Miracle-dz/UniFAR-FTUs huggingface dataset:
Aggressive Quadriceps Loading Can Induce Noncontact Anterior Cruciate Ligament Injury

Background The force responsible for noncontact anterior cruciate ligament (ACL) injuries remains controversial. The patella tendon to tibial shaft angle causes an anterior tibial shear force with quadriceps activation. Hypothesis An aggressive quadriceps contraction can injure the ACL. Methods The authors characterized noncontact ACL injury and kinematics with aggressive quadriceps loading. Thirteen freshfrozen knees were potted in a jig held in 20 ° of flexion while a 4500 N quadriceps contraction was simulated. Knee kinematics were recorded. A KT-1000 arthrometer and a simulated active quadriceps test assessed anterior displacement. Statistics were performed using paired t tests and 1-way analysis of variance. Results Kinematics revealed the following mean values: anterior displacement, 19.5 mm; valgus, 2.3 °; and internal rotation, 5.5 °. Mean KT-1000 and active quadriceps test differences were 4.0 mm and 2.7 mm, respectively (statistically significant P = .002 and P = .002). Six knees showed gross ACL injury at the femoral insertion. Based on ACL injury, KT-1000 differences were statistically significant (P = .029). Conclusions Aggressive quadriceps loading, with the knee in slight flexion, produces significant anterior tibial translation and ACL injury. This suggests that the quadriceps is the intrinsic force in noncontact ACL injuries, producing a model for further investigation.
Area-wide systemic insecticide treatment for control of cattle grubs, Hypoderma spp. (Diptera: Oestridae): two approaches.

As part of the Joint United States—Canada Cattle Grub Project, progress of two different governmental approaches toward eradication of cattle grubs, Hypoderma spp. , was evaluated. In the United States, governmental assistance to purchase insecticide and provide labor to apply the chemical was used for 3 consecutive years as an inducement to achieve 100% participation by producers in the treatment area. In Canada, long-standing legislation requires treatment of all cattle with costs for treatment borne by the individual stockowner. Compliance is monitored in Canada by federal and provincial government inspectors in the spring, at auction markets and slaughter facilities, and during follow-up visits to farms with infested cattle. The two approaches were evaluated by extensive onranch examination of cattle in the spring following each fall’s treatment. Following systemic insecticide application in the United States treatment area, prevalence dropped from 85% before initiation of the project to 9.2, 2.5, and 1.2%, respectively, for each of the 3 years 1983–85. In comparison, prevalence in the Canadian treatment area remained relatively steady at 8.8, 6.7, and 7.3% for the same 3 years. Although both approaches substantially reduced populations of grubs by >90%, neither achieved the long-range goal of eradication. Samples of segregated untreated monitor cattle from both treatment areas indicated reinfestation rates as high as 90% and resulted in recommendations for utilization of integrated management techniques to complement progress achieved with chemical control strategies.
Metallic 3D printed Ka-band pyramidal horn using binder jetting

Metallic RF-Microwave components fabricated using additive manufacturing are continually being demonstrated as viable solutions in terms of cost and performance when compared to components fabricated by traditional methods such as machining. In this work, binder jetting is used to fabricate a Ka-Band pyramidal horn antenna, as a test structure to evaluate the performance of this metal 3D printing technology. The measured parameters (S11 and radiation pattern) have good agreement with the simulated ones. The measured return loss is >20 dB across the band. The simulated antenna gain is 8.43 dBi (at 26.5 GHz), and simulations show that the performance degradation due to the finite conductivity and surface roughness is less than 0.1 dBi.
Grand Rounds What is the Real Function of the Liver ‘ Function ’ Tests ?

Liver enzymes are commonly used in the evaluation of patients with a range of diseases. Classically they are used to give information on whether a patient’s primary disorder is hepatitic or cholestatic in origin. However, knowledge of enzyme ratios and pattern recognition allow much more information to be derived from these simple tests. This paper offers an insight to generalists on how to extract greater information from these tests in order to improve the investigation and management of liver disease.
A Clinical Process Change and Educational Intervention to Reduce the Use of Unnecessary Preoperative Tests.

