Miracle-dz/UniFAR-FTUs huggingface dataset:
Tarsometatarsal joint injuries in the athlete

This is a retrospective review of the presentation, di agnosis, treatment, and outcome of 19 patients who injured the tarsometatarsal joint of the foot during ath letic activity. Diagnosis by clinical and radiographic ex amination was supplemented by stress fluoroscopy of the articulation under anesthesia. Injuries were classi fied as either a first- or second-degree sprain of the tarsometatarsal joint, a third-degree sprain (with dias tasis between the metatarsals or cuneiforms), a frac ture, or frank dislocation. Poor functional results were seen in those for whom diagnosis was delayed and for whom the injury was not treated adequately. Three patients were unable to return to sports, one of whom eventually required fusion of the tarsometatarsal joint. The third-degree sprains were indistinguishable from fracture and fracture-dislocations in that good results were not reliably obtained by nonoperative treatment, and both classes of injury seem to require open reduc tion and internal fixation for optimal return to function. The delay in return to full activity is a marker of the severity of this injury despite an often benign appear ance on radiograph.
Mental health literacy in higher education students

Aim: With approximately 50% of young people aged 18–24 in tertiary education, these are potential settings for programmes to improve mental health literacy. A survey was carried out with students and staff of a tertiary education institution to investigate recognition of depression, help‐seeking intentions, beliefs about interventions and stigmatizing attitudes.
Dissecting JNK signaling, one KKKinase at a time

Specificity in signal transduction is essential to ensure distinct and appropriate cellular responses to extracellular cues. Determining the mechanisms that mediate specificity is key to understanding complex cell behaviors in development, when multiple pathways fire simultaneously and individual pathways are used recurrently. Jun kinase (JNK) signal transduction exemplifies a pathway that is used multiple times in animal development and homeostasis. Indeed, molecular genetic analysis of JNK signaling in Drosophila has shown that a core signaling module consisting of Hep (JNKK), Bsk (JNK), and Jun regulates various processes, including tissue morphogenesis, wound repair, stress response, innate immune response, and others. Six putative JNKK kinase (JNKKK) family members are present in the fly genome, which could activate the core module in response to distinct stimuli. The diversity of kinases at this level of the signaling hierarchy could substantially increase the number of possible signals that feed into activation of the core module. Recent studies have described the distinct phenotypic consequences of mutations in three of the genes, Slpr (dMLK), Tak1, and Mekk1. These data, together with Drosophila cell culture and genomic array analyses support the contention that the choice of JNKKK may contribute to signaling specificity in vivo. Whether this is achieved by individual JNKKKs or by means of a combinatorial mechanism will require a systematic characterization of compound mutants and a toolbox of transcriptional reporters specific for distinct JNK‐dependent processes. Developmental Dynamics 232:575–584, 2005. © 2005 Wiley‐Liss, Inc.
The impact of an inpatient physician program on quality, utilization, and satisfaction.

OBJECTIVE To evaluate an inpatient physician system initiated in June 1996 for all patients of a health maintenance organization admitted to the general medicine service of an urban teaching hospital. In the new program, attending physician duties were transferred from the patient's own general internist to another internist serving on a hospital-based rotation. STUDY DESIGN Cohort with historical controls. PARTICIPANTS AND METHODS We compared the following measures before and after the new inpatient physician program began: (1) hospital length of stay and total charges, (2) outcomes related to quality of care, (3) primary care physician satisfaction, and (4) housestaff satisfaction. Differences before and after initiation of the inpatient physician program were evaluated using multivariate analyses to adjust for patient differences and secular trends. RESULTS There were 2265 patients discharged from the general medical service in the year following implementation of the inpatient physician program. Postintervention average length of stay decreased from 3.5 to 3.0 days (P < .001). In multivariate analyses, average length of stay was reduced by 0.3 days (P = .008), and total hospital charges were reduced an average of $426 per admission (P = .001). In-hospital mortality rates, percentage of patients discharged home directly, and 30-day readmission rates did not change significantly in the postintervention period. Satisfaction among primary care physicians was high, with 90% of those answering a survey responding that they would recommend a similar program to other primary care groups. Medical housestaff satisfaction with their educational experience also increased. CONCLUSIONS Implementation of an inpatient physician program at this institution significantly decreased resource utilization while maintaining or improving quality of care. Satisfaction with the program was high among primary care internists and housestaff.
Prognostic implications of neuroendocrine differentiation and hormone production in patients with Stage I nonsmall cell lung carcinoma

Approximately 10–20% of nonsmall cell lung carcinomas (NSCLC) show neuroendocrine (NE) differentiation, as evaluated by panendocrine markers or ultrastructural evidence of dense‐core secretory granules. However, little is known regarding the prevalence and clinical implications of NE differentiation in patients with Stage I NSCLC.
In vivo selection for intronic splicing signals from a randomized pool.

