Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessing Elbow Assessment, past, Present and Future

The state of elbow assessment is reviewed using a timeline of past, present and future. Empirical evidence is provided supporting the conclusions made in recent years that patient self-assessed evaluation of elbow function is valid, consistent and reliable. This form of assessment is so robust that it does not appear to matter whether the scale is composed of four, five or seven categories or even a visual analogue scale per item. The raw scores are not linear but can be constructed as such using Rasch modelling. Items included in any one scale have been identified as being on a continuum of difficulty, and the continuum itself can be considered as a ‘ruler’ of difficulty. Finally, the health of the elbow cannot be summarized as just one domain. We suggest that health of the elbow be considered by an expert panel (BESS) where the concepts of pain, function and impairment are fitted to the International Classification of Functioning, Disability and Health framework, so that a standardized assessment regime is available on a national basis.
Adolescent units: a need for change?

AIMS AND METHOD To describe the characteristics and diagnoses of patients admitted to a general adolescent psychiatric inpatient unit. We describe the age, gender and psychiatric diagnosis of the patient, as well as whether the patient exhibited violent behaviour in the ward, whether he/she needed to be transferred to a different service and whether he/she was admitted under a section of the Mental Health Act 1983. RESULTS Patients were evenly distributed in terms of gender, with most being 14-16 years old. Diagnoses were varied with adjustment disorder predominating, but could be separated into four main groups. Levels of violence were high, being associated with detention under the Mental Health Act 1983, and often resulted in transfer to another service. CLINICAL IMPLICATIONS The needs of certain adolescents admitted to a general-purpose adolescent unit may not be best met in this environment. Current services must change to meet the needs of their patients. There may be a need for greater specialisation.
Use of the Ponseti Method in the Iranian Population

Background: The most common congenital orthopaedic condition requiring treatment is clubfoot. The Ponseti method, which has improved the recurrence rate, is at present the most attractive method of treatment in the north of America. The purpose of this study was to evaluate the outcome of this method in an Iranian population and look for characteristics that may affect the treatment process. Methods: A total of 78 patients (129 feet) were treated by precisely adhering to the technique originally introduced by Ponseti. Relapse was defined as any return of each of 4 clubfoot components according to the Dimeglio-Bensahel system. The mean follow-up period was 24.7 months and relapse was analyzed with respect to severity of primary disorder, number of casts, compliance with postcorrection bracing and stretching exercise, and educational level of parents. Results: At the end of the follow-up, 24 (18.6%) clubfeet experienced relapse as defined. The mean time to relapse was 13.7 months, 30 feet had brace noncompliance, and stretching was not done for 35 feet. Significant association was detected between recurrence and severity of clubfoot, number of casts for complete correction, and bracing and stretching exercise noncompliance. Conclusions: The Ponseti method is a successful treatment protocol for idiopathic clubfoot. Its success rate will increase with use of abduction orthosis after complete correction and also by performing regular stretching exercises. Level of Evidence: Therapeutic level II.
Buscando una aguja en un pajar: las técnicas de conexión de registros en los sistemas de información sanitaria

: Linking records from two or more data sets with information on an issue allows us to identify those belonging to the same individual. The linkage process can be manual, deterministic, or probabilistic. Probabilistic linkage was developed for those situations where there is no single identifier, the number of identifying variables is limited, and they have little discriminating power. Considering the possibilities for the linkage to be correct or incorrect and based on the degree of agreement among variables and their frequencies, this process weights each variable. This manuscript presents linkage techniques, describes probabilistic linkage step by step, and illustrates it with examples taken from the actual operation of our services.
In Vivo Brain Imaging: Fluorescence or Bioluminescence, Which to Choose?

