Miracle-dz/UniFAR-FTUs huggingface dataset:
Pain management strategies in orthopedic extremity trauma

Trauma and traumatic injuries represent a huge burden on society and health care systems. In the United States, unintentional injuries are the number 1 cause of death of people ages 1 to 45 years. According to the CDC, in 2018, there were an estimated 28 million nonfatal injuries, the majority of which were from falls. In 2010, nonfatal injuries from falls and other accidents combined led to almost 600,000 hospital admissions for extremity trauma, resulting in an estimated $55 billion in total lifetime medical costs and lost work productivity. A survey of 8000 survivors of major traumas 1 year after discharge found that 70%had not yet returned towork. Hospital discharge does not mark the end of a patient’s trauma experience. Almost 60% of patients who sustained orthopedic trauma injuries reported moderate to severe pain at the time of discharge. Untreated acute pain in the extremities can lead to patient immobility, which predisposes to deep venous thrombosis with possible pulmonary embolism, atelectasis, and pneumonia. Episodes of resultant hypoxia interfere with optimal oxygen delivery for postsurgical wound healing. Treatment for acute postoperative deep venous thrombosis or pulmonary embolism with anticoagulation puts patients at risk of surgical site bleeding in perioperative settings. In addition to these negative consequences, untreated and severe acute pain is predictive for developing chronic pain. The prevalence of chronic pain—ranging from 5 to 7 years after a traumatic injury—is as high as 62% to 80% among patients. More than a quarter of these patients find that chronic pain interferes with their daily activities. Chronic pain affects >100 million Americans and treatment costs reach billions of dollars annually. Opioid analgesics are effective at decreasing pain scores in both the acute and chronic settings. More than half of trauma victims are discharged with a prescription for opioids. Patients who received opioid therapy during the first 3 months after discharge for a traumatic injury report lower levels of pain than those who did not receive opioid therapy in a 7-year follow-up survey. The risks of opioid therapy are well known and chronic use can lead to dependence and hyperalgesia. Numerous studies have looked at predictors for severe and ongoing pain. Factors such as sex, lower education levels, preinjury health burden, and injury severity cannot be altered by providers. However, providers can alter other independent predictors of chronic pain in trauma injury such as initial 24-hour pain severity, presence of moderate to severe pain at discharge, low self-efficacy, peritraumatic anxiety, and depression. Adequate analgesia in traumatic injury patients presents a unique challenge due to a sometimes tenuous hemodynamic state and balancing the side effects of analgesic medications with adequate resuscitation. The following reviews analgesic modalities for treating traumatic injuries of the extremities.
A comparison of fragmenting lead-based and lead-free bullets for aerial shooting of wild pigs

In response to the health threats posed by toxic lead to humans, scavenging wildlife and the environment, there is currently a focus on transitioning from lead-based to lead-free bullets for shooting of wild animals. We compared efficiency metrics and terminal ballistic performance for lead-based and lead-free (non-lead) bullets for aerial shooting of wild pigs (Sus scrofa) in eastern Australia. Ballistic testing revealed that lead-based and lead-free bullets achieved similar performance in precision and muzzle kinetic energy (E0) levels (3337.2 J and 3345.7 J, respectively). An aerial shooting trial was conducted with wild pigs shot with one type of lead-based and one type of lead-free bullets under identical conditions. Observations were made from 859 shooting events (n = 430 and 429 respectively), with a sub-set of pigs examined via gross post-mortem (n = 100 and 108 respectively), and a further sub-set examined via radiography (n = 94 and 101 respectively). The mean number of bullets fired per pig killed did not differ greatly between lead-based and lead-free bullets respectively (4.09 vs 3.91), nor did the mean number of bullet wound tracts in each animal via post-mortem inspection (3.29 vs 2.98). However, radiography revealed a higher average number of fragments per animal (median >300 vs median = 55) and a broader distribution of fragments with lead-based bullets. Our results suggest that lead-based and lead-free bullets are similarly effective for aerial shooting of wild pigs, but that the bullet types behave differently, with lead-based bullets displaying a higher degree of fragmentation. These results suggest that aerial shooting may be a particularly important contributor to scavenging wildlife being exposed to lead and that investigation of lead-free bullets for this use should continue.
Contrast-enhanced computed tomography prior to percutaneous transthoracic needle biopsy reduces the incidence of hemorrhage

