Miracle-dz/UniFAR-FTUs huggingface dataset:
A quantitative study of intervertebral disc morphologic changes following plasma-mediated percutaneous discectomy.

OBJECTIVE To quantitatively evaluate interval magnetic resonance imaging (MRI) changes in disc morphology following plasma-mediated percutaneous discectomy. DESIGN/SETTING A retrospective comparison of pretreatment and posttreatment MRIs at a single university spine clinic. SUBJECTS From a group of 60 consecutively treated patients, 15 met the study inclusion and exclusion criteria. All had either failed treatment or had other clinical reasons for a posttreatment MRI. METHODS Two independent physicians electronically measured disc protrusion size and disc height at the treatment discs and adjacent discs on pre- and posttreatment MRI scans. Additionally, images were compared for gross anatomic changes including disc degeneration by Pfirrman classification, new disc herniations, high intensity zone (HIZ), vertebral endplate changes, post-contrast enhancement, and changes in segmental alignment. Pearson r correlation was used to determine interobserver reliability between the two physicians' MRI measurements. Paired t-tests were calculated for comparisons of pre- and posttreatment MRI measurements, and an ANOVA was performed for comparison of pre- to posttreatment changes in disc height measurements at treatment levels relative to adjacent levels. RESULTS Correlation was high for measurement of disc height change (r = 0.89; P < 0.0001) and good for anteroposterior protrusion size change (r = 0.51; P = 0.0512). Disc height at treated discs demonstrated a small but statistically significant mean interval reduction of 0.48 mm (P = 0.0018). This remained significant when compared with the adjacent control discs (P < 0.0001). Pretreatment mean disc protrusion size (4.74 mm; range 3.75-6.55 mm) did not differ significantly (P = 0.1145) from posttreatment protrusion size (4.42 mm; range 2.55-7.95 mm). Gross anatomic changes at treatment levels included reduced disc protrusion size (N = 6), enlarged protrusion (N = 3), resolution of HIZ (N = 3), and improvement in endplate signal changes (N = 1). Also, 11/15 posttreatment MRIs included post-contrast images that showed epidural fibrosis (N = 1), rim enhancement (N = 2), and enhancement of the posterior annulus (N = 4). CONCLUSIONS Based on MRI examinations, subtle anatomic changes may occur following plasma-mediated percutaneous discectomy. Further study is required to determine the clinical relevance of these changes.
Prevalence of pain reporting and associated health outcomes across emerging markets and developed countries.

OBJECTIVE The current study represents the first broad, multi-country, population-based survey of pain, assessing the association between pain and health outcomes, plus comparing the burden of pain across emerging and developed countries. DESIGN Data from the 2011/2012 National Health and Wellness Surveys were used. Respondents reporting pain (neuropathic pain, fibromyalgia, back pain, surgery pain, and/or arthritis pain) vs no pain in emerging (Brazil, China, Russia) vs developed (European Union, Japan, United States) countries were compared on sociodemographic characteristics and measures of quality of life (SF-12v2 and SF-36v2), work productivity and activity impairment, and health care resource use. SUBJECTS Respondents included 128,821 without pain and 29,848 with pain in developed countries, and 37,244 without pain and 4,789 with pain in emerging countries. RESULTS Pain reporting and treatment rates were lower in China (6.2% and 28.3%, respectively) and Japan (4.4% and 26.3%, respectively) than in other countries (≥ 14.3% and 35.8%, respectively). Significant impairments in quality of life, productivity, and resource use were associated with pain across all health outcomes in both developed and emerging countries, with some productivity and physical health status impairments greater with pain in developed countries, whereas mental health status impairment and resource use were greater with pain in emerging countries. CONCLUSIONS Pain was associated with burden across all study outcomes in all regions. Yet, differences emerged in the degree of impairment, pain reporting, diagnosis, treatment rates, and characteristics of patients between emerging and developed nations, thus helping guide a broader understanding of this highly prevalent condition globally.
A Rapid Method for Improving Colposcopic Accuracy

