Miracle-dz/UniFAR-FTUs huggingface dataset:
The Epidemiology of Upper Extremity Fractures in the United States, 2009

Background: No single epidemiological study of upper extremity fractures exists in the United States using data from all payers. Current epidemiological estimates are based on case series, foreign databases, or Medicare data, which are not representative of the entire US population. The objective of this project was to accurately describe the incidence of fractures of the upper extremity in a representative sample of the US population. Methods: Using International Classification of Disease, Ninth Edition codes for patient visits reported in the 2009 State Emergency Department Database and the State Inpatient Database, available from the Healthcare Cost and Utilization Project, and 2010 US Census data, we calculated the annual incidence rates per 10,000 persons of upper extremity fractures of all patients, regardless of age or payer type. This was done using a representative national sample from 8 states: Arizona, California, Iowa, Maryland, Massachusetts, New Jersey, and Vermont. Results: Overall, in this population of over 87 million Americans, there were 590,193 fractures of the upper extremity, yielding an annual incidence of 67.6 fractures per 10,000 persons. Distal radius and ulna fractures were the most common upper extremity fractures (16.2 fractures per 10,000 persons), followed by hand fractures (phalangeal and metacarpal fractures; 12.5 and 8.4 per 10,000, respectively), proximal humerus fractures (6.0 per 10,000), and clavicle fractures (5.8 per 10,000). The most common type of fracture for all age groups was distal radius fractures, except in the 18- to 34-year-old group, in which metacarpal and phalangeal fractures were more common (16.1 and 12.5 per 10,000, respectively) and the 35- to 49-year-old group, in which phalangeal fractures were most common (11.5 per 10,000). The incidence of distal radius fractures was bimodal, with the highest rates in the under 18 and over 65 age groups (30.18 and 25.42 per 10,000, respectively) with lower rates in the middle age groups. The most common type of fracture for males was phalangeal fractures (11.5 per 10,000), and distal radius and ulna fractures were the most common type for females (11.8 per 10,000). Interestingly, phalangeal and metacarpal fractures varied by socioeconomic status (SES), which decreased with increasing SES. No other fracture type varied by SES. Conclusions: Epidemiological studies are necessary for research, clinical applications, and public health and health policy initiatives. This study reports national estimates of upper extremity fractures with subgroup analysis.
Do pediatric residents prefer interactive learning? Educational challenges in the duty hours era

Background: The volume of information that physicians must learn is increasing; yet, trainee educational time is limited. Many experts propose using trainees’ learning preferences to guide teaching. However, data regarding predominant learning preferences within pediatrics are limited. Aim: Identify predominant learning preferences among pediatric residents in a Residency Training Program. Methods: The Visual–Aural–Read/Write–Kinesthetic (VARK) questionnaire and Kolb Learning Style Inventory (LSI) were administered anonymously to 50 pediatric residents. Results: Learning style assessments were completed by 50 pediatric residents. Residents were significantly more likely to be accommodating on the Kolb LSI, which is consistent with an interactive learning preference (p < 0.01); 30% demonstrated a multimodal preference on the Kolb LSI (Figure 1). VARK assessments demonstrated that 45 (90%) respondents were kinesthetic, which is also consistent with a significant preference for interactive learning (p < 0.01). Forty (80%) were found to be multimodal on the VARK (Figure 1). There was no association between learning preference and the residents’ anticipated career choice or level of training. Conclusions: The predominant learning preferences among a cohort of pediatric residents from a single training program were consistent with a preference for interactive learning, suggesting that some trainees may benefit from supplementation of educational curricula with additional interactive experiences. Continued investigation is needed in this area to assess the effectiveness of adapting teaching techniques to individual learning preferences.
Glycogen metabolism in the rat retina

It has been reported that glycogen levels in retina vary with retinal vascularization. However, the electrical activity of isolated retina depends on glucose supply, suggesting that it does not contain energetic reserves. We determined glycogen levels and pyruvate and lactate production under various conditions in isolated retina. Ex vivo retinas from light‐ and dark‐adapted rats showed values of 44 ± 0.3 and 19.5 ± 0.4 nmol glucosyl residues/mg protein, respectively. The glycogen content of retinas from light‐adapted animals was reduced by 50% when they were transferred to darkness. Glycogen levels were low in retinas incubated in glucose‐free media and increased in the presence of glucose. The highest glycogen values were found in media containing 20 mm of glucose. A rapid increase in lactate production was observed in the presence of glucose. Surprisingly, glycogen levels were the lowest and lactate production was also very low in the presence of 30 mm glucose. Our results suggest that glycogen can be used as an immediate accessible energy reserve in retina. We speculate on the possibility that gluconeogenesis may play a protective role by removal of lactic acid.
Absence of Bilateral Differences in Child Baseball Players with Throwing-related Pain