Background Hemorrhage is the second most common complication of percutaneous transthoracic needle biopsy (PTNB), and at present, there is no effective prevention strategy. Contrast-enhanced computed tomography (CECT) has the advantage of clearly visualizing blood supply within the lesion and aiding in the imaging of blood vessels, which can reduce hemorrhage complicating PTNB. As no large-sample studies were evaluating whether CECT could reduce hemorrhage, we conducted the present retrospective study. Methods From November 2011 to February 2016, 1,282 biopsies at Jinling Hospital were retrospectively reviewed; 555 underwent CECT, and 727 underwent non-contrast computed tomography (CT). Factors associated with hemorrhage were defined, and hemorrhage rates were compared between the 2 groups. Results We found that pre-biopsy CECT was associated with a reduced incidence of biopsy-related hemorrhage compared to non-contrast CT (16.4% vs. 23.1%, P=0.003). Propensity score matching (PSM) analysis also showed that the incidence of hemorrhage in the CECT group was lower than that of the non-contrast CT group at a ratio of 1:1 (P=0.039), 1:2 (P=0.028), or 1:3 (P=0.013). In the multivariate analysis, CECT before PTNB was found to be significantly associated with a reduced risk of hemorrhage [odds ratio (OR): 0.671, 95% confidence interval (CI): 0.499–0.902, P=0.008]. Puncture position, lesion size, depth of needle tract, and the number of punctures were also found to be associated with hemorrhage (all P<0.05). Conclusions Compared with non-contrast CT, CECT significantly reduced the risk of post-biopsy pulmonary hemorrhage, which suggests that CECT should be performed before PTNB.
β-blocker prescription is associated with lower cumulative risk of knee osteoarthritis and knee pain consultations in primary care: a propensity score–matched cohort study

Abstract Objectives To examine the association between β-blocker prescription and first primary-care consultation for knee OA, hip OA, knee pain and hip pain. Methods Data source: Clinical Practice Research Datalink. Participants aged ≥40 years in receipt of new oral β-blocker prescriptions were propensity score (PS) matched to an unexposed control. Cox proportional hazard ratios (HRs) and 95% CIs were calculated, and adjusted for non-osteoporotic fractures, number of primary-care consultations for knee or hip injury, and, the number of primary-care consultations, out-patient referrals and hospitalizations in the 12 months preceding cohort entry. Analysis was stratified according to β-blocker class and for commonly prescribed drugs. P < 0.05 was considered statistically significant. Results A total of 111 718 β-blocker–exposed participants were 1:1 PS matched to unexposed controls. β-blocker prescription was associated with reduced cumulative risk of knee OA, knee pain, and hip pain consultations [with a HR (95% CI) of 0.90 (0.83, 0.98), 0.88 (0.83, 0.92) and 0.85 (0.79, 0.90), respectively]. Propranolol and atenolol were associated with a lower incidence of knee OA and knee pain consultations with a HR of between 0.78 and 0.91. β-blockers were associated with reduced incidence of consultation for large-joint lower-limb OA/pain as a composite outcome, defined as the earliest of knee OA, knee pain, hip OA or a hip pain consultation [with a HR (95% CI) of 0.87 (0.84, 0.90)]. Conclusion Commonly used β-blockers have analgesic properties for musculoskeletal pain. Atenolol might be a therapeutic option for OA and cardiovascular co-morbidities in which β-blockers are indicated, while propranolol may be suitable for people with co-morbid anxiety. A confirmatory randomized controlled trial is needed before clinical practice is changed.
Don’t put all social network sites in one basket: Facebook, Instagram, Twitter, TikTok, and their relations with well-being during the COVID-19 pandemic

