Miracle-dz/UniFAR-FTUs huggingface dataset:
[Design of the reduction fixator and its clinical application in treating fracture of lesser trochanter of femur].

OBJECTIVE To discuss the clinical significance of the reduction and fixation for femoral lesser trochanteric fragment in treating the femoral comminuted intertrochanteric fractures. METHODS From January 2012 to December 2013,32 patients with intertrochanteric fractures were treated by surgery, and self-designed reduction fixators were used in the patients for the fixation of lesser trochanter of femur. There were 11 males and 21 females, ranging in age from 45 to 81 years old with an average of 64 years old. According to the Evans typing, 12 cases were type II, 13 cases were type III and 7 cases were type IV. Simple lag screw fixed in 19 cases and steel wire fixed in 13 cases. Hip joint function was evaluated according Harris score and the complications such as coxa adducta,cutting of femoral head and neck,implants breakage were observed. RESULTS Thirty-two patients were followed up from 9 to 24 months with an average of 13 months. Coxa adducta occurred in 1 case,no cutting of femoral head and neck occurred and implants breakage were found. The mean Harris score was 91.80 ± 3.05 in 32 patients. CONCLUSION The reconstruction and fixation for the posterior medial bone cortex continuity is a key factor on affect the stability of femoral intertrochanteric fracture. Self-designed reduction fixators can effective reduce and fix the lesser trochanter of femur, it has advantage of fast reduction and fixation, and simple operation.
Home‐made carbonated water and the consumption of water and other beverages in German children and adolescents: results of the DONALD study

Aim: To determine differences in intake of water, drinking water and beverages between consumers (C) and non‐consumers (NC) of carbonated water prepared at home. Methods: Matched pairs design; 3‐d‐weighed diet records; participants of the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) aged 2–18 y (n= 550, mean: 8.2 y). Results: The most important beverage was either carbonated (C: females 265, males 299 g/d) or bottled water (NC: males 267, females 282 g/d) followed by juice (120–174 g/d), soft drinks (134–167 g/d) and milk (84–149 g/d). Water intake from beverages was higher in males (NC: 902 and C: 906 g/d) than in females (NC: 789 and C: 771 g/d). However, total water intake per energy was higher in females (NC: 0.88 and C: 0.91g/kcal) than in males (NC: 0.80 and C: 0.83 g/kcal). C had a significantly higher mean drinking water intake (tap + bottled + carbonated water) in percentage of total water intake (%TW) than NC, and lower mean intakes of milk, bottled water and tap water, respectively. There was a significantly lower mean fat intake in C (females: 32 and males: 33% of energy) versus NC (females: 34 and males: 36% of energy). Irrespective of carbonated water consumption, females had better drinking habits than males, with significantly higher mean intakes of water from food (%TW), water from beverages + food (%TW), and total water per energy.
Colonization history and clonal richness of asexual Daphnia in periglacial habitats of contrasting age in West Greenland.

Due to climate change, Arctic ice sheets are retreating. This leads to the formation of numerous new periglacial ponds and lakes, which are being colonized by planktonic organisms such as the water flea Daphnia. This system provides unique opportunities to test genotype colonization dynamics and the genetic assemblage of populations. Here, we studied clonal richness of the Daphnia pulex species complex in novel periglacial habitats created by glacial retreat in the Jakobshavn Isbrae area of western Greenland. Along a 10 km transect, we surveyed 73 periglacial habitats out of which 61 were colonized by Daphnia pulex. Hence, for our analysis, we used 21 ponds and 40 lakes in two clusters of habitats differing in age (estimated <50 years vs. >150 years). We tested the expectation that genetic diversity would be low in recently formed (i.e. young), small habitats, but would increase with increasing age and size. We identified a total of 42 genetically distinct clones belonging to two obligately asexual species of the D. pulex species complex: D. middendorffiana and the much more abundant D. pulicaria. While regional clonal richness was high, most clones were rare: 16 clones were restricted to a single habitat and the five most widespread clones accounted for 68% of all individuals sampled. On average, 3·2 clones (range: 1-12) coexisted in a given pond or lake. There was no relationship between clonal richness and habitat size when we controlled for habitat age. Whereas clonal richness was statistically higher in the cluster of older habitats when compared with the cluster of younger ponds and lakes, most young habitats were colonized by multiple genotypes. Our data suggest that newly formed (periglacial) ponds and lakes are colonized within decades by multiple genotypes via multiple colonization events, even in the smallest of our study systems (4 m(2) ).
Ca2+‐Regulating mechanisms that modulate bull sperm capacitation and acrosomal exocytosis as determined by chlortetracycline analysis

