Miracle-dz/UniFAR-FTUs huggingface dataset:
Osteochondral Allograft for Unsalvageable Osteochondritis Dissecans in the Skeletally Immature Knee

Background: While an excellent option for osteochondral defects in the adult knee, fresh osteochondral allograft (FOCA) in the skeletally immature adolescent knee has been infrequently studied. Purpose: To compare radiographic and patient-reported outcomes (PROs) in skeletally mature and immature adolescents after FOCA in the knee for treatment of unsalvageable osteochondritis dissecans (OCD). Study Design: Cohort study; Level of evidence, 3. Methods: Included were 34 patients (37 knees) who underwent size-matched FOCA of the knee for unsalvageable OCD lesions. All patients were aged ≤19 years and had a minimum of 12 months of follow-up. Patient characteristics, lesion characteristics, reoperations, and PROs were evaluated and compared between patients with open physes (skeletally immature; n = 20) and those with closed physes (skeletally mature; n = 17). Graft failure was defined as the need for revision osteochondral grafting. Postoperative radiographs were analyzed at 1 year and the final follow-up for graft incorporation and classified as A (complete), B (≥50% healed), or C (<50% healed). Results: The mean patient age was 15.4 years (range, 9.6-17.6 years), and the mean follow-up was 2.1 years (range, 1-5.3 years). The mean graft size was 5.0 cm2 and did not differ significantly between the study groups. Patients with open physes were younger (14.7 vs 16.2 years; P = .002) and more commonly male (80% vs 35%; P = .008). At the 1-year follow-up, 85% of immature patients and 82% of mature patients had radiographic healing grades of A or B. Patients with open physes were more likely to achieve complete radiographic union at 1 year (65% vs 15%; P = .007) and demonstrated better Knee injury and Osteoarthritis Outcome Score (KOOS) Daily Living (96.8 vs 88.5; P = .04) and KOOS Quality of Life (87.0 vs 56.8; P = .01) at the final follow-up. Complications were no different in either group, and graft failure occurred in only 1 skeletally mature patient with a trochlear lesion. Conclusion: FOCA treatment for unsalvageable OCD in the young knee may be expected to yield excellent early results. Despite the presence of open physes and immature epiphyseal osteochondral anatomy, equivalent or improved healing and PRO scores compared with those of skeletally mature patients may be expected.
Multiple Intracranial Meningiomas in Absence of Neurofibromatosis Type 2: A Case Report and Literature Review

Meningiomas are one of the most common primary intracranial tumors known to exist since pre-historic times. Most of these tumors are benign, sporadic, and solitary. Multiple meningiomas are rare and have mostly been described in patients with neurofibromatosis type 2 (NF2). The presence of multiple lesions poses a unique challenge in strategizing the treatment. We present a rare case of multiple intracranial meningiomas in the absence of NF2, which we treated at Tata Main Hospital, Jamshedpur. The relevant literature has also been discussed.
Lipid-based nutrient supplement at initiation of antiretroviral therapy does not substitute energy from habitual diet among HIV patients – a secondary analysis of data from a randomised controlled trial in Ethiopia

Introduction Malnutrition is common among people with HIV in sub-Saharan Africa. Nutritional supplementation at initiation of antiretroviral treatment (ART) has shown beneficial effects, but it is not known if supplementation replaces or supplements the habitual energy intake in a context of food insecurity. Methods As part of a randomised controlled trial among people with HIV initiating ART in Ethiopia, we assessed whether the provision of a lipid-based nutrient supplement (LNS) affected energy intake from the habitual diet. People with HIV aged ≥18 years with a body mass index (BMI) >17 were randomly allocated 2:1 to receive either early (month 1–3 after ART initiation) or delayed (month 4–6 after ART initiation) supplementation with LNS (≈4,600 kJ/day). Participants with BMI 16–17 were all allocated to early supplementation. The daily energy intake from the habitual diet (besides the energy contribution from LNS) was assessed using a 24-h food recall interview at baseline and at monthly follow-up visits. Linear mixed models were used to compare habitual energy intake in (1) early versus delayed supplementation groups and (2) supplemented versus unsupplemented time periods within groups. Results Of 301 participants included, 67% of the participants were women, mean (±standard deviation [SD]) age was 32.9 (±8.9) years and 68% were living in moderately or severely food insecure households. Mean (±SD) reported habitual energy intake at baseline was 5,357 kJ/day (±2,246) for women and 7,977 kJ/day(±3,557) for men. Among all participants, there were no differences in mean habitual energy intake between supplemented and unsupplemented groups in neither the first 3 (P = 0.72) nor the following 3 months (P = 0.56). Furthermore, habitual energy intake did not differ within groups when comparing periods with or without supplementation (P = 0.15 and P = 0.20). The severity of food insecurity did not modify the effect of supplementation in habitual energy intake (P = 0.55). Findings were similar when participants with BMI 16–17 were excluded. Conclusion Our findings indicate that the LNS provided after ART initiation supplement, rather than substitute, habitual energy intake among people with HIV, even among those who are food insecure. This supports the feasibility of introducing nutritional supplementation as part of HIV treatment.
Striatal Cholinergic Signaling in Time and Space

