Miracle-dz/UniFAR-FTUs huggingface dataset:
Measurement of movements of the lumbar spine

This review is an appraisal of the current methods of measurement of lumbar spine movements. Three-dimensional measurement of the movements is technically difficult, and most clinical methods, such as the fingertips-to-floor method, the Schober (skin distraction) method and the inclinometers, are able to provide one-dimensional information only. Radiographic techniques are able to give accurate measurements of the intervertebral movements in three dimensions, but it has the inherent health risk of repeated X-ray exposure. Optoelectronic systems are increasingly popular due to the improvement in camera quality and computer capabilities, but they are rather complex and time-consuming to be suitable for routine clinical use. It appears that electromagnetic tracking system is suitable for measuring three-dimensional spinal movements in a clinical environment. It provides real-time information, and is highly accurate and reliable if adequate precautions are taken to ensure that it is not adversely affected by the presence of metals. Finally, this review describes the problems involved in the mathematical computation of anatomical angles. It is concluded that there is a need to further develop the current measurement methods and to employ new technologies to solve some of the methodological problems.
Comparative analysis of radiation dose and image quality between thyroid shielding and unshielding during CT examination of the neck.

OBJECTIVE The purpose of this study is to evaluate the feasibility of thyroid shielding by measuring radiation dose, CT attenuation, and noise of superficial neck structures during CT examination. SUBJECTS AND METHODS We divided 84 patients without abnormalities seen on CT into two groups depending on whether shielding with a cotton spacer was applied over the thyroid. On CT images, we measured the CT attenuation and noises in the strap and sternocleidomastoid (SCM) muscles. The superficial radiation dose was measured using a head CT dose phantom containing ionization chambers located at the 3, 6, 9, and 12 o'clock positions. RESULTS With thyroid shielding, the CT attenuation was significantly increased (shielded strap and SCM muscles, 117.6 ± 19.2 HU and 113.7 ± 31.8 HU, respectively; unshielded strap and SCM muscles, 84.1 ± 12.2 HU and 78.4 ± 10.1 HU, respectively; p < 0.05), whereas noise was unaffected (shielded strap and SCM muscles, 7.2 ± 4.2 HU and 10.8 ± 4.9 HU, respectively; unshielded strap and SCM muscles, 8.6 ± 4.9 HU and 10.7 ± 6.6 HU, respectively; p > 0.05). On the phantom study, the shield significantly reduced the superficial unshielded dose at the 12 o'clock position only (27.5% reduction; p < 0.01). CONCLUSION Below the shielded surface, thyroid shielding significantly reduced the superficial radiation dose of the neck without a remarkable noise increase while increasing CT attenuation.
Radiation-related cancer risks in a clinical patient population undergoing cardiac CT.

OBJECTIVE The purpose of our study was to estimate cancer induction risk and generate risk conversion factors in cardiac CT angiography. MATERIALS AND METHODS Under an institutional review board waiver and in compliance with HIPAA, we collected characteristics for a consecutive cohort of 100 patients (60 men and 40 women; mean age, 59 ± 11 years) who had previously undergone ECG-gated cardiac CT angiography on a 64-slice CT scanner. The volume CT Dose Index (CTDI(vol)) and dose-length product (DLP) were recorded and used with the ImPACT CT Patient Dosimetry Calculator to compute organ and effective doses in a standard 70 kg phantom. Patient-specific organ and effective doses were obtained by applying a weight-based correction factor. Radiation doses to radiosensitive organs were converted to risks using age- and sex-specific data published in BEIR VII. RESULTS Median values were 62 mGy for CTDI(vol), 1,084 mGy-cm for DLP, and 17 cm for scan length. Effective doses ranged from 20 mSv (10th percentile) to 31 mSv (90th percentile). Median cancer induction risks in sensitive organs for men and women were 0.065% and 0.17%, respectively. For men and women, the range of risks was about a factor of 2. In men and women, about three quarters of the cancer risk was from lung cancer. Inclusion of the remaining less sensitive organs exposed during cardiac CT angiography examinations would likely increase the cancer induction risk by ∼20%. CONCLUSION The average cancer induction risk in sensitive organs from cardiac CT angiography for our patient cohort was 0.13%, with a female to male cancer induction risk ratio of 2.6.
Operative Management of Patellofemoral Pain With Degenerative Arthrosis

