Miracle-dz/UniFAR-FTUs huggingface dataset:
Work-related injuries in a state trauma registry: Relationship between industry and drug screening

BACKGROUND Work-related injuries exert a great financial and economic burden on the US population. The study objectives were to identify the industries and occupations associated with worker injuries and to determine the predictors for injured worker drug screening in trauma centers. METHODS Work-related injury cases were selected using three criteria (expected payer source of workers’ compensation, industry-related e-codes, and work-related indicator) from the Kentucky Trauma Registry data set for years 2008 to 2012. Descriptive analyses and multiple logistic regression were performed on the work-related injury cases. RESULTS The “other services” and construction industry sectors accounted for the highest number of work-related cases. Drugs were detected in 55% of all drug-screened work-related trauma cases. Higher percentages of injured workers tested positive for drugs in the natural resources and mining, transportation and public utilities, and construction industries. In comparison, higher percentages of injured workers in the other services as well as transportation and public utilities industries were drug screened. Treatment at Level I trauma centers and Glasgow Coma Scale (GCS) scores indicating a coma or severe brain injury were both significant independent predictors for being screened for drugs; industry was not a significant predictor for being drug screened. The injured worker was more likely to be drug screened if the worker had a greater than mild injury, regardless of whether the worker was an interfacility transfer. CONCLUSION These findings indicate that there may be elevated drug use or abuse in natural resources and mining, transportation and public utilities, as well as construction industry workers; improved identification of the specific drug types in positive drug screen results of injured workers is needed to better target prevention efforts. LEVEL OF EVIDENCE Epidemiologic study, level III.
Existence of outermost apparent horizons with product of spheres topology

In this paper we find new examples of Riemannian manifolds with outermost apparent horizons with nonspherical topology, in dimensions four and above. More precisely, for any $n,m\ge1$, we construct asymptotically flat, scalar flat Riemannian manifolds containing smooth outermost minimal hypersurfaces with topology $S^n\times S^{m+1}$. In the context of general relativity these hypersurfaces correspond to outermost apparent horizons of black holes.
EMG Activity in Selected Target Muscles During Imagery Rising on Tiptoes in Healthy Adults and Poststrokes Hemiparetic Patients

The authors sought to gain further knowledge about activation of target muscles during imagery engagement in a motor task. Six hemiparetic patients and 9 healthy participants performed 3 real rises on tiptoes and then, after pausing, 3 imagery rises on tiptoes. Metronome beats guided the rate of rises and descents. Electromyographic (EMG) activity from the medial gastrocnemius and the rectus femoris muscles were monitored bilaterally throughout the performance of both tasks. In 3 healthy participants and 3 individuals with hemiparesis, EMG activity was related to the imagery task in at least 1 of the target muscles. Conversely, in the other participants, motor imagery practice was not accompanied by task-related EMG activity in the monitored muscles. In all cases, the increment in activation level during motor imagery practice was very low in comparison with that of real performance. The findings were not unequivocal; therefore, EMG activity may sometimes, but not always, be recorded during motor imagery practice both in healthy individuals and in poststroke hemiparetic participants. Further research is needed to align motor imagery practice with the objectives of motor rehabilitation.
Synchronization Techniques for Burst-Mode Continuous Phase Modulation

