Miracle-dz/UniFAR-FTUs huggingface dataset:
Health economic aspects of low back pain

Four out of five people experience low back pain sometime during their lifetime. Problems of the back—and to a less extent of the neck—are consistently in the top seats among the most burdensome diseases in the developed world. In addition to its often-debilitating pain, low back pain is a major contributor to health care costs and lost productivity. Health economics is the study of how the health care system’s scarce resources can and should be used to maximise health. The objective of this thesis is to enhance the understanding of the economic aspects of low back pain. The overarching research themes are two. First, are surgical interventions for low back pain cost-effective? Second, what is its burden in Sweden? The first two papers present results from analyses of a vast database assembled from a range of Swedish institutions covering health care consumption of all patients with low back pain in the Västra Götaland region during 2000–2012. The former paper shows that the national cost of all patients that experienced an episode of low back pain in 2011 was €739 million or €78 per capita. Of this, 65% were due to indirect costs such as absence from work. The second paper draws on the dataset to create an economic model. It shows that although the majority of patients improve within a few months at a relatively low cost, the sheer number of patients experiencing back pain make the disease costly. Narrowing down, using results from a randomised controlled trial, the third paper shows that under certain assumptions, surgical treatment of degenerative disc disease is cost-effective when compared to multidisciplinary treatment involving physical therapy and cognitive behavioural therapy. The results are not robust to different assumptions and the interpretation of the results should take that into account. The fourth and last paper also uses results from a randomised controlled trial of decompression surgery for spinal stenosis. This type of surgery, the most common of all spinal surgeries, involves treating the spinal stenosis—painful narrowing of the spinal canal—with decompression, where parts of bone and soft tissue are removed to make room for the nerves. The study shows with robust results that fusing vertebra together as part of decompression surgery increases costs with neither short-term nor long-term benefits. This dissertation shows that the burden of low back pain, including lumbar spinal stenosis and lumbar disc herniation, is not only heavy but distributed widely within and outside of the health care system. Although most treatments are effective, this thesis shows an example of treatments that are being used extensively but are in fact quite wasteful. This could not have been shown without careful research and robust methodology. In order to improve the use of money within the health care, research needs to be conducted to assess where to spend it.
Cannulated Cancellous Screw and Ender’s Nail Fixation in Stable Intertrochanteric Femur Fracture in Elderly Patient with Co-Morbid Condition

Background: Intertrochanteric Femur fracture is common in elderly patient with co-morbidity.Ender and Simon Weidner popularized the concept of closed condylocephlic nailing for intertrochanteric fractures in 1970. The clinical experience of authors revealed that Ender nailing alone cannot provide secure fixation in elderly patients with osteoporosis. Aims and objectives; we conducted a study to evaluate the efficacy of a combined fixation procedure using Ender nails and a cannulated compression screw for intertrochanteric fractures. Study Design: This is a prospective observational type of study Place and duration of study: Department of orthopaedics, NHL medical college between January 2015 to June 2018 Methodology: 52 patients with intertrochanteric fractures were treated using intramedullary Ender nails and cannulated compression screw from January 2015 to june 2018. We included those patients having age ≥50 years, with multiple co- morbid conditions like diabetes, hypertension, COPD, Asthma, bleeding disorders and multiple fractures, and duration of the Intertrochanteric fracture ≤ two week. We exclude young active patients < 50 yrs age, fracture > 2 weeks duration, fracture with lateral wall comminution and open fractures. The two Ender nails of 4.5mm each were passed across the fracture site into the proximal neck. This was reinforced with a 6.5 mm cannulated compression screw passed from the sub trochanteric region, across the fracture into the head. Results; All the fractures were united within an average period of 13 weeks with a range of 10 – 13 weeks. The functional assessment was done with modified Harris hip score(Table no 1,2) and the mean was 86.3 with a range from 73 to 95 , and 26 patients were excellent, 20 patients were good , 4 patients were fair and two patients were poor with respect to total score. The analysis of this study fulfils the objectives of good functional outcome Conclusions: The Ender nailing combined with compression screw fixation in cases of intertrochanteric fractures in high risk elderly patients could achieve reliable fracture stability with minimal complications. Keywords: Compression screw, Ender nails, osteoporosis, inter-trochanteric fracture
Amyloid‐β Deposition Is Associated with Decreased Hippocampal Glucose Metabolism and Spatial Memory Impairment in APP/PS1 Mice