Retroviruses utilize balanced splicing to express multiple proteins from a single primary transcript. A number of cis -acting signals help maintain this balance, including the branch point sequence (BPS), polypyrimidine tract (PPyT) and sequences within the downstream exon. In general, regulated splicing requires weak splicing signals and we have previously shown the same requirement for the simple retrovirus, avian sarcoma virus (ASV). Here we take advantage of the requirement for balanced splicing in retroviral replication to examine the sequence constraints of an intronic splicing element. Selection for replication competence makes it possible to amplify and identify functional sequences from a pool of all possible sequences. In this report we examine the role of pyrimidines within the PPyT. Our results provide in vivo confirmation that the functional strength of a PPyT is related to its length and uridine content and that the PPyT plays a role in the second step of the splicing reaction. We also show that the minimal distance between the 3'-splice site and the BPS in this system is 16 nt. With modification, the selection system described here can be used to examine the sequence constraints of other exonic or intronic splicing elements in vivo .
Implementing the “Simple” Model of Reading Deficits: A Connectionist Investigation of Interactivity

The “Simple model” of reading proposes that reading deficits can be understood in terms of single or combined contributions of comprehension and phonological impairments [1]. Phonological or semantic deficits have been effectively tested in isolation in computational models of reading, and their results map onto the predictions of the simple model. However, the subtle interactions between impaired representations have not yet been fully explored. We implemented a connectionist triangle model of reading which learned to map between orthographic, phonological, and semantic representations of words for a large sample of monosyllabic words in English. During learning, the model was impaired in terms of its ability to stably represent phonological or semantic information. The model was then tested on a variety of word and picture naming tasks. The model replicated previous studies of dyslexia resulting from a phonological deficit, and comprehension difficulties resulting from a semantic deficit. However, we also found that impairment at either phonological or semantic representations affected the fidelity of representations throughout the model, indicating that pure deficits in reading will be difficult to observe. The implemented model provides constraints on the extent to which phonological and semantic information may interact in order to explain reading and its deficits.
Multipurpose quick 3D packaging process

A novel small-sized chip circuit auxiliary layer (SCCAL) multipurpose 3D package process in order to solve the problem of shortages in flexibility and diversity of the traditional through-silicon via (TSV) process is presented in this paper. It meets the requirement of large amount of silicon dies which need connecting together by TSV technology but were designed respectively that wafers were processed without via holes drilling. This process involves a small-sized chip circuit auxiliary layer which is used as a carrying base and connecting auxiliary layer. Also, an improved TSV technology is involved that via holes could be produced through the PADs in the silicon dies. It is verified that, the whole process time of 3D packaging process is shortened drastically and the flexibility of the 3D packaging is greatly improved.
High-speed gold laser-plating on nickel-plated copper leadframe toward flip-chip packaging

High-speed laser plating (HLP) of gold nanoparticles on a nickel-electroplated copper leadframe has been developed. Dot patterns with a diameter of around 100 μm are formed using an inkjet printer on the substrate, being locally heated with a near-infrared laser in air for a short-time irradiation of less than 1 s. The resulting HLP gold film with a thickness of about 0.3 μm has a bulky structure as well as a high adhesion to the substrate. The successful bonding of gold wire with the gold pad can be utilized to form a stud bump, the height of which can be adjusted to around 60 μm. A flip-chip LED package has been successfully fabricated by employing the present HLP-based method, but reliability tests still need to be done for practical application.
Direct transport to tertiary trauma centers versus transfer from lower level facilities: impact on mortality and morbidity among patients with major trauma.