Prior studies indicated that actively using social network sites (SNSs) is positively associated with well-being by enhancing social support and feelings of connectedness. Conversely, passively using SNSs is negatively associated with well-being by fostering upward social comparison and envy. However, the majority of these studies has focused on Facebook. The present research examined the relationships between well-being—satisfaction with life, negative affect, positive affect—and using actively or passively various SNSs—Facebook, Instagram, Twitter, TikTok—during the COVID-19 pandemic. In addition, two mediators were tested: social support and upward social comparison. One thousand four persons completed an online survey during the quarantine measures; the analyses employed structural equation modeling. Results showed that passive usage of Facebook is negatively related to well-being through upward social comparison, whereas active usage of Instagram is positively related to satisfaction with life and negative affect through social support. Furthermore, active usage of Twitter was positively related to satisfaction with life through social support; while passive usage was negatively related to upward social comparison, which, in turn, was associated with more negative affect. Finally, TikTok use was not associated with well-being. Results are discussed in line with SNSs’ architectures and users’ motivations. Future research is required to go beyond methodological and statistical limitations and allow generalization. This study concludes that SNSs must be differentiated to truly understand how they shape human interactions.
Onset of aggregation for water-soluble polymeric associative thickeners : a fluorescence study

Poly(ethylene oxide) polymers end-capped with n-hexadecyl groups are members of a class of water-soluble polymers which associate at modest concentrations and impart unusual rheological properties to aqueous solutions. We have used pyrene(Py) as a fluorescent probe to study the association process. For each of two samples of these polymers (M w =40 000,47 000) in water, we find that above a critical polymer concentration the pyrene fluorescence shows a large increase in intensity and mean lifetime
Does the Initial Width of Cleft Lip Play a Role in the Occurrence of Immediate Local Complications Following Primary Cleft Lip Repairs?

Supplemental Digital Content is available in the text Objective: Among the several factors implicated in the occurrence of local surgical site complications following cleft lip repair is the initial width of the cleft. The aim of the study was to examine the effect of cleft width in the occurrence of immediate local surgical site complications. Material and methods: All consecutive subjects with diagnosis of unilateral or bilateral cleft lip with or without cleft palate who presented at the cleft clinic and satisfied the inclusion criteria were recruited in the study. The width of the cleft lip defect as adopted for the study was measured from the peak of the Cupid bow on the non-cleft side to a point where the white roll begins to thin out on the cleft side. Measurement was done using a Vernier Calliper. Surgery was performed under general anesthesia after which subjects were evaluated for the presence or absence of immediate local surgical site complications which included dehiscence, infection, and vermillion notching of the lip. Results: A total of 70 subjects consisting of 36 (51.4%) males and 34 (48.6%) females were included in the study. Mean age (±SD) was 9.0 ± (19.4) months with age range of 3 months to 13 years. The prevalence of early surgical site complications was 24.3%. The width of cleft above a critical level (14 mm) statistically correlate significantly with the occurrence of early surgical site complications (P = 0.048). Conclusion: This study showed that the width of cleft lip of and above critical level of 14 mm may be associated with a clinically significant risk of immediate local surgical site complications.
Use of spin‐coated TXRF reference samples for ToF‐SIMS metal contaminant quantification on silicon wafers

Among the emerging techniques able to reveal the metals contaminating the wafer surface in the manufacturing processes of microelectronic devices, time-of-flight secondary ion mass spectrometry (ToF-SIMS) is considered very promising. Despite the potentialities of this analytical tool, some of the phenomena that affect the signal intensity are not fully investigated and still hinder the use of the technique. To evaluate the capabilities of ToF-SIMS to detect quantitatively metal traces on silicon wafers, we analyzed contaminated reference samples produced by spin coating. These standards were also characterized by total reflection x-ray fluorescence spectroscopy (TXRF), x-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). The comparison between results obtained by TXRF and ToF-SIMS allowed us to evaluate the metal detection sensitivities and to estimate the detection limits for most of the elements that produce detrimental effects on device yield. We prove that the metals' secondary ion yields are governed by silicon oxide matrix effects and that a linear relationship between the ToF-SIMS signal intensity and the elemental areal density holds for most of the considered elements for changes in the uppermost layer composition ranging over more than three orders of magnitude. Besides, it is shown that although spin-coating is commonly employed to produce reference samples, the lateral distribution and the physical status of the contaminants produced by this technique may seriously affect the results obtained by both ToF-SIMS and TXRF.
Prognostic value of free triiodothyronine and N-terminal pro-B-type natriuretic peptide for patients with acute myocardial infarction undergoing percutaneous coronary intervention: a prospective cohort study