In Alzheimer disease (AD) patients, early memory dysfunction is associated with glucose hypometabolism and neuronal loss in the hippocampus. Double transgenic (Tg) mice co-expressing the M146L presenilin 1 (PS1) and K670N/ M671L, the double “Swedish” amyloid precursor protein (APP) mutations, are a model of AD amyloid-β deposition (Aβ) that exhibits earlier and more profound impairments of working memory and learning than single APP mutant mice. In this study we compared performance on spatial memory tests, regional glucose metabolism, Aβ deposition, and neuronal loss in APP/PS1, PS1, and non-Tg (nTg) mice. At the age of 2 months no significant morphological and metabolic differences were detected between 3 studied genotypes. By 8 months, however, APP/PS1 mice developed selective impairment of spatial memory, which was significantly worse at 22 months and was accompanied by reduced glucose utilization in the hippocampus and a 35.8% dropout of neurons in the CA1 region. PS1 mice exhibited a similar degree of neuronal loss in CA1 but minimal memory deficit and no impairment of glucose utilization compared to nTg mice. Deficits in 22 month APP/PS1 mice were accompanied by a substantially elevated Aβ load, which rose from 2.5% ± 0.4% at 8 months to 17.4% ± 4.6%. These findings implicate Aβ or APP in the behavioral and metabolic impairments in APP/PS1 mice and the failure to compensate functionally for PS1-related hippocampal cell loss.
DNA-binding site recognition by bHLH and mads-domain transcription factors

OF DISSERTATION DNA-BINDING SITE RECOGNITION BY bHLH AND MADS-DOMAIN TRANSCRIPTION FACTORS Herewithin, two transcription factor (TF) regulatory complexes were investigated. A bHLH–MYB–WDR (BMW) DNA-binding complex from maize was the first complex to be studied. R, a maize bHLH involved in the activation of genes in the anthocyanin pathway, had been characterized to indirectly bind DNA despite the presence of a functional DNA-binding domain. Findings presented here reveal that this is only partially correct. Direct DNA-binding by R was found to be dependent upon two distinct dimerization domains that function as a switch. This switch-like mechanism allows R to be repurposed for the activation of promoters of differing cis-element structure. The second regulatory complex studied was of the Arabidopsis thaliana MIKC-MADS TF family. For many TFs, DNA-binding site recognition is relatively straightforward and very sequence specific, while others exhibit relaxed sequence specificity. MADS-domain TFs are one family of TFs with a wider range of cis-element sequences. Though consensus cis-element sequences have been determined for various MADS-domains, correctly predicting and identifying biologically functional cis-elements has been a challenge. In order to study the influence of nucleobase associations within the cis-element, a DNAProtein Interaction (DPI)-ELISA method was modified and optimized to screen a panel of specific probes. Screening of the SEP3 homodimer against a panel of sequential, palindromic probes revealed that nucleobases in position -1:+1 of the CArG-box influence binding strength between the MADS-domain and DNA. Additionally, the specificity of AGL15 towards CT-W6-AG forms was discovered to be determined by the functional groups present in the minor groove at position -4:+4 using inosine:cytosine (I:C) base pairs. Finally, the FLC–SVP MADS-domain heterodimer, bound to a native cis-element, was modeled and binding simulated using molecular dynamics. In conjunction with simulations of AGL15 and SEP3 homodimers, a potential binding mechanism was identified for this unique heterodimer. DNA sequence recognition by the MADS-domain was found to occur asymmetrically. In the case of the FLC–SVP heterodimer, the direction of asymmetrical DNA-binding in heterodimers was found to be fixed. Furthermore, the molecular dynamics simulations provided insight towards understanding the results generated from previous DPI-ELISA experiments, which should provide an improved means for predicting biologically significant CArG-boxes around genes.
Effect of Whole Body Vibration versus Suspension Therapy on Balance and Functional Capacity in Children with Diplegic Cerebral Palsy

