Miracle-dz/UniFAR-FTUs huggingface dataset:
Direct Plantar Approach to Henry's Knot for Flexor Hallucis Longus Transfer

Background: Transfer of the flexor hallucis longus (FHL) tendon is an established method to replace a dysfunctional Achilles tendon. When using a single incision, the FHL tendon has to be transferred as a single stranded graft into the calcaneus and the distal FHL stump cannot be directly attached to the flexor digitorum longus tendon (FDL). Another concern with tendon retrieval is neurovascular damage. We report our results with a direct plantar approach for tendon harvest. Methods: A direct plantar approach to the master knot of Henry with reattachment to its distal stump while protecting the medial plantar nerve was used allowing a double stranded FHL-transfer in 25 cases of a severely dysfunctional Achilles tendon in 24 consecutive patients. Patients were evaluated prospectively and at an average followup of 73 (range, 20 to 121) months. Results: No wound healing problems and no lesion of the medial plantar nerve occurred. The subjective result was rated as excellent in 18 (72%), good in five (20%), and fair in one case (8%). The AOFAS hindfoot score averaged 95.4 (range, 61 to 100) points and the AOFAS hallux score averaged 97.6 (range, 87 to 100) points. No loss of plantarflexion force was observed in the big toe as compared to the contralateral side. Conclusion: The plantar approach to Henry's knot allowed the use of a double stranded FHL transplant. The distal stump was attached to the FDL tendon to preserve flexion at the great toe without damaging to the medial plantar nerve. Level of Evidence: IV, Case Series
Trefoil factor family peptides in human saliva and cyclical cervical mucus. Method evaluation and results on healthy individuals

Abstract Background: Trefoil peptides are 7–12 kDa molecules, se-creted by a variety of mucin-producing epithelial cells from different tissues and believed to be essential for protection and maintenance of gastrointestinal mucosa. Data on concentrations of trefoil peptides in secretions are limited. Methods: We validated in-house ELISA assays, developed for measurement of trefoil peptide concentrations (TFF1, TFF2 and TFF3) in serum, for use with saliva and cervical mucus. Saliva from healthy individuals (n=30), and cervical mucus as well as blood collected three times during the menstrual cycle from healthy women (n=18) were analyzed. Results: Recovery of all trefoil peptides in the initial supernatants of saliva and (cervical mucus) were 86 and (92)% or more. Recovery of exogenously added trefoil peptides was 93 and (95)% or more. Western blotting showed that antibodies used in the TFF3-ELISA assay recognised one molecule of the same size as TFF3 in both saliva and cervical mucus. Median concentrations of TFF1, TFF2 and TFF3 in saliva and (cervical mucus) were 2.7 (2.7), 0.08 (0.58) and 14 (430) nmol/g protein, with a significant decrease in concentrations in cervical mucus after ovulation. Serum concentrations resembled previously measured values in blood donors and showed no cyclic change. Conclusions: Previously established ELISA assays can be employed for measurement of trefoil peptides in saliva and cervical mucus. TFF3 was the predominant trefoil peptide in both saliva and cervical mucus, and TFF3 in cervical mucus represents the highest concentration measured in a biological fluid to date.
Equal Results with Laparoscopic and Shouldice Repairs of Primary Inguinal Hernia in Men. Report from a Prospective Randomised Study

Aim: To compare the laparoscopic and Shouldice techniques for repair of inguinal hernia. Material: 261 healthy men over 50 years with primary, unilateral inguinal hernia were randomly allocated to laparoscopic (total extraperitoneal approach, TEP) treatment (n = 131) or to a modified Shouldice technique (n = 130). Results: Apart from a longer operative time in the laparoscopic group, there were no significant differences between the two methods with regard to perioperative complications, hospital stay, recurrencies or pain in the groin. Conclusions: Results following the total extraperitoneal laparoscopic and the Shouldice technique do not differ significantly 2 years after hernia repair.
Descriptive epidemiology of nonsyndromic omphalocele in Texas, 1999–2004