Abstract The aim of this study was to assess whether side-to-side differences in morphology and function of the upper limbs in 11–12 year-old male baseball players with throwing-related pain (n=14) were more pronounced than that of age-matched healthy untrained subjects (n=16). Baseball players 1) had played baseball≥4.5 h·wk−1 for ≥ 4 years and (2) suffered from moderate-intensity (3–6 points on 10-point questionnaire scale) throwing-related pain in the shoulder or elbow in at least 2 training sessions within the past month. The range of motion (ROM), function and structure of the elbows and shoulders were assessed using goniometry, isokinetic dynamometry and ultrasonography. While the ROM and eccentric external peak torque of internal shoulder rotation were lower, the thickness of the supraspinatus tendon, the ulnar collateral ligament and articular cartilage of the humeral head were larger in baseball players than controls. There were, however, no significant side-to-side differences in any parameter in either group. In conclusion, it is unlikely that side-to-side differences in shoulder and upper limb structure and function contributed to the throwing-related pain in young baseball players, but low shoulder eccentric external peak torque and range of internal rotation may predispose to throwing-related pain.
Comparison of the ultrastructure of cortical and retinal terminals in the rat dorsal lateral geniculate and lateral posterior nuclei

We compared the ultrastructure and synaptic targets of terminals of cortical or retinal origin in the rat dorsal lateral geniculate nucleus (LGN) and lateral posterior nucleus (LPN). Following injections of biotinylated dextran amine (BDA) into cortical area 17, two types of corticothalamic terminals were labeled by anterograde transport. Type I terminals, found throughout the LGN and LPN, were small, drumstick‐shaped terminals that extended from thin axons. At the ultrastructural level in both the LGN and LPN, labeled type I corticothalamic terminals were observed to be small profiles that contained densely packed round vesicles (RS profiles) and contacted small‐caliber dendrites. In tissue stained for gamma amino butyric acid (GABA) using postembedding immunocytochemical techniques, most dendrites postsynaptic to type I corticothalamic terminals did not contain GABA (97%). Type II corticothalamic terminals, found only in the LPN, were large terminals that sometimes formed clusters. At the ultrastructural level, type II terminals were large profiles that contained round vesicles (RL profiles) and contacted large‐caliber dendrites, most of which did not contain GABA (98%). Retinogeniculate terminals, identified by their distinctive pale mitochondria, were similar to type II corticothalamic terminals except that 26% of their postsynaptic targets were vesicle‐containing profiles that contained GABA (F2 profiles). Our results suggest that type I corticothalamic terminals are very similar across nuclei but that the postsynaptic targets of RL profiles vary. Comparison of the responses to retinal inputs in the LGN and to layer V cortical inputs in the LPN may provide a unique opportunity to determine the function of interneurons in the modulation of retinal signals and, in addition, may provide insight into the signals relayed by cortical layer V. J. Comp. Neurol. 460:394–409, 2003. © 2003 Wiley‐Liss, Inc.
Constant-Order Policies for Lost-Sales Inventory Models with Random Supply Functions: Asymptotics and Heuristic

We consider an infinite-horizon lost-sales inventory model where the supply takes positive lead times and is a random function of the order quantity (e.g., random yield/capacity). The optimal policy for this model is computationally intractable; and no heuristic has been proposed in the literature. In this paper, we focus on a simple class of constant-order policies (COP) that place the same order in every period, regardless of the system state. Under some assumptions on the random supply function, we prove that the best COP is asymptotically optimal with large lead times and the optimality gap converges to zero exponentially fast in the lead time. We also prove that, if the mean supply capacity is less than the mean demand, then the best COP is also asymptotically optimal with large penalty costs; otherwise, the long-run average cost of the best COP asymptotically increases at the rate of square-root of the penalty cost. Further, we construct a simple heuristic COP and show that it performs very close to the best COP. Finally, we provide a numerical study to derive further insights into the performance of the best COP.
Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up.

