pinecone/core-2020-05-10-deduplication huggingface dataset:
Trauma Surveillance in Cape Town, South Africa: An Analysis of 9236 Consecutive Trauma Center Admissions.

PublishedJournal ArticleResearch Support, Non-U.S. Gov'tThis is the final version of the article. Available from American Medical Association via the DOI in this record.IMPORTANCE: Trauma is a leading cause of death and disability worldwide. In many low- and middle-income countries, formal trauma surveillance strategies have not yet been widely implemented. OBJECTIVE: To formalize injury data collection at Groote Schuur Hospital, the chief academic hospital of the University of Cape Town, a level I trauma center, and one of the largest trauma referral hospitals in the world. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective study of all trauma admissions from October 1, 2010, through September 30, 2011, at Groote Schuur Hospital. A standard admission form was developed with multidisciplinary input and was used for both clinical and data abstraction purposes. Analysis of data was performed in 3 parts: demographics of injury, injury risk by location, and access to and maturity of trauma services. Geographic information science was then used to create satellite imaging of injury "hot spots" and to track referral patterns. Finally, the World Health Organization trauma system maturity index was used to evaluate the current breadth of the trauma system in place. MAIN OUTCOMES AND MEASURES: The demographics of trauma patients, the distribution of injury in a large metropolitan catchment, and the patterns of injury referral and patient movement within the trauma system. RESULTS: The minimum 34-point data set captured relevant demographic, geographic, incident, and clinical data for 9236 patients. Data field completion rates were highly variable. An analysis of demographics of injury (age, sex, and mechanism of injury) was performed. Most violence occurred toward males (71.3%) who were younger than 40 years of age (74.6%). We demonstrated high rates of violent interpersonal injury (71.6% of intentional injury) and motor vehicle injury (18.8% of all injuries). There was a strong association between injury and alcohol use, with alcohol implicated in at least 30.1% of trauma admissions. From a systems standpoint, the data suggest a mature pattern of referral consistent with the presence of an inclusive trauma system. CONCLUSIONS AND RELEVANCE: The implementation of injury surveillance at Groote Schuur Hospital improved insights about injury risk based on demographics and neighborhood as well as access to service based on patterns of referral. This information will guide further development of South Africa's already advanced trauma system.This work was supported by the Canadian Institute for Health Research and the Social Sciences and Humanities Research Council
Analysis of Cases inWhich a Biopsy Specimen Is Positive and an Excised Lesion Is Negative for Nonmelanoma Skin Cancer

Nonmelanoma skin cancers (NMSCs), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), are the most common types of cancer with the fastest-growing treatment costs in the United States.1 Standard treatment requires biopsy for histologic confirmation, followed by excision. Oftentimes, no residual carcinoma is detected, implying spontaneous clearance at rates reported to vary from 24% to 76%.2- 5 These types of lesions have been investigated by others2- 5 and are not fully understood. Our study aims to determine the lesion and patient characteristics that would most strongly predict a histologically negative result for an excised lesion after a biopsy specimen had positive margins
Understanding the Operative Experience of the Practicing Pediatric Surgeon: Implications for Training and Maintaining Competency

Importance  The number of practicing pediatric surgeons has increased rapidly in the past 4 decades, without a significant increase in the incidence of rare diseases specific to the field. Maintenance of competency in the index procedures for these rare diseases is essential to the future of the profession.

Objective  To describe the demographic characteristics and operative experiences of practicing pediatric surgeons using Pediatric Surgery Board recertification case log data.

Design, Setting, and Participants  We performed a retrospective review of 5 years of pediatric surgery certification renewal applications submitted to the Pediatric Surgery Board between 2009 and 2013. A surgeon’s location was defined by population as urban, large rural, small rural, or isolated. Case log data were examined to determine case volume by category and type of procedures. Surgeons were categorized according to recertification at 10, 20, or 30 years.

Main Outcome and Measure  Number of index cases during the preceding year.

