Miracle-dz/UniFAR-FTUs huggingface dataset:
Phenylmercuric acetate as primary irritant.

To the Editor. — This letter is in reference to an article by Fisher et al which appeared in the September issue of theArchives(104:286, 1971). Following Dr. Fisher's recommendation for a vehicle tray, we have begun using such a tray in the Dermatology Clinic at Letterman General Hospital. In the first three patients tested, the only positive reactions have been 4+ vesicular eruptions at the site of application of phenylmercuric acetate 0.1% in petrolatum. This, of course, suggested that the reaction was an irritant rather than contact dermatitis. I therefore treated myself with the same substance and found I was unable to tolerate the patch longer than 24 hours. Upon removing it, I found again, as in three out of three previous patients, a 4+ vesicular patch test reaction. I would like, therefore, to respectfully suggest that phenylmercuric acetate is capable of eliciting an intense primary irritant reaction and
Case of Rheumatoid Arthritis of Two Years' Duration Successfully Treated at Woodhall Spa

ON Friday, August 20th, my partner, Mr. Husband, was sent for to see a joiner named W. G. ; and, in his absence, I went. I found W. G. in bed; he informed me that he met with his accident in the following way. He was sitting upon the roof of a shed in his yard, with his legs hanging over the side, doing some repairs, when he suddenly slipped, coming to the ground upon his feet, a distance of from six to eight feet. He rolled on the ground; and, upon attempting to rise and walk, found he was unable to do so. He was then carried into the house. Upon making an examination, I found the left knee-joint very much swollen from effuLsion into it; and also detected a transverse fracture of the tibia, just below the tuberosities, the separated portion being split into two pieces, apparently from the lower end having been driven into the upper one. The outer tuberosity was displaced somewhat outwards, and the head of the tibia measured an inch more in circumference than the sound one. The fibula was not broken. Mr. Husband afterwards examined the leg, and quite agreed with me as to the nature of the injury. The limb was placed upon a Macintyre's splint, slightly bent, and an evaporating lotion applied to the knee. It was kept upon this a little over five weeks, when the splint was taken off, and a gum-and-chalk bandage put on. The peculiarity of the case is that the head of the tibia should be fractured by indirect violence, and with such apparent ease, the distance which he fell being at the most eight feet. As a rule, the bone that is injured from a fall upon the feet is the femur, either the neck or the shaft; and the reason is manifest, there being but one bone in the thigh to receive the shock. In the leg, the case is different; there being two bones, the fibula as well as the tibia must sustain some of the force; and, in this case, the fibula was not injured, but the tibia was broken at its thickest part. The patient informed me that the leg was perfectly right before the accident. The man, the recipient of the injury, is sixty-one years of age, but looks older, has the arcus senilis well marked, and his arteries, also, are in a rigid condition (atheroma ? ), showing that the tissues are undergoing a process of degeneration. His bones seem peculiarly liable to fracture, as he tells me that he has previously sustained fractures of the right tibia and ulna, and also some ribs. I have referred to several surgical works, but can find no mention of a fracture of the upper end of the tibia being occasioned in this manner, all writers giving direct violence as the cause.
THE HUMBLE BEGINNINGS OF THE STUDY OF NITROGEN EXCRETION IN FISH

> Tamara Rodela discusses Homer William Smith's classic paper ‘The excretion of ammonia and urea by the gills of fish’, published in the Journal of Biological Chemistry in 1929. Homer William Smith (1895–1962) was best known for his work as a renal physiologist. His extensive research on the
Long‐term outcome of serious traumatic brain injury

Summary Follow‐up studies on individuals who suffer severe head injury give a picture of poor cognitive and psychosocial outcome. However, recent evidence suggests that with the passage of time, many individuals make adjustments that compensate for early disability, leading to a reduction in social handicap with a corresponding improvement in life quality and personal satisfaction. This article will attempt to briefly review the main sources of evidence contributing to long‐term outcome following serious head trauma.
Nonlinear Acoustics for Structural Health Monitoring – Classical vs . Non-classical Approaches

