Miracle-dz/UniFAR-FTUs huggingface dataset:
Hindlimb movement in the cat induced by amplitude-modulated stimulation using extra-spinal electrodes

Hindlimb movement in the cat induced by electrical stimulation with an amplitude-modulated waveform of the dorsal surface of the L5-S1 spinal cord or the L5-S1 dorsal/ventral roots was investigated before and after acute spinal cord transection at the T13-L1 level. Stimulation of the spinal cord or dorsal/ventral root at the same spinal segment induced similar movements including coordinated multi-joint flexion or extension. The induced movements changed from flexion to extension when the stimulation was moved from rostral (L5) to caudal (S1) spinal segments. Stimulation of a dorsal or ventral root on one side induced only ipsilateral hindlimb movement. However, stimulation on the dorsal surface of the spinal cord along the midline or across the spinal cord induced bilateral movements. The extension induced by stimulation of L7 dorsal root produced the largest ground reaction force that was strong enough to support body weight. Dorsal root stimulation induced a larger ground reaction force than ventral root stimulation and produced a more graded recruitment curve. Stepping at different speeds could be generated by combined stimulation of the rostral (L5) and the caudal (L6/L7) spinal segments with an appropriate timing between the different stimulation channels. Acute transection of the spinal cord did not change the responses indicating that the induced movements did not require the involvement of the supraspinal locomotor centers. The methods and the stimulation strategy developed in this study might be utilized to restore locomotor function after spinal cord injury.
An Uncommon Presentation of Neuroblastoma

Neuroblastoma (NB) is the most common extra-cranial solid malignancy in children but rarely described in adults, being 10% of all cases diagnosed after the first decade of life. Currently, there are no standard treatment guidelines for adult NB patients. We report the case of 26 year old man who presented with a retroperitoneal neuroblastoma. Treatment included chemotherapy and radiotherapy. The patient remains asymptomatic 1 year after completion of chemotherapy.
Hospital outcomes and disposition of trauma patients who are intubated because of combativeness.

BACKGROUND The purpose of this study was to determine whether trauma patients who are intubated because of combativeness, and not because of medical necessity, have more complications resulting in longer lengths of stay. METHODS Data were retrospectively collected from 2001 through 2004 on trauma patients who were intubated because of combative behavior before hospital admission (group 1, N = 34). Cases were matched 1:2 by age, sex, injury severity score (ISS), and injury to controls each who were not intubated (group 2, N = 68). Additionally, there were 187 patients identified who were intubated because of medical necessity before hospital admission; these represented unmatched intubated controls and were divided based on ISS <15 (group 3, N = 58) and ISS >15 (group 4, N = 129). RESULTS There were no significant differences between groups 1, 2, and 3 with regard to age, sex, or ISS. There was no significant difference between the groups 1 and 2 in frequency of head injuries as demonstrated by positive computed tomography (50 vs. 37%, p = 0.28); however, there was a significant difference in frequency of neurologic deficit at discharge (33 vs. 6%, p = 0.006). There was a significant difference in the frequency of head injuries between groups 1 and 3 (50 vs. 22%, p = 0.006); however, there was no significant difference in neurologic deficit at discharge (33 vs. 22%, p = 0.24). There was a significant difference in hospital length of stay between groups 1 and 2 (7.4 +/- 5.9 vs. 4.3 +/- 4.5 days, p = 0.0009). The incidence of pneumonia was significantly greater in group 1 than in group 2 (29 vs. 0%, p < 0.0001). The amount of lorazepam in average mg per day was also significantly greater in group 1 versus group 2 (4.4 +/- 11.5 vs. 0.4 +/- 1.6, p < 0.0001). There was also a difference in the discharge status, with significantly fewer group 1 cases being discharged home compared with group 2 (56 vs. 91%, p < 0.0001). There was no significant difference between groups 1 and 3 with regard to length of stay, ventilator days, pneumonia, or discharge status. There was a significant difference between groups 1 and 3 in the amount of lorazepam per day (4.4 +/- 11.5 vs. 0.4 +/- 1.6, p = 0.002). CONCLUSION The results from this study indicate that trauma patients who are intubated because of combativeness, and not because of medical necessity, have longer lengths of stay, increased incidence of pneumonia, and poorer discharge status when compared with matched controls. The outcomes of this group are similar to that of patients who are intubated because of medical necessity.
Categorizing facial creases: A review