Synchronization is a critical operation in digital communication systems, which establishes and maintains an operational link between transmitter and the receiver. As the advancement of digital modulation and coding schemes continues, the synchronization task becomes more and more challenging since the new standards require high-throughput functionality at low signalto-noise ratios (SNRs). In this work, we address feedforward synchronization of continuous phase modulations (CPMs) using data-aided (DA) methods, which are best suited for burstmode communications. In our transmission model, a known training sequence is appended to the beginning of each burst, which is then affected by additive white Gaussian noise (AWGN), and unknown frequency, phase, and timing offsets. Based on our transmission model, we derive the Cramer-Rao bound (CRB) for DA joint estimation of synchronization parameters. Using the CRB expressions, the optimum training sequence for CPM signals is proposed. It is shown that the proposed sequence minimizes the CRB for all three synchronization parameters asymptotically, and can be applied to the entire CPM family. We take advantage of the simple structure of the optimized training sequence in order to design a practical synchronization algorithm based on the maximum likelihood (ML) principles. The proposed DA algorithm jointly estimates frequency offset, carrier phase and symbol timing in a feedforward manner. The frequency offset estimate is first found by means of maximizing a one dimensional function. It is then followed by symbol timing and carrier phase estimation, which are carried out using simple closed-form expressions. We show that the proiii posed algorithm attains the theoretical CRBs for all synchronization parameters for moderate training sequence lengths and all SNR regions. Moreover, a frame synchronization algorithm is developed, which detects the training sequence boundaries in burst-mode CPM signals. The proposed training sequence and synchronization algorithm are extended to shaped-offset quadrature phase-shift keying (SOQPSK) modulation, which is considered for next generation aeronautical telemetry systems. Here, it is shown that the optimized training sequence outperforms the one that is defined in the draft telemetry standard as long as estimation error variances are considered. The overall bit error rate (BER) plots suggest that the optimized preamble with a shorter length can be utilized such that the performance loss is less than 0.5 dB of an ideal synchronization scenario.
Maple Syrup Urine Disease

Serum amino-acid chromatogram. Note the intense leucine/isoleucine and valine spots. bronchopneumonia at 3 weeks, was drowsy from birth and fed poorly. Examination showed our patient to be unresponsive, with increased tone and occasional opisthotonic spasms. A strong odour of maple syrup was present. Investigations. -Urinary chromatograms showed marked increase in valine (from which the odour was detected), leucine, and isoleucine, with moderate increases in other amino-acids. The a-keto acids of the branched amino-acids were also present in large amounts. Indolyl-lactic acid was present in excess but not indolyl-acetic acid. Asparagine and ethanolamine were also detected. The serum and cerebrospinal fluid showed greatly increased amounts of valine,leucine, and isoleucine; other amino-acids were normal or low in quantity (see Fig.). COMMENT. -While clinically this case is one of maple syrup urine disease the biochemical findings suggest the presence of a renal tubular defect and hepato-cellular damage. Previously reported cases have shown an increase in indolyl-acetic acid; this was not present in the above case. Detailed biochemical findings will be published later, with the results of a dietary trial which is proceeding.
The Area Under the Concentration-Time Curve Is a Better Estimate for Vancomycin Exposure Than Trough Levels.

To the Editor: With interest we read the article by Hanrahan et al (1). The authors conducted a retrospective multivariate regression analysis to evaluate the influence of vancomycin dose, serum trough concentration, and dosing strategy on new-onset acute kidney injury in critically ill patients. Concomitant vasoactive therapy, median serum vancomycin concentration, and duration of therapy seemed to predict vancomycin-associated nephrotoxicity (VAN). We thank the authors for identifying the predictors of VAN in their large dataset. However, when multiple trough serum vancomycin concentrations were available, the median and maximum trough concentrations were recorded in this study. Trough levels tend to underestimate true exposure by ~25%, which hampers drawing conclusions about the relationship between vancomycin exposure and VAN (2). Also, it has been shown that trough levels are often not collected at the correct time: one study showed that 61% of samples that needed to be drawn within 1 hour were actually collected greater than 2 hours prior to the next dose (2). In the retrospective design of Hanrahan et al (1), it is questionable whether the samples were all collected within 30 minutes of the next dose. The area under the concentration-time curve (AUC) is probably a better reflection of total vancomycin exposure. We have just conducted a prospective study to analyze VAN in critically ill patients, using AUC 0–24 after vancomycin initiation to measure exposure. VAN was registered in the same way as in the study by Hanrahan et al (1). The results from our study regarding the correlation between VAN and vancomycin exposure were not previously published and are listed in Table 1. No significant difference between vancomycin exposure and VAN was observed: the AUC 24 in the nephrotoxic group was 642.52 mg/L/hr (n = 14) and 545.32 mg/L/hr in the TablE 1. Results of Correlation between Vancomycin-associated Nephrotoxicity and Vancomycin Exposure in Terms of area Under the Concentration-Time Curve in 0–24 Hours
Albuminuria, Insulin Resistance and Dyslipidaemia in Chinese Patients with Non‐insulin‐dependent Diabetes (NIDDM)

