Miracle-dz/UniFAR-FTUs huggingface dataset:
Characteristics of opioid prescriptions in 2009.

we chose the latter; indeed network meta-analysis has been shown to potentially give more reliable results because of the integration of additional information. Although studies included in our review were from different sources, they were all randomized controlled trials and hence contrasts between treatment groups within each study should be comparable. In addition, we focused only on CP/CPPS categories IIIA and IIIB to reduce heterogeneity due to disease severity and focused on outcomes measured using National Institutes of Health Chronic Prostatitis Symptom Index scales to reduce heterogeneity due to measurement error. Nevertheless, we explored potential discrepancies in treatment effects between direct and network meta-analysis results using the standardized normal method (z). Directions of treatment effect for the 2 methods were identical for all 12 comparisons; moreover, the magnitude of the effects between the 2 methods were similar except for -blocker vs placebo, where z was large and reached statistical significance (2.9380, P=.003). We believe that this is an example of increased precision of treatment effects due to the network method “borrowing” information from indirect comparisons. Third, Jackson et al disagree that study data should be expanded using a Stata command so that it could be included in the meta-analysis, questioning how we could know the distribution of data. We only used this command for the treatment responsiveness outcome, which is a dichotomous outcome and does not need any assumption about distribution, normal or otherwise. We believe that using all available data, rather than omitting studies, is an advantage and will lead to more valid estimates.
Impact Of The 2002 Bioterrorism Act On The New Jersey Food Industry

This paper provides an overview of the four key sections of the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, with regard to Administrative Detention (Section 303), Facilities Registration (Section 305), Records and Maintenance (Section 306), and Prior Notice of Food Imports (Section 307). The potential impacts of the Bioterrorism Act on the food industry are examined through qualitative analysis of industry submissions to the Food and Drug Administration (FDA) docket for each provision, and quantitatively through survey results, which were administered online by the Food Institute (FI) of Woodbridge, NJ and analyzed by Rutgers, Food Policy Institute (FPI). Of the four key sections from the Bioterrorism Act that most affect the food industry, stakeholders were surveyed on two sections, Prior notice of Food Imports and Facilities Registration. While survey responses reveal that many food firms are aware of pending Bioterrorism Act policies, few however, have taken action towards compliance. Facilities registration is touted as the least cumbersome in terms of compliance. Results indicate that 50 percent of food industry professionals surveyed were not aware that many food firms must register with the FDA by the 12 December 2003 deadline; and, 20 percent, while aware of the facilities registration deadline, have done nothing to prepare. Being unprepared for and subsequently complying with Bioterrorism Act rules is an overarching concern, which is apparent in both the survey results and docket summaries. Moreover, upon review of docket submissions to the FDA, it seems that food firms are generally sympathetic towards the need for increased food system security; however, the impact of the Bioterrorism Act can be both daunting and costly. Many perceive that significant changes to capitol costs will be required to meet FDA standards.
Learning from Experience: The Public Health Response to West Nile Virus, SARS, Monkeypox, and Hepatitis A Outbreaks in the United States

Abstract : State and local public health systems play a critical role in responding to emergencies and are central to the nation's efforts to improve its preparedness for bioterrorism. But public health departments have faced some significant challenges over the years. During the last half of the 20th century, the capacity of state and local public health systems in the United States seriously declined. Problems in the systems -- such as weaknesses in laboratory capacity and poor communications with the public and health care professionals -- were vividly displayed during the anthrax attack in 2001. In the aftermath of these events. Congress and the Department of Health and Human Services (HHS) accelerated efforts to strengthen the public health infrastructure. In the spring of 2002. approximately $1.1 billion was distributed through the Office of Public Health Emergency Preparedness. the Centers for Disease Control and Prevention (CDC). and the Health Resources and Services Administration (HRSA) as part of cooperative agreements to strengthen state and local public health as well as hospital preparedness, with an additional $2.9 billion provided to the states in 2003 and 2004 (Schuler, 2004). After 3 years of major federal investment, it is appropriate to take stock of the current state of preparedness in local and state public health departments. Four recent disease outbreaks from 1999 to 2003 provide a rare opportunity to assess the quality of the public health response and to gain insights into overall preparedness for a bioterrorist attack. These outbreaks include Severe Acute Respiration Syndrome (SARS), monkeypox. and hepatitis A in 2003, and West Nile virus. Taken together, the four outbreaks tested a wide range of public health capabilities.
Iron In The Deep Gray Matter: Association With Cognitive Impairment In Multiple Sclerosis (P6.125)

