Miracle-dz/UniFAR-FTUs huggingface dataset:
Intentional Poisoning in Pediatric Patients

Objectives Poisonings in children are common reasons for presentation to the emergency department and can potentially have serious complications. Our research aims to review risk factors leading to intentional self-poisoning. Methods A retrospective medical record review of all intentional pediatric poisoning cases presenting to the Children's Emergency at National University Hospital, Singapore between January 2014 and December 2015 was performed. Results Eighty-seven cases of intentional poisonings were identified, 31 (36.5%) of which were with suicidal intent. The majority of cases were female (85.1%) and adolescents older than 16 years (93.1%). A known psychiatric history was present in 57.5% and 62 (71.3%) had a history of deliberate self-harm. Being diagnosed with a new psychiatric illness during that presentation was associated with a history of self-harm (adjusted odds ratio [Adj OR], 6.74; 95% confidence interval [CI]; 1.04–43.62; P = 0.045). Twenty-seven (31.0%) patients had a history of intentional poisoning, and 15 (17.2%) went on to have subsequent presentations for poisoning. Recurrent poisoning attempts were strongly associated with a known psychiatric history (Adj OR, 5.91; 95% CI, 1.62–21.58; P = 0.007) and a history of deliberate self-harm (Adj OR, 7.49; 95% CI, 1.38–40.66; P = 0.02). Deliberate overdosing on personal long-term medication was seen in 15 (35.7%) of 42, of which 12 (80%) of 15 were psychiatric medications. Conclusions Known psychiatric history or a history of deliberate self-harm are risk factors for intentional poisoning. Appropriate risk stratification and preemptive interventions involving closer surveillance or cognitive behavioral programs are possible measures to prevent intentional self-poisoning, especially in these at-risk groups.
Severe COVID-19 during Pregnancy and Possible Vertical Transmission

Abstract There are few cases of pregnant women with novel corona virus 2019 (COVID-19) in the literature, most of them with a mild illness course. There is limited evidence about in utero infection and early positive neonatal testing. A 41-year-old G3P2 with a history of previous cesarean deliveries and diabetes mellitus presented with a 4-day history of malaise, low-grade fever, and progressive shortness of breath. A nasopharyngeal swab was positive for COVID-19, COVID-19 serology was negative. The patient developed respiratory failure requiring mechanical ventilation on day 5 of disease onset. The patient underwent a cesarean delivery, and neonatal isolation was implemented immediately after birth, without delayed cord clamping or skin-to-skin contact. The neonatal nasopharyngeal swab, 16 hours after delivery, was positive for severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR), and immunoglobulin (Ig)-M and IgG for SARS-CoV-2 were negative. Maternal IgM and IgG were positive on postpartum day 4 (day 9 after symptom onset). We report a severe presentation of COVID-19 during pregnancy. To our knowledge, this is the earliest reported positive PCR in the neonate, raising the concern for vertical transmission. We suggest pregnant women should be considered as a high-risk group and minimize exposures for these reasons. Key Points We report a severe presentation of COVID-19 in pregnancy requiring invasive ventilatory support. This is a case of positive RT-PCR in first day of life, suggesting possible vertical transmission. There were no detectable maternal antibodies for COVID-19 until after delivery.
Experimental investigation of far‐field human cough airflows from healthy and influenza‐infected subjects

Abstract Seasonal influenza epidemics have been responsible for causing increased economic expenditures and many deaths worldwide. Evidence exists to support the claim that the virus can be spread through the air, but the relative significance of airborne transmission has not been well defined. Particle image velocimetry (PIV) and hot‐wire anemometry (HWA) measurements were conducted at 1 m away from the mouth of human subjects to develop a model for cough flow behavior at greater distances from the mouth than were studied previously. Biological aerosol sampling was conducted to assess the risk of exposure to airborne viruses. Throughout the investigation, 77 experiments were conducted from 58 different subjects. From these subjects, 21 presented with influenza‐like illness. Of these, 12 subjects had laboratory‐confirmed respiratory infections. A model was developed for the cough centerline velocity magnitude time history. The experimental results were also used to validate computational fluid dynamics (CFD) models. The peak velocity observed at the cough jet center, averaged across all trials, was 1.2 m/s, and an average jet spread angle of θ = 24° was measured, similar to that of a steady free jet. No differences were observed in the velocity or turbulence characteristics between coughs from sick, convalescent, or healthy participants.
Concomitant Aspirin and Anticoagulation Is Associated With Increased Risk for Major Bleeding in Surgical Patients Requiring Postoperative Intensive Care*