In order to examine the relationships between albuminuria, insulin resistance, and dyslipidaemia in non‐insulin‐dependent diabetes (NIDDM), we studied 164 Chinese patients (68 men, 96 women), treated with diet or oral hypoglycaemic agents, on three occasions during a 6‐week period. Antihypertensive treatment, if previously prescribed, was withdrawn for at least 2 weeks before the study period. Insulin resistance was calculated from simultaneous fasting plasma glucose and insulin concentrations using the homeostasis model assessment (HOMA) method. Based on two of three 24 h urinary collections, 87 (53 %) patients had normoalbuminuria, 46 (28 %) microalbuminuria, and 31 (19 %) macroalbuminuria. Despite similar glycaemic control, patients with abnormal albuminuria had higher mean arterial pressure, fasting plasma total cholesterol, triglyceride and serum apo B concentrations and were more insulin resistant than normoalbuminuric patients. Albuminuria correlated with mean arterial pressure (r = 0.31, p < 0.001), triglyceride (r = 0.36, p<0.001), total cholesterol (r = 0.28, p = 0.001), apolipoprotein B (apo B) (r = 0.25, p = 0.003), and insulin resistance (r = 0.25, p < 0.002). These close associations may contribute to the increased cardiovascular risk in Chinese NIDDM patients with abnormal albuminuria.
Effects of a Dual Sensory Loss Protocol on Hearing Aid Outcomes: A Randomized Controlled Trial

Objectives: Dual sensory loss (DSL; concurrent vision and hearing loss) negatively affects quality of life. As speechreading is hampered, use of hearing aids (HAs) is important for older adults with DSL. However, due to vision loss, use of small and complex HAs is assumed to be difficult. An integrative DSL protocol that addresses rehabilitative care for older adults with DSL, including proper HA use, was implemented in low vision rehabilitation centers. The present study aims to evaluate the effectiveness of the DSL protocol among HA owners on HA outcomes (i.e., HA use, benefit, satisfaction with HAs, and hearing with HAs). Design: In a randomized controlled trial, the DSL protocol was compared to a waiting list control group among clients (aged ≥50 years) of low vision rehabilitation centers with DSL. The International Outcome Inventory for Hearing Aids (IOI-HA) and the HA Fitting Questionnaire (HAFQ) were administered at baseline and 3 months follow-up. Participants (n = 128) were randomly allocated to either the intervention (n = 63) or control group (n = 65). Results: Intention-to-treat analyses showed a near significant effect on IOI-HA Residual problems (effect size, 0.35; p = 0.063). Per-protocol analyses showed similar (nonsignificant) results on the main outcomes, and a ceiling effect was found on the HAFQ. Significant effects were found in subgroups of patients: among patients with low HAFQ scores (HAFQ-Use: effect size = 0.56, p = 0.046; HAFQ-Hearing with HAs: effect size = 0.64, p = 0.019), male participants (effect size = 0.80; p = 0.003), and those with moderate hearing loss (effect size = 0.72; p = 0.028), significantly better IOI-HA scores were found in the intervention group at 3 months follow-up. Conclusions: Although the per-protocol and subgroup analyses need to be interpreted with caution, DSL patients who experience HA difficulties could benefit from the DSL protocol by making better use of their HAs. The increasing prevalence and impact of DSL on a person’s independence and social participation call for more awareness of concurrent sensory impairments in both low vision and audiology rehabilitation. Interdisciplinary training for rehabilitation professionals could be an important step, followed by integration of vision and hearing services using the DSL protocol.
Identifying Conserved Gene Clusters in the Presence of Homology Families