The past two decades have marked significant research interest in nonlinearities produced in micro-cracked and cracked solids. These investigations have been based on the analysis of nonlinear static stress-strain characteristics and various ultrasonic wave interactions. Crack-induced elastic, thermo-elastic and dissipative-type nonlinearities have been observed within various material scales and for various strain levels. The paper gives an overview of classical and non-classical nonlinear acoustic damage detection methods. Modelling, numerical simulation and damage detection applications are briefly reviewed. Some examples of recent research developments – related to damage localisation, nonlinear guided waves and enhancement techniques are demonstrated.
Jones' Fractures and Related Fractures of the Proximal Fifth Metatarsal

At least three fracture types occur in the proximal fifth metatarsal: the Jones' fracture, the proximal diaphysial stress fracture, and the tuberosity avulsion fracture. Each has distinct characteristics. The diaphysial stress fracture is commonly confused with the Jones' fracture, thereby obscuring vital differences in prognosis and treatment. Anatomical and biomechanical characteristics, as well as vascular studies of the proximal portion of the fifth metatarsal, are discussed in an attempt to better understand their diverse healing potentials. Guidelines for treatment are controversial, and must frequently be individualized. Although surgical intervention for certain proximal fifth metatarsal fracture types may speed recovery time, most fractures heal with immobilization. Treatment of displaced, intra-articular fractures, delayed unions, and nonunions usually requires operative methods.
Mechanisms of replication fork protection: a safeguard for genome stability

During S-phase, the genome is extremely vulnerable and the progression of replication forks is often threatened by exogenous and endogenous challenges. When replication fork progression is halted, the intra S-phase checkpoint is activated to promote structural stability of stalled forks, preventing the dissociation of replisome components. This ensures the rapid resumption of replication following DNA repair. Failure in protecting and/or restarting the stalled forks contributes to alterations of the genome. Several human genetic diseases coupled to an increased cancer predisposition are caused by mutations in genes involved in safeguarding genome integrity during DNA replication. Both the ATR (ataxia telangiectasia and Rad3-related protein) kinase and the Replication pausing complex (RPC) components Tipin, Tim1 and Claspin play key roles in activating the intra S-phase checkpoint and in stabilizing the stalled replication forks. Here, we discuss the specific contribution of these factors in preserving fork structure and ensuring accurate completion of DNA replication.
Polycomb Ezh2 controls the fate of GABAergic neurons in the embryonic cerebellum

Although the genetic interactions between signaling pathways and transcription factors have been largely decoded, much remains to be learned about the epigenetic regulation of cerebellar development. Here, we report that cerebellar deletion of Ezh2, the methyltransferase subunit of the PRC2 complex, results in reduced H3K27me3 and profound transcriptional dysregulation, including that of a set of transcription factors directly involved in cerebellar neuronal cell-type specification and differentiation. Such transcriptional changes lead to increased GABAergic interneurons and decreased Purkinje cells. Transcriptional changes also inhibit the proliferation of granule precursor cells derived from the rhombic lip. The loss of both cell types ultimately results in cerebellar hypoplasia. These findings indicate Ezh2/PRC2 plays crucial roles in regulating neurogenesis from both cerebellar germinal zones. Summary: Cerebellar deletion of Ezh2 leads to increased GABAergic interneurons, decreased Purkinje cells and blocked proliferation of granule precursor cells derived from the rhombic lip.
Ultra‐fast imaging using low flip angles and fids

A new ultra‐fast imaging technique that does not place extreme demands on the speed of the gradient system is described. When used with comparable MRI systems, the rotating ultra‐fast imaging sequence (RUFIS) can acquire images 4 to 5 times faster than gradient‐moment nulled EPI and more than twice as fast as DUFIS, OUFIS, or BURST techniques. Because the technique uses free induction decays instead of echoes, it can be made particularly insensitive to effects of motion, flow, and diffusion. Preliminary images of turbulent flow are presented to demonstrate this insensitivity. However, with appropriate encoding, flow effects may be imaged.
Prediction of neurologic deterioration in patients with lacunar infarction in the territory of the lenticulostriate artery using perfusion CT.