Omphalocele is a congenital malformation that involves protrusion of abdominal contents into the umbilicus. Though omphalocele may present as a manifestation of several chromosomal and Mendelian syndromes, the etiology for nonsyndromic omphalocele is unknown. The present study sought to estimate the birth prevalence of nonsyndromic omphalocele in offspring of women residing in Texas from 1999 to 2004, and to describe prevalence as a function of parental and infant demographic characteristics. Data on 325 cases with nonsyndromic omphalocele and 2,208,758 live births delivered during 1999–2004 were obtained from the Texas Birth Defects Registry. These data were used to estimate omphalocele birth prevalence and obtain both crude and adjusted prevalence ratios for the association of nonsyndromic omphalocele with parental and infant demographic characteristics. Nonsyndromic omphaloceles were significantly more common among the offspring of women without previous live births (adjusted prevalence ratio: 1.80, 95% CI: 1.41–2.30), compared to the offspring of women with previous live births. The prevalence of nonsyndromic omphalocele was also increased among women aged 25–29 (adjusted prevalence ratio: 1.68, 95% CI: 1.12–2.50) and women aged 40 and older (adjusted prevalence ratio: 4.83, 95% CI: 2.63–8.86) compared to the offspring of women age <20, and in infants of multiple gestation pregnancies compared to singleton infants (adjusted prevalence ratio: 2.03, 95% CI: 1.22–3.37). In addition, among Hispanic women, the prevalence of nonsyndromic omphalocele was higher in the offspring of those born in the U.S. as compared to those born elsewhere (adjusted prevalence ratio: 1.50, 95% CI: 1.12–2.00). These findings augment the existing omphalocele literature. © 2009 Wiley‐Liss, Inc.
Prophylactic Antibiotics Reduce Pancreatic Necrosis in Acute Necrotizing Pancreatitis: A Meta-Analysis of Randomized Trials

Background and Aim: The use of prophylactic antibiotics to prevent infection and reduce mortality in patients with acute necrotizing pancreatitis (ANP) remains controversial. The aim of this study is to perform a systematic review of the data from randomized controlled trials to compare prophylactic antibiotic treatment of patients with ANP versus placebo. Methods: A computerized literature search was conducted using Medline, PubMed, EMBase and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published in English from January 1990 to March 2010. MeSH terms and keywords used to identify articles included ‘antibiotic’, ‘pancreatitis’, and ‘randomized’. Outcome measures were infected pancreatic necrosis (IPN), mortality, nonpancreatic infection (NPN) and need for surgical intervention. Results: Nine trials involving 564 patients were included. Analysis suggested that IPN was significantly reduced by treatment with antibiotics (RR 0.73, 95% CI 0.54–0.98, p = 0.04). Mortality (p = 0.1), NPN (p = 0.07), and need for surgical intervention (p = 0.17) were not significantly reduced by antibiotic treatment. Subsequent subgroup analysis confirmed that antibiotics were statistically superior to controls in reducing of infected necrosis (p = 0.003) and also mortality (p = 0.02) in single-blinded randomized controlled trials. Conclusion: Prophylactic antibiotic treatment reduced occurrence of IPN, but did not affect mortality, NPN, or surgical intervention in patients with ANP.
Severe Sexual Sadism—An Underdiagnosed Disorder? Evidence from a Sample of Forensic Inpatients

Abstract: Severe sexual sadism is a disorder of sexual preference that focuses on humiliation and subjugation of the victim, sometimes causing grievous injury or death. Sexual sadists pose a particular risk. However, the diagnosis as such is unreliable and prevalence estimates vary. In a sample of male high‐security forensic inpatients who had committed sexual offenses, we found two‐thirds of sexual sadists had not been identified as such prior to commitment. Possible reasons for missing the diagnosis are many fold. Present data support the notion that unrecognized sexual sadists more closely resembled non‐sadistic sex offenders than accurately diagnosed sadists. In particular, initially unrecognized sexual sadists had less severe previous convictions, less vocational training, and experienced a less supportive upbringing than their correctly identified sadistic counterparts. The latter, in contrast, more often reached media coverage through their offense(s). We conclude that severe sexual sadism is likely an underdiagnosed, yet forensically highly relevant disorder.
The Effect of Opening Windows on Air Change Rates in Two Homes

