Miracle-dz/UniFAR-FTUs huggingface dataset:
Shoulder Impingement Presenting as Neck Pain

Background: Chronic neck pain can be a difficult problem to evaluate and treat, as it can have several different causes. We studied a series of patients with neck pain near the superomedial aspect of the scapula that was referred pain from inflammation of the shoulder secondary to chronic impingement. We postulate that some patients with specific clinical findings and neck pain can benefit from treatment of shoulder impingement.Methods: We conducted a retrospective review of the charts of thirty-four patients with neck pain who met three criteria for the diagnosis of shoulder impingement syndrome: (1) a positive impingement sign with pain referred to the neck, (2) radiographic abnormalities, and (3) relief of neck pain after injection of lidocaine and cortisone into the subacromial space. Subjective pain scores were determined before and after the injection.Results: Thirty of the thirty-four patients obtained immediate relief of the neck pain following injection into the subacromial space, and the remaining four had substantial pain relief when they were evaluated three weeks following the injection. Avoidance of the shoulder impingement position (forward elevation of the arm above 90°) subsequently minimized recurrences.Conclusions: In selected patients, chronic neck pain may be caused by shoulder impingement, which can be easily diagnosed with standard techniques. The difficulty in making this diagnosis is that the patient presents with neck pain rather than with the typical shoulder pain. The differential diagnosis of chronic lower neck pain should include shoulder impingement syndrome, which can be identified by classic physical and radiographic signs and can be treated with injection into the subacromial space and avoidance of the shoulder impingement position.Level of Evidence: Diagnostic study, Level IV-2 (poor reference standard). See Instructions to Authors for a complete description of levels of evidence.
Motivation and language behavior: a content analysis of suicide notes.

WHENEVER a person produces a message, whether it be conversation, an ordinary letter to a relative, or a suicide note, he employs a complex set of encoding habits. It seems reasonable to assume that these language habits are organized in much the same way as the habits underlying nonlanguage behavior and that the general principles of learning and performance therefore apply equivalently in both cases. This paper is concerned with the effects of motivation upon language behavior. It is assumed that the author of a suicide note—presumably written shortly before he takes his own life—is functioning under heightened motivation. Therefore, the structure and content of suicide notes should differ from both ordinary letters and from simulated suicide notes in certain ways predictable from a general theory of behavior. Following a brief theoretical discussion, we describe the application of a number of relevant content measures to a comparison, first, of suicide notes with ordinary letters to relatives and, second, of suicide notes with faked notes. Many of these measures differentiate in predicted ways suicide notes from normal control notes; a smaller number differentiate suicide from simulated suicide notes, suggesting that nonsuicidal individuals are able to adopt the state of the suicidal person in some respects but not in others. Language habits, like habits in general, appear to be organized into hierarchies of alternatives. We shall assume that increased drive has two distinct effects upon selection within such hierarchies: generalized energizing effects and specific cue effects (cf., Osgood, 1957, for a more complete analysis). The generalized energizing effects of drives
In the Shadow of Coal: How Large-Scale Industries Contributed to Present-Day Regional Differences in Personality and Well-Being

Recent research has identified regional variation of personality traits within countries but we know little about the underlying drivers of this variation. We propose that the Industrial Revolution, as a key era in the history of industrialized nations, has led to a persistent clustering of well-being outcomes and personality traits associated with psychological adversity via processes of selective migration and socialization. Analyzing data from England and Wales, we examine relationships between the historical employment share in large-scale coal-based industries (coal mining and steam-powered manufacturing industries that used this coal as fuel for their steam engines) and today’s regional variation in personality and well-being. Even after controlling for possible historical confounds (historical energy supply, education, wealth, geology, climate, population density), we find that the historical local dominance of large-scale coal-based industries predicts today’s markers of psychological adversity (lower Conscientiousness [and order facet scores], higher Neuroticism [and anxiety and depression facet scores], lower activity [an Extraversion facet], and lower life satisfaction and life expectancy). An instrumental variable analysis, using the historical location of coalfields, supports the causal assumption behind these effects (with the exception of life satisfaction). Further analyses focusing on mechanisms hint at the roles of selective migration and persisting economic hardship. Finally, a robustness check in the U.S. replicates the effect of the historical concentration of large-scale industries on today’s levels of psychological adversity. Taken together, the results show how today’s regional patterns of personality and well-being (which shape the future trajectories of these regions) may have their roots in major societal changes underway decades or centuries earlier.
A province-wide needs assessment of oncology health care professionals in psychosocial oncology.

