Miracle-dz/UniFAR-FTUs huggingface dataset:
Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Health Care System.

OBJECTIVES We examined prevalence of major medical conditions and extent of disease burden among patients with and without substance use disorders (SUDs) in an integrated health care system serving 3.8 million members. METHODS Medical conditions and SUDs were extracted from electronic health records in 2010. Patients with SUDs (n = 45,461; alcohol, amphetamine, barbiturate, cocaine, hallucinogen, and opioid) and demographically matched patients without SUDs (n = 45,461) were compared on the prevalence of 19 major medical conditions. Disease burden was measured as a function of 10-year mortality risk using the Charlson Comorbidity Index. P-values were adjusted using Hochberg's correction for multiple-inference testing within each medical condition category. RESULTS The most frequently diagnosed SUDs in 2010 were alcohol (57.6%), cannabis (14.9%), and opioid (12.9%). Patients with these SUDs had higher prevalence of major medical conditions than non-SUD patients (alcohol use disorders, 85.3% vs 55.3%; cannabis use disorders, 41.9% vs 23.0%; and opioid use disorders, 44.9% vs 26.1%; all P < 0.001). Patients with these SUDs also had higher disease burden than non-SUD patients; patients with opioid use disorders (M = 0.48; SE = 1.46) had particularly high disease burden (M = 0.23; SE = 0.09; P < 0.001). CONCLUSIONS Common SUDs, particularly opioid use disorders, are associated with substantial disease burden for privately insured individuals without significant impediments to care. This signals the need to explore the full impact SUDs have on the course and outcome of prevalent conditions and initiate enhanced service engagement strategies to improve disease burden.
A new parametric model for fitting fertility curves

What is the optimum way of describing the age-specific fertility pattern by mathematical functions? We propose a parametric fitting model, based on a mixture of Weibull functions, which performs well for countries where the fertility curve shows a non-traditional pattern. We also consider a simplified version of this model with a reduced number of parameters that can be applied to fit fertility curves in countries where the fertility pattern exhibits a classical shape. To test the new model, fertility curves for a range of countries and years are fitted empirically. The results show that both versions of the new model outperform existing procedures in most cases.
Household wealth and child health in India

Using data from the Indian National Family Health Surveys (1992–93, 1998–99, 2005–06), this study examined how the relationship between household wealth and child health evolved during a time of significant economic change in India. The main predictor was an innovative measure of household wealth that captures changes in wealth over time. Discrete-time logistic models (with community fixed effects) were used to examine mortality and malnutrition outcomes: infant, child, and under-5 mortality; stunting, wasting, and being underweight. Analysis was conducted at the national, urban/rural, and regional levels, separately for boys and girls. The results indicate that the relationship between household wealth and under-5 mortality weakened over time but this result was dominated by infant mortality. The relationship between wealth and child mortality stayed strong for girls. The relationship between household wealth and malnutrition became stronger over time for boys and particularly for girls, in urban and (especially) rural areas.
The educational gradient in marital disruption: A meta-analysis of European research findings

A large number of empirical studies have investigated the effects of women's education on union dissolution in Europe, but results have varied substantially. This paper seeks to assess the relationship between educational attainment and the incidence of marital disruption by systematizing the existing empirical evidence. A quantitative literature review (a meta-analysis) was conducted to investigate the temporal change in the relationship, net of inter-study differences. The results point to a weakening of the positive educational gradient in marital disruption over time and even to a reversal in the direction of this gradient in some countries. The findings also show that the change in the educational gradient can be linked to an increase in access to divorce. Finally, the results suggest that women's empowerment has played an important role in changing the educational gradient, while the liberalization of divorce laws has not.
The Effect of Computer-Mediated Administration on Self-Disclosure of Problems on the Addiction Severity Index

Objectives:People tend to disclose more personal information when communication is mediated through the use of a computer. This study was conducted to examine the impact of this phenomenon on the way respondents answer questions during computer-mediated, self-administration of the Addiction Severity Index (ASI) called the Addiction Severity Index-Multimedia Version (ASI-MV). Methods:A sample of 142 clients in substance abuse treatment were administered the ASI via an interviewer and the computerized ASI-MV, 3 to 5 days apart in a counterbalanced order. Seven composite scores were compared between the 2 test administrations using paired t tests. Post hoc analyses examined interviewer effects. Results:Comparisons of composite scores for each of the domains between the face-to-face administered and computer-mediated, self-administered ASI revealed that significantly greater problem severity was reported by clients in 5 of the 7 domains during administration of the computer-mediated, self-administered version compared with the trained interviewer version. Item analyses identified certain items as responsible for significant differences, especially those asking clients to rate need for treatment. All items that were significantly different between the 2 modes of administration revealed greater problem severity reported on the ASI-MV as compared with the interview administered assessment. Post hoc analyses yielded significant interviewer effects on 4 of the 5 domains where differences were observed. Conclusions:These data support a growing literature documenting a tendency for respondents to be more self-disclosing in a computer-mediated format over a face-to-face interview. Differences in interviewer skill in establishing rapport may account for these observations.
Attention Deficit Hyperactivity Disorder Is Associated With a More Severe Pattern of Cocaine Consumption in Cocaine Users From French West Indies

