Miracle-dz/UniFAR-FTUs huggingface dataset:
Measurement of knee stiffness and laxity in patients with documented absence of the anterior cruciate ligament.

Thirty-five patients with documented absence of the anterior cruciate ligament were tested on the University of California, Los Angeles, instrumented clinical knee-testing apparatus and we measured the response curves for the following testing modes: anterior-posterior force versus displacement at full extension and at 20 and 90 degrees of flexion; varus-valgus moment versus angulation at full extension and 20 degrees of flexion; and tibial torque versus rotation at 20 degrees of flexion. Absolute values of stiffness and laxity and right-left differences for these injured knees were compared with identical quantities measured previously for a control population of forty-nine normal subjects with no history of treatment for injury to the knee. For both the uninjured knees and the knees without an anterior cruciate ligament, at 20 and 90 degrees of flexion the anterior-posterior laxity was greatest at approximately 15 degrees of external rotation of the foot. The injured knees demonstrated significantly increased total anterior-posterior laxity and decreased anterior stiffness when compared with the uninjured knees in all tested positions of the foot and knee. The mean increase in paired anterior-posterior laxity for the injured knees in this group of patients at +/- 200 newtons of applied anterior-posterior force was 3.1 millimeters (+39 per cent) at full extension, 5.5 millimeters (+57 per cent) at 20 degrees of flexion, and 2.5 millimeters (+34 per cent) at 90 degrees of flexion. The mean reduction in anterior stiffness for injured knees was also greatest (-54 per cent) at 20 degrees of knee flexion. Only slight reduction in posterior stiffness (-16 per cent) was measured at 20 degrees of flexion, and this probably reflected the presence of associated capsular and meniscal injuries. In the group of anterior cruciate-deficient knees, the patients with an absent medial meniscus showed greater total anterior-posterior laxity in all three positions of knee flexion than did the patients with an intact or torn meniscus. Varus-valgus laxity at full extension increased an average of 1.7 degrees (+36 per cent) for the injured knees, while varus and valgus stiffness decreased 21 per cent and 24 per cent. Absence of the medial meniscus (in a knee with absence of the anterior cruciate ligament) increased varus-valgus laxity at zero and 20 degrees of flexion. (ABSTRACT TRUNCATED AT 400 WORDS)
Indications for use of damage control surgery and damage control interventions in civilian trauma patients: A scoping review

BACKGROUND Variation in the use of damage control (DC) surgery across trauma centers may partially be driven by uncertainty as to when the procedure is indicated. We sought to scope the literature on DC surgery and DC interventions, identify their reported indications, and examine the content and evidence upon which they are based. METHODS We searched MEDLINE, EMBASE, PubMed, Scopus, Web of Science, and the Cochrane Library (1950–February 14, 2014) and the grey literature for original and nonoriginal citations reporting indications for DC surgery or DC interventions in civilian trauma patients. RESULTS Among 27,732 citations identified, we included 270 peer-reviewed articles in the scoping review. Of these, 156 (57.8%) represented original research, primarily (75.0%) cohort studies. The articles reported 1,099 indications for DC surgery and 418 indications for 15 different DC interventions. The majority of indications for DC interventions were for abdominal (56.5%) procedures, including therapeutic perihepatic packing (56.5%), temporary abdominal closure/open abdominal management (40.7%), and staged pancreaticoduodenectomy (2.8%). Most DC surgery indications were based on intraoperative findings (71.7%) and represented characteristics of the injured patient (94.5%), including their physiology (57.6%), injuries (38.9%), and/or the amount or type of resuscitation provided (14.3%). Others were dependent on characteristics of the treating surgeon (12.1%), the patient’s physiologic response to trauma care (9.6%), and/or the trauma care environment (1.5%). Approximately half (49.5%) included a decision threshold (e.g., pH < X) and, while most (74.7%) were based on a single clinical finding/injury, 25.3% required the presence of multiple findings concurrently. Only 87 indications were evaluated in original research studies and only 9 by more than one study. CONCLUSION The vast number, varying underlying content, and lack of original research relating to indications for DC suggests that substantial uncertainty exists around when the procedure is indicated and highlights the need to establish evidence-informed consensus indications.
Mutant alcohol dehydrogenase (ADH III) presequences that affect both in vitro mitochondrial import and in vitro processing by the matrix protease

