Miracle-dz/UniFAR-FTUs huggingface dataset:
Transfacetal Fusion for Low-grade Degenerative Spondylolisthesis of the Lumbar Spine: Results of a Prospective Single Center Study

Study Design Prospective, nonrandomised, single center. Objective To study the clinico-radiologic and functional outcome after transfacetal screw fixation and fusion for low-grade degenerative spondylolisthesis of the lumbar spine. Summary of Background Data Surgery for degenerative spondylolisthesis conventionally involves instrumented fusion using 3 column pedicle screw fixation systems. Recently transfacetal fusion techniques have been reported to produce good results without the surgical morbidity associated with posterolateral fusion and the neurologic complications associated with pedicle screw fixation. Methods 30 patients with low-grade degenerative spondylolisthesis of the lumbar and lumbosacral spine underwent transfacetal fusion using 2 cortical screws and local cancellous bone grafts. Results Clinical and radiologic evidence of fusion was obtained in 29 patients. One patient developed pseudoarthrosis with progression of slip and was reoperated. Quadruple visual analog scores and Oswestry disability assessment showed a significant improvement at 1-year follow-up. Conclusions Degenerative spondylolisthesis with lower grade slips and normal anterior structures represent an ideal indication for transfacetal fusion. This is a simple and useful technique for short segment fusions of the lumbar spine.
Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. FRISC Study Group. Fragmin during Instability in Coronary Artery Disease.

BACKGROUND In patients with unstable coronary artery disease, there is a relation between the short-term risk of death and blood levels of troponin T (a marker of myocardial damage) and C-reactive protein and fibrinogen (markers of inflammation). Using information obtained during an extension of the follow-up period in the Fragmin during Instability in Coronary Artery Disease trial, we evaluated the usefulness of troponin T, C-reactive protein, and fibrinogen levels and other indicators of risk as predictors of the long-term risk of death from cardiac causes. METHODS Levels of C-reactive protein and fibrinogen at enrollment and the maximal level of troponin T during the first 24 hours after enrollment were analyzed in 917 patients included in a clinical trial of low-molecular-weight heparin in unstable coronary artery disease. The patients were followed for a mean of 37.0 months (range, 1.6 to 50.6). RESULTS During follow-up, 1.2 percent of the 173 patients with maximal blood troponin T levels of less than 0.06 microg per liter died of cardiac causes, as compared with 8.7 percent of the 367 patients with levels of 0.06 to 0.59 microg per liter and 15.4 percent of the 377 patients with levels of at least 0.60 microg per liter (P=0.007 and P=0.001, respectively). The rates of death from cardiac causes were 5.7 percent among the 314 patients with blood C-reactive protein levels of less than 2 mg per liter, 7.8 percent among the 294 with levels of 2 to 10 mg per liter, and 16.5 percent among the 309 with levels of more than 10 mg per liter (P=0.29 and P=0.001, respectively). The rates of death from cardiac causes were 5.4 percent among the 314 patients with blood fibrinogen levels of less than 3.4 g per liter, 12.0 percent among the 300 with levels of 3.4 to 3.9 g per liter, and 12.9 percent among the 303 with levels of at least 4.0 g per liter (P=0.004 and P=0.69, respectively). In a multivariate analysis, levels of troponin T and C-reactive protein were independent predictors of the risk of death from cardiac causes. CONCLUSIONS In unstable coronary artery disease, elevated levels of troponin T and C-reactive protein are strongly related to the long-term risk of death from cardiac causes. These markers are independent risk factors, and their effects are additive with respect to each other and other clinical indicators of risk.
Institutional ownership and simultaneity of strategic financial decisions: an empirical analysis in the case of Pakistan stock exchange

