Miracle-dz/UniFAR-FTUs huggingface dataset:
Information overload and missed test results in electronic health record-based settings.

cal one, especially because of the rapid proliferation of decision aids. However, reducing alert fatigue comes at the expense of a higher rate of false negatives (lower sensitivity). If the alert threshold were increased from 40% to 80%, this would increase its specificity even further, but such an approach would have limited clinical utility. The best way to determine the right threshold is to prospectively test the tool in real-world settings and examine how it changes physician treatment behavior and/or the outcomes and efficiency of patient care. What about the use of chest radiography as part of the computerized screening tool? The chest radiograph is considered the reference standard for the diagnosis of pneumonia, despite the fact that it is neither 100% sensitive, nor 100% specific. Pneumonia can be present in the absence of an acute radiographic infiltrate, particularly among elderly patients with dehydration at the time of presentation. In addition, substantial interobserver variation among ED physicians and even radiologists has been well documented for the interpretation of chest radiographic findings compatible with pneumonia. Notably, 59% of the false positives of the reported screening tool were due to incorrect reading of the imaging reports using natural language processing. If trained radiologists cannot agree, it comes as no surprise that the tool itself also has difficulty interpreting radiography reports. Perhaps a more basic need in the diagnosis of pneumonia is to standardize the interpretation and reporting of chest radiographic findings prior to attempting to integrate such findings into a computerized decision aid. This innovative and unique tool may foreshadow the future of medicine—a future in which vast amounts of data are synthesized by computers to improve physician diagnosis and treatment decisions. As others have discussed, the quality and accuracy of diagnosis is often overlooked in most efforts to improve quality and safety, which instead focus on the management of alreadydiagnosed problems. Although there is clearly a role for decision-support tools, prior to their wide adoption they will need to show an incremental benefit over physician judgment alone and demonstrate improvements in patient outcomes.
Snack purchasing is healthier when the cognitive demands of choice are reduced: A randomized controlled trial.

OBJECTIVE Individuals with inefficient executive (higher level cognitive) function have a reduced ability to resist dietary temptation. The present study aimed to design and test a theory-based point-of-purchase intervention for coffee shops that reduced the calorie content of customers' purchases by reducing the need for executive function (EF) at the moment of choice. METHODS Key facets of EF were identified by a multidisciplinary group and used to develop a point-of-purchase intervention (signage). This intervention was evaluated in a randomized controlled trial (RCT) in a public coffee shop on consumer purchases of >20,000 snacks and drinks over 12 weeks. A sample of customers (n = 128) was recruited to complete an embedded cross-sectional study measuring EF strength, dietary intentions, typical purchases, and purchases made after exposure to the intervention. RESULTS The proportion of snack purchases that were high in calorie reduced significantly (t(10) = 2.34, p = . 04) in intervention weeks relative to control. High calorie drink purchases were also lower in intervention than control weeks, however, this difference was not significant (t(10) = 1.56, p = . 15). On average, customers purchased items containing 66 calories < usual after exposure to the intervention. The magnitude of the intervention's positive effect on customer behavior increased as EF strength decreased (β = .24, p = .03). CONCLUSIONS The calorie content of cafe purchases can be lowered by reducing the cognitive demands of healthy food choice at the moment of purchase, especially in those with poor EF. Environmental changes like these have the potential to help achieve population weight control.
Cone structure in patients with usher syndrome type III and mutations in the Clarin 1 gene.

OBJECTIVE To study macular structure and function in patients with Usher syndrome type III (USH3) caused by mutations in the Clarin 1 gene (CLRN1). METHODS High-resolution macular images were obtained by adaptive optics scanning laser ophthalmoscopy and spectral domain optical coherence tomography in 3 patients with USH3 and were compared with those of age-similar control subjects. Vision function measures included best-corrected visual acuity, kinetic and static perimetry, and full-field electroretinography. Coding regions of the CLRN1 gene were sequenced. RESULTS CLRN1 mutations were present in all the patients; a 20-year-old man showed compound heterozygous mutations (p.N48K and p.S188X), and 2 unrelated women aged 25 and 32 years had homozygous mutations (p.N48K). Best-corrected visual acuity ranged from 20/16 to 20/40, with scotomas beginning at 3° eccentricity. The inner segment-outer segment junction or the inner segment ellipsoid band was disrupted within 1° to 4° of the fovea, and the foveal inner and outer segment layers were significantly thinner than normal. Cones near the fovea in patients 1 and 2 showed normal spacing, and the preserved region ended abruptly. Retinal pigment epithelial cells were visible in patient 3 where cones were lost. CONCLUSIONS Cones were observed centrally but not in regions with scotomas, and retinal pigment epithelial cells were visible in regions without cones in patients with CLRN1 mutations. High-resolution measures of retinal structure demonstrate patterns of cone loss associated with CLRN1 mutations. CLINICAL RELEVANCE These findings provide insight into the effect of CLRN1 mutations on macular cone structure, which has implications for the development of treatments for USH3. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00254605.
Potential of pretreatment neural activity in the visual cortex during emotional processing to predict treatment response to scopolamine in major depressive disorder.