Results  Of 308 recertifying pediatric surgeons, 249 (80.8%) were men, and 143 (46.4%) were 46 to 55 years of age. Most of the pediatric surgeons (304 of 308 [98.7%]) practiced in urban areas (ie, with a population >50 000 people). All recertifying applicants were clinically active. An appendectomy was the most commonly performed procedure (with a mean [SD] number of 49.3 [35.0] procedures per year), nonoperative trauma management came in second (with 20.0 [33.0] procedures per year), and inguinal hernia repair for children younger than 6 months of age came in third (with 14.7 [13.8] procedures per year). In 6 of 10 “rare” pediatric surgery cases, the mean number of procedures was less than 2. Of 308 surgeons, 193 (62.7%) had performed a neuroblastoma resection, 170 (55.2%) a kidney tumor resection, and 123 (39.9%) an operation to treat biliary atresia or choledochal cyst in the preceding year. Laparoscopy was more frequently performed in the 10-year recertification group for Nissen fundoplication, appendectomy, splenectomy, gastrostomy/jejunostomy, orchidopexy, and cholecystectomy (P < .05) but not lung resection (P = .70). It was more frequently used by surgeons recertifying in the 10-year group (used in 11 375 of 14 456 procedures [78.7%]) than by surgeons recertifying in the 20-year (used in 6214 of 8712 procedures [71.3%]) or 30-year group (used in 2022 of 3805 procedures [53.1%]).

Conclusions and Relevance  Practicing pediatric surgeons receive limited exposure to index cases after training. With regard to maintaining competency in an era in which health care outcomes have become increasingly important, these results are concerning
Discounting a surgical risk: data, understanding, and gist

Excerpt: A few days after the surgery, Ms. Reid came in for an emergency appointment with Dr. Feng. It was obvious that she was irate,but her voice could barely be heard above the noise of the clinic. "I thought you said this was rare," she said, shaking a printout of a journal article on the subject. My recurrent laryngeal nerve was injured. I'm a teacher, and I have children! I need my voice. I would have never done the surgery if I knew there was a 4 percent risk that I would lose my voice!" Was Dr. Feng negligent in explaining the risks of surgery to Ms. Reid? Was she required to use precise percentages of risk
The diet-body offset in human nitrogen isotopic values: a controlled dietary study

The ‘trophic level enrichment’ between diet and body results in an overall increase in nitrogen isotopic values as the food chain is ascended. Quantifying the diet–body Δ15N spacing has proved difficult, particularly for humans. The value is usually assumed to be +3-5‰ in the archaeological literature. We report here the first (to our knowledge) data from humans on isotopically known diets, comparing dietary intake and a body tissue sample, that of red blood cells. Samples were taken from 11 subjects on controlled diets for a 30-d period, where the controlled diets were designed to match each individual’s habitual diet, thus reducing problems with short-term changes in diet causing isotopic changes in the body pool. \ud
The Δ15Ndiet-RBC was measured as +3.5‰. Using measured offsets from other studies, we estimate the human Δ15Ndiet-keratin as +5.0-5.3‰, which is in good agreement with values derived from the two other studies using individual diet records. We also estimate a value for Δ15Ndiet-collagen of ≈6‰, again in combination with measured offsets from other studies. This value is larger than usually assumed in palaeodietary studies, which suggests that the proportion of animal protein in prehistoric human diet may have often been overestimated in isotopic studies of palaeodiet
An evolutionary approach to modelling the thermo-mechanical behaviour of unsaturated soils

A new data mining approach is presented for modelling of the stress-strain and volume change behaviour of unsaturated soils considering temperature effects. The proposed approach is based on the evolutionary polynomial regression (EPR), which unlike some other data mining techniques, generates a transparent and structured representation of the behaviour of systems directly from raw experimental (or field) data. The proposed methodology can operate on large quantities of data in order to capture nonlinear and complex relationships between contributing variables. The developed models allow the user to gain a clear insight into the behaviour of the system. Unsaturated triaxial test data from literature was used for development and verification of EPR models. The developed models were also used (in a coupled manner) to produce the entire stress path of triaxial tests. Comparison of the EPR model predictions with the experimental data revealed the robustness and capability of the proposed methodology in capturing and reproducing the constitutive thermo-mechanical behaviour of unsaturated soils. More importantly, the capability of the developed models in accurately generalising the predictions to unseen data cases was illustrated. The results of a sensitivity analysis showed that the models developed from data are able to capture and represent the physical aspects of the unsaturated soil behaviour accurately. The merits and advantages of the proposed methodology are also discussed
Transport of malic acid in the yeast Schizosaccharomyces pombe: evidence for a proton-dicarboxylate symport

