Miracle-dz/UniFAR-FTUs huggingface dataset:
Antidepressants may double risk of suicide and aggression in children, study finds

Doctors should avoid prescribing antidepressants to children and teenagers wherever possible because they are associated with a doubling in the risk of aggression and suicide, Danish researchers have concluded in The BMJ . 1 They recommend considering alternative treatments such as exercise or psychotherapy. The researchers carried out a systematic review and meta-analysis of 70 trials with 18 526 patients. The trials examined the use of five of the most commonly prescribed antidepressants: duloxetine; fluoxetine; paroxetine; sertraline, and venlafaxine. They included in their study only double blind placebo …
Disparities in Diabetes Care Quality by English Language Preference in Community Health Centers

OBJECTIVE To conduct a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. STUDY SETTING/DATA COLLECTION Clinical outcomes (2011) and patient survey data (2012) for Type 2 diabetes adults from 14 CHCs (n = 1,053). STUDY DESIGN We estimated separate regression models for Latino and Asian patients by English language preference for Clinician & Group-Consumer Assessment of Healthcare Providers and System, Patient Assessment of Chronic Illness Care, hemoglobin A1c, and self-reported hypoglycemic events. We used the Blinder-Oaxaca decomposition method to parse out observed and unobserved differences in outcomes between English versus non-English language groups. PRINCIPAL FINDINGS After adjusting for socioeconomic and health characteristics, disparities in patient experiences by English language preference were found only among Asian patients. Unobserved factors largely accounted for linguistic disparities for most patient experience measures. There were no significant differences in glycemic control by language for either Latino or Asian patients. CONCLUSIONS Given the importance of patient retention in CHCs, our findings indicate opportunities to improve CHC patients' experiences of care and to reduce disparities in patient experience by English preference for Asian diabetes patients.
A generalized statistical model for binary change detection in multispectral images

Recently, a thresholding method based on the Rayleigh-Rice mixture has been proposed for solving binary change detection problems in multispectral image pairs. However, when images acquired by the last generation of multispectral scanners having high radiometric resolution are considered, the distribution fitting is still not satisfactory and computed thresholds remain quite distant from the optimal values. The main reason for this seems to be that in all previous approaches the unchange class is modeled as a single class. Instead, both practice and recent studies showed that this is not the case for new generation data. In this work, we propose a generalized statistical model for the difference image that allows the unchange class to be complex. The resulting model has more degrees of freedom, therefore it better fits real distributions and returns almost optimal thresholds for binary decision also with high radiometric resolution images.
Orientation program for first year undergraduate medical students: knowledge, attitudes and perceptions

Introduction: During a week-long orientation program at KIST Medical College newly joined first year undergraduate medical (MBBS) students are introduced to the institution, to teaching-learning activities, to the MBBS curriculum and to faculty members. The program has been conducted previously for three batches of students but feedback has not been obtained. Hence the study was conducted to study knowledge and attitude scores of students before and after the orientation program among the newly joined fourth batch of students, and note student perception about the effectiveness of different sessions. Methods: A questionnaire administered at the end of the program measured knowledge and attitudes of students about selected subject areas before and after the program. Students were asked to indicate their present level of knowledge and attitude and also indicate their levels at the beginning of the program. The median knowledge and attitudes scores were calculated and compared among male and female respondents. The median scores before and after the module was compared using appropriate nonparametric tests (p <0.05). The effectiveness of different lecture sessions was also studied. Results: Sixty-three of the 72 students (87.5%) participated in the study. Forty students (63.5%) were male, 21 (33.3%) were female and two did not mention their gender. The median knowledge and attitudes scores significantly increased after the program. The effectiveness score was 3 for most sessions expect a few where the score was 4. Conclusions: The knowledge and attitude scores in different subject areas improved after the module. The program was perceived by students to be effective.
Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial

