Miracle-dz/UniFAR-FTUs huggingface dataset:
The problem of back pain in physiotherapists

The epidemiology, subjective perception of the cause, consequences and attitudes towards their back pain were compared in a representative group of 249 physiotherapists and a control group of 236 predominantly female workers from a wide range of non-medical occupations. In addition, the physiotherapists were asked about their involvement in back care education for others, their own training and their present speciality. A self-completion questionnaire was used and the results were analysed using the Statistical Package for Social Sciences (SPSS-X). There were no significant differences between the groups in the occurrence of lifetime prevalence (ever had back pain? ), annual prevalence (back pain last year), annual incidence (new cases of back pain last year), and point prevalence (back pain now). The anatomical distribution was similar, as was the number of episodes. Earlier precautions to avoid further back pain did not affect the recurrence rate.Significantly more of the physiotherapists than the control.
Ethics in Home Care

With the growth of in-home care provision, ethical questions have arisen. This articles looks at some of these questions for the purpose of discussion and awareness. Ethical questions arise from several facets of in-home care, including the paid staff/caregivers, the provider organization, the clients, and the family of clients, as well as the industry as a whole. This author shares information for the intent of increasing awareness and information sharing to the industry.
Phenotypical Manifestations of Mutations in the Genes Encoding Subunits of the Cardiac Sodium Channel

Variations in the gene encoding for the major sodium channel (Nav1.5) in the heart, SCN5A, has been shown to cause a number of arrhythmia syndromes (with or without structural changes in the myocardium), including the long-QT syndrome (type 3), Brugada syndrome, (progressive) cardiac conduction disease, sinus node dysfunction, atrial fibrillation, atrial standstill, and dilated cardiomyopathy. Of equal importance are variations in genes encoding for various subunits and regulatory proteins interacting with the &agr;-subunit Nav1.5 and modifying its function. Based on detailed studies of genotype–phenotype relationships in these disease entities, on detailed studies of the basic electrophysiological phenotypes (heterologous expressed wild-type and mutant sodium channels and their interacting proteins), and on attempts to integrate the obtained knowledge, the past 15 years has witnessed an explosion of knowledge about these disease entities.
Diagnostic Workup of the Short Child

Documents detailing the diagnostic approach to identification of short stature in children have been generated following several consensus meetings. Besides assessment of medical history and a physical examination, specific tests are proposed based on clinical suspicion. In the absence of abnormal findings, patients are typically screened using laboratory tests and radiographs of the hand. However, there is limited evidence as to the choice of screening components; these decisions are based on clinical experience. To improve the diagnostic approach in children with short stature, diagnostic tools should be improved to allow better characterization of patient subpopulations and better measures of certain parameters.
Enlargement of the sella turcica in pseudotumor cerebri.

OBJECT The sella turcica usually appears partially empty in MR images obtained from patients with chronic elevation of intracranial pressure. The authors measured the size of the sella turcica to determine if enlargement of the pituitary fossa explains the partially empty sella associated with pseudotumor cerebri. METHODS The medical records from 2005 to 2011 of a single neuro-ophthalmologist were searched to identify consecutive patients with pseudotumor cerebri. Age-matched control patients were selected from the same practice. The sella turcica and pituitary gland were measured on sagittal T1-weighted MR images. RESULTS Measurements were obtained for 48 patients with pseudotumor cerebri and 48 controls. The cross-sectional area of the sella was 38% greater in the patients with pseudotumor cerebri, with only a slight reduction in mean pituitary gland size. CONCLUSIONS Chronic elevation of intracranial pressure is associated with bony enlargement of the sella turcica. Enlargement of the sella turcica contributes to its partially empty appearance.
Three-Dimensional 123I-Meta-Iodobenzylguanidine Cardiac Innervation Maps to Assess Substrate and Successful Ablation Sites for Ventricular Tachycardia: Feasibility Study for a Novel Paradigm of Innervation Imaging

