LLukas22/scidocs huggingface dataset:
Risk of death during and after opiate substitution treatment in primary care: prospective observational study in UK General Practice Research Database

OBJECTIVE
To investigate the effect of opiate substitution treatment at the beginning and end of treatment and according to duration of treatment.


DESIGN
Prospective cohort study. Setting UK General Practice Research Database.


PARTICIPANTS
Primary care patients with a diagnosis of substance misuse prescribed methadone or buprenorphine during 1990-2005. 5577 patients with 267 003 prescriptions for opiate substitution treatment followed-up (17 732 years) until one year after the expiry of their last prescription, the date of death before this time had elapsed, or the date of transfer away from the practice.


MAIN OUTCOME MEASURES
Mortality rates and rate ratios comparing periods in and out of treatment adjusted for sex, age, calendar year, and comorbidity; standardised mortality ratios comparing opiate users' mortality with general population mortality rates.


RESULTS
Crude mortality rates were 0.7 per 100 person years on opiate substitution treatment and 1.3 per 100 person years off treatment; standardised mortality ratios were 5.3 (95% confidence interval 4.0 to 6.8) on treatment and 10.9 (9.0 to 13.1) off treatment. Men using opiates had approximately twice the risk of death of women (morality rate ratio 2.0, 1.4 to 2.9). In the first two weeks of opiate substitution treatment the crude mortality rate was 1.7 per 100 person years: 3.1 (1.5 to 6.6) times higher (after adjustment for sex, age group, calendar period, and comorbidity) than the rate during the rest of time on treatment. The crude mortality rate was 4.8 per 100 person years in weeks 1-2 after treatment stopped, 4.3 in weeks 3-4, and 0.95 during the rest of time off treatment: 9 (5.4 to 14.9), 8 (4.7 to 13.7), and 1.9 (1.3 to 2.8) times higher than the baseline risk of mortality during treatment. Opiate substitution treatment has a greater than 85% chance of reducing overall mortality among opiate users if the average duration approaches or exceeds 12 months.


CONCLUSIONS
Clinicians and patients should be aware of the increased mortality risk at the start of opiate substitution treatment and immediately after stopping treatment. Further research is needed to investigate the effect of average duration of opiate substitution treatment on drug related mortality.
Dose-response for chiropractic care of chronic low back pain.

BACKGROUND CONTEXT
There have been no trials of optimal chiropractic care in terms of number of office visits for spinal manipulation and other therapeutic modalities.


PURPOSE
To conduct a pilot study to make preliminary identification of the effects of number of chiropractic treatment visits for manipulation with and without physical modalities (PM) on chronic low back pain and disability.


STUDY DESIGN/SETTING
Randomized controlled trial with a balanced 4x2 factorial design. Conducted in the faculty practice of a chiropractic college outpatient clinic.


PATIENT SAMPLE
Seventy-two patients with chronic, nonspecific low back pain of mechanical origin.


MAIN OUTCOME MEASURES
Von Korff pain and disability (100-point) scales.


METHODS
Patients were randomly allocated to visits (1, 2, 3 or 4 visits/week for 3 weeks) and to treatment regimen (spinal manipulation only or spinal manipulation with PM). All patients received high-velocity low-amplitude spinal manipulation. Half received one or two of the following PM at each visit: soft tissue therapy, hot packs, electrotherapy or ultrasound.


RESULTS
Pain intensity: At 4 weeks, there was a substantial linear effect of visits favoring a larger number of visits: 5.7 points per 3 visits (SE=2.3, p=.014). There was no effect of treatment regimen. At 12 weeks, the data suggested the potential for a similar effect of visits on patients receiving both manipulation and PM. Functional disability: At 4 weeks, a visits effect was noted (p=.018); the slope for group means was approximately 5 points per 3 visits. There were no group differences at 12 weeks.


CONCLUSIONS
There was a positive, clinically important effect of the number of chiropractic treatments for chronic low back pain on pain intensity and disability at 4 weeks. Relief was substantial for patients receiving care 3 to 4 times per week for 3 weeks.
Regional Variation in Postoperative Myocardial Infarction in Patients Undergoing Vascular Surgery in the United States.

BACKGROUND
The aim of this study is to assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following nonemergent vascular surgery across the United States to identify potential areas for quality improvement initiatives.