Abstract More than 300 air change rate experiments were completed in two occupied residences: a two-story detached house in Redwood City, CA, and a three-story townhouse in Reston, VA. A continuous monitor was used to measure the decay of SF6 tracer gas over periods of 1-18 hr. Each experiment first included a measurement of the air change rate with all exterior doors and windows closed (State 0), then a measurement with the single change from State 0 conditions of opening one or more windows. The overall average State 0 air change rate was 0.37 air changes per hour (hr-1) (SD = 0.10 hr-1; n = 112) for the California house and 0.41 hr-1 (SD = 0.19 hr-1; n = 203) for the Virginia house. Indoor/outdoor temperature differences appeared to be responsible for the variation at the Virginia house of 0.15-0.85 hr-1 when windows were closed. Opening a single window increased the State 0 air change rate by an amount roughly proportional to the width of the opening, reaching increments as high as 0.80 hr-1 in the California house and 1.3 hr-1 in the Virginia house. Multiple window openings increased the air change rate by amounts ranging from 0.10 to 2.8 hr-1 in the California house and from 0.49 to 1.7 hr-1 in the Virginia house. Compared with temperature differences and wind effects, opening windows produced the greatest increase in the air change rates measured in both homes. Results of this study indicate the importance of occupant window-opening behavior on a home’s air change rate and the consequent need to incorporate this factor when estimating human exposure to indoor air pollutants.
Saponins from Vietnamese ginseng, Panax vietnamensis Ha et Grushv. Collected in central Vietnam. I.

From rhizomes and roots of Panax vietnamensis Ha et Grushv. , Araliaceae, commonly known as Vietnamese Ginseng, two new acetylate saponins named vina-ginsenoside-R1 (13) and vina-ginsenoside-R2 (15) were isolated. On the basis of chemical and spectral data, 13 was formulated as monoacetyl 24(S)-pseudo-ginsenoside-F11 and 15 was proved to be monoacetyl majonside-R2. Besides the two new saponins and beta-sitosteryl-3-O-beta-D-glucopyranoside, sixteen known saponins were also isolated and identified. Dammarane saponins:ginsenoside-Rh1 and 20(R)-ginsenoside-Rh1 (1), ginsenosides-Rg1 (2), -Re (3), -Rd (6), -Rb3 (7), -Rb2 (8), -Rb1 (9), pseudo-ginsenoside-RS1 (= monoacetyl ginsenoside-Re, 4), notoginsenosides-R1 (5) and -Fa (10). Ocotillol-type saponins:pseudo-ginsenoside-RT4 (11), 24(S)-pseudo-ginsenoside-F11 (12), majonosides-R1 (16) and -R2 (14). Oleanolic acid saponins:ginsenoside-Ro (= chikusetsusaponin V, 17) and hemsloside-Ma3 (18), a saponin previously isolated from a cucurbitaceous plant, Hemsleya macrosperma C. Y. Wu. Despite having large horizontally elongated rhizomes, the underground part of this plant contains mainly dammarane saponins and a small amount of oleanolic acid saponins. In addition, the yield of ocotillol-type saponins, especially majonoside-R2, is surprisingly very high (more than 5% and ca. half of the total yield of saponin). This characteristic saponin composition has made Vietnamese Ginseng an interesting species among Panax spp.
RON: Reverse Connection with Objectness Prior Networks for Object Detection

We present RON, an efficient and effective framework for generic object detection. Our motivation is to smartly associate the best of the region-based (e.g., Faster R-CNN) and region-free (e.g., SSD) methodologies. Under fully convolutional architecture, RON mainly focuses on two fundamental problems: (a) multi-scale object localization and (b) negative sample mining. To address (a), we design the reverse connection, which enables the network to detect objects on multi-levels of CNNs. To deal with (b), we propose the objectness prior to significantly reduce the searching space of objects. We optimize the reverse connection, objectness prior and object detector jointly by a multi-task loss function, thus RON can directly predict final detection results from all locations of various feature maps. Extensive experiments on the challenging PASCAL VOC 2007, PASCAL VOC 2012 and MS COCO benchmarks demonstrate the competitive performance of RON. Specifically, with VGG-16 and low resolution 384&#xd7;384 input size, the network gets 81.3% mAP on PASCAL VOC 2007, 80.7% mAP on PASCAL VOC 2012 datasets. Its superiority increases when datasets become larger and more difficult, as demonstrated by the results on the MS COCO dataset. With 1.5G GPU memory at test phase, the speed of the network is 15 FPS, 3 times faster than the Faster R-CNN counterpart. Code will be made publicly available.
Evaluating Genetic Risk for Prostate Cancer among Japanese and Latinos