BACKGROUND The purpose of the study was to compare the outcome of severely injured patients who were transported directly to a Level I, tertiary trauma center with those who were transferred after being first transported to less specialized hospitals. METHODS The data were based on all patients treated at three tertiary trauma centers in Quebec between April 1, 1993, and December 31, 1995. There were 1,608 patients (37%) transferred and 2,756 patients (63%) transported directly. RESULTS The mean age of the patients was approximately 45 years, and more than 60% were males. The predominant mechanisms of injury were falls and motor vehicle crashes. The transfer and direct transport groups were similar with respect to age, gender, and mechanism of injury. Body regions injured were also similar with the exception of head or neck injuries (transfer, 56%; direct, 28%; p < 0.0001). The mean Injury Severity Score was 14, the mean Pre-Hospital Index score was 5.5, and the mean Revised Trauma Score was 7.5. The two groups were similar with respect to these injury severity measures. The primary outcome of interest was mortality described as overall death rate, death rate in the emergency room, and death rate after admission. Other outcomes studied were hospital length of stay and duration of treatment in an intensive care unit. When compared with the direct transport group, transferred patients were at increased risk for overall mortality (transfer, 8.9%; direct, 4.8%; odds ratio, 1.96; 95% confidence interval (CI) = 1.53-2.50), emergency room mortality (transfer, 3.4%; direct, 1.2%; odds ratio, 2.96; 95% CI = 1.90-4.6), and mortality after admission (transfer, 5.5%; direct, 3.6%; odds ratio, 1.57; 95% CI = 1.17-2.11). All of these differences were statistically significant (p < 0.003). Stratified and multiple logistic regression analysis did not alter these results and failed to identify a patient subgroup for which transfer was associated with a reduced risk of mortality. After adjusting for patient age, Injury Severity Score, and presence of injuries to the head or neck and extremities, transferred patients stayed significantly longer in the hospital and the intensive care unit as indicated by the mean length of stay (transfer, 16.0 days; direct, 13.2 days; p = 0.02) and the mean intensive care unit stay (transfer, 2.0 days; direct, 0.95 days; p = 0.001). CONCLUSION The results of this study have shown that transportation of severely injured patients from the scene directly to Level I trauma centers is associated with a reduction in mortality and morbidity. Further studies are required for the evaluation of transport protocols for rural trauma. Economic and cost-effectiveness considerations of patient triage are also essential.
Investigation of 3-D RCS Image formation of ships using ISAR

Conventional Inverse Synthetic Aperture Radar (ISAR) utilises the rotational motion of a target such as a ship or an aircraft to obtain a 2-D image of the target’s radar cross section (RCS) profile from a coherent radar system. This concept can be extended to obtain a 3-D RCS profile if the target's translational and rotational motion has the required attributes and is known with sufficient accuracy. This paper is a preliminary investigation to see whether 3-D ISAR images can be generated with a single antenna, using an approach that is different from interferometric ISAR. Simulation results have verified that 3-D ISAR images can be obtained under certain circumstances. A major problem experienced with ship ISAR data is multipath reflection off the sea surface. Simulations have been performed, which illustrate the degrading effect of specular multipath on the final 3-D image.
Designing a dual-polarized octave bandwidth bowtie antenna for a linear array

In this paper, we propose a linear array configuration for Random Line-of-Sight Over-The-Air testing set-up in anechoic chamber. For this aim, we use the self-grounded dual-polarized bowtie antenna as the element in the array. We present a new design of the bowtie to improve the array performance in terms of reflection coefficient and directivity. The new design has a simpler profile to manufacture. A good reflection coefficient performance has been achieved over the entire band of interest, i.e., 1.6-3GHz. The directivity of the array is almost constant for both polarizations over the entire frequency band.
Matrix metalloproteinase 13-deficient mice are resistant to osteoarthritic cartilage erosion but not chondrocyte hypertrophy or osteophyte development.

OBJECTIVE To investigate the role of matrix metalloproteinase 13 (MMP-13; collagenase 3) in osteoarthritis (OA). METHODS OA was surgically induced in the knees of MMP-13-knockout mice and wild-type mice, and mice were compared. Histologic scoring of femoral and tibial cartilage aggrecan loss (0-3 scale), erosion (0-7 scale), and chondrocyte hypertrophy (0-1 scale), as well as osteophyte size (0-3 scale) and maturity (0-3 scale) was performed. Serial sections were stained for type X collagen and the MMP-generated aggrecan neoepitope DIPEN. RESULTS Following surgery, aggrecan loss and cartilage erosion were more severe in the tibia than femur (P<0.01) and tibial cartilage erosion increased with time (P<0.05) in wild-type mice. Cartilaginous osteophytes were present at 4 weeks and underwent ossification, with size and maturity increasing by 8 weeks (P<0.01). There was no difference between genotypes in aggrecan loss or cartilage erosion at 4 weeks. There was less tibial cartilage erosion in knockout mice than in wild-type mice at 8 weeks (P<0.02). Cartilaginous osteophytes were larger in knockout mice at 4 weeks (P<0.01), but by 8 weeks osteophyte maturity and size were no different from those in wild-type mice. Articular chondrocyte hypertrophy with positive type X collagen and DIPEN staining occurred in both wild-type and knockout mouse joints. CONCLUSION Our findings indicate that structural cartilage damage in a mouse model of OA is dependent on MMP-13 activity. Chondrocyte hypertrophy is not regulated by MMP-13 activity in this model and does not in itself lead to cartilage erosion. MMP-13 deficiency can inhibit cartilage erosion in the presence of aggrecan depletion, supporting the potential for therapeutic intervention in established OA with MMP-13 inhibitors.
An experimental study on changes in finger blood pressure during chain-saw operation.