The cholinergic interneurons of the striatum account for a small fraction of all striatal cell types but due to their extensive axonal arborization give the striatum the highest content of acetylcholine of almost any nucleus in the brain. The prevailing theory of striatal cholinergic interneuron signaling is that the numerous varicosities on the axon produce an extrasynaptic, volume-transmitted signal rather than mediating rapid point-to-point synaptic transmission. We review the evidence for this theory and use a mathematical model to integrate the measurements reported in the literature, from which we estimate the temporospatial distribution of acetylcholine after release from a synaptic vesicle and from multiple vesicles during tonic firing and pauses. Our calculations, together with recent data from genetically encoded sensors, indicate that the temporospatial distribution of acetylcholine is both short-range and short-lived, and dominated by diffusion. These considerations suggest that acetylcholine signaling by cholinergic interneurons is consistent with point-to-point transmission within a steep concentration gradient, marked by transient peaks of acetylcholine concentration adjacent to release sites, with potential for faithful transmission of spike timing, both bursts and pauses, to the postsynaptic cell. Release from multiple sites at greater distance contributes to the ambient concentration without interference with the short-range signaling. We indicate several missing pieces of evidence that are needed for a better understanding of the nature of synaptic transmission by the cholinergic interneurons of the striatum.
Deforestation in Continental Ecuador with a Focus on Protected Areas

Forest conservation is of particular concern in tropical regions where a large refuge of biodiversity is still existing. These areas are threatened by deforestation, forest degradation and fragmentation. Especially, pressures of anthropogenic activities adjacent to these areas significantly influence conservation effectiveness. Ecuador was chosen as study area since it is a globally relevant center of forest ecosystems and biodiversity. We identified hotspots of deforestation on the national level of continental Ecuador between 1990 and 2018, analyzed the most significant drivers of deforestation on national and biome level (the Coast, the Andes, The Amazon) as well as inside protected areas in Ecuador by using multiple regression analysis. We separated the national system of protected areas (SNAP) into higher and lower protection levels. Besides SNAP, we also considered Biosphere Reserves (BRs) and Ramsar sites. In addition, we investigated the rates and spatial patterns of deforestation in protected areas and buffer zones (5 km and 10 km outwards the protected area boundaries) using landscape metrics. Between 1990 and 2018, approximately 4% of the accumulated deforestation occurred within the boundaries of SNAP, and up to 25.5% in buffer zones. The highest rates of deforestation have been found in the 5 km buffer zone around the protected areas with the highest protection level. Protected areas and their buffer zones with higher protection status were identified as the most deforested areas among SNAP. BRs had the highest deforestation rates among all protected areas but most of these areas just became BRs after the year 2000. The most important driver of deforestation is agriculture. Other relevant drivers differ between the biomes. The results suggest that the SNAP is generally effective to prevent deforestation within their protection boundaries. However, deforestation around protected areas can undermine conservation strategies to sustain biodiversity. Actions to address such dynamics and patterns of deforestation and forest fragmentation, and developing conservation strategies of their landscape context are urgently needed especially in the buffer zones of areas with the highest protection status.
Dietary intake of animal and plant proteins and risk of all cause and cause-specific mortality: The Epic-Italy cohort

