Miracle-dz/UniFAR-FTUs huggingface dataset:
Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients.

OBJECT Three-column resection osteotomies (3COs) are commonly performed for sagittal deformity but have high rates of reported complications. Authors of this study aimed to examine the incidence of and intercenter variability in major intraoperative complications (IOCs), major postoperative complications (POCs) up to 6 weeks postsurgery, and overall complications (that is, both IOCs and POCs). They also aimed to investigate the incidence of and intercenter variability in blood loss during 3CO procedures. METHODS The incidence of IOCs, POCs, and overall complications associated with 3COs were retrospectively determined for the study population and for each of 8 participating surgical centers. The incidence of major blood loss (MBL) over 4 L and the percentage of total blood volume lost were also determined for the study population and each surgical center. Complication rates and blood loss were compared between patients with one and those with two osteotomies, as well as between patients with one thoracic osteotomy (ThO) and those with one lumbar or sacral osteotomy (LSO). Risk factors for developing complications were determined. RESULTS Retrospective review of prospectively acquired data for 423 consecutive patients who had undergone 3CO at 8 surgical centers was performed. The incidence of major IOCs, POCs, and overall complications was 7%, 39%, and 42%, respectively, for the study population overall. The most common IOC was spinal cord deficit (2.6%) and the most common POC was unplanned return to the operating room (19.4%). Patients with two osteotomies had more POCs (56% vs 38%, p = 0.04) than the patients with one osteotomy. Those with ThO had more IOCs (16% vs 6%, p = 0.03), POCs (58% vs 34%, p < 0.01), and overall complications (67% vs 37%, p < 0.01) than the patients with LSO. There was significant variation in the incidence of IOCs, POCs, and overall complications among the 8 sites (p < 0.01). The incidence of MBL was 24% for the study population, which varied significantly between sites (p < 0.01). Patients with MBL had a higher risk of IOCs, POCs, and overall complications (OR 2.15, 1.76, and 2.01, respectively). The average percentage of total blood volume lost was 55% for the study population, which also varied among sites (p < 0.01). CONCLUSIONS Given the complexity of 3COs for spinal deformity, it is important for spine surgeons to understand the risk factors and complication rates associated with these procedures. In this study, the overall incidence of major complications following 3CO procedures was 42%. Risks for developing complications included an older age (> 60 years), two osteotomies, ThO, and MBL.
Using Ontologies and Soft Systems Methodology to Provide Multi-user Support in Problem Structuring

Decision support systems (DSS) are aimed at helping decision makers in devising appropriate solutions to business problems while negotiation support systems (NSS) are aimed at assisting stakeholders in reaching mutually satisfactory decisions. The successful use of these systems involves a combination of human ability and computer support. An implicit assumption underlying their use is that the business problems for which they are deployed have been carefully defined by the stakeholders prior to their use. This includes, in particular, understanding of the problem variables and their possible impact on the decision outcomes and knowing which information is necessary for supporting it. However, this assumption might not hold in the modern business environment. This is due to the increasing complexity and rate of change of the environment, the geographical and temporal dispersion of modern organizations, and the diversity and quantity of information sources that is available. In this paper we propose the idea of extending the scope of these systems to include a step preceding the solution process: problem framing. We claim that new technologies such as Web 2.0 provide novel opportunities to add this facility to DSS and NSS. To achieve this, we propose a novel approach combining domain and task ontologies. The task ontology we propose employs concepts from soft systems methodology. Specifically, we suggest that a stakeholder can use the ontologies to understand the problem, frame the issue, and identify the information required for the task. The ontologies can support accessing the information sources when the system is being used by stakeholders.
Implementation and Evaluation of an Undergraduate Sociocultural Medicine Program