Background Altered thyroid function and increased N-terminal pro-B-type natriuretic peptide (NT-proBNP) are prognostic factors in acute myocardial infarction (AMI). The study aims to investigate whether free triiodothyronine (fT3) and NT-proBNP are prognostic factors for long-term outcomes in patients with AMI undergoing percutaneous coronary intervention (PCI). Methods This was an observational, prospective, single-center study of consecutive patients enrolled at Fuwai Hospital between January, 2013 and December, 2013. The patients were divided into two groups according to fT3 levels: low fT3 (<2.5 pg/mL) and normal fT3 (2.50–4.09 pg/mL). The primary outcome of this study was the incidence of major adverse cardiovascular events (MACEs). Results There were 252 patients with low fT3 and 561 patients with normal fT3. After >2 years of follow-up, patients with low fT3 levels had higher rates of MACEs than those with normal fT3 (27.0% vs. 7.8%, P<0.001). Univariable Cox proportional hazards regression analyses showed that NT-proBNP >802.7 pg/mL [hazard ratio (HR) =5.063, 95% confidence interval (CI): 3.176–8.071, P<0.001] and fT3 <2.5 pg/mL (HR =3.867, 95% CI: 2.646–5.651, P<0.001) were the strongest predictors of MACEs. After adjustment for traditional risk predictors, fT3 <2.5 pg/mL (HR =2.570, 95% CI: 1.653–3.993, P<0.001) was one of the most important independent predictors of MACEs. Patients with NT-proBNP ≤802.7 pg/mL and fT3 ≥2.5 pg/mL had the best prognosis, while patients with NT-proBNP >802.7 pg/mL and fT3 <2.5 pg/mL had the worst outcomes (P<0.001). Conclusions Low fT3 is a strong predictor of poor prognosis after AMI. The fT3+NT-proBNP combination might be a valuable predictor of the long-term outcomes of PCI after AMI.
Private Self-Consciousness and Self-Monitoring on Instagram: The Mediating Effect of Internal Locus of Control and Self-Concept

Abstract Past studies examining the direct relationship between private self-consciousness and online self-presentation behavior have not met with much success. The aim of this study was to examine the direct relationship between private self-consciousness and self-monitoring as well as the indirect relationship between these two variables through the mediation of locus of control and self-concept among Instagram users. Besides investigating locus of control and self-concept independently, serial mediation of locus of control and self-concept in the relationship between private self-consciousness and self-monitoring was also examined. A sample of 309 university students was conveniently drawn from three private universities in Kuala Lumpur, Malaysia. Participants completed a survey that collected data on private self-consciousness, internal locus of control, self-concept, self-monitoring on Instagram and relevant demographic data. Results of this study showed that there is no direct relationship between private self-consciousness and self-monitoring on Instagram. Independently, locus of control was found to mediate the relationship between private self-consciousness and self-monitoring while self-concept did not. The serial-multiple mediation test supported the mediating role of locus of control and self-concept on this relationship. These indirect relationships contribute to our understanding of the underlying mechanism through which private self-consciousness influences self-monitoring on Instagram.
The orientation of Langmuir–Blodgett monolayers using NEXAFS

Carbon K‐shell NEXAFS (near edge x‐ray absorption fine structure) spectra of oriented hydrocarbon chains in Langmuir–Blodgett (LB) monolayers were measured and used to study the orientation of these molecules. The LB monolayers were assembled from arachidic acid or cadmium or calcium arachidate on the oxidized Si(111) surface. The observed NEXAFS resonances are assigned to transitions to excited states which are localized on individual CH2 groups or C–C bonds. From a detailed analysis using curve‐fitting techniques of the angular dependence of the various spectral peaks, the hydrocarbon chains of the cadmium arachidate monolayer is estimated to lie within 15° of the surface normal, the hydrocarbon chains of the calcium arachidate monolayer is estimated to be tilted by 33±5° from the surface normal, while the arachidic acid monolayer is not ordered at all. The determined chain orientations are discussed in terms of a microscopic model involving lateral interactions between the zig–zag hydrocarbon chains.
Comparison of alternate preparative techniques on wall thickness in coronary artery bypass grafts: The HArVeST randomized controlled trial