OBJECTIVE To investigate effects of a novel dementia care coordination program on health services utilization. DATA SOURCES/STUDY SETTING A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011). STUDY DESIGN Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team. DATA COLLECTION/EXTRACTION METHODS Study partners reported acute care/inpatient, outpatient, and home- and community-based service utilization at baseline, 9, and 18 months. PRINCIPAL FINDINGS From baseline to 18 months, there were no significant group differences in acute care/inpatient or total outpatient services use, although intervention participants had significantly increased outpatient dementia/mental health visits from 9 to 18 months (p = .04) relative to controls. Home and community-based support service use significantly increased from baseline to 18 months in the intervention compared to control (p = .005). CONCLUSIONS While this dementia care coordination program did not impact acute care/inpatient services utilization, it increased use of dementia-related outpatient medical care and nonmedical supportive community services, a combination that may have helped participants remain at home longer. Future care model modifications that emphasize delirium, falls prevention, and behavior management may be needed to influence inpatient service use.
A phase 1 trial of the anti-KIR antibody IPH2101 in patients with relapsed/refractory multiple myeloma.

Natural killer (NK) cells elicit cytotoxicity against multiple myeloma (MM); however, MM cells express HLA class I molecules as ligands to NK cell inhibitory killer immunoglobulin-like receptors (KIRs) as a means of immunoevasion. KIR-ligand mismatch may improve outcomes in allogeneic transplantation for MM. Extrapolating on this concept, we conducted a phase 1 trial of IPH2101, an anti-KIR antibody, in patients with relapsed/refractory MM. IPH2101 was administered intravenously every 28 days in 7 dose-escalated cohorts (0.0003-3 mg/kg) for up to 4 cycles. Pharmacokinetic, pharmacodynamic, and correlative immunologic studies were completed. A total of 32 patients were enrolled. The biologic endpoint of full KIR2D occupancy across the dosing cycle was achieved without dose-limiting toxicity or maximally tolerated dose. One severe adverse event was noted. Pharmacokinetic and pharmacodynamic findings approximated preclinical predictions, and IPH2101 enhanced ex vivo patient-derived NK cell cytotoxicity against MM. No objective responses were seen. No evidence of autoimmunity was observed. These findings suggest that IPH2101 is safe and tolerable at doses that achieve full inhibitory KIR saturation, and this approach warrants further development in MM. This trial was registered at www.clinicaltrials. gov as #NCT00552396.
Prescription Drug Monitoring Programs Produce a Limited Impact on Painkiller Prescribing in Medicare Part D

OBJECTIVE To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV. PRINCIPAL FINDINGS Prescription drug monitoring programs were associated with a 5.2 percent decrease in days supply prescribed per physician for oxycodone in addition to smaller reductions for hydrocodone and opioids overall (2.8 percent and 2 percent, respectively) and a small increase in prescribing for Schedule IV opioids. PDMPs were not associated with changes for nonopioid analgesics or other opioids in Schedules II and III. The effects of PDMPs were negated in states where statutes explicitly did not require use of the PDMP. CONCLUSIONS Prescription drug monitoring programs have a modest effect targeted at the high-profile drug oxycodone among the Medicare Part D population and an even smaller effect for hydrocodone and opioids in general. The findings suggest some substitution toward lower schedule opioids. Substantially addressing the widespread opioid abuse problem will require enhancing existing PDMPs or implementing new policies.
Nebivolol compared with metoprolol for erectile function in males undergoing coronary artery bypass graft

