Miracle-dz/UniFAR-FTUs huggingface dataset:
Patellofemoral problems after anterior cruciate ligament reconstruction

Between 1982 and 1986, 126 patients who had under gone ACL reconstruction were followed in a prospec tive manner. One year follow-up statistics were re viewed for the presence of 13 different complications. The most prevalent complications were quadriceps weakness, flexion contracture, and patellofemoral pain. Quadriceps weakness (strength less than 80% of the normal side) was present in 65% of patients and cor related positively with flexion contracture, patellar irrit ability, and ACL reconstructions using patellar tendon grafts. Flexion contracture of 5° or more was present in 24% of patients and correlated positively with in creased age and patellar irritability. Patellofemoral pain was present in 19% of patients and correlated positively with flexion contracture. Clinical relevance: The three most common compli cations of knee ligament surgery are shown to be strongly interrelated. It is likely that a causal relationship is present in which flexion contracture causes patello femoral irritability, and that both of these factors, alone or in combination, result in quadriceps weakness. If this theory is correct, then it is crucial that postoperative rehabilitation programs place a major emphasis on the avoidance of flexion contracture.
The nucleoporin ELYS regulates nuclear size by controlling NPC number and nuclear import capacity

How intracellular organelles acquire their characteristic sizes is a fundamental cell biological question. Given the stereotypical changes in nuclear size in cancer, it is particularly important to understand the mechanisms that control nuclear size in human cells. Here we use a high-throughput imaging RNAi screen to identify and mechanistically characterize ELYS, a nucleoporin required for postmitotic nuclear pore complex (NPC) assembly, as a determinant of nuclear size in mammalian cells. We show that ELYS knockdown results in small nuclei, the accumulation of cytoplasmic lamin aggregates, reduced nuclear lamin B2 localization, lower NPC density, and decreased nuclear import. Increasing nuclear import by importin α overexpression rescues nuclear size and lamin B2 import, while inhibiting importin α/β nuclear import decreases nuclear size. Conversely, ELYS overexpression leads to increased nuclear size, enrichment of nuclear lamin B2 staining at the nuclear periphery, and elevated NPC density and nuclear import. Consistent with these observations, knockdown or inhibition of exportin 1 increases nuclear size. In summary, we identify ELYS and NPC density as novel positive effectors of mammalian nuclear size and propose that nuclear size is controlled by nuclear import capacity.
The Ser/Thr Kinase PrkC Participates in Cell Wall Homeostasis and Antimicrobial Resistance in Clostridium difficile

Clostridium difficile is the leading cause of antibiotic-associated diarrhea in adults. During infection, C. difficile must detect the host environment and induce an appropriate survival strategy. Signal transduction networks involving serine/threonine kinases (STKs) play key roles in adaptation, as they regulate numerous physiological processes. PrkC of C. difficile is an STK with two PASTA domains. We showed that PrkC is membrane associated and is found at the septum. ABSTRACT Clostridium difficile is the leading cause of antibiotic-associated diarrhea in adults. During infection, C. difficile must detect the host environment and induce an appropriate survival strategy. Signal transduction networks involving serine/threonine kinases (STKs) play key roles in adaptation, as they regulate numerous physiological processes. PrkC of C. difficile is an STK with two PASTA domains. We showed that PrkC is membrane associated and is found at the septum. We observed that deletion of prkC affects cell morphology with an increase in mean size, cell length heterogeneity, and presence of abnormal septa. A ΔprkC mutant was able to sporulate and germinate but was less motile and formed more biofilm than the wild-type strain. Moreover, a ΔprkC mutant was more sensitive to antimicrobial compounds that target the cell envelope, such as the secondary bile salt deoxycholate, cephalosporins, cationic antimicrobial peptides, and lysozyme. This increased susceptibility was not associated with differences in peptidoglycan or polysaccharide II composition. However, the ΔprkC mutant had less peptidoglycan and released more polysaccharide II into the supernatant. A proteomic analysis showed that the majority of C. difficile proteins associated with the cell wall were less abundant in the ΔprkC mutant than the wild-type strain. Finally, in a hamster model of infection, the ΔprkC mutant had a colonization delay that did not significantly affect overall virulence.
Incidence and mortality of bone cancer among children, adolescents and young adults of Brazil

