Miracle-dz/UniFAR-FTUs huggingface dataset:
SUPRACONDYLAR FRACTURE; COMPARISON OF OUTCOMES OF OPEN VERSUS CLOSED PERCUTANEOUS K-WARE FIXATION IN DISPLACED SUPRACONDYLAR FRACTURE

… Objectives: is to compare the outcomes of open versus closed Percutaneous K wire fixation in displaced supracondy fracture of humerus in children. Period: May 2016 to May 2017. Setting: Orthopedic unit of Nishtar Hospital Multan. Methodology: Total number of 170 (100%) patients of displaced supracondylar fracture of humerus was enrolled. Patients were divided into two equal groups by lottry method (85 patients in each group). SPSS version 23 was used to analyze the data, mean and standard deviation was calculated for numerical variables like age and flayn et al score, and frequencies with percentages were calculated for categorical variables like gender and outcome variable satisfactory/unsatisfactory. Chi square test was applied to see the effect of effect modifiers on outcome variable. P value of ≤0.05 was considered as significant. Results: Total of 170 (100%) divided in two equal groups A and B, 85 patients in each group. Out of 170 patients 97 (57.1%) were male and 73 (42.9%) were female. Out of these in group A 75 (88.1%) patients have satisfactory outcome and 10 (11.7%) patients have unsatisfactory outcome. Similarly in group B, 71 (83.5%) were having satisfactory and 14 (16.47%) have unsatisfactory outcome and P= 0.37. Conclusion: Results of our study concluded that open reduction with K wire fixation technique have better satisfactory outcome (union rate) as compared to closed reduction and K wire fixation in the management of supracondaylar fracture of humerus in young age group. Open reduction.
Emergency obstetric hysterectomy: a retrospective study from a teaching hospital over eight years

Background: EOH is define as removal of uterus (total or subtotal) at the time of caesarean section or following vaginal delivery within puerperium. Objective of present study was to determine the frequency, demographic characteristics, indications, and maternal outcomes associated with emergency obstetric hysterectomy. Methods: It was a retrospective, observational, and analytical study conducted over a period of eight years, from January 2009 to December 2016. A total of 64 cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynecology, SRG Hospital and Jhalawar Medical College Jhalawar (Rajasthan). Results: The incidence of EOH in our study was 0.4 per 1000 following vaginal delivery and 3.5 per 1000 following cesarean section. The overall incidence was 1.03 per 1000 deliveries. Rupture uterus 30 (46.8%) was the most common indication followed by postpartum hemorrhage 23 (35.9%) and morbidly adherent placenta 11 (17.1%). Subtotal abdominal hysterectomy was performed in most of the cases. Maternal mortality was 6.2%. Conclusions: This study concluded the great role of EOH as a life-saving procedure in those cases where medical management has failed.
The use of a forensic blood substitute for impact pattern area of origin estimation via three trajectory analysis programs

ABSTRACT This study explores the use of forensic synthetic blood substitute (FBS) for impact pattern simulation and area of origin estimation. Ten impact patterns were created at a known origin using the FBS and were analyzed by groups of undergraduate students participating in a basic bloodstain pattern analysis course. The students selected 20 upward-moving stains from their given patterns to estimate an area of origin. Three linear trajectory models – BackTrack™, Hemospat, and Sherlock – were used to estimate each pattern's area of origin. Coordinate data from each model's analysis were compared with the known origin and between programs at the x-, y-, z-coordinates, and overall. Results from this analysis yielded estimates comparable to the known. A one-way ANOVA found no significant difference between programs at the x- (p = 0.79), y- (p = 0.84), z- (p = 0.96) coordinates, and overall (p = 0.81). These results support the practical use of the FBS as an alternative to whole blood for impact pattern simulations and area of origin estimation.
Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial

We have studied the characteristics of bone ingrowth of a new porous tantalum biomaterial in a simple transcortical canine model using cylindrical implants 5 x 10 mm in size. The material was 75% to 80% porous by volume and had a repeating arrangement of slender interconnecting struts which formed a regular array of dodecahedron-shaped pores. We performed histological studies on two types of material, one with a smaller pore size averaging 430 microm at 4, 16 and 52 weeks and the other with a larger pore size averaging 650 microm at 2, 3, 4, 16 and 52 weeks. Mechanical push-out tests at 4 and 16 weeks were used to assess the shear strength of the bone-implant interface on implants of the smaller pore size. The extent of filling of the pores of the tantalum material with new bone increased from 13% at two weeks to between 42% and 53% at four weeks. By 16 and 52 weeks the average extent of bone ingrowth ranged from 63% to 80%. The tissue response to the small and large pore sizes was similar, with regions of contact between bone and implant increasing with time and with evidence of Haversian remodelling within the pores at later periods. Mechanical tests at four weeks indicated a minimum shear fixation strength of 18.5 MPa, substantially higher than has been obtained with other porous materials with less volumetric porosity. This porous tantalum biomaterial has desirable characteristics for bone ingrowth; further studies are warranted to ascertain its potential for clinical reconstructive orthopaedics.
An Analysis of Hydroacoustic Transmission Loss Associated with Marine Pile Driving