Purpose To demonstrate an effective model for designing, implementing, and evaluating the Sociocultural Medicine Program (SMP), part of a comprehensive sociocultural medicine curriculum at the University of Michigan Medical School. Method This study followed a cross-sectional, pre- and post-intervention survey design. A total of 167 medical students completed a measure of attitudes toward sociocultural issues in medicine prior to and following participation in the SMP. Students' attitudes were assessed in the domains of “exposure to sociocultural issues,” “sociocultural factors in clinical scenarios,” and “sociocultural background in patient/physician/health status issues. ” Results Paired t-tests of the pre- and post-intervention responses revealed significant positive changes for items in the domain of exposure to sociocultural issues in medicine: experience with sociocultural issues in a clinical setting (p < .01), understanding of relationship among sociocultural background, health, and medicine (p < .001), and importance of sociocultural background in students' future patient populations (p < .01). Significant changes were also found for the impact of sociocultural background in patient/physician/health status issues: physician—patient relationship (p < .001) and patients' health behavior (p < .001). Conclusions The SMP had a significant educational impact on students' attitudes towards sociocultural issues in medicine. Students reported greater exposure to these issues conceptually and clinically, and greater influence of sociocultural factors in patients' behaviors and patient— physician relationships. Critical components of this SMP were faculty development, multiple teaching approaches, and pre- and post-intervention evaluation.
Primary Human and Rat β-Cells Release the Intracellular Autoantigens GAD65, IA-2, and Proinsulin in Exosomes Together With Cytokine-Induced Enhancers of Immunity

The target autoantigens in several organ-specific autoimmune diseases, including type 1 diabetes (T1D), are intracellular membrane proteins, whose initial encounter with the immune system is poorly understood. Here we propose a new model for how these proteins can initiate autoimmunity. We found that rat and human pancreatic islets release the intracellular β-cell autoantigens in human T1D, GAD65, IA-2, and proinsulin in exosomes, which are taken up by and activate dendritic cells. Accordingly, the anchoring of GAD65 to exosome-mimetic liposomes strongly boosted antigen presentation and T-cell activation in the context of the human T1D susceptibility haplotype HLA-DR4. Cytokine-induced endoplasmic reticulum stress enhanced exosome secretion by β-cells; induced exosomal release of the immunostimulatory chaperones calreticulin, Gp96, and ORP150; and increased exosomal stimulation of antigen-presenting cells. We propose that stress-induced exosomal release of intracellular autoantigens and immunostimulatory chaperones may play a role in the initiation of autoimmune responses in T1D.
Rotational gait patterns in children and adolescents following tension band plating of idiopathic genua valga

Literature suggests that children and adolescents with idiopathic genua valga present with considerable gait deviations in frontal and transverse planes, including altered frontal knee moments, reduced external knee rotation, and increased external hip rotation. This study aimed to evaluate gait parameters in these patients after surgical correction using tension band plating (TBP). We prospectively evaluated 24 consecutive, skeletally immature patients, who received full‐length standing radiographs and three‐dimensional gait analysis before and after correction, and compared the results observed to a group of 11 typically developing peers. Prior to TBP the cohort showed significantly decreased (worse) internal frontal knee moments compared to the control group. After axis correction the mean and maximum knee moments changed significantly into normalized knee moments (p < 0.0001). In the transverse plane, only the foot progression angle (p = 0.020) changed significantly following intervention. Post‐correction knee moments were similar to controls (p = 0.175), but the patient cohort exhibited a significantly decreased knee external rotation (p = 0.004) and increased external hip rotation (p < 0.001) during gait. In addition, the effect of transverse plane changes on knee moments in patients with restored, straight limb axis was calculated. Hence, patients with restored alignment but persistence of decreased external knee rotation demonstrated significantly greater knee moments than those without rotational abnormalities (p = 0.001). This study found that frontal knee moments during gait normalized in children with idiopathic genua valga after surgery. However, decreased external knee rotation and increased external hip rotation during gait persisted in the study cohort. Despite radiological correction, decreased external rotation during gait was associated with increases in medial knee loading. Surgical correction for children with genua valga but normal knee moments may be detrimental, due to redistribution of dynamic knee loading into the opposite joint compartment. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1617–1624, 2017.
Relationship among Role Conflict, Role Ambiguity, Organizational Justice, and Job Satisfaction – A Case of State Administrative Agencies in Vinh Long Province, Vietnam