Supplemental Digital Content is available in the text. Objectives: Critically ill surgical patients may receive concomitant aspirin and therapeutic anticoagulation postoperatively, yet the safety of this practice remains unknown. We evaluated the risk of major bleeding with concomitant therapy compared with anticoagulation alone. Design: Observational cohort study. Inverse probability of treatment weighting was used to assess the association between concomitant therapy and a primary outcome of major bleeding. Setting: Postoperative ICUs at an academic medical center. Patients: Adults (≥ 18 yr old) receiving anticoagulation during postoperative ICU admission between 2007 and 2016. Interventions: None. Measurements and Main Results: Nine thousand five hundred eighteen anticoagulated patients were included, including 3,237 (34%) receiving aspirin. A total of 1,874 unique patients (19.7%) experienced a major bleeding event. In inverse probability of treatment weighting analyses, concomitant therapy was associated with increased odds for major bleeding (odds ratio, 1.20; 95% CI, 1.05–1.36; p = 0.006) compared with anticoagulation alone. An interaction test suggested a differential relationship between aspirin use and major bleeding based on aspirin use in the 7 days prior to anticoagulation, such that a strong association between aspirin and major bleeding was observed for recent initiators of aspirin (1.40; 1.13–1.72;p = 0.002) but not for those continuing prior aspirin use. Aspirin use prior to anticoagulation did not modify the relationship between concomitant therapy and new myocardial infarction or stroke (i.e., rates were not increased with aspirin discontinuation prior to anticoagulation). Conclusions: Concomitant aspirin and anticoagulation in critically ill surgical patients was associated with an increased rate of major bleeding. Future investigations are warranted to further define optimal management of antiplatelet therapy during anticoagulation in surgical patients.
Normothermic machine perfusion of donor-lungs ex-vivo: promoting clinical adoption.

PURPOSE OF REVIEW Lung transplantation offers the only realistic therapeutic option for patients with end-stage lung disease. However, this is impacted by a shortfall in availability of suitable donor-lungs. Normothermic machine perfusion of donor-lungs outside the donor body also known as ex-vivo lung perfusion (EVLP) offers a potential solution through objective assessment, reconditioning and treatment of donor-lungs initially deemed unsuitable for use. This review discusses key advances and challenges in the wider clinical adoption of this technology. RECENT FINDINGS This review will summarize key research within the following areas: recent clinical trials utilizing EVLP, logistical challenges, EVLP protocol innovations, novel assessment methods and current research into therapeutic modulation of lung function during EVLP. SUMMARY Normothermic machine perfusion of donor-lungs ex-vivo offers a promising platform to assess and modulate donor-lung quality prior to transplantation. Consensus on how and when to best utilize EVLP is yet to be reached, meaning that widespread clinical adoption of the technology has not yet become a reality. Further work is needed on agreed indications, perfusion protocols and organization of services before becoming a regularly used procedure prior to lung transplantation.
Reduction in twin stillbirth following implementation of NICE guidance

There has been an unprecedented fall in the rate of stillbirth in twin pregnancy in the UK. It is contested whether implementation of the National Institute for Health and Care Excellence (NICE) guidance on the antenatal management of uncomplicated twin pregnancies has contributed to this change. The aim of this study was to investigate whether the implementation of NICE guidance was associated with a reduction in the rate of stillbirth in twin pregnancies delivered in a large UK hospital.
Mutations in Myosin 5B (MYO5B) in Children with Early Onset Cholestasis.

