Miracle-dz/UniFAR-FTUs huggingface dataset:
Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis.

BACKGROUND There are conflicting reports with respect to the outcomes of total hip arthroplasties with ceramic bearings in young patients with osteonecrosis of the femoral head. We prospectively investigated the outcomes after cementless total hip arthroplasties with contemporary alumina bearings in patients with osteonecrosis of the femoral head in this age group. METHODS We prospectively followed sixty patients (seventy-one hips) with a mean age of 39.1 years for an average of 7.1 years. All procedures were performed at the same institution by one surgeon, and the results were evaluated serially. The clinical evaluations included use of the Harris hip score, and activities of daily living were evaluated with use of the criteria of Johnston et al. RESULTS The mean Harris hip score was 97.0 points at the time of final follow-up. Thirteen patients (fourteen hips, 20%) reported noise in the hip. Loosening or osteolysis was not observed in any hip, and no prosthesis had been revised. No hip had dislocated, and no ceramic fracture had occurred. CONCLUSIONS After a minimum of six years of follow-up, this cementless total hip arthroplasty with contemporary alumina bearings was found to be a promising procedure for young, active patients with osteonecrosis of the femoral head. However, we remain concerned about the long-term implications of the noise that was reported in these hips.
Chemotherapeutic Responsibility according to Polymorphism of ERCC1, XRCC1 and GSTP1 in Gastric Cancer Patients Receiving Oxaliplatin Based Chemotherapy

Purpose: The platinum-based modified FOLFOX-6 has been reported as an acceptable chemotherapeutic regimen in treatment of advanced gastric cancer patients. The response rate and drug-induced toxicity of platinum-based chemoagents is different according to several gene polymorphism such as ERCC1, XRCC1 and GSTP1 genes, which were related with therapeutic mechanisms. We aimed to evaluate the effect of gene polymorphism and determine the possibility as prediction factor for responsibility in advanced and recurrent gastric cancer patients treated with modified FOLFOX-6 regimen. Methods: This study was conducted with 55 patients. We sampled 20 ml of peripheral blood to isolate DNA from lymphocytes, and identified genotypes of 3 genes (ERCC1, XRCC1, GSTP1) by PCR-RFL of extracted DNA. Based on medical records, retrospective analysis was made on the patients’ clinical characteristics. Results: The overall response rate to modified FOLFOX-6 was 40.0% (22/55). In polymorphism of ERCC1 C8092A, the wild type (CC) showed a statistically significantly lower response rates to chemoagents than the mutant type (CA/AA). In the subtypes of ERCC1 C118T, however, the wild type (CC) showed statistically significantly lower hematological toxicity than the mutant type (CA/AA). But, there was no statistically significance in survival analysis. Conclusion: We suggest that ERCC1 gene polymorphism is clinically more adequate as a feasible factor for predicting the response rate and toxicity of modified FOLFOX-6 regimen in gastric cancer patients.
Lentiviral vector mediated haematopoietic stem cell gene therapy for mucopolysaccharidosis type IIIA