The traditional interpretation of corporate finance is characterized by ownership. Although, their rights are widely distributed among individual stockholders, but can be managed by few managers. Hence, conflict of interest is arisen among managers and shareholders and this results in an agency problem (Fama, 1980; Fama & Jensen, 1983). A number of empirical studies also confirmed the ownership concentration of firms, especially those dominated by few large owners or block-holders (La Porta et al., 1999). The concentrated structure of ownership also contributes towards agency conflict between block-holders and minority shareholders. From another perspective, the block-holders can benefit minority shareholders by their role in monitoring managers and also can be hazardous if they strive to achieve their own private goals (Shleifer & Vishny, 1997).
An assessment of the Down syndrome antenatal screening policies of East and West Gloucestershire between 1993 and 1999

This retrospective observational study of registered pregnancies in Gloucestershire between 1 April 1993 and 31 March 1999 compares the impact of different Down syndrome antenatal screening policies on detection and amniocentesis rates. The screening policies in East and West Gloucestershire are based on early second-trimester maternal serum and maternal age screening, respectively. Maternal serum screening can identify a greater proportion of pregnancies affected by Down syndrome than a programme founded on age-based amniocentesis and 20 weeks' ultrasound. In addition, maternal serum screening of women older than 34 approximately halves the number of amniocenteses performed to detect one affected fetus. However, the proportion of pregnant women who have amniocentesis is nearly doubled by offering serum screening to women aged over 24 years. These findings of the impact of established second-trimester screening policies in low-risk populations provides an useful benchmark to compare the performance of screening procedures that will be introduced in the United Kingdom over the next 3 years.
“You must first save her life”: community perceptions towards induced abortion and post-abortion care in North and South Kivu, Democratic Republic of the Congo

ABSTRACT Structural barriers such as a restrictive legal environment, limited medical resources, and high-costs inhibit access to safe abortion in the Democratic Republic of the Congo (DRC); these barriers are exacerbated by two decades of conflict. Socio-normative barriers further complicate access to safe abortion and post-abortion care (PAC) in DRC, where fear of abortion-related stigma may lead women to avoid PAC services. Programme partners support the Ministry of Health to provide good quality contraceptive and PAC services in North and South Kivu, DRC. This paper presents results from focus group discussions that explored community members’ attitudes towards women who induce abortion and their care-seeking behaviour in programme areas. Results indicate that while abortion stigma was widespread, community members’ attitudes towards women who induced abortions were not one-dimensional. Although they initially expressed negative opinions regarding women who induced abortion, beliefs became more nuanced as discussion shifted to the specific situations that could motivate a woman to do so. For example, many considered it understandable that a woman would induce abortion after rape: perhaps unsurprising, given the prevalence of conflict-related sexual violence in this area. While community members believed that fear of stigma or associated negative social consequences dissuaded women from seeking PAC, a majority believed that all women should have access to life-saving PAC. This commitment to ensuring that women who induced abortion have access to PAC, in addition to the professed acceptability of induced abortion in certain situations, indicates that there could be an opening to destigmatise abortion access in this context.
RelB/p50 Complexes Regulate Cytokine-Induced YKL-40 Expression

The secreted protein, YKL-40, has been proposed as a biomarker of a variety of human diseases characterized by ongoing inflammation, including chronic neurologic pathologies such as multiple sclerosis and Alzheimer’s disease. However, inflammatory mediators and the molecular mechanism responsible for enhanced expression of YKL-40 remained elusive. Using several mouse models of inflammation, we now show that YKL-40 expression correlated with increased expression of both IL-1 and IL-6. Furthermore, IL-1 together with IL-6 or the IL-6 family cytokine, oncostatin M, synergistically upregulated YKL-40 expression in both primary human and mouse astrocytes in vitro. The robust cytokine-driven expression of YKL-40 in astrocytes required both STAT3 and NF-κB binding elements of the YKL-40 promoter. In addition, YKL-40 expression was enhanced by constitutively active STAT3 and inhibited by dominant-negative IκBα. Surprisingly, cytokine-driven expression of YKL-40 in astrocytes was independent of the p65 subunit of NF-κB and instead required subunits RelB and p50. Mechanistically, we show that IL-1–induced RelB/p50 complex formation was further promoted by oncostatin M and that these complexes directly bound to the YKL-40 promoter. Moreover, we found that expression of RelB was strongly upregulated during inflammation in vivo and by IL-1 in astrocytes in vitro. We propose that IL-1 and the IL-6 family of cytokines regulate YKL-40 expression during sterile inflammation via both STAT3 and RelB/p50 complexes. These results suggest that IL-1 may regulate the expression of specific anti-inflammatory genes in nonlymphoid tissues via the canonical activation of the RelB/p50 complexes.
The third person in the room: frequency, role, and influence of companions during primary care medical encounters.