Background—Innervation is a critical component of arrhythmogenesis and may present an important trigger/substrate modifier not used in current ventricular tachycardia (VT) ablation strategies. Methods and Results—Fifteen patients referred for ischemic VT ablation underwent preprocedural cardiac 123I- meta-iodobenzylguanidine (123I-mIBG) imaging, which was used to create 3-dimensional (3D) innervation models and registered to high-density voltage maps. 3D 123I-mIBG innervation maps demonstrated areas of complete denervation and 123I-mIBG transition zone in all patients, which corresponded to 0% to 31% and 32% to 52% uptake. 123I-mIBG denervated areas were ≈2.5-fold larger than bipolar voltage–defined scar (median, 24.6% [Q1–Q3, 18.3%–34.4%] versus 10.6% [Q1–Q3, 3.9%–16.4%]; P<0.001) and included the inferior wall in all patients, with no difference in the transition/border zone (11.4% [Q1–Q3, 9.5%–13.2%] versus 16.6% [Q1–Q3, 12.0%–18.8%]; P=0.07). Bipolar/unipolar voltages varied widely within areas of denervation (0.8 mV [Q1–Q3, 0.3–1.7 mV] and 4.0 mV [Q1–Q3, 2.9–5.6 mV]) and 123I-mIBG transition zones (0.8 mV [Q1–Q3, 0.4–1.8 mV] and 4.6 mV [Q1–Q3, 3.2–6.3 mV]). Bipolar voltages in denervated areas and 123I-mIBG transition zones were <0.5 mV, 0.5 to 1.5 mV, and >1.5 mV in 35%, 36%, and 29%, as well as 35%, 35%, and 30%, respectively (P>0.05). Successful ablation sites were within bipolar voltage–defined scar (7%), border zone (57%), and areas of normal voltage (36%), but all ablation sites were abnormally innervated (denervation/123I-mIBG transition zone in 50% each). Conclusions—123I-mIBG innervation defects are larger than bipolar voltage–defined scar and cannot be detected with standard voltage criteria. Thirty-six percent of successful VT ablation sites demonstrated normal voltages (>1.5 mV), but all ablation sites were within the areas of abnormal innervation. 123I-mIBG innervation maps may provide critical information about triggers/substrate modifiers and could improve understanding of VT substrate and facilitate VT ablation. Clinical Trial Registration—URL: http://www.clinicaltrials. gov. Unique Identifier: NCT01250912.
Peritonitis due to Vancomycin‐Resistant Enterococci: A Case Report and Review of the Literature

Chronic peritoneal dialysis–associated peritonitis is the leading cause of patient morbidity and dropout from this therapy, despite improvements in the connection devices used in chronic peritoneal dialysis (CPD) and research aimed at better understanding the risk factors that predispose patients to the development of peritonitis (1). Vancomycin has been recommended as a particularly useful antibiotic in managing CPD-associated peritonitis (2). Thus, the recent emergence of vancomycin-resistant organisms, including enterococci, coagulase-negative staphylococci, andStaphylococcus aureus , responsible for CPD-associated peritonitis is of particular concern (3–7). We now describe a recent episode of vancomycinresistant enterococci (VRE) peritonitis developing in a patient maintained on CPD therapy in our unit and review the risk factors, treatment strategies, patient outcomes, and future concerns regarding the emergence of vancomycin resistance.
Sorting with Self-Organizing Maps

A self-organizing feature map (Von der Malsburg 1973; Kohonen 1984) sorts n real numbers in O(n) time apparently violating the O(n log n) bound. Detailed analysis shows that the net takes advantage of the uniform distribution of the numbers and, in this case, sorting in O(n) is possible. There are, however, an exponentially small fraction of pathological distributions producing O(n2) sorting time. It is interesting to observe that standard learning produced a smart sorting algorithm.
Duration and Exposure to Virtual Environments: Sickness Curves During and Across Sessions