Ensuring uniformity in the nomenclature standardization of facial creases is important to enable the scholarly community to follow and debate the advancements in research. This review highlights the prevailing disparity in the nomenclature that refers to the same facial crease by researchers and laypeople, and suggests uniform names for the facial creases based on available literature. The previous and current trends in facial crease classification are also discussed. The nomenclature of the facial creases considered for this review include the following: the nasolabial fold, corner of the mouth lines, upper and lower lip creases around the mouth region, the mandibular folds, the bifid nose, the transverse nasal line, the vertical glabellar line, chin crease, the mental crease, four type of creases around the eyes, forehead creases, and periauricular creases. A figure illustrating the above facial creases is included as reference. It is hoped that the proposed standardization of nomenclature would ensure a more scientific referencing of facial creases enabling more effective scientific interaction among the scholarly community as well as the laypeople interested in the research and application of facial creases.
Differential representation of arm movement direction in relation to cortical anatomy and function

Information about arm movement direction in neuronal activity of the cerebral cortex can be used for movement control mediated by a brain–machine interface (BMI). Here we provide a topographic analysis of the information related to arm movement direction that can be extracted from single trials of electrocorticographic (ECoG) signals recorded from the human frontal and parietal cortex based on a precise assignment of ECoG recording channels to the subjects' individual cortical anatomy and function. To this aim, each electrode contact was identified on structural MRI scans acquired while the electrodes were implanted and was thus related to the brain anatomy of each patient. Cortical function was assessed by direct cortical electrical stimulation. We show that activity from the primary motor cortex, in particular from the region showing hand and arm motor responses upon electrical stimulation, carries most directional information. The premotor, posterior parietal and lateral prefrontal cortex contributed gradually less, but still significant information. This gradient was observed for decoding from movement-related potentials, and from spectral amplitude modulations in low frequencies and in the high gamma band. Our findings thus demonstrate a close topographic correlation between cortical functional anatomy and direction-related information in humans that might be used for brain–machine interfacing.
Comparison of intrathecal magnesium and fentanyl as adjuvants to hyperbaric bupivacaine in preeclamptic parturients undergoing elective cesarean sections

Aims: The aim of this study was to evaluate the onset, duration of sensory and motor block, hemodynamic effects (if any), duration and quality of postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing elective caesarean sections. Materials and Methods: A total of 60 women with mild preeclampsia undergoing elective cesarean section were included in a prospective, double-blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg fentanyl (Group F) or 0.1 mL of 50% magnesium sulfate (50 mg) (Group M) with 0.15 ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anesthesia and postoperative analgesia requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher′s exact tests and independent Student′s t-test where appropriate. Results: The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anesthesia (246 min ± 11 min vs. 284 min ± 15 min; P < 0.001) and motor block (186.3 ± 12 min vs. 210 ± 10 min; P < 0.001) were significantly longer in the magnesium group. Total analgesic dose requirement was less in Group M. Hemodynamic parameters were comparable in the two groups. Intrathecal magnesium caused minimal side effects. Conclusions: The addition of magnesium sulfate 50 mg to bupivacaine for sub-arachnoid block in patients with mild preeclampsia undergoing elective cesarean section prolongs the duration of analgesia and reduces postoperative analgesic requirements without additional side effects and adverse neonatal outcomes
'Sustaining Place' - a grounded theory of how informal carers of people with dementia manage alterations to relationships within their social worlds.