OBJECTIVES: Bone cancers occur frequently in children, adolescents, and young adults aging 15 to 29 years. Osteosarcoma and Ewing sarcoma are the most frequent subtypes in this population. The aim of this study was to describe incidence and mortality trends of bone cancers among Brazilian children, adolescents and young adults. METHODS: Incidence information was obtained from 23 population-based cancer registries. Mortality data were extracted from the Atlas of Cancer Mortality from 1979 to 2013. Specific and adjusted rates per million were analyzed according to gender, morphology and age at diagnosis. Median rates were used as a measure of central tendency. Joinpoint regression was applied to analyze trends. RESULTS: Median incidence rates were 5.74 and 11.25 cases per million in children and young adults respectively. Osteosarcoma in the 15-19 years aged group had the highest incidence rates. Stable incidence rates were observed among five registries in 0-14 year's age group. Four registries had a decreased incidence trend among adolescents and young adults. Median mortality rates were 1.22 and 5.07 deaths per million in children and young adults respectively. Increased mortality was observed on the North and Northeast regions. Decreased mortality trends were seen in the South (children) and Southeast (adolescents and young adults). CONCLUSION: Osteosarcoma and Ewing Sarcoma are the most incident bone cancers in all Brazilian regions. Bone cancers showed incidence and mortality patterns variation within the geographic regions and across age groups, although not significant. Despite limitations, it is crucial to monitor cancer epidemiology trends across geographic Brazilian regions.
Kinematics of Stewart Platform Explains Three-Dimensional Movement of Honeybee’s Abdominal Structure

Abstract The Stewart platform is a typical parallel mechanism, used extensively in flight simulators with six degrees of freedom. It is rarely found in animals and has never been reported to regulate and control physiological activities. Now an equivalent Stewart platform structure is found in the honey bee (Hymenoptera: Apidae: Apis mellifera L.) abdomen to explain its three-dimensional movements. The stereoscope and scanning electron microscope are used to observe the internal structures of honeybees’ abdomens. Experimental observations show that the muscles and intersegmental membranes connect the terga with the sterna and guarantee the honey bee abdominal movements. From the perspective of mechanics, a Stewart platform is evolved from the lateral connection structure of the honey bee abdomen, and the intrasegmental muscles between the sternum and tergum function as actuators between planes of the Stewart platform. The extraordinary structure provides various advantages for a honey bee to complete a variety of physiological activities. This equivalent Stewart platform structure can also be used to illustrate the flexible abdominal movements of other insects with the segmental abdomen.
Effects of Grit on the Academic Success of Adult Female Students at Korean Open University

This study examined the structural relationship between age, grit (i.e., perseverance of effort and consistency of interest), conscientiousness, self-control, and school success of female students at an Open University in Korea. We analyzed 509 students’ responses, and it turned out that the level of perseverance of effort was negatively correlated with academic maladjustment. Also, perseverance of effort had a positive indirect effect on grade point average scores. Conscientiousness and self-control were found to be positively correlated with grit factors and they had negative effects on academic maladjustment through perseverance of effort. Age had both direct and indirect effects on grit and academic success of the students.
On the Feasibility of Built-In Self Repair for Logic Circuits

According to recent investigations on fault mechanisms in nano-scale integrated circuits, they suffer from wear-out effects that limit their life time seriously. For applications that combine a long life time and safety-critical functionality, means of fault compensation, de-stressing and eventual self repair are therefore becoming a must. This paper presents a circuit architecture that combines capabilities of self repair and de-stressing for logic circuits. Circuits that administrate repair functions are introduced. The necessary overhead for redundancy as well as for circuit re-organization is shown, depending on the granularity of repair. Finally limitations as well as single points of failure are discussed.
Dead or dying? Quantifying the point of no return from hydraulic failure in drought‐induced tree mortality