The success of coronary artery bypass grafting surgery (CABG) is dependent on long‐term graft patency, which is negatively related to early wall thickening. Avoiding high‐pressure distension testing for leaks and preserving the surrounding pedicle of fat and adventitia during vein harvesting may reduce wall thickening.
Nomogram predictive model of post-operative recurrence in non-functioning pituitary adenoma.

Background To analyze and predict the possibility of post-operative recurrence in non-functioning pituitary adenoma (NFPA) patients, we investigated the clinical factors leading to tumor recurrence and built a nomogram predictive model based on these risk factors. Methods A single-center retrospective study was performed. A total of 145 NFPA patients who underwent surgical treatment at Shenzhen People's Hospital from September 2013 to January 2019 were selected. Among them, 52 patients were diagnosed with recurrence of NFPA according to follow-up investigations. Binary logistic regression analysis was used to determine the significant risk factors. A nomogram model was then built to predict recurrence using these factors. Results The univariate analysis and the binary logistic regression analysis showed that age, tumor size, cavernous invasion, sphenoid sinus invasion, and surgical extension were significant factors affecting tumor recurrence. We then built a nomogram model to predict post-operative recurrence in NFPA patients using these factors. The correlation analysis indicated that sphenoid sinus invasion [hazard ratio (HR) =13.14, 95% confidence interval (CI): 7.03-24.58, P<0.0001], cavernous sinus invasion (HR =7.53, 95% CI: 4.27-13.28, P<0.0001), and tumor size (HR =11.06, 95% CI: 6.11-20.03, P<0.0001) could promote the recurrence of NFPA. In contrast, advanced age (HR =0.50, 95% CI: 0.28-0.86, P<0.0001) and gross total resection (HR =0.12, 95% CI: 0.07-0.22, P<0.0001) could effectively inhibit recurrence. Conclusions In this study, we developed a nomogram predictive model based on the significant recurrence-associated factors for NFPA. This nomogram may aid neurosurgeons in the post-operative prediction of recurrence, and may facilitate tailored counseling of individual patients.
Super-resolution shadow imaging reveals local remodeling of astrocytic microstructures and brain extracellular space after osmotic challenge

The extracellular space (ECS) plays a central role for brain physiology, shaping the time course and spread of neurochemicals, ions and nutrients that ensure proper brain homeostasis and neuronal communication. Astrocytes are the most abundant type of glia cell in the brain, whose processes densely infiltrate the brain’s parenchyma. As astrocytes are highly sensitive to changes in osmotic pressure, they are capable of exerting a potent physiological influence on the ECS. However, little is known about the spatial distribution and temporal dynamics of the ECS that surrounds astrocytes, owing mostly to a lack of appropriate techniques to visualize the ECS in live brain tissue. Mitigating this technical limitation, we applied the recent SUper-resolution SHadow Imaging technique (SUSHI) to astrocyte-labeled organotypic hippocampal brain slices, which allowed us to concurrently image the complex morphology of astrocytes and the ECS with nanoscale resolution in a live experimental setting. Focusing on ring-like astrocytic microstructures in the spongiform domain, we found them to enclose sizable pools of interstitial fluid and cellular structures like dendritic spines. Upon an experimental osmotic challenge, these microstructures remodeled and swelled up at the expense of the pools, effectively increasing the physical contact between astrocytic and cellular structures. Our study reveals novel facets of the dynamic microanatomical relationships between astrocytes, neuropil and the ECS in living brain tissue, which could be of functional relevance for neuronglia communication in a variety of (patho)physiological settings, e.g. LTP induction, epileptic seizures or acute ischemic stroke, where osmotic disturbances are known to occur.