OBJECTIVE: We evaluated the relationship between iron and cognition in several deep gray matter (DGM) structures while accounting for the influence of volume loss in multiple sclerosis (MS). BACKGROUND: DGM atrophy, a sign of neurodegeneration, and cognitive dysfunction are correlated in MS. However, the cause of neurodegeneration in MS is poorly understood. Because iron accumulation in the DGM is increased in MS compared to age- and sex-matched healthy controls, it may contribute to disease progression. DESIGN/METHODS: Eighty-five MS patients underwent magnetic resonance imaging (MRI) and neuropsychological examination. We used susceptibility-weighted imaging (SWI) filtered phase to analyze the mean phase of low phase voxels (MP-LPV), indicative of abnormal iron accumulation. RESULTS: Correlations between MP-LPV and cognition in MS were found in the caudate nucleus (R=0.240, p=0.030 Symbol Digits Modalities Test (SDMT); R=0.232, p=0.036 Paced Auditory Serial Addition Test 3s (PASAT3)), putamen (R=0.368, p=0.001 SDMT; R=0.252, p=0.022 Delis-Kaplan Executive Function System Sorting Test-Correct Sorts (DKEFS-CS); R=0.238, p=0.031 Brief Visuospatial Memory Test-Revised, Total Learning (BVMTR-TL)), globus pallidus (R=0.235, p=0.033 BVMTR-TL), and pulvinar nucleus of thalamus (R=0.244, p=0.027 SDMT; R=0.255, p=0.021 DKEFS-CS; R=0.251, p=0.023 BVMTR-TL). However, correlations between structure volume and cognition were more robust than correlations between MP-LPV and cognition, and the introduction of structure volume into hierarchical regression analyses after iron metrics significantly improved most models. Furthermore, MP-LPV did not account for significant variance after structure volume when predicting cognitive performance. CONCLUSIONS: These findings suggest that iron accumulation plays a significant, if minor, role in MS cognitive decline. This use of SWI technology strengthens previous findings of cognitive relationships with iron accumulation using T2 hypointensities, R2*, and magnetic field correlation. Study Supported by: This study was funded in part by National MS Society grant #RG4060A3/1 awarded to RHB Benedict. Disclosure: Dr. Modica has nothing to disclose. Dr. Zivadinov has received personal compensation for activities with Teva, Biogen Idec, EMD Serono, Novartis, Claret and Sanofi-Genzyme. Dr. Zivadinov has received research support from Biogen Idec, Teva Pharmaceuticals, Sanofi-Genzyme, Novartis and EMD Serono. Dr. Dwyer has received personal compensation for activities with EMD Serono and Claret. Dr. Bergsland has nothing to disclose. Dr. Weeks has nothing to disclose. Dr. Benedict has received personal compensation for activities with Actelion, Biogen Idec, Bayer, and Novartis. Dr. Benedict has received royalty payments from Psychological Assessment Resources. Dr. Benedict has received research support from Acorda, Biogen Idec, and Shire.
Pronostic obstétrical et fœtal des patientes atteintes de maladie de Crohn traitées par anti-TNFα pendant la grossesse. À propos d'une série rétrospective de 23 cas à l'hôpital Beaujon