Patellofemoral disorders, especially patellofemoral pain with degenerative arthrosis, are difficult to treat unless the physician understands the importance of a thorough history, physical examination, and radiographic imaging. The presence of patellofemoral arthrosis does not always cause pain and disability. Likewise, patellofemoral pain and disability can exist without arthrosis. Although nonoperative treatment is the mainstay and the most successful of treatment options for patellofemoral pain with arthrosis, surgical treatment often is required. Surgical options include arthroscopic debridement, abrasion arthroplasty/microfracture, cartilage transplantation, tibial tubercle anteriorization (Maquet osteotomy), anteromedial tibial tubercle transfer (Fulkerson), anteroproximal tibial tubercle transfer (DeLee), patellar resurfacing, patellofemoral arthroplasty, total knee replacement, and patellectomy. The authors review operative treatment options for patellofemoral pain with arthrosis with an emphasis on grade III or IV Outerbridge changes, with specific attention to the results that have been presented in the literature.
The Correlation between Gender Inequalities and Their Health Related Factors in World Countries: A Global Cross-Sectional Study

The study aimed to investigate gender inequalities and their health associated factors in world countries. A cross-sectional survey was undertaken using data of United Nations Development Programme (UNDP) and World Health Organization (WHO). The main variable in this study was gender inequality index (GII). All countries were stratified by WHO regions. Pearson correlation coefficient was used to assess the linear correlation between GII and investigated factors by WHO regions. The mean of GII was greater in Africa and lower in Europe region. There was negative significant association between GII and life expectancy at birth and mean years of schooling, prevalence of current tobacco smoking, high blood pressure and overweight and obesity, alcohol consumption rate, and cancer death rate. But there was positive significant association between GII and noncommunicable diseases death rates. In conclusion, gender inequalities, though decreasing over the past decades in world, remain notably greater in Africa and Eastern Mediterranean regions than in Europe. Gender inequality is also an important issue which is related to health factors. Hence, countries will need to focus on public health intervention and equal distribution of economic resources to reduce gender inequality in society.
Image quality of low-energy pulmonary CT angiography: comparison with standard CT.

OBJECTIVE The purpose of this article is to prospectively compare visualization of central and peripheral pulmonary arteries on simultaneously acquired low-energy and standard pulmonary CT angiography. SUBJECTS AND METHODS Thirty-three consecutive patients (20 women and 13 men; mean age, 55.6 years; range, 21-92 years) with suspected pulmonary embolism (PE) were scanned (140 kVp; 250-300 mA) on a single-source dual-layer dual-energy MDCT scanner. Attenuation and image noise were measured at the main and segmental pulmonary arteries. Signal-to-noise ratios were calculated. Two blinded experienced radiologists assessed segmental and subsegmental artery visibility in consensus, using slab maximum-intensity-projection (MIP) reconstructions. Nonparametric sign test and kappa statistic were used for statistical analysis. RESULTS PE was detected in three patients (9.1%); two segmental vessel and subsegmental emboli were seen in the low-energy images only. Higher attenuation was noted in low-energy versus standard images for all arteries evaluated, with a mean (± SD) increase of 66.6 ± 4.4 HU (p < 0.0001). Low-energy images improved visualization of segmental and subsegmental arteries from 97.0% to 99.2% and from 88.0% to 93.9%, respectively. A larger number of subsegmental vessels was seen on low-energy MIP reconstructions in 69.7% (95% CI, 36.5-71.89%) of studies compared with 9.1% on the standard images. Visualization of subsegmental vessels was superior in 55.5% of cases using low-energy imaging. The mean image noise increased by 9.7 ± 0.6 HU (p < 0.0001). The mean signal-to-noise ratio showed no significant difference in the low-energy (8.2) versus standard (8.1) CT images (p = 0.7759). CONCLUSION Improved visualization of central and peripheral arteries can be obtained with low-energy pulmonary CT angiography, without a substantial decrease in image quality.
How to protect environment and employees against cytotoxic agents, the UZ Ghent experience