BACKGROUND Oncology professionals still lack the knowledge and skills to provide effective psychosocial care. Continuing education (CE) aimed at addressing this lack may improve the provision of psychosocial care to patients and their families. METHODS The authors conducted a province-wide cross-sectional mail survey of oncology health care professionals [oncologists (MDs), nurses (RNs) and radiation therapists (RTs)] and assessed psychosocial orientation, self-assessed knowledge, and motivation to learn about psychosocial oncology. In addition, they sought factors that might influence professionals' willingness to attend CE programs. RESULTS In total, 241 surveys were completed and returned. Psychosocial orientation was highest in the RN subgroup. MDs rated their knowledge to deal with specific psychosocial issues higher than did RNs and RTs, while their motivation to learn more about providing psychosocial care was significantly lower. Seventy-three percent of respondents indicated that they would like CE in psychosocial oncology. Self-reported motivation to learn was the most significant factor associated with this interest. CONCLUSION These findings raise questions about perceived learning needs and aided in the development of an interprofessional curriculum in psychosocial oncology.
Paced-Walk and Step Tests to Assess Exertional Dyspnea in COPD

This study reports on the development and test-retest reproducibility of a modified shuttle walking and step testing protocols to assess exertional dyspnea in patients with COPD. Patients with COPD randomly performed four externally paced 3-min bouts of shuttle walking at 1.5, 2.5, 4.0 and 6.0 km·h− 1 or stepping at constant rate of 18, 22, 26 and 32 steps·min− 1. Walking and stepping procedures were repeated once, on a separate occasion. Ventilation, heart rate, gas exchange parameters and dyspnea Borg scores were obtained at the end of each exercise bout. Most patients completed walking or stepping at the slow and middle speed cadences but only 33% completed walking at 6.0 km·h− 1 and 40% completed stepping at 32 steps·min− 1. Walking and stepping at progressively faster pace caused a progressive increase in ventilation and dyspnea. Test-retest Pearson correlation coefficients for ventilation, heart rate, gas exchange parameters and dyspnea scores over the four exercise bouts, all exceeded 0.80. Intra-class correlation coefficients were at least as strong as Pearson coefficients. Bland & Altman representation showed that for repeated Borg scores, 92 and 96% of points lied within 2 SD of the mean difference between test-retest values for walking and stepping. The majority of moderate and severe COPD patients completed the 3-min shuttle waking testing at 1.5 to 4.0 km·h− 1 and the 3-min of step testing at rates between 18 and 26 steps·min− 1. Both field tests were highly reproducible in patients with COPD.
A Semi-Lagrangian Finite Volume Method for Newtonian Contraction Flows

A new finite volume method for solving the incompressible Navier--Stokes equations is presented. The main features of this method are the location of the velocity components and pressure on different staggered grids and a semi-Lagrangian method for the treatment of convection. An interpolation procedure based on area-weighting is used for the convection part of the computation. The method is applied to flow through a constricted channel, and results are obtained for Reynolds numbers, based on half the flow rate, up to 1000. The behavior of the vortex in the salient corner is investigated qualitatively and quantitatively, and excellent agreement is found with the numerical results of Dennis and Smith [ Proc. Roy. Soc. London A, 372 (1980), pp. 393--414] and the asymptotic theory of Smith [J. Fluid Mech. , 90 (1979), pp. 725--754].
A Smart Phone Based Accident Fall Detection, Positioning and Rescue System