There has been a growing concern in recent years about the effects of anthropogenic noise due to marine pile driving on underwater wildlife. Current guidelines for mitigating hydroacoustic effects associated with these events are based upon relatively simple transmission loss formulations. The advantage to these guidelines is that computing transmission loss using their prescribed methods is not labor intensive, but their disadvantage is that they may not take all variables into account. Because of this, it may be possible to improve transmission loss computations. To better-characterize marine pile driving sound transmission loss, a unique inwater instrumentation system was developed. This system consists of several hydrophoneequipped buoys that transmit sound data to a field team in real time via a wireless network. The sound data are also recorded onboard the buoys along with geospatial data and water temperature data at depth. Testing was conducted using this buoy system at various water-based pile driving sites throughout Florida and sound data were used to compute transmission loss as a function of distance from the sound sources to utilize data from these sites to improve the knowledge base associated with generating mitigation guidelines. This research found that the coefficients used to calculate the simplified transmission loss model were consistently above those recommended by the current set of guidelines. Future areas of improvement and additional testing are recommended to address the growing concern of anthropogenic noise on underwater wildlife species and the effects of underestimating the actual transmission losses.
The independent patient factors that affect length of stay following hip fractures

INTRODUCTION Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. METHODS A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. RESULTS American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. CONCLUSIONS Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.
Histopathological Spectrum of Benign Breast Lesions

Breast lesions have gained global attention as breast cancer has become one of the leading causes of death among women. The importance of benign lesions lie in their ability to mimic cancers and not all benign lesions are completely free of risks. The present study was undertaken with an aim to determine the incidence and the histopathological spectrum of various benign breast lesions at our institute. A retrospective study was done in the department of pathology over a period of three years from Jan 2014 to Dec 2016. Relevant clinical details of the cases were obtained from the requisition forms. All breast samples were processed by standard procedure and formalin fixed paraffin embedded tissue sections were studied and analyzed. Total 177 cases of breast lesions were studied and analyzed. Of the total 177 cases, 160(85%) cases were benign lesions. Fibroadenoma (65.7%) was the commonest lesion followed by fibrocystic disease (10%) and benign Phylloides tumour(5.6%). Majority of the benign breast lesions were in the age group of 21-30 years(45.5%). breast lesions are a heterogeneous group of disorder ranging from inflammatory to invasive cancers. Distinguishing these heterogeneous forms by histopathological examination is crucial for prognostic prediction.
To What Extent Are Multiword Sequences Associated With Oral Fluency?

This study examines the relationship between oral fluency and use of multiword sequences (MWSs) across four proficiency levels (Low B1 to C1 of the Common European Framework of Reference; Council of Europe, 2001). Data from 56 learners taking the TEEP speaking test were analyzed for different measures of fluency (speed, breakdown, repair) and MWSs (frequency, proportion, association). Results showed that (a) high frequency n-grams correlated positively with articulation rate, (b) n-gram proportion correlated negatively with frequency of mid-clause pauses, and (c) n-gram association strength correlated positively with frequency of end-clause pauses and negatively with repair frequency. The qualitative analysis suggested that the test-takers borrowed some task-specific n-grams from the task instructions and used them frequently in their performance. While lower proficiency speakers used these n-grams verbatim, C1 level speakers used them competently in a variety of forms. Significant implications of the findings for phraseology and language testing research are discussed.
Finite element limit analysis of the seismic bearing capacity of strip footing adjacent to excavation in c-φ soil

ABSTRACT In this study, several effective parameters and geometrical features were considered to present the design charts and the reduction coefficients tables to obtain the bearing capacity of a strip footing placed near a c-ϕ excavation under static and seismic conditions by using Finite Element Limit Analysis (FELA). The effects of setback distance to footing width ratio (L/B), cohesion (c), soil friction angle (ϕ), pseudo-static horizontal earthquake coefficient (kh ), and the height of the excavation to the footing width ratio (H/B) on the bearing capacity and failure mechanism were studied. Also, a design procedure and example of its application were presented to obtain the static and seismic bearing capacities of the strip footing placed near the c-ϕ excavation based on the design charts and the reduction coefficients tables.
Reduction characteristics of disinfection by-product (DBPs) generated by allogenic organic matter (AOM) using micro-hollow beads in terms of particulate removal