BACKGROUND: To examine the associations of animal and plant protein intake with all-cause, cardiovascular and cancer mortality risk in middle-aged Italian men and women with substantially lower animal protein intake than North Americans. METHODS AND RESULTS: Food consumption was assessed by validated Epic semiquantitative FFQs. Multivariable Cox models stratified by center, age, and sex, and adjusted for confounders, estimated associations of animal and plant protein consumption with mortality for all causes, cardiovascular disease, and cancer. After a median follow-up of 15.2 years, 2,449 deaths were identified in 45,009 participants. No significant association between intake of total, animal or plant protein and mortality was found in the fully adjusted models. Substitution of plant protein for animal protein was inversely associated with cardiovascular mortality (HR, 0.47; 95% CI, 0.24–0.92) only in people with at least 1 unhealthy lifestyle risk factor and poor adherence to a Mediterranean diet. Participants in the highest quintile group of animal protein intake had higher glucose, total and LDL cholesterol levels than those in the lowest quintile. In contrast, higher plant protein intake was negatively associated with fasting insulin and cholesterol, despite higher BMI, physical inactivity and starch consumption. CONCLUSIONS: Replacing plant protein for animal protein was associated with lower cardiovascular mortality among individuals with unhealthy lifestyle risk factors. High animal but not plant protein intake is associated with impaired fasting glucose and hypercholesterolemia, despite lower calorie and carbohydrate intake, suggesting that protein source plays crucial roles in modulating cardiometabolic health independently of body weight.
Posterior pelvic exenteration for ovarian cancer: surgical and oncological outcomes

Objective Posterior pelvic exenteration (PPE) can be required to achieve complete resection in ovarian cancer (OC) patients with large pelvic disease. This study aimed to analyze morbidity, complete resection rate, and survival of PPE. Methods Ninety patients who underwent PPE in our Comprehensive Cancer Center between January 2010 and February 2021 were retrospectively identified. To analyze practice evolution, 2 periods were determined: P1 from 2010 to 2017 and P2 from 2018 to 2021. Results A 82.2% complete resection rate after PPE was obtained, with rectal anastomosis in 96.7% of patients. Complication rate was at 30% (grade 3 in 9 patients), without significant difference according to periods or quality of resection. In a binary logistic regression adjusted on age and stoma, only age of 51–74 years old was associated with a lower rate of complication (odds ratio=0.223; p=0.026). Median overall and disease-free survivals (OS and DFS) from initial diagnosis were 75.21 and 29.84 months, respectively. A negative impact on OS and DFS was observed in case of incomplete resection, and on DFS in case of final cytoreductive surgery (FCS: after ≥6 chemotherapy cycles). Age ≥75-years had a negative impact on DFS for new OC surgery. For patients with complete resection, OS and DFS were decreased in case of interval cytoreductive surgery and FCS in comparison with primary cytoreductive surgery. Conclusion PPE is an effective surgical measure to achieve complete resection for a majority of patients. High rate of colorectal anastomosis was achieved without any mortality, with acceptable morbidity and high protective stoma rate.
EFEITOS DOS EXERCÍCIOS FÍSICOS NA DENSIDADE MINERAL ÓSSEA DE MULHERES ACIMA DE 50 ANOS: REVISÃO INTEGRATIVA

Objetivo: analisar os dados na literatura do período 2015-2020 sobre os efeitos de distintos exercícios físicos na densidade mineral óssea (DMO) em adultos mais velhos e classifica-los de forma quantitativa. Métodos: trata-se de uma revisão integrativa da literatura, em que na seleção dos artigos, utilizou as plataformas de dados SCIELO, PUBMED, LILACS e BVS. Resultados: foram selecionados quatorze estudos categorizados a seguir: A – treinamento resistido isolado (TRI); B- plataforma vibratória (PV); C- Exercícios multicomponentes (EM). Conclusão: exercícios físicos podem ter um impacto positivo na DMO, especialmente nas mulheres. Assim, programas de treinamento com mais de um tipo de exercício, usando a PV e também o TRI demonstraram melhores resultados para a DMO no período estudado. Observou-se ainda, que as regiões mais incidentes foram: coluna lombar, colo do fêmur e quadril total. Além disso, não foi possível classificar quantitativamente os métodos de exercícios, devido as diferentes formas metodológicas de abordar os métodos de treinamento.
Fisetin as an adjuvant treatment in prostate cancer patients receiving androgen-deprivation therapy

