimorbidity and polypharmacy, physiologic frailty, falls and fragility fractures and cognitive dysfunction, which further compromise the quality of life long before they lead to mortality. SummaryViral suppression of HIV with combination antiviral therapy has led to increasing longevity but has not enabled a complete return to health among ageing HIV-infected individuals (HIV+). As adults age with HIV, the role of HIV itself and associated inflammation, effects of exposure to antiretroviral agents, the high prevalence of modifiable risk factors for age-associated conditions (e.g. smoking), and the effects of other viral coinfections are all influencing the health trajectory of persons ageing with HIV. We must move from the simplistic notion of HIV becoming a ‘chronic controllable illness’ to understanding the continually evolving ‘treated’ history of HIV infection with the burden of age-associated conditions and geriatric syndromes in the context of an altered and ageing immune system.
Analysis of the original causes of placental oxidative stress in normal pregnancy and pre-eclampsia: A hypothesis

Pre-eclampsia (PE) and eclampsia remain enigmatic despite intensive research. Growing evidence suggests that placental oxidative stress (OS) is involved in the etiopathogenesis of pre-eclampsia. Reduced perfusion as a result of abnormal placentation was proposed to be responsible for placental OS in PE. However, placental OS was also observed in normal pregnancy. The exact differences and correlation of placental OS in PE and normal pregnancy remain elusive. In this review, we attempted to link both normal pregnancy and PE on the causes of placental OS and proposed a hypothesis that placental OS in normal pregnancy, plus the exploration of other placental and/or maternal factors, could provide a novel explanation of that in PE. We concluded that pregnancy, placental abnormality and preexisting maternal constitutional conditions are three principle factors that could contribute to placental OS in PE. The specific causes in each clinical case could be heterogeneous, which requires individual analysis.
A qualitative study into the impact of fasting within a large tertiary hospital in Australia--the patients' perspective.

AIMS AND OBJECTIVES This qualitative study aims to explore the physical and emotional impact of fasting from the patients' perspective. BACKGROUND Fasting patients in hospital is common practice and generally viewed as necessary for symptom management or for safety of healthcare provision. Negative impacts of repeated or prolonged fasting on nutritional status have been well researched, but little is documented as to how fasting impacts an individual patient's psyche. DESIGN Qualitative descriptive design within a tertiary hospital in Sydney, Australia. METHODS Twelve patients having had prolonged periods of continuous or intermittent fasting were invited to participate in a semi-structured interview between January-September 2012. Questions for interview explored each patient's experience of fasting, including physical and emotional impacts, interpretation of communication regarding fasting and the process of recommencing on fluids or foods. An inductive thematic analysis approach was used. RESULTS Analyses showed six main themes: physical impacts; emotional impacts; food as structure; nil by mouth as jargon; fear of food re-introduction; and dissatisfaction regarding unnecessary fasting. Overwhelmingly, thirst was reported as the worst physical effect of fasting. In the first few days of fasting, patients became emotionally fixated on food. This quickly dissipated leading to a lack of appetite and fear of starting to eat again. CONCLUSIONS Discomfort experienced by patients coupled with lack of appetite resulting from prolonged fasting and difficulty with food re-introduction strengthens the argument for reducing fasting times in hospital. When patients are fasted, proper hydration and establishing alternate routes of medication administration should be a priority. RELEVANCE TO CLINICAL PRACTICE It is well recognised that fasting for prolonged periods is detrimental to health outcomes, but this study also shows the distress that fasting can cause. Inadequate hospital systems and out-dated practices need to be replaced with evidence-based, patient-centred governance, addressing the physical, emotional and psychosocial impact of fasting.
Seroprevalence and antibiotic sensitivity of serotypes of Salmonella enterica in Greek pig herds

Blood samples were taken from 50 pigs in each of 59 farrow-to-finish production herds and from 40 pigs in each of four of five registered multiplying herds. Samples of feed and faeces were also collected from 17 of the production herds and from the four multiplying herds. The sera were tested for antibodies to Salmonella enterica by the Danish mix-ELISA, and the organisms were isolated, serotyped and sensitivity tested by standard techniques. The average within-herd seroprevalence was 3.4 per cent and at least one pig tested seropositive in 21 of the 59 herds. In the multiplying herds, only a single seroreactor was detected. Salmonellae were isolated from only five of 95 feed samples, from two of the 17 herds sampled, Salmonella tennessee in four of five samples from one herd and an untypable strain in one of five samples from another. Four infected faecal samples were detected in four herds; they harboured Salmonella typhimurium, Salmonella bredeney or Salmonella london. No salmonellae were isolated from the samples of feed and faeces taken from the multiplying herds. The S london and S typhimurium had a low sensitivity to streptomycin, kanamycin and neomycin, and the S typhimurium also had low sensitivity to amoxycillin, ticarcillin, piperacillin, amoxycillin + clavulanic acid, cefalotin and cefoperazone. The other isolates were sensitive to all the antimicrobial agents tested.