OBJECTIVE We wanted to characterize patient accompaniment to medical encounters and to explore the rationale and influence of the companion on the primary care medical encounter. STUDY DESIGN This was a descriptive study. POPULATION Academic general internal medicine physicians, patients, and patient companions participated. OUTCOMES MEASURED We measured the frequency of waiting and examination room companions, the reasons for accompaniment, the influence on the encounter, and the overall helpfulness of the companion as assessed by patients and companions. We also determined the physicianamprsquos assessment of the companionamprsquos influence, helpfulness, and behavior during the encounter. RESULTS Companions were in the examination room for 16% of visits; 93% were family members. The rationales for waiting and examination room companions were to help with transportation, provide emotional support, and provide company. Examination room companions helped communicate concerns to the physician, remember the physicianamprsquos advice, make decisions, and communicate their own concerns to the physician. Patients believed that examination room companions influenced 75% of medical encounters, mainly by improving communication between physician and patient. Physicians agreed that examination room companions favorably influenced physician and patient understanding (60% and 46% of encounters, respectively). Patients indicated that waiting and examination room companions were very helpful for 71% and 83% of visits, respectively. CONCLUSIONS Companions frequently accompany patients to their primary care medical encounters. They are often family members, and they assume important roles in enhancing patient and physician understanding.
Elastography Complements Ultrasound as Principle Modality in Breast Lesion Assessment

Background: The study aimed to improve breast cancer diagnosis with new ultrasound (US) modalities. We examined whether real-time elastography (RTE) complements the diagnostic performance of US. Methods: The Ethical Committee approved the study. Patients provided written informed consent and received a whole breast workup. Breast lesions were evaluated by US and RTE. Lesions were assessed by BI-RADS, Tsukuba score (TS) and strain ratio (SR). Results: The study included 164 breast lesions of which 101 were benign and 63 malignant. Women with benign lesions were predominantly premenopausal with sonographic dense breast tissue. Women with breast cancer were mostly postmenopausal, with a low sonographic density. Benign lesions had a mean TS of 2.05, which was significantly lower than the mean TS of 3.25 for malignant lesions. The SR for benign lesions (SR 1.83) was significantly smaller than for breast cancer (SR 4.83). Sensitivity and specificity was 95 and 81% for BI-RADS, 39 and 94% for TS, and 57 and 83% for SR, with a cutoff at 2.5. The combination of BI-RADS, TS and SR yielded a sensitivity of 95% and a specificity of 85%. Conclusion: Besides morphologic features revealed by US, elastic properties of breast lesions obtained by RTE can be exploited for diagnostic breast imaging.
Islamic Expansion in the Ideology of Pancasila and State Sovereignty

Islam is a religion that is adopted by the majority of Indonesian people and is believed to be a guide to life in order to obtain salvation in the world and in life after death. It makes a significant contribution to the initial process of negotiations to formulate the nation's philosophy of life, namely Pancasila. As a life guideline, the Pancasila nation and state are the main reference to conceptualize the sovereignty meaning which is then derived into International Law owned by Indonesia. This article uses the approach of discourse analysis in the implementation of Islamic values in the ideology of Pancasila. Islam's most important contribution to Pancasila is the 'monotheism' element which is the essence of Islamic teachings. Therefore, the dichotomy of Islam and Pancasila, or Islam and Negara Kesatuan Republik Indonesia (NKRI) becomes no longer relevant.
Pediatric multiple sclerosis