CONTEXT The need for improved treatment options for patients with major depressive disorder (MDD) is critical. Faster-acting antidepressants and biomarkers that predict clinical response will facilitate treatment. Scopolamine produces rapid antidepressant effects and thus offers the opportunity to characterize potential biomarkers of treatment response within short periods. OBJECTIVE To determine if baseline brain activity when processing emotional information can predict treatment response to scopolamine in MDD. DESIGN A double-blind, placebo-controlled, crossover study together with repeated functional magnetic resonance imaging, acquired as participants performed face-identity and face-emotion working memory tasks. SETTING National Institute of Mental Health Division of Intramural Research Programs. PARTICIPANTS Fifteen currently depressed outpatients meeting DSM-IV criteria for recurrent MDD and 21 healthy participants, between 18 and 55 years of age. MAIN OUTCOME MEASURE The magnitude of treatment response to scopolamine (percentage of change in the Montgomery-Asberg Depression Rating Scale score between study end and baseline) was correlated with blood oxygen level-dependent (BOLD) signal associated with each working memory component (encode, maintenance, and test) for both identity and emotion tasks. Treatment response also was correlated with change in BOLD response (scopolamine vs baseline). Baseline activity was compared between healthy and MDD groups. RESULTS Baseline BOLD response in the bilateral middle occipital cortex, selectively during the stimulus-processing components of the emotion working memory task (no correlation during the identity task), correlated with treatment response magnitude. Change in BOLD response following scopolamine administration in overlapping areas in the middle occipital cortex while performing the same task conditions also correlated with clinical response. Healthy controls showed higher activity in the same visual regions than patients with MDD during baseline. CONCLUSION These results implicate cholinergic and visual processing dysfunction in the pathophysiology of MDD and suggest that neural response in the visual cortex, selectively to emotional stimuli, may provide a useful biomarker for identifying patients who will respond favorably to scopolamine. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00055575.
Childhood Amnesia in Children: A Prospective Study Across Eight Years.

This was a prospective study of earliest memories across 8 years for 37 children who were of age 4-9 years initially. In three interviews (initial and after 2 and 8 years) children provided their three earliest memories; those from earlier interviews that were not spontaneously provided later were cued. There was little consistency in the earliest memory or overlap across interviews in spontaneous memories. The youngest group also forgot over half their initial memories although few were forgotten by older children. For consistency of content, 25%-32% of information by former 6- to 9-year-olds was the same after 8 years, but < 10% provided by the youngest children was the same and 22% was contradictory. Emotion and contextual coherence predicted memory retention.
Peer Problems Among Postinstitutionalized, Internationally Adopted Children: Relations to Hypocortisolism, Parenting Quality, and ADHD Symptoms.

Seventy-eight postinstitutionalized (PI) children adopted at ages 17-36 months were assessed 2, 8, 16, and 24 months postadoption on measures of cortisol and parenting quality, and compared to same-aged children adopted from foster care (FC, n = 45) and nonadopted children (NA, n = 45). In kindergarten (Mage = 6.0 years), teachers, parents, and trained observers completed measures of peer relationships and attention deficit hyperactivity disorder (ADHD) symptoms. PI children had more peer problems and ADHD symptoms according to teachers and observers than NA children with FC children in between, whereas both PI and FC children were at significantly greater risk of hypocortisolism (i.e., blunted cortisol diurnal rhythm and reactivity). Hypocortisolism and ADHD symptoms mediated the association between preadoption adversity and peer difficulties. Higher postadoption parenting quality was protective.
Exploring the impact of oral diseases and disorders on quality of life of preschool children.