Mucopolysaccharidosis type III (Sanfilippo) is comprised of four phenotypically similar lysosomal storage disorders (MPS IIIA-D) caused by the deficiency of enzymes that catabolise heparan sulphate (HS). Progressive accumulation of HS results in abnormal behaviour, progressive cognitive and motor impairment and death in mid-teens. There are currently no treatments for MPS III. To assess the effect of novel therapeutics in the mouse models of MPS III it is necessary to examine the effect on primary storage of HS, secondary storage and behaviour. The reported behaviour of MPS IIIA and B mice is conflicting therefore we developed a one-hour open field test, performed at the same time of day during a period of hyperactivity observed in a previous circadian rhythm study of MPS IIIB mice. At 8 months of age MPS IIIB mice were hyperactive, with increased rapid exploratory behaviour and a reduction in immobility time. The MPS IIIA mice presented with the same behavioural phenotype as the MPS IIIB mice and were significantly hyperactive at 4 and 6 months of age and also displayed a reduced sense of danger. The hyperactivity and reduced sense of danger observed in the mice is consistent with the patient phenotype. Whilst haematopoietic stem cell transplant (HSCT) is the standard therapy used to treat the similar HS storage disorder MPS I Hurler, it is ineffectual in MPS IIIA. We hypothesise that HSCT failure in MPS IIIA is due to insufficient enzyme production in the brain by donor-derived microglial cells. By increasing expression of N-sulphoglucosamine sulphohydrolase (SGSH) we may be able to treat MPS IIIA. Therefore we compared the effect of HSCT using normal haematopoietic stem cells (WT-HSCT) to lentiviral overexpression of SGSH in normal cells (LV-WT-HSCT) or MPS IIIA cells (LV-IIIA-HSCT) in MPS IIIA mice, using the behavioural tests developed.SGSH activity in the brain of MPS IIIA recipients was not significantly increased by WT-HSCT, but was significantly increased by LV-IIIA-HSCT and LV-WT-HSCT. HS was significantly reduced by all transplants but the best treatment was LV-WT-HSCT. Neuroinflammation, indicated by the number of microglia in the brain, was significantly reduced by all treatments but remains significantly elevated. GM2 gangliosides were significantly reduced by WT-HSCT and LV-WT-HSCT and were no longer significantly elevated, but LV-IIIA-HSCT had no significant effect. Critically LV-WT-HSCT corrected the behaviour at 4 and 6 months of age whilst the other treatments had no significant effect. LV-WT-HSCT and WT-HSCT reduced GM2 gangliosides and neuroinflammation equally but only LV-WT-HSCT corrected behaviour and primary HS storage, suggesting they are the important factors in MPS IIIA pathology.LV-WT-HSCT corrects the neurological phenotype in MPS IIIA mice and is a clinically viable approach to treat MPS IIIA and other neuropathic lysosomal storage disorders.
Multiple Injuries in Paramotoring: a Case Report to Assess this Sport's Risks

Paramotoring is a sport clearly distinct from paragliding in which the pilot flies using a special wing and wearing a motor on his back to take off. Generally paramotoring is not considered a high risk sport but since it is a relatively new sport, there aren't any reports in literature about injuries associated with its practice. We report the case of a 48 year old healthy professional athlete which had an accident during takeoff in one of his training flights and received diffuse axonal injury, vertebral fractures and anterior shoulder sprain with associated humeral trochiter fracture. We compared injuries to those connected to the practice of other aerial sports: paragliding in particular. Probably in paramotoring, unlike in paragliding, take-off is the more critical phase of flight and the use of the motor may aggravate the dynamics of trauma in case of accident. Although the patient was wearing a helmet at the time of the incident, he suffered a diffuse axonal injury: probably the impact location and impact speed compromised the effectiveness of helmet. So more research about the biomechanics of traumatic brain injuries in paramotoring is necessary to improve protection systems, such as helmets, to reduce injury risks in this sport. Furthermore padded back protection should be made obligatory when flying with power paragliding.
Human Resource Development and Vocational and Technical Education at Kenyatta University, Kenya

This paper is based on an institutional linkage assignment (Spring, 1996 and Winter, 1997) between the University of Minnesota in the United States of America and Kenyatta University in Kenya. The Kenyan institution had plans to implement changes in its programs to include vocational and technical teacher education at both baccalaureate and graduate levels. Objectives related to physical education, social studies and citizenship education, and vocational and technical education were established for the linkage.
Robots with tears can convey enhanced sadness and elicit support intentions

The behaviour of shedding tears is a unique human expression of emotion. Human tears have an emotional signalling function that conveys sadness and a social signalling function that elicits support intention from others. The present study aimed to clarify whether the tears of robots have the same emotional and social signalling functions as human tears, using methods employed in previous studies conducted on human tears. Tear processing was applied to robot pictures to create pictures with and without tears, which were used as visual stimuli. In Study 1, the participants viewed pictures of robots with and without tears and rated the intensity of the emotion experienced by the robot in the picture. The results showed that adding tears to a robot’s picture significantly increased the rated intensity of sadness. Study 2 measured support intentions towards a robot by presenting a robot’s picture with a scenario. The results showed that adding tears to the robot’s picture also increased the support intentions indicating that robot tears have emotional and social signalling functions similar to those of human tears.
WAR NEUROSES, SHELL SHOCK AND NERVOUSNESS IN SOLDIERS