ABSTRACT Four colposcopic signs (margins, color, vascular atypia, and iodine staining) are graded into three objective categories representing (1) subclinical papillomaviral infection, (2) lower-grade dysplasia, and (3) grade 3 cervical intraepithelial neoplasia. Attempts to grade lesions by the prominence of the acetowhitening reaction or the mere presence of aberrant surface capillaries are unsuccessful. In contrast, each of four colposcopic criteria described in this article is significantly correlated with histologic severity. Combined into a weighted index, these colposcopic features were 96% correct in forecasting approximate histologic findings. Because this method relies on critical analysis rather than pattern recall, the use of this colposcopic index greatly simplifies the learning of colposcopy.
Scaffolds for design communication: Research through design of shared understanding in design meetings

Abstract In this paper we explore the influence of the physical and social environment (the design space) son the formation of shared understanding in multidisciplinary design teams. We concentrate on the creative design meeting as a microenvironment for studying processes of design communication. Our applied research context entails the design of mixed physical–digital interactive systems supporting design meetings. Informed by theories of embodiment that have recently gained interest in cognitive science, we focus on the role of interactive “traces,” representational artifacts both created and used by participants as scaffolds for creating shared understanding. Our research through design approach resulted in two prototypes that form two concrete proposals of how the environment may scaffold shared understanding in design meetings. In several user studies we observed users working with our systems in natural contexts. Our analysis reveals how an ensemble of ongoing social as well as physical interactions, scaffolded by the interactive environment, grounds the formation of shared understanding in teams. We discuss implications for designing collaborative tools and for design communication theory in general.
Impact of imaging landmark on the risk of MRI‐related heating near implanted medical devices like cardiac pacemaker leads

Implanted medical devices such as cardiac pacemakers pose a potential hazard in magnetic resonance imaging. Electromagnetic fields have been shown to cause severe radio frequency‐induced tissue heating in some cases. Imaging exclusion zones have been proposed as an instrument to reduce patient risk. The purpose of this study was to further assess the impact of the imaging landmark on the risk for unintended implant heating by measuring the radio frequency‐induced electric fields in a body phantom under several imaging conditions at 1.5T. The results show that global radio frequency‐induced coupling is highest with the torso centered along the superior–inferior direction of the transmit coil. The induced E‐fields inside the body shift when changing body positioning, reducing both global and local radio frequency coupling if body and/or conductive implant are moved out from the transmit coil center along the z‐direction. Adequate selection of magnetic resonance imaging landmark can significantly reduce potential hazards in patients with implanted medical devices. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
The contribution of chemical exchange to MRI frequency shifts in brain tissue

Recent high‐field MRI studies based on resonance frequency contrast have revealed brain structure with unprecedented detail. Although subtle magnetic susceptibility variations caused by iron and myelin seem to be important to this contrast, recent research on protein solutions suggests that chemical exchange between water and macromolecular protons may contribute substantially to the observed gray‐white matter frequency contrast. To investigate this, we performed spectroscopic MRI experiments at 14 T on samples of fixed human visual cortex and fresh pig brain. To allow direct observation of any exchange‐induced frequency shifts, these samples were soaked in reference chemicals (TSP and dioxane) that are assumed not to be involved in exchange. For both fresh and fixed tissues and with both reference chemicals, substantial negative exchange‐induced gray‐white matter frequency contrast (–6.3 to –13.5 ppb) was found, whereas intracortical contrast was negligible. The sign of the gray‐white matter exchange‐induced frequency difference was opposite to the overall gray‐white matter frequency difference observed in vivo. This suggests that exchange contributes to, but is not sufficient to explain, the frequency contrast in vivo and tissue susceptibility differences may have a greater contribution than previously thought. The exchange‐dependent contribution may report on tissue chemical composition and pH. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
Dose escalation during the first year of long-term opioid therapy for chronic pain.