BACKGROUND AND PURPOSE A significant proportion of patients with lacunar infarctions experience neurologic deterioration after onset. However, no clinical examination has been established for prediction of the progress of symptoms. To determine the hemodynamic predictors of such progression, we performed perfusion CT to quantitatively assess cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) of patients with lacunar infarctions in the territory of the lenticulostriate artery. METHODS We performed MR imaging and perfusion CT of 26 patients with lacunar infarction within 24 hr after onset. On the CBF map on perfusion CT scans, a round small region of interest was set at the region, with decreased CBF in the territory of the lenticulostriate artery (region of interest 1). Another region of interest was set in the mirror position to region of interest 1 in the contralateral hemisphere (region of interest 2). Using these two regions of interest, CBF, CBV, and MTT were measured. All patients underwent neurologic and MR imaging follow-up while receiving equivalent medical treatment. RESULTS Neurologic deterioration after onset was shown in 13 patients (progress group), whereas no neurologic deterioration was shown in the other 13 patients (control group). In the progress group, lacunar infarctions were enlarged on follow-up MR images. The ratio of region of interest 1/region of interest 2 showed significantly lower CBF and higher MTT in the progress group than in the control group. CONCLUSIONS These results suggest that progressive lacunar infarction in the territory of the lenticulostriate artery could be predicted with a higher MTT ratio (>1.26) and a lower CBF ratio (<0.76) on perfusion CT scans obtained within 24 hr after onset.
SACRAL Syndrome

We read the article SACRAL Syndrome: Spinal Dysraphism, Anogenital, Cutaneous, Renal and Urologic Anomalies, Associated with an Angioma of Lumbosacral Localization [1] . The association between cutaneous hemangiomas in the lumbosacral area and underlying developmental anomalies was first reported by Goldberg and Esterly over 20 years ago and the acronym PELVIS was recently published to emphasize this well-recognized association [2, 3] . We believe the authors highlight the importance of this association; however, they have underemphasized the importance of the location of the cutaneous hemangioma and associated anomalies. In the ‘Methods’ section, the authors state that they retrospectively reviewed all hemangiomas in the ‘perineal region’ not the lumbosacral region. The anatomic definition of the perineum is the region of the body between the anus and the opening of the urethra. This is a very important distinction as the perineum is derived from a separate embryonic unit than the lumbosacral region. Knowledge of developmental origin of the skin in these regions is essential and may help predict the risk of underlying anomalies and dictate the need for screening [4] . In this study, every patient with associated spinal dysraphism had hemangioma involving the skin of the midline lumbosacral region. So in essence the only infants that had occult (not obvious by physical examination) abnormalities had hemangiomas that involved the lumbosacral region of the skin. The skin overlying the lumbosacral region has an intimate developmental relationship with the neural tube, whereas sacral, coccegeal, and perineal skin does not. Cutaneous dimples over the lumbosacral region are often indicative of underlying spinal dysraphism whereas isolated anorectal, perineal, and sacral dimples are not associated with dysraphism. Hemangiomas in the perineal region are most often seen as an isolated finding and infrequently they may occur with obvious anogenital anomalies, as described in case number 1. The authors conclude that 4/9 ‘midline’ lesions had associated anomalies. The term ‘midline’ is used loosely, without specifying midline perineum, midline sacrum, or midline lumbar. A reader may be lead to believe all midline lesions need a screening MRI. In practice most practitioners do not screen all patients with perineal hemangiomas as the associated malformations are often easily visualized [5] . In contrast hemangiomas of the lumbosacral region are frequently markers of occult spinal anomalies that are often asymptomatic in young children and may result in the permanent neurologic deficits (tethered cord syndrome). Although the authors Dermatology 2007;215:360
GENETIC CONTROL OF RESPONSES TO BACTERIAL LIPOPOLYSACCHARIDES IN MICE

In vivo immune responses and in vitro mitogenic responses to bacterial lipopolysaccharides (LPS) have been compared in strains of C3H mice. C3H/HeJ spleen cultures did not support mitogenic responses to LPS and in vivo these mice produce low IgM responses to LPS. On the basis of these two responses, C3H/HeJ mice have been termed low LPS responders. All other strains of C3H mice tested (C3HeB/FeJ, C3H/DiSn, C3H/Str, CWB, CSW, and C3H/Sf and its H-2 congenics) are high LPS responders supporting large in vitro mitogenic and in vivo immune responses to LPS. The immune response difference between low and high LPS responders is a quantitative one. IgM responses are observed in C3H/HeJ mice in the range of 1.0–10 µg LPS. At lower and higher LPS concentrations, immune responses are not observed. In contrast, high LPS responders elicit LPS immune responses over a much wider dose range (0.1–200 µg). The ability to respond well to LPS is dominant as shown by the response of F1 hybrid mice of low responder and high responder strains. The linkage relationships of mitogenic and immune responsiveness to LPS have been investigated in backcross (C3H/HeJ x CWB)F1 x CWB mice. All mice that gave in vivo immune responses to LPS also supported mitogenic responses to LPS. The defect in C3H/HeJ mice that limits mitogenic and immune responsiveness to be due to a single autosomal gene which is not linked to the H-2 histocompatibility or heavy-chain allotype loci.
Measurement of shoulder related disability: results of a validation study.