Multiple sclerosis (MS) in children manifests with a relapsing-remitting MS (RRMS) disease course. Acute relapses consist of new neurologic deficits persisting greater than 24 hours, in the absence of intercurrent illness, and occur with a higher frequency early in the disease as compared to adult-onset RRMS. Most pediatric patients with MS recover well from these early relapses, and cumulative physical disability is rare in the first 10 years of disease. Brainstem attacks, poor recovery from a single attack, and a higher frequency of attacks portend a greater likelihood of future disability. Although prospective pediatric-onset MS cohorts have been established in recent years, there remains very limited prospective data detailing the longer-term clinical outcome of pediatric-onset MS into adulthood. Whether the advent of MS therapies, and the largely off-label access to such therapies in pediatric MS, has improved prognosis is unknown. MS onset during the key formative academic years, concurrent with active cognitive maturation, is an important determinant of long-term outcome, and is discussed in detail in another article in this supplement. Finally, increasing recognition of pediatric MS worldwide, recent launch of phase III trials for new agents in the pediatric MS population, and the clear imperative to more fully appreciate health-related quality of life in pediatric MS through adulthood highlight the need for standardized, validated, and robust outcome measures.
Current trends in newly registered blindness in Denmark.

Current pattern of blindness (i.e. visual acuity < or = 6/60) in Denmark was studied based on 1585 application forms for new membership to the Danish Society of the Blind during 1993. Statistics on blindness are very sensitive to the definitions used. A change of blindness definition to visual acuity < 6/60 reduced the number of formally blind subjects with 32%, and by using the definition of WHO (visual acuity < 3/60) only 562 subjects (35%) would have been considered blind. The prevailing causes of blindness were age-related macular degeneration with 1132 cases (71.4%), followed by diabetic retinopathy 133 cases (8.4%), and glaucoma 80 cases (5.0%). Among the younger subjects (133 persons) aged 20-59 years diabetic retinopathy comprised 36% and lesions of the optic pathways 26%, while myopia and retinitis pigmentosa accounted for 5% each. The majority of the applicants (92%) were > or = 60 years old. In this group, age-related macular degeneration was the main cause of blindness in 78%. Figures from 1993 were compared with six similar studies on newly registered blindness from the last 35 years. The annual number of registrations was doubled during the last 25 years. The annual number of registered blind due to diabetic retinopathy fell during the 60's and 70's followed by a constant rate during the last decades. Glaucoma blindness fell with a factor two, and declined from a relative frequency of 15% among the causes of blindness to 5%. The impact of age related macular degeneration increased from 20% to 70% during the same period.
Circulating endocannabinoid concentrations and sexual arousal in women.

INTRODUCTION Several lines of evidence point to the potential role of the endocannabinoid system in female sexual functioning. These include results from studies describing the subjective effects of exogenous cannabinoids on sexual functioning in humans and the observable effects of exogenous cannabinoids on sexual functioning in other species, as well as results from studies investigating the location of cannabinoid receptors in the brain and periphery, and the effects of cannabinoid receptor activation on neurotransmitters implicated in sexual functioning. While these lines of research suggest a role for the endocannabinoid system in female sexual functioning, no studies investigating the relationship between concentrations of endogenous cannabinoids (i.e., arachidonoylethanolamide [AEA] and 2-arachidonoylglycerol [2-AG]) and sexual functioning have been conducted in any species. AIM To measure circulating endocannabinoid concentrations in relation to subjective and physiological indices of sexual arousal in women (N = 21). METHODS Serum endocannabinoid (AEA and 2-AG) concentrations were measured immediately prior to, and immediately following, viewing of neutral (control) and erotic (experimental) film stimuli in a repeated measures design. Physiological sexual arousal was measured via vaginal photoplethysmography. Subjective sexual arousal was measured both continuously and noncontinuously. Pearson's correlations were used to investigate the relationships between endocannabinoid concentrations and sexual arousal. MAIN OUTCOME MEASURES Changes in AEA and 2-AG concentrations from pre- to post-film and in relation to physiological and subjective indices of sexual arousal. RESULTS Results revealed a significant relationship between endocannabinoid concentrations and female sexual arousal, whereby increases in both physiological and subjective indices of sexual arousal were significantly associated with decreases in AEA, and increases in subjective indices of sexual arousal were significantly associated with decreases in 2-AG. CONCLUSIONS These findings support the hypothesis that the endocannabinoid system is involved in female sexual functioning, with implications for furthering understanding of the biological mechanisms underlying female sexual functioning.
Transcriptional repression and developmental functions of the atypical vertebrate GATA protein TRPS1

