Miracle-dz/UniFAR-FTUs huggingface dataset:
Development of a scoring tool (BLARt score) to predict functional outcome in lower limb amputees

Abstract Purpose: To develop a valid preoperative scoring tool that predicts the probability of walking with a prosthetic limb after major lower limb amputation. Methods: A retrospective review of 338 patients who had undergone lower limb amputation was conducted to identify characteristics that affected the success of rehabilitation with a prosthetic limb. These data were used to devise an assessment tool (the BLARt score), which was then tested and validated in 199 patients planned to undergo lower limb amputation in two UK regional centers. Functional rehabilitation outcomes were recorded at 12 months after surgery using the SIGAM mobility grading. Results: No patient with a BLARt score ≥13 achieved good functional outcome (defined as independent mobility, SIGAM grade E or F) and only 6 patients with a BLARt score ≥17 achieved any functional outcome (defined as any ability to walk unaided, SIGAM grade C or greater). Conclusions: In the patient cohorts studied, the BLARt assessment tool was a strong predictor of whether or not patients would be able to walk with a prosthetic limb after surgery. It is simple to administer and could be useful in clinical practice to inform expectations for patients and clinicians. Implications for rehabilitation Patients undergoing lower limb amputation face major physical and psychological challenges after surgery that have a considerable impact on rehabilitation and their ability to walk independently. Many amputees are unable to walk with a prosthetic limb, but there are no validated tools to predict this before surgery. The BLARt is a potentially valuable measure that can predict the likelihood of being unable to walk after amputation. It is simple to use and could be useful to inform patients’ and clinicians’ expectations before surgery.
Dynamic Success on YouTube: A Longitudinal Analysis of Click Counts and Contents of Political Candidate Clips during the 2009 German National Election

Since the 2008 Obama victory, mass media and academic research have contributed to the widespread notion that modern political campaigns are won in the so-called ‘web 2.0’, more precisely on YouTube. While respective studies were able to identify some major factors for the success of political YouTube videos, some videos ‘failed’ to have the presumed success online. This lack of clarity has not been convincingly explained by cross-sectional designs without taking into account the dynamic aspects of the success of YouTube videos. This study evaluates and validates the impact of presentation, professionalism, topic, age and the typical slope of the website-visits over time on the total amount of page visits. Political YouTube videos were analysed over a five-month period before the 2009 German national election. Most strikingly, one has to ignore some of the YouTube conventions to be successful on the platform during an election campaign, like uploading user-generated content.
Mysterious “Monsieur Leborgne”: The Mystery of the Famous Patient in the History of Neuropsychology is Explained

As of spring 2011, 150 years have passed since the death of one of the most famous neurological patients of the nineteenth century. A Frenchman, “Monsieur Leborgne” also known by the nickname “Tan,” was hospitalized due to an almost complete loss of speech. His case was presented in 1861, during a seating of the Société d'Anthropologie de Paris by a physician, Pierre Paul Broca (1824–1880), who used this occasion to report that he had discovered, in the middle part of patient's left frontal lobe, the cortical speech center. This area was later named “Broca's area. ” Both the patient and his medical records were the subject of numerous descriptions and citations in the medical literature. The patient's full identity and social background has remained a mystery until now. This article presents biographical data concerning Leborgne and his family based on archive registers in France.
The Value-Based Medicine Comparative Effectiveness and Cost-Effectiveness of Penetrating Keratoplasty for Keratoconus

Objective: To perform a base case, comparative effectiveness, and cost-effectiveness (cost-utility) analysis of penetrating keratoplasty for patients with severe keratoconus. Methods: Visual acuity data were obtained from a large, retrospective multicenter study in which patients with keratoconus with less than 20/40 best corrected visual acuity and/or the inability to wear contact lenses underwent penetrating keratoplasty, with an average follow-up of 2.1 years. The results were combined with other retrospective studies investigating complication rates of penetrating keratoplasty. The data were then incorporated into a cost-utility model using patient preference-based, time trade-off utilities, computer-based decision analysis, and a net present value model to account for the time value of outcomes and money. The comparative effectiveness of the intervention is expressed in quality-of-life gain and QALYs (quality-adjusted life-years), and the cost-effectiveness results are expressed in the outcome of $/QALY (dollars spent per QALY). Results: Penetrating keratoplasty in 1 eye for patients with severe keratoconus results in a comparative effectiveness (value gain) of 16.5% improvement in quality of life every day over the 44-year life expectancy of the average patient with severe keratoconus. Discounting the total value gain of 5.36 QALYs at a 3% annual discount rate yields 3.05 QALYs gained. The incremental cost for penetrating keratoplasty, including all complications, is $5934 ($5913 discounted at 3% per year). Thus, the incremental cost-utility (discounted at 3% annually) for this intervention is $5913/3.05 QALYs = $1942/QALY. If both eyes undergo corneal transplant, the total discounted value gain is 30% and the overall cost-utility is $2003. Surgery on the second eye confers a total discounted value gain of 2.5 QALYs, yielding a quality-of-life gain of 11.6% and a discounted cost-utility of $2238/QALY. Conclusions: Penetrating keratoplasty for patients with severe keratoconus seems to be a comparatively effective and cost-effective procedure when compared with other interventions across different medical specialties.
Characterization of Clinical Response in Patients with Vitiligo Undergoing Autologous Epidermal Punch Grafting