BACKGROUND Internal medicine residents receive limited training on how to be good stewards of health care dollars while preserving high-quality care. INTERVENTION We implemented a clinical process change and an educational intervention focused on the appropriate use of preoperative diagnostic testing by residents at a Veterans Administration (VA) medical center. METHODS The clinical process change consisted of reducing routine ordering of preoperative tests in the absence of specific indications. Residents received a short didactic session, which included algorithms for determining the appropriate use of perioperative diagnostic testing. One outcome was the average cost savings on preoperative testing for a continuous cohort of patients referred for elective knee or hip surgery. Resident knowledge and confidence prior to and after the intervention was measured by pre- and posttest. RESULTS The mean cost of preoperative testing decreased from $74 to $28 per patient after the dual intervention (P < .001). The bulk of cost savings came from elimination of unnecessary blood and urine tests, as well as reduced numbers of electrocardiograms and chest radiographs. Among residents who completed the pretest and posttest, the mean score on the pretest was 54%, compared with 80% on the posttest (P = .027). Following the educational intervention, 70% of residents stated they felt "very comfortable" ordering appropriate preoperative testing (P = .006). CONCLUSIONS This initiative required few resources, and it simultaneously improved the educational experience for residents and reduced costs. Other institutions may be able to adopt or adapt this intervention to reduce unnecessary diagnostic expenditures.
A TECHNIQUE FOR LIGHT AND ELECTRON MICROSCOPIC IDENTIFICATION OF ADRENALIN- AND NORADRENALIN-STORING CELLS

Fixation of adrenal glands with 6.5% glutaraldehyde in Millonig buffer at pH 7.2 for 1 or more hours results in a yellow color in noradrenalin-storing cells while adrenalin-containing cells remains uncolored. When frozen sections of adrenal gland fixed in glutaraldehyde are treated with an ammoniacal silver solution, silver is reduced by noradrenalin cells in less than 30 seconds. A deep brown or black color according to the silver solution used, appears in noradrenalin-containing cells while the adrenalin ones remain uncolored. Based on these facts a technique for light and electron microscopic localization of noradrenalin has been developed. The results permit the following interpretation of the glutaraldehyde silver reaction for noradrenalin-containing cells. The condensation of glutaraldehyde with noradrenalin forms a yellow azomethine. Whereas this compound is insoluble adrenalin will not combine with glutaraldehyde and remains soluble. During washing adrenalin therefore disappears from sections while the yellow glutaraldehyde-noradrenalin compound remains. The aldehyde group of this compound reduces ammoniacal silver solutions.
Identification of orthopaedic infections using broad-range polymerase chain reaction and reverse line blot hybridization.

BACKGROUND Culture remains the gold standard in the diagnosis of bacterial infection, but molecular biological techniques have yielded promising results. In this study, we validated a combined polymerase chain reaction and reverse line blot hybridization protocol for identifying musculoskeletal infections. METHODS Samples were obtained from seventy-six patients undergoing orthopaedic surgery for various aseptic and septic indications. The diagnosis of infection was based on a review of all available clinical and culture data. In addition to routine culture for aerobic and anaerobic growth, samples were analyzed with a broad-range 16S rRNA polymerase chain reaction and subsequent reverse line blot hybridization with use of twenty-eight group, genus, and species-specific oligonucleotide probes. RESULTS An infection was diagnosed on the basis of patient data in thirty-one patients. All but one of the patients with a clinical diagnosis of infection had a positive result of the polymerase chain reaction-reverse line blot hybridization. Five of the forty-five patients in whom an infection was not suspected on the basis of patient data had at least one positive result of the polymerase chain reaction-reverse line blot hybridization. Cultures demonstrated microorganisms in twenty-five patients with an infection and in two patients in whom an infection was not suspected on the basis of the patient data. Staphylococcus aureus was the most common organism grown on culture. The species identified by the polymerase chain reaction-reverse line blot hybridization was in full accordance with that grown on culture in all but one patient. CONCLUSIONS Polymerase chain reaction-reverse line blot hybridization performed well in detecting and identifying the various bacterial species and was more sensitive than routine culture. It identified Staphylococcus aureus as the most frequently found microorganism. Five patients in whom an infection was not suspected on the basis of the patient data had a positive result of the polymerase chain reaction, which may have been caused by contamination of the samples. However, three of these patients had aseptic loosening of a total hip prosthesis, suggesting the presence of a low-grade bacterial infection that remained undetected by the culture but was detected by the polymerase chain reaction-reverse line blot hybridization. LEVEL OF EVIDENCE Diagnostic Level III.
Tracing the Conversion Process from Primordial Germ Cells to Pluripotent Stem Cells in Mice1