In the last decade, several different optical-imaging techniques have been developed to study neuronal activity, with the aim to map and decipher the neural code underlying major neurophysiologic functions, such as odor perception, learning and memory, locomotor activity, and sleep, to name a few. The first generation of these techniques was principally based on detecting either transmembrane voltage or calcium activity by using fluorescent dye markers. Recently, the development of genetically encoded probes has extended the limits, increased the accessibility of deeper structures, and more importantly, allowed investigators to precisely label and identify the desired neurons. However, several deep structures of the brain still remain refractive to these approaches, suggesting that the development of other techniques will be welcome. Recently, a new bioluminescence approach has been described, and although it is still a new technique, the first reported results, and the biological phenomena that have been revealed, make it extremely promising. This review will summarize the recent progress of these different imaging approaches, comparing the limits and constraints of each of them, and will guide the reader in choosing the most appropriate method in accordance with the desired neurons or functions under investigation.
Controlled release of IGF‐I from a biodegradable matrix improves functional recovery of skeletal muscle from ischemia/reperfusion

Ischemia/reperfusion (I/R) injury is a considerable insult to skeletal muscle, often resulting in prolonged functional deficits. The purpose of the current study was to evaluate the controlled release of the pro‐regenerative growth factor, insulin‐like growth factor‐I (IGF‐I), from a biodegradable polyethylene glycol (PEG)ylated fibrin gel matrix and the subsequent recovery of skeletal muscle from I/R. To accomplish this, the hind limbs of male Sprague–Dawley rats were subjected to 2‐h tourniquet‐induced I/R then treated with saline, bolus IGF‐I (bIGF), PEGylated fibrin gel (PEG‐Fib), or IGF‐I conjugated PEGylated fibrin gel (PEG‐Fib‐IGF). Functional and histological evaluations were performed following 14 days of reperfusion, and muscles from 4‐day reperfusion animals were analyzed by Western blotting and histological assessments. There was no difference in functional recovery between saline, bIGF, or PEG‐Fib groups. However, PEG‐Fib‐IGF treatment resulted in significant improvement of muscle function and structure, as observed histologically. Activation of the PI3K/Akt pathway was significantly elevated in PEG‐Fib‐IGF muscles, compared to PEG‐Fib treatment, at 4 days of reperfusion, suggesting involvement of the pathway PI3K/Akt as a mediator of the improved function. Surprisingly, myoblast activity was not evident as a result of PEG‐Fib‐IGF treatment. Taken together, these data give evidence for a protective role for the delivered IGF. These results indicate that PEG‐Fib‐IGF is a viable therapeutic technique in the treatment of skeletal muscle I/R injury. Biotechnol. Bioeng. 2012; 109:1051–1059. © 2011 Wiley Periodicals, Inc.
The Genetic Basis of Emotional Behavior: Has the Time Come for a Drosophila Model?

Abstract: The aim of this review was to summarize the studies potentially relevant to whether Drosophila can be used as a genetically tractable model to study the genetic and molecular basis of emotional behavior. Can these studies contribute to a better understanding of neural substrates of abnormal emotional states and specific neuropsychiatric illnesses, such as depression and anxiety?
Recent developments in β lactamases and extended spectrum β lactamases

Resistance to β lactam antibiotics is an increasing problem worldwide. This review describes the classification and mechanism of action of βlactamases and the options available for detecting, treating, and controlling extended spectrum β lactamases βlactam antimicrobial agents are the most common treatment for bacterial infections (table 1). 1 Rates of bacterial resistance to antimicrobial agents are increasing worldwide, including in Lebanon.2 Production of β lactamases is the most common mechanism of bacterial resistance (table 2). 1 3 These enzymes are numerous, and they mutate continuously in response to the heavy pressure of antibiotic use, leading to the development of extended spectrum β lactamases (ESBLs). 4 Examples are the mutated TEM and SHV genes, mainly found in strains of Escherichia coli and Klebsiella pneumoniae respectively. Infections with ESBL producing bacterial strains are encountered singly or in outbreaks, especially in critical care units in hospitals, resulting in increasing costs of treatment and prolonged hospital stays. We aim to present a simplified review of this highly complex subject, in the hope that it will guide the practising physician in appropriate decisions relating to the use of β lactams in patient care. View this table: Table 1 Groups and examples of β lactam antimicrobial agents View this table: Table 2 Antimicrobial agents, their modes of action, and the corresponding mechanisms of bacterial resistance We examined new information from the most recent relevant literature retrieved from PubMed and the internet. The β lactams are a family of antimicrobial agents consisting of four major groups: penicillins, cephalosporins, monobactams, and carbapenems (table 1). They all have a β lactam ring, which can be hydrolysed by β lactamases. The groups differ from each other by additional rings (thiazolidine ring for penicillins, cephem nucleus for cephalosporins, none for monobactams, double ring structure for carbapenems). The various antibiotics in each group differ by the nature of one …
A computational framework for the design of optimal protein synthesis