METHODS
We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups that comprised 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010 to 2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n = 39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n = 15,106), infrainguinal bypass (INFRA, n = 17,176), and open infrarenal AAA repair (OAAA, n = 3,657). POMI was categorized by the method of diagnosis as troponin-only or clinical/ECG and rates were investigated in regions with ≥100 consecutive cases. Regions with significantly different POMI rates were defined as those >1.5 interquartile lengths beyond the 75th percentile of the distribution. Risk-adjusted rates of POMI were assessed using the VQI Cardiac Risk Index all-procedures prediction model to compare the observed versus expected rates for each region.


RESULTS
Overall rates of POMI varied by procedure type: CEA 0.8%, EVAR 1.1%, INFRA 2.7%, and OAAA 4.2% (P < 0.001). Significant variation in POMI rates was observed between regions, resulting in differing ranges of POMI rates for each procedure: CEA 0.5-2.0% (P = 0.001), EVAR 0.3-3.1% (P < 0.001), INFRA 1.1-4.8% (P < 0.001), and OAAA 2.2-10.0% (P < 0.001). A single region in 3 of the 4 procedure-specific datasets was identified as a statistical outlier with a significantly higher POMI rate after CEA, EVAR, and OAAA; this region was identical for the EVAR and OAAA datasets but was a different region for the CEA dataset. No significant variation in POMI was noted between regions after INFRA. Procedure-specific clinical POMI rates (mean; range) were significantly different between regions for EVAR (0.4%; 0-1.1%, P = 0.01) and INFRA (1.4%; 0.5-2.9%, P = 0.01), but not for CEA (0.4%; 0-0.8%, P = 0.53) or OAAA (1.6%; 0-3.8%, P = 0.23). Procedure-specific troponin-only POMI rates (mean; range) were significantly different between regions for all procedures: CEA (0.4%; 0.1-1.2%, P < 0.001), EVAR (0.7%; 0-2.1%, P < 0.001), INFRA (1.3%; 0.4-2.5%, P = 0.001), and OAAA (2.5%; 0-8.5%, P < 0.001). After risk adjustment, regional variation was again noted with 3 regions having higher and 4 regions having lower than expected rates of POMI.


CONCLUSIONS
Significant variation in POMI rates following major vascular surgery exists across VQI regions even after risk adjustment. These findings may present an opportunity for focused regional quality improvement efforts.
ST-DBSCAN: An algorithm for clustering spatial-temporal data

This paper presents a new density-based clustering algorithm, ST-DBSCAN, which is based on DBSCAN. We propose three marginal extensions to DBSCAN related with the identification of (i) core objects, (ii) noise objects, and (iii) adjacent clusters. In contrast to the existing density-based clustering algorithms, our algorithm has the ability of discovering clusters according to non-spatial, spatial and temporal values of the objects. In this paper, we also present a spatial–temporal data warehouse system designed for storing and clustering a wide range of spatial–temporal data. We show an implementation of our algorithm by using this data warehouse and present the data mining results. 2006 Elsevier B.V. All rights reserved.
Content-Based Image Retrieval: Color-selection exploited

This research presents a new color selection interface that facilitates query-by-color in Content-Based Image Retrieval (CBIR). Existing CBIR color selection interfaces, are being judged as non-intuitive and difficult to use. Our interface copes with these problems of usability. It is based on 11 color categories, used by all people, while thinking of and perceiving color. In addition, its usability is supported by Fitts’ law. The design of the color selection interface provides fast, unambiguous, intuitive, and accurate color selection.
Capsular contracture rate in a low-risk population after primary augmentation mammaplasty.

BACKGROUND
The safety of augmentation mammaplasty has increased dramatically in the past 20 years. Capsular contracture (CC) is the most commonly reported complication of augmentation mammaplasty.


OBJECTIVES
The authors report the incidence of CC in a low-risk patient population after primary augmentation.


METHODS
The authors retrospectively reviewed the charts of 856 consecutive patients who underwent primary augmentation mammaplasty between 1999 and 2009. This series did not include patients who underwent breast augmentation-mastopexy, secondary augmentation, revision, and/or reconstruction. Data points included demographics, functional and aesthetic outcomes, complications, and revision rate/type.