The study of conserved gene clusters is important for understanding the forces behind genome organization and evolution, as well as the function of individual genes or gene groups. In this paper, we present a new model and algorithm for identifying conserved gene clusters from pairwise genome comparison. This generalizes a recent model called "gene teams. " A gene team is a set of genes that appear homologously in two or more species, possibly in a different order yet with the distance of adjacent genes in the team for each chromosome always no more than a certain threshold. We remove the constraint in the original model that each gene must have a unique occurrence in each chromosome and thus allow the analysis on complex prokaryotic or eukaryotic genomes with extensive paralogs. Our algorithm analyzes a pair of chromosomes in O(mn) time and uses O(m+n) space, where m and n are the number of genes in the respective chromosomes. We demonstrate the utility of our methods by studying two bacterial genomes, E. coli K-12 and B. subtilis. Many of the teams identified by our algorithm correlate with documented E. coli operons, while several others match predicted operons, previously suggested by computational techniques. Our implementation and data are publicly available at euler.slu. edu/ approximately goldwasser/homologyteams/.
Towards intelligent assistance for to-do lists

Assisting users with to-do lists presents new challenges for intelligent user interfaces. This paper presents a detailed analysis of to-do list entries jotted by users of a system that automates tasks for users that we would like to extend to assist users with their to-do entries. We also present four distinct stages of interpretation of to-do entries that can be accomplished and evaluated separately. A system that has good performance in any of these four stages can provide intelligent assistance that is useful to users.
Architectural organization of filiform papillae in normal and black hairy tongue epithelium: dissection of differentiation pathways in a complex human epithelium according to their patterns of keratin expression.

BACKGROUND An inadequate understanding of the complex morphologic characteristics of human filiform papillae has hampered the histopathological characterization of disorders affecting tongue keratinization. To better define the 3-dimensional cytoarchitecture of tongue epithelium, we performed detailed immunohistochemical analyses of normal and black hairy tongue tissues using a panel of antikeratin antibodies. OBSERVATIONS The dome-shaped base of the human filiform papilla (primary papilla) is surmounted by 3 to 8 elongated structures (secondary papillae). These secondary papillae are composed of a central column of epithelial cells expressing hair-type keratins and an outer rim of cells expressing skin-type keratins. The epithelium overlying the primary papillae and between the individual primary papillae express esophageal-type keratins. In black hairy tongue disease, there is a marked retention of secondary papillary cells expressing hair-type keratins. CONCLUSIONS Using a panel of antikeratin probes, we define the precise topographical localization of cell populations undergoing 3 distinct differentiation programs in dorsal tongue epithelium. Comparative analyses of black hairy tongue specimens indicate that defective desquamation of the cells in the central column of filiform papillae results in the formation of highly elongated, cornified spines or, "hairs"--the hallmark of this disease.
Laparoscopic Skills Suffer on The First Shift of Sequential Night Shifts: Program Directors Beware and Residents Prepare

Objective:Research evaluating fatigue-induced skills decline has focused on acute sleep deprivation rather than the effects of circadian desynchronization associated with multiple shifts. As a result, the number of consecutive night shifts that residents can safely be on duty without detrimental effects to their technical skills remains unknown. A prospective observational cohort study was conducted to assess the impact of 7 successive night shifts on the technical surgical performance of junior residents. Methods:The interventional strategy included training 21 residents from surgery and allied disciplines on a virtual reality surgical simulator, towards the achievement of preset benchmark scores, followed by 294 technical skills assessments conducted over 1764 manpower night shift hours. Primary outcomes comprised serial technical skills assessments on 2 tasks of a virtual reality surgical simulator. Secondary outcomes included assessments of introspective fatigue, duration of sleep, and prospective recordings of activity (number of “calls” received, steps walked, and patients evaluated). Results:Maximal deterioration in performance was observed following the first night shift. Residents took significantly longer to complete the first (P = 0.002) and second tasks (P = 0.005) compared with baseline. They also committed significantly greater numbers of errors (P = 0.025) on the first task assessed. Improved performance was observed across subsequent shifts towards baseline levels. Conclusions:Newly acquired technical surgical skills deteriorate maximally after the first night shift, emphasizing the importance of adequate preparation for night rotas. Performance improvements across successive shifts may be due to ongoing learning or adaptation to chronic fatigue. Further research should focus on assessments of both technical procedural skills and cognitive abilities to determine the rotas that best minimize errors and maximize patient safety.
Reduced Pleasant Touch Appraisal in the Presence of a Disgusting Odor