Although simulator sickness is known to increase with protracted exposure and to diminish with repeated sessions, limited systematic research has been performed in these areas. This study reviewed the few studies with sufficient information available to determine the effect that exposure duration and repeated exposure have on motion sickness. This evaluation confirmed that longer exposures produce more symptoms and that total sickness subsides over repeated exposures. Additional evaluation was performed to investigate the precise form of this relationship and to determine whether the same form was generalizable across varied simulator environments. The results indicated that exposure duration and repeated exposures are significantly linearly related to sickness outcomes (duration being positively related and repetition negatively related to total sickness). This was true over diverse systems and large subject pools. This result verified the generalizability of the relationships among sickness, exposure duration, and repeated exposures. Additional research is indicated to determine the optimal length of a single exposure and the optimal intersession interval to facilitate adaptation.
Cancer Statistics, 2009

Each year, the American Cancer Society estimates the number of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. Incidence and death rates are standardized by age to the 2000 United States standard million population. A total of 1,479,350 new cancer cases and 562,340 deaths from cancer are projected to occur in the United States in 2009. Overall cancer incidence rates decreased in the most recent time period in both men (1.8% per year from 2001 to 2005) and women (0.6% per year from 1998 to 2005), largely because of decreases in the three major cancer sites in men (lung, prostate, and colon and rectum [colorectum]) and in two major cancer sites in women (breast and colorectum). Overall cancer death rates decreased in men by 19.2% between 1990 and 2005, with decreases in lung (37%), prostate (24%), and colorectal (17%) cancer rates accounting for nearly 80% of the total decrease. Among women, overall cancer death rates between 1991 and 2005 decreased by 11.4%, with decreases in breast (37%) and colorectal (24%) cancer rates accounting for 60% of the total decrease. The reduction in the overall cancer death rates has resulted in the avoidance of about 650,000 deaths from cancer over the 15‐year period. This report also examines cancer incidence, mortality, and survival by site, sex, race/ethnicity, education, geographic area, and calendar year. Although progress has been made in reducing incidence and mortality rates and improving survival, cancer still accounts for more deaths than heart disease in persons younger than 85 years of age. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population and by supporting new discoveries in cancer prevention, early detection, and treatment. CA Cancer J Clin 2009;59:225‐249. 2009 American Cancer Society, Inc.
Prognostic Significance of PD-L1+ and CD8+ Immune Cells in HPV+ Oropharyngeal Squamous Cell Carcinoma

Assessment of CD8+ cell infiltration and PD-L1 expression on intratumoral immune cells identified a subgroup of HPV+ OPSCC patients with excellent clinical outcomes. Immunophenotyping tumors provided prognostic information beyond that provided by existing TNM-based staging systems. Human papilloma virus–positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) represents a distinct subgroup of head and neck cancers associated with clinical outcomes that are not accurately categorized by existing tumor–node–metastasis-based staging methods. Given the significant impact of immune parameters, such as tumor-infiltrating lymphocytes (TIL) in many cancers, we sought to determine if immunophenotyping tumors can improve categorization of HPV+ OPSCCs for prognostic purposes. In a cohort of 190 patients with HPV+ OPSCC, we quantified and determined the localization of CD8+ TILs, as well as PD-L1–expressing tumor cells (TC) and immune cells (IC). The prognostic significance of these parameters on overall survival (OS) was evaluated, and their contribution to existing prognostic models was determined. High CD8+ TIL abundance (≥30% on stromal or intratumoral ICs) was seen in 61.3% patients and was associated with improved OS [HR, 0.4; 95% confidence interval (CI), 0.2–0.9; P = 0.017]. Although the expression of PD-L1 on TC was not prognostic, high expression of PD-L1 on ≥5% of intratumoral ICs was found in 38.5% patients and was significantly associated with improved OS (HR, 0.37; 95% CI, 0.15–0.93; P = 0. 023). Both high intratumoral IC PD-L1 expression and abundant CD8+ TILs in HPV+ OPSCCs identify subgroups of patients with excellent outcomes and provide additional prognostic information beyond existing staging systems. Cancer Immunol Res; 6(3); 295–304. ©2018 AACR.
A methodology to counter DoS attacks in mobile IP communication

