Miracle-dz/UniFAR-FTUs huggingface dataset:
RF shimming for spectroscopic localization in the human brain at 7 T

Spectroscopic imaging of the human head at short echo times (≤15 ms) typically requires suppression of signals from extracerebral tissues. However, at 7 T, decreasing efficiency in B 1+ generation (hertz/watt) and increasing spectral bandwidth result in dramatic increases in power deposition and increased chemical shift registration artifacts for conventional gradient‐based in‐plane localization. In this work, we describe a novel method using radiofrequency shimming and an eight‐element transceiver array to generate a B 1+ field distribution that excites a ring about the periphery of the head and leaves central brain regions largely unaffected. We have used this novel B 1+ distribution to provide in‐plane outer volume suppression (>98% suppression of extracerebral lipids) without the use of gradients. This novel B 1+ distribution is used in conjunction with a double inversion recovery method to provide suppression of extracerebral resonances with T1s greater than 400 ms, while having negligible effect on metabolite ratios of cerebral resonances with T1s > 1000 ms. Despite the use of two adiabatic pulses, the high efficiency of the ring distribution allows radiofrequency power deposition to be limited to 3‐4 W for a pulse repetition time of 1.5 sec. The short echo time enabled the acquisition of images of the human brain, displaying glutamate, glutamine, macromolecules, and other major cerebral metabolites. Magn Reson Med, 2010. © 2009 Wiley‐Liss, Inc.
Evidence for weak protein binding of commercial extracellular gadolinium contrast agents

It is widely assumed that commercial extracellular gadolinium‐based contrast agents do not bind to proteins. Here, nuclear magnetic relaxation dispersion was used to characterize the interaction between the contrast agents gadodiamide and gadopentetate dimeglumine and the proteins human serum albumin, chicken egg white lysozyme, egg white proteins, or milk proteins. In all cases, contrast agent relaxivity was increased at all field strengths measured (0.0002 to 1.4 T) when protein was added. A distinct peak in relaxivity was observed between 0.5 and 0.7 T that is consistent with fractional protein binding and that could not be attributed to changes in solution viscosity. This peak was observed for gadodiamide with all four protein solutions and for gadopentetate dimeglumine with lysozyme, human serum albumin, and milk proteins. Protein binding was both contrast agent and protein dependent. For gadodiamide, the highest affinity was to egg white and milk proteins, while gadopentetate dimeglumine interacted most strongly with lysozyme. Protein binding was estimated at 30–40% for a 0.7 mmol/kg solution of gadodiamide in egg white or milk proteins. These results have implications for the accurate determination of contrast agent concentration in vivo. Weak protein binding may be an additional discriminating factor in understanding differences in the toxicokinetics of contrast agents. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
A systematic review of the effectiveness of CT-guided, lumbar transforaminal injection of steroids.

OBJECTIVE To determine the effectiveness and safety of computerized tomography (CT) guided, lumbar transforaminal injection of steroids in the treatment of radicular pain. DESIGN Systematic review of published literature. INTERVENTIONS Two reviewers independently assessed 19 publications on the effectiveness and safety of CT-guided, lumbar transforaminal injection of steroids. OUTCOME MEASURES For effectiveness, the primary outcome was the success rate for relief of pain. For safety, the radiation exposure involved and the nature of complications were determined. RESULTS Much of the literature fails to provide evidence. Two studies reported decreases in mean or median pain scores but no other data. Two studies reported success rates of between 34% and 62% for achieving 50% relief of pain at between 1 and 6 months after treatment. CT-guided injections may involve greater radiation exposure than does fluoroscopy-guided injections and do not avoid catastrophic spinal cord injury. CONCLUSION The evidence-base for CT-guided lumbar transforaminal injection of steroids is meagre. This intervention is not more effective than fluoroscopy-guided injections and is not demonstrably safer.
Role of Medications in Otological Vertigo and Balance Disorders