AIMS AND OBJECTIVES This paper presents a theory explaining the processes used by informal carers of people with dementia to mange alterations to their, and people with dementias' relationships with and places within their social worlds. BACKGROUND Informal carers provide the majority of care to people with dementia. A great deal of international informal dementia care research is available, much of which elucidates the content, impacts and consequences of the informal caring role and the coping mechanisms that carers use. However, the socially situated experiences and processes integral to informal caring in dementia have not yet been robustly accounted for. DESIGN A classic grounded theory approach was used as it is designed for research enquiries that aim to generate theory illustrating social patterns of action used to address an identified problem. METHODS Thirty interviews were conducted with 31 participants between 2006-2008. The theory was conceptualised from the data using the concurrent methods of theoretical sampling, constant comparative analysis, memo writing and theoretical sensitivity. RESULTS Informal carers' main concern was identified as 'Living on the fringes', which was stimulated by dementia-related stigma and living a different life. The theory of 'Sustaining Place' explains the social pattern of actions employed by informal carers to manage this problem on behalf of themselves and the person with dementia. CONCLUSIONS The theory of 'Sustaining Place' identifies an imperative for nurses, other formal carers and society to engage in actions to support and enable social connectedness, social inclusion and citizenship for informal carers and people with dementia. RELEVANCE TO CLINICAL PRACTICE 'Sustaining Place' facilitates enhanced understanding of the complex and socially situated nature of informal dementia care through its portrayal of informal carers as social agents and can be used to guide nurses to better support those who live with dementia.
Characterizing the complexity of spontaneous motor unit patterns of amyotrophic lateral sclerosis using approximate entropy

This paper presents a novel application of the approximate entropy (ApEn) measurement for characterizing spontaneous motor unit activity of amyotrophic lateral sclerosis (ALS) patients. High-density surface electromyography (EMG) was used to record spontaneous motor unit activity bilaterally from the thenar muscles of nine ALS subjects. Three distinct patterns of spontaneous motor unit activity (sporadic spikes, tonic spikes and high-frequency repetitive spikes) were observed. For each pattern, complexity was characterized by calculating the ApEn values of the representative signal segments. A sliding window over each segment was also introduced to quantify the dynamic changes in complexity for the different spontaneous motor unit patterns. We found that the ApEn values for the sporadic spikes were the highest, while those of the high-frequency repetitive spikes were the lowest. There is a significant difference in mean ApEn values between two arbitrary groups of the three spontaneous motor unit patterns (P < 0.001). The dynamic ApEn curve from the sliding window analysis is capable of tracking variations in EMG activity, thus providing a vivid, distinctive description for different patterns of spontaneous motor unit action potentials in terms of their complexity. These findings expand the existing knowledge of spontaneous motor unit activity in ALS beyond what was previously obtained using conventional linear methods such as firing rate or inter-spike interval statistics.
SU‐C‐220‐03: Texture‐Based Identification of Pathologic Change on Temporally Subtracted Radiographic Chest Images