Summary Determining physiological mechanisms and thresholds for climate‐driven tree die‐off could help improve global predictions of future terrestrial carbon sinks. We directly tested for the lethal threshold in hydraulic failure – an inability to move water due to drought‐induced xylem embolism – in a pine sapling experiment. In a glasshouse experiment, we exposed loblolly pine (Pinus taeda) saplings (n = 83) to drought‐induced water stress ranging from mild to lethal. Before rewatering to relieve drought stress, we measured native hydraulic conductivity and foliar color change. We monitored all measured individuals for survival or mortality. We found a lethal threshold at 80% loss of hydraulic conductivity – a point of hydraulic failure beyond which it is more likely trees will die, than survive, and describe mortality risk across all levels of water stress. Foliar color changes lagged behind hydraulic failure – best predicting when trees had been dead for some time, rather than when they were dying. Our direct measurement of native conductivity, while monitoring the same individuals for survival or mortality, quantifies a continuous probability of mortality risk from hydraulic failure. Predicting tree die‐off events and understanding the mechanism involved requires knowledge not only of when trees are dead, but when they begin dying – having passed the point of no return.
Hidden interactions in financial markets

Significance The importance of understanding the structure of financial markets has been progressively coming to a head in public discourse. With the rise and prevalence of big datasets, it is a crucial time for academics to study the interdependency outside conventional analysis. Thus, the methodology proposed in this paper does not only allow distinction between positive and negative interdependence, but additionally identifies a yet unexplored form of interaction we coin as “dark causality. ” We benchmark this method on asset pairs and on a network of sovereign credit default swaps, where the dominant form of interaction is that of dark causality. Our results are relevant to finance practitioners who, by virtue of their profession, tend to engage on a regular basis with retail investors. The hidden nature of causality is a puzzling, yet critical notion for effective decision-making. Financial markets are characterized by fluctuating interdependencies which seldom give rise to emergent phenomena such as bubbles or crashes. In this paper, we propose a method based on symbolic dynamics, which probes beneath the surface of abstract causality and unveils the nature of causal interactions. Our method allows distinction between positive and negative interdependencies as well as a hybrid form that we refer to as “dark causality. ” We propose an algorithm which is validated by models of a priori defined causal interaction. Then, we test our method on asset pairs and on a network of sovereign credit default swaps (CDS). Our findings suggest that dark causality dominates the sovereign CDS network, indicating interdependencies which require caution from an investor’s perspective.
Mitochondrial lineages in Ladin–speaking communities of the eastern Alps

European mitochondrial alleles cluster into five haplogroups. Haplogroup 2 is rare in general, but represents more than half of the few known sequences among Ladin speakers of the Alps. Here we describe DNA diversity in control region I of the hypervariable D–loop in 43 Ladins, and in 25 Italian speakers. Analysis of these data, and of previously published sequences, confirms a high degree of differentiation among Ladins and their geographical neighbours. This cannot be regarded as a simple effect of isolating factors, geographic or linguistic, as diversity is high within Ladin communities too. Rather, allele genealogies, population trees, and principal component analysis suggest a relationship between Ladin and Near Eastern samples. Two evolutionary hypotheses seem compatible with these findings. The view whereby Ladins could be descended from Palaeolithic inhabitants of the Alps is supported by the identification, in this study, of the probable ancestral haplotype of group 2, never previously observed in central Europe. Alternatively, a comparatively recent, Neolithic immigration of the ancestors of current Ladin speakers seems consistent with recent linguistic theories. In both cases, the number of lineages present, and their extensive diversity, are not compatible with a serious bottleneck in the Ladin population's history.
CD21‐CD23 ligand pair expression in children with allergic asthma