Background: There have been few genome-wide association studies (GWAS) of prostate cancer among diverse populations. To search for novel prostate cancer risk variants, we conducted GWAS of prostate cancer in Japanese and Latinos. In addition, we tested prostate cancer risk variants and developed genetic risk models of prostate cancer for Japanese and Latinos. Methods: Our first-stage GWAS of prostate cancer included Japanese (cases/controls = 1,033/1,042) and Latino (cases/controls = 1,043/1,057) from the Multiethnic Cohort (MEC). Significant associations from stage I (P < 1.0 × 10−4) were examined in silico in GWAS of prostate cancer (stage II) in Japanese (cases/controls = 1,583/3,386) and Europeans (cases/controls = 1,854/1,894). Results: No novel stage I single-nucleotide polymorphism (SNP) outside of known risk regions reached genome-wide significance. For Japanese, in stage I, the most notable putative novel association was seen with 10 SNPs (P ≤ 8.0 × 10−6) at chromosome 2q33; however, this was not replicated in stage II. For Latinos, the most significant association was observed with rs17023900 at the known 3p12 risk locus (stage I: OR = 1.45; P = 7.01 × 10−5 and stage II: OR = 1.58; P = 3.05 × 10−7). The majority of the established risk variants for prostate cancer, 79% and 88%, were positively associated with prostate cancer in Japanese and Latinos (stage I), respectively. The cumulative effects of these variants significantly influence prostate cancer risk (OR per allele = 1.10; P = 2.71 × 10−25 and OR = 1.07; P = 1.02 × 10−16 for Japanese and Latinos, respectively). Conclusion and Impact: Our GWAS of prostate cancer did not identify novel genome-wide significant variants. However, our findings show that established risk variants for prostate cancer significantly contribute to risk among Japanese and Latinos. Cancer Epidemiol Biomarkers Prev; 21(11); 2048–58. ©2012 AACR.
Serum levels of interleukin-6 and dehydroepiandrosterone sulphate in response to either fasting or a ketogenic diet in rheumatoid arthritis patients.

OBJECTIVE To investigate the effects of either a 7-day fast or a 7-day ketogenic diet upon serum interleukin-6 (IL-6) and dehydroepiandrosterone sulphate (DHEAS) in RA patients. METHODS We measured serum concentrations of DHEAS and IL-6 in 23 RA patients with active disease, 10 of whom followed a 7-day sub-total fast and 13 of whom consumed a ketogenic diet (isoenergetic, carbohydrate < 40 g/day) for 7 days. Clinical and laboratory variables were measured at baseline, on day 7 and after re-feeding on day 21. Correlation analyses were used to assess the associations between serum IL-6, DHEAS and disease activity variables at each timepoint. RESULTS Fasting, but not the ketogenic diet, decreased serum IL-6 concentrations by 37% (p < 0.03) and improved disease activity at day 7. Both fasting and the ketogenic diet increased serum DHEAS levels by 34% as compared with baseline (both p < 0.006). Levels of IL-6, but not DHEAS, correlated with several disease activity variables. CONCLUSION Both fasting and a ketogenic diet significantly increased serum DHEAS concentrations in RA patients. Only fasting significantly decreased serum IL-6 levels and improved disease activity. As the increases in serum DHEAS were similar in response to both fasting and a ketogenic diet, it is unlikely that the fall in serum IL-6 or clinical improvements after fasting were directly related to increases in serum DHEAS. The fasting-induced fall in serum IL-6 may underlie the fall in CRP and ESR observed in RA patients in response to a 7-day fast.
A Modification of Apolipoprotein B Accounts for Most of the Induction of Macrophage Growth by Oxidized Low Density Lipoprotein*

It has recently been shown that macrophage proliferation occurs during the progression of atherosclerotic lesions and that oxidized low density lipoprotein (LDL) stimulates macrophage growth. Possible mechanisms for this include the interaction of oxidized LDL with integral plasma membrane proteins coupled to signaling pathways, the release of growth factors and autocrine activation of growth factor receptors, or the potentiation of mitogenic signal transduction by a component of oxidized LDL after internalization. The present study was undertaken to further elucidate the mechanisms involved in the growth-stimulating effect of oxidized LDL in macrophages. Only extensively oxidized LDL caused significant growth stimulation, whereas mildly oxidized LDL, native LDL, and acetyl LDL were ineffective. LDL that had been methylated before oxidation (to block lysine derivatization by oxidation products and thereby prevent the formation of a scavenger receptor ligand) did not promote growth, even though extensive lipid peroxidation had occurred. The growth stimulation could not be attributed to lysophosphatidylcholine (lyso-PC) because incubation of oxidized LDL with fatty acid-free bovine serum albumin resulted in a 97% decrease in lyso-PC content but only a 20% decrease in mitogenic activity. Similarly, treatment of acetyl LDL with phospholipase A2 converted more than 90% of the initial content of phosphatidylcholine (PC) to lyso-PC, but the phospholipase A2-treated acetyl LDL was nearly 10-fold less potent than oxidized LDL at stimulating growth. Platelet-activating factor receptor antagonists partly inhibited growth stimulation by oxidized LDL, but platelet-activating factor itself did not induce growth. Digestion of oxidized LDL with phospholipase A2 resulted in the hydrolysis of PC and oxidized PC but did not attenuate growth induction. Native LDL, treated with autoxidized arachidonic acid under conditions that caused extensive modification of lysine residues by lipid peroxidation products but did not result in oxidation of LDL lipids, was equal to oxidized LDL in potency at stimulating macrophage growth. Albumin modified by arachidonic acid peroxidation products also stimulated growth, demonstrating that LDL lipids are not essential for this effect. These findings suggest that oxidatively modified apolipoprotein B is the main growth-stimulating component of oxidized LDL, but that oxidized phospholipids may play a secondary role.
Improved Pain Control in Terminally Ill Cancer Patients by Introducing Low-Dose Oral Methadone in Addition to Ongoing Opioid Treatment.