Objectives Odors are powerful emotional stimuli influencing mood, attention and behavior. Here we examined if odors change the perception of pleasant touch. In line with the warning function of the olfactory system, we proposed that especially unpleasant odors will reduce touch pleasantness, presumably through a disgust-related mechanism. Methods Forty-five healthy participants (mean age 23.3 +/− 3years SD, 24 females) were presented to slow (3 cm/s) and fast (30 cm/s) brush stroking delivered by a robot to the forearm. Touch pleasantness under the influence of an unpleasant odor (Civette, smelling like feces) and an intensity matched pleasant odor (Rose) was compared to an odorless control condition. In a pilot study with 30 participants (mean age 25.9 +/−6 years, 21 females), the odors were matched according to their intensity, and we studied the influence of disgust sensitivity on the perception of 4 different odor qualities. Results The unpleasant odor decreased touch pleasantness for both stroking velocities compared to the odorless control (p<0.005) whereas the rose odor did not change touch pleasantness significantly. Disgust sensitivity was correlated with the modulation of touch pleasantness. The pilot study revealed a significant correlation between disgust sensitivity and the perception of the unpleasant odor qualities (r = −0.56; p = 0.007), but not with any of the other odors. Conclusion Unpleasant odors are powerful in modulating touch pleasantness, and disgust might be a moderating variable.
Metoprolol succinate vs. ivabradine in the treatment of inappropriate sinus tachycardia in patients unresponsive to previous pharmacological therapy.

AIMS Inappropriate sinus tachycardia (IST) is a clinical syndrome characterized by excessive resting heart rate (HR) or disproportional increasing HR during exercise. The treatment of IST symptoms using beta-blockers or calcium channel-blockers is often non-effective or not well tolerated. Ivabradine is a new agent inhibiting sinus node I(f) current, resulting in a decrease of HR without haemodynamic compromise. METHODS AND RESULTS We enrolled 20 patients (36 ± 10 years; 14 women) affected by IST and resistant to previous administered therapy by using beta-blockers or verapamil. After 4 weeks of treatment with metoprolol succinate (up to 190 mg once a day) the therapy was switched to ivabradine up to 7.5 mg twice daily. Holter monitoring and treadmill stress test were performed after 1 and 2 months following start of the study. We observed a significant reduction of resting HR both for metoprolol and for ivabradine compared with baseline (92.8 vs. 90.2 vs. 114.3 b.p.m.; P< 0.001). During daily activity there was an even larger decrease of HR on ivabradine (mean daytime HR 94.6 vs. 87.1 vs. 107.3 b.p.m.; P< 0.001). Ivabradine was very well tolerated whereas in 10 patients on metoprolol we observed hypotension or bradycardia requiring dose reduction. Significantly lower incidence of IST-related symptoms were registered on ivabradine therapy than on metoprolol. Fourteen patients (70%) treated with I(f) blocker were free of IST-related complaints. CONCLUSIONS Metoprolol and ivabradine exert a similar effect on resting HR in patients with IST. Ivabradine seems to be more effective to relieve symptoms during exercise or daily activity.
Self-efficacy to avoid suicidal action: factor structure and convergent validity among adults in substance use disorder treatment.

Individuals with substance use disorders (SUDs) are at high risk of suicidal behaviors, highlighting the need for an improved understanding of potentially influential factors. One such domain is self-efficacy to manage suicidal thoughts and impulses. Psychometric data about the Self-Efficacy to Avoid Suicidal Action (SEASA) Scale within a sample of adults seeking SUD treatment (N = 464) is provided. Exploratory factor analysis supported a single self-efficacy construct. Lower SEASA scores, or lower self-efficacy, were reported in those with more severe suicidal ideation and those with more suicide attempts, providing evidence for convergent validity. Implications of measuring self-efficacy in the context of suicide risk assessment are discussed.