Reprint requests: Dr. Cass, Eye & Ear Institute of Pittsburgh, 230 Lothrop, Suite 500, Pittsburgh, PA 15213. Otological medical management seeks to identify and treat specific pathology underlying the symptoms of vertigo and imbalance. The first step of medical management, the neurotological history and physical examination, focuses on characterizing the presenting balance disorder. Based on the initial audiological, vestibular, and physical examination, laboratory and radiographic studies should be obtained to diagnose any potentially treatable metabolic and endocrine abnormalities, infectious disease, or central nervous system (CNS) abnormality. These studies commonly include fasting and glucose tolerance testing; cholesterol and triglyerides; complete blood cell (CBC) count; blood urea nitrogen (BUN); creatine; liver enzymes; fluorescent treponemal antibody absorption (FTA-ABS) test; an autoimmune panel; thyroid function tests; and magnetic resonance imaging of the eighth nerve complex, brainstem, and cerebrum. Once the potential contribution of these factors to the etiology of the balance disorder are identified and corrected, a pharmacological treatment plan can be offered. The ideal drug therapy stabilizes or reverses the pathological process underlying symptoms of vertigo and imbalance. Unfortunately, the development of effective drugs is hampered by a number of factors. First, vertigo and imbalance are not specific to one underlying pathology, but are symptoms associated with a variety of etiologies. Second, within a group of patients with similar clinical presentations or a particular constellation of laboratory findings, the specific underlying cause of vertigo usually remains unknown and may vary between patients. Third, the results of therapeutic drug trials are usually based on subjective reports and are rarely based on objective measurement of vestibular or balance function. Finally, the fluctuating nature of many types of vertigo and imbalance, and the tendency for vestibular compensation to spontaneously reduce symptoms over time, complicates the interpretation of therapeutic drug trials. These inherent problems make it difficult to convincingly demonstrate the efficacy of medications to treat balance disorders. This situation forces clinicians to choose medications based on 257
A retrospective study of fracture cases presented to university of maiduguri, veterinary teaching hospital.

In a nineteen years survey, 70 fracture cases were presented to the University of Maiduguri Veterinary Teaching Hospital (UMVTH). The percentage distribution of the fracture cases was determined according to species, etiology, affected bone, sex, age and type of fracture. The canine specie had the highest number of cases (41.4%), followed by Antelope, Ovine, and Feline with 17.1%, 15.7% and 11.4 % respectively. Thirty four (48.5%) of the fracture cases were of unknown etiology, while 25 (35.7%) of the fracture of known etiology occurred as a result of automobile Road Traffic Accident (RTA). The tibia, humerus and femur accounted for the majority of cases in this study. 31 (44.3%) cases were females and 36 (51.4%) were males. It is suggested that roaming of animals in areas with high volume of motor-vehicle traffic and dense population may be responsible for the high incidence of automobile accidents and trauma to animals resulting in the high incidences of fractures with unknown etiology. Keywords : Survey, Fractures, Percentage Distributions Nigerian Veterinary Journal Vol. 27 (3) 2006 pp. 25-35
Pain is independently associated with impaired physical function in HIV-infected patients.

INTRODUCTION Human immunodeficiency virus (HIV)-infected patients in the current treatment era can achieve normal life expectancies but experience a high degree of medical and psychiatric comorbidity. Impaired physical function and pain, often in the context of mood disorders and substance abuse, are common in HIV-infected patients. The objective of this study was to investigate the relationship of pain, a modifiable condition, to functional impairment in HIV-infected patients, independent of mood disorders and substance abuse. METHODS Participants in a prospective cohort of HIV-infected patients at the University of Alabama at Birmingham were included. Patient-reported outcome measures were used to cross-sectionally assess pain and physical function (EuroQOL), mood disorders (PHQ), and substance abuse (ASSIST). Univariate and multivariable models were built with pain as the principal independent variable of interest and three domains of physical function (mobility, self-care, and usual activities) as outcomes. Covariates included mood, substance abuse, age, race, sex, insurance status, HIV transmission risk factor, and CD4+ T-cell count. RESULTS Among 1,903 participants, 693 (37%) reported pain; 509 (27%) had a mood disorder; and 157 (8.4%) reported current substance abuse. In multivariable models, pain was independently associated with increased odds of impairment in all three domains of physical function investigated-mobility (aOR 10.5, 95% CI 7.6-14.6), self-care (aOR 4.1, 95% CI 2.2-7.4), and usual activities (aOR 5.4, 95% CI 4.0-7.4). DISCUSSION Pain was associated with substantially increased odds of impairment in physical function. Pain should be an important consideration in HIV primary care. Interventions to address pain and impaired physical function should be investigated.
Ventral hernia: retrospective cost analysis of primary repair, repair with synthetic mesh, and repair with acellular xenograft implant