OBJECTIVE To identify patient factors and health care utilization patterns associated with dose escalation during the first year of long-term opioid therapy for chronic pain. DESIGN Retrospective cohort study using electronic health record data. SETTING University health system. SUBJECTS Opioid naïve adults with musculoskeletal pain who received a new outpatient opioid prescription between July 1, 2011 and June 30, 2012 and stayed on opioids for 1 year. METHODS Mixed-effects regression was used to estimate patients' rate of opioid dose escalation. Demographics, clinical characteristics, and health care utilization for patients with and without dose escalation were compared. RESULTS Twenty-three (9%) of 246 patients in the final cohort experienced dose escalation (defined as an increase in mean daily opioid dose of ≥30-mg morphine equivalents over 1 year). Compared with patients without dose escalation, patients with escalation had higher rates of substance use diagnoses (17% vs 1%, P = 0.01) and more total outpatient encounters (51 vs 35, P = 0.002) over 1 year. Differences in outpatient encounters were largely due to more non face-to-face encounters (e.g., telephone calls, emails) among patients with dose escalation. Differences in age, race, concurrent benzodiazepine use, and mental health diagnoses between patients with and without dose escalation were not statistically significant. Primary care clinicians prescribed 89% of opioid prescriptions. CONCLUSIONS Dose escalation during the first year of long-term opioid therapy is associated with higher rates of substance use disorders and more frequent outpatient encounters, especially non face-to-face encounters.
Transfer of Patients in a Telestroke Network: What Are the Relevant Factors for Making This Decision?

Abstract Background/Introduction: Current telestroke network consultations are focused on decision-making in the hyperacute stage of stroke management. The two main questions in telestroke consultations are whether thrombolysis should be initiated and whether the patient should be transferred to a hub hospital. Although guidelines exist for initiating intravenous thrombolytic therapy, the question of whether patients should be transferred is far more elusive. Materials and Methods: In this study, we investigated the factors involved in the decision to transfer stroke patients to a hub hospital. We were particularly interested in identifying factors that promote or impede the transfer of patients. We enrolled 1,615 cases of telestroke consultation of the University Hospital Jena. Results: The two main factors that independently influenced the probability of transferring a patient were the patient's age and the identification of a proximal vessel occlusion. Interestingly, factors such as the severity of sym.
Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer

Diffusion‐weighted imaging plays important roles in cancer diagnosis, monitoring, and treatment. Although most applications measure restricted diffusion by tumor cellularity, diffusion‐weighted imaging is also sensitive to vascularity through the intravoxel incoherent motion effect. Hypervascularity can confound apparent diffusion coefficient measurements in breast cancer. We acquired multiple b‐value diffusion‐weighted imaging at 3 T in a cohort of breast cancer patients and performed biexponential intravoxel incoherent motion analysis to extract tissue diffusivity (Dt), perfusion fraction (fp), and pseudodiffusivity (Dp). Results indicated significant differences between normal fibroglandular tissue and malignant lesions in apparent diffusion coefficient mean (±standard deviation) values (2.44 ± 0.30 vs. 1.34 ± 0.39 μm2/msec, P < 0.01) and Dt (2.36 ± 0.38 vs. 1.15 ± 0.35 μm2/msec, P < 0.01). Lesion diffusion‐weighted imaging signals demonstrated biexponential character in comparison to monoexponential normal tissue. There is some differentiation of lesion subtypes (invasive ductal carcinoma vs. other malignant lesions) with fp (10.5 ± 5.0% vs. 6.9 ± 2.9%, P = 0.06), but less so with Dt (1.14 ± 0.32 μm2/msec vs. 1.18 ± 0.52 μm2/msec, P = 0.88) and Dp (14.9 ± 11.4 μm2/msec vs. 16.1 ± 5.7 μm2/msec, P = 0.75). Comparison of intravoxel incoherent motion biomarkers with contrast enhancement suggests moderate correlations. These results suggest the potential of intravoxel incoherent motion vascular and cellular biomarkers for initial grading, progression monitoring, or treatment assessment of breast tumors. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.
Effects of inflow and radiofrequency spoiling on the arterial input function in dynamic contrast‐enhanced MRI: A combined phantom and simulation study