Despite the establishment of design principles to optimize codon choice for heterologous expression vector design, the relationship between codon sequence and final protein yield remains poorly understood. In this work, we present a computational framework for the identification of a set of mutant codon sequences for optimized heterologous protein production, which uses a codon‐sequence mechanistic model of protein synthesis. Through a sensitivity analysis on the optimal steady state configuration of protein synthesis we are able to identify the set of codons, that are the most rate limiting with respect to steady state protein synthesis rate, and we replace them with synonymous codons recognized by charged tRNAs more efficient for translation, so that the resulting codon‐elongation rate is higher. Repeating this procedure, we iteratively optimize the codon sequence for higher protein synthesis rate taking into account multiple constraints of various types. We determine a small set of optimized synonymous codon sequences that are very close to each other in sequence space, but they have an impact on properties such as ribosomal utilization or secondary structure. This limited number of sequences can then be offered for further experimental study. Overall, the proposed method is very valuable in understanding the effects of the different properties of mRNA sequences on the final protein yield in heterologous protein production and it can find applications in synthetic biology and biotechnology. Biotechnol. Bioeng. 2012; 109:2127–2133. © 2012 Wiley Periodicals, Inc.
Management of Hip Instability in Trisomy 21

The unstable hip in Trisomy 21 presents with a spectrum of hip instability with different problems at different ages. What links this multiphase problem, in many patients, is the final common pathway of untreated instability, that of a stiff, dislocated, and often-painful hip, leading to significant functional disability. Historically, the results of treating hip instability in Trisomy 21 were variable with a notable frequency of poor results. With an improved understanding of the Trisomy 21 hip in terms of its pathoanatomy and a more contemporary surgical approach to hip reconstruction, much improved results can be expected and indeed have recently been shown. The mainstay of treatment for the habitual dislocation group presenting before 8 years of age is the femoral varus derotation osteotomy. The older group presenting with painful subluxation often show signs of secondary acetabular dysplasia and thus are best treated with redirectional acetabular osteotomy with or without the use of femoral varus derotation osteotomy. The presence of radiographic features of degenerative arthritis in the fixed dislocation group precludes the use of joint-preserving techniques for hip reconstruction, and these patients can achieve excellent results with total joint arthroplasty. The natural history, historical results, assessment, treatment, and management of complications of hip instability in Trisomy 21 are addressed in this paper.
Spoken word processing creates a lexical bottleneck

We report 3 experiments that examined whether presentation of a spoken word creates an attentional bottleneck associated with lexical processing in the absence of a response to that word. A spoken word and a visual stimulus were presented in quick succession, but only the visual stimulus demanded a response. Response times to the visual stimulus increased as the lag between it and the spoken word decreased, suggesting a bottleneck in processing. This effect was modulated by the uniqueness point of the spoken word; bottleneck effects were strongest when the spoken word had a late uniqueness point (Experiment 1). The effect was also modulated by the nature of the second task, with the effect stronger when the visual stimulus was a word rather than a shape (Experiment 2) or face (Experiment 3). Word processing appears to create a transient lexical bottleneck that is driven by the magnitude of lexical activity.
Urinary β2-Microglobulin Is Associated With Acute Renal Allograft Rejection