Allogenic organic matter (AOM) removal technologies using micro-hollow beads have been developed. Micro-hollow beads with low density (0.125 g/cm3) were found to be effective for the flotation in terms of particulate matter removal. To investigate the characteristics of AOM, extracellular organic matter (EOM), and intracellular organic matter (IOM) before and after chlorine injection, the effect of molecular weight distribution on liquid chromatography with organic carbon detection was examined. The chromatography dissolved organic carbon values of EOM and IOM were 7.5 and 1.6 mg/L, respectively, and the compositions of building blocks and humic substances of EOM and IOM were 58% and 20%, respectively. A particle counter was used to confirm the reduction in the number of residual particles by micro-hollow beads. The concentration of particulate matter decreased with a higher concentration of micro-hollow bead injection due to the attachment and flotation of micro-hollow beads to particulate matter. By removing precursors of the disinfection by-products (DBPs), micro-hollow beads were able to reduce the concentration of DBPs and DBPFP. Haloacetic acids (HAAs) were converted to particulate material through a chlorination process rather than through trihalomethanes (THM) and are efficiently removed by the microhollow beads. Compared with THMs/total organic carbon (TOC), HAAs/TOC showed better removal characteristics. THMFP concentrations remained constant over time, whereas HAAFP and HANFP values increased with retention time. Over 7 d of reaction, THMFP and HANFP showed no change in constituents, but HANFP was detected as TCAN, DCAN, and DBAN.
Cervical Spondylotic Myelopathy: Pathophysiology and Surgical Approaches

This paper reviews the pathophysiology of cervical spondylotic myelopathy (CSM) and several surgical approaches for the treatment of CSM. CSM is a degenerative disease with severe morbidity. The pathophysiology of CSM involves static, dynamic, and ischemic factors. The management of mild CSM typically involves conservative treatments and medication; whereas, moderate and severe CSM are better treated surgically. Surgical treatments for CSM are basically classified into anterior and posterior surgeries. The common techniques are anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), laminectomy, and laminoplasty. Each technique has its own advantages and disadvantages. In this paper, we review the research papers from PubMed database to elaborate the advantages and disadvantages of each technique.
Gondwana breakup: Messages from the North Natal Valley

The Natal Valley, offshore Mozambique, is a key area for understanding the evolution of East Gondwana. Within the scope of the integrated multidisciplinary PAMELA project, we present new wide‐angle seismic data and interpretations, which considerably alter Geoscience paradigms. These data reveal the presence of a 30‐km‐thick crust that we argue to be of continental nature. This falsifies all the most recent palaeo‐reconstructions of the Gondwana. This 30‐km‐thick continental crust 1,000 m below sea level implies a complex history with probable intrusions of mantle‐derived melts in the lower crust, connected to several occurrences of magmatism, which seems to evidence the crucial role of the lower continental crust in passive margin genesis.
Management of traumatic and non traumatic hollow visceral perforation in North India

Background: Hollow visceral perforation is the commonest perforation among all the hollow viscera in the body. The perforation can be traumatic or non-traumatic and it constitute commonest surgical emergency worldwide. The diagnosis of perforation can be made clinically but for confirmation basic radiological investigations and sometimes special investigation are required. Methods: This is a prospective observational study conducted in our institute in the Department of General Surgery. The patients who are included in this study were more than 15 years of age in both sexes having hollow visceral perforation presenting in accident and emergency department. Results: Out of 624 patients, 530 (84.93%) were males while only 94 (15.06%) were females, with a male: female ratio of 5.63:1. The site of perforation are ileum 37.01% duodenum, 28.36% maximum sites of hollow viscous perforation. Acid peptic disease was the cause of perforation in 27.40% of 171 cases. Enteric fever accounted maximally for 29% of 181 cases and all in the ileum. Acute appendicitis resulted in perforation of the appendix in 64 cases (10.25%) while blunt trauma abdomen causes perforation in 12.66% of 79 cases. Perforation due to stab injury accounted for 5.12% and fire arm injury perforation seen in 19 patients (3.04%). Conclusions: Early diagnosis of perforation, resuscitation with crystalloids with broad spectrum antibiotic coverage and urgent surgical intervention whenever patient is fit for anaesthesia are the important factors which decides the ultimate fate of the patient in case of hollow visceral perforation peritonitis.
Preoperative blood transfusion in adults with sickle cell disease undergoing elective surgical procedures: A survey of practice and outcome in Zaria, Nigeria