OBJECTIVE--To develop and validate a questionnaire to quantify disability associated with shoulder symptoms. METHODS--A set of questions relevant to shoulder symptoms from a general disability interview was developed and the questionnaire applied to a cross-sectional population survey and a prospective study of general practice attenders. Subjects included adults who reported current shoulder pain in a population survey and patients from three general practices who attended with shoulder symptoms during a six month period. The main outcome measures were: frequency of problems with daily living related to shoulder symptoms, total score on 22-item disability questionnaire, and measures of shoulder movement. RESULTS--A higher proportion (80%) of patients attending their general practitioner with shoulder symptoms had five or more disabilities compared with subjects reporting shoulder pain in a community survey (34%). The ranked frequency with which each disability was reported was similar in the two groups, although sleep disturbance was the most common problem in consulters. Self-reported disability is correlated with measures of restricted shoulder movement. CONCLUSION--This disability questionnaire was simple to complete and should prove useful for both general practice and population-based studies of shoulder pain.
Prognostic significance of ventricular arrhythmia modified by ability to adapt to stressful situations.

BACKGROUND Ventricular arrhythmia is a risk factor for myocardial infarction and mortality but many individuals with this abnormality live long and healthy lives. The aim of this study is to analyse the prognostic significance of frequent and complex ventricular arrhythmia in men who differed regarding ability to adapt to a stressful situation. DESIGN Prospective cohort study. METHODS The serial Color Word Test is a semi-experimental way to assess how individuals behave in a stressful encounter. This test was included in the prospective cohort study 'Men born in 1914' together with 24-h ambulatory electrocardiographic recordings at a baseline examination in 1982/83. Behaviour in the test was categorized as either adaptive or maladaptive. Behaviour in the test and occurrence of ventricular arrhythmia at baseline were analyzed in relation to incidence of myocardial infarction and mortality during approximately 14 years of follow-up. RESULTS Multivariate analyses showed that ventricular arrhythmia was not associated with the incidence of myocardial infarction or all-cause mortality in the presence of an adaptive behaviour. Ventricular arrhythmia together with a maladaptive behaviour was associated with the incidence of myocardial infarction [relative risk (RR) 2.43; 95% confidence interval (CI) 1.37 to 4.31] and with all-cause mortality (RR 1.56; 95% CI 1.01 to 2.41) during follow-up. CONCLUSIONS A maladaptive behaviour in a stressful encounter makes men with electrocardiographically detected ventricular arrhythmias more vulnerable and thereby exposed to an increased risk of a future myocardial infarction and overall mortality.
Faster Aspart Versus Insulin Aspart as Part of a Basal-Bolus Regimen in Inadequately Controlled Type 2 Diabetes: The onset 2 Trial

