Miracle-dz/UniFAR-FTUs huggingface dataset:
Reconstruction of forearm deformities in multiple cartilaginous exostoses

The management of complex forearm deformities in patients with multiple cartilaginous exostoses is controversial. The objective of this study is to look into the outcome of treatment with the combined use of ulna lengthening, radial osteotomy, and excision of exostosis in our six patients, who all had Masada type 1 deformity of the forearm. Clinical assessment was performed using the pre- and postoperative range of motion of the wrist, forearm and elbow. The chief symptom each patient had was noted as well as the demographic data of all patients. Radiological assessment was performed by checking the degree of negative ulna variance, the radial articular angle, and the degree of carpal slip. The degree of satisfaction of the patients and their parents were noted. Good clinical and radiological results were obtained at a mean follow-up of 2.5 years. All patients and parents were satisfied and there was no recurrence of deformity in the latest follow-up. The authors believe in early and aggressive treatment of Masada type 1 deformity of the wrist and forearm for multiple cartilaginous exostoses with a combination of excision of exostosis, ulna lengthening and radial osteotomy.
Gliomas: classification with MR imaging.

The findings at magnetic resonance (MR) imaging in a group of 36 pathologically verified supratentorial gliomas were analyzed and compared with the biopsy diagnoses (a) to determine whether MR imaging could be used to classify astrocytic-series tumors into a three-tiered system of low-grade astrocytoma, anaplastic astrocytoma, and glioblastoma multiforme; and (b) to evaluate MR imaging features that may aid in this classification. The MR characteristics evaluated were crossing of the midline, edema, tumor signal heterogeneity, hemorrhage, border definition, cyst formation or necrosis, and mass effect. The statistically significant MR characteristics (positive predictors) were mass effect (P = .0000) and cyst formation or necrosis (P = .0512). The MR accuracy rate approached that of neuropathologic diagnosis, which is subject to sampling errors. MR imaging may serve as an adjunct in case management when the clinical course and MR findings appear to be at odds with the neuropathologic diagnosis.
Gill bacteria enable a novel digestive strategy in a wood-feeding mollusk

Significance In animals, gut microbes are essential for digestion. Here, we show that bacteria outside the gut can also play a critical role in digestion. In shipworms, wood-eating marine bivalves, endosymbiotic bacteria are found within specialized cells in the gills. We show that these endosymbionts produce wood-degrading enzymes that are selectively transported to the shipworm’s bacteria-free gut, where wood digestion occurs. Because only selected wood-degrading enzymes are transported, the shipworm system naturally identifies those endosymbiont enzymes most relevant to lignocellulose deconstruction without interference from other microbial proteins. Thus, this work expands the known biological repertoire of bacterial endosymbionts to include digestion of food and identifies previously undescribed enzymes and enzyme combinations of potential value to biomass-based industries, such as cellulosic biofuel production. Bacteria play many important roles in animal digestive systems, including the provision of enzymes critical to digestion. Typically, complex communities of bacteria reside in the gut lumen in direct contact with the ingested materials they help to digest. Here, we demonstrate a previously undescribed digestive strategy in the wood-eating marine bivalve Bankia setacea, wherein digestive bacteria are housed in a location remote from the gut. These bivalves, commonly known as shipworms, lack a resident microbiota in the gut compartment where wood is digested but harbor endosymbiotic bacteria within specialized cells in their gills. We show that this comparatively simple bacterial community produces wood-degrading enzymes that are selectively translocated from gill to gut. These enzymes, which include just a small subset of the predicted wood-degrading enzymes encoded in the endosymbiont genomes, accumulate in the gut to the near exclusion of other endosymbiont-made proteins. This strategy of remote enzyme production provides the shipworm with a mechanism to capture liberated sugars from wood without competition from an endogenous gut microbiota. Because only those proteins required for wood digestion are translocated to the gut, this newly described system reveals which of many possible enzymes and enzyme combinations are minimally required for wood degradation. Thus, although it has historically had negative impacts on human welfare, the shipworm digestive process now has the potential to have a positive impact on industries that convert wood and other plant biomass to renewable fuels, fine chemicals, food, feeds, textiles, and paper products.
The safety of treatments for prolactinomas