Similar to wired communication, Mobile IP communication is susceptible to various kinds of attacks. Of these attacks, Denial of Service DoS attack is considered as a great threat to mobile IP communication. The number of approaches hitherto proposed to prevent DoS attack in the area of mobile IP communication is much less compared to those for the wired domain and mobile ad hoc networks. In this work, the effects of Denial of Service attack on mobile IP communication are analyzed in detail. We propose to use packet filtering techniques that work in different domains and base stations of mobile IP communication to detect suspicious packets and to improve the performance. If any packet contains a spoofed IP address which is created by DoS attackers, the proposed scheme can detect this and then filter the suspected packet. The proposed system can mitigate the effect of Denial of Service DoS attack by applying three methods: i by filtering in the domain periphery router ii by filtering in the base station and iii by queue monitoring at the vulnerable points of base-station node. We evaluate the performance of our proposed scheme using the network simulator NS-2. The results indicate that the proposed scheme is able to minimize the effects of Denial of Service attacks and improve the performance of mobile IP communication.
Naturally occurring infections in non-human primates (NHP) and immunotoxicity implications: Discussion sessions

Non-human primates (NHP) are used to best understand and address pharmacology and toxicology obligations for human patients with highest and/or unmet need. In order to ensure the most appropriate care and use of NHP, it is important to understand the normal micro flora and fauna of NHP and ensure their utmost health to generate the most valuable and applicable data. There are many infections, including viral, bacterial, parasitic, and fungal that may perturb physiologic endpoints relevant to human health, and are essential to monitor and/or eradicate for NHP health. This publication captures a discussion involving the experience, knowledge and opinion from academic, industry and government experts regarding emerging and normal infections in NHP as they relate to immunotoxicity, and treatment and consequences of known infections.
Prevalence and Risk Factors of Somatic and Autonomic Neuropathy in Prediabetic and Diabetic Patients

Aims/Hypothesis: To investigate the prevalence and correlates of somatic and autonomic neuropathies concurrently in prediabetic and diabetic subjects in the general population. Subjects and Methods: Nerve conduction and heart rate variability studies were used for detecting both types of diabetic neuropathy. Of 1,576 inhabitants, 143 persons were identified as prediabetic or having diabetic mellitus. One hundred and thirty-three persons completed a nerve conduction test and 118 persons a valid heart rate variability test. Significant correlates responsible for diabetic neuropathies were also collected. Results: The prevalence rates of definite, probable and no somatic neuropathy were 9.0% (12/133), 20.3% (27/133) and 70.7% (94/133), respectively. The corresponding figures for autonomic neuropathy were 14.4% (17/118), 54.2% (64/118) and 31.4% (37/118). The prevalence rate for the presence of both neuropathies was 16.9%. In a univariate analysis, age, renal insufficiency, HbA1c and fasting glucose level were significantly associated with somatic neuropathy whereas only systolic blood pressure was statistically significantly associated with autonomic neuropathy. In a multivariate analysis, systolic blood pressure and fasting glucose level were positively associated with somatic neuropathy and systolic blood pressure remained statistically significant for autonomic neuropathy. Conclusions: The prevalence of autonomic neuropathy is twofold compared with somatic neuropathy. Concurrence of the two kinds of neuropathy was approximately half of sole somatic neuropathy and a quarter of sole autonomic neuropathy. Systolic blood pressure and fasting glucose level were related to somatic neuropathy whereas only systolic blood pressure was correlated with autonomic neuropathy.
Relationship between vestibular sensitivity and multisensory temporal integration.