Objective:Attention deficit hyperactivity disorder (ADHD) is a frequent comorbidity in patients with substance use disorder. The aim of this cross-sectional study was to evaluate the consequences of ADHD comorbidity in cocaine users seeking treatment in Martinique. Methods:During 15 months, all patients seeking treatment for cocaine dependence in a specialized center were assessed using the ADHD DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision) criteria and the French version of the Wender Utah Rating Scale. Results:Forty-six (44 men and 2 women) cocaine abusers were included. Among them, 10 (21.7%) patients met DSM-IV-TR full criteria for adult ADHD. Patients with ADHD spend significantly more money (3 fold) on cocaine per week than those without ADHD, which means that they use a higher dose. All patients with ADHD used cocaine in a pipe, which allowed a greater absorption compared to smoking cocaine in a joint or snorting cocaine powder; in contrast, only 53% of the subjects without ADHD used cocaine in a pipe. Conclusions:Our study shows that cocaine users seeking treatment in Martinique with reported ADHD have a more severe pattern of cocaine consumption and the prevalence of ADHD's comorbidity in cocaine users is proximately equal to values previously found in the literature.
Children’s educational attainment, occupation, and income and their parents’ mortality

Using data from Finland, this paper contributes to a small but growing body of research regarding adult children's education, occupation, and income and their parents' mortality at ages 50+ in 1970–2007. Higher levels of children's education are associated with 30–36 per cent lower parental mortality at ages 50–75, controlling for parents' education, occupation, and income. This association is fully mediated by children's occupation and income, except for cancer mortality. Having at least one child educated in healthcare is associated with 11–16 per cent lower all-cause mortality at ages 50–75, an association that is largely driven by mortality from cardiovascular diseases. Children's higher white-collar occupation and higher income is associated with 39–46 per cent lower mortality in the fully adjusted models. At ages 75+, these associations are much smaller overall and children's schooling remains more strongly associated with mortality than children's occupation or income.
Internet Addiction as an Important Predictor in Early Detection of Adolescent Drug Use Experience—Implications for Research and Practice

We present results from a cross-sectional study of the entire adolescent student population aged 14 to 18 years of the island of Kos, on the correlates between personality, illicit chemical substance use, and Internet abuse. Results demonstrate that adolescents who have used illicit substances and are abusing the Internet as well appear to share some common personality characteristics, namely those that are classified under the label of “psychoticism” in the Eysenck's personality model. An increase in the severity of pathological Internet use has been linked to increased chances of having used an illicit substance. Taking into account any common personality attributes, Internet addiction can still be useful as a predictor variable for substance use experiences. Future research should attempt to verify any biological common factors between chemical substances use and Internet abuse. Targeting the adolescent population that engages in increased Internet use may be of benefit for drug abuse prevention programs.
Perceived Discrimination Is a Potential Contributing Factor to Substance Use and Mental Health Problems Among Primary Care Patients in Chile

Objectives:Perceived discrimination is a prevalent problem that has been linked to negative health outcomes for victims. The goal of this research was to examine whether perceived discrimination within the past 6 months was related to 6-month prevalence of problem drinking, illicit drug use, major depressive disorder (MDD), and posttraumatic stress disorder (PTSD) in a sample of primary care patients in Chile. Methods:Structured diagnostic assessments were administered to assess for MDD and PTSD using the Composite International Diagnostic Interview. The Alcohol Use Disorders Identification Test assessed hazardous alcohol use. Additional measures captured illegal drug use and discrimination in the past 6 months. Measures were administered to 2839 participants between the ages of 15 to 98 in primary care centers in the Chilean cities of Concepcion and Talcahuano. Results:Controlling for demographic variables and previous trauma victimization, patients who reported discrimination in the past 6 months were significantly more likely to engage in hazardous alcohol use, illegal drug use, be diagnosed with MDD, and PTSD within this same time period than patients not reporting discrimination. Conclusions:This study highlights the importance of considering discrimination as a potential contributing factor to substance use and mental health problems in a Latin American sample.
A Study of 6-Year Retention in Methadone Maintenance Treatment Among Opioid-Dependent Patients in Xi'an