Objectifs : Presenter et etudier le devenir de 23 grossesses chez des patientes atteintes de maladie de Crohn exposees aux anti-TNF-α, afin de determiner l'effet du traitement sur la maladie et la grossesse, et d'etablir le pronostic obstetrical et fœtal de ces patientes. Methode : Realisation d'une etude descriptive sur dossiers qui a permis d'identifier 23 grossesses de 2008 a 2012 a l'hopital BEAUJON, centre de reference tertiaire des MICI, AP-HP, PARIS. Resultats : 18 femmes ont eu au total 23 grossesses parmi lesquelles on compte 5 fausses couches, 14 accouchements a terme, et 4 accouchements prematures. Une moitie des patientes a ete traitee par infliximab (n=11) et l'autre moitie par adalibumab (n=12). Ce traitement a systematiquement ete arrete au debut du 3e trimestre de la grossesse en prevention de l'immunosuppression neonatale. La moitie des patientes a accouche par cesarienne, pour indications obstetricales dont une pour suspicion de SHAG. 18 enfants sont nes vivants, l'un des nouveau-nes est decede quelques heures apres l'accouchement d'une acidose metabolique. Aucune malformation apparente n'a ete retrouvee chez les nouveau-nes a la naissance. Conclusion : Le benefice/risque du traitement semble en faveur du maintien du traitement au cours de la grossesse, puisque nous n'avons retrouve aucun sur risque lie au traitement. Un suivi de grossesse regulier et une prise en charge etroite entre gynecologue, gastro-enterologue et sage-femme reste necessaire.
Coronary revascularization trends in the United States, 2001-2008.

CONTEXT Coronary revascularization is among the most common hospital-based major interventional procedures performed in the United States. It is uncertain how new revascularization technologies, new clinical evidence from trials, and updated clinical guidelines have influenced the volume and distribution of coronary revascularizations over the past decade. OBJECTIVE To examine national time trends in the rates and types of coronary revascularizations. DESIGN, SETTING, AND PATIENTS A serial cross-sectional study with time trends of patients undergoing coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions (PCIs) between 2001 and 2008 at US hospitals in the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, which reports inpatient coronary revascularizations. These data were supplemented by Medicare outpatient hospital claims. MAIN OUTCOME MEASURES Annual procedure rates of coronary revascularizations, CABG surgery, and PCI. RESULTS A 15% decrease (P < .001) in the annual rate of coronary revascularizations was observed from 2001-2002 to 2007-2008. The annual CABG surgery rate decreased steadily from 1742 (95% confidence interval [CI], 1663-1825) CABG surgeries per million adults per year in 2001-2002 to 1081 (95% CI, 1032-1133) CABG surgeries per million adults per year in 2007-2008 (P < .001), but PCI rates did not significantly change (3827 [95% CI, 3578-4092] PCI per million adults per year in 2001-2002 vs 3667 [95% CI, 3429-3922] PCI per million adults per year in 2007-2008, P = .74). Between 2001 and 2008, the number of hospitals in the Nationwide Inpatient Sample providing CABG surgery increased by 12% (212 in 2001 vs 241 in 2008, P = .03), and the number of PCI hospitals increased by 26% (246 in 2001 vs 331 in 2008, P < .001). The median CABG surgery caseload per hospital decreased by 28% (median [interquartile range], 253 [161-458] in 2001 vs 183 [98-292] in 2008; P < .001) and the number of CABG surgery hospitals providing fewer than 100 CABG surgeries per year increased from 23 (11%) in 2001 to 62 (26%) in 2008 (P < .001). CONCLUSIONS In US hospitals between 2001 and 2008, a substantial decrease in CABG surgery utilization rates was observed, but PCI utilization rates remained unchanged.
PRETERM DELIVERY: A MAJOR PREDICTOR OF PERINATAL MORBIDITY AND MORTALITY

Objective: To observe the risk factors for preterm labour and perinatal outcome in preterm fetuses. Material and Methods: This descriptive observational study was carried out in department of Obstetrics and Gynaecology, Hayatabad Medical Complex, Peshawar from 1 st December 2001 to 2002. Preterm deliveries confirmed by dates or early ultrasound between 28 and 36.6 weeks of gestation were included in this study. Socio demographic and clinical data was collected on a proforma. All data was analyzed using various statistical tests. Results: During this study period, 100 cases were observed. Significant obstetrical risk factors for preterm labour were preterm rupture of membranes and malpresentation. 104 babies were born; where 10 babies were expired, thus perinatal mortality was 9.6%. The main causes of perinatal death were birth asphyxia (40%), respiratory distress (20%), and neonatal jaundice (20%). Breech presentation, period of gestation (<32 weeks) and birth weight < 2 kg were the significant risk factors for perinatal mortality. Perinatal morbidity occurred in 20 (19.2 %) babies. Significant morbidity was birth asphyxia (n=6), neonatal jaundice (n=6) and respiratory distress (n=4). Conclusion: Significant risk factors for preterm labour were preterm premature rupture of membranes and malpresentation. Breech presentation, period of gestation and birth weight (< 2 kg) significantly contributed to early neonatal morbidity and mortality. These reflect ignorance and poor health services, which need to be improved by improving prenatal health services and advanced neonatal care.
A case report of laparoscopic management of a giant cystic ovarian mass