This paper proposes the architecture of accident fall detection, positioning and rescue system that uses 3G networks. To perceive the fall detection algorithm, the angles acquired by the electronic compass and the waveform sequence of the tri-axial accelerometer on the smart phone are used as the system inputs. The obtained signals are used to produce an ordered feature sequence and then tested in consecutive way by the proposed cascade classifier for identification purpose. As soon as equivalent characteristic is confirmed by the classifier at the current state, it can continue to the state; contrarily the system will come back to the initial state and halt for the emergence of another feature sequence. When a fall accident event is diagnosed the victim’s position can be acquired by global positioning system (GPS) and forwarded to the rescue centre via 3G network so that immediate medical help can be provided.With the proposed cascaded classification architecture, the computational burden and power consumption issue on the smart phone system can be mollified. Moreover, known fall incident detection accuracy and reliability up to 92% on the sensitivity and 99. 75% on the specificity.
Towards safer endoscopic retrograde cholangiopancreatography (ERCP)

EDITOR,-Diagnostic and therapeutic ERCPs are the most dangerous procedures regularly performed by medical gastroenterologists. The leading article from Thornton and Axon (Gut 1993; 34: 721-4) discussing safety aspects is pertinent and helpful, but omits several key points and references. The first problem is knowing what published figures mean. Bad outcomes cannot be discussed, studied, or minimised, without clear definitions. Suggested definitions for complications (and severity) were made recently after a consensus conference involving 25 experts in ERCP.2 Reported data vary according to the completeness of their collection. Most retrospective (certainly multicenter) studies minimise the problems, and prospective analyses almost always show higher rates. Another issue is that the risk of a bad outcome is certainly influenced by the severity of the patient's presenting illness and burden of concomitant diseases. We cannot assess our results, or compare them with others, without being able to describe the risk factor spectrum of our patient material.2 Furthermore, the significance ofany risk ofcomplication must be judged against the available alternative techniques in that specific clinical context. Pancreatitis is the commonest complication ofERCP. Thornton and Axon give it only a few lines, stating that 'clinically significant pancreatitis occurs in only about 2% of procedures. ' It depends what you mean by 'clinically significant'. Much higher figures have been published.3 We are still seeing this complication with distressing frequency at Duke University Medical Center. In a strict prospective computer based study using agreed definitions, we have recorded a total of 160 complications in 3001 ERCP procedures performed over the last three years. One hundred and thirteen (71%) were pancreatitis, an incidence of 3-7%; most cases (55%) were graded as mild (less than three days in hospital). Sphincter of Oddi manometry carries a 12% pancreatitis rate at this institution. The whole problem of pancreatitis after ERCP has been discussed exhaustively by Sherman and Lehman recently in an important review article, with 181 references.3 Unfortunately there have been no major breakthroughs in understanding or prevention. The hope that non-ionic contrast materials might be safer has not been realised in a large randomised controlled trial.4 Many studies have failed to show any protective value of drugs given before ERCP; the latest showed that prophylactic somatostatin actually increased the risk of pancreatitis.5 It is surprising that the leading article has nothing to say about training, as emphasised by my colleagues in the accompanying letter. Although difficult to prove, it is probable that quality training and substantial ongoing experience have some effect on the results of our interventions. Indeed, there is a danger that widespread application of these potentially dangerous techniques in inexperienced hands will cause them to fall into disrepute.
Reduced joining of DNA double strand breaks with an abnormal mutation spectrum in rodent mutants of DNA-PKcs and Ku80.

PURPOSE To characterize further the contribution of the DNA-PK-dependent dsb repair pathway in mammalian cells. MATERIALS AND METHODS The efficiency and fidelity of the joining of linear plasmids by DNA-PKcs-defective mouse cells (SCID) and Ku80-defective Chinese hamster ovary cells (xrs-6) was measured using either linear or circular replicating shuttle vector pZ189. RESULTS The authors found a 3.9-10.7-fold reduced joining of the DNA ends, as compared with wild-type cells. Mutation analysis of the joining site revealed that the joining process was not hypermutable in the mutated cells. However, the SCID and xrs-6 cells produced a different spectrum of mutations at the joining site with a significantly lower proportion of insertions or more complex mutations. CONCLUSIONS The remaining joining ability of the mutant cells points to an alternative DNA-PK-independent pathway of dsb repair. Comparison of these data with similar data from yeast suggest that the postulated alternative pathway of dsb repair is at least as efficient and less error-prone in rodent cells.
Investigation of the Antioxidative Potential of Various Solvent Fractions from Fruiting Bodies of Schizophyllum commune (Fr.) Mushrooms and Characterization of Phytoconstituents