Purpose: Temporal subtraction images created from sequential chest radiographs provide a tool for the enhanced visualization of pathologic change. Although these images provide valuable information to radiologists, the presence of misregistration artifacts could confound the appreciation of actual pathologic change regions. The purpose of this study was to develop a method for the automated identification of pathologic change depicted on temporal subtraction images using a texture‐based classification framework.Methods: Eighty‐eight temporal subtraction images derived from the posteroanterior chest radiographs of 49 patients were created using an existing temporal subtraction algorithm. With the corresponding computed tomography(CT) scan as a reference, an experienced radiologist manually outlined all regions of pathologic change on each subtraction image to provide the “truth. ” Generated with each subtraction image was a corresponding “lung mask” image that defined the spatial extent of the lung fields within the image. Candidate pathologic change regions were segmented within the lung mask using a gray‐level thresholding technique, and morphological features computed for each region (e.g., area, circularity, perimeter) were used to reduce false positives. Texture features extracted from a 64×64‐pixel region of interest (ROI) placed over the centroid of each remaining candidate within the subtraction image were input to an automated linear discriminant classifier, which was trained using the regions of actual change outlined by the radiologist. Performance was evaluated using receiver operating characteristic (ROC) analysis.Results: A resubstitution classifier training/testing paradigm applied to the set of change region candidates yielded an area‐under‐the‐ROC‐curve value (Az) of 0.75. A 10‐fold cross validation training/testing paradigm for evaluating “truth” regions yielded Az=0.88 Conclusions: This study demonstrates the potential for texture features to distinguish regions of pathologic change from misregistration artifacts on temporal subtraction images of the chest. Future work will seek to improve the extraction of initial region candidates. Disclosure statement: SGA and HM receive royalties and licensing fees through the University of Chicago related to computer‐aided diagnosis. HM is a consultant for Riverain Medical.
An alternative short-form Mini-Nutritional Assessment for rating the risk of malnutrition in persons on haemodialysis.

AIMS AND OBJECTIVES To improve the short-form Mini-Nutritional Assessment (MNA) to ameliorate under-rating the risk of malnutrition in patients on haemodialysis. BACKGROUND The full MNA was found to be appropriate for rating the risk of malnutrition in persons undergoing haemodialysis but the short-form under-rated the risk. DESIGN A cross-sectional study with purposive sampling. METHODS The study recruited 152 adult ambulatory patients on maintenance haemodialysis from one dialysis centre in Taiwan. Each subject was rated with the Subjective Global Assessment (SGA), the original and selected alternative short-forms (by replacing better performing nonshort-form items for lesser performing short-form items) of a Taiwanese-specific MNA (T1). Serum albumin and creatinine concentrations and the SGA were also used as referents. Results were evaluated with Pearson's correlation analysis, binary classification test and receiver operating characteristic (ROC) curves. RESULTS The full MNA showed good consistency with the SGA, but the original short-form rated fewer patients at risk of malnutrition compared with the full MNA. Exchanging item O (self-rated nutritional status) with item E (neuropsychological problems) produced the best results and restored the predictive ability of the short-form. Replacing item P for E produced the next best results. CONCLUSION Results suggest that the predictive ability of the short-form can be greatly restored by rearranging the component items of the short-form without affecting the performance of the full MNA. The study is probably the first example of a disease-specific version of the MNA. RELEVANCE TO CLINICAL PRACTICE The revision makes short-form MNA suitable for rating the risk of malnutrition in patients on haemodialysis in clinical practice.
Non-invasive method for selection of electrodes and stimulus parameters for FES applications with intrafascicular arrays

High-channel-count intrafascicular electrode arrays provide comprehensive and selective access to the peripheral nervous system. One practical difficulty in using several electrode arrays to evoke coordinated movements in paralyzed limbs is the identification of the appropriate stimulation channels and stimulus parameters to evoke desired movements. Here we present the use of a six degree-of-freedom load cell placed under the foot of a feline to characterize the muscle activation produced by three 100-electrode Utah Slanted Electrode Arrays (USEAs) implanted into the femoral nerves, sciatic nerves, and muscular branches of the sciatic nerves of three cats. Intramuscular stimulation was used to identify the endpoint force directions produced by 15 muscles of the hind limb, and these directions were used to classify the forces produced by each intrafascicular USEA electrode as flexion or extension. For 451 USEA electrodes, stimulus intensities for threshold and saturation muscle forces were identified, and the 3D direction and linearity of the force recruitment curves were determined. Further, motor unit excitation independence for 198 electrode pairs was measured using the refractory technique. This study demonstrates the utility of 3D endpoint force monitoring as a simple and non-invasive metric for characterizing the muscle-activation properties of hundreds of implanted peripheral nerve electrodes, allowing for electrode and parameter selection for neuroprosthetic applications.
Ground level falls are associated with significant mortality in elderly patients.