Objectives: To compare the effects of whole body vibration with suspension therapy in relation to balance and functional capacity in diplegic cerebral palsied children. Subjects and methods: Thirty diplegic cerebral palsied children of both sexes were enrolled in the study with their ages ranged between 7 and 9 years. They were randomly and equally distributed into two study groups. The first group underwent the whole body vibration training and second group underwent suspension therapy through the spider cage. Also, both groups received the same designed physical therapy program. Stability indices and functional capacity were evaluated by using 6-minute walk test and Biodex stability system respectively before and after six successive months of treatment. Results: significant differences were obtained when comparing the pre and post treatment results of all measuring variables of both groups showed (P <0.05) except non-significant differences in medio-lateral stability index (P >0.05) in group I. Also, the results showed that the group underwent the suspension had more effect in comparison to the group of whole body vibration. Conclusion: Whole body vibration and suspension therapy training are effective additional tools in rehabilitation of diplegic cerebral palsied children with decreased balance and functional capacity in favor of the suspension therapy.
Validation of the Early Feeding Skills Assessment Scale for the Evaluation of Oral Feeding in Premature Infants

Background: Feeding difficulties are common and important in premature infants. In order to identify neonatal feeding difficulties, clinicians and nurses require assessment tools to conduct an objective evaluation of infant oral feeding (breast/bottle-feeding). Early identification of infants with feeding difficulty is critical to implement appropriate therapies and optimize the infant’s nutrition and oral feeding skill development. The aim of this study was to validate the Early Feeding Skills (EFS) Instrument for the Evaluation of Oral Feeding in Premature Infants. Methods: In this descriptive cross-sectional study, the researcher initially got permission from the designer of the tool through email. Then, the main version of this tool was translated into Persian using the standard backward/forward method. Subsequently, the formal and content validity of the questionnaire was confirmed. After visiting a neonatal specialist, the assessment of preterm infants' oral feeding skills was performed using the EFS Instrument by observing the infants (n=180) during feeding. The exploratory factor analysis and Cronbach’s alpha were utilized to determine the construct validity and assess the reliability of the instrument, respectively. Results: All items of the EFS Instrument had formal validity. Two items were removed from the instrument, based on content validity. On the basis of factor analysis, the items with a minimum factor load of 0.4 were evaluated and according to the factor load of all items (above 0.4), EFS Instrument had the appropriate construct validity. The Cronbach's coefficient of the instrument was obtained 0.88. Conclusion: The EFS Instrument obtained the required reliability and validity for the evaluation of preterm infants oral feeding.
Determination of bacterial chemotaxis response functions by optical trapping