In the past, researchers have paid a little attention on relationship among role conflict, role ambiguity, organization justice and job satisfaction at administrative agencies in Vietnam. Therefore, the main purpose of this thesis is to test the above-mentioned relationship. Research has selected the civil servants (officials) in state agencies and workers in Binh Tan district. The civil servants and workers in Binh Tan district were sampled to investigate which personal characteristics will make significantly differentiation on role conflict, role ambiguity, organizational justice, job satisfaction; simultaneously which relationships the role conflict, role ambiguity, organizational justice and job satisfaction in turn to job satisfaction are also considered. A total of 400 people were sampled by a survey questionnaire. Collected data is done for statistical analysis using SPSS version 17.0. Many hypotheses are tested by such methods as descriptive statisticals, reliability analysis, t-test and linear regression analysis. Research results will show which personal characteristics will make significantly differentiation on the above variants and which ones will not affect them; and will display how strongly the variants are related to job satisfaction. Research flame out a finding: Emotional, spiritual factors will significant impact on effectiveness of employees’ working, a condition to achieve the organization's goals.The study also flame out an other finding . It is a hypothesis (as thinking logically normal), which was identified to be true, it was rejected: Role conflict not impact negatively, but positively impact on job satisfaction. On this basis, the study proposes solutions to strengthen and improve the efficiency of human resources management at local area.
Teacher Communities as a Means to Support Professional Development

The field of teaching is a dynamic, evolving field since its goals are to fulfil the needs of learners and teachers. Teaching practices in the District of Bogota are not an exemption. The recent General Law of Education required that teachers work institutionally as a team. Therefore, team work is beginning to take place at schools and as a phenomenon it is necessary to research on how to build teacher communities in order to improve teachers' professional development as individuals and as members of a community.
Speaker Attribution in Cabinet Protocols

Historical cabinet protocols are a useful resource which enable historians to identify the opinions expressed by politicians on different subjects and at different points of time. While cabinet protocols are often available in digitized form, so far the only method to access their information content is by keyword-based search, which often returns sub-optimal results. We present a method for enriching German cabinet protocols with information about the originators of statements. This requires automatic speaker attribution. Unlike many other approaches, our method can also deal with cases in which the speaker is not explicitly identified in the sentence itself. Such cases are very common in our domain. To avoid costly manual annotation of training data, we design a rule-based system which exploits morpho-syntactic cues. We show that such a system obtains good results, especially with respect to recall which is particularly important for information access.
Hydrolysis of GTP on rab11 is required for the direct delivery of transferrin from the pericentriolar recycling compartment to the cell surface but not from sorting endosomes.

Rab11 is a small GTP-binding protein that in cultured mammalian cells has been shown to be concentrated in the pericentriolar endosomal recycling compartment and to play a key role in passage of the recycling transferrin receptor through that compartment [Ullrich, O. , Reinsch, S. , Urbé, S. , Zerial, M. & Parton, R. G. (1996) J. Cell Biol. 135, 913-924]. To obtain insights into the site(s) of action of rab11 within the recycling pathway, we have now compared the effects on recycling at 37 degreesC of overexpression of wild-type rab11 and various mutant forms of this protein in cells that had been loaded with transferrin at either 37 degreesC or 16 degreesC. We show that incubation at 16 degreesC blocks passage of endocytosed transferrin into the recycling compartment and that, whereas the rab11 dominant negative mutant form (S25N) inhibits transferrin recycling after interiorization at either temperature, the wild-type rab11 and constitutively active mutant (Q70L) have no inhibitory effect on the recycling of molecules that were interiorized at 16 degreesC. This differential inhibitory effect shows that two distinct pathways for recycling are followed by the bulk of the transferrin molecules interiorized at the two different temperatures. The incapacity of the constitutively active form of rab11 (Q70L) to inhibit recycling of molecules interiorized at 16 degreesC is consistent with their recycling taking place directly from sorting endosomes, in a process that does not require hydrolysis of GTP on rab11. The fact that the dominant negative (S25N) form of rab11 inhibits recycling of molecules interiorized at both temperatures indicates that activation of rab11 by GTP is required for exit of transferrin from sorting endosomes, regardless of whether this exit is toward the recycling compartment or directly to the plasma membrane.
Phage conversion in Salmonella enterica serotype Enteritidis: implications for epidemiology

Summary A model system for the study of phage conversion of Salmonella enterica serotype Enteritidis is reported. Temperate phages 1,2,3 and 6 from the phage typing scheme were used to convert several individually recognized phage types into others. Phage type 4 was converted to PT8, PT6a to PT4, PT6a to PT7, PT13 to PT13a and PT15 to PT11; some new phage lysis patterns were also detected. This model was used to examine the relationships between phage types within a previously denned clonal lineage, SECLIII, to establish whether or not Enteritidis like Salmonella enterica serotype Typhi and Salmonella enterica serotype Paratyphi B possessed type determining phages. We were able to convert PT1 to PT20, and PT15 to PT11.
World modeling for cooperative intelligent vehicles