OBJECTIVE To assess the impact of oral health outcomes on Oral Health-Related Quality of Life (OHRQoL) in a school-based sample of Brazilian preschool children and their families. METHODS A cross-sectional study was conducted in 1036 children aged 2-5 years attending all the public nurseries in Canoas, Brazil. Caregivers were asked to complete questionnaire on socioeconomic status and the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the children's OHRQoL. Clinical assessment included dental caries, traumatic dental injuries (TDI) and malocclusion. Multivariable Poisson regression models with robust variance were fitted to assess covariates for the prevalence of impacts on OHRQoL following a theoretical hierarchical framework. RESULTS 17.4% of the caregivers reported that their child had an impact on at least one ECOHIS item. Negative impacts were more prevalent on items related to pain, difficult drinking and eating some foods. The multivariable Poisson regression analysis showed that dental caries, TDI and malocclusion were associated with the outcome. The prevalence of having any impact on OHRQoL was almost three times higher for children with dental caries (PR 2.74 95% CI 2.02-3.72) compared to those who were caries free; and approximately 1.5 times higher for those who presented TDI (PR 1.70 95% CI 1.27-2.27) and malocclusion (PR 1.42 95% CI 1.04-1.94). CONCLUSIONS The findings showed that caregivers of young children with oral disease and disorders perceived that both the children and other family members had poorer quality of life. Oral health policies should be included into general health programs based on common risk approach.
Obesity and Cancer Risk: Hypothesis of Competing Causes

Recent evidence suggests an important association between obesity and several cancers. However, the possibility of a causal relationship between obesity and cancer, and competing risk factors are also being investigated. As such, several mechanisms have been proposed for different obesity-cancer pathways. In addition, the benefits of cancer patient weight loss and physical activity have also been noted. As the ramifications of obesity and overweight adults continue to provide challenges to our society, increasing attention is warranted to more comprehensively investigate the association between cancer and obesity.
The alleged "Ferguson Effect" and police willingness to engage in community partnership.

In response to increasing violent crime rates in several U.S. cities over the past year, some have pointed the finger of blame at de-policing, a result of the so-called "Ferguson Effect. " Although the Ferguson Effect on crime rates remains an open question, there may also be a Ferguson Effect on other aspects of police officers' jobs, such as willingness to partner with community members. This study used data from a cross-sectional survey of 567 deputies at an agency in the southeastern U.S. to accomplish 2 objectives: (a) to determine whether the Ferguson Effect is associated with de-policing in the form of decreased willingness to engage in community partnership, and (b) to determine whether such an effect persists upon accounting for perceived organizational justice and self-legitimacy. Ordinary least squares (OLS) regression equations revealed that the Ferguson Effect (as operationalized by reduced motivation stemming from recent negative publicity) was associated with less willingness to engage in community partnership (b = -.10; 95% CI = -.16, -.05). However, upon accounting for organizational justice and self-legitimacy, the Ferguson Effect was rendered insignificant (b = .01; 95% CI = -.05, .07). The findings suggest that officers who have confidence in their authority or perceive their agency as fair are more willing to partner with the community to solve problems, regardless of the effects of negative publicity.
Detecting Deception in Children: A Meta-Analysis

Although research reveals that children as young as 3 can use deception and will take steps to obscure truth, research concerning how well others detect children’s deceptive efforts remains unclear. Yet adults regularly assess whether children are telling the truth in a variety of contexts, including at school, in the home, and in legal settings, particularly in investigations of maltreatment. We conducted a meta-analysis to synthesize extant research concerning adults’ ability to detect deceptive statements produced by children. We included 45 experiments involving 7,893 adult judges and 1,858 children. Overall, adults could accurately discriminate truths/lies at an average rate of 54%, which is slightly but significantly above chance levels. The average rate at which true statements were correctly classified as honest was higher (63.8%), whereas the rate at which lies were classified as dishonest was not different from chance (47.5%). A small positive correlation emerged between judgment confidence and judgment accuracy. Professionals (e.g., social workers, police officers, teachers) slightly outperformed laypersons (e.g., college undergraduates). Finally, exploratory analyses revealed that the child’s age did not significantly affect the rate at which adults could discriminate truths/lies from chance. Future research aimed toward improving lie detection accuracy might focus more on individual differences in children’s lie-telling abilities in order to uncover any reliable indicators of deception.
Psychosocial correlates of oral hygiene behaviour in people aged 9 to 19 - a systematic review with meta-analysis.