OBJECTIVES Mutations in Myosin 5B (MYO5B) are known to be associated with microvillous inclusion disease (MVID) a genetic cause of neonatal intractable diarrhoea. More recently they have been reported in children with cholestasis but without typical gastrointestinal symptoms of MVID. We describe our series of children with cholestasis and mutations in MYO5B. METHODS Clinical, laboratory and histological data were collected from patients with cholestasis and pathogenic mutations in MYO5B, found by Next Generation Sequencing (NGS), but with minimal gastrointestinal disease. RESULTS Six patients (3 M) were identified. Median age at presentation was 19 months (range, 3-92). Presenting features were jaundice, pale stools, pruritus and failure to thrive. Patient 5 and 6 had intractable diarrhoea until the age of 3 and 7 years, respectively, but currently are on full enteral diet with no intestinal symptoms. Median values for serum total bilirubin were 55 μmol/L(2-500), alanine aminotransferase 73I IU/L(32-114), γ-glutamyltransferase 7 IU/L(7-10) and serum bile acids 134 μmol/L(18-274). Three patients underwent one or more types of biliary diversion for symptom control. Median follow up was 5 years (2-22). At most recent follow up they all reported pruritus while on antipruritics. Patient 1 had a liver transplant. CONCLUSIONS We identified six patients, with mutations in MYO5B, early onset cholestasis and pruritus, with variable response to biliary diversion without typical MVID.
The prevalence and antimicrobial resistance phenotypes of Salmonella, Escherichia coli and Enterococcus sp. in surface water

Surface water is prone to bacterial contamination as it receives wastes and pollutants from human and animal sources, and contaminated water may expose local populations to health risks. This review provides a brief overview on the prevalence and antimicrobial resistance (AR) phenotypes of Salmonella, Escherichia coli and Enterococcus, found in natural freshwaters. These bacteria are frequently detected in surface waters, sometimes as etiological agents of waterborne infections, and AR strains are not uncommonly identified in both developed and developing countries. Data relating to Salmonella, E. coli and Enterococcus present in environmental water are lacking, and in order to understand their development and dissemination using the One Health approach, understanding the prevalence, distribution and characteristics of the bacteria present in surface water as well as their potential sources is important. Furthermore, AR bacteria in natural watersheds are not well investigated and their impacts on human health and food safety are not well understood. As surface water is a receptacle for AR bacteria from human and animal sources and a vehicle for their dissemination, this is a crucial data gap in understanding AR and minimizing its spread. For this review, Salmonella, E. coli and Enterococcus were chosen to evaluate the presence of primary pathogens and opportunistic pathogens as well as to monitor AR trends in the environmental water. Studies around the world have demonstrated the widespread distribution of pathogenic and AR bacteria in surface waters of both developing and developed countries, confirming the importance of environmental waters as a reservoir for these bacteria and the need for more attention on the environmental bacteria for emerging AR.
Frequency and Molecular Typing of Human Metapneumovirus in Children with Acute Respiratory Tract Infection in Bojnurd, Northeastern Iran

Background: Acute respiratory infection plays a major role in hospitalization of children worldwide and viruses are one of the most important causative pathogens of acute respiratory tract infections (ARTIs). Human metapneumovirus (hMPV) is a respiratory pathogen responsible for ARTIs in infants and children around the world. The epidemiology of hMPV in the northeast of Iran is poorly described. This study aims to evaluate the prevalence and molecular types of hMPV in children under the age of 12 along with clinical relevance in northeast Iran. Methods: In this cross sectional study, from autumn 2015 to spring 2016 (nine months), 150 nasopharyngeal swabs were collected from children with ARTI and were evaluated for the presence of hMPV by reverse transcriptase-polymerase chain reaction (RT-PCR) technique; after that hMPV typing on positive samples was performed using PCR method. Results: Among the 150 patients that were included the study, 31 (20.6%) were positive for the hMPV genome. We also found that 96.8% (n = 30 cases) of positive cases belonged to genotype A; whereas no B genotype was detected. One of our hMPV isolates was non typable (3.2%). Conclusions: This study, for the first time, reports the existence of Human metapneumovirus virus in children with respiratory symptoms in northeastern Iran. We have also shown that the genotype A is the predominant circulating type among our patients.
University of New Hampshire Scholars' Repository University of New Hampshire Scholars' Repository