Objective: The aim of this study was to evaluate erectile function in males undergoing coronary artery bypass graft (CABG) while on two different adrenoceptor beta-blocker regimens, namely nebivolol and metoprolol. We hypothesize that the negative effects of cardiopulmonary bypass on erectile function may be possibly attenuated by preferring a vasodilating selective β1-blocker, nebivolol, to metoprolol as an anti-ischemic and antiarrhythmic agent in males undergoing CABG. Methods: This randomized, double-blind, prospective clinical study was conducted in patients scheduled for CABG surgery between February 2012 and June 2014. A total of 60 consecutive patients who met inclusion criteria were randomized and divided into the following two groups: N group, which received 5 mg of nebivolol orally for 2 weeks before surgery plus 12 weeks after surgery or M group, which received 50 mg of metoprolol orally for the same period. All patients were evaluated by the erectile function domain of the International Index of Erectile Function-5 (IIEF-5) at the time of admission (before starting the beta-blocker) and 3 months after surgery. Results: In the metoprolol group, the mean IIEF-5 score decreased significantly from a baseline of 15.2±5.8 to 12.9±5.8 (p<0.001), but in the nebivolol group, this difference was not significant (from a baseline 12.9±5.5 to 12.4±5.5, p=0.053). In all patients, the mean IIEF-5 score decreased significantly from a baseline of 14.0±5.7 to 12.6±5.6 (p<0.001). Conclusion: Although erectile function in males undergoing CABG surgery decreases when metoprolol is used, nebivolol exerts protective effects on erectile function against the disruptive effects of cardiopulmonary bypass in patients undergoing CABG.
Identification of Hearing Loss in Infants Using Auditory Brainstem Response: Strategies and Program Choices

Reprint requests: Dr. Folsom, Dept. of Speech and Hearing Sciences, CDMRC, WJ-10, University of Washington, Seattle, WA 98195. The assessment of hearing loss in early infancy is a multifaceted process, combining identification, intervention, and continued assessment. The importance of this process cannot be overstated. The earlier in life that intervention can be initiated, the greater the opportunity to mitigate the impact of that impairment on speech, language, and learning. One of the difficulties in any identification program, regardless of specific approach, is managing many normal infants while separating out those few with a high likelihood of impairment. The specific tool chosen for this process must be efficient and easily administered. Under any circumstance of hearing screening, it is the efficiency with which these two populations (normal infants and suspected abnormal infants) are separated from one another that defines the optimal program. The reader is referred to Fria for a thorough treatment of screening efficiency.
Effect of aging of chemicals in soil on their biodegradability and extractability.

A study was conducted to determine whether the time that a compound remains in a soil affects its biodegradability and the ease of its extraction. Phenanthrene and 4-nitrophenol were aged in sterilized loam and muck, and bacteria able to degrade the compounds were then added to the soils. increasingly smaller amounts of phenanthrene in the muck and 4-nitrophenol in both soils were mineralized with increasing duration of aging. Aging also increased the resistance of phenanthrene to biodegradation in nutrient-amended aquifer sand. The rate of miner- alization of the two compounds in both soils declined with increasing periods of aging. The amount of phenanthrene and 4-nitrophenol added to sterile soils that was recovered by butanol extraction declined with duration of aging, but subsequent Soxhlet extraction recovered phenanthrene from the loam but not the muck. The extents of mineralization of phenanthrene previously incubated for up to 27 days with soluble or insoluble organic matter from the muck were similar. Less aged than freshly added phenanthrene was biodegraded if aggregates in the muck were sonically disrupted. The data show that phenanthrene and 4-nitrophenol added to soil become increasingly more resistant with time to biodegradation and extraction.
Automated HPLC Fractionation of PCDDs and PCDFs and Planar and Nonplanar PCBs on C18-Dispersed PX-21 Carbon.

The separation of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and a number of specific di-, mono-, and non-ortho,-ortho'-chlorine (o,o'-Cl) substituted chlorobiphenyl congeners (PCBs) of toxicological significance from bulk PCBs and other interfering residues is critical for accurate quantitation of these compounds. Activated carbon has long been the most commonly used adsorbent for separation of these compounds into fractions suitable for analysis by capillary GC/ECD and by GC/MS. We have developed a procedure that uses HPLC columns containing PX-21 activated carbon dispersed by C 18 (octadecylsilane) sorbent in combination with an automated, quaternary HPLC autoinjector-fraction collector apparatus to attain these separative objectives. Our system produces four discrete fractions containing bulk PCBs (di- to tetra-o,o'-chlorosubstituted); mono-o,o'-Cl PCBs ; non-o,o'-Cl PCBS ; and PCDDs/PCDFs. The fractionations are achieved with reduced requirements for manpower, and our system provides flexibility toward easy customization to meet specific analytical needs.
Children's Health-Related Locus of Control Beliefs: Ethnicity, Gender, and Family Income