RESULTS
The overall incidence of CC in 856 patients was 2.8%. Average follow-up time was 14.9 months. Antibiotic irrigation decreased CC rates from 3.9% to 0.4% (P = .004). Tobacco users had higher rates of contracture than nonsmokers (5.5% vs 1.9%; P = .036). Saline implants had a higher CC rate than silicone gel (4.3% vs 1.3%; P = .032). Using multivariate logistic regression, CC was 7.89 times more likely in saline implants than in silicone gel (P = .027, 95% confidence interval, 1.26-49.00).


CONCLUSIONS
Based on our findings, it is apparent that the early CC rate in primary augmentation can be less than 1%. To avoid CC, we advocate an inframmamary approach, submuscular implant placement, and antibiotic irrigation of the breast pocket.


LEVEL OF EVIDENCE
3.
PDE-Net 2.0: Learning PDEs from Data with A Numeric-Symbolic Hybrid Deep Network

Partial differential equations (PDEs) are commonly derived based on empirical observations. However, recent advances of technology enable us to collect and store massive amount of data, which offers new opportunities for data-driven discovery of PDEs. In this paper, we propose a new deep neural network, called PDE-Net 2.0, to discover (time-dependent) PDEs from observed dynamic data with minor prior knowledge on the underlying mechanism that drives the dynamics. The design of PDE-Net 2.0 is based on our earlier work [1] where the original version of PDE-Net was proposed. PDE-Net 2.0 is a combination of numerical approximation of differential operators by convolutions and a symbolic multi-layer neural network for model recovery. Comparing with existing approaches, PDE-Net 2.0 has the most flexibility and expressive power by learning both differential operators and the nonlinear response function of the underlying PDE model. Numerical experiments show that the PDE-Net 2.0 has the potential to uncover the hidden PDE of the observed dynamics, and predict the dynamical behavior for a relatively long time, even in a noisy environment.
Solution to Detect, Classify, and Report Illicit Online Marketing and Sales of Controlled Substances via Twitter: Using Machine Learning and Web Forensics to Combat Digital Opioid Access

BACKGROUND
On December 6 and 7, 2017, the US Department of Health and Human Services (HHS) hosted its first Code-a-Thon event aimed at leveraging technology and data-driven solutions to help combat the opioid epidemic. The authors—an interdisciplinary team from academia, the private sector, and the US Centers for Disease Control and Prevention—participated in the Code-a-Thon as part of the prevention track.


OBJECTIVE
The aim of this study was to develop and deploy a methodology using machine learning to accurately detect the marketing and sale of opioids by illicit online sellers via Twitter as part of participation at the HHS Opioid Code-a-Thon event.


METHODS
Tweets were collected from the Twitter public application programming interface stream filtered for common prescription opioid keywords in conjunction with participation in the Code-a-Thon from November 15, 2017 to December 5, 2017. An unsupervised machine learning–based approach was developed and used during the Code-a-Thon competition (24 hours) to obtain a summary of the content of the tweets to isolate those clusters associated with illegal online marketing and sale using a biterm topic model (BTM). After isolating relevant tweets, hyperlinks associated with these tweets were reviewed to assess the characteristics of illegal online sellers.


RESULTS
We collected and analyzed 213,041 tweets over the course of the Code-a-Thon containing keywords codeine, percocet, vicodin, oxycontin, oxycodone, fentanyl, and hydrocodone. Using BTM, 0.32% (692/213,041) tweets were identified as being associated with illegal online marketing and sale of prescription opioids. After removing duplicates and dead links, we identified 34 unique “live” tweets, with 44% (15/34) directing consumers to illicit online pharmacies, 32% (11/34) linked to individual drug sellers, and 21% (7/34) used by marketing affiliates. In addition to offering the “no prescription” sale of opioids, many of these vendors also sold other controlled substances and illicit drugs.


CONCLUSIONS
The results of this study are in line with prior studies that have identified social media platforms, including Twitter, as a potential conduit for supply and sale of illicit opioids. To translate these results into action, authors also developed a prototype wireframe for the purposes of detecting, classifying, and reporting illicit online pharmacy tweets selling controlled substances illegally to the US Food and Drug Administration and the US Drug Enforcement Agency. Further development of solutions based on these methods has the potential to proactively alert regulators and law enforcement agencies of illegal opioid sales, while also making the online environment safer for the public.
1 ( Language , Function and Cognition , 2011-12 ) Introduction to Systemic Functional Linguistics for Discourse Analysis

This course provides a basic introduction to Systemic Functional Linguistics (SFL) particularly in regards to those aspects most applicable to analyzing discourse.
Mirtazapine for anorexia nervosa with depression.