A two-lobe response function is considered as a manifestation of temporal signal comparison in bacterial chemosensing. The second lobe in the response function appears as a result of adaptive behavior of the underlying signaling network, which allows bacteria to stay sensitive over a wide range of background signal levels. It has been argued that this two-lobe response reflects the dual requirements of the bacteria to taxis along a chemical gradient and to localize once the top of the gradient is reached. Calculations based on the run-tumble motility pattern of Escherichia coli showed that the second lobe improved the bacterium's localization capability. Intrigued by a recently observed run-reverse-flick motility cycle of a marine bacterium Vibrio alginolyticus, we investigate the motility-response relationship in this bacterium. Using a novel optical trapping technique, we measure the response of V. alginolyticus to an impulsive stimulus of chemoattractant serine. By exploiting an asymmetry in the rotation of the polar flagellum, we are able to determine for the first time how the bacterium responds to chemical stimuli while swimming forward or backward. Our measurements suggest that this marine bacterium regulates its forward and backward swimming intervals differently, exhibiting behaviors that is consistent with an exploration-exploitation strategy. In our measurements, we also find that the cell-body Ω(t) and the flagellar ω(t) rotational angular frequencies oscillate in time and are in synchrony with the forward and backward swimming intervals. Unexpectedly, Ω(t) and ω(t) are found to be anticorrelated in that the cell body rotates slower in the forward direction than in the backward direction, Ωf<Ωb, but the flagellum rotates faster in the forward direction than in the backward direction. The change in the rotational load (~25%) is significantly greater than that predicted by flagellum deformation but can be accounted for by the precession of the flagellum about the body axis during the backward swimming interval. We postulate that as a result of the precession, a kink is generated at the base of the flagellum that is subsequently amplified when the flagellum motor reverses direction, leading to the flick, the direction randomization step in V. alginolyticus' motility pattern.
Raman Spectroscopy of Microhabitats and Microbial Communities: Antarctic Deserts Mars Analogues

DESERTS AND MARS ANALOGUES. D.D. Wynn-Williams, H.G. M. Edwards and E.M. Newton British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Rd., Cambridge CB3 0ET, UK e-mail: ddww@bas.ac. uk; Tel. : +44 (0)1223 221554; Fax: +44 (0) 1223 221259; * corresponding author 2 Department of Chemical and Forensic Sciences, University of Bradford, Bradford, West Yorkshire BD7 1DP, UK e-mail: h.g. m.edwards@bradford.ac. uk; Tel. : +44 (0)1274 233787; Fax: +44 (0)1274 235350
Aligning airway management strategy with resuscitation priorities for out-of-hospital cardiac arrest.

Out-of-hospital cardiac arrest (OHCA) is a common and deadly event, occurring more than 350,000 times per year in the United States, with less than 10% of patients surviving to hospital discharge (1). The optimal airway management strategy for these patients remains unknown. Endotracheal intubation (ETI), supraglottic airway (SGA) placement, and bag mask ventilation (BMV) are common initial approaches, and are all mentioned as options in the most recent Advanced Cardiovascular Life Support (ACLS) guidelines (2).
Characterization of Twelve New Microsatellite Markers for the Endangered Chinese Horseshoe Crab (Tachypleus Tridentatus) through Next-Generation Sequencing

The Chinese horseshoe crab, Tachypleus tridentatus(Leach, 1819), is an endangered marine benthic arthropod. In this study, we describe and characterize twelve new microsatellite markers for T. tridentatusthrough mining next-generation sequencing data. Genotypes from two populations, Beihai ( n = 15 ) and Dongshan ( n = 15 ), demonstrated the usefulness of these loci for population-level studies. The number of alleles ranged from 3 to 8, with an average of 4.67 alleles per locus. The observed and expected heterozygosity in our populations ranged from 0.0667 to 0.9444, and 0.2339 to 0.8253, respectively. These new informative microsatellite markers will be useful for further genetic variation analyses, parentage determination and conservation studies.
Growth and Production of Juvenile Trout in Michigan Streams: Influence of Temperature