Cooperative intelligent vehicle systems constitute a promising way to improving traffic throughput, safety and comfort. The state-of-the-art intelligent-vehicle applications usually can be described as a collection of interacting, highly autonomous, complex dynamical systems (the individual vehicles). The vehicles implement onboard a wide spectrum of (possibly cooperative) functionalities (applications). In order for an application ldquoto do the right thingrdquo it should have a formal representation and understanding of the relevant surrounding world to implement the proper (e.g. efficient, safe) behavior. In the proposed approach, developed for the SAFESPOT Integrated Project, the Local Dynamic Map (LDM) forms a key element of the onboard system responsible for representing and maintaining a real-time world model. From the applicationspsila point of view, the LDM is the model of the world as known by the vehicle: it contains objects characterized by attributes, uncertainties and relevant relationships between objects. The world model in the LDM is created based on high resolution digital maps, sensory inputs and communication. The LDM implements an abstraction layer between the data interpretation and the higher level behavioral functions. The paper describes the motivation behind the LDM based system decomposition approach, introduces the basic concepts of the world modeling dedicated to cooperative vehicle systems and summarizes the main features of a prototype implementation. The consequences of the LDM based system architecture on application development and testing are also presented.
[Cost-of-illness study of asthma in Korea: estimated from the Korea National Health insurance claims database].

OBJECTIVES We estimated the asthma-related health care utilization and costs in Korea from the insurer' s and societal perspective. METHODS We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had > or =2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines. Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to healthcare providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. RESULTS A total of 699,603 people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct healthcare costs accounted for 84.9%, transportation costs for 15.1% and time costs for 9.2% of the total costs. CONCLUSIONS Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.
Observations and Mechanisms of a Simple Stochastic Dynamical Model Capturing El Niño Diversity

AbstractEl Nino–Southern Oscillation (ENSO) has significant impact on global climate and relevance for seasonal forecasts. Recently, a simple modeling framework was developed that captures the ENSO diversity, where state-dependent stochastic wind bursts and nonlinear advection of sea surface temperature are coupled to a simple ocean–atmosphere model that is otherwise deterministic, linear, and stable. In this article, the coupled model is compared with observations using reanalysis data over the last 34 yr, where the observed non-Gaussian statistics and the overall mechanisms of ENSO are both captured by the model. Then the formation mechanisms of both the central Pacific (CP) and the traditional El Nino in the model are systematically studied. First, ocean Rossby waves induced by easterly trade wind anomalies facilitate the heat content buildup. Then the reflected ocean Kelvin waves and the nonlinear advection lead to positive SST anomalies in the CP region and create a CP El Nino. Second, two formation .
The Role of Diverting Stoma After an Ultra-low Anterior Resection for Rectal Cancer

Purpose A diverting stoma is known to reduce the consequences of distal anastomotic failure following colorectal surgery. The aim of this study was to evaluate the efficacy of a diverting stoma after an ultra-low anterior resection (uLAR) for rectal cancer. Methods Between 2000 and 2007, 836 patients who underwent an uLAR were divided into two groups, depending on the fecal diversion: 246 received fecal diversion, and 590 had no diversion. Patient- and disease-related variables were compared between the two groups. Results Thirty-two of the 836 patients (3.8%) had immediate anastomosis-related complications and required reoperation. Anastomosis leakage comprised 72% of the complications (23/32). The overall immediate complication rate was significantly lower in patients with a diverting stoma (0.8%, 2/246) compared to those without a diverting stoma (5.1%, 30/590; P = 0.005). The fecal diversion group had lower tumor location, lower anastomosis level, and more preoperative chemo-radiation therapy (P < 0.001). In total, 12% of patients in the diverting stoma group had complications either in making or reversing the stoma (30/246). Conclusion The diverting stoma decreased the rate of immediate anastomosis-related complications. However, the rate of complications associated with the diverting stoma was non-negligible, so strict criteria should be applied when deciding whether to use a diverting stoma.