RESUMEN Objetivo: revisar las consideraciones tecnicas, indicaciones, riesgos y beneficios de este tipo de abordaje en masas pelvicas gigantes. Se presenta un caso en el que se realizo el abordaje laparoscopico de una masa quistica ovarica de gran tamano y su extraccion a traves de colpotomia posterior. La cirugia laparoscopica de los quistes gigantes de ovario surge como una alternativa a considerar en el manejo de estas pacientes. Palabras clave: quiste gigante de ovario, laparoscopia, colpotomia. SUMMARY Objective: reviewing technical considerations, indications, risks and benefits of a laparoscopic approach to giant ovarian cysts. A case is presented where a giant ovarian cyst was extracted by posterior colpotomy. Laparoscopic surgery on giant pelvic mass represents an alternative for managing such patients.
Faktorer associerade med låg respektive hög sjukfrånvaro vid Försäkringskassans avdelning för aktivitetsstöd

Bakgrunden till vart examensarbete var att Forsakringskassan hade som mal att sanka sjukfranvaron hos personalen. Syftet med denna studie var att undersoka de anstalldas uppfattning om vilka faktor .
Effect of Carvedilol on Blood Pressure Variability

Hypertension is currently one of the chronic diseases most frequently encountered in clinical practice, affecting a growing number of people worldwide. According to the World Health Organization, the prevalence of hypertension in people over 25 years is approximately 40%, with one billion patients being considered as uncontrolled hypertensives in 2008. Hypertension is also associated with increased cardiovascular events including acute myocardial infarction, stroke, chronic renal failure and finally death. At present there are ample pharmacological tools to manage hypertension including beta blockers, diuretics, calcium channel blockers, angiotensin converting enzymes inhibitor and angiotensin receptor inhibitor, among other agents. Although blood pressure is similarly reduced by these antihypertensive drugs, the long term benefits and the type of adverse events are not the same. As an example, beta blockers were considered a first-line treatment for this disease; however, in the last hypertension clinical guideline published in the United States, the JNC-8 (1) as well as in other clinical guidelines such as NICE in the United Kingdom, (2) this family of drugs was excluded as one of the initial therapies for hypertension. This decision was based on the increased incidence of cardiovascular events, such as cardiac death, acute myocardial infarction and stroke associated with the use of beta blockers, compared with other antihypertensive agents. Of note, these issues regarding the safety of beta blockers are mainly derived from studies with atenolol (3) and metoprolol. (4) Unfortunately, there is no similar evidence from clinical trials on the novel beta blockers with more powerful vasodilatory effect, such as carvedilol and nebivolol, which in addition have a lower risk of developing diabetes compared with classical beta blockers. The mechanism by which hypertension produces organ injury has not been clearly established. The hypothesis of mean blood pressure has been the most plausible; however, it only partially explains the pathophysiology of organ injury caused by hypertension. Subsequent studies have identified blood pres-
Influence of apolipoprotein-E gene on lipid profile, physical activity and body fat relationship

Physical activity and body fat modify lipemia, and this effect seems to be influenced by apolipoprotein-E (APOE) gene polymorphism. Thus, the purpose of this article was to review main results of studies that have analyzed the relation of APOE gene with physical activity and body fat on triglycerides, total cholesterol and low (LDL) and high density lipoprotein (HDL) concentrations. The Scientific Electronic Library Online – SciELO, Web of Science and PubMed database were used to locate the articles. The keywords used in combination were: apoe genotype, apolipoprotein-E polymorphism, physical exercise, physical activity, aerobic exercise, body fat and obesity. Originals scientific investigations performed with humans were included, and excluded those ones which involved samples with diseases, except obesity and/or lipemic disorders. It was observed a trend, that e2 allele carriers are the ones with the greater improvements on lipemia from physical exercise. In addition, the body fat impact on the elevation of triglycerides and LDL are stronger in carriers of the e2 and e4 allele, respectively. Considering the small number of originals scientific investigations and their divergent results, reliable inferences can not be made about the APOE gene polymorphism influences on physical activity and body fat effect on lipemia. Thus, further studies with others populations and more volunteers for allele, as well as others exercise modalities and intensities, are necessary.
Complementary and Alternative Medicine Secrets