A single event can generate asynchronous sensory cues due to variable encoding, transmission, and processing delays. To be interpreted as being associated in time, these cues must occur within a limited time window, referred to as a "temporal binding window" (TBW). We investigated the hypothesis that vestibular deficits could disrupt temporal visual-vestibular integration by determining the relationships between vestibular threshold and TBW in participants with normal vestibular function and with vestibular hypofunction. Vestibular perceptual thresholds to yaw rotation were characterized and compared with the TBWs obtained from participants who judged whether a suprathreshold rotation occurred before or after a brief visual stimulus. Vestibular thresholds ranged from 0.7 to 16.5 deg/s and TBWs ranged from 13.8 to 395 ms. Among all participants, TBW and vestibular thresholds were well correlated ( R2 = 0.674, P < 0.001), with vestibular-deficient patients having higher thresholds and wider TBWs. Participants reported that the rotation onset needed to lead the light flash by an average of 80 ms for the visual and vestibular cues to be perceived as occurring simultaneously. The wide TBWs in vestibular-deficient participants compared with normal functioning participants indicate that peripheral sensory loss can lead to abnormal multisensory integration. A reduced ability to temporally combine sensory cues appropriately may provide a novel explanation for some symptoms reported by patients with vestibular deficits. Even among normal functioning participants, a high correlation between TBW and vestibular thresholds was observed, suggesting that these perceptual measurements are sensitive to small differences in vestibular function. NEW & NOTEWORTHY While spatial visual-vestibular integration has been well characterized, the temporal integration of these cues is not well understood. The relationship between sensitivity to whole body rotation and duration of the temporal window of visual-vestibular integration was examined using psychophysical techniques. These parameters were highly correlated for those with normal vestibular function and for patients with vestibular hypofunction. Reduced temporal integration performance in patients with vestibular hypofunction may explain some symptoms associated with vestibular loss.
METASTATIC BREAST CARCINOMA WITH MULTIPLE OSTEOLYTIC LESIONS - A DIAGNOSTIC DILEMMA

Bone is one of the common sites for distant metastasis from breast cancer. About 6%- 10% of breast carcinomas have already spread to distant sites at the time of initial diagnosis. Presence of bone metastasis affects patient's prognosis and the planning of treatment. We report a case of 32year old female who presented with a subtrochanteric fracture left femur and multiple osteolytic lesions throughout the axial skeleton leading to clinical suspicion of multiple myeloma. Hematological work up suggested a metastatic deposit. Subsequent detailed examination revealed a breast lump in right breast. On core biopsy it was diagnosed as duct cell carcinoma. This report addresses the role of bone marrow examination in arriving at a diagnosis in multiple osteolytic lesions which pose wide differential diagnoses.
Estimated Global, Regional, and National Disease Burdens Related to Sugar-Sweetened Beverage Consumption in 2010

Background— Sugar-sweetened beverages (SSBs) are consumed globally and contribute to adiposity. However, the worldwide impact of SSBs on burdens of adiposity-related cardiovascular diseases (CVDs), cancers, and diabetes mellitus has not been assessed by nation, age, and sex. Methods and Results— We modeled global, regional, and national burdens of disease associated with SSB consumption by age/sex in 2010. Data on SSB consumption levels were pooled from national dietary surveys worldwide. The effects of SSB intake on body mass index and diabetes mellitus, and of elevated body mass index on CVD, diabetes mellitus, and cancers were derived from large prospective cohort pooling studies. Disease-specific mortality/morbidity data were obtained from Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We computed cause-specific population-attributable fractions for SSB consumption, which were multiplied by cause-specific mortality/morbidity to compute estimates of SSB-attributable death/disability. Analyses were done by country/age/sex; uncertainties of all input data were propagated into final estimates. Worldwide, the model estimated 184 000 (95% uncertainty interval, 161 000–208 000) deaths/y attributable to SSB consumption: 133 000 (126 000–139 000) from diabetes mellitus, 45 000 (26 000–61 000) from CVD, and 6450 (4300–8600) from cancers. Five percent of SSB-related deaths occurred in low-income, 70.9% in middle-income, and 24.1% in high-income countries. Proportional mortality attributable to SSBs ranged from <1% in Japanese >65 years if age to 30% in Mexicans <45 years of age. Among the 20 most populous countries, Mexico had largest absolute (405 deaths/million adults) and proportional (12.1%) deaths from SSBs. A total of 8.5 (2.8, 19.2) million disability-adjusted life years were related to SSB intake (4.5% of diabetes mellitus–related disability-adjusted life years). Conclusions— SSBs are a single, modifiable component of diet that can impact preventable death/disability in adults in high-, middle-, and low-income countries, indicating an urgent need for strong global prevention programs.