Correspondence: George DeNoto III Division of General Surgery, St Francis Hospital and Hofstra North Shore-LIJ School of Medicine, 139 Plandome Road, Manhasset, NY 11030, USA Tel +1 516 627 5262 Fax +1 516 627 0641 Email george.denoto@chsli.org Background: The purpose of this study was to evaluate resource utilization and costs of repair of potentially contaminated/infected complex ventral hernias using primary repair, synthetic mesh, or acellular xenograft. Methods: We used 2008–2009 insurance claims (Truven Health Analytics MarketScan) to identify patients who underwent grade 3 or 4 ventral hernia repair between January 1 and June 30, 2008. Patients were categorized into synthetic mesh or xenograft groups based on Current Procedural Terminology and Healthcare Common Procedure Coding System codes, with primary repair identified by the absence of mesh or xenograft codes. Claims were reviewed for an 18-month post-procedure period to identify the incidence of medical complications, number of post-index events, and hospital costs. Results: A total of 740 patients were included. Complication rates in grade 3 patients were significantly lower with xenograft (18%) and primary repair (24%) versus synthetic mesh (37%, P = 0.001). There were minimal differences between grade 4 patients. In grade 3 patients, synthetic mesh was associated with hospital returns for complications about three times as often as those with xenograft repairs and significantly more often than those with primary repairs (P , 0.0001). The average treatment cost for a xenograft repair in grade 3 patients was $33,266 versus a primary repair at $34,948 and synthetic mesh at $35,891 (difference not statistically significant). In grade 4 patients, there was no statistically significant difference between the study arms in the rate of returns for treatment of complications or costs. Conclusion: In this analysis of grade 3 and 4 hernia repair, total 18-month costs were similar across the three study arms despite some significant differences in complications favoring xenograft and primary repair over synthetic mesh.
Single-entity hydrocodone extended-release capsules in opioid-tolerant subjects with moderate-to-severe chronic low back pain: a randomized double-blind, placebo-controlled study.

OBJECTIVE A single-agent, extended-release formulation of hydrocodone (HC) has been developed for treatment of chronic moderate-to-severe pain. This study was designed to examine the safety and efficacy of HC extended release in opioid-experienced adults with moderate-to-severe chronic low back pain (CLBP). METHODS This multicenter, enriched enrollment, randomized withdrawal study comprised an open-label conversion/titration phase (≤6 weeks) followed by placebo-controlled, double-blind treatment (12 weeks). During the conversion/titration phase, subjects (N = 510) converted from their current opioid and were titrated to a stabilized dose of HC extended release (20-100 mg every 12 hours). During treatment, subjects (N = 151 per group) received HC extended release or placebo; rescue medication was permitted. The primary efficacy end point was mean change in average pain intensity from baseline to day 85. Response rates (30% pain improvement) and satisfaction (Subject Global Assessment of Medication) were assessed. RESULTS Demographic and baseline characteristics were similar between groups. Mean ± SD change in average pain intensity score from baseline to day 85 was significantly lower in the HC extended-release treatment group vs placebo (0.48 ± 1.56 vs 0.96 ± 1.55; P = 0.008). Significantly more responders were in the treatment group (68% vs 31%; P < 0.001). Mean Subject Global Assessment of Medication scores increased significantly (0.8 ± 1.3 vs 0.0 ± 1.4; P < 0.0001), indicating greater satisfaction with HC extended release. The adverse event profile was consistent with other opioids. CONCLUSIONS Extended-release HC is well tolerated and effective, without acetaminophen-associated risks of liver toxicity, for treatment of CLBP.
Hematopoietic stem cell transplantation: ASBMT/CIBMTR 2010 tandem meeting highlights and discussion†