Objective. To compare two different systems for the reconstitution and preparation of cytotoxic drug-containing infusion bags. The Classical System (open) uses Luer lock syringes and needles, and the PhaSealA System (closed) uses special devices. Methods. Both wipe samples of the Biological Safety Cabinet (BSC) plus surroundings and urine analysis of technicians and pharmacists involved in the preparatory activities were used. Analyses were performed using gas chromatography in tandem with mass spectroscopy. Results. An important difference has been found in the surface contamination rate and in the number, periods and values of contaminated urine samples in favour of the closed PhaSealA System. J Oncol Pharm Practice (2001) 6, 146-152.
Quality of Board and Care Homes Serving Low-Income Elderly: Structural and Public Policy Correlates

From data on 205 board and care homes that serve the poor elderly in seven states, structural and process variables were used to construct seven indexes covering dimensions of quality that contribute to the safety and quality of life of residents. Systematic differences were found in the indexes among homes of differing size and staffing patterns, as well as between proprietary and nonprofit facilities. For several dimensions of quality, state funding appears to result in improved quality. Overall, governmental regulatory policies did not significantly effect board and care home quality.
An epidemiological overview of the relationship between hormone replacement therapy and breast cancer

Large-scale randomized clinical trials and observational studies have consistently found that use of hormone replacement therapy (HRT) increases the risk of breast cancer. More recently, ecological studies have shown correlations between dramatic reductions in use of HRT in many countries, and declines in the rates of breast cancer in older women. Meta-analyses of data from the trials and observational studies show that the increase in breast cancer risk is greater for combined estrogen–progestin therapies compared with estrogen alone; that for both types of preparation, breast cancer risk increases with duration of use; and that the risks decrease relatively quickly after cessation of use. For both estrogen-only and combined therapies, the risk of breast cancer is higher if therapy is initiated close to the time of the menopause, relative to the risks in women starting HRT later. Most drug regulatory authorities currently recommend that HRT be prescribed only to fully informed women who have moderate-to-severe menopausal symptoms, for the shortest duration possible; and it is recommended that the need for therapy be reviewed at least every 6–12 months.
The role of the radiologist when encountering osteoporosis in women.

OBJECTIVE This article describes the extent and potentially devastating consequences of osteoporosis in adult women. There is discussion of the importance of radiologists in the correct diagnosis and reporting of probable osteoporotic vertebral fractures on medical imaging studies. CONCLUSION The Genant semiquantitative method for diagnosing osteoporotic vertebral fractures is presented. The importance of dual-energy x-ray absorptiometry reproducibility is also briefly discussed.
The "memory effect" for repeated radiologic observations.

OBJECTIVE It is assumed that memory has a role to play in repeated radiologic observation studies. The main objective of this study was to examine this assumption and evaluate the effect that memory may have on receiver operating characteristic (ROC) methods. MATERIALS AND METHODS A two-center observer study was performed with a total of 24 experienced radiologists. Over two viewings, chest radiographs showing the tip of a central line in either the superior vena cava or the azygos vein were presented. Half of the images were changed between the two viewings. The participants' attention was directed on the first reading to the position of the central line. At the second reading, the participants were asked to assign a confidence score on a 6-point scale about whether each image had been included in the first reading. RESULTS For the images that were scored as "definitely included" in the first viewing, readers at our two centers recalled only an average of 2.5 and 4.9 of the 20 repeated images, which is close to a random allocation of images to each score. As the confidence levels diminished for positive identification of repeated images, the numbers of correct answers increased. For images scored as not having been previously included, the numbers of correct answers remained low suggesting that identification of nonrepeated images is poor. Images with a greater number of incidental abnormalities and with more striking abnormalities were recognized more accurately than those with fewer and less striking abnormalities. CONCLUSION This study shows a "memory effect" when the same images are presented at a second viewing within a small interval period. This effect appears to occur mainly at low confidence levels. These results suggest that including images with obvious incidental abnormalities in reader performance studies should be avoided.
DISSECTING NEUROFIBROMATOSIS TYPE 1 RELATED VASCULOPATHY