ABSTRACT To understand mechanisms underlying acquisition of pluripotency, it is critical to identify cells that can be converted to pluripotent stem cells. For this purpose, we focused on unipotent primordial germ cells (PGCs), which can be reprogrammed into pluripotent embryonic germ (EG) cells under defined conditions. Treatment of PGCs with combinations of signaling inhibitors, including inhibitors of MAP2K (MEK), GSK3B (GSK-3beta), and TGFB (TGFbeta) type 1 receptors, induced cells to enter a pluripotent state at a high frequency (12.1%) by Day 10 of culture. When we employed fluorescence-activated cell sorting to monitor conversion of candidate cells to a pluripotent state, we observed a cell cycle shift to S phase, indicating enrichment of pluripotent cells, during the early phase of EG formation. Transcriptome analysis revealed that PGCs retained expression of some pluripotent stem cell-associated genes, such as Pou5f1 and Sox2, during EG cell formation. On the other hand, PGCs lost their germ lineage characteristics and acquired expression of pluripotent stem cell markers, such as Klf4 and Eras. The overall gene expression profiles revealed by this system provide novel insight into how pluripotency is acquired in germ-committed cells.
Approche markovienne bidimensionnelle d'analyse et de reconnaissance de documents manuscrits

Dans cette these, nous presentons une approche bidimensionnelle markovienne generale pour l'analyse et la reconnaissance de documents manuscrits appelee AMBRES (Approche Markovienne Bidimensionnelle pour la Reconnaissance et la Segmentation d'images). Elle est fondee sur les champs de Markov, la programmation dynamique 2D et une analyse bidimensionnelle de l'image. AMBRES a ete appliquee avec succes a des tâches aussi diverses que la reconnaissance de caracteres et de mots manuscrits isoles, la structuration de documents manuscrits et la reconnaissance de logos et pourrait etre etendue a d'autres problematiques du domaine de la vision. Des protocoles rigoureux ont ete utilises pour l'etude du systeme et de ses parametres ainsi que pour l'evaluation des performances. En particulier, AMBRES a pu etre validee au sein de la campagne d'evaluation RIMES (Reconnaissance et Indexation de donnees Manuscrites et de fac similES).
Clearance of exogenous parathyroid hormone-related protein in pregnant, non-pregnant and fetal sheep, goats and pigs.

In the sheep, goat and pig, radiolabelled parathyroid hormone related protein (PTHRP) and immunoreactive PTHRP(1-34) and (1-86) were rapidly cleared from the circulation. Metabolic clearance rates (MCR) were in the range of 1.25-7.5 ml/min per kg and were slightly slower than that of intact PTH in man (10 ml/min per kg); while the mean MCR of labelled PTHRP(1-86) in fetal sheep and goats was significantly faster than that in their respective mothers (14.4 vs 4.0 ml/min per kg respectively). This may reflect increased metabolism of PTHRP by fetal tissues, e.g. the placenta. Similar rates of clearance of radiolabelled PTHRP(1-141), (1-86) and (1-34) suggest that clearance involves the amino terminus of the molecule.
Hepatitis C Virus Hypervariable Region 1 Modulates Receptor Interactions, Conceals the CD81 Binding Site, and Protects Conserved Neutralizing Epitopes