Point mutations in the presequence of the mitochondrial alcohol dehydrogerase isoenzyme (ADH III) have been shown to affect either the import of the precursor protein into yeast mitochondria in vivo or its processing within the organelle. In the present work, the behavior of these mutants during in vitro import into isolated mitochondria was investigated. All point mutants tested were imported with a slower initial rate than that of the wild-type precursor. This defect was corrected when the precursors were treated with urea prior to import. Once imported, the extent of processing to the mature form of mutant precursors varied greatly and correlated well with the defects observed in vivo. This result was not affected by prior urea treatment. When matrix extracts enriched for the processing protease were used, this defect was shown to be due to failure of the protease to efficiently recognize or cleave the presequence, rather than to a lack of access to the precursor. The rate of import of two ADH III precursors bearing internal deletions in the leader sequence was similar to those of the point mutants, whereas a deletion leading to the removal of the 15 amino-terminal amino acids was poorly imported. The mature amino terminus of wild-type ADH III was determined to be Gln-25. Mutant m01 (Ser-26 to Phe), which reduced the efficiency of cleavage in vitro by 80%, was cleaved at the correct site.
Primary CNS lymphoma of T-cell origin: a descriptive analysis from the international primary CNS lymphoma collaborative group.

PURPOSE To describe the demographic and tumor related characteristics and outcomes for patients with primary T-cell CNS lymphoma (TPCNSL). PATIENTS AND METHODS A retrospective series of patients with TPCNSL was compiled from twelve cancer centers in seven countries. RESULTS We identified 45 patients with a median age of 60 years (range, 3 to 84 years). Twenty (44%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1. Twenty-six (58%) had involvement of a cerebral hemisphere and sixteen (36%) had lesions of deeper sites in the brain. Serum lactate dehydrogenase was elevated in 7 (32%) of 22 patients, and CSF protein was elevated in 19 of 24 patients (79%) with available data. The median disease-specific survival (DSS) was 25 months (95% CI, 11 to 38 months). The 2- and 5-year DSS were 51% (95% CI, 35% to 66%) and 17% (95% CI, 6% to 34%), respectively. Univariate and multivariate analyses were conducted for age (</= 60 v > 60 years), PS (0 or 1 v 2, 3, or 4), involvement of deep structures of the CNS (no v yes), and methotrexate (MTX) use in the primary treatment (yes v no). Only PS and MTX use were significantly associated with better outcome with hazard ratios of 0.2 (95% CI, 0.1 to 0.4) and 0.4 (95% CI, 0.2 to 0.8), respectively. CONCLUSION This is the largest series ever assembled of TPCNSL. The presentation and outcome appear similar to that of B cell PCNSL. PS 0 or 1 and administration of MTX are associated with better survival.
Reducing Contamination of Peripheral Blood Cultures in a Pediatric Emergency Department