The aim of the present study was to investigate the antioxidative potential of components extracted from the indigenous medicinal mushroom, Schizophyllum commune, using solvents of different polarities. The effectiveness of antioxidants in each solvent fraction was evaluated by quantitating the total phenolic content, 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, cupric ion reducing antioxidant capacity (CUPRAC), peroxidation inhibition in the egg yolk system, metal chelating potential, and β-carotene bleaching activity. Our findings revealved that the ethyl acetate fraction of S. commune had a phenolic content of 82.42±7.23 and exhibited good activities for DPPH radical scavenging (70.52±2.17%), CUPRAC (0.38±0.03), peroxidation inhibition (73.38±1.39%), metal chelating (81.29±4.19%), and β-carotene bleaching (63.25±2.5%) at concentration of 0.1 to 1.0 mg/mL. In addition, gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry were used to determine the volatile and non-volatile constituents of the potent antioxidative ethyl acetate fraction from cultivated S. commune fruiting bodies. This comprehensive analysis demonstrates that the ethyl acetate fraction of S. commune fruiting bodies is a viable source of natural antioxidants that can be utilized for functional foods and nutraceutical applications.
How well are patients doing up to 30 years after a mustard operation?

BACKGROUND Right heart failure and baffle complications may affect the health status of patients with transposition of the great arteries after an atrial switch operation. METHODS This study aims to identify risk factors for late death, the incidence of reoperations, and the functional status of 88 patients who underwent a Mustard operation with a mean follow-up of 20.9 +/- 10.0 years. RESULTS There were 7 early and 19 late deaths. Follow-up was complete for 97 % of the hospital survivors. Survival and freedom from reoperation of the hospital survivors at 20 years was 83.7 +/- 4.2 %, and 70.6 +/- 5.4 %, respectively. Seven reoperations were performed for systemic ventricular failure, and 24 for baffle complications, with no operative mortality. Presence of a ventricular septal defect at the time of the Mustard operation was predictive for late death in multivariate analysis ( P = 0.040). At follow-up, 82 % of the patients were able to work full-time, 11 % part-time, and 7 % experienced noticeable limitations of their activities. CONCLUSIONS Presence of a VSD at the time of the Mustard operation defines a distinct subgroup with an increased risk for late death. Long-term survivors were in a good functional status but had to be reoperated frequently due to baffle complications that seemed to increase in adulthood.
Role of dihydrotestosterone in androgen action

Androgen action differs from that of most hormones in that testosterone, the major androgen secreted from the testes and the most abundant androgen in the circulation of men, is not the principal androgen within target cells. Indeed, abundant evidence indicates that most androgen actions are mediated by the 5α‐reduced metabolite dihydrotestosterone that is formed in target tissues. The conversion of testosterone to dihydrotestosterone is mediated by two isoenzymes; mutations in the steroid 5α‐reductase 2 gene cause a rare autosomal‐recessive form of male pseudohermaphroditism, and inhibition of this enzyme causes regression of the prostate gland. Dihydrotestosterone binds more tightly to the androgen receptor than does testosterone, but it is not clear whether this property is the sole explanation for its essential role in androgen action. Nor is it clear whether some androgenic effects may be mediated by circulating dihydrotestosterone acting as a hormone. © 1996 Wiley‐Liss, Inc.
Molecular mechanisms governing thymocyte migration: combined role of chemokines and extracellular matrix