OBJECTIVE This multicenter, double-blind, treat-to-target, phase 3 trial evaluated the efficacy and safety of fast-acting insulin aspart (faster aspart) versus insulin aspart (IAsp) in adults with type 2 diabetes receiving basal insulin and oral antidiabetic agents. RESEARCH DESIGN AND METHODS The primary end point was HbA1c change from baseline after 26 weeks’ treatment. After an 8-week run-in to optimize basal insulin, subjects were randomized (1:1) to mealtime faster aspart (n = 345) or IAsp (n = 344), titrated using a simple daily patient-driven algorithm, plus insulin glargine U100 and metformin. RESULTS HbA1c change was –1.38% (faster aspart) and –1.36% (IAsp); mean HbA1c was 6.6% for both groups. Faster aspart demonstrated noninferiority versus IAsp in reducing HbA1c (estimated treatment difference [ETD] [95% CI] –0.02% [–0.15; 0.10]). Both treatments improved postprandial plasma glucose (PPG) control; the PPG increment (liquid meal test) was statistically significant in favor of faster aspart after 1 h (ETD [95% CI] −0.59 mmol/L [−1.09; −0.09]; −10.63 mg/dL [−19.56; −1.69]; P = 0.0198), but not after 2–4 h. Change from baseline in fasting plasma glucose, body weight, and overall severe/blood glucose–confirmed hypoglycemia rates (rate ratio [RR] [95% CI] 1.09 [0.88; 1.36]) were similar between treatments. Postmeal hypoglycemia (0−2 h) rates were 2.27 (faster aspart) and 1.49 (IAsp) per patient-year of exposure (RR [95% CI] 1.60 [1.13; 2.27]). CONCLUSIONS Faster aspart and IAsp were confirmed noninferior in a basal-bolus regimen regarding change from baseline in HbA1c. Faster aspart improved 1-h PPG with no differences in 2−4-h PPG versus IAsp. Overall hypoglycemia rates were similar except for an increase in 0−2-h postmeal hypoglycemia with faster aspart.
Current Equalization in Photovoltaic Strings With Module Integrated Ground-Isolated Switched Capacitor DC–DC Converters

A ground-isolated switched capacitor (SC) dc-dc converter-based current equalization scheme for partially shaded photovoltaic (PV) strings of a grid-connected system is presented. SC converters are compact, light, and have very high efficiency even for a wide variation in load under certain operating conditions. These features make them ideal for integration with the PV module for current equalization. The factors affecting the maximum output power that the SC converter can deliver, the limiting value of the maximum output power, and efficiency issues of the SC converter are studied. These studies are required to optimize the design of the equalizing SC converter and to maximize its efficiency. A novel algorithm that utilizes the results of the aforementioned analysis to maximize the net power available due to the SC converter-based current equalization scheme for grid-connected applications is proposed. Experimental results showing the advantages of current equalization with SC converters as compared to that with conventional dc-dc converters are presented.
Impact of reduction of tinnitus intensity on patients’ quality of life

Abstract Objective: Assess the impact of a reduction of tinnitus intensity achieved through sound stimulation during sleep on the improvement in the patients’ quality of life. Design: Acoustic stimuli consisted of a highly customized sound that reproduced the spectral and intensity characteristics of the tinnitus in each patient. This stimulus was uploaded into a portable electronic device and delivered through customized ear buds during sleep, every night for three months. Study sample: Twelve patients with subjective idiopathic chronic tinnitus were studied. Results: Results were assessed through: (1) the measurement in dB SPL of tinnitus intensity reduction over time; (2) the results of three psychometric tests: Tinnitus handicap inventory (THI), Tinnitus reaction questionnaire (TRQ), Tinnitus functional index (TFI); and (3) a Visual analog scale (VAS) for tinnitus annoyance. After three months of treatment, we observed an average decrease in tinnitus intensity of 14.1 dB SPL (p < 0.001), implying a 62% reduction of the perceived sound. This improvement was followed by a statistically significant decrease of TRQ (78%), THI (65%), and TFI (77%). Conclusions: These results suggested that the intensity reduction achieved through the protocol used in this study had a direct impact on the improvement in the patients’ quality of life.
SUCCESSFUL TREATMENT OF PROGRESSIVE OUTER RETINAL NECROSIS SYNDROME

Purpose Progressive outer retinal necrosis is a destructive retinopathy found in patients with acquired immune deficiency syndrome. Treatment of this disorder has been unsuccessful in reported patient series, with the patients experiencing profound bilateral loss of vision. Methods We treated six patients with combination antiviral therapy, usually with intravenous foscarnet and either ganciclovir or acyclovir. Results These six patients retained a visual acuity of 20/100 or better in at least one eye for the remainder of their lives (a period >4 months for each patient). Retinal detachments developed in four patients, for which vitrectomy and silicone oil tamponade were required. Conclusions A combination of intravenous antiviral therapy and aggressive vitrectomy techniques to repair any associated detachments may allow the preservation of useful visual acuity in patients with progressive outer retinal necrosis. This is the first reported series of successful long-term treatment of patients with this disorder.