Background: Preoperative blood transfusion, which decreases the proportion of sickle red blood cells and improves anemia, has been associated with decreased risk of perioperative complications. The aim of this study was to retrospectively review our experience in the management of adult patients with sickle cell anemia undergoing elective surgery, and to determine blood transfusion requirement and surgery-related perioperative complications. Patients and Methods: Patients were divided into two groups: Group A had top-up transfusion and Group B received a partial exchange transfusion. Four surgical procedures were analyzed: open cholecystectomy, total hip replacement, total knee replacement, and split thickness skin grafts. Postoperative complications were categorized into three groups – (1) SCD-related, (2) non-SCD-related, and (3) transfusion-related perioperative complications. Results: Twelve (12) patients received top-up transfusion before surgery (Group A) while 20 patients (Group B) received partial exchange transfusions. There were 6 (18%) postoperative complications; two occurred in group A patients who received top-up transfusion and four occurred in group B patients who had partial exchange transfusion. Sickle cell disease-related complications consisted of acute vaso-occlusive pain in two patients (6%). Four patients (12%) had episodes of postoperative fever secondary to atelectasis, urinary tract infection, and wound infection. Only one (3%) patient in group A (top up) had a mild hemolytic transfusion reaction. Conclusion: This study showed that preoperative blood transfusion was associated with a reduced risk of perioperative complications in patients with sickle cell disease who underwent low and medium-risk surgery.
The validity of the index of vulnerable homes: evidence from consumers vulnerable to energy poverty in the UK

ABSTRACT Energy poverty is a multidimensional issue, and this means that it is difficult to understand the different levels of vulnerability to this phenomenon and its relationship with households’ quality of life. This paper presents the validation of an innovative index for the analysis of vulnerability to energy poverty according to monetary, energy, and thermal comfort factors: The Index of Vulnerable Homes (IVH). The IVH goes beyond the use of single self-reported indicators of thermal comfort, and instead uses the adaptive thermal-comfort model defined in the normative UNE EN 15251:2007 to assess thermal comfort in relation to energy poverty. Furthermore, it has the potential to evaluate the societal impacts of current energy poverty policies by providing the economic analysis of different situations of vulnerability. The IVH is validated by comparing its results to those obtained from a survey conducted in a small-scale study undertaken in Salford, UK. To this end, evidence from households living in terraced houses built before 1980 is used to analyze health status in terms of vulnerability to energy poverty vulnerability according to their monetary situation and the characteristics of the dwelling. In the end, the results show good agreement between both the IVH’s assessment and households’ evidence, leading to consider the IVH as a suitable approach to understanding different levels of vulnerability to energy poverty.
Effectiveness and cost-effectiveness of systemic family therapy compared with treatment as usual for young people after self-harm: a pragmatic randomised controlled trial

Background: Self-harm in adolescents is common and repetition high. There is limited evidence for effectiveness of interventions to reduce self-harm. Methods: This pragmatic, multi-centre, individually-randomised, controlled trial recruited young people aged 11-17 who had self-harmed at least twice and presented to Child & Adolescent Mental Health Services (CAMHS) following recent self-harm. Participants were randomised to manualised family therapy (FT) delivered by trained and supervised family therapists or treatment as usual (TAU) by local CAMHS. Participants and therapists were aware of treatment allocation; researchers were blinded. Primary outcome was rate of repetition of self-harm leading to hospital attendance due to self-harm within 18 months post-randomisation. Researchers collected secondary, participant-reported outcomes at 12 and 18-months’ post-randomisation. Findings: Between November 2009 and December 2013, 3554 young people were screened, 1603 were eligible, 832 consented to participation and were randomised (415 to FT, 417 to TAU). Primary outcome data were available for 795 (95.6%) participants; there was substantial loss to follow-up for participant-reported secondary outcomes with 12and 18-month researcher follow-up for 437 (52.5%) and 369 (44.4%) respectively. There was no statistically significant difference in the primary outcome between groups (Hazard ratio for FT compared to TAU 1.14, 95% CI: 0.87, 1.49, p-value=0.33). FT was not cost-effective when compared with TAU in the primary analysis of young people’s QALY gains and most sensitivity analyses. When young people’s and caregivers’ QALY gains were combined, FT incurred higher costs and better health outcomes than TAU within the NICE cost-effectiveness range. In secondary outcomes, caregivers and young people reported significantly better outcomes on the Strengths and Difficulties Questionnaire (SDQ) for the FT arm. Self-reported suicidal ideation reduced faster in FT (significantly lower at 12 months but equal at 18 months). No significant differences were detected on other participant-reported measures. Adverse events were distributed similarly across both arms.