SECTION ONE: GENERAL. History of Complementary and Alternative Medicine (CAM) in the US. Science and Research in CAM. Integrative medicine approach. SECTION TWO: THERAPEUTIC MODALITITES. History/traditions of each modality. How is it used? For what diagnoses has it been proven beneficial? What to look for in a practitioner of this field/ certifications & licensure. For the following modalities: Mind-body-Spirit Interventions. Placebo and belief. Creative arts therapies. Hypnosis and Imagery. Meditation. Relaxation techniques [Breathing, progressive muscle relaxation, biofeedback]. Spirituality . Yoga. Alternative Systems of Medical Practice. Ayurvedic medicine. Traditional Oriental Medicine and Acupuncture. Homeopathy. SECTION THREE: ALLOPATHIC MEDICINE. Manual healing and physical touch. Osteopathic medicine. Chiropractic. Massage. Botanical medicine. Supplements (vitamins, minerals, bioactive compounds). Nutrition (Role of fats/carbs/protein, the "best" diets, patterns of eating). Exercise, Fitness & Lifestyle. Energy medicine. SECTION FOUR: DIAGNOSES SECTION. Is there a "best" CAM treatment for this diagnosis? Evidence for diagnoses. How does CAM approach compare to allopathic approach? For these diagnoses: Affective disorders. Anxiety. Autoimmune disorders. Fibromyalgia/ chronic fatigue syndrome. Rheumatoid arthritis. Cancer. Cardiovascular. Dermatology. Gastrointestinal. Gender specific care. Infectious Disease. Metabolic/endocrine. Musculoskeletal. Neurology. Pediatrics. Resipiratory. Appendices. Searching the literature for CAM topics. The best on the Web. Legal issues and CAM. Drug herb interactions. Insurance coverage for CAM.
How Cognitive Load Influences Speakers' Choice of Referring Expressions

We report on two experiments investigating the effect of an increased cognitive load for speakers on the choice of referring expressions. Speakers produced story continuations to addressees, in which they referred to characters that were either salient or non-salient in the discourse. In Experiment 1, referents that were salient for the speaker were non-salient for the addressee, and vice versa. In Experiment 2, all discourse information was shared between speaker and addressee. Cognitive load was manipulated by the presence or absence of a secondary task for the speaker. The results show that speakers under load are more likely to produce pronouns, at least when referring to less salient referents. We take this finding as evidence that speakers under load have more difficulties taking discourse salience into account, resulting in the use of expressions that are more economical for themselves.
Malpractice risk in ambulatory settings: an increasing and underrecognized problem.

F A GROUP OF PHYSICIANS WERE ASKED TO LIST THE SPEcialties of clinical medicine that carry the highest risk of malpractice, invariably the first responses would includeobstetrics/gynecology,anesthesia,andvarioussurgical specialties. These clinical domains are well recognized to carry risk and have done so for many years. The results of adverse events in these clinical fields tend to be catastrophic and historically have often resulted in highprofilelegalcases,coveredinthemediaandassociatedwith large indemnity payments. It is the rare clinician who will list a general internist or other noninterventional outpatient specialty in the list of high-risk physicians. This unrecognized risk, and the associated absence of risk management programs in ambulatory care settings across the country, is a cause for concern. ThearticlebyBishopandcolleagues 1 inthisissueofJAMA highlights an increasing risk of malpractice in the ambulatory area and makes some tentative initial steps to identify its causes. In this way, the study is a wake-up call for physicians who practice primarily in ambulatory settings and forphysiciansandadministratorswiththeabilitytosetpolicy for these areas. Bishop and colleagues 1 used data from the National Practitioner Data Bank (NPDB), which inventories payments madeonmalpracticeeventsnationally,eitherthroughsettlement or trial resolution. The NPDB also tracks disciplinary actions made against physicians at the state level. Although 71% of the events from 2005 to 2009, the period of the study, included in the database were related to disciplinary actions, there were more than 10000 malpractice payments registered each year, resulting in a large number for the analysis by Bishop et al. 1