Miracle-dz/UniFAR-FTUs huggingface dataset:
Pediatric Acetaminophen Overdose: Assessing the Risk

Isbister and collegues (1) take issue with the prompt use of ipecac syrup at home to decontaminate children who ingested 150–200 mg/kg of acetaminophen as recommended in our study (2). They also question the validity of the current Rumack-Matthews nomogram to predict hepatotoxicity in children and suggest that dose may be a better predictor. They propose a new nomogram treatment line for ingestion of liquid preparations based on a 2-hour serum concentration that is more conservative than the original ‘‘probable risk’’ line. The serum acetaminophen concentration is currently the best biomarker available to predict which patient may develop hepatotoxicity after an acute ingestion. Like much data in pharmacology and toxicology, this information was derived from adults and has been extrapolated to children. In order to determine whether children would tolerate substantially larger doses or higher blood concentrations than adults, a large observational study of untreated subjects would be required. Such a study would be difficult to perform since the risks of N-acetylcysteine (NAC) treatment are relatively benign compared to the adverse effects associated with hepatic toxicity. Thus, we are obligated to use the current nomogram to assess the need for treatment of acute acetaminophen overdose in children even if it overestimates the risk. The conservative use of a biomarker with a high negative predictive value may be partially responsible for the low mortality of such ingestions. Obtaining a history from small children is usually ‘‘by proxy’’ through parents or caretakers and frequently unreliable. The standard method used in poison centers to
Juvenile Referrals in Texas: An Assessment of Criminogenic Needs and the Gap Between Needs and Services

Researchers emphasize the importance of risk and criminogenic needs in developing intervention strategies for juvenile offenders. Yet, few jurisdictions collect information about the risk/needs profile of known youthful offenders or whether their needs are being addressed. This study estimated the prevalence of mental health, substance abuse, educational, and family-related needs for youths referred to seven juvenile probation departments in Texas, which represent 21% of referrals statewide. Analyses indicate that the most prevalent needs are problems associated with parental supervision, school behavior, school attendance, parental/family problems, disposition/self-image, and substance abuse. Additional analyses suggest that substantial gaps exist between the number of juveniles needing and receiving programs and services. It is concluded that such information is absolutely essential if policy makers are to formulate appropriate and adequate intervention strategies for court-involved youth.
Special Issue on Compilation Techniques for Distributed Memory Systems: Guest Editors' Introduction

these systems to achieve the desired high performance is very complex and needs a highly advanced programmer. Even debugging such parallel programs through detecting asynchronous race conditions and deadlocks demands considerable sophistication on the part of the compiler and the debugger. In these systems, the cost of interprocessor communication is higher than that of accessing data in local memories. Since communication is a bottleneck, a popular approach is to first determine a data partition and then align the code to minimize the communication. One of the programmer’s difficulties is that they must specify a data partition and/ or a code mapping. Data parallel programming, in which the user is responsible for mapping the data elements and the compiler manages code generation to maximize locality of reference and avoid expensive communication, is one of the most popular and successful approaches. This approach works quite well for most regular numeric applications and saves much analysis on the part of the compiler. Although popular, such an approach mandating user participation has severe limitations due to the following reasons:
Embeddings of Star Graphs into Optical Meshes without Bends

We show an embedding of the star graph into a rectangular optical multichannel mesh ofddimensions such that the embedding has no bends; that is, neighbors in the star graph always differ in exactly one coordinate in the mesh, to facilitate one-hop optical communication. To embed ann-star, the mesh can have any number of dimensionsdbetween 1 andn? 1. The embedding has load 1 and an expansion of at mostnd? 1/d! The size of the mesh will be at most We optimize the size of the host mesh using clique-partitioning to produce embeddings with expansions as low as unity. In two dimensions, for evenn, the mesh will be no larger thann×n(n? 2)! , and have an expansion of no more than 1 1/(n? 1). Further, we show how we can use a contraction method to efficiently embed the star graph into an optical mesh with near-unity aspect ratios. Contraction on a two-dimensional embedding will yield a mesh of size no larger thann×nfor evennwith a load of (n? 2)!
The Onshore Transport of an Oil Spill by Internal Waves

Internal waves generated by tidal currents concentrated and transported an oil spill (liquid asphalt) onshore. Plankton net samples were collected in front of and behind a set of internal waves as well as in the convergence and divergence zones over the waves. Tar "balls" were most abundant (greater than 30-fold) in the samples from the convergence zone. Comparison of the abundance of tar balls in front of and behind the set of waves suggests that the internal waves "caught" about 68% of the asphalt encountered and concentrated and swept shoreward tar balls from almost 8 kilometers of ocean.
Race/Ethnicity and Gender Differences in Hyperhomocysteinemia and Folate and Vitamin B12 Status in American Elderly