Health-related locus of control (HLC) beliefs are important predictors of health behaviors, but few studies have focused on children, and rarely have ethnicity, gender, or income been considered. Caucasian American, Latino American, and African American children (N = 167) completed the children's Multidimensional HLC scales, measuring internal, powerful others, and chance beliefs. Latino American and African American children endorsed stronger chance beliefs than Caucasian American children; Caucasian American children showed a trend toward less belief in powerful others compared to African American children. Patterns for boys and girls were similar. For children from higher income families, African American children scored higher than Caucasian American or Latino American children on belief in powerful others and chance; there were no ethnic group differences at lower income levels. Results suggest ethnicity and family income levels may be more important than gender as determinants of children's HLC beliefs.
Adapting the Pregnancy Physical Activity Questionnaire for Japanese pregnant women.

OBJECTIVE To assess the psychometric properties of the Pregnancy Physical Activity Questionnaire (PPAQ) for women who read and speak Japanese. DESIGN This longitudinal study used a self-report questionnaire and quantitative biometric and instrumental measurements (actigraph) to assess the reliability and criterion validity. SETTING A university hospital in Tokyo, Japan. PARTICIPANTS Sixty-nine pregnant women living in Tokyo and its suburbs were recruited. METHODS The test-retest reliability of the Japanese version of the Pregnancy Physical Activity Questionnaire (PPAQ-J) was evaluated through intraclass correlation coefficients (ICCs) between PPAQ-J results administered three times (at recruitment, 7 and 14 days later). Criterion validity was assessed by comparing results to actigraph measures using Spearman's correlation coefficients. Participants wore the actigraph over the 2-week research period. Data from 58 participants were analyzed for test-retest reliability. The data of 54 participants were used to analyze criterion validity. RESULTS The ICCs for the first and second and for the first and third PPAQ-J questionnaires were ≥0.56 for total activity and activities broken down by intensity and type (in metabolic equivalents [METs] × hours/day). To evaluate criterion validity, Spearman's correlation coefficients were calculated between the first measurement of the PPAQ-J and three published cut-points used to classify actigraph data (minutes/day); correlations ranged from . 02 to . 35 for total activity, -. 21 to -. 25 for vigorous activity, -. 09 to . 38 for moderate activity, and . 01 to . 28 for light activity. CONCLUSION The PPAQ-J is a psychometrically sound and comprehensive measure of physical activity in pregnant Japanese women.
Assessing annual water-air fluxes of polychlorinated biphenyls in lake michigan.

Air-water exchange of PCBs was determined in Lake Michigan on an event and seasonal basis in 1991-1993. Instantaneous fluxes of ΣPCB (sum of 77 congener peaks) based on air-water concentration gradients drawn from air and water samples collected simultaneously aboard ship demonstrated net volatilization in September 1991. Air samples collected on the northeastern shore of Lake Michigan (Sleeping Bear Dunes State Park) between December 1991 and July 1993 showed no seasonal trend in vapor-phase ΣPCB concentrations and ranged from 30 to 400 pg/m 3 . These air concentrations were used to calculate seasonal water-airfluxes Of ΣPCB that ranged from -18 ng m -2 day -1 (net deposition) to 60 ng m -2 day -1 (net volatilization). The seasonal variation of vapor-phase and dissolved-phase PCBs in the impacted southern quarter of the lake are unknown, thereby hindering estimation of fluxes in this region. The estimated annual net ΣPCB flux is 12.3 μg m -2 yr -1 , which corresponds to 520 kg for the northern three-quarters of Lake Michigan.
A Drug Fatality Involving Kratom