We have used chlortetracycline (CTC) analysis to investigate mechanisms that may play important roles during bull sperm capacitation in a culture medium (containing glucose, heparin, and caffeine) known to promote capacitation and fertilization in vitro. In initial experiments employing the Ca2+ ionophore A23187, we identified three discrete CTC patterns so similar to those described for mouse and human sperm that we have employed the same nomenclature: “F,” characteristic of uncapacitated, acrosome‐intact cells; “B,” characteristic of capacitated, acrosome‐intact, cells; “AR,” characteristic of capacitated, acrosome‐reacted cells. Over a 60‐min period, A23187 stimulated significant increases in B and AR pattern cells, with concomitant decreases in F pattern cells, suggesting a very rapid transition from the uncapacitated to the capacitated state and then on to exocytosis. Without ionophore, significant changes in the proportions of F and B pattern cells were also observed, but the maximum responses required 4 hr; the proportion of AR cells was consistently ∼ 15% throughout, indicating a low incidence of spontaneous acrosome loss. Analysis of cells in media with altered composition indicated that the inclusion of either heparin or caffeine significantly promoted capacitation to about the same extent, but together, heparin plus caffeine had an even more stimulatory effect. Despite this, none of these treatments triggered acrosome loss above the levels seen in media lacking these constituents. In the presence of caffeine, with or without heparin, the inclusion of glucose had little effect on responses, but in the presence of heparin there were fewer B cells. In the presence of either quercetin, a Ca‐ATPase inhibitor used at 50–200 μM, or W‐7, a calmodulin antagonist used at 5–125 μM, capacitation per se was accelerated, as evidenced by significant decreases in F and significant increases in B pattern cells; only the highest concentration of each caused significant increases in AR cells. In addition, 25 and 125 μM W‐7 markedly stimulated motility, both quantitatively and qualitatively. Finally the Na+ ionophore monensin at 500 μM significantly accelerated both capacitation and acrosomal exocytosis. The addition of the dihydropyridine calcium channel blocker nifedipine at 10 nM, just prior to monensin, did not inhibit capacitation (F to B transition) but blocked acrosomal exocytosis (B to AR transition). We suggest that Ca2+ is required for functional changes in bull sperm, with a Ca2+‐ATPase modulating intracellular Ca2+ during capacitation and calcium channels controlling the Ca2+ influx required for acrosomal exocytosis. © 1995 Wiley‐Liss, Inc.
Allergic-Type Reactions to Corticosteroids

OBJECTIVE: To review reported cases of suspected allergic reactions to various corticosteroids. DATA SOURCES: A MEDLINE search (January 1966–December 1997) was performed to obtain case reports and review articles on allergic-type reactions to corticosteroids. Further references were obtained from these publications. STUDY SELECTION: Reports involving allergic or allergic-type reactions to systemic administration of corticosteroids were chosen for this review. An allergic-type reaction was defined as any reaction after administration of the drug that involved the appearance of adverse symptoms that are characteristic of unwanted immune responses. These symptoms include rash, sneezing, dyspnea, edema, bronchospasm, or death. Articles were excluded from the evaluation if they described reactions to topical, intraarticular, or ophthalmic corticosteroid administration. DATA SYNTHESIS: Corticosteroids are medications that are often used to treat allergic reactions. However, it appears that patients can also have allergic-type reactions to these agents. The severity of the reaction can vary from a rash to anaphylaxis or death. Both immediate and delayed reactions can occur. Allergic-type reactions are reported to occur more frequently in asthmatic and renal transplant patients than other patient populations. However, it is questionable whether all of these are true allergic responses, as there is conflicting evidence regarding the mechanism of the reaction. The most commonly implicated corticosteroids are methylprednisolone and hydrocortisone, but reactions have also occurred with others. Intradermal skin testing can help determine cross-sensitivity, although its value has not been conclusively demonstrated. CONCLUSIONS: Clinicians should be aware that allergic reactions to corticosteroids are possible. Worsening of symptoms may not always mean treatment failure, but may indicate an allergic reaction. High doses of corticosteroids (≥500 mg) should be given over 30–60 minutes, and patients should be observed after administration for at least the same time period. Asthmatics, renal transplant patients, and hemodynamically unstable patients may be at higher risk for adverse events. If a patient is found to be allergic to one corticosteroid, intradermal skin testing may help identify another corticosteroid that can be tolerated.
Antiviral T‐cell therapy