In this study finger blood pressure was observed by using a new method to determine if vasoconstriction activated by sympathetic nervous system takes part in changes in peripheral circulation with exposure to vibration, noise and tool weight. Finger blood pressure was measured every one minute by ambulatory monitoring system. The time profile of a single experiment consisted of 5 minutes pre-exposure period followed by one exposure period lasting 2 minutes and a post exposure period of 5 minutes. Measurement was carried out as a factorial experiment of combination of vibration (17.8 m/s2 in X-axis, 20.0 m/s2 in Y-axis and 50 m/s2 in Z-axis), noise (105 dBA) and tool weight (7.9 kg). Finger blood pressure increased significantly under the following conditions: vibration + noise + tool weight > vibration + noise . =. vibration . =. tool weight > noise . =. control. During exposure period the combination with vibration, noise and finger grip exercise induced 29.7 mmHg of increases on average in finger blood pressure. On the other hand, finger blood pressure was increased 9.5 mmHg by vibration alone. These results agreed with our previous studies which observed the decreases of finger skin temperature and finger blood flow during the same conditions. The present study suggests that possible activation of the sympathetic nervous system may be involved in the physiological mechanisms of the changes in blood flow during chain-saw operation.
Effects on sleep stages and microarchitecture of caffeine and its combination with zolpidem or trazodone in healthy volunteers

Abstract Caffeine is the world’s most popular stimulant and is known to disrupt sleep. Administration of caffeine can therefore be used in healthy volunteers to mimic the effects of insomnia and thus to test the hypnotic effects of medication. This study assessed the effects of caffeine on sleep architecture and electroencephalography (EEG) spectrum alone and in combination with two different sleep-promoting medications. Home polysomnography was performed in 12 healthy male volunteers in a double-blind study whereby subjects received placebo, caffeine (150 mg), caffeine plus zolpidem (10 mg) and caffeine plus trazodone (100 mg) at bedtime in a randomised crossover design. In addition to delaying sleep onset, caffeine decreased total sleep time (TST), sleep efficiency (SE) and stage 2 sleep without significantly altering wake after sleep onset or the number of awakenings. Zolpidem attenuated the caffeine-induced decrease in SE and increased spindle density in the caffeine plus zolpidem combination compared with placebo. Trazodone attenuated the decrease in SE and TST, and it also increased stage 3 sleep, decreased the number of awakenings and decreased the spindle density. No significant changes in rapid eye movement (REM) sleep were observed, neither was any significant alteration in slow wave activity nor other EEG spectral measures, although the direction of change was similar to that previously reported for caffeine and appeared to ‘normalise’ after trazodone. These data suggest that caffeine mimics some, but not all of the sleep disruption seen in insomnia and that its disruptive effects are differentially attenuated by the actions of sleep-promoting compounds with distinct mechanisms of action.
Local binary fitting energy solution by graph cuts for MRI segmentation

This paper proposes a new solution for local binary fitting energy minimization based on graph cuts for automatic brain structure segmentation on magnetic resonance images. The approach establishes an effective way to embed the energy formulation into a directed graph, such that the energy is minimized by maximizing the graph flow. Proposed and conventional solutions are compared by segmenting the well-known BrainWeb synthetic brain Magnetic Resonance Imaging database. Achieved results show an improvement on the computational cost (about 10 times shorter) while maintaining the segmentation accuracy (96%).
Provision of pharmaceutical care to patients with limited English proficiency.

PURPOSE A study was conducted to evaluate the current practices of pharmacists in ambulatory care clinics in communicating with and providing pharmaceutical care to patients who have limited English proficiency. METHODS Semistructured surveys were used to gather data from 16 pharmacists and 8 physicians from 15 ambulatory care clinics in metropolitan Toronto. The survey examined pharmacists' knowledge about the linguistic services, policies, and guidelines in their ambulatory care practice settings; the strategies that pharmacists and physicians use to communicate with patients with limited English proficiency; the challenges pharmacists face when providing pharmaceutical care to those patients; the drug-related problems observed by pharmacists and physicians; and how pharmacists and physicians can collaborate to resolve medication issues for those patients. RESULTS Many pharmacists (69%) were unaware of existing institutional policies for communicating with patients with limited English proficiency. Language interpretation services in clinics were nonstandardized and did not always reflect practitioners' preferences. All aspects of pharmaceutical care were reported to be difficult to accomplish in patients with limited English proficiency. Pharmacists and physicians identified similar drug-related problems, with nonadherence being the most commonly observed drug-related problem. Strategies suggested by pharmacists and physicians to improve communication with patients involved proactively identifying language needs of patients before appointments, having translated medication information available and using trained language interpreters. CONCLUSION Pharmacists at 15 ambulatory care clinics reported difficulty communicating with and providing pharmaceutical care to patients with limited English proficiency. Strategies suggested by pharmacists and physicians to enhance communication with those patients may help improve the quality of pharmaceutical care delivered.