OBJECTIVE
To report the use of Mirtazapine in the treatment of anorexia nervosa with depression primarily regarding its propensity for weight gain.


METHOD
We present an outpatient case report of anorexia nervosa with depression. The patient's subsequent progress was recorded.


RESULTS
The patient gained 2.5 kg within 3 months to eventually attain a body mass index of 15 after 5 months. Her depression achieved full remission at 6 weeks of treatment.


CONCLUSIONS
Mirtazapine is the choice medication in this case. However, treating depression requires caution, given these patients' physical vulnerability. Controlled trials of Mirtazapine for anorexia nervosa are needed.
Effect of combination exercise training on metabolic syndrome parameters in postmenopausal women with breast cancer.

CONTEXT
Studies have shown that physical activity or exercise training may decrease the metabolic syndrome.


AIM
The aim of the present study is to clarify the effect of combination exercise training on metabolic syndrome parameters in postmenopausal women with breast cancer.


SETTING AND DESIGN
Twenty nine postmenopausal women (58.27 +/- 6.31 years) with breast cancer were divided into two groups randomly as experimental group (n=14) and control group (n=15).


MATERIALS AND METHODS
Subjects of experimental group were performed 15 weeks combination exercise training including walking (2 sessions per week) and resistance training (2 sessions per week that was different from walking days). Before and after 15 weeks, fasting insulin and glucose, insulin resistance, high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were calculated. Also, Vo2peak, rest heart rate (RHR), systolic blood pressure (SBP), body weight (BW), body mass index (BMI) and waist to hip ratio (WHR) were measured in two groups.


STATISTICAL ANALYSIS USED
Mean values of two groups in pre and post test were compared by independent and paired t-test for all measurements (P ≤ 0.05).


RESULTS
Significant differences were observed for VO2peak, RHR, BW, BMI, WHR, SBP, fasting insulin and glucose, HDL-C and TG between experimental and control groups after 15 weeks (P< 0.05).


CONCLUSIONS
Combination exercise training can improve metabolic syndrome parameters in postmenopausal women with breast cancer.
Assessment of Still and Moving Images in the Diagnosis of Gastric Lesions Using Magnifying Narrow-Band Imaging in a Prospective Multicenter Trial

OBJECTIVES
Magnifying narrow-band imaging (M-NBI) is more accurate than white-light imaging for diagnosing small gastric cancers. However, it is uncertain whether moving M-NBI images have additional effects in the diagnosis of gastric cancers compared with still images.


DESIGN
A prospective multicenter cohort study.


METHODS
To identify the additional benefits of moving M-NBI images by comparing the diagnostic accuracy of still images only with that of both still and moving images. Still and moving M-NBI images of 40 gastric lesions were obtained by an expert endoscopist prior to this prospective multicenter cohort study. Thirty-four endoscopists from ten different Japanese institutions participated in the prospective multicenter cohort study. Each study participant was first tested using only still M-NBI images (still image test), then tested 1 month later using both still and moving M-NBI images (moving image test). The main outcome was a difference in the diagnostic accuracy of cancerous versus noncancerous lesions between the still image test and the moving image test.


RESULTS
Thirty-four endoscopists were analysed. There were no significant difference of cancerous versus noncancerous lesions between still and moving image tests in the diagnostic accuracy (59.9% versus 61.5%), sensitivity (53.4% versus 55.9%), and specificity (67.0% versus 67.6%). And there were no significant difference in the diagnostic accuracy between still and moving image tests of demarcation line (65.4% versus 65.5%), microvascular pattern (56.7% versus 56.9%), and microsurface pattern (48.1% versus 50.9%). Diagnostic accuracy showed no significant difference between the still and moving image tests in the subgroups of endoscopic findings of the lesions.


CONCLUSIONS
The addition of moving M-NBI images to still M-NBI images does not improve the diagnostic accuracy for gastric lesions. It is reasonable to concentrate on taking sharp still M-NBI images during endoscopic observation and use them for diagnosis.