Background: Identifying urinary biomarkers associated with acute rejection (AR) of kidney allografts could improve recipient care by allowing AR to be diagnosed noninvasively and treated earlier. We attempted to identify novel biomarkers associated with AR by analyzing urinary proteins by using matrix-associated laser desorption ionization time-of-flight mass spectroscopy (MALDI-TOF MS). Methods: Using MALDI-TOF MS, we analyzed urine samples from 30 renal allograft recipients with biopsy-proven AR, 15 allograft recipients without AR, preoperative samples from 29 kidney donors, and 10 subjects with proteinuric native kidney disease. Results: In samples obtained at the time of AR, we identified a protein peak at 11.7 kd that correlated strongly with AR. In regard to its predictive power for AR, this protein peak showed sensitivity of 83.3%, specificity of 80%, positive predictive value of 89%, and negative predictive value of 70.6%, suggesting that this protein is highly associated with AR. We identified this peak as being β2-microglobulin. This was validated by using enzyme-linked immunosorbent assay, which documented the presence of high urinary β2-microglobulin levels in subjects with AR. Conclusion: β2-Microglobulin could be a strong biomarker for AR if used in conjunction with other biomarkers, producing an AR-specific urinary protein signature. This possibility must be confirmed in a larger cohort of kidney transplant recipients.
Real-Time Updating of 2D Map for Autonomous Robot Locomotion Based on Distinction Between Static and Semi-Static Objects

Abstract Autonomous mobile robots are increasingly being used in complex 2D environments such as factories, warehouses, and offices. For such environments, we propose a real-time technique for updating an environmental map for a robot’s self-localization using a bearing-range sensor in situations where a basis map can be preliminarily prepared. These environments include many semi-static objects such as cardboard boxes, and the locations of these objects change frequently. Therefore, the self-localization needs to reflect the changes in both the existence and position of semi-static objects in the map in real-time. However, if the robot uses a traditional technique that updates all objects and if it keeps updating the map for a long period, static objects such as walls will move slightly on the map due to errors of both measurement and self-localization, and the map will be distorted. Therefore, our technique distinguishes between static and semi-static objects on the map, and it defines the changeability of the occupancy probability of every spatial grid in order to update the map without changing the occupancy probabilities of grids around static objects. By doing so, we prevented the map from being distorted. In addition, by estimating the grids’ statuses during two observations of the same grids and by changing the probabilities of the objects’ fixedness based on the statuses, our technique can robustly distinguish the objects on the map even if the timing of observing grids is irregular.
Managing methanogens and homoacetogens to promote reductive dechlorination of trichloroethene with direct delivery of H2 in a membrane biofilm reactor

A study with H2‐based membrane biofilm reactors (MBfRs) was undertaken to examine the effectiveness of direct H2 delivery in ex‐situ reductive dechlorination of chlorinated ethenes. Trichloroethene (TCE) could be reductively dechlorinated to ethene with up to 95% efficiency as long as the pH‐increase effects of methanogens and homoacetogens were managed and dechlorinators were selected for during start‐up by creating H2 limitation. Based on quantitative PCR, the dominant bacterial groups in the biofilm at the end of reactor operation were Dehalococcoides, Geobacter, and homoacetogens. Pyrosequencing confirmed the dominance of the dechlorinators and identified Acetobacterium as the key homoacetogen. Homoacetogens outcompeted methanogens for bicarbonate, based on the effluent concentration of acetate, by suppressing methanogens during batch start‐up. This was corroborated by the methanogenesis functional gene mcrA, which was 1–2 orders of magnitude lower than the FTHFS functional gene for homoacetogens. Imaging of the MBfR fibers using scanning electron microscopy showed a distinct Dehalococcoides‐like morphology in the fiber biofilm. These results support that direct addition of H2 can allow for efficient and complete reductive dechlorination, and they shed light into how H2‐fed biofilms, when operated to manage methanogenic and homoacetogenic activity, can be used for ex‐situ bioremediation of chlorinated ethenes. Biotechnol. Bioeng. 2012;109: 2200–2210. © 2012 Wiley Periodicals, Inc.
Does our bundle stack up! Innovative nurse-led changes for preventing catheter-associated urinary tract infection (CAUTI)