Serious viral infections are a common cause of morbidity and mortality after allogeneic stem cell transplantation. They occur in the majority of allograft recipients and are fatal in 17–20%. These severe infections may be prolonged or recurrent and add substantially to the cost, both human and financial, of the procedure. Many features of allogeneic stem cell transplantation contribute to this high rate of viral disease. The cytotoxic and immunosuppressive drugs administered pretransplant to eliminate the host hematopoietic/immune system and any associated malignancy, the delay in recapitulating immune ontogeny post‐transplant, the immunosuppressive drugs given to prevent graft versus host disease (GvHD), and the effects of GvHD itself, all serve to make stem cell transplant recipients vulnerable to disease from endogenous (latent) and exogenous (community) viruses, and to be incapable of controlling them as quickly and effectively as most normal individuals.
NADPH Oxidase NOX1 Controls Autocrine Growth of Liver Tumor Cells through Up-regulation of the Epidermal Growth Factor Receptor Pathway*

FaO rat hepatoma cells proliferate in the absence of serum through a mechanism that requires activation of the epidermal growth factor receptor (EGFR) pathway. The aim of this work was to analyze the molecular mechanisms that control EGFR activation in these and other liver tumor cells. Reactive oxygen species production is observed a short time after serum withdrawal in FaO cells, coincident with up-regulation of the NADPH oxidase NOX1. NOX1-targeted knockdown, the use of antioxidants, or pharmacological inhibition of NADPH oxidase attenuates autocrine growth, coincident with lower mRNA levels of EGFR and its ligand transforming growth factor-α (TGF-α) and a decrease in phosphorylation of EGFR. EGFR-targeted knockdown induces similar effects on cell growth and downstream signals to those observed in NOX1-depleted cells. Early NOX1 activation induces both a feedback-positive loop via an Src-ERK pathway that up-regulates its own levels, and a parallel signaling pathway through p38 MAPK and AKT resulting in EGFR and TGF-α up-regulation. Human hepatocellular carcinoma cell lines, but not non-tumoral hepatocytes, show autocrine growth upon serum withdrawal, which is also coincident with NOX1 up-regulation that mediates EGFR and TGF-α expression. The use of antioxidants, or pharmacological inhibition of NADPH oxidase, effectively attenuates autocrine growth in hepatocellular carcinoma cell lines. In summary, results presented in this study indicate that NOX1 might control autocrine cell growth of liver tumor cells through regulation of the EGFR pathway.
Strain Localization of Elastic-Damaging Frictional-Cohesive Materials: Analytical Results and Numerical Verification