ABSTRACT Introduction: Prolactinomas are the most common hormone-secreting pituitary tumors, accounting for approximately 40% of all pituitary tumors. Infertility, gonadal and sexual dysfunction are usually the most relevant clinical features in both sexes. Area covered: This review focuses on safety and tolerability of therapeutic approaches for prolactinomas. Complications from trans-sphenoidal surgery vary depending on tumor size, and mortality rate ranges 0.6%-31% for patients with microprolactinomas and macroprolactinoms, respectively. More than 50% of patients receiving pituitary radiotherapy will develop at least one hormone deficiency within the following decade, whereas cerebrovascular accidents, second brain tumors and optic neuropathy rarely occur. Nowadays, treatment of prolactinomas is based on dopamine-agonists (DA), mainly cabergoline (CAB). Whether CAB is associated with an increased risk of clinically relevant cardiac valvulopathy in patients with prolactinomas as in those with Parkinson’s disease (PD), is still debated. In most studies, CAB has been found not to be associated with an increased risk of significant valvulopathy in prolactinomas, and no correlation has been shown between valvular abnormalities and CAB duration or cumulative dose. Expert opinion: DA are safe and well tolerated, and the main safety concerns are related to the potential risk of clinically relevant valvulopathy following treatment with CAB, rarely occurring in patients with prolactinomas.
Looking Upstream: Optimal Policies for a Class of Capacitated Multi‐Stage Inventory Systems

We consider a multi‐stage inventory system with stochastic demand and processing capacity constraints at each stage, for both finite‐horizon and infinite‐horizon, discounted‐cost settings. For a class of such systems characterized by having the smallest capacity at the most downstream stage and system utilization above a certain threshold, we identify the structure of the optimal policy, which represents a novel variation of the order‐up‐to policy. We find the explicit functional form of the optimal order‐up‐to levels, and show that they depend (only) on upstream echelon inventories. We establish that, above the threshold utilization, this optimal policy achieves the decomposition of the multidimensional objective cost function for the system into a sum of single‐dimensional convex functions. This decomposition eliminates the curse of dimensionality and allows us to numerically solve the problem. We provide a fast algorithm to determine a (tight) upper bound on this threshold utilization for capacity‐constrained inventory problems with an arbitrary number of stages. We make use of this algorithm to quantify upper bounds on the threshold utilization for three‐, four‐, and five‐stage capacitated systems over a range of model parameters, and discuss insights that emerge.
Improving access to research literature in developing countries : challenges and opportunities provided by Open Access

The Open Access movement has grown from pockets of regional initiatives to an increasingly coordinated world wide movement, facilitated by common technical standards and open source software. While debates on open access have focused on the so-called “serial crisis” and copyright issues, relatively little attention has been paid to the myriads of benefits OA provide, particularly to researchers in the developing countries. In this paper, we highlight important developments and experimentations in knowledge sharing enabled by different modes of open access, and point to collaborative and sustainable models that will be highly beneficial to research institutions in the developing world in the long term. The recommendations in this
Ethical Leadership and Communication

This analysis of leadership and communication research argues that effective leadership is manifested through the ethical communication a leader practices with group members. This paper approaches leadership as an interactional process and corroborates this view with supporting research and theory from the fields of business and communication. Ethical communication is used as a framework for how groups can communicate more effectively. A review of extant literature concluded that effective leadership does not exist with the leader's hands alone, but is created through communication and interaction within the group. Findings indicated that the more effective and productive managers approach their positions as interactive, supporting roles within the group. Communicative styles and behaviors of ethical and unethical leaders were determined. Personality factors were found to predispose leaders to engage in ethical or unethical behavior. Situational factors found to foster unethical behavior were leadership style, superior-subordinate relationship, supervisor immediacy, the threat of getting caught, and moral character. Implications for groups and organizations are discussed Ethical Leadership 3
Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up