BACKGROUND Falls from height are considered to be high risk for multisystem injury. Ground-level falls (GLF) are often deemed a low-energy mechanism of injury (MOI) and not a recommended triage criterion for trauma team activation. We hypothesize that in elderly patients, a GLF may represent a high-risk group for injury and concurrent comorbidities that warrant trauma service evaluation and should be triaged appropriately. METHODS This is a retrospective study based on the National Trauma Data Bank. All patients with MOI consistent with GLF were identified. Demographics, type and severity of injuries, and outcomes were analyzed. RESULTS We identified 57,302 patients with GLF. The group had 34% men, with mean age of 68 years ± 17 years and injury severity score of 8 ± 5. Overall mortality was 3.2%. There were 32,320 elderly patients (older than 70 years). The mortality in the elderly was significantly higher than the nonelderly (4.4% vs. 1.6%, p < 0.0001). The elderly were more likely to sustain long-bone fracture (54.5% vs. 35.9%, p < 0.0001), pelvic fracture (7.6% vs. 2.4%, p < 0.0001), and intracranial injury (10.6% vs. 8.7%, p<0.0001). Multivariate analysis showed that Glasgow Coma Scale (GCS) score <15 (odds ratio, 4.98) and older than 70 years (odds ratio, 2.75) were significant predictors of mortality inpatients after GLF. CONCLUSIONS Patients older than 70 years and with GCS score <15 represent a group with significant inhospital mortality.
Measuring reliability and validity of a newly developed stress instrument: Newly Diagnosed Breast Cancer Stress Scale.

AIMS AND OBJECTIVES To assess the reliability and validity of a developed instrument entitled Newly Diagnosed Breast Cancer Stress Scale. BACKGROUND Distress, clinical anxiety and depression are evident in patients with cancer, leading to poor psychosocial and quality-of-life outcomes. DESIGN Instrument development study with norm-referenced measurements. METHODS Content validity was determined by expert review. Cronbach's α was used to assess internal consistency reliability and product-moment correlations were conducted. Exploratory factor analysis measured validity of items using varimax rotation method. Criterion-related validity testing used the Perceived Stress Scale and the convergent validity test of construct validity used the Hospital Anxiety and Depression Scale. A total of 125 women pathologically diagnosed with breast cancer were interviewed on the day prior to initial breast surgery. RESULTS After testing, the Newly Diagnosed Breast Cancer Stress Scale consisted of four main factors with 17 items with acceptable reliability and good validity, and its length and time to complete the questionnaire were appropriate. Internal consistency reliability of the scale was shown by Cronbach's α = 0·84, the criterion validity of Perceived Stress Scale-10 was r = 0·46 (p < 0·001), the convergent validity of Hospital Anxiety and Depression Scale-14 was r = 0·57 (p < 0·001) for anxiety and r = 0·35 (p < 0·001) for depression. CONCLUSIONS The Newly Diagnosed Breast Cancer Stress Scale has acceptable reliability and good validity to measure stress in newly diagnosed patients with breast cancer. RELEVANCE TO CLINICAL PRACTICE The Newly Diagnosed Breast Cancer Stress Scale can provide healthcare workers with an instrument to better identify stress levels in newly diagnosed breast cancer patients and provide valuable information when defining psychosocial care interventions.
Essays on Women, Medicine and Health

Ann Oakley, University of Edinburgh Press, (pounds sterling) 14.95, pp 295 ISBN 0-7486-0450-2 A jaded young housewife from Wapping Said her life was all cleaning and shopping Her husband said jokily Try reading Ann Oakley So she did and left home without stopping This prize winning limerick, published some years ago in the New Statesman, fetes Oakley as a radical heroine; Women, Health and Medicine, published by Edinburgh University Press last year, shows a much more comfortable relationship with the establishment. This collection of papers from the 1980s includes talks given to such …