The arterial input function is crucial in pharmacokinetic analysis of dynamic contrast‐enhanced MRI data. Among other artifacts in arterial input function quantification, the blood inflow effect and nonideal radiofrequency spoiling can induce large measurement errors with subsequent reduction of accuracy in the pharmacokinetic parameters. These errors were investigated for a 3D spoiled gradient‐echo sequence using a pulsatile flow phantom and a total of 144 typical imaging settings. In the presence of large inflow effects, results showed poor average accuracy and large spread between imaging settings, when the standard spoiled gradient‐echo signal equation was used in the analysis. For example, one of the investigated inflow conditions resulted in a mean error of about 40% and a spread, given by the coefficient of variation, of 20% for Ktrans. Minimizing inflow effects by appropriate slice placement, combined with compensation for nonideal radiofrequency spoiling, significantly improved the results, but they remained poorer than without flow (e.g., 3–4 times larger coefficient of variation for Ktrans). It was concluded that the 3D spoiled gradient‐echo sequence is not optimal for accurate arterial input function quantification and that correction for nonideal radiofrequency spoiling in combination with inflow minimizing slice placement should be used to reduce the errors. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.
The Road To Meaningful Reform: A Conversation With Oregon’s John Kitzhaber

EDITOR’S NOTE: When Oregon sought approval in the mid-1990s to trim benefits in its Medicaid program to finance an expansion of coverage, the proposal stirred intense controversy and was eventually rejected by federal officials. In October 2002 the U.S. Department of Health and Human Services approved a second proposal to reduce benefits for some beneficiaries to pay for coverage of up to 60,000 uninsured Oregonians under new flexibility guidelines promulgated by the Bush administration and described elsewhere in this volume by Cindy Mann. John Kitzhaber spearheaded both efforts, initially as a state legislator and then as Oregon’s governor, often citing the conflict between his experiences as an emergency physician treating uninsured patients and as a legislator forced to curtail Medicaid coverage for budget reasons.
THE JOHNS HOPKINS ATLAS OF DIGITAL EEG: AN INTERACTIVE TRAINING GUIDE

THE JOHNS HOPKINS ATLAS OF DIGITAL EEG: AN INTERACTIVE TRAINING GUIDE edited by Gregory L. Krauss and Robert S. Fisher , 360 pp., The Johns Hopkins University Press, 2007, $125 The greatest strength of this 360-page atlas with over 200 examples of adult and pediatric EEG is the interactive EEG program on the included DVD. The reader can either select a specific EEG finding or …
Physiological Profiles of Elite Freestyle Wrestlers

The U.S. Freestyle Wrestling Team was evaluated while in preparation for the 1997 World Championships. Athletes were tested on 6 physiological parameters: upper-body muscular power and endurance (5.6-m rope climb, RC, and 5-stage modified Wingate); body composition (BF%, skinfold measures); lower-body muscular power (vertical jump, VJ); upper-body power and anaerobic capacity (5-stage modified Wingate protocol); peak aerobic power (peak Vo2) using the treadmill or cycle ergometer; and lower back/hamstring flexibility (sit and reach). Blood lactate (HLa) measures were taken 2 minutes after the Wingate and peak Vo2 tests. Major results (mean ± SD) are as follows: BF% 7.6 ± 3.4; VJ (cm) 60 ± 10; RC (seconds) 9.3 ± 4.4; flexibility (cm) 3.8 ± 5.8. Mean peak Vo2, HLa, and heart rate results from the treadmill test were 54.6 ± 2.0 ml·kg−1·min−1, 15.1 ± 3.5 mmol·L−1, and 186 ± 7.0 b·min−1, respectively. Mean peak Vo2, HLa, and heart rate results from the cycle ergometer test were 41.2 ± 6.1 ml·kg−1·min−1, 10.6 ± 0.2 mmol·L−1, and 176 ± 1.0 b·min−1, respectively. For repetitions 1–5 of the upper-body Wingate test, peak power averaged 6.3, 4.7, 3.8, 3.5, and 3.5 W·kg body weight−1, respectively. The fatigue indices for efforts 1–5 were 35.0, 33.2, 30.9, 29.4, and 31.6%, respectively. These results may provide a profile of elite freestyle wrestlers that can be used as training targets for developing athletes. The results may also provide information for training and tactical emphases.
An exploratory spatial analysis of pneumonia and influenza hospitalizations in Ontario by age and gender