A recent visit to France and England furnished me with opportunities for observing the various phases of war neuroses, shell shock and nervousness in soldiers. In France the patients were seen attriages, or sorting stations, field and army, and base hospitals. Those seen in England gave as a rule longer histories and were satisfactorily separated from the front by a stretch of salt water. In both countries, facilities for studying the different methods of treatment and management were made freely available to me, and I also was able to profit by the views of medical officers of long experience in these matters. The present article is a summary of the impressions gained from this visit IMPORTANCE OF NEUROLOGIC SUPERVISION The neurologic problems of war have assumed an importance quite undreamed of, and the necessity of neurologists for a modern army is receiving general recognition. In battle areas the need
The Risk of Occupational Human Immunodeficiency Virus Infection in Health Care Workers: Italian Multicenter Study

Background: More than 50 cases of occupationally acquired human immunodeficiency virus (HIV) infection in health care workers (HCWs) have been reported world-wide. Determinants of injuries and of infection are important to investigate to design effective prevention programs. Methods: In Italy, 29 acute-care public hospitals were enrolled in a multicenter study between 1986 and 1990. At each facility, all HCWs were enrolled who reported percutaneous, mucous-membrane, or nonintact-skin exposure to the body fluids and tissues to which universal precautions apply from an HIV-infected patient. Data were collected at the time of the incident on clinical status of the HIV-infected source, circumstance and type of exposure, and use of infection control precautions. The HCWs were followed up clinically and serologically for HIV infection at 1, 3, 6, and 12 months. Results: A total of 1592 HIV exposures were reported in 1534 HCWs; most exposures (67%) occurred in nurses, followed by physicians and surgeons (17.5%). Needlesticks were the most common source of exposure (58.4%), followed by nonintact-skin and mucous-membrane contamination (22.7% and 11.2%, respectively) and cuts (7.7%). At the time of exposure, 77.5% of the HCWs knew or suspected that the source patient was HIV infected. Two seroconversions were observed among a total of 1488 HCWs followed up for at least 6 months: one occurred in a student nurse who had been stuck with a needle used for an HIV antibody—negative, p24 HIV antigen—positive drug addict; the other was in a nurse who experienced mucousmembrane contamination with a large quantity of blood from an HIV-positive hemophilic patient. The seroconversion rate was 0.10% after percutaneous exposure (1/ 1003; 95% confidence interval, 0.006% to 0.55%) and 0.63% after mucous-membrane contamination (1/158; 95% confidence interval, 0.018% to 3.47%). Conclusions: The study demonstrates a small but real risk of HIV infection after percutaneous and mucousmembrane exposure to blood of HIV-infected patients and that transmission can occur during the "window period" of infection. Furthermore, exposures to HIV are not infrequent, and many exposures could be prevented with the use of barrier precautions, appropriate behaviors, and safer devices and techniques. (Arch Intern Med. 1993;153:1451-1458)
Mecanismos de hipo e hiper alfalipoproteinemia en individuos adultos chilenos