The transport system for malic acid present in Schizosaccharomyces pombe cells, growing in batch culture on several corbon sources, has been studied. It was found that the diarboxylic acid carrier of S. pombe is a proton-dicarboxylate symporter that allows transport and accumulation as a function of pH with the following kinetic parameters at pH 5·0: Vmax = 0·01 nmol of total malic acids 1 mg (dry weight) of cells, 1and Km = 0·1mM total malic acid uptake (pH 5·0) was accompanied by disappearance of extracellular protons, the uptake rates of which followed Michaelis-Menten kinetics as a function of the acid concentration. The Km values, calculated as the concentrations either of anions or of undissociated acid, at various extracellular pH values, pointed to the monoanionic form as the transported species. Furthermore, accumulated free acid suffered rapid efflux after the addition of the portonophore carbonyl cyanid m-chlorophenyl hydrazone. These results suggested that the transport system was a dicarboxylateproton symporter. Growth of cells in a medium with glucose (up to 14%, w/v) and malic acid (1·5%, w/v) also resulted in proton-dicarboxylate activity, suggesting that the system, besides being constitutive, was still active at high glucose concentrations. The following dicarboxylic acids acted as competitive inhibitors of malic acid transport at pH 5·0: D- malic acid, succinic acid, fumaric acid oxaloacetic acid, -Ketoglutaric acid, maleic acid, maleic and malonic acid. In addition all of these dicarboxylic acids induced proton movements that followed MichaelisMenten kinetics. It was concluded that the malic negatively charged form (probably the monoanionic form) was transported by a proton-symport mechanism and that the carrier appeared to be a common dicarboxylat transport sysmem. The undissociated acid entered the cells slowly by simple diffusion
Recycling of polypropylene 1 based eco-composites

BACKGROUND: Renewable resources and recyclable thermoplastic polymers provide attractive eco-friendly quality as well as environmental sustainability to the resulting natural fiber reinforced composites. The properties of polypropylene (PP) based composites reinforced with rice hulls or kenaf fibers were investigated with respect to recyclability. Maleic anhydride grafted PP was used as 1 a coupling agent (CA) to improve the compatibility and adhesion between fibers and matrix. The composites containing 30 wt % reinforcement were manufactured by melt mixing and their mechanical and thermal properties were determined. The composites were then grand into granules used for production of new samples by compression molding.\ud
RESULTS: It was found that the flexural strength and thermal stability of recycled composites is similar to the initial ones. The composites based on kenaf fibers have\ud
shown better properties after recycling than those based on rice hulls.\ud
CONCLUSION: The obtained results for flexural strength and modulus of PP-based composites produced from the recycled samples with kenaf fibers or rice hulls as reinforcement are comparable to conventional formaldehyde wood medium density fiberboards. The recycled composites exhibit good characteristics for using as construction materials for housing systems.\u
Diagnostic accuracy of intracranial translucency in detecting spina bifida: a systematic review and meta-analysis