OBJECTIVES This systematic and meta-analytic review aimed to quantify the association of psychosocial correlates with oral hygiene behaviour among 9- to 19-year olds. METHODS A systematic search up to August 2015 was carried out using the following databases: PubMed, PsycInfo, Embase, CINAHL and Web of Science. If necessary, authors of studies were contacted to obtain unpublished statistical information. A study was eligible for inclusion when it evaluated the association between the psychosocial correlates and oral hygiene behaviour varying from self-reports to clinical measurements, including plaque and bleeding scores. A modified New Castle Ottawa Scale was applied to examine the quality of the included studies. RESULTS Twenty-seven data sets (k) presented in 22 publications, addressing nine psychosocial correlates, were found to be eligible for the meta-analysis. For both tooth brushing and oral hygiene behaviour, random effect models revealed significant weighted average correlation (r+ ) for the psychosocial factors: 'intention', 'self-efficacy', 'attitude' (not significant for tooth brushing), 'social influence', 'coping planning' and 'action planning' (r+ ranging from 0.18 to 0.57). Little or no associations were found for 'locus of control', 'self-esteem' and 'sense of coherence' (r+ ranges from 0.01 to 0.08). CONCLUSIONS The data at present indicates that 'self-efficacy', 'intention', 'social influences', 'coping planning' and 'action planning' are potential psychosocial determinants of oral health behaviour. Future studies should consider a range of psychological factors that have not been studied, but have shown to be important psychosocial determinants of health behaviours, such as 'self-determination', 'anticipated regret', 'action control' and 'self-identity'. Effectiveness of addressing these potential determinants to induce behaviour change should be further examined by intervention trials.
Oral health status of children in Los Angeles County and in the United States, 1999–2004

OBJECTIVE To ascertain and compare the oral health status and related sociodemographic risk indicators in children in Los Angeles (LA) County with children in the United States. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 were used to calculate prevalence estimates for children aged 2-13 years living in LA County and in the United States. Sociodemographic indicators were evaluated using multiple logistic regression modeling. RESULTS Overall, children in LA County were more likely to experience dental caries than children in the United States in 1999-2004. In the primary dentition, nearly 40% of preschool children residing in LA County had dental caries compared to 28% of same-age children in the United States. Among children aged 6-13, 44% living in LA County had dental caries in the permanent dentition compared to 27% in the United States. Mexican American children in LA County had higher caries experience in permanent teeth (but not in primary teeth) than US Mexican American children. Among children aged 6-9 years, there was no difference in the prevalence of dental sealants in permanent teeth between those living in LA County and in the United States. However, among children aged 10-13 years, dental sealants were more than twice as prevalent in US children (40.8%) than in LA County children (17.5%). Among LA County children, the adjusted odds of having caries experience or untreated dental caries in permanent teeth were not higher among children from lower income families than in lower income children in the United States. CONCLUSIONS Children residing in LA County had less favorable oral health than children in the United States in 1999-2004. The usual sociodemographic caries risk indicators identified among children in the United States were not consistently observed among children in LA County. Unlike in the wider United States, poverty was not a risk indicator for dental caries in older children in LA County.
Laparoscopic Lymphadenectomy and Radical or Modified Radical Vaginal Hysterectomy for Endometrial and Cervical Carcinoma: Preliminary Experience

ABSTRACT With the standard vaginal surgical approaches to gynecologic malignancy, it is often difficult to remove the adnexa or to detect metastases in the abdominal cavity or the retroperitoneal lymph nodes. To address these difficulties, we studied a combined laparoscopic-vaginal surgical approach in patients with endometrial and early cervical carcinoma. A total of 15 patients were treated by this method, and 15 patients who had undergone standard exploratory laparotomy procedures were used as matched controls. Results indicate that with the laparoscopic-vaginal procedure there was a reduction in operative blood loss, number of patients transfused, number of blood transfusions, number of days with urinary catheter, and number of days in the hospital. Complications were about evenly distributed in the two groups. The laparoscopy procedures lasted 32 min longer, on average, than the laparotomies. Although a smaller number of lymph nodes were accounted for in the laparoscopy group, in these patients no vi.
Cognitive functioning in people with chronic fatigue syndrome: a comparison between subjective and objective measures.

OBJECTIVE The purpose of this study was to examine the relationship between subjective and objective assessments of memory and attention in people with chronic fatigue syndrome (CFS), using tests that have previously detected deficits in CFS samples and measures of potential confounds. METHOD Fifty people with CFS and 50 healthy controls were compared on subjective (memory and attention symptom severity, Cognitive Failures Questionnaire, Everyday Attention Questionnaires) and objective (California Verbal Learning Test, Rey-Osterreith Complex Figure Test, Paced Auditory Serial Addition Test, Stroop task) measures of memory and attention. Fatigue, sleep, depression, and anxiety were also assessed. RESULTS The CFS group reported experiencing more cognitive problems than the controls, but the two groups did not differ on the cognitive tests. Scores on the subjective and objective measures were not correlated in either group. Depression was positively correlated with increased severity of cognitive problems in both the CFS and control groups. CONCLUSIONS There is little evidence for a relationship between subjective and objective measures of cognitive functioning for both people with CFS and healthy controls, which suggests that they may be capturing different constructs. Problems with memory and attention in everyday life are a significant part of CFS. Depression appears to be related to subjective problems but does not fully explain them.