BACKGROUND Cancer pain is often not well controlled and there is a need for improved treatment strategies. Methadone exhibits unique properties among opioids and recent reports show promising results from adding a low dose of methadone to regular opioid therapy. OBJECTIVE To examine the effects of oral low-dose methadone added to regular scheduled opioids in terminally ill patients with complex cancer-related pain. DESIGN This was a retrospective chart review. SETTING/SUBJECTS All patients with advanced cancer treated in a specialized palliative care unit who had received oral methadone in addition to another regular opioid were identified. MEASUREMENTS Intensity of pain, opioid doses, and occurrence of sedation, delirium, and respiratory depression were obtained from the patients' medical records for a period of one week after initiation of methadone. RESULTS Eighty patients were included. The median daily methadone dose was 10 mg during the treatment period. Eighty percent of the patients had improved pain control (p < 0.001). There was an increased risk for sedation and delirium, most pronounced in patients living 14 days or less after the start of methadone. No patient experienced respiratory depression. CONCLUSION Addition of low-dose oral methadone to regular high-dose opioid treatment in cancer patients with complex pain close to death improves pain control, but also increases the risk for sedation and delirium.
Metabolic monitoring for youths initiating use of second-generation antipsychotics, 2003-2011.

OBJECTIVE In 2004, the American Diabetes Association (ADA) released treatment guidelines recommending metabolic screening for children and adolescents before and after initiation of second-generation antipsychotics. Prior studies showed that the guidelines coincided with a small increase in glucose testing of children and adults but had limited follow-up. This study sought to evaluate changes in metabolic screening of children initiating second-generation antipsychotics around the time of the 2004 guidelines and in the following eight years. METHODS Study patients (N=52,407) were identified in a large nationwide commercial insurance claims database for the period January 1, 2003, through December 31, 2011. The study population was a cohort of nondiabetic new users of second-generation antipsychotics who were ages 5-18. Glucose and HbA1c tests completed before and after second-generation antipsychotic initiation were identified with Current Procedural Terminology-4 codes. Metabolic screening was also examined by second-generation antipsychotic agent prescribed and psychiatric diagnosis. RESULTS The proportion of patients receiving a glucose test preinitiation increased from 17.9% in 2003 to 18.9% in 2004, and testing postinitiation increased from 14.7% to 16.6% in the same period. The slight increase in glucose testing was not sustained; the proportion tested dropped in the following years before rising again in 2008. Glucose screening was most common for patients taking aripiprazole. Patients with a diagnosis of hyperkinetic disorder were less likely to be tested. HbA1c testing was less frequent but had a similar usage pattern. CONCLUSIONS The small improvement in metabolic screening immediately after the 2004 ADA guidelines were issued was not sustained. Overall, metabolic screening rates remained suboptimal throughout the study period.
Accurate reinnervation of motor end plates after disruption of sheath cells and muscle fibers

After injury, regenerating motor axons grow back to form neuromuscular junctions at the original synaptic sites on muscle fibers. The pathways they grow along consist of basement membrane, Schwann cells, and perineurium that remained after degeneration of the original axons. All the factors necessary for directing axons to the original synaptic sites persist in muscles even after disruption of myofibers. The aim of the present experiments was to determine whether structural integrity of nerve sheath cells is required for precise reinnervation in the presence and absence of muscle fiber targets.