BACKGROUND Punch grafting is a well‐established treatment for vitiligo, but predictive factors for outcomes are not well established. OBJECTIVE To determine the characteristics of responses to punch grafting performed in patients with vitiligo. METHODS AND MATERIALS Retrospective, single‐center chart review. Response rates were assessed using photographs taken before and after grafting using a 1.5‐mm punch instrument. Effectiveness of repigmentation was assessed using the following scale: worse, no improvement, 0% to 25% improvement, 25% to 50% improvement, 50% to 75% improvement, and 75% to 100% improvement. Repigmentation rates were correlated with patient demographics. RESULTS Thirty‐seven charts were reviewed, from which data were available from 30 patients. The total number grafts was 606 in 44 transplanted areas; 87% (530/606) of the transplants survived, and 26 of the 30 (87%) patients achieved some degree of repigmentation. Patients younger than 20 achieved the greatest average improvement in repigmentation (mean 61%), whereas those aged 60 and older showed the least improvement (mean 38%). Punch grafting of the neck and trunk achieved the greatest repigmentation, with 65% and 63% average improvement, respectively. Acral sites and skin overlying joints improved the least. CONCLUSION Punch grafting is successful in most patients with vitiligo, with an 87% graft survival rate, but the rates of repigmentation vary depending on clinical characteristics.
Lack of benefit of central nervous system prophylaxis for diffuse large B‐cell lymphoma in the rituximab era

Little is known about the utility of central nervous system (CNS) prophylaxis for diffuse large B‐cell lymphoma (DLBCL) in the rituximab era. The objective of this study was to characterize patterns of CNS prophylaxis for patients who received combined rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP) chemotherapy using the National Comprehensive Cancer Network Non‐Hodgkin Lymphoma Outcomes Database, a prospective cohort study that collects clinical and outcomes data for patients at 7 participating centers.
Comparative study of the effect of Morinda citrifolia (Noni) with selected physiotherapy modalities in the management of patients with cervical spondylosis

Background : Neck pain treatment has been a subject of controversy and heated debate among healthcare professionals and opinion leaders over years. Objective: The purpose of this study was to compare the effectiveness of Noni juice and some selected physiotherapy modalities in the management of neck pain and stiffness in patients with cervical spondylosis. Methodology : Ninety (90) patients, 42 men and 48 women diagnosed with cervical spondylosis participated in the study. They were assigned to three groups of thirty (14 men and 16 women) patients in each group. Group A subjects were treated with Noni juice alone; Group B with a combination of Noni and physiotherapy; and group C with physiotherapy alone. Pre and post treatment measures of cervical range of movements (ROM) and pain intensity were assessed using the universal goniometer and the visual analogue scale respectively. Results : Significant reductions in pain intensity and improved neck flexibility (ROM) were achieved in all the three groups at the end of the four weeks study. 18/30 (60%), 27/30 (90%), and 25/30 (83%) of the subjects in groups A, B and C had complete relief or marked improvement of symptoms at the end of the study. The study reported a greater reduction in pain and improved neck flexibility/ROM in the group that received Noni combined with physiotherapy than either of the two groups. Conclusion : There is a need for further research studies concerning the therapeutic effects of Noni in degenerative musculoskeletal conditions. But from the results of this study, Noni combined with physiotherapy is an efficacious treatment for the management of neck pain and neck stiffness in patients with cervical spondylosis. Therefore Noni may be incorporated into the treatment regimen of patients undergoing physiotherapy for degenerative condition of the spine. Keywords : Tahitian Noni (Morinda citrifolia) , Cervical spondylosis, neck pain, neck flexibility/ROM Nigerian Journal of Health and Biomedical Sciences Vol. 5 (2) 2006: 6-11
The Use of Voriconazole in the Treatment of Cylindrocarpon Keratomycosis