Objective: To describe the clinical changes following two different physiotherapy treatment protocols after rotator cuff repair. Design: A prospective, randomized pilot study with a two-year follow-up. Subjects: Five women and nine men, 55 (40—64) years old, were included. Intervention: The progressive group (n = 7) started with dynamic, specific muscle activation of the rotator cuff the day after surgery as well as passive range of motion. After four weeks of immobilization the loading to the rotator cuff increased and in a progressive manner throughout the rehabilitation. In the traditional group (n = 7) the rotator cuff was protected from loading. Patients were immobilized for six weeks and started with passive range of motion the day after surgery. No specific exercises to the rotator cuff were introduced during this period. Main measures: A clinical evaluation was made preoperatively, 3, 6, 12 and 24 months after surgery. Pain rating during activity and at rest, patient satisfaction, active range of motion and muscle strength, Constant score, hand in neck, hand in back and pour out of a pot, as well as Functional Index of the Shoulder were used. Results: At two years follow-up, the progressive group and traditional group scored pain during activity visual analogue scale (VAS) 2/0 mm and pain at rest 0/0 mm, respectively. The groups attained 170/175° in active abduction in standing and 70/90° in passive external rotation while lying in supine. Using Constant score, the groups attained 82/77 points respectively. Conclusion: The present study showed that the progressive protocol produced no adverse effects compared with the traditional protocol.
Foot infections in diabetic patients. Decision and cost-effectiveness analyses.

OBJECTIVE To examine the cost-effectiveness of approaches to the diagnosis and treatment of patients with type II (non-insulin-dependent) diabetes mellitus (NIDDM) who have foot infections and suspected osteomyelitis. DESIGN Decision and cost-effectiveness analyses were performed using a Markov model. We examined the prevalence of osteomyelitis, the major complications and efficacies of long-term antibiotic therapy and surgery, and the performance characteristics of four diagnostic tests (roentgenography, technetium Tc 99m bone scanning, indium in 111-labeled white blood cell scanning, and magnetic resonance imaging). Data were drawn from the English-language literature using MEDLINE searches and bibliographies from selected articles. SETTING Primary care. PATIENTS Patients with NIDDM who had foot infections and suspected osteomyelitis but no signs of systemic toxicity. INTERVENTIONS Following hospitalization for surgical débridement and intravenous antibiotic therapy: (1) treatment for presumed soft-tissue infection, (2) culture-guided empiric treatment for presumed osteomyelitis, (3) 71 combinations of diagnostic tests preceding antibiotic therapy for osteomyelitis, (4) 71 combinations of tests preceding amputation, and (5) immediate amputation. MAIN OUTCOME MEASURES Quality-adjusted life expectancy, average costs. RESULTS Culture-guided empiric treatment for osteomyelitis with 10 weeks of oral antibiotic therapy has similar effectiveness to testing followed by a long course of antibiotic therapy if any test result is positive. However, empiric treatment is the least expensive strategy. CONCLUSIONS Noninvasive testing adds significant expense to the treatment of patients with NIDDM in whom pedal osteomyelitis is suspected, and such testing may result in little improvement in health outcomes. In patients without systemic toxicity, a 10-week course of culture-guided oral antibiotic therapy following surgical débridement may be as effective as and less costly than other approaches.
Sorafenib and hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombus.