Background: High density lipoprotein (HDL) cholesterol is inversely associated to atherosclerotic cardiovascular risk. Disturbances in HDL cholesterol plasma leves are frecuent in the Chilean population, however the pathophysiological mechanisms are unknown. Aim: To evaluate the mechanisms involved in the hypo and hyper alfalipoproteinemias in Chilean subjects. Materials and Methods: Twenty three subjects with hyperalphalipoproteinemia and 12 with hypoalphalipoproteinemia, paired with control subjects (colHDL between 35 and 55 mg/dl) were studied. We measured plasma lipids, subfractions and sizing of HDL particles and enzymatic activity of cholesteryl ester transfer protein (CETP), lecithin: cholesterol acyltransferase (LCAT), lipoprotein lipase (LPL) and hepatic lipase (LH). Results: Subjects with hyperalphalipoproteinemia showed significantly higher levels of total HDL-cholesterol (70±2 vs 44±1 mg/dl), HDL 2 (30±3 vs 5±1 mg/dl), Apo A I (175±3 vs 146±4 mg/dl), lower HL activity (23,7±0,8 vs 32,4±1,8 mmol/h/l) and HDL particles of greater size, compared to their controls. Subjects with hypoalphalipoproteinemia, showed significantly lower levels of total HDL-cholesterol (26±1 vs 48±2 mg/dl), HDL 3 (21±1 vs 40±2 mg/dl), Apo A I (107±5 vs 145±7 mg/dl), lower LCAT activity (18,6±1,9 vs 26,2±1,6 nmol/h/ml) and smaller HDL particles, compared to their controls. Conclusion: Changes in hepatic lipase and lecithin cholesterol acyltransferase activities may explain the hyper and hypo alphalipoproteinemia respectively, in Chilean subjects (Rev Med Chile 2004; 132: 421-8). (Key Words: Lecithin acyltransferasa deficiency; Lipoproteins, HDL; Lipoproteins, HDL cholesterol; Lipoproteins, VLDL cholesterol)
Clinical trials in orthopaedics research. Part I. Cultural and practical barriers to randomized trials in orthopaedics.

Randomized clinical trials are the most rigorous clinical research design. However, trials are expensive, time-consuming, and challenging to design and complete. In May 2009, the Clinical Trials in Orthopaedics Research Symposium, sponsored by the American Academy of Orthopaedic Surgeons (AAOS), the Orthopaedic Research and Education Foundation (OREF), and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), brought together multiple disciplines to define a randomized clinical trials research agenda by focusing on important clinical questions in each subspecialty and to debate the major important methodological, cultural, and practical barriers to performing more randomized clinical trials in orthopaedics. We defined barriers as any challenge that makes a randomized clinical trial difficult to design or perform. We plan to report the deliberations of the Clinical Trials in Orthopaedics Research Symposium in three publications. The purpose of this first article is to present the cultural and practical barriers and to highlight the key infrastructure needed to support performing randomized trials in orthopaedics. We largely focused on randomized clinical trials but realized that methodologically sound prospective cohort studies also provide important information1. Our deliberations were clearly not exhaustive, and readers can refer to texts for basic information about randomized clinical trials not addressed during the symposium2. We have included the names of symposium speakers in parentheses after the title for each section. Randomized clinical trials have been infrequently performed in surgery3. We use the term culture in this article to reflect how orthopaedic surgeons resolve clinical questions, respond to clinical controversies, express their participation enthusiasm, and respond to the results of randomized clinical trials. Culture is one potential explanation for the paucity of trials in orthopaedics and may be a barrier to more trials. Each surgical procedure provides challenges that require ingenuity and often require deviations …
Efectos del té verde sobre el riesgo de cáncer de mama

Phytochemicals like catechins from green tea might modify the epigenome and transcirptome of tumoral cells. The objective of the present review is to retrospectively evaluate literature examining the mechanisms throughout the green tea could exert a protective effect on breast cancer risk. In this work, more than 100 articles published during the last 15 years that relate tea consumption and breast cancer prevalence and development have been analysed. Green tea polyphenols can reduce risk of breast cancer throughout the inhibition of estrogenic and chemotoxic activity in liver, stimulation of metabolic pathway of glutathione conjugation, improvement of the metabolic syndrome, as well as control of immune system regulation, oxidative stress and DNA methylation. Although in vitro and animal studies show the potential ability of green tea polyphenols to act against breast cancer, the lack of experiments in humans, are the major factors in limiting us to conduct dietary recommendations based on scientific evidence for the management of patients with breast cancer.
Using allogeneic stem cell/T-cell grafts to cure hematologic malignancies