Purpose: To describe a rare form of fungal keratitis due to Cylindrocarpon lichenicola. Method: A 56-year-old woman presented with an atypical corneal ulcer that did not respond to broad- spectrum antibiotics. Results: Additional diagnostic tests such as confocal microscopy and corneal biopsy were useful aids in establishing the diagnosis of fungal keratitis. The ulcer healed completely after the initiation of antifungal therapy. Conclusions: To the best of our knowledge, this is the first case of C. lichenicola keratomycosis in the United Kingdom. Our case demonstrates that prompt recognition and effective treatment of this condition can lead to a good visual outcome.
The prognostic significance of lymphovascular invasion in invasive breast carcinoma

Although lymphovascular invasion (LVI) has been associated with a poor outcome in patients with breast cancer, it is not included in most internationally recognized staging systems, including the American Joint Committee on Cancer tumor, lymph node, metastasis (TNM) classification. This is mainly because it remains unclear whether the presence of LVI is an independent, high‐risk criterion in clinically relevant staging subgroups.
NY‐ESO‐1 is a ubiquitous immunotherapeutic target antigen for patients with myxoid/round cell liposarcoma

Myxoid/round cell liposarcoma (MRCL) is the second most common liposarcoma subtype, accounting for >33% of liposarcomas and approximately 10% of all soft tissue sarcomas. Although MRCL is a chemosensitive subtype, patients with metastatic disease have a poor outcome. NY‐ESO‐1 is a cancer‐testis antigen (also known as cancer germ cell antigen) that has been successfully targeted in vaccine trials and in adoptive T‐cell therapy trials for the treatment of several solid tumors.
Corticosteroid injection versus percutaneous release surgery in treatment of trigger fingers

Background: Trigger finger is a common problem encountered in rheumatologic practice that causes a triggering or locking that may produce an uncomfortable sensation. There are various methods of treatment ranging from conservative management to surgical release. Aim: To determine effectiveness of corticosteroid injection and percutaneous release in terms of symptomatic relief, patient satisfaction and complications. Materials and Methods: At this prospective study, 50 patients who presented with trigger finger Grade 2 and 3 were randomized into 2 groups. One group received corticosteroid injection and in the other group, percutaneous release was done. These patients were then assessed weekly over a period of 6 weeks and their progress noted. Results: Thirty cases (60%) were females and 20 (40%) were males. The age of patients at this study was 40-65 years (mean: 48). Twenty-three (46%) were manual workers, 17 (34%) were semi-professionals and 10 (20%) were housewives. Most of the patients had involvement of dominant hand (62%); non-dominant hand was involved in 38% of the cases. The most common presenting symptom was pain with triggering. In both groups, significant improvement in pain and triggering occurs in the first 2 weeks but there was improvement in pain and triggering in the corticosteroid group after 2 weeks. In terms of swelling of the digits, no difference was noted during the course of the treatment in the two groups. The corticosteroid group of patients had a complication rate of 6% while the percutaneous group had 18% complication rate. A total of 12 patients had recurrence (recurrence rate: 24%); 5 (41.6%) cases in the first or corticosteroid group and 7 (58.3%) cases in the surgery group. Conclusion: The group of patients treated with corticosteroid had better relief from pain and triggering and had a lower complication rate. Recurrence was equal in both the groups.
Reverse phase protein array profiling reveals distinct proteomic signatures associated with chronic myeloid leukemia progression and with chronic phase in the CD34‐positive compartment

Chronic myeloid leukemia (CML) is a clonal stem cell malignancy whose pathogenesis is driven by constitutive activation of the breakpoint cluster region–v‐abl Abelson murine leukemia viral oncogene homolog 1 (BCR‐ABL1) kinase. Although BCR‐ABL1 activation is present in all patients with CML, patients can present in 3 different phases characterized by an increasingly worse prognosis and diminished responsiveness to tyrosine kinase inhibitors: chronic phase, accelerated phase, or blastic phase. The biologic basis for progression from chronic phase to blastic phase and for regulating the homeostasis of tyrosine kinase inhibitor‐resistant CML stem cells is not entirely understood.
Use of heart blood flow analysis in clinical practice

Often in the treatment of patients echocardiograms are performed to analyse cardiac function. As part of the calculation the shear and normal stress on the endocardial surface of the left ventricle can be calculated. This was undertaken for five elderly women patients undergoing stress testing. It was found that when the stress was plotted as a function of strain rate the expected variation would be a linear increase in stress. In some patients there was initially a sharp increase in stress with strain rate then an abrupt change in the stress at the apex or at the mitral valve annulus. With further increase in strain rate the rate of increase in stress decreased. This would suggest that there was some defect in the wall structure. The variation of ventricular volume with strain rate can be obtained. In this case the volume should decrease initially and as the strain rate increases the volume change becomes less. In two of the five patients the expected initial rise in stress did not occur. This suggests a lack of strength of the ventricle. As expected these were not the same patients where the abrupt increase in stress occurred. Such information may be helpful to a clinician in reaching a diagnosis.
A New Method of Harvesting Descemet Membrane-Endothelium Complex Approaching From the Suprachoroidal Space for Descemet Membrane Endothelial Keratoplasty: An Experimental Animal Study