–Thermal conditions and trout population characteristics were followed at 17 sites in northern lower Michigan over a 3-year period to determine the influence of temperature on growth and production of juvenile brook trout Salvelinus fortinalis and brown trout Salmo trutta. Thermal regimes were summarized from 25 separate indicators using principal components analysis. The first two principal axes accounted for 99.8% of the variation in the summarized temperature variables. The first component was strongly and negatively correlated with summer mean temperature (r=-0.98) while the second principal component was most strongly correlated with mean winter temperature (r=0.95). Growth rate of juvenile brook trout was not significantly correlated with density of juvenile brook or brown trout. Growth rate of juvenile brown trout was not significantly correlated with density of juvenile brook trout, but was negatively correlated with density (r=-0.52) and standing stock (r=-0.46) of juvenile brown trout. Temperature principal components explained 29.7% of the variation in the growth rate of juvenile brook trout and 47.6% of the variation in the growth rate of juvenile brown trout. Addition of density of juvenile trout to these models improved the fit to 33.5% for juvenile brook trout growth rate but did not improve the fit of the growth rate model for juvenile brown trout (R=0.45). Production, as measured by standing stocks of juvenile brook and brown trout, was not significantly correlated with either principal temperature component. In order to allow for greater use of the data collected for this study, the basic temperature summaries were used to form simple linear regression (SLR) models for growth rate and standing stock of juvenile brook and brown trout. The best simple model for growth rate of juvenile brook trout explained 48.2% of the variance from the mean daily temperature fluctuation in July. The best brown trout growth rate model explained 53.1% of the variance using the mean daily temperature for the month of July. These types of data are easily collected by fisheries managers and will allow for estimation of expected growth rates at sites containing juvenile brook or brown trout. While lethal thermal limits for trout in laboratory settings have long been established (e.g., Fry et al. 1946) the influences of temperature on trout living within their range of thermal tolerance is poorly understood. Temperature can be considered a master variable with respect to growth and production of fish due to its influence on both rates of metabolism and foraging activity. Brett (1979) lists temperature, ration, and size of fish as the three main factors influencing the growth of fish. Elliott (1994) has examined thermal influences on growth and production of brown trout Salmo trutta in a series of laboratory and field studies. By following characteristics of fish populations (e.g., growth rate, density, standing stock) and
Characterization of Mycoplasma agalactiae membrane proteome

Mycoplasma agalactiae is the etiological agent of contagious agalactia, a serious disease of small ruminants characterized by mastitis, polyarthritis, keratoconjunctivitis, and abortion. Mycoplasmas totally lack the cell wall, so membrane proteins are directly exposed to environment. To date, a limited number of M. agalactiae antigens have been described. The combination of 2-D PAGE and mass spectrometry is a well-established method for proteome studies; however, it is reported that standard 2-D PAGE lacks in resolution of hydrophobic and basic proteins, which are abundant in mycoplasmas membrane. Indeed, membrane proteins are poorly represented in total extracts maps. In this study, the membrane proteome of M. agalactiae PG2T was characterized. The Triton X-114 fractionation allowed the enrichment for M. agalactiae PG2T membrane proteins. Liposoluble proteins were subjected to 2-D PAGE-MS, leading to the identification of 40 unique proteins. The differential expression of liposoluble proteins, among PG2T strain and two field isolates, was revealed by 2D DIGE. The use of GeLC-MS/MS allowed to increase the coverage of the liposoluble proteome. A total of 194 unique proteins were identified, (26% of M. agalactiae PG2T genes) and subjected to gene ontology analysis for localization and function. Interestingly, the 11.5% of identified proteins derived from putative horizontal gene transfer events. This work paves the way for the development of diagnostic and prophylaxis tools.
A Guide to the Beetles of Australia

Most Australian stag beetles live secretive lives, spending the majority of their life cycle inside decaying timber or under logs sunken in the soil. Yet these active recyclers of the forest are admired by beetle-loving people worldwide. Their aesthetic appeal and the rarity of some species make them of great value to collectors: the beetles in the subfamily Lampriminae are splendidly colourful, while others show an amazing variety in male mandible size and structure. A Guide to Stag Beetles of Australia is a comprehensive account of the 95 lucanid species found in Australia. This book reveals their diversity and beauty, looks in detail at their morphology, habitats and ecology, and explains how to collect, keep and preserve them. Natural history enthusiasts and professional and amateur coleopterists alike will benefit from the use of this guide. The book features some stunning images from entomologist and photographer Paul Zborowski. Paul has over 40 years' experience of field-based study of insects and related creatures in habitats all over the world.