Objective:We analyzed a 6-year methadone maintenance treatment (MMT) retention rate in 8 MMT clinics in Xi'an and the factors that influenced the retention rate. Methods:We conducted a 6-year retrospective dynamic cohort study of 5849 eligible patients from 2006 to 2011. Participants were serially enrolled on the basis of opioid addiction, age, residence status, and civil capacity. Cumulative retention in treatment was calculated using survival analyses (life tables) on the basis of the number of days in MMT. We also used the Cox proportional hazard regression model to analyze the factors that may influence treatment retention. Results:The MMT retention varied from a less than 1 month to a maximum of 71.2 months; the average dose was 48.76 ± 17.03 mg/d. The cumulative retention for 12, 24, 36, 48, 60, and 72 months after MMT initiation were 0.87, 0.76, 0.66, 0.57, 0.49, and 0.43, respectively. The MMT retention rate was significantly associated with factors that included the particular clinic for MMT, the year when the subject initiated MMT, average daily dose, hidden drug use, sex, age, length of drug abuse history, needle sharing, living arrangements, and employment status. Conclusions:The 6-year retention rates for MMT in the 8 clinics in Xi'an were higher than those reported in other studies of other clinics. High therapeutic doses (>60 mg/d) could reduce the risk of patients withdrawing from treatment. Retention rates were relatively high in cohorts who were elderly, living with family, employed, or drug users, especially those with a long history of drug abuse.
Assessment of bone repair associated to the use of organic bovine bone and membrane irradiated with 830nm

The aim of the present investigation was to assess histologically the effect of LLLT (λ830nm, Thera Lase, DMC, Sao Carlos, SP, Brazil, 40mW, CW, spot size 0.60mm, 16J/cm2 per session) on the repair of surgical defects created in the femur of the Wistar Albinus rat. The defects were filled to lyophilized organic bovine bone associated or not to GTR (decalcified cortical osseous membrane). Surgical bone defects were created in 42 animals divided into five groups: Group I (control - 6 animals); Group II (organic bovine bone - 9 animals); Group III (organic bovine bone + LLLT - 9 animals); Group IV (organic bovine bone + decalcified cortical osseous membrane - 9 animals); Group V (organic bovine bone + decalcified cortical osseous membrane + Laser - 9 animals). The animals on the irradiated groups received 16J/cm2 per session divided into four points around the defect (4J/cm2) being the first irradiation immediately after surgery and repeated seven times at every 48h. The animals were humanely killed after 15, 21 and 30 days. The results of the present investigation showed histological evidence of improved amount of collagen fibers at early stages of the bone healing (15 days) and increased amount of well organized bone trabeculae at the end of the experimental period (30 days) on irradiated animals compared to non irradiated ones. It is concluded that a positive biomodulative effect on the healing process of one defect associated or not to the use of organic lyophilized bone and biological bovine membrane on the femur of the rat.
Coping Mechanisms of Physicians Who Routinely Work with Dying Patients

Physicians routinely care for dying patients, yet many report being uncomfortable doing so. Discomfort with death can compromise patient care through insensitive or inadequate interactions and can lead to physicians' feeling remorse, anger, guilt, and inadequacy. The purpose of this study was to explore how physicians cope with the discomfort of caring for dying patients, as well as how the coping process can affect patient care. Twenty physicians who routinely cared for dying patients were interviewed about related discomfort. Transcripts were analyzed according to the grounded theory method using Atlas/ti software. Eight coping mechanisms were identified, including medicalization, dehumanizing the patient, anger directed at the patient, use of euphemisms, use of humor, denial of the lack of skill, going numb, and talking to others. Improvement of support mechanisms would provide a forum for physicians to speak about discomfort and would encourage the development and sharing of productive coping mechanisms.
Integrity of the osteocyte bone cell network in osteoporotic fracture: Implications for mechanical load adaptation

The human skeleton has the ability to modify its material composition and structure to accommodate loads through adaptive modelling and remodelling. The osteocyte cell network is now considered to be central to the regulation of skeletal homeostasis; however, very little is known of the integrity of the osteocyte cell network in osteoporotic fragility fracture. This study was designed to characterise osteocyte morphology, the extent of osteocyte cell apoptosis and expression of sclerostin protein (a negative regulator of bone formation) in trabecular bone from the intertrochanteric region of the proximal femur, for postmenopausal women with fragility hip fracture compared to age-matched women who had not sustained fragility fracture. Osteocyte morphology (osteocyte, empty lacunar, and total lacunar densities) and the degree of osteocyte apoptosis (percent caspase-3 positive osteocyte lacunae) were similar between the fracture patients and non-fracture women. The fragility hip fracture patients had a lower proportion of sclerostin-positive osteocyte lacunae in comparison to sclerostin-negative osteocyte lacunae, in contrast to similar percent sclerostin-positive/sclerostin-negative lacunae for non-fracture women. The unexpected finding of decreased sclerostin expression in trabecular bone osteocytes from fracture cases may be indicative of elevated bone turnover and under-mineralisation, characteristic of postmenopausal osteoporosis. Further, altered osteocytic expression of sclerostin may be involved in the mechano-responsiveness of bone. Optimal function of the osteocyte cell network is likely to be a critical determinant of bone strength, acting via mechanical load adaptation, and thus contributing to osteoporotic fracture risk.
Recent trend of bacterial aetiology of lower respiratory tract infection in a tertiary care centre of Nepal