cylindrical silk gland (cY) spigots distinguish a large clade of modern spiders, the cY spigot clade, which includes all entelegyne spiders and their closest relatives. following a widespread paradigm, cYs and their spigots are only known to occur in female spiders and they produce silk used in the construction of egg sacs. Here we report the occurrence of a cY spigot or cY nubbin on each posterior median spinneret (PMS) in males (5 th stadium and later) of the spider Australomimetus maculosus . Late juvenile males had a cY spigot on each pMS, whereas adult males either had a cY spigot or, more often, a non-functional cY nubbin. this indicates that potential cY use by males is at least largely limited to late juvenile instars and is not involved with egg sac construction. Despite the presence of cY spigots in both sexes, sexual dimorphism with respect to cYs was still evident since males lacked the cY spigot on each posterior lateral spinneret present in late juvenile and adult females, and cY spigots of males never had the wide shaft and opening of adult females. this study adds to our knowledge of spinning apparatus variability in modern spiders and demonstrates an exception to the paradigm that, in the cY spigot clade, such spigots are restricted to female spiders. Recent, extensive phylogenetic analyses of spiders have recognized a clade that includes all “modern” (araneo-morph) spiders except the Synspermiata, Filistatidae, and Hypochilidae 1–3 . A synapomorphy of this “CY spigot clade” 2,4 is the possession of spinneret spigots that are outlets for a type of silk gland known for many years as either tubuliform or cylindrical silk glands (CYs) 5,6 . CY spigots generally occur
Effects of display size and navigation type on a classification task

The advent of ultra-high resolution wall-size displays and their use for complex tasks require a more systematic analysis and deeper understanding of their advantages and drawbacks compared with desktop monitors. While previous work has mostly addressed search, visualization and sense-making tasks, we have designed an abstract classification task that involves explicit data manipulation. Based on our observations of real uses of a wall display, this task represents a large category of applications. We report on a controlled experiment that uses this task to compare physical navigation in front of a wall-size display with virtual navigation using pan-and-zoom on the desktop. Our main finding is a robust interaction effect between display type and task difficulty: while the desktop can be faster than the wall for simple tasks, the wall gains a sizable advantage as the task becomes more difficult. A follow-up study shows that other desktop techniques (overview+detail, lens) do not perform better than pan-and-zoom and are therefore slower than the wall for difficult tasks.
Does Herding Exist? Evidence from Pakistan’s Stock Exchange

Herding transpires when an investor imitates the decision of other stockholders or shadow market consensus (Rizzi, 2008). The Chartered Financial Analyst Institute affirms “Herding Behavior Bias” as the principal presumption influencing the investor’s decision. (Kunte, S.2015). Herding behavior contradicts the validity of an Efficient Market Hypothesis (Famma and Franch, 1970). The investigation of herd behavior in the Pakistan stock market is indispensable as the inconsistent behavior of stockholders stems from the inefficient assets pricing and resource misallocation. The study’s result affirms the existence of herd behavior in the stock exchange of Pakistan and contradicts rational assets pricing model and stock price efficiency theory
Assessment of Risk Factors for Developing Phacomorphic Glaucoma

Aim:to study the roles of axial length and anterior chamber depth as risk factors for the development of phacomorphic glaucoma in eyes with mature cataract. Material and Methods: This is a prospective case-control study done in the year 2019 at Department of Ophthalmology, MLB Medical College, Jhansi. Phacomorphic glaucoma was diagnosed by Intraocular Pressure of more than 21 mmHg, intumescent cataract with signs and symptoms of phacomorphic glaucoma, axial length and anterior chamber depth Results: The Mean Intra ocular pressure of phacomorphic glaucoma was 50±8 mmHg and of mature cataract was 14.6±8.0 mmHg. Vision was Light perception in phacomorhic glaucoma and Hand movement was observed mature cataract. The mean axial length was 23.06±0.31mmHgamong phacomorphic glaucoma, shorter than mature cataract, where the mean axial length was 23.65±0.88mmHg. Conclusion:patients with shorter axial lengths are at increased risk for phacomorphic glaucoma.
Depression and Anxiety in Children and Adolescents