The CD23 antigen, a low affinity receptor for IgE, was recently shown to interact with another ligand, CD21, and the pairing of these molecules is important in T cell‐B cell interaction and control of IgE production. Here, we analysed the expression of CD21 andCD23 on CD4+ and CD20+ lymphocytes in 25 allergic children and 12 age‐matched non‐allergic controls. Both the percentage (P<0.01) and the absolute number (P<0.00l) of CD23+ cells were increased in allergic children. There was no difference of CD21+ cells. Double positive CD4+CD23+ cells (2.5%) were only detected in one patient, in others all CD23 being expressed on B cells. The CD21 antigen was expressed only on B cells. Furthermore, allergic children had an increased mean fluorescence intensity of both the CD21 (P<0.00l) and the CD23 (P<0.001) receptor. To analyse the possible difference in B cell subsets expressing CD21 and CD23 antigens, three‐colour fluorescence analysis was performed. In allergic children the subset of CD20+CD21− cells expressed more CD23 than in controls (P<0.001). These results may mean an impaired expression and possibly regulation of CD21‐CD23 interaction in allergic conditions.
How to ...

Feedback is the information given to a trainee about their performance. It can be intrinsic, when there is a sense of a job well done, or perhaps one that could have been done better, or extrinsic, when it is provided by a supervisor or peer. Receiving constructive feedback is an essential element in learning. It enables the learner to raise the level of their awareness in relation to their strengths and can highlight the areas of their knowledge, skills or attitudes which require attention. Trainees often complain that they rarely receive feedback on their performance; however, with the introduction of work-based placed assessments into all aspects of curricula, the skill of providing constructive feedback has become increasingly important. There are essentially two types of feedback, informal and formal, but it is clear that irrespective of the type of interaction or the context of the interaction, the principles of giving constructive feedback remain the same. If it is to have any educational value then feedback needs to be developmental, delivered in a manner that focuses on behaviours and helps strengthen the relationships between trainer and trainee.
Associations between non-anaemic iron deficiency and outcomes following surgery for colorectal cancer: An exploratory study of outcomes relevant to prospective observational studies

Iron deficiency is common in colorectal cancer. Despite perioperative guidelines advocating for the correction of non-anaemic iron deficiency prior to major surgery, the impact of this pathology on postoperative outcome is unclear. We conducted a single-centre, historical cohort study of 141 elective resections for colorectal cancer. We stratified non-anaemic patients into iron deficient and iron replete groups, and collected data on baseline characteristics, preoperative laboratory results, intraoperative events and postoperative outcomes. As this study was an exploratory work for future research, a P-value of 0.25 was considered relevant. Patients in the deficient group demonstrated lower baseline ferritin (median (interquartile range, IQR) 76 (41–141) µg/L versus 207 (140–334) µg/L, P < 0.001) and transferrin saturation (mean (standard deviation, SD) 18% (8%) versus 32% (12%), P < 0.001) than those in the replete group, and lower starting haemoglobin (mean (SD) 138 (10) g/L versus 144 (12) g/L, P = 0.01). The deficient group had increased re-admission (25% (24%) versus 4% (11%), P = 0.15) and all-cause infection (25% (24%) versus 5% (14%), P = 0.24). A decrease of two days in days alive and out of hospital at postoperative day 90 was seen in the deficient group on univariate analysis (median (IQR) 81 (75–84) versus 83 (78–84), P = 0.25). This reduced to 1.24 days in multivariate adjusted quantile regression analysis (P = 0.22). Days alive and out of hospital at day 90, postoperative re-admission and postoperative infection may be meaningful outcome measures for future prospective observational work examining non-anaemic iron deficiency in patients undergoing major surgery for colorectal cancer.
Transdermal fentanyl as an adjuvant to paravertebral block for pain control after breast cancer surgery: A randomized, double-blind controlled trial