Objective: Blood culture contamination rates (CRs) in emergency departments (EDs) vary from 1% to 9% in previous studies. High CRs cause unnecessary admissions, antibiotics, and costs. Different measures have been tried to improve CR. This study sought to determine the ED CR at Arkansas Children's Hospital (ACH) and evaluate an educational intervention. Design: A slide presentation of the ACH's blood culture collection procedure was made. The ED nursing staff viewed this individually and demonstrated the procedure on a mock extremity. Data before (from June 1 to November 30, 2007; PRE) and after (from February 1 to July 31, 2008; POST) intervention regarding blood cultures positive for organism submitted to the ED and any descriptive data were collected retrospectively. Descriptive statistics described the CR, positivity rate (PSR), and pathogen rate (PR). Frequent collectors were identified as those submitting more than 72 blood cultures during PRE and during POST. Contamination rate in frequent collectors was independently assessed for improvement. This study was approved by the institutional review board of the University of Arkansas for Medical Sciences. Results: Positivity rate during PRE was 6.8% (n = 15; 95% confidence interval [CI], 2.9-10.7); 114 were contaminants (CR, 5.0%; 95% CI, 1.04-8.98) and 40 were pathogens (PR, 1.8%; 95% CI, ±4.28). Positivity rate during POST was 6.3% (n = 157; 95% CI, 2.6-10.0); 124 were contaminants (CR, 4.9%; 95% CI, 1.14-8.66) and 33 were pathogens (PR, 1.4%; 95% CI, ±4.22). For both PRE and POST, contaminants represented 74% or greater of all the positives and more than 75% of contaminants occurred in patients 0 to 36 months old. Contamination rates of individual practitioners ranged from 0% to 17% (PRE) and from 0% to 21% (POST). The CR was lower in POST for samples submitted from frequent collectors (practitioners submitting >72 blood cultures per study period, n = 6), was evaluated separately, and found to improve in POST (from 4.1% to 2.7%). A t test for matched samples for these samplers revealed a significant decrease in the POST period, P = 0.03. Conclusions: The CR in the ACH ED for peripherally drawn blood cultures is approximately 5% monthly with less than 2% PR. For each culture positive for organism, the chance of contamination is 75% or higher. An intervention emphasizing the appropriate technique, monitored training, and improved CR of a group of frequent collectors is warranted.
[Hemodynamic effects of oral captopril in patients with critical aortic stenosis].

OBJECTIVES To analyse the hemodynamic and ventricular function effects of oral captopril in severe aortic stenosis. PATIENT POPULATION inclusion criteria: patients older than 18 years with critical aortic stenosis. EXCLUSION CRITERIA angiotensin-converting enzyme inhibitor used previously contraindication to right catheterisation aortic insufficiency, valvular prosthesis in aortic position, or other valvulopathy. As well as the need for immediate valvular aortic replacement arrhythmia, A-V conduction alterations, or ventilatory support. PROTOCOL prospective, no randomized. Swan-Ganz catheter was used. Basal hemodynamic measurements were made on 1, 2, 4, 6 and 8 hours during 48 hours. Captopril was administered 12.5 mg first and then 8 mg tid (6 doses). STATISTICAL ANALYSIS Neuman-Keuls test was used for multivariate comparisons. Statistical significance was determined with P < 0.05. RESULTS 22 patients were analyzed. Systemic vascular resistance fell from 1750 Dyn/seg/cm-5 to 1200 (P-0.001), cardiac output increased from 4.1l/min to 5.8 (P-0.001), cardiac index increased from 2.4 l/min/m2 to 2.9 (P-0.009), stroke volume from 47 ml to 64 (P-0.04) and stroke volume index from 27 ml/m2 to 36 (P-0.002). In patients with heart failure (n = 7) the systemic vascular resistance fell from 2050 Dyn/seg/cm-5 to 1463 (P-0.04), cardiac output increased from 2.8l/min to 4.1 (P-0.04), cardiac index from 2.07 l/min/m2 to 2.75 (P-0.04), stroke volume from 46 ml to 64 (P-0.03), pulmonary capillary wedge pressure fell from 19 mmHg to 16 (0.04) and the systolic pulmonary arterial pressure fell from 63 mmHg to 42 (P-0.009). CONCLUSIONS captopril improves the hemodynamic parameters in patients with critical aortic stenosis, principally in those with heart failure.
Technologies for localization and diagnosis of prostate cancer

The gold standard for detecting prostate cancer (PCa), systematic biopsy, lacks sensitivity as well as grading accuracy. PSA screening leads to over-treatment of many men, and it is unclear whether screening reduces PCa mortality. This review provides an understanding of the difficulties of localizing and diagnosing PCa. It summarizes recent developments of ultrasound (including elastography) and MRI, and discusses some alternative experimental techniques, such as resonance sensor technology and vibrational spectroscopy. A comparison between the different methods is presented. It is concluded that new ultrasound techniques are promising for targeted biopsy procedures, in order to detect more clinically significant cancers while reducing the number of cores. MRI advances are very promising, but MRI remains expensive and MR-guided biopsy is complex. Resonance sensor technology and vibrational spectroscopy have shown promising results in vitro. There is a need for large prospective multicentre trials that unambiguously prove the clinical benefits of these new techniques.
CALM: cascading system with leaking detection mechanism for medical image segmentation