ABSTRACT The variability of the hepatitis C virus (HCV), which likely contributes to immune escape, is most pronounced in hypervariable region 1 (HVR1) of viral envelope protein 2. This domain is the target for neutralizing antibodies, and its deletion attenuates replication in vivo. Here we characterized the relevance of HVR1 for virus replication in vitro using cell culture-derived HCV. We show that HVR1 is dispensable for RNA replication. However, viruses lacking HVR1 (ΔHVR1) are less infectious, and separation by density gradients revealed that the population of ΔHVR1 virions comprises fewer particles with low density. Strikingly, ΔHVR1 particles with intermediate density (1.12 g/ml) are as infectious as wild-type virions, while those with low density (1.02 to 1.08 g/ml) are poorly infectious, despite quantities of RNA and core similar to those in wild-type particles. Moreover, ΔHVR1 particles exhibited impaired fusion, a defect that was partially restored by an E1 mutation (I347L), which also rescues infectivity and which was selected during long-term culture. Finally, ΔHVR1 particles were no longer neutralized by SR-B1-specific immunoglobulins but were more prone to neutralization and precipitation by soluble CD81, E2-specific monoclonal antibodies, and patient sera. These results suggest that HVR1 influences the biophysical properties of released viruses and that this domain is particularly important for infectivity of low-density particles. Moreover, they indicate that HVR1 obstructs the viral CD81 binding site and conserved neutralizing epitopes. These functions likely optimize virus replication, facilitate immune escape, and thus foster establishment and maintenance of a chronic infection.
Oxidative stress contributes to large elastic arterial stiffening across the stages of the menopausal transition

ObjectiveIt is unclear how changes in ovarian hormones during the menopausal transition contribute to age-associated arterial stiffening. We sought to evaluate differences in arterial stiffness and the role of oxidative stress across the stages of the menopausal transition in healthy women. MethodsArterial stiffness (carotid artery compliance and ultrasound) was measured during immediate infusions of saline (control) and ascorbic acid (experimental model to immediately decrease oxidative stress) in 97 healthy women (22-70 y) classified as premenopausal (n = 24; mean [SD] age, 33 [7] y), early perimenopausal (n = 21; 49 [3] y) or late perimenopausal (n = 21; 50 [4] y), or postmenopausal (n = 31; 57 [5] y). ResultsBasal carotid artery compliance was different among the groups (P < 0.001). Mean [SD] compliance was highest in premenopausal women (1.31 [0.25] mm2/mm Hg × 10−1), with progressive decrements in perimenopausal (early perimenopausal, 0.98 [0.31] mm2/mm Hg × 10−1; late perimenopausal, 0.90 [0.25] mm2/mm Hg × 10−1) and postmenopausal (0.75 [0.24] mm2/mm Hg × 10−1) women. Ascorbic acid infusion improved compliance in late perimenopausal (15% [18%] increase, P = 0.001) and postmenopausal (17% [26%] increase, P = 0.002) women but not in early perimenopausal or premenopausal women. ConclusionsArterial stiffening worsens across the stages of the menopausal transition in healthy women. This seems to be mediated, in part, by oxidative stress, particularly during the late perimenopausal and postmenopausal periods. It remains uncertain whether this is specifically caused by loss of ovarian function or aging.
Mothers in Prison: Maintaining Connections with Children

The significant increase in the number of incarcerated women ensures that many children must live without their mothers for some period of time. Women in prison were interviewed about their efforts to maintain relationships with their children. Mail and telephone contacts were more frequent than actual visits. Almost one half of mothers had never received a visit from their children. This article identifies challenges to the development and maintenance of contact between incarcerated mothers and their children. Recommendations are made for correctional agencies to enhance opportunities for incarcerated mothers to foster positive connections with their children.
Analysis of genetic diversity in cytotoxin-producing and non-cytotoxin-producing Helicobacter pylori strains.

Analysis of 32 Helicobacter pylori strains indicated a strong association between the presence of the cagA gene and a specific type of vacA allele found predominantly in cytotoxin-producing strains (P < .001). To determine whether tox+/CagA+ and tox-/CagA- strains constituted two separate noncombining lineages, sequences of the H. pylori ureC gene, cysS homologue, and the intergenic region between cysS and vacA were determined for multiple strains. The mean levels of nucleotide identity in the three regions were 96.7% +/- 0.5%, 95.0% +/- 1.0%, and 89.0% +/- 2.9%, respectively. Multiple sequence alignments and dendrograms based on these three regions failed to identify two clonal populations of organisms for which cagA and vacA genotypes were markers. The presence of a 63- to 64-bp insertion in the cysS-vacA intergenic region was unrelated to the vacA genotype of the strains. These data suggest that recombination between Helicobacter genomes may occur in vivo.
OKT3 treatment for allograft rejection is a risk factor for cytomegalovirus disease in liver transplantation.