BACKGROUND Patients with advanced hepatocellular carcinoma (aHCC) and portal vein tumor thrombus (PVTT) still have a very poor prognosis, even though the oral multikinase inhibitor sorafenib has revolutionized treatment of aHCC in patients with liver cirrhosis (LC). Standardization of multimodal therapy for aHCC with PVTT has not yet been achieved. AIM This retrospective study was performed to clarify the usefulness of combined treatment with sorafenib and hepatic arterial infusion chemotherapy (HAIC) for patients with LC, aHCC and PVTT. PATIENTS AND METHODS Twenty adult Japanese patients with LC underwent HAIC (HAIC group) between 2002 and 2009, while 18 patients received HAIC after treatment with sorafenib between 2009 and 2014 (SF-HAIC group). RESULTS Among patients with Child-Pugh class A disease, the median survival time of the SF-HAIC group (315 days) was significantly longer than that of the HAIC group (197 days), while there was no significant difference between the two groups (234 and 228 days) among patients with Child-Pugh class B disease. HAIC led to a partial response (PR) in 16.7% of patients with class A disease and 21.4% of patients with class B disease. With SF-HAIC, PR was obtained in 63.8% and 42.9% of patients respectively, although the PR rate was only 9.1% and 0.0%, respectively, after treatment with sorafenib alone for four weeks. CONCLUSION When multimodal therapy is employed for patients with LC in Child-Pugh class A disease with aHCC and PVTT, performing HAIC after four weeks of sorafenib treatment might improve both the tumor response and patient survival.
Quality of life and clinical predictors of rehospitalization of persons with severe mental illness.

OBJECTIVE The study examined whether rehospitalization of patients with severe and persistent mental illness could be predicted by patients' quality of life. The predictive ability of two clinical factors associated with rehospitalization--history of hospitalizations and severity of symptoms--was also examined. METHODS A total of 559 patients were assessed at two follow-up points, two and 12 months after an index hospital discharge. Patients who were rehospitalized and those who were not rehospitalized between the two follow-up points were compared on subjective and objective quality of life, symptom severity at first follow-up, and previous rehospitalization. Multivariate analysis was used to determine the best predictors of rehospitalization. RESULTS Compared with patients who were not rehospitalized, those who were rehospitalized had more severe symptoms and were more likely to have a history of hospitalization. Rehospitalized patients reported more dissatisfaction with family relations and were more likely to report an arrest in the past two months. The two groups did not differ in other quality-of-life domains and in global quality of life. CONCLUSIONS The best predictors of rehospitalization were previous rehospitalization, more severe symptoms, and dissatisfaction with family relations. Interventions should promote positive relationships between patients with severe mental illness and their families to reduce the risk of relapse and rehospitalization.
Time course of bronchoconstriction induced by dry gas hyperpnea in guinea pigs.

We examined the effects of hyperpnea duration and abrupt changes in inspired gas heat and water content on the magnitude and time course of hyperpnea-induced bronchoconstriction (HIB) in anesthetized mechanically ventilated male Hartley guinea pigs. In 12 animals subjected to 5, 10, and 15 min (random order) of dry gas isocapnic hyperpnea [tidal volume (VT) 4-6 ml, 150 breaths/min) followed by quiet breathing of humidified air (VT 2-3 ml, 60 breaths/min), severe bronchoconstriction developed only after the cessation of hyperpnea; the magnitude of respiratory system resistance (Rrs) increased with the duration of dry gas hyperpnea [peak Rrs 1.0 +/- 0.2, 1.8 +/- 0.3, and 2.3 +/- 0.3 (SE) cmH2O.ml-1.s, respectively]. Seven other guinea pigs received, in random order, 10 min of warm humidified gas hyperpnea, 10 min of room temperature dry gas hyperpnea, and 5 min of dry gas hyperpnea immediately followed by 5 min of warm humidified gas hyperpnea. After each hyperpnea period, the animal was returned to quiet breathing of humidified gas. Rrs rose appreciably after the 10 min of dry and 5 min of dry-5 min of humidified hyperpnea challenges (peak Rrs 1.3 +/- 0.2 and 0.7 +/- 0.2 cmH2O.ml-1.s, respectively) but not after 10 min of humidified hyperpnea (0.2 +/- 0.04 cmH2O.ml-1.s). An additional five animals received 10 min of room temperature dry gas hyperpnea followed by quiet breathing of warm humidified air and 10 min of room temperature dry gas hyperpnea followed by 30 min of warm humidified gas hyperpnea in random order. (ABSTRACT TRUNCATED AT 250 WORDS)
Malaria Transmission and Naturally Acquired Immunity to PfEMP-1