BACKGROUND There is little information on the stability of abstinent and nonabstinent remission from alcohol dependence in the general U.S. population. The aim of this study was to examine longitudinal changes in recovery status among individuals in remission from DSM-IV alcohol dependence, including rates and correlates of relapse, over a 3-year period. METHODS This analysis is based on data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of U.S. adults aged 18 years and older originally interviewed in 2001 to 2002 and reinterviewed in 2004 to 2005. The Wave 1 NESARC identified 2,109 individuals who met the DSM-IV criteria for full remission from alcohol dependence. Of these, 1,772 were reinterviewed at Wave 2, comprising the analytic sample for this study. Recovery status at Wave 2 was examined as a function of type of remission at Wave 1, with a focus on rates of relapse, alternately defined as recurrence of any alcohol use disorder (AUD) symptoms and recurrence of DSM-IV alcohol dependence. Logistic regression models were used to estimate the odds of relapse among asymptomatic risk drinkers and low-risk drinkers relative to abstainers, adjusted for a wide range of potential confounders. RESULTS By Wave 2, 51.0% of the Wave 1 asymptomatic risk drinkers had experienced the recurrence of AUD symptoms, compared with 27.2% of low-risk drinkers and 7.3% of abstainers. Across all ages combined, the adjusted odds of recurrence of AUD symptoms relative to abstainers were 14.6 times as great for asymptomatic risk drinkers and 5.8 times as great for low-risk drinkers. The proportions of individuals who had experienced the recurrence of dependence were 10.2, 4.0, and 2.9%, respectively, and the adjusted odds ratios relative to abstainers were 7.0 for asymptomatic risk drinkers and 3.0 for low-risk drinkers. Age significantly modified the association between type of remission and relapse. Differences by type of remission were not significant for younger alcoholics, who had the highest rates of relapse. CONCLUSIONS Abstinence represents the most stable form of remission for most recovering alcoholics. Study findings highlight the need for better approaches to maintaining recovery among young adults in remission from alcohol dependence, who are at particularly high risk of relapse.
Mutations in Critical Domains Confer the Human mTOR Gene Strong Tumorigenicity*

Background: The tumorigenic potential of mTOR has not been established. Results: Mutations of the mTOR gene confer gain-of-function to it and induce cell transformation, anchorage-independent growth, invasion, and tumorigenesis. Conclusion: The mTOR gene is tumorigenic upon mutation. Significance: The results demonstrate for the first time the tumorigenicity of mTOR, hence establishing its oncogenicity and important role in human tumorigenesis. Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase that regulates cell growth, proliferation, and survival. mTOR is frequently activated in human cancers and is a commonly sought anticancer therapeutic target. However, whether the human mTOR gene itself is a proto-oncogene possessing tumorigenicity has not been firmly established. To answer this question, we mutated evolutionarily conserved amino acids, generated eight mutants in the HEAT repeats (M938T) and the FAT (W1456R and G1479N) and kinase (P2273S, V2284M, V2291I, T2294I, and E2288K) domains of mTOR, and studied their oncogenicity. On transient expression in HEK293T cells, these mTOR mutants displayed elevated protein kinase activities accompanied by activated mTOR/p70S6K signaling at varying levels, demonstrating the gain of function of the mTOR gene with these mutations. We selected P2273S and E2288K, the two most catalytically active mutants, to further examine their oncogenicity and tumorigenicity. Stable expression of the two mTOR mutants in NIH3T3 cells strongly activated mTOR/p70S6K signaling, induced cell transformation and invasion, and remarkably, caused rapid tumor formation and growth in athymic nude mice after subcutaneous inoculation of the transfected cells. This study confirms the oncogenic potential of mTOR suggested previously and demonstrates for the first time its tumorigenicity. Thus, beyond the pivotal position of mTOR to relay the oncogenic signals from the upstream phosphatidylinositol 3-kinase/Akt pathway in human cancer, mTOR is capable potentially of playing a direct role in human tumorigenesis if mutated. These results also further support the conclusion that mTOR is a major therapeutic target in human cancers.
Vestibular evoked myogenic potentials in multiple sclerosis: clinical and imaging correlations

Patients with multiple sclerosis (MS) frequently report symptoms related to vestibular disorders in the course of their disease. At present, the fundamental tests assessing vestibulospinal involvement are posturography and vestibular evoked myogenic potentials (VEMPs). While posturography cannot be performed in every subject requiring minimal stance control, VEMPs do not require any specific skill on the part of the subjects and they may be investigated in all patients able to sit. VEMPs were recorded for 40 patients (17 men, 23 women; mean age 38 years, range 17-71 years) fulfilling diagnostic criteria of clinically defined MS, by means of rarefaction clicks, recording modulation of sterno-cleido-mastoideus tonic contraction saccule-mediated modulation. VEMPs were found to be abnormal in 28 of 40 patients. In 18 of the cases the VEMPs were asymmetric, i.e., had a prolonged latency on one side. In six cases latency was increased on both sides (mean delay 4.1 ms). In four subjects VEMPs were absent on one side. C oncordance with clinical findings of presence/absence of brainstem involvement was found in 55% and with MRI findings in 65% of the cases. A bnormal VEMPs indicated brainstem dysfunction in four patients (10%) with normal MRI and no specific clinical signs.
Simultaneous Catabolite Repression between Glucose and Toluene Metabolism in Pseudomonas putida Is Channeled through Different Signaling Pathways