The role of OKT3 monoclonal antibody administration was studied as a risk factor for symptomatic cytomegalovirus (CMV) infection in 229 consecutive liver transplant recipients not receiving specific CMV prophylaxis. Twenty-six patients (11.4%) received OKT3 and 17 of them developed CMV infection, 11 (4.8%) being symptomatic. OKT3 use was a significant risk factor for symptomatic CMV infection by both univariate (relative risk [RR], 2.9; 95% confidence interval [CI], 1.5-5.8; P = .002) and multivariate time-dependent (RR, 3.4; 95% CI, 1.7-7.1; P = .001) analyses. A subgroup analysis revealed that OKT3 use was a significant risk factor for symptomatic CMV infection in CMV-seropositive but not seronegative recipients. OKT3 therapy for steroid-resistant rejection is a risk factor for symptomatic CMV infection in liver transplant recipients who are seropositive for CMV before transplantation. This group should be targeted for antiviral prophylaxis when OKT3 antirejection therapy is used.
C6 mediates chronic progression of tubulointerstitial damage in rats with remnant kidneys.

Although it was once considered only a marker of glomerular damage, accumulating evidence indicates that proteinuria per se is nephrotoxic and contributes to the progression of renal injury. Several studies have demonstrated that activation of complement in proteinuric urine results in tubular and interstitial damage. It was previously demonstrated that acute complement-mediated interstitial disease is induced by C5b-9. Here the role of C5b-9 in the progression of chronic proteinuric renal disease was investigated in a nonimmunologic remnant kidney model. Five-sixths nephrectomies were performed for normocomplementemic control and C6-deficient PVG rats. Tubulointerstitial injury was assessed by measurement of two independent markers of tubular injury (i.e., vimentin and osteopontin), interstitial accumulation of the extracellular matrix components collagen type I, collagen type IV, and laminin, interstitial macrophage infiltration, and renal function. The two groups developed similar levels of proteinuria and BP. Whereas C3 deposition on the brush border was equivalent for rats in the two groups, C5b-9 deposition was observed only for normocomplementemic rats. At day 35, the degrees of both tubulointerstitial injury and renal failure were the same for the two groups. Tubulointerstitial injury in normocomplementemic rats was still severe at day 70. In contrast, interstitial injury in C6-deficient rats had improved markedly at day 70, with improvements in renal function. In a rat model of chronic progressive renal disease secondary to nephron loss, the initial interstitial changes are complement-independent and largely reversible, whereas progressive interstitial fibrosis is mediated predominantly by C5b-9. Treatment to reduce C5b-9 attack in tubular cells may slow progression and facilitate recovery.
An update on iron chelation therapy.

Iron overload is a common clinical problem, arising from disorders of increased iron absorption such as hereditary haemochromatosis or thalassaemia intermedia syndromes or as a consequence of chronic blood transfusions for various blood disorders. Regular red blood cell (RBC) transfusions are the principal supportive therapy for many rare anaemias involving a decrease in RBC production, an increase in cell destruction, or chronic blood loss1. Anaemias such as beta-thalassaemia and sickle cell disease are examples of chronic diseases that require long-term transfusion therapy to improve life expectancy. Although transfusion requirements may vary according to the diagnosis, chronic blood transfusion therapy inevitably leads to secondary iron overload that can cause significant damage to many organs, such as the liver and heart, and to the endocrine system2,3. Iron overload is associated with the production of free radicals that can damage tissues, resulting in cardiac toxicity, endocrine dysfunction, and liver toxicity. The effects of iron overload are visible after damage has been done, when patients already have liver dysfunction, cirrhosis, cardiomyopathy or diabetes1,4. Iron is an essential element within the body and its quantity is tightly regulated physiologically; however, the body has no mechanism to excrete excess iron and it deposits iron into end organs leading to severe dysfunction. Each unit of RBC transfused contains 180 to 200 mg of iron. Chronic packed RBC transfusion therapy increases liver iron by approximately 1 mg/mL (by dry weight) for every 15 mL/kg delivered5. Labile plasma iron (LPI) is a toxic and chelatable form of iron that is produced continually during conditions of iron overload, and has been linked to the development of co-morbidities6. It is very important to remove excess iron and suppress LPI to avoid the serious clinical sequelae associated with iron overload. In this specific context phlebotomy cannot be used because patients are usually anaemic and other means must be used to mobilise the excess iron. The gold standard is iron chelation therapy.