Medical image segmentation is a challenging process due to possible image over-segmentation and under-segmentation (leaking). The CALM medical image segmentation system is constructed with an innovative scheme that cascades threshold level-set and region-growing segmentation algorithms using Union and Intersection set operators. These set operators help to balance the over-segmentation rate and under-segmentation rate of the system respectively. While adjusting the curvature scalar parameter in the threshold level-set algorithm, we observe that the abrupt change in the size of the segmented areas coincides with the occurrences of possible leaking. Instead of randomly choose a value or use the system default curvature scalar values, this observation prompts us to use the following formula in CALM to automatically decide the optimal curvature values γ to prevent the occurrence of leaking : δ2S/δγ2 >= M, where S is the size of the segmented area and M is a large positive number. Motivated for potential applications in organ transplant and analysis, the CALM system is tested on the segmentation of the kidney regions from the Magnetic Resonance images taken from the National University Hospital of Singapore. Due to the nature of MR imaging, low-contrast, weak edges and overlapping regions of adjacent organs at kidney boundaries are frequently seen in the datasets and hence kidney segmentation is prone to leaking. The kidney segmentation accuracy rate achieved by CALM is 22% better compared with those achieved by the component algorithms or the system without leaking detection mechanism. CALM is easy-to-implement and can be applied to many applications besides kidney segmentation.
Thrombophilia in Korean patients with arterial or venous thromboembolisms

Purpose To determine the prevalence of thrombophilia in Korean patients with an arterial thromboembolism (ATE) or a venous thromboembolism (VTE), and to evaluate the characteristic of VTE in patients with thrombophilia. Methods Hospital records of 294 patients (228 with VTE, 66 with ATE) including two foreign ones (mean age, 51.4 years) who underwent thrombophilia testing between August 2006 and March 2015 were reviewed retrospectively. In general, such screening was performed according to the guidelines of the international consensus statement for VTE. Thrombophilia testing included evaluations of the factor V Leiden and prothrombin G20210A mutations, levels of proteins C and S and antithrombin, and antiphospholipid antibody syndrome (APLS). Results A factor V Leiden mutation was not found in the 292 Korean patients. A prothrombin G21210A mutation was investigated in 33 patients but none was found. Among 226 Korean patients with VTE, 130 demonstrated no thrombophilia and 55 patients did after exclusion of 41 patients without confirmatory test. The most common form was protein S deficiency (31 of 55, 56%) followed by protein C deficiency, antithrombin deficiency, and APLS. When comparing patients with a VTE or deep vein thrombosis (DVT) according to the presence of thrombophilia, thrombophilia was associated with younger age (P = 0.001 for VTE; P < 0.001 for DVT) and a family history (P < 0.001 for VTE and DVT). Conclusion We did not find any factor V Leiden mutation in Korean subjects at high risk for thrombophilia. Therefore, this testing is not warranted. Thrombophilia was associated with VTE in younger age and a family history.
Retinal microvascular abnormalities and stroke: a systematic review