S: 2008 “Nf1 Mice Have Enhanced Neointima Formation via Hyperactivation of a Gleevec Sensitive Pathway and Complex Interactions of Multiple Vascular Cell Lineages”, Children’s Tumor Foundation NF Conference 2008 (oral presentation). 2009 “Neurofibromatosis Type 1 Vasculopathy Results from Interaction Between Vascular Cells and Bone Marrow Derived Cells”, Arteriosclerosis Thrombosis and Vascular Biology Scientific Sessions. 2009 “Vascular Inflammation Contributes to Neointima Formation in Nf1 Mice”, Children’s Tumor Foundation NF Conference.
Patients presenting with depression to a psychiatry clinic:a descriptive survey

Clinical experience suggests that depression is common in Sri Lanka. This study aims to describe the characteristics of patients with depressive symptoms presenting to a psychiatry clinic at a teaching hospital in central Sri Lanka, over a period of one year. Information was collected retrospectively, based on clinic notes. Relatively older patients (mean age 41 years), female patients (65.3%) and those with a recent history of attempted self harm (28.5%) were common. Attempted self-poisoning was the commonest method of attempted self harm. Patients with co-morbid alcohol use disorders (5.6%), and those with prominent symptoms of somatisation (31.2%), were less than expected. DOI: http://dx.doi. org/10.4038/sljpsyc.v2i1. 3166 SL J Psychiatry 2011; 2 (1): 36-38
Left ventricular hypertrophy and its detection in an African community

Left ventricular hypertrophy (LVH), the detection of which is recommended for routine risk prediction by all guidelines, is more prevalent in groups of African ancestry. This is in-part attributed to higher prevalence rates of obesity. The ability to detect LVH using electrocardiographic (ECG) criteria may be modified in groups of African ancestry. The impact of co-existent obesity on the ability to detect ECG-LVH in this ethnic group has not been determined. Moreover, whether estimated glomerular filtration rate (eGFR) or serum C-reactive protein (CRP concentrations are independently associated with LV mass index (LVMI) and can therefore be used to complement ECG criteria for LVH detection is uncertain. ECG voltage criteria for the detection of echocardiographic LVH were evaluated in 661 participants from a community sample of African ancestry (43% obese). Body mass index (BMI) was inversely associated with Sokolow-Lyon (SL) voltages (partial r=-0.27, p<0.0001) and no BMI-Cornell voltage relations were noted (p=0.21). BMI was associated with voltage criteria that incorporate only limb lead recordings (r=0.17-0.23), but these relationships were weaker than BMI-LVMI relations (r=0.36, p<0.01-p<0.0001 for comparisons of r values). All ECG criteria were as strongly related to blood pressure (BP) as LVMI. Sokolow-Lyon voltage-LVMI relations were noted only after adjustments for BMI (p<0.02) and SL voltages showed no performance for LVH detection. Cornell voltages showed significant performance in the non-obese (area under the receiver operating curve [AUC]=0.67±0.04, p<0.0005), but not the obese (AUC=0.56±0.04, p=0.08). ECG criteria which employ limb-lead recordings only (e.g. RaVL) showed better performance in non-obese than obese (AUC=0.75±0.04 and 0.59±0.04 respectively, p<0.005 for comparison) and markedly reduced specificity for LVH detection in obese (76%) than non-obese (92%, p<0.0001) despite similar sensitivities (32 vs 29%). Thus, in groups of African ancestry, obesity contributes toward a poor validity and performance of all voltage criteria for the detection of LVH. None of the current criteria are recommended for use in
Optimizing peer review: A year of experience after instituting a real-time comment-enhanced program at a children's hospital.