OBJECTIVE:\ud
To evaluate the diagnostic accuracy of intracranial translucency (IT) in the detection of spina bifida (SB) in the first trimester of pregnancy.\ud
\ud
METHODS:\ud
We included study assessing the accuracy of sonographic measurements of IT in a mid-sagittal view of the fetal face in prediction of SB in the first trimester of pregnancy. The primary outcome was the accuracy of IT in prediction of spina bifida. Summary estimates of sensitivity, specificity, positive and negative likelihood ratios (LR), and diagnostic odds ratio for the overall predictive accuracy of IT were computed.\ud
\ud
RESULTS:\ud
Nine studies (21 070 fetuses) were included in the analysis. IT was successfully assessed in the majority of fetuses 97.8% (95% CI 97.6-98.0). The diagnostic performance of IT in detecting SB was as follows: sensitivity: 53.5% (95% CI 42.4-64.3), specificity: 99.7% (95% CI 99.6-99.8), positive LR: 62.1 (95% CI 12.2-317), negative LR:0.55 (95% CI 0.45-0.68), and diagnostic odds ratio: 223 (95% CI 25-2039).\ud
\ud
CONCLUSIONS:\ud
Intracranial translucency had low diagnostic accuracy in prediction of open spina bifida, thus questioning its role as a screening marker for open SB in an unselected population. When looking at the individual study data, it appears that IT assessment for open SB prediction can be affected by a high rate of false positive results potentially leading to unnecessary parental anxiet
Convergence of the two-dimensional dynamic Ising-Kac model to Φ 4 2\ud

The Ising-Kac model is a variant of the ferromagnetic Ising model in which each spin variable interacts with all spins in a neighborhood of radius γ−1 for γ ≪ 1 around its base point. We study the Glauber dynamics for this model on a discrete two-dimensional torus inline image for a system size N ≫ γ−1 and for an inverse temperature close to the critical value of the mean field model. We show that the suitably rescaled coarse-grained spin field converges in distribution to the solution of a nonlinear stochastic partial differential equation.\ud
\ud
This equation is the dynamic version of the inline image quantum field theory, which is formally given by a reaction-diffusion equation driven by an additive space-time white noise. It is well-known that in two spatial dimensions such equations are distribution valued and a Wick renormalization has to be performed in order to define the nonlinear term. Formally, this renormalization corresponds to adding an infinite mass term to the equation. We show that this need for renormalization for the limiting equation is reflected in the discrete system by a shift of the critical temperature away from its mean field value. © 2016 Wiley Periodicals, Inc
Midcheek endoscopic anatomy

Background Surgical approaches to the midcheek area are challenging. Recent clinical reports have proposed minimally endoscopic approach again, in order to obtain to obtain a correct balance between the operation's safety and the cosmetic and minimally invasive outcome, but none of them provides a careful anatomic description of the midcheek area. The purpose of this study was to provide a new anatomic perception of the midcheek area through a detailed anatomic endoscopic-assisted dissection. Methods Four freshly injected cadaver heads were dissected to illustrate the endoscopic anatomy of the midcheek region. Results An endoscope provided an excellent surgical window that achieved greater exposure for dissection and at the same time improved magnification of the noble key anatomic elements. Conclusion This study emphasizes the critical role of the transverse facial artery and the facial retaining ligaments as a fundamental endoscopic landmark that allows the identification of key anatomic structures and the creation of safe surgical corridors. © 2015 Wiley Periodicals, Inc.
Closely linked cis-acting modifier of expansion of the CGG repeat in high risk FMR1 haplotypes.

In its expanded form, the fragile X triplet repeat at Xq27.3 gives rise to the most common form of inherited mental retardation, fragile X syndrome. This high population frequency persists despite strong selective pressure against mutation-bearing chromosomes. Males carrying the full mutation rarely reproduce and females heterozygous for the premutation allele are at risk of premature ovarian failure. Our diagnostic facility and previous research have provided a large databank of X chromosomes that have been tested for the FRAXA allele. Using this resource, we have conducted a detailed genetic association study of the FRAXA region to determine any cis-acting factors that predispose to expansion of the CGG triplet repeat. We have genotyped SNP variants across a 650-kb tract centered on FRAXA in a sample of 877 expanded and normal X chromosomes. These chromosomes were selected to be representative of the haplotypic diversity encountered in our population. We found expansion status to be strongly associated with a approximately 50-kb region proximal to the fragile site. Subsequent detailed analyses of this region revealed no specific genetic determinants for the whole population. However, stratification of chromosomes by risk subgroups enabled us to identify a common SNP variant which cosegregates with the subset of D group haplotypes at highest risk of expansion (chi(1)(2)=17.84, p=0.00002). We have verified that this SNP acts as a marker of repeat expansion in three independent samples
Infant and adult visual attention during an imitation demonstration