Depression, anxiety, and related “internalizing” problems of children and adolescents have been the focus of increased professional concern during the past two or three decades. During the majority of the 20th century, relatively little attention was given to these problems. In fact, until about the 1980s there was widespread professional denial that certain types of internalizing disorders, such as depression, could even exist in children. Fortunately, clinicians and researchers alike now understand that these problems are real, serious, complex, and most importantly, treatable and even preventable in many cases. This class of problems and disorders, particularly depression and anxiety, is the focus of this handbook for school-based practitioners. Although there are several excellent scholarly books available in this area, there are surprisingly few practical guides available to assist in understanding, evaluating, and treating depression, anxiety, and related internalizing problems of children and youth. Even fewer available resources are designed specifically to be applicable to intervention in school settings. This book is specifically designed to be such a practical handbook. This introductory chapter is designed to provide a foundation for understanding internalizing problems in straightforward and practical terms. The specific purpose of this introductory chapter is to help you develop a general understanding of depression, anxiety, and related internalizing disorders and problems, by
The Influence of Regional Knowledge Spillovers on the Innovative Performance of Firms. A Multilevel Approach

The objective of this paper is to study the effects of regional context and negative regional knowledge spillovers on the innovative performance of industrial firms. The author adopts a multilevel approach to the analysis of these effects, taking into account the hierarchical structure of the data. The innovative performance of a firm depends on its own attributes and on the regional context and the knowledge spillovers between regions. The empirical analysis uncovers evidence relative to the debate about positive and negative innovation spillovers between regions. I estimate a multilevel model of innovation at firm level, where variables of both the firm and regional levels intervene. The conclusion is that both levels have a direct and significant influence on the innovative performance. A database of 6,670 Colombian firms operating in 26 regions is used in the analysis. The main result is that innovation spillovers from neighboring regions have a negative influence over the firm’s innovative performance. The relationship is mediated by the number of inhabitants in the region with graduate degrees. These results have implications for regional innovation policies.
Differential Diagnosis of Pancytopenia: A Correlated Study of Peripheral Blood Smear Along With Bone Marrow Aspiration and Bone Marrow Biopsy

Background: A review of both Western and Indian literature shows that there are few comprehensive studies on pancytopenia. InIndia, thecauses ofpancytopeniaarenotwelldefined. Thisdata, would help in planning the diagnostic and therapeutic approach in patients with pancytopenia. AimTo evaluate the cases of pancytopenia by peripheral smear and/ orbonemarrowaspirationandbonemarrowbiopsytofindoutthe etiology, clinical, haematological, and histomorphologic features of pancytopenia. Materials and Methods:Total 86 cases were selected anddetailed haematological investigations including complete hemogram, peripheral smear examination, bone marrow aspiration, and biopsy examination were done.Results: The most common cause of pancytopenia in our study was megaloblastic anaemia (50%), followed by nutritional anaemia (16.3%) and hypoplastic/aplastic anaemia (10.5 %), myelofibrosis (8.1%) and malaria (4.3%). Conclusion: Megaloblastic anaemia duetovitaminB12/folatedeficiency seems toreflectthe higher prevalence of pancytopenia in Indian subjects, putting nutritional anaemia and hypoplastic/aplastic anaemia in the second and third position respectively. So, a simultaneous evaluation of BMA and BMB along with complete hemogram and peripheral blood smear is essential to give a definitive diagnosis which would help in the early treatment of pancytopenia.
CEO Pay-Share and Risk-taking in Large Bank Holding Companies

February 28, 2018 Abstract This study investigates the relationship between CEO pay-share (pay inequality between the CEO and other executives) and risk-taking in large bank holding companies (BHCs) (defined as banks with assets in excess of the Dodd-Frank threshold for greater oversight) over the period 1992–2016. We find that CEO pay-share is associated with less BHC risk, so providing support to the CEO power hypothesis, which argues that CEOs reduce the riskiness of the firms to protect their own financial wealth and human capital invested in the firm.