OBJECTIVE Peer review has become an essential component of a comprehensive radiology department quality assurance program. Multiple commercial programs, such as RADPEER, are available to fill this need but may be limited by low radiologist compliance and delayed or limited feedback. Consequently, these peer review programs may not achieve the greater goal of improving diagnostic quality. This article presents data from a peer review system implemented in an academic radiology group at a large urban multidisciplinary children's hospital. The peer review system offered instantaneous feedback with an enhanced comment feature for peer radiologists. MATERIALS AND METHODS Peer review data were collected on 5278 radiologic studies over a 12-month period including 15 radiologists. The data were analyzed for compliance rate, discrepancy rate, and comment usage. RESULTS The compliance rate for peer review averaged 52% for the 12-month period. The compliance rate trended upward over the course of the year, with a final month's compliance rate of 76%. The discrepancy rate between original interpretation and peer review was 3.6%. Comments were voluntarily included in 7.3% of nondiscrepant peer review scores. CONCLUSION Our peer review process was enhanced by real-time comment-enriched feedback on both discrepant and nondiscrepant peer reviews. We show improved radiologist compliance over the course of a year in a peer review program with no incentives or penalties for performing reviews. To our knowledge, no compliance rates exist in current literature for comparison.
Validation of MRI classification system for tibial stress injuries.

OBJECTIVE The purpose of our study was to compare an MRI classification system for tibial stress injuries with semiquantitative MR features of injury severity and clinical outcome. MATERIALS AND METHODS Two musculoskeletal radiologists retrospectively reviewed in consensus the MR findings of 142 tibial stress injuries to quantify the degree of periosteal and bone marrow edema and grade the injuries using the Fredericson classification system (grade 1 = periosteal edema only, grade 2 = bone marrow edema visible on T2-weighted images, grade 3 = bone marrow edema visible on T1-weighted and T2-weighted images, grade 4a = multiple focal areas of intracortical signal abnormality, and grade 4b = linear areas of intracortical signal abnormality). Kruskal-Wallis tests were used to determine the relationship between the grade of stress injury and the degree of periosteal and bone marrow edema and the time to return to sports activity. RESULTS Grade 4b injuries had significantly (p < 0.002) more severe and grade 1 injuries less severe periosteal and bone marrow edema than grades 2, 3, and 4a injuries. Grade 4b injuries had significantly (p < 0.002) longer time and grade 1 injuries shorter time to return to sports activity than grades 2, 3, and 4a injuries. There was no significant difference (p = 0.06-0.79) among grades 2, 3, and 4a injuries in the degree of periosteal and bone marrow edema and the time to return to sports activity. CONCLUSION Grades 2, 3, and 4a stress injuries had similar degrees of periosteal and bone marrow edema and similar time to return to sports activity, which suggests that these three grades can be combined into a single category in an abbreviated Fredericson classification system.
Orocaecal Transit Time in Chronic Diarrhea

B ackground : The diagnosis and treatment of chronic diarrhea is sometimes difficult. Orocaecal transit time may explained some pathogenesis mechanism in chronic diarrhea. Methods : Twenty six chronic diarrhea patients and 35 normal adult subjects were included in this study. After fasting for at least 10 hours, subjects were asked to drink 20 ml (13.3 g) lactulose, then performed the breath hydrogen test. If there were an increment of H2 concentration 10 ppm in ½ -1 hour, the subject was considered as rapid transit time. If an increment of H concentration 10 ppm in 1 - 2 hour, the subject was considered as normal transit time. If an increment of H2 concentration 10 ppm in 2 - 3 hour,the subject was considered as delayed transit time Results : In the chronic diarrhea group, 10 (38.4%) had rapid OCTT, 15 (57.6%) had normal OCTT and only 1 (4%) had delayed OCTT. In the normal adults group, 2 (5.7%) had rapid OCTT, 22 (62.9%) had normal OCTT and 11 (31.4%) had delayed OCTT. The difference was statistically significant (p < 0.001). The mean value of OCTT in chronic diarrhea and normal adults were 84.23 + 39.82 min vs. 114.00 + 51.35 min (p = 0.027). Conclusions : The rapid OCTT was more likely to be found in the chronic diarrhea patients compare to normal adults significantly. The mean OCTT in chronic diarrhea was shorter than the mean OCTT in normal adults. Keyw ords: orocaecal transit time, OCTT, chronic diarrhea