Background: Lacunar strokes account for 25% of ischaemic strokes, but their precise aetiology is unknown. Similarities between the retinal and cerebral small vessels mean that clarification of the exact relationship between retinal microvascular abnormalities and stroke, and particularly with stroke subtypes, may aid understanding of the aetiology of lacunar stroke and stroke risk. Methods: A systematic review of the literature was performed by searching Medline and Embase to October 2007 for studies in humans that investigated the association between retinal microvascular abnormalities and prevalent or incident stroke. Data and calculated summary risk ratios (sRR) were extracted for associations between retinal microvascular abnormalities and stroke, including stroke subtypes where possible, adjusted for key variables. 37 papers from 22 different studies were included with 62 975 subjects (mean age 62 years) among whom there were 2893 strokes. Stroke identification and diagnosis methods varied. Results: Retinopathy was associated with incident stroke (sRR 2.1, 95% CI 1.7 to 2.6) and prevalent stroke (sRR 2.5, 95% CI 1.4 to 4.3). Incident stroke was also associated with retinal artery embolism (sRR 2.9, 95% CI 1.6 to 5.1) and venular widening (sRR 1.4, 95% CI 1.1 to 1.7). There was significant heterogeneity between studies for some associations. There were no data on retinal microvascular abnormalities and haemorrhagic versus ischaemic stroke or ischaemic stroke subtypes. Conclusions: Retinal microvascular abnormalities are associated with stroke, but more data are required to clarify associations between specific types of retinal microvascular abnormality and stroke, as well as between different stroke subtypes. Future retinal-stroke studies should concentrate on carefully diagnosing and accurately sub-typing ischaemic stroke.
Morphological Features and Activation Patterns of Motor Units

The force that a muscle exerts depends on which motor units have been recruited and at what rate they are discharging action potentials. Because of differences in motor-unit morphology (innervation ratio, average cross-sectional area, specific force, and geometric distribution of muscle fibers), the maximum motor-unit force within a motor-neuron pool is not constant but rather can vary by ∼50 times. Consequently, muscle force is affected by which motor units have been activated. Similarly, the rate at which a motor neuron discharges action potentials depends on the pattern and quantity of the synaptic input it receives and its intrinsic frequency-current relation. The force that a single motor unit can exert will vary by ∼ 3 to 15 times when discharge rate is increased from a minimum to a maximum. In the performance of voluntary contractions, therefore, humans appear to have an infinite number of combinations of motor-unit recruitment and discharge rate that can be used to vary muscle force. However, control strategies have evolved that reduce these options substantially. From experiments on low-force, isometric contractions, it appears that the recruitment order of motor units is relatively fixed and that muscle force is graded by concurrent variations in recruitment and discharge rate over much of the force range. Whereas the recruitment order of motor units appears to be robust in other tasks also, perhaps with the exception of lengthening contractions, the use of discharge rate to grade muscle force seems more variable. When subjected to acute and chronic challenges, motor-unit properties can adapt within limited ranges, and motor-unit discharge rate appears to be more affected than recruitment order, although the extent of recruitment may be affected by changes in use. Because movement is controlled by motor-unit activity, an understanding of motor-unit physiology can have a significant impact on the evaluation and treatment of movement disorders.
Lentiviral vector-mediated doxycycline-inducible iASPP gene targeted RNA interference in hepatocellular carcinoma.

BACKGROUND AND OBJECTIVE iASPP, an inhibitory member of the apoptosis-stimulating proteins of p53 (ASPP) family, has been found to be up-regulated in various human tumor types. This study was to construct an efficient doxycycline-regulated, lentiviral vector-mediated knockdown system for iASPP that will allow for inducible down-regulation of iASPP gene expression and preliminary functional analysis. METHODS A pair of complementary oligos with hairpin structures targeting the iASPP gene and a negative control were synthesized, then ligated with pLVTHM vector and sequenced. The fragment containing the shRNA cassette was cloned to pLVCT-tTR-KRAB plasmid. The recombinant vectors were co-transfected with viral packaging mix into 293T cells, and viral supernatant was harvested to determine the titer. After treatment with or without doxycycline, HepG2 cells infected with virus were harvested and the expression of iASPP was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. Its effects on tumor growth were characterized using MTS assay, soft agar colony formation, and flow cytometry analysis. RESULTS The lentiviral vector expressing shRNA that targets to the oncogene iASPP was constructed successfully. HepG2 infected with the lentivirus expressing shRNA against iASPP inhibited the expression of iASPP in the presence of doxycycline, which resulted in the repression of tumor cell proliferation and anchorage-independent growth potential. CONCLUSIONS The lentiviral vector-mediated tet-on system demonstrates efficient and inducible knockdown of iASPP in hepatocellular carcinoma cells. iASPP gene may be involved in tumorigenesis and progression of human tumors.