Abstract The purpose of this research was to study the racial and gender differences in the prevalence of hyperhomocysteinemia > 16.4 nmol/ml), and in the status of folate and vitamin B12 in the American elderly from the NHANES III data. Black males had the highest prevalence (17.3%) of hyperhomocysteinemia, followed by Mexican males (12.7%), White males (12.4%), Black females (10.6%), White females (9.8%) and Mexican females (3.4%). Higher incidences of hyperhomocysteinemia were associated with lower folate and vitamin B12 status. The Black elderly had the poorest folate status, followed by the Mexican and White elderly. Conversely, the White elderly had the poorest vitamin B status, followed by Blacks and Mexicans.
Distance based multiple swarms formulation method in particle swarm optimization

Particle swarm optimization (PSO) is a solution to the functional optimization problem. PSO has been used in various fields because it has a simple algorithm and is characterized by being versatile with rapid convergence. However, because of its rapid convergence, it may fall into a local optimum especially when the problem has a large number of local solutions. In this paper, we propose a new type of PSO that forms swarms according to distances between particles, with the aim of addressing this local optima issue. Forming swarms in this way makes it possible for each particle to search the region of its own periphery in detail. The results of performance evaluation experiments using computer simulation verified that this method is less likely to get trapped in a local solution compared with conventional PSO.
Aripiprazole for the Treatment of Adolescent Tourette’s Syndrome

Gilles de la Tourette syndrome (GTS) is a neuropsychiatric, lifelong disorder with onset in childhood. The essential features of this disorder are multiple motor tics and one or more vocalizations. The neurochemical pathophysiology of GTS involves an unknown abnormality in the central dopaminergic system. Atypical antipsychotics, such as aripiprazole, serve as a new therapeutic option for GTS. The authors describe a unique case of Tourette’s syndrome (TS) in an adolescent in which aripiprazole resolved the patient’s symptoms. A 17-year-old, 5′11′′ tall, African American male weighing 220 lbs was diagnosed with TS at 9 years old. By age 16, the patient developed prominent symptoms of intermitted eye blinking, forehead raising, finger snapping, heavy breathing, and head bobbing. Clonidine, in addition to homeopathic remedies (N-acetylcholine and alpha lipoic acid), was administered to the patient without significant diminution of symptoms. Later, aripiprazole was initiated at 5 mg/d. As a result, noticeable symptomatic improvement occurred within 48 hours. Aripiprazole was titrated over the next 4 weeks to 6.5 mg/d, with significant results. Over the next 6 months, aripiprazole was titrated again to 10 mg/d with additional symptom reduction. This case illustrates a patient who responded to aripiprazole with no reported adverse effects, when standard therapy failed to improve symptoms.
Discovering contextual knowledge with associated information in dimensional structured knowledge bases

The visualization and simplification of complex semantically-related knowledge is one of the main challenges in knowledge discovery. In this regard, the knowledge map is a good visualization instrument to represent and provide suitable information with analysis potential. Multidimensional knowledge bases aim to support this objective and store automatically extracted facts and their dimensional relations from textual knowledge resources. In this paper, a dynamic layout structure for knowledge maps based on dimensional information is introduced. The Concept of the Imitation of the Mental Ability of Word Association (CIMAWA) is applied in this approach to create a graphical structure as arrangement of associated information on different levels of textual information.
Fundamentals of Pediatric Orthopedics

Features: Thoroughly up-to-date and evidence-based, including expanded material on sports medicine. Lavishly illustrated with over 1,700 color drawings and photographs – a uniquely visual approach you’ll appreciate for rapid reference and quick understanding. Parent education guides make it easy to provide important information to caregivers and increase compliance. Comprehensive coverage includes growth, evaluation, management, trauma, sports, infections, and tumors, as well as each anatomical area: lower limb, foot, knee, hip, spine, and upper limb. Designed to meet the everyday needs of health care practitioners who are involved with pediatric musculoskeletal problems, including primary care physicians, pediatricians, and orthopedists.
Self-Stabilizing Deterministic Network Decomposition

We present a simple and efficient self-stabilizing protocol for the network partitioning problem. Given a graph with k2 nodes, our decomposition scheme partitions the network into connected and disjoint partitions, with k nodes per partition. The proposed algorithm starts with a spanning tree of the graph, but uses some links which do not belong to the tree, if necessary. The protocol is self-stabilizing meaning that starting from an arbitrary state, it is guaranteed to reach a state where the network is correctly partitioned. The protocol stabilizes in 3(h+1) rounds, where h is the height of the tree. We also propose solutions to the case where the network size is n? k2. Hence our protocol works for dynamic systems in the sense that the protocol can adapt to changes of the network size. We discuss an important application of the proposed protocol.
Ingestion of Microplastics by Freshwater Tubifex Worms.