Damage-induced strain softening is of vital importance for the modeling of localized failure in frictional-cohesive materials. This paper addresses strain localization of damaging solids and the resulting consistent frictional-cohesive crack models. As a supplement to the framework recently established for stress-based continuum material models in rate form (Wu and Cervera 2015, 2016), several classical strain-based damage models, expressed usually in total and secant format, are considered. Upon strain localization of such damaging solids, Maxwell’s kinematics of a strong (or regularized) discontinuity has to be reproduced by the inelastic damage strains, which are defined by a bounded characteristic tensor and an unbounded scalar related to the damage variable. This kinematic constraint yields a set of nonlinear equations from which the discontinuity orientation and damage-type localized cohesive relations can be derived. It is found that for the “Simó and Ju 1987” isotropic damage model, the localization angles and the resulting cohesive model heavily depend on lateral deformations usually ignored in classical crack models for quasi-brittle solids. To remedy this inconsistency, a modified damage model is proposed. Its strain localization analysis naturally results in a consistent frictional-cohesive crack model of damage type, which can be regularized as a classical smeared crack model. The analytical results are numerically verified by the recently-proposed mixed stabilized finite element method, regarding a singly-perforated plate under uniaxial tension. Remarkably, for all of the damage models discussed in this work, the numerically-obtained localization angles agree almost exactly with the closed-form results. This agreement, on the one hand, consolidates the strain localization analysis based on Maxwell’s kinematics and, on the other hand, illustrates versatility of the mixed stabilized finite element method.
Rebounds after discharge from the emergency department for community-acquired pneumonia: focus on the usefulness of severity scoring systems

Background: Community-acquired pneumonia (CAP) is common cause of hospital admission and leading cause of morbidity and mortality. Severity scoring systems are used to predict risk profile, outcome and mortality, and to help decisions about management strategies. Aim of the work and Methods: To critically analyze pneumonia “rebound” cases, once discharged from the emergency department (ED) and afterwards admitted. We conducted an observational clinical study in the acute setting of a university teaching hospital, prospectively analyzing, in a 1 year period, demographic, medical, clinical and laboratory data, and the outcome. Results: 249 patients were discharged home with diagnosis of CAP; 80 cases (32.1%) resulted in the high-intermediate risk class according to CURB-65 or CRB-65. Twelve patients (4.8%) presented to the ED twice and were then admitted. At their first visit 5 were in the high-intermediate risk group; just 4 of them were in the non-low risk group at the time of their admission. The rebound cohort showed some peculiar abnormalities in laboratory parameters (coagulation and renal function) and severe chest X-rays characteristics. None died in 30 days. Conclusions: The power of CURB-65 to correctly predict mortality for CAP patients discharged home from the ED is not confirmed by our results; careful clinical judgement seems to be irreplaceable in the management process. Many patients with a high-intermediate risk according to CURB-65 can be safely treated as outpatients, according to adequate welfare conditions; we identified a subgroup of cases that should worth a special attention and, therefore, a brief observation period in the ED before the final decision to safely discharge or admit. (www.actabiomedica.it)
The Effects of Contextual and Structural Factors on Patient Safety in Nursing Units

Background: Because of limited research on patient safety from a macrolevel perspective, our understanding of how to reduce the risk of system failures that impact patient safety outcomes in Taiwanese healthcare organizations is limited. Purpose: We conducted this study to explore the relationships between macrolevel factors and patient safety outcomes. Methods: Structural contingency theory was used as the framework for the study. A cross-sectional design was used, and data were collected from self-administered questionnaires. Head nurses and registered nurses working in 64 in-patient nursing units at three hospitals participated in the study. A tailored design method was used for data collation, and the data collection lasted 3 weeks during the winter of 2010. Data were aggregated from the individual to the unit level, and path analysis was used to examine the hypothesized model. Results: Sixty-two head nurses (96.8%) and 977 staff nurses (72%) completed and returned the questionnaire. Eta-squared coefficient (&eegr;2), interitem consistency (rwg), and F ratio results showed that data at the individual level are appropriate for aggregating to the unit level. These findings show that nursing units with high degrees of professional autonomy, comparatively higher proportions of nursing experts, and relatively large unit sizes tend to have higher rates of medication errors. In addition, we found high degrees of unit technology associated with higher rates of medication errors and patient falls. Conclusions/Implications for Practice: These findings suggest a link between macrolevel factors and patient safety outcomes. This study shows that redesigning continuing education programs encourages nurses to participate in patient safety training and understand the nursing unit characteristics that enhance patient safety outcomes to improve the patient safety of nursing units.
Health status by gastrointestinal diagnosis and abuse history.