Objective: The aim of this study is to investigate the effect of transdermal fentanyl (TDF) as an adjuvant to paravertebral block (PVB) for pain control after breast cancer surgery. Patients and Methods: This randomized, double-blind trial included fifty females with breast cancer scheduled for surgery. They were randomly allocated into one of two equal groups. The TDF group used transdermal fentanyl patches (TFPs) 25 μg/h applied 10 h preoperative then PVB with 20 mL of bupivacaine 0.25% was done before induction of general anesthesia. The PVB group used placebo patches in addition to PVB the same way as TDF group. Postoperative pain was assessed with a visual analog scale (VAS) score up to 48 h. Intravenous morphine 0.1 mg/kg was given when the VAS is ≥ 3 or on patient request. The primary outcome measures were the time to first request for analgesia and the total analgesic consumption in the first 48 h. Results: Relative to the VAS score reading was 30 min. After the end of surgery, VAS score decreased significantly in the two groups up to 48 postoperative hours and was significantly lower in TDF group up to 24 h. The time to first request of additional analgesia was significantly longer, and total dose of morphine consumption was significantly lower in TDF group (P < 0.001, and P = 0.039, respectively). Conclusion: TFPs releasing 25 μg/h is a safe and effective adjuvant to PVB after breast cancer surgery. It provides adequate analgesia with reduction of opioid consumption and minimal adverse effects.
Cost-effectiveness Evaluations Among the Direct Oral Anticoagulants for the Prevention and Treatment of Venous Thromboembolism: Systematic Review

Venous thromboembolism (VTE) is associated with high recurrence, mortality, and cost burden. Direct oral anticoagulants (DOACs) are currently used for VTE treatment, and they offer more benefits over warfarin, despite being more expensive. There is no consensus on the most cost-effective DOAC agent, especially in VTE. This systematic review aims to summarize the comparative cost-effectiveness studies and their impact among DOACs in the treatment of VTE. Literature systematic review of PubMed, Embase, and EconLit was conducted in February 2018 to identify all cost-effectiveness studies of DOAC for the treatment and prevention of VTE. Two independent investigators systematically collected search results and assessed the quality of the studies. The search identified 7 articles, all of which had dabigatran and rivaroxaban as comparators, 6 of which also included apixaban, and 2 of which also had edoxaban. Results of 3 articles concluded that apixaban is a dominant strategy compared to other DOACs in terms of Incremental Cost-Effectiveness Ratio (ICER) in the treatment and prevention of recurrent VTE. One article compared rivaroxaban and dabigatran, with the latter dominating rivaroxaban in terms of ICER. Compared to other DOACs, 2 articles reported apixaban being associated with highest annual total medical cost avoidance of US$4244 and US$4440 per patient-year (ppy), respectively. One article reported that apixaban had the highest annual total medical cost differences of US$918 ppy compared to other DOACs. This systematic review demonstrates that apixaban is considered a cost-effective strategy for VTE treatment and prevention of recurrent VTE.
Ethical Issues Considered When Establishing a Pediatrics Gender Surgery Center

The establishment of a gender surgery center in a pediatric setting requires institutions to address a unique group of ethical and legal challenges. As part of establishing a gender surgery center at a pediatric academic hospital, we undertook a process of identifying key ethical, legal, and contextual issues through collaboration among clinical providers, review by hospital leadership, discussions with key staff and hospital support services, consultation with the hospital’s ethics committee, outreach to other institutions providing transgender health care, and meetings with hospital legal counsel. This process allowed the center to identify key issues, formulate approaches to resolving those issues, and develop policies and procedures addressing stakeholder concerns. Key issues identified during the process included the appropriateness of providing gender-affirming surgeries to adolescents and adults, given the hospital’s mission and emphasis on pediatric services; the need for education on the clinical basis for offered procedures; methods for obtaining adequate informed consent and assent; the lower and upper acceptable age limits for various procedures; the role of psychological assessments in determining surgical eligibility; the need for coordinated, multidisciplinary patient care; and the importance of addressing historical access inequities affecting transgender patients. The process also facilitated the development of policies addressing the identified issues, articulation of a guiding mission statement, institution of ongoing educational opportunities for hospital staff, beginning outreach to the community, and guidance as to future avenues of research and policy development. Given the sensitive nature of the center’s services and the significant clinical, ethical, and legal issues involved, we recommend such a process when a establishing a program for gender surgery in a pediatric institution.