Known vertebrate GATA proteins contain two zinc fingers and are required in development, whereas invertebrates express a class of essential proteins containing one GATA‐type zinc finger. We isolated the gene encoding TRPS1, a vertebrate protein with a single GATA‐type zinc finger. TRPS1 is highly conserved between Xenopus and mammals, and the human gene is implicated in dominantly inherited tricho‐rhino‐phalangeal (TRP) syndromes. TRPS1 is a nuclear protein that binds GATA sequences but fails to transactivate a GATA‐dependent reporter. Instead, TRPS1 potently and specifically represses transcriptional activation mediated by other GATA factors. Repression does not occur from competition for DNA binding and depends on a C‐terminal region related to repressive domains found in Ikaros proteins. During mouse development, TRPS1 expression is prominent in sites showing pathology in TRP syndromes, which are thought to result from TRPS1 haploinsufficiency. We show instead that truncating mutations identified in patients encode dominant inhibitors of wild‐type TRPS1 function, suggesting an alternative mechanism for the disease. TRPS1 is the first example of a GATA protein with intrinsic transcriptional repression activity and possibly a negative regulator of GATA‐dependent processes in vertebrate development.
The Endogenous African Business: Why and How It Is Different, Why It Is Emerging Now and Why It Matters

ABSTRACT Africa is currently undergoing a transition that is unprecedented in its history. For the first time, the demand of urban populations pulls business development, thus creating economies with higher levels of specialization than before. This essay highlights the phenomenon of the endogenous African businesses that are arising in this process. These businesses tap into the natural resources and the social, economic, and cultural systems that build upon them. These resources and systems make the African business environment different from business environments in other parts of the world. Furthermore, the endogenous businesses have access to knowledge on how to manage modern businesses in the formal sector of the economy. In combination with African resources and systems, such knowledge enables them to create and sustain and competitive advantage in modern dynamic marketplaces. Endogenous African businesses are important because they have the potential to fuel economic growth, to revitalize rural areas, to contribute to food security and healthy diets, and to provide role models of which Africans can be proud. Hence, these businesses deserve our attention in the next two decades of scholarly research and education on African business.
The Chemokine Macrophage-Inflammatory Protein-1α and Its Receptor CCR1 Control Pulmonary Inflammation and Antiviral Host Defense in Paramyxovirus Infection

In this work, we explore the responses of specific gene-deleted mice to infection with the paramyxovirus pneumonia virus of mice (PVM). We have shown previously that infection of wild type mice with PVM results in pulmonary neutrophilia and eosinophilia accompanied by local production of macrophage-inflammatory protein-1α (MIP-1α). Here we examine the role of MIP-1α in the pathogenesis of this disease using mice deficient in MIP-1α or its receptor, CCR1. The inflammatory response to PVM in MIP-1α-deficient mice was minimal, with ∼10–60 neutrophils/ml and no eosinophils detected in bronchoalveolar lavage fluid. Higher levels of infectious virus were recovered from lung tissue excised from MIP-1α-deficient than from fully competent mice, suggesting that the inflammatory response limits the rate of virus replication in vivo. PVM infection of CCR1-deficient mice was also associated with attenuated inflammation, with enhanced recovery of infectious virus, and with accelerated mortality. These results suggest that the MIP-1α/CCR1-mediated acute inflammatory response protects mice by delaying the lethal sequelae of infection.