BACKGROUND & AIMS Standardized assessment of health status by diagnosis (functional vs. organic) and the relative influence of abuse history on health status have not been studied previously. The aim of this study was to estimate the health status and abuse history for gastrointestinal diagnoses among patients seen in a tertiary-care gastroenterology clinic and to evaluate the relative predictive effects of diagnosis and abuse history on health status. METHODS Standardized measures of sexual and physical abuse history and six health status measures were estimated for the patients by diagnosis. Analysis of covariance was performed to determine the relative contributions of diagnosis type and abuse history on the health status measures. RESULTS Patients with functional gastrointestinal diagnoses had poorer health status and a higher frequency of severe types of abuse than patients with structural diagnoses. Independent of abuse history, functional diagnosis was significantly associated with greater pain severity and psychological distress and poorer daily function. Independent of diagnosis, abuse history significantly contributed to greater pain severity, more days in bed, more psychological distress, and poorer daily function. CONCLUSIONS The type of diagnosis and abuse history independently contributed to the health status of this population. Therefore, medical symptoms alone may not be sufficient to understand patients' health status. Attention must also be paid to contributing psychosocial factors.
Social Networks and Health: Models, Methods, and Applications

Relationships and the pattern of relationships have a large and varied influence on both individual and group action. The fundamental distinction of social network analysis research is that relationships are of paramount importance in explaining behavior. Because of this, social network analysis offers many exciting tools and techniques for research and practice in a wide variety of medical and public health situations including organizational improvements, understanding risk behaviors, coordinating coalitions, and the delivery of health care services. This book provides an introduction to the major theories, methods, models, and findings of social network analysis research and application. In three sections, it presents a comprehensive overview of the topic; first in a survey of its historical and theoretical foundations, then in practical descriptions of the variety of methods currently in use, and finally in a discussion of its specific applications for behavior change in a public health context. Throughout, the text has been kept clear, concise, and comprehensible, with short mathematical formulas for some key indicators or concepts. Researchers and students alike will find it an invaluable resource for understanding and implementing social network analysis in their own practice.
Variability in, and factors associated with, sizing of polyps by endoscopists at a large community practice

Abstract Background and aims Accurate sizing of polyps at time of colonoscopy is critical for determining surveillance intervals. Endoscopists routinely over- or underestimate the size of polyps at colonoscopy. We evaluated the variability in sizing of polyps among multiple endoscopists, and the effect of patient and physician related factors on polyp size estimation in a large community-based practice. Methods Adult patients who underwent a colonoscopy with polypectomy at five endoscopy centers in Minneapolis/St. Paul by one of 52 endoscopists in 2013 were included in this study. Association of patient, physician, and procedure related factors on polyp sizing was assessed. Results In the study time frame, 38 624 colonoscopies were performed at five ambulatory endoscopy centers. Of these, 16 336 had one or more polyp removed with size information available, and were included in this analysis. There was significant inter-physician variation for estimating polyp sizes larger than 5 mm (intraclass correlation coefficient [ICC] 0.13). Older patient age (OR 1.08, 95 %CI 1.06 – 1.11), and male physician gender (OR 1.92, 95 %CI 1.26 – 2.94) were associated with increased odds of physicians sizing polyps as larger in size. Surveillance procedures had a higher odds of larger polyp sizing compared to screening (OR 0.91, 95 %CI 0.86 – 0.97) and diagnostic procedures (OR 0.86, 95 %CI 0.78 – 0.94). Conclusion In a large community setting, variation of polyp sizing estimates exists between physicians. Male physicians were more likely to size polyps as larger in size. Older patients and patients undergoing surveillance procedures were more likely to have polyps that were sized as larger in size.
Disentangling relative from absolute amplitude in Fitts' law experiments

Target distance (D) and target width (W), traditionally treated as independent variables in Fitts' target acquisition paradigm, are shown to suffer inextricable confounds with task difficulty. Through a simple geometrical analogy, it is shown that relative movement amplitude D/W(which determines difficulty) and absolute movement amplitude D (or scale) are the only two variables that can be manipulated independently in a Fitts' task experiment. Disentangling relative amplitude from absolute amplitude with an appropriate experimental design should help to study target acquisition in graphical user interfaces.