ABSTRACT Why there are so few gametocytes (the transmission stage of malaria) in the blood of humans infected with Plasmodiumspp. is intriguing. This may be due either to reproductive restraint by the parasite or to unidentified gametocyte-specific immune-mediated clearance mechanisms. We propose another mechanism, a cross-stage immunity to Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP-1). This molecule is expressed on the surface of the erythrocyte infected with either trophozoite or early gametocyte parasites. Immunoglobulin G antibodies to PfEMP-1, expressed on both life cycle stages, were measured in residents from an area where malaria is endemic, Papua New Guinea. Anti-PfEMP-1 prevalence increased with age, mirroring the decline in both the prevalence and the density of asexual and transmission stages in erythrocytes. These data led us to propose that immunity to PfEMP-1 may influence malaria transmission by regulation of the production of gametocytes. This regulation may be achieved in two ways: (i) by controlling asexual proliferation and density and (ii) by affecting gametocyte maturation.
The effect of monetary policy on interest rates in Kenya

There is general agreement among economists and policymakers that monetary policy works mainly through interest rates. When the central bank policy is tightened through a decrease in reserve provision, for instance, interest rates rise. Interest rates reflect the interaction between the supply o f savings and the demand for capital; or between the demand for and the supply of money. This study set to establish the effect of monetary policy on interest rates. In doing this, the study set to answer the question: how does the monetary policy relate to interest rates in Kenya? The study adopted a quantitative comparative design. The target population for this study included 44 banking institutions (43 commercial banks and 1 mortgage finance company MFC), transacting business in Kenya as at December 2011. Because consolidated data on the variables of the study was available at the Central bank of Kenya, the study conducted a census by including all the members o f the population. The study used secondary data from the Central bank of Kenya. Data was obtained from the CBK covering the period between 31st January 2001 and 31st December 2011. The study focused on three major monetary policy instruments including: Central bank rate, 91-Day Treasury bill rate, and REPO rate. The researcher conducted a multiple regression analysis in order to determine the effect of monetary policy on interest rates in the Kenya. The study concluded that lending rates in Kenya were affected by various factors key among them being the 91 Day Treasury bill Rate which had the highest impact among the three variables studied in this study. The repo rate determines the rate at which the financial institutions can borrow from one another to meet their short term shortfalls and came in second in affecting the lending rates in Kenya. The Central Bank Monetary policy Committee uses the central bank rate to check on the Macroeconomic changes in the economy. It uses it to check the inflation among other variables in the economy hence affecting the lending rates.
Entrepreneurial sport policy

ABSTRACT For most sport policy planners, the integration of entrepreneurial initiatives that are practical and relevant to the community is an important way of staying competitive, innovative and forward thinking. Policy regarding sport tries to balance ways to improve financial and social results but facilitate the interest of non-profits and community stakeholders. In addition, with the introduction of more sport policies aimed at increasing tax and other related revenues, there has been an emphasis on innovative policy strategies that go beyond the current status quo and present unique ideas. The aim of this article in this special section is to discuss how the concept of entrepreneurial sport policy can make a contribution to the disciplines of sport management, public policy, entrepreneurship and innovation. This is due to studies of the sport policy process from an entrepreneurial perspective having the prospect of making an interdisciplinary contribution to the literature. As very few studies link the disparate sport and entrepreneurship literature, this article will present a theoretical framework to help understand the importance of taking an entrepreneurial sport policy perspective. Suggestions for policy planners and future research are stated.