A 17‐year‐old white man who showed no obvious signs of trauma was found unresponsive in bed and was pronounced dead at the scene. The decedent had a documented history of heroin abuse and chronic back pain and reportedly self‐medicated with Kratom (mitragynine). The autopsy was remarkable only for pulmonary congestion and edema and a distended bladder, both of which are consistent with, though not diagnostic of, opiate use. A laboratory work‐up revealed therapeutic levels of over‐the‐counter cold medications and benzodiazepines. However, of interest was a level of mitragynine at 0.60 mg/L. Given the facts of the case, the Medical Examiner certified the cause of death as “possible Kratom toxicity” and the manner of death was classified as “accident. ”
Distribuição dos diagnÓsticos de lesões pré-neoplásicas e neoplásicas de pele no Hospital Universitário Evangélico de Curitiba

BACKGROUND: Skin cancer is the most common cancer in Caucasians. It is estimated that there are one million new cases a year of nonmelanoma skin cancer (Basal Cell Carcinoma - BCC and Squamous Cell Carcinoma - SCC) all over the world. Regarding skin tumors, BCC is the most frequent. Among precancerous lesions, Actinic Keratosis - AK is the most common. OBJECTIVE: To analyze the incidence and parts of the body most affected by cancerous skin lesions and also Actinic Keratosis in our environment. METHODS: Retrospective study that analyzed skin biopsies of 491 patients with a diagnosis of AK, BCC, SCC or melanoma, resulting in 531 diagnoses registered by Pathologic Anatomy Service of Evangelical Hospital in Curitiba during 2002. RESULTS: Regarding sex, 270 were female (54.99%) and 221 were male (45.01%). BCC (58.46% - 114/195) and melanoma (61.5% - 16/26) were most prevalent among females, as well as AK dermatosis (60.79% - 107/176). SCC were prevalent in males (64.39% - 61/94). From 531 diagnoses, 62.90% (334) were malignant skin tumors. The most common tumor was BCC (39.74% - 211). In relation to dermatosis, 37.10% (197) corresponded to AK. The mean age was 59.81 years old. In relation to the location of the lesions, there was a higher occurrence in the cephalic extremity with 50.47% (268) of the cases. The most affected areas (11.50% - 3/26) in melanoma were the malar region, back and feet. CONCLUSIONS: BCC was the most common tumor. The prevalence was higher in the 6th decade of life. Females were most affected. Cephalic extremity was the most common location among the studied lesions, except for melanoma, which prevailed in the malar region back and feet.
Fatal Intoxications in a Forensic Autopsy Material from Epirus, Greece, During the Period 1998‐2010

In this retrospective study, we report the epidemiological characteristics of all poisoning deaths in Epirus, Greece, from 1998 to 2010; we present the toxicological findings and the statistical evaluation of the results. This is the first detailed scientific report on all the officially certified poisoning deaths concerning part of the Greek population. A total of 126 poisoning fatalities were recorded, 67 of them being mono‐intoxications (53.2%). The cause of poisoning was as follows: drugs of abuse (60%); carbon monoxide (19.8%); pesticides (9.5%); corrosives (4.8%); pharmaceuticals (4.8%); and spider bite (0.8%). The most frequently detected poisonous substances were as follows: heroin (65 cases), ethanol (55), benzodiazepines (42), carbon monoxide (25), cocaine (17), cannabinoids (17) and pesticides (12). Increasing tendency in poisoning death rates was recorded, due to an increase in accidental poisoning deaths attributed mainly to drugs of abuse (total, accidental, and drugs‐of‐abuse poisoning death rates per 100,000 inhabitants per year were 1.87, 1.19, and 0.79, respectively, in the period 1998–2002 and 3.97, 3.41, and 2.55, respectively, in the period 2007–2010).
INDUCTION OF LABOUR WITH PROSTAGLANDIN E2

The effect of prostaglandin E2 on the activity of the pregnant human uterus in vivo has been studied in 50 women at or near term and in need of induction. Labour was successfully induced in all cases with a continuous infusion of 0·5 μg. /min. The uterine activity produced by prostaglandin infusion resembled that of normal spontaneous labour. No unphysiological increase in uterine tonus was observed. The average infusion time was 5·5 hours and the average infusion‐delivery interval was 10 hours.