Purpose: To report the study in rabbits of a new method of harvesting Descemet membrane-endothelium complex approaching from the suprachoroidal space for Descemet membrane endothelial keratoplasty. Materials and Methods: Twenty-four eyes of 12 rabbits were used for microscopic analysis, whereas 24 eyes of 12 cats were used for gross photographic analysis. The enucleated eyeballs of the rabbits and cats were incised 360 degrees circumferentially along the equator. Manual separation was performed between the sclera and the underlying connective tissue approaching from the suprachoroidal space in the direction of the central cornea step by step in spiral pattern. After complete separation of the stroma from the Descemet membrane-endothelium-iris complex, it was excised from the globe at the outside of the iris root. The synthetic carrier (soft contact lens) was laid down on the punch block, and then the excised complex was brought over the carrier with the endothelium-iris side upward. Two steps of down punch for the designed graft size were performed. The harvested complexes were processed for vital stains and were evaluated through photography taken under a light microscope and gross close-up. The endothelial cell loss rates were calculated by a computer software. Results: The overall harvest success rate was 89.6% (43 of 48). The overall structural cell loss rate was 1.83 ± 2.34 by microscopic analysis and 4.68% ± 1.68% by gross photographic analysis. Conclusion: The new method of en bloc harvesting Descemet membrane-endothelium complex approaching from the suprachoroidal space could provide minimal damage to the endothelium during harvesting, and it can be carried and passed through an injector.
The role of economic evidence in Canadian oncology reimbursement decision-making: to lambda and beyond.

OBJECTIVE The overarching question addressed in this article is: what has been the impact of economic evidence to Canadian drug reimbursement decisions; within this, has an (explicit or implicit) threshold been identified for making such decisions; and is the impact or threshold different for oncology medications? METHODS Three sequential strategies were employed: a literature search, a review of publicly available Canadian reimbursement recommendations, and a one-day key informant roundtable, held with a purposive sample of 13 individuals from across Canada to gain information not readily accessible from the public domain. RESULTS Despite the formal requirement for structured economic evidence, the limited public information suggests that its uptake in the Canadian decision-making process has been tentative. Implicit economic thresholds have been published in Australia and the United Kingdom, but not in Canada. Based on reviews of reimbursement recommendations, thresholds specific to oncology medications may be higher than for nononcology medications, in Canada and elsewhere. Canadian reimbursement recommendations can appear inconsistent with respect to clinical evidence, economic evidence, and nonevidentiary factors, possibly because of a lack of transparency or context-sensitive interpretations. The key informant roundtable provided reasons for the inconsistent uptake of economic evidence: panelists were divided between those who found economic information useful and supportive to decision-making, and those who did not. Panelists generally agreed on the need for publicly defensible and ethical reimbursement restrictions. They suggested the following improvements: transparency of processes and decisions, dynamic formularies that can adapt with evolving treatment practices and clinical data, broader representation of expertise on review panels, greater use of ethics to resolve conflicts arising from different perspectives, and the development of an explicit Canadian weighting system for evidence and values. CONCLUSIONS Economic evidence has been tentatively incorporated in reimbursement decision-making in Canada. Public reasons for recommendation indicate that this evidence is used primarily with respect to the attractiveness of an incremental cost-effectiveness ratio. Oncology drugs seem to be adopted at the highest thresholds of acceptability. Yet, decision-makers expressed a need to move beyond lambda, rejecting the simplicity of the incremental cost-effectiveness ratio and considering alternative strategies to improve decision-making, including formal guidance for weighting both evidence and values.
Revisiting the rise and fall of false recall: Presentation rate effects depend on retention interval

Leading theories of false memory predict that veridical and false recall of lists of semantically associated words can be dissociated by varying the presentation speed during study. Specifically, as presentation rate increases from milliseconds to seconds, veridical recall is predicted to increase monotonically while false recall is predicted to show a rapid rise and then a slow decrease—a pattern shown by McDermott and Watson (2001) in a study using immediate recall tests. In three experiments we tested the generality of the effects of rapid presentation rates on veridical and false memory. In Experiments 1 and 2 participants exhibited high levels of false recall on a delayed recall test, even for very fast stimulus onset asynchronies (SOA)—contrary to predictions from leading theories of false memory. When we switched to an immediate recall test in Experiment 3 we replicated the pattern predicted by the theories and observed by McDermott and Watson. Follow-up analyses further showed that the relative output position of false recalls is not affected by presentation rate, contrary to predictions from fuzzy trace theory. Implications for theories of false memory, including activation monitoring theory and fuzzy trace theory, are discussed.