Background: Allogeneic stem cell and T-cell-based therapies are widely used in the treatment of hematologic malignancies and can treat or cure otherwise refractory disease. However, in spite of major advances in the understanding and practice of allogeneic hematopoietic cell transplantation (HCT), several important challenges remain. Objective: Here the authors review the use of allogeneic HCT and T-cell-based therapy, with the goal of providing an overview of the uses and limitations of this approach as well as a survey of areas of active research. Methods: The authors review and summarize recent publications and expert opinions in the field of allogeneic HCT, along with a brief historical perspective, with a focus on challenges and recent advances in the field. Results/conclusion: Present areas of research include efforts to expand the donor pool through the use of umbilical cord blood and human leukocyte antigen-haploidentical donors, the use of reduced-intensity conditioning regimens, which allow treatment of previously ineligible patients, enhancement of immune reconstitution after transplantation, more effective prevention and treatment of acute and chronic graft-versus-host disease, and the augmentation of the immunologic graft-versus-tumor response and its uncoupling from deleterious graft-versus-host alloreactivity.
Repair integrity and functional outcomes after arthroscopic suture-bridge rotator cuff repair.

BACKGROUND We evaluated the clinical and imaging outcomes of arthroscopic suture-bridge repair of full-thickness rotator cuff tears. METHODS From May 2007 to April 2008, seventy-nine patients with a full-thickness rotator cuff tear consecutively underwent arthroscopic suture-bridge repair. The mean age of the patients was 58.3 years (range, thirty-eight to seventy-eight years), and the mean duration of follow-up was 30.6 months (range, twenty-four to forty-four months). Seventy-three patients underwent postoperative ultrasonography or magnetic resonance imaging; seventy-one underwent the imaging at a minimum of two years postoperatively, and the remaining two did so after the operation because of persistent symptoms. The clinical results of seventy-seven patients (all except two who had undergone revision) were evaluated at a minimum of two years postoperatively. University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), and Constant-Murley scores were used for clinical and functional evaluations before surgery and at the time of final follow-up. RESULTS The imaging follow-up rate was 92%, and the follow-up rate for clinical evaluation was 100%. The re-tear rate after suture-bridge repair was 15%. The re-tear rate of the medium, large, and massive tears (as classified according to the anterior-to-posterior diameter of the tear) was 12%, 21%, and 22%, respectively. Massive and large tears tended to show a higher re-tear rate than did medium tears, but the difference was not significant (p = 0.417 and p = 0.964, respectively). The mean UCLA, ASES, and Constant-Murley scores improved from 21.6, 50.4, and 52.7 preoperatively to 30.9, 86.2, and 74.7 at the time of final follow-up (p < 0.001). However, the clinical outcomes after the operation did not differ significantly between the patients who had healing of the tear and those who did not (p = 0.438, p = 0.625, and p = 0.898 for the UCLA, ASES, and Constant-Murley scores, respectively). CONCLUSIONS Arthroscopic suture-bridge repair of full-thickness rotator cuff tears was followed by a re-tear rate of 15% as seen with imaging and resulted in significant improvement of functional outcomes and clinical results compared with the preoperative findings.
Evaluating the Population Health Impact of Physical Activity Interventions in Primary Care—Are We Asking the Right Questions?

Background: This article evaluates the extent to which the literature on primary care-based physical activity interventions informs the translation of research into practice and identifies priorities for future research. Methods: Relevant databases were searched for: (1) descriptive studies of physician barriers to physical activity counseling (n = 8), and (2) reviews of the literature on pri-mary care-based physical activity intervention studies (n = 9). The RE-AIM framework was used to guide the evaluation. Results: Lack of time, limited patient receptiveness, lack of remuneration, and limited counseling skills are the predominant barriers to physical activity counselling. Issues of internal validity (i.e., effectiveness and implementation) have received much more attention in the literature than have issues of external validity (i.e., reach and adoption). Conclusions: The research agenda for primary care-based physical activity interventions needs greater attention to the feasibility of adoption by busy primary care staff, generalizability, and dissemination.