INTRODUCTION: Lower respiratory tract infections (LRTIs) are among the most common infectious diseases of humans. This study focused on determining the recent trend of bacterial aetiology of LRTIs among the patients attending Tribhuvan University Teaching Hospital (TUTH) in Kathmandu. MATERIALS AND METHODS: This was a prospective study conducted over a period of six months in the bacteriology laboratory of TUTH. A total of 1120 specimens representing lower respiratory tract were received from patients with suspected LRTIs. The specimens were collected and processed according to standard methodology. RESULTS: Respiratory pathogens were recovered from 44.4% cases (n=497). Gram-negative bacteria were recovered in 84.1% (n=488). Bacteria were more commonly recovered from endotracheal secretion (41/61, 67.2%) than in sputum (454/1039, 43.7%) and bronchial washing (2/20, 10%). Ninety-one percent (n=454) growth was monomicrobial while the rest accounted for mixed growth. Among the organisms isolated, Haemophilus influenzae (112, 21%) was the most predominant pathogen followed by Klebsiella pneumoniae (102, 19.1%), Pseudomonads (91, 17.1%), Acinetobacter baumannii calcoaceticus complex (60, 10.9%), Streptococcus pneumoniae (46, 8.6%), Escherichia coli (37, 6.9%). CONCLUSIONS: H. influenzae and S. pneumoniae were the most common Gram-negative and Grampositive bacterial isolates recovered, respectively from LRTIs urging for monitoring and surveillance of these pathogens. DOI: http://dx.doi. org/10.3126/ijim.v1i1. 6639 Int J Infect Microbiol 2012;1(1):3-8
Phonological Development During the First Year: Implications for Intervention

The growing trend for early identification and intervention with developmentally delayed infants has been strengthened by a supportive attitude of society in general toward children with problems, as well as legislation mandating early intervention. The re is a strong data base in the rapidly growing transdisciplinary child development literature that combines both theoretical and empirical research. Knowledge of early phonological development is important in working with infants born with clefts because aberrant compensatory articulatory postures may develop dur ing the prelinguistic period. Researchers in the field of phonological development (Oiler, 1980; Stark, 1975, 1980) have proposed and replicated a sequence that follows infant vocalizations from birth through symbolization. Shames and Rubin (1979) identified a number of processes that operated in the acquisition of language and presented them within a developmental framework (Fig. 1). T h e sound-making process of language development is of importance in dealing with infants with orofacial anomalies and is the focus of this article. Sound making will be discussed in relation to the socialization process of communication for phonological development cannot be viewed without reference to socialization. According to Ferguson and Garnica (1975):
The importance of postprandial glycemic control: optimizing add-on therapy to basal insulin

Abstract Diabetes, mainly type 2 diabetes mellitus (T2DM), is associated with a growing clinical and economic burden in the United States, which is expected to increase in association with an aging population. Sufficient glycemic control in patients with T2DM, in order to reduce the risk of micro- and macrovascular complications associated with diabetes, is mediated by lifestyle modifications and a regimen of increasingly intensive antidiabetes drugs. Several treatments and strategies are available for primary care physicians to select from when choosing the most appropriate therapy for their individual patients with T2DM, but, ultimately, due to the progressive nature of the disease, most of these patients will require insulin therapy to maintain glycemic control. Regimens containing basal and postprandial insulins are widely used, but there is still widespread reluctance to initiate insulin treatment due to fear of weight gain and hypoglycemia. Furthermore, as patients approach recommended glycated hemoglobin targets, postprandial hyperglycemia becomes the main contributor to hyperglycemic exposure, necessitating the timely initiation of prandial treatment. Finally, insulin treatment can be limited by factors like the number of injections, mealtime restrictions, complex titration algorithms and patient adherence. Recent developments in antidiabetes drug research have brought more convenient basal and postprandial regimens closer. Clinical evaluation of the efficacy and safety of basal insulins plus add-on glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has yielded promising results. Primary care physicians are continually challenged to optimize insulin treatment strategies to maximize patient outcomes. Emerging strategies such as long-acting basal insulin analogs and short-acting GLP-1 RAs are particularly appealing to address this challenge.