Giuseppe Di Lorenzo1,2,3, Luca Scafuri1,2, Ferdinando Costabile1,2, Liuba Pepe3, Anna Scognamiglio3, Felice Crocetto4, Germano Guerra3 & Carlo Buonerba*,1,2 1Oncology Unit, Hospital ‘Andrea Tortora’, ASL Salerno, Pagani, Italy 2Associazione O.R. A. , Somma Vesuviana, Naples, Italy 3Department of Medicine & Health Science, University of Molise, Campobasso, Italy 4Department of Neurosciences, Reproductive Sciences & Odontostomatology, Federico II University, Naples, Italy *Author for correspondence: carbuone@hotmail.com
The Role of Empathy in Bias towards Mental Illness among Prospective Law Enforcement Officers

Abstract The criminalization hypothesis states that due to the deinstitutionalization of mental health patients and lack of available care, law enforcement officers (LEO) are interacting with people with mental illness (PWMI) more often. However, there is a lack of research regarding LEO attitudes towards PWMI. This study measures implicit and explicit bias along with levels of empathy prospective LEO hold towards mental illness. Participants completed the Go-No-Go Association Task and a survey. Results suggested that participants viewed PWMI as unpredictable, but did not hold fear/avoidance, malevolence, or authoritarian views towards PWMI. Participants did not hold negative implicit bias towards PWMI, nor did implicit bias scores predict explicit bias scores. Empathy, however, was significantly negatively correlated with explicit bias scores, and was a significant predictor of explicit bias. Participants who scored lower on empathy scored higher on explicit bias, while participants with higher empathy scores scored lower on explicit bias.
Shoulder Pathology on Magnetic Resonance Imaging in Asymptomatic Elite-Level Rock Climbers

Background: The prevalence of findings on shoulder magnetic resonance imaging (MRI) is high in asymptomatic athletes of overhead sports. Purpose/Hypothesis: The purpose of this study was to determine the prevalence of atypical findings on MRI in shoulders of asymptomatic, elite-level climbers and to evaluate the association of these findings with clinical examination results. It was hypothesized that glenoid labrum, long head of the biceps tendon, and articular cartilage pathology would be present in >50% of asymptomatic athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 50 elite climbers (age range, 20-60 years) without any symptoms of shoulder pain underwent bilateral shoulder examinations in addition to dedicated bilateral shoulder 3-T† MRI. Physical examinations were performed by orthopaedic sports medicine surgeons, while MRI scans were interpreted by 2 blinded board-certified radiologists to determine the prevalence of abnormalities of the articular cartilage, glenoid labrum, biceps tendon, rotator cuff, and acromioclavicular joint. Results: MRI evidence of tendinosis of the rotator cuff, subacromial bursitis, and long head of the biceps tendonitis was exceptionally common, at 80%, 79%, and 73%, respectively. Labral pathology was present in 69% of shoulders, with discrete labral tears identified in 56%. Articular cartilage changes were also common, with humeral pathology present in 57% of shoulders and glenoid pathology in 19% of shoulders. Climbers with labral tears identified in this study had significantly increased forward elevation compared with those without labral tears in both active (P = .026) and passive (P = .022) motion. Conclusion: The overall prevalence of intra-articular shoulder pathology detected by MRI in asymptomatic climbers was 80%, with 57% demonstrating varying degrees of glenohumeral articular cartilage damage. This high rate of arthritis differs significantly from prior published reports of other overhead sports athletes.
The manufacture and origin of the Tutankhamen meteoritic iron dagger