TRIAL REGISTRATION
Umin.ac.jp UMIN-CTR000008048.
Classification cost: An empirical comparison among traditional classifier, Cost-Sensitive Classifier, and MetaCost

Loan fraud is a critical factor in the insolvency of financial institutions, so companies make an effort to reduce the loss from fraud by building a model for proactive fraud prediction. However, there are still two critical problems to be resolved for the fraud detection: (1) the lack of cost sensitivity between type I error and type II error in most prediction models, and (2) highly skewed distribution of class in the dataset used for fraud detection because of sparse fraud-related data. The objective of this paper is to examine whether classification cost is affected both by the cost-sensitive approach and by skewed distribution of class. To that end, we compare the classification cost incurred by a traditional cost-insensitive classification approach and two cost-sensitive classification approaches, Cost-Sensitive Classifier (CSC) and MetaCost. Experiments were conducted with a credit loan dataset from a major financial institution in Korea, while varying the distribution of class in the dataset and the number of input variables. The experiments showed that the lowest classification cost was incurred when the MetaCost approach was used and when non-fraud data and fraud data were balanced. In addition, the dataset that includes all delinquency variables was shown to be most effective on reducing the classification cost. 2011 Elsevier Ltd. All rights reserved.
The relationship of palliative transurethral resection of the prostate with disease progression in patients with prostate cancer.

OBJECTIVES
To test, in a prostate-cancer population-based database, the validity of the finding that in single-institution series, palliative transurethral resection of prostate (TURP) is associated with an increased risk of progression.


PATIENTS AND METHODS
Using the Surveillance Epidemiology and END Results Registry, we identified men who had a TURP subsequent to their diagnosis of prostate cancer, from 1998 or 1999. The outcome of interest was disease progression, as defined by the initiation of androgen-deprivation therapy or procedures indicating progressive urinary obstruction. Multivariable logistic regression analysis was used to assess the adjusted odds of signal events related to disease progression adjusting for the concurrent effect of the covariates.


RESULTS
There were 29,361 men with prostate cancer and 2742 (9.3%) had a TURP after the diagnosis. These men had a mean age of 75 years and were unlikely to undergo definitive primary treatment. Men receiving TURP were more likely to undergo orchidectomy than men who did not have a TURP (odds ratio 1.64; 95% confidence interval 1.03-2.60) even after adjusting for differences in cancer-directed treatment, tumour stage and grade, prostate-specific antigen level, race, and age at diagnosis. These men were also more likely to have malignant urinary obstruction (ureteric and bladder outlet) than were men who did not have TURP.


CONCLUSION
The requirement for TURP is an adverse prognostic marker even when this is adjusted for classical tumour characteristics. Although the exact reasons for this finding are unclear, consideration should be given to adjuvant treatment in patients undergoing TURP.
Feminizing genitoplasty for congenital adrenal hyperplasia: what happens at puberty?

PURPOSE
We document the postpubertal outcome of feminizing genitoplasty.


MATERIALS AND METHODS
A total of 14 girls, mean age 13.1 years, with congenital adrenal hyperplasia were assessed under anesthesia by a pediatric urologist, plastic/reconstructive surgeon and gynecologist. Of these patients 13 had previously undergone feminizing genitoplasty in early childhood at 4 different specialist centers in the United Kingdom.


RESULTS
The outcome of clitoral surgery was unsatisfactory (clitoral atrophy or prominent glans) in 6 girls, including 3 whose genitoplasty had been performed by 3 different specialist pediatric urologists. Additional vaginal surgery was necessary for normal comfortable intercourse in 13 patients. Fibrosis and scarring were most evident in those who had undergone aggressive attempts at vaginal reconstruction in infancy.


CONCLUSIONS
These disappointing results, even in the hands of specialists, highlight the importance of late followup and challenge the prevailing assumption that total correction can be achieved with a single stage operation in infancy. Although simple exteriorization of a low vagina can reasonably be combined with cosmetic correction of virilized external genitalia in infancy, we now believe that in some cases it may be best to defer definitive reconstruction of the intermediate or high vagina until after puberty. The psychological issues surrounding sexuality in these patients are inadequately researched and poorly understood.