The American Society for Blood and Marrow Transplantation (ASBMT) and the Center for International Blood and Marrow Transplantation Research (CIBMTR) held their 12th Annual Tandem Meeting this February in Orlando, Florida. This International Transplant Meeting brought together a record 2,570 attendees from 45 countries, and included the state of the art educational and plenary sessions and 478 oral and poster presentations. Recently, the American Journal of Hematology published a series of articles reviewing the "Top 10 clinically oriented abstracts" presented at the 2009 American Society of Hematology meeting [1]. Given how well this series was received, we believed it would be worthwhile providing a similar review of relevant abstracts from this year's BMT meetings. There has been dramatic progress in this field that we believe is of great interest and importance to the hematology/oncology community. There was an incredible body of work presented and it is misleading to suggest that there is a "top 10" list. Many more abstracts than can be presented here are worthy of discussion and recognition and any exclusion of important studies is solely a reflection of space limitation rather than quality of work. We tried to pick abstracts that were important, novel, biologically interesting, and that address either changing or controversial areas in the field. All 10 abstracts are published in full in the February 2010 issue of Biology of Blood and Marrow Transplantation (volume 16, No. 2) and are identified here by their abstract number.
Challenges in Patient Recruitment, Implementation, and Fidelity in a Mobile Telehealth Study.

INTRODUCTION Mobile telehealth (MTH) evaluations in diabetes have been conducted, but few report details and issues related to recruitment, implementation (intervention delivery), fidelity, and context. These have important implications on the interpretation of the findings and effectiveness of the intervention. This article reports these data from an MTH study and describes the challenges experienced in running an intervention such as this in an active clinical environment. MATERIALS AND METHODS We conducted a mixed-methods MTH study that included a 9-month randomized controlled trial in people with poorly controlled diabetes. Detailed recruitment data were recorded during the study. Data on contacts between MTH participants and the MTH team were collected and used to report on intervention delivery and fidelity. Meeting and field notes, as well as communications between research team members during the study, were used to report on the contextual factors that affected recruitment, implementation, and fidelity. RESULTS The recruited sample size represented 6% of the total clinic population (n = 1,360) and 10.7% of the number of potentially eligible people at the clinic (n = 802) identified at the beginning of the study. Contextual factors related to patients, healthcare providers, the institution, or the recruitment protocol contributed to influence access to study participants and the number of participants randomized (n = 81). Technical and device-related aspects of the MTH intervention were delivered successfully, but the expected education and clinical feedback by the MTH nurse were not delivered according to the protocol. Although 92.5% of introductory calls were made by the MTH nurses, only 13.3% of expected educational calls were performed. Changes to the MTH nursing staff affected intervention participants differently and contributed to the low fidelity of intervention delivery. CONCLUSIONS The current article presents data on the influence of contextual factors on the conduct of this MTH study and underlines the need for these processes to be assessed and reported adequately in future MTH research.
Proof of Concept of a Mobile Health Short Message Service Text Message Intervention That Promotes Adherence to Oral Anticancer Agent Medications: A Randomized Controlled Trial.

INTRODUCTION This multisite, randomized controlled trial assigned 75 adult cancer patients prescribed an oral anticancer agent to either an experimental group that received daily text messages for adherence for 21 days plus usual care or a control group that received usual care. MATERIALS AND METHODS Measures were administered at baseline, weekly (Weeks 1-8), and at exit (Week 9). A satisfaction survey was conducted following the intervention. Acceptability, feasibility, and satisfaction were examined. Primary outcomes were adherence and symptoms. Secondary outcomes were depressive symptoms, self-efficacy, cognition, physical function, and social support. Mixed or general linear models were used for the analyses comparing trial groups. Effect sizes (ES) were estimated to gauge clinical significance. RESULTS Regarding acceptability, 57.2% (83 of 145) of eligible patients consented, 88% (n = 37 of 42) receiving text messages read them most or all of the time, and 90% (n = 38) were satisfied. The differences between experimental and control groups' ES were 0.29 for adherence, 0.21 for symptom severity, and 0.21 for symptom interference, and differences were not statistically significant. Furthermore, perceived social support was higher (p = 0.04; ES = 0.54) in the experimental group. CONCLUSIONS Proof of concept and preliminary efficacy of a mobile health intervention using text messages to promote adherence for patients prescribed oral anticancer agents were demonstrated. Patients accepted and had high satisfaction with the intervention, and adherence improved after the intervention. Text messages show promise. Additional research is needed prior to use in practice.
Patient recall of health care provider counseling for opioid-acetaminophen prescriptions.