Cell migration is crucial for thymocyte differentiation, and the cellular interactions involved now begin to be unraveled, with chemokines, extracellular matrix (ECM) proteins, and their corresponding receptors being relevant in such oriented movement of thymocytes. This notion derives from in vitro, ex vivo, and in vivo experimental data, including those obtained in genetically engineered and spontaneous mutant mice. Thymic microenvironmental cells produce both groups of molecules, whereas developing thymocytes express chemokine and ECM receptors. It is important that although chemokines and ECM proteins can drive thymocyte migration per se, a combined role of these molecules likely concurs for the resulting migration patterns of thymocytes in their various differentiation stages. In this respect, among ECM moieties, there are proteins with opposing functions, such as laminin or fibronectin versus galectin‐3, which promote, respectively, adhesion and de‐adhesion of thymocytes to the thymic microenvironment. How chemokines and ECM are produced and degraded remains to be more clearly defined. Nevertheless, matrix metalloproteinases (MMPs) likely play a role in the intrathymic ECM breakdown. It is interesting that these molecules also degrade chemokines. Thus, the physiological migration of thymocytes should be conceived as a resulting vector of multiple, simultaneous, or sequential stimuli, involving chemokines, adhesive, and de‐adhesive ECM proteins. Moreover, these interactions may be physiologically regulated in situ by matrix MMPs and are influenced by hormones. Accordingly, one can predict that pathological changes in any of these loops may result in abnormal thymocyte migration. This actually occurs in the murine infection by the protozoan Trypanosoma cruzi, the causative agent of Chagas disease. In this model, the abnormal release of immature thymocytes to peripheral lymphoid organs is correlated with the higher migratory response to ECM and chemokines. Lastly, the fine dissection of the mechanisms governing thymocyte migration will provide new clues for designing therapeutic strategies targeting developing T cells. The most important function of the thymus is to generate T lymphocytes, which once leaving the organ, are able to colonize specific regions of peripheral lymphoid organs, the T cell zones, where they can mount and regulate cell‐mediated, immune responses. This intrathymic T cell differentiation is a complex sequence of biological events, comprising cell proliferation, differential membrane protein expression, gene rearrangements, massive programmed cell death, and cell migration. In this review, we will focus on the mechanisms involved in controlling the migration of thymocytes, from the entrance of cell precursors into the organ to the exit of mature T cells toward peripheral lymphoid organs. Nevertheless, to better comprehend this issue, it appeared worthwhile to briefly comment on some key aspects of thymocyte differentiation and the tissue context in which it takes place, the thymic microenvironment.
Intermittent PTH Administration Stimulates Pre‐Osteoblastic Proliferation Without Leading to Enhanced Bone Formation in Osteoclast‐Less c‐fos−/− Mice

This study aimed to investigate the behavior and ultrastructure of osteoblastic cells after intermittent PTH treatment and attempted to elucidate the role of osteoclasts on the mediation of PTH‐driven bone anabolism. After administering PTH intermittently to wildtype and c‐fos−/− mice, immunohistochemical, histomorphometrical, ultrastructural, and statistical examinations were performed. Structural and kinetic parameters related to bone formation were increased in PTH‐treated wildtype mice, whereas in the osteoclast‐deficient c‐fos−/− mice, there were no significant differences between groups. In wildtype and knockout mice, PTH administration led to significant increases in the number of cells double‐positive for alkaline phosphatase and BrdU, suggesting active pre‐osteoblastic proliferation. Ultrastructural examinations showed two major pre‐osteoblastic subtypes: one rich in endoplasmic reticulum (ER), the hypER cell, and other with fewer and dispersed ER, the misER cell. The latter constituted the most abundant preosteoblastic phenotype after PTH administration in the wildtype mice. In c‐fos−/− mice, misER cells were present on the bone surfaces but did not seem to be actively producing bone matrix. Several misER cells were shown to be positive for EphB4 and were eventually seen rather close to osteoclasts in the PTH‐administered wildtype mice. We concluded that the absence of osteoclasts in c‐fos−/− mice might hinder PTH‐driven bone anabolism and that osteoclastic presence may be necessary for full osteoblastic differentiation and enhanced bone formation seen after intermittent PTH administration.