ABSTRACT Pseudomonas putida KT2440(pWW0) can use toluene via the TOL plasmid-encoded catabolic pathways and can use glucose via a series of three peripheral chromosome-encoded routes that convert glucose into 6-phosphogluconate (6PG), namely, the glucokinase pathway, in which glucose is transformed to 6PG through the action of glucokinase and glucose-6-phosphate dehydrogenase. Alternatively, glucose can be oxidized to gluconate, which can be phosphorylated by gluconokinase to 6PG or oxidized to 2-ketogluconate, which, in turn, is converted into 6PG. Our results show that KT2440 metabolizes glucose and toluene simultaneously, as revealed by net flux analysis of [13C]glucose. Determination of glucokinase and gluconokinase activities in glucose metabolism, gene expression assays using a fusion of the promoter of the Pu TOL upper pathway to ′lacZ, and global transcriptomic assays revealed simultaneous catabolite repression in the use of these two carbon sources. The effect of toluene on glucose metabolism was directed to the glucokinase branch and did not affect gluconate metabolism. Catabolite repression of the glucokinase pathway and the TOL pathway was triggered by two different catabolite repression systems. Expression from Pu was repressed mainly via PtsN in response to high levels of 2-dehydro-3-deoxygluconate-6-phosphate, whereas repression of the glucokinase pathway was channeled through Crc.
Differential effect of lithium on cell number in the hippocampus and prefrontal cortex in adult mice: a stereological study

Neuroimaging studies have revealed lithium‐related increases in the volume of gray matter in the prefrontal cortex (PFC) and hippocampus. Postmortem human studies have reported alterations in neuronal and glial cell density and size in the PFC of lithium‐treated subjects. Rodents treated with lithium exhibit cell proliferation in the dentate gyrus (DG) of the hippocampus. However, it is not known whether hippocampal and PFC volume are also increased in these animals or whether cell number in the PFC is altered.
Lower extremity amputation prevention in Singapore: economic analysis of results.

INTRODUCTION The aim of the study was to determine the cost-effectiveness of the Lower Extremity Amputation Prevention (LEAP) strategy in comparison to standard clinical practice for treating patients with critical limb ischaemia (CLI). METHODS A retrospective cost-effectiveness analysis of the LEAP programme relative to pre-LEAP practice was performed from the perspective of Singapore hospitals. The cost incorporated in the analysis included direct medical costs incurred during the admission. Outcomes included the number of amputations, number of deaths and length of hospital stay after the initial treatment. RESULTS During the study period, the LEAP group had a lower amputation rate (29 percent versus 76 percent, p-value is 0.00001), lower related death rate (one percent versus 19 percent, p-value is 0.00001) and fewer in-hospital days per patient (17.8 days versus 23.16 days, p-value is 0.048) as compared to the standard clinical practice group. The implementation of the LEAP strategy generated cost savings of S$2,566 per patient during admission when compared with the pre-LEAP approach. The results were robust to variations in input parameters. CONCLUSION The LEAP strategy dominated standard practice in the management of patients with diabetes mellitus and CLI. The implementation of the LEAP strategy significantly improved patient outcomes and reduced hospital costs.
The association between corporate social responsibility and dividend pay-outs

We examine the association between corporate social responsibility (CSR) and dividend pay-outs for US firms. In theory, high dividend pay-outs could limit managers' ability to invest in CSR. Managers' decision to invest in CSR could be driven by a desire to attain a competitive advantage for the firm or by a desire for personal kudos. If an investment in CSR leads to a competitive advantage with the economic benefits that entail, then high dividend pay-outs and investments in CSR will not be mutually exclusive. We find that high dividend pay-outs are associated with better CSR performance. Therefore, we conclude that investments in CSR are mostly driven by managers' desire to seek a competitive advantage and that this strategy is mostly successful. We contribute to a better understanding of the causal relationships at work, including providing evidence that suggest that investments in CSR are generally not driven by personal agenda, but that apart from being (per definition) good for society, CSR is also good for firms. These findings and their implications will be of interest to investors and analysts, because the findings show that better CSR performance should be seen as a positive signal.
Shareholder Conflicts and Dividends

We examine how dividend policy is used to mitigate potential conflicts of interest between majority and minority shareholders in private Norwegian firms. The average payout is 50% higher if the majority shareholder’s equity stake is 55% (high conflict potential) rather than 95% (low conflict potential). Such minority-friendly payout is also associated with higher subsequent minority shareholder investment. These results suggest that controlling shareholders voluntarily use dividends to reduce agency conflicts and build trust, rather than opportunistically preferring private benefits to dividends. We show that our results are unlikely to arise from liquidity or signaling motives.