OBJECTIVE The aim of this study was to determine the frequency and nature of physician, nurse, and pharmacist verbal counseling at the time of a new prescription for an opioid-acetaminophen containing medication as recalled by patients. DESIGN A mixed methods approach with data from cross sectional, structured interviews was used. SETTING The settings were one academic emergency department in Chicago, IL and one outpatient pharmacy at a public hospital in Atlanta, GA. PATIENTS One hundred forty-nine patients receiving a new prescription for an opioid-acetaminophen medication were enrolled. METHODS Interviews assessed patient recall of counseling they received from their physician, nurse, and pharmacist upon receiving the new prescription. Their responses were unitized and assigned to categories. RESULTS One hundred forty-nine patients were enrolled; 61.1% African American and 58.4% female. Seven major categories of responses were noted; frequencies of patient recall for counseling in these categories were reported. Four categories related to the content of the counseling discussion were (1) details of administration (patient recall counseling from: physician/nurse only 44.3%, pharmacist only 5.4%, both providers 12.8%); (2) activities to avoid and side effects (36.2%, 4.7%, 8.7%); (3) medication indication (32.9%, 4%, 4%); and (4) addictive potential (9.3%, 1.3%, 0%). Three categories describe patients' recall of the interaction in broad terms: (5) being referred to print informational material accompanying the prescription (MD/RN only 7.4%, pharmacist only 20.1%, both providers 2.7%); (6) having questions solicited (0%, 11.4%, 0%); (7) having no interaction relating to medication counseling (3.4%, 32.2%, 1.3%). CONCLUSIONS Patients infrequently recall counseling from providers on topics that are important to prevent harm from opioid-acetaminophen prescriptions. Future patient-centered clinical research should target identifying optimal strategies to convey these critical messages.
Health transition in middle-income countries: new challenges for health care

The health transition occurring in middle-income countries such as Mexico is characterized by competition for scarce health resources between people with "leftover" ills such as infectious diseases and malnutrition and emerging threats such as chronic diseases mental illness and AIDS. This epidemiologic transition can not be expected to occur in the same way as it did in the industrialized countries. Their model was a series of 3 eras: pestilence and famine with high mortality no population growth and life expectancy of 20-40; receding pandemias and falling mortality with population growth; degenerative and man-made diseases with life expectancy over 50. In middle-income countries however the 3 eras are not necessarily sequential but may be protracted with reverses for some diseases. The co-existence of pre- and post-transitional diseases leads to polarization of different populations in the country. Data from Mexican mortality statistics indeed show decreased overall mortality from malaria childhood diarrhea and whooping cough but increased mortality from heart disease cancer diabetes and motor vehicle accidents. Data from Mexico City reveal falling postneonatal deaths due to diarrhea and respiratory infections but rising neonatal deaths (1st month of age) due to low birth weight and prematurity. Another aspect of the epidemiologic transition model is that the decline in mortality from infectious diseases in industrialized countries was due to lower incidence. In Mexico the incidence of infections remains high but mortality is lower because of antibiotics vaccines and vector control all reversible measures. Examples are diarrhea treated by ORT malaria considered "refractory" dengue fever considered "re-emerging" and AIDS considered "emerging. " Resources to handle this continuing mixture of old and emerging diseases will be stressed to the limit with the coincident population growth due to momentum of the young population already born. 6 principles are presented to make primary health services equitable: population-based service delivery quality assurance community participation anticipatory care operation integrated with other social services and innovative models of health care.