The Iron Age was the time when people acquired iron processing technology and is generally thought to have begun after 1200 B.C. Some prehistoric iron artifacts made of iron meteorites are dated from the Bronze Age. A nicely preserved meteoritic iron dagger was found in the tomb of King Tutankhamen (1361–1352 B.C.) of ancient Egypt. Yet, its manufacturing method and origin remain unclear. Here, we report nondestructive two‐dimensional chemical analyses of the Tutankhamen iron dagger, conducted at the Egyptian Museum of Cairo. Elemental mapping of Ni on the dagger blade surface shows discontinuous banded arrangements in places with “cubic” symmetry and a bandwidth of about 1 mm, suggesting a Widmanstätten pattern. The intermediate Ni content (11.8 ± 0.5 wt%) with the presence of the Widmanstätten pattern implies the source meteorite of the dagger blade to be octahedrite. The randomly distributed sulfur‐rich black spots are likely remnants of troilite (FeS) inclusions in iron meteorite. The preserved Widmanstätten pattern and remnant troilite inclusion show that the iron dagger was manufactured by low‐temperature (<950 °C) forging. The gold hilt with a few percent of calcium lacking sulfur suggests the use of lime plaster instead of gypsum plaster as an adhesive material for decorations on the hilt. Since the use of lime plaster in Egypt started during the Ptolemaic period (305–30 B.C.), the Ca‐bearing gold hilt hints at its foreign origin, possibly from Mitanni, Anatolia, as suggested by one of the Amarna letters saying that an iron dagger with gold hilt was gifted from the king of Mitanni to Amenhotep III, the grandfather of Tutankhamen.
The Implications of Sports Biomechanics Studies on the Research and Development of Running Shoes: A Systematic Review

Although various sports footwear demonstrated marked changes in running biomechanical variables, few studies have yielded definitive findings on the underlying mechanisms of shoe constructions affecting running-related performance and injuries. Therefore, this study focused on examining the effect of basic shoe constructions on running biomechanics and assessing the current state of sports shoe production in terms of injury and efficiency. Relevant literature was searched on five databases using Boolean logic operation and then screened by eligibility criteria. A total of 1260 related articles were retrieved in this review, and 41 articles that met the requirements were finally included, mainly covering the influence of midsole, longitudinal bending stiffness, heel-toe drop, shoe mass, heel flare, and heel stabilizer on running-related performance and injuries. The results of this review study were: (1) The functional positioning of running shoe design and the target groups tend to influence running performance and injury risk; (2) Thickness of 15–20 mm, hardness of Asker C50-C55 of the midsole, the design of the medial or lateral heel flares of 15°, the curved carbon plate, and the 3D printed heel cup may be beneficial to optimize performance and reduce running-related injuries; (3) The update of research and development concepts in sports biomechanics may further contribute to the development of running shoes; (4) Footwear design and optimization should also consider the influences of runners’ strike patterns.
Gravity wave generation in balanced sheared flow revisited

The generation of internal gravity waves from an initially geostrophically balanced flow is diagnosed in non-hydrostatic numerical simulations of shear instabilities for varied dynamical regimes. A non-linear decomposition method up to third order in the Rossby number Ro is used as the diagnostic tool for a consistent separation of the balanced and unbalanced motions in the presence of their non-linear coupling. Wave emission is investigated in an Eady-like and a jet-like flow. For the jet-like case, geostrophic and ageostrophic unstable modes are used to initialize the flow in different simulations. Gravity wave emission is in general very weak over a range of values for Ro. At sufficiently high Ro, however, when the condition for symmetric instability is satisfied with negative values of local potential vorticity, significant wave emission is detected even at the lowest order. This is related to the occurrence of fast ageostrophic instability modes, generating a wide spectrum of waves. Thus, gravity waves are excited from the instability of the balanced mode to lowest order only if the condition of symmetric instability is satisfied and ageostrophic unstable modes obtain finite growth rates.
Exploring the desire to be an entrepreneur among university-educated youths: lessons from Sierra Leone

ABSTRACT The developing country entrepreneur is championed as a driver of economic growth, poverty alleviation, and social development. Yet little is known about what drives entrepreneurial ambitions in developing countries. This study uses qualitative data from focus group discussions with university-educated Sierra Leonean youths to explore these issues. Findings show that very few have entrepreneurial ambitions ex ante, though a large share resort to entrepreneurship as a survival mechanism. Limited entrepreneurial ambitions can be explained by macro-level factors such as access to credit, but are largely driven by individual-level factors such as conceptions of success and cultural perceptions about entrepreneurship.