Abstract Introduction The aim of this project was to develop and implement an innovative nurse-led model of care in the use and management of indwelling urinary catheters (IUC) utilising evidence-based ‘bundle interventions' to reduce the incidence of catheter-associated urinary tract infections (CAUTI). Design and method A pre and post intervention study designed to progress in three phases was conducted in the orthopaedic ward and urology ward of a large tertiary referral facility. Phase one involved a clinical data collection pre intervention on all inpatients receiving an IUC over a 3-month period from February to April 2013. A staff survey assessed knowledge and skills and an evidence-based care bundle, nurse-led protocols, and education resources were developed through collaboration with clinicians. Phase two involved implementation and Phase three was an evaluation with the primary outcome targets being reduced IUC usage, days IUC in situ and incidence of CAUTI. Results Pre audit data revealed a high rate of IUC use: 31% of all inpatients in the orthopaedic ward and 25% in the urology ward. Compliance with current guidelines was inconsistent and documentation related to IUCs was poor. Overall CAUTI rate was relatively low at 2.2% of all patients with an IUC and was higher in the orthopaedic ward. Conclusion The development of a systematic and standardised approach to IUC care for inpatients using bundle care interventions will potentially reduce IUC use, provide a clear pathway for nurse-initiated IUC removal and reduce the incidence of catheter-associated urinary tract infections (CAUTI).
Role of non‐specific DNA in reducing coding DNA requirement for transient gene expression with CHO and HEK‐293E cells

Transient gene expression (TGE) is a rapid method for the production of recombinant proteins in mammalian cells. While the TGE volumetric productivity has improved significantly over the past decade, the amount of plasmid DNA (pDNA) needed for transfection remains very high. Here, we examined the use of non‐specific (filler) DNA to partially replace the transgene‐bearing plasmid DNA (coding pDNA) in transfections of Chinese hamster ovary (CHO) and human embryo kidney (HEK‐293E) cells. When the optimal amount of coding pDNA for either host was reduced by 67% and replaced with filler DNA, the recombinant protein yield decreased by only 25% relative to the yield in control transfections. Filler DNA did not affect the cellular uptake or intracellular stability of coding pDNA, but its presence lead to increases of the percentage of transfected cells and the steady‐state level of transgene mRNA compared to control transfections. Studies of the physicochemical properties of DNA–polyethyleneimine (PEI) complexes with or without filler DNA did not reveal any differences in their size or surface charge. The results suggest that filler DNA allows the coding pDNA to be distributed over a greater number of DNA–PEI complexes, leading to a higher percentage of transfected cells. The co‐assembly of filler DNA and coding pDNA within complexes may also allow the latter to be more efficiently utilized by the cell's transcription machinery, resulting in a higher level of transgene mRNA. Biotechnol. Bioeng. 2012;109: 2271–2278. © 2012 Wiley Periodicals, Inc.
Redefining the Role of the Community Interpreter: The Concept of Role-space

'Redefining the Role of the Community Interpreter' questions the traditional notion of 'role' that is so often taught on interpreter education and training courses and, more often than not, prescribed by the Codes of Ethics/Practice/Conduct published by institutional users and providers of interpreting services. By examining the nature of face-to-face interactions and drawing on the most recent research into community and public service interpreting, the authors propose and describe a wholly new approach to the role of the interpreter; one based on research and the experiences of the authors, both of whom have, for many years, taught postgraduate interpreting courses and, for even more years, interpreted in a wide variety of settings, from international conferences to social services departments, from presidential addresses to benefits offices, and from doctors’ surgeries to Courts of Appeal. The ‘role-space’ model treats all interactions as unique and offers the interpreter a tool to prepare for and participate in those interactions. Excellent language skills are taken for granted, as is the integrity of the interpreter; what is new is the freedom of the interpreter to make appropriate professional decisions based on the reality of the interaction they are interpreting.