Pneumonia and influenza represent a significant public health burden in Canada and abroad. Knowledge of how this burden varies geographically provides clues to understanding the determinants of these illnesses, and insight into the effective management of health-care resources. We conducted a retrospective, population-based, ecological-level study to assess age- and gender-specific spatial patterns of pneumonia and influenza hospitalizations in the province of Ontario, Canada from 1992 to 2001. Results revealed marked variability in hospitalization rates by age, as well as clear and statistically significant patterns of high rates in northern rural counties and low rates in southern urban counties. A moderate yet significant level of positive spatial autocorrelation (Moran's I=0·21, P<0·05) was found in the global data, with significant, age-specific clusters of high values or ‘hot spots’ identified in several northern counties. Findings illustrate the need for geographically focused prevention strategies, and resource and service allocation policies informed by regional and population-specific demands.
Plastic detection comb better than visual screening for diagnosis of head louse infestation

SUMMARY Finding lice can be difficult in head louse infestation. We compared a new louse detection comb with visual inspection. All children in two rural Turkish schools were screened by the two methods. Those with lice were offered treatment and the results monitored by detection combing. Children with nits only were re-screened to identify latent infestations. Using visual inspection we found 214/461 children (46%) with nits but only 30 (6·5%) with live lice. In contrast detection combing found 96 (21%) with live lice, of whom 20 had no nits. Detection combing was 3·84 times more effective than visual inspection for finding live lice. Only 10/138 (7·2%) children with nits and no lice were found to have active infestation by day 16. We found that the detection comb is significantly (P<0·001) more effective than visual screening for diagnosis; that nits are not a good indicator of active infestation; and that treatment with 1% permethrin was 89·6% effective.
Part III. Analysis of data gaps pertaining to enterotoxigenic Escherichia coli infections in low and medium human development index countries, 1984–2005

SUMMARY Enterotoxigenic Escherichia coli (ETEC) is a common cause of profuse watery diarrhoea in the developing world, often leading to severe dehydration or death. We found only 15 population-based studies in low and medium human development index (HDI) countries from 1984 to 2005 that evaluate disease incidence. Reported incidence ranged from 39 to 4460 infections/1000 persons per year. The peak incidence of ETEC appeared to occur between ages 6 and 18 months. A median of 14% (range 2–36%) of diarrhoeal specimens were positive for ETEC in 19 facility- and population-based studies conducted in all age groups and 13% (range 3–39%) in 51 studies conducted in children only. Heat-labile toxin (LT)-ETEC is thought to be less likely to cause disease than heat-stable toxin (ST)-ETEC or LT/ST-ETEC. Because population-based studies involve enhanced clinical management of patients and facility-based studies include only the most severe illnesses, reliable data on complications and mortality from ETEC infections was unavailable. To reduce gaps in the current understanding of ETEC incidence, complications and mortality, large population-based studies combined with facility-based studies covering a majority of the corresponding population are needed, especially in low-HDI countries. Moreover, a standard molecular definition of ETEC infection is needed to be able to compare results across study sites.
The influence of radial undersampling schemes on compressed sensing reconstruction in breast MRI

Fast imaging applications in magnetic resonance imaging (MRI) frequently involve undersampling of k‐space data to achieve the desired temporal resolution. However, high temporal resolution images generated from undersampled data suffer from aliasing artifacts. In radial k‐space sampling, this manifests as undesirable streaks that obscure image detail. Compressed sensing reconstruction has been shown to reduce such streak artifacts, based on the assumption of image sparsity. Here, compressed sensing is implemented with three different radial sampling schemes (golden‐angle, bit‐reversed, and random sampling), which are compared over a range of spatiotemporal resolutions. The sampling methods are implemented in static scenarios where different undersampling patterns could be compared. Results from point spread function studies, simulations, phantom and in vivo experiments show that the choice of radial sampling pattern influences the quality of the final image reconstructed by the compressed sensing algorithm. While evenly undersampled radial trajectories are best for specific temporal resolutions, golden‐angle radial sampling results in the least overall error when various temporal resolutions are considered. Reduced temporal fluctuations from aliasing artifacts in golden‐angle sampling translates to improved compressed sensing reconstructions overall. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.