Deferred imitation tasks have shown that manipulations at encoding can enhance infant learning and memory performance within an age, suggesting that brain maturation alone cannot fully account for all developmental changes in early memory abilities. The present study investigated whether changes in the focus of attention during learning might contribute to improving memory abilities during infancy. Infants aged 6, 9, and 12 months, and an adult comparison group, watched a video of a puppet imitation demonstration while visual behavior was recorded on an eye tracker. Overall, infants spent less time attending to the video than adults, and distributed their gaze more equally across the demonstrator and puppet stimulus. In contrast, adults directed their gaze primarily to the puppet. When infants were tested for their behavioral recall of the target actions, “imitators” were shown to have increased attention to the person and decreased attention to the background compared to “non-imitators.” These results suggest that attention during learning is related to memory outcome and that changes in attention may be one mechanism by which manipulations to the learning event may enhance infant recall memory
Friendship and loneliness among bullies and victims : data from seven countries

Research suggests that the relationship between school bullying and its various risk factors should be
clearer among girls than boys, and should become stronger with age, as roles within the peer group
stabilise. This paper tests this theory by comparing sex, school type, and bully/victim status differences
in friendships and playground social interactions, using data from nine surveys in seven countries:
China, England, Ireland, Italy, Japan, Portugal, and Spain. A total of approximately 48,000 children
completed various translations of the Olweus Bullying Questionnaire. Small but generally consistent
main effects were found for sex and school type (boys and primary pupils enjoyed playtimes more and
had more friends, but were also more likely to spend playtimes alone). Larger effects were consistently
found for bully/victim status (victims were significantly worse off on all the measures in all the samples
where a difference was found, while bullies and neutrals did not differ consistently), but the interactions
between these factors varied widely between samples and there were few consistent patterns. It is
concluded that bullying is a universal phenomenon with many negative correlates for victims and few
(if any) for bullies, but that there are cultural variations in the way that bullying is related to sex, age,
and social support.CIFPEC/CIEC – Research Centre on Child Studies, UM (FCT R&D 317)
Phylogeny of the titi monkeys of the Callicebus moloch group (Pitheciidae, Primates)

Callicebus is a Neotropical primate genus of the family Pitheciidae, which\ud
27 currently comprises 34 recognized species. Based on their morphological traits\ud
28 and geographic distribution, these species are currently assigned to five\ud
groups: the C. moloch, C. cupreus, C. donacophilus, C. torquatus, and C.\ud
30 personatus groups, although in the past, alternative arrangements have been\ud
31 proposed based on the analysis of morphological data. The principal\ud
32 disagreements among these arrangements are related to the composition of the\ud
33 C. moloch group. In the present study, we tested the different taxonomic\ud
proposals for the C. moloch group, based on the molecular analysis of nuclear\ud
35 markers (Alu insertions and flanking regions) and three mitochondrial genes\ud
36 (16S, COI and Cyt b), with a total of approximately 7 kb of DNA sequence\ud
37 data. Phylogenetic reconstructions based on maximum likelihood and\ud
Bayesian inference methods indicated that the species of the current C.\ud
39 cupreus group should be reintegrated into the C. moloch group. In addition,\ud
40 our results corroborated previous studies suggesting that the species of the\ud
41 current C. personatus group form a distinct species group. We also observed a\ud
42 relatively subtle level of divergence between C. dubius and C. caligatus.\ud
While the known diversity of Callicebus is considerable, these findings\ud
44 indicate that the relationships among groups and species may still not be\ud
45 completely understood, highlighting the need for further research into the\ud
46 biological, geographic and genetic variability of these primates, which will be\ud
fundamental to the effective conservation of the genu