Microplastic contamination of the aquatic environment is a global issue. Microplastics can be ingested by organisms leading to negative physiological impacts. The ingestion of microplastics by freshwater invertebrates has not been reported outside the laboratory. Here we demonstrate the ingestion of microplastic particles by Tubifex tubifex from bottom sediments in a major urban waterbody fed by the River Irwell, Manchester, UK. The host sediments had microplastic concentrations ranging from 56 to 2543 particles kg-1. 87% of the Tubifex-ingested microplastic particles were microfibers (55-4100 μm in length), while the remaining 13% were microplastic fragments (50-4500 μm in length). FT-IR analysis revealed ingestion of a range of polymers, including polyester and acrylic fibers. While microbeads were present in the host sediment matrix, they were not detected in Tubifex worm tissue. The mean concentration of ingested microplastics was 129 ± 65.4 particles g-1 tissue. We also show that Tubifex worms retain microplastics for longer than they retain other particulate components of the ingested sediment matrix. Microplastic ingestion by Tubifex worms poses a significant risk for trophic transfer and biomagnification of microplastics up the aquatic food chain.
Fluid Processes in Subduction Zones

Fluids play a critical role in subduction zones and arc magmatism. At shallow levels in subduction zones (<40 kilometers depth), expulsion of large volumes of pore waters and CH4-H2O fluids produced by diagenetic and low-grade metamorphic reactions affect the thermal and rheological evolution of the accretionary prism and provide nutrients for deep-sea biological communities. At greater depths, H2O and CO2 released by metamorphic reactions in the subducting oceanic crust may alter the bulk composition in the overlying mantle wedge and trigger partial melting reactions. The location and conse-quences of fluid production in subduction zones can be constrained by consideration of phase diagrams for relevant bulk compositions in conjunction with fluid and rock pressure-temperature-time paths predicted by numerical heat-transfer models. Partial melting of subducting, amphibole-bearing oceanic crust is predicted only within several tens of million years of the initiation of subduction in young oceanic lithosphere. In cooler subduction zones, partial melting appears to occur primarily in the overlying mantle wedge as a result of fluid infiltration.
Evaluation of Pharmacist Continuing Professional Development Portfolios

Objective: The purpose of this study was to conduct a random continuing professional development (CPD) portfolio audit to assess the portfolios of pharmacists who completed CPD training in the state of North Carolina and reported adopting it in place of the annual 15-hour continuing education (CE) requirement when applying for re-licensure. Methods: The NC Board of Pharmacy (NCBOP) staff randomly selected 30 pharmacists to provide CPD portfolio documentation to the Board electronically or in paper format. This documentation included their completed learning plan, a learning activity worksheet for each completed activity, and the Accreditation Council on Pharmacy Education (ACPE) universal activity number for the CPD training program attended. The Task Force used a multicomponent audit tool to assess each portfolio. Results: Eighty percent of portfolios had at least 15 hours of learning reported. Portfolio assessments indicated an average of 5 learning objectives per individual. Based on the scale of 1 to 5, the Measurable and Specific sections of the objectives scored the lowest with an average score of 3 on both sections. An overall assessment of “adequate” or “comprehensive” was noted for 60% of the portfolios. Conclusion: Pharmacists completing CPD training are capable of following the CPD process with some potential challenges in documentation. Information submitted to the board of pharmacy is considered sufficient for license renewal purposes.
Research misconduct is widespread and harms patients

The best writing transforms the writer as well as the reader. I can’t claim transformation for you when you read the editorial on research misconduct in the UK (doi:10.1136/bmj.d8357), but I do claim it for me. Writing it with Elizabeth Wager changed my own views, largely thanks to conversations with those we sent it to for comment. The editorial prefaces a joint BMJ /COPE meeting on 12 January on research misconduct in the UK. As Aniket Tavare makes clear, the UK is lagging behind other developed countries in still having no proper system for tackling misconduct (doi:10.1136/bmj.d8212). Discussions and initiatives have focused on research fraud, defined as fabrication, …
Safety of Varenicline in Patients With Cardiovascular Disease

Smoking cessation lowers the risk of death substantially in patients with cardiovascular disease. Although varenicline is an effective medication for smoking cessation, its safety in this population has been questioned and evaluated in several studies. In 2 randomized controlled trials of patients with cardiovascular disease, the rates of serious cardiovascular events were up to 2% higher in patients receiving varenicline than placebo, though the differences were not statistically significant. In the first meta-analysis of mostly trials involving patients with a history of cardiovascular disease, varenicline was found to significantly increase the risk of cardiovascular events by 72%; however, a second meta-analysis did not find a significant increased risk. In an observational study, varenicline was not associated with an increased risk of events when compared to bupropion in a subgroup analysis of patients with a history of cardiovascular disease. Because the evidence on the safety of varenicline in this population is limited and conflicting, additional data are needed to formulate stronger conclusions. In the meantime, health care professionals should consider individual smoking patterns, concomitant medical conditions, and cost when recommending smoking cessation pharmacotherapy for patients with cardiovascular disease.
Informal caregivers in home palliative care

Abstract In order to deliver palliative care in line with the WHO definition, we must identify and support caregivers. This paper addresses some fundamental questions in defining, identifying and delivering interventions to caregivers. These considerations are key to organisation of appropriate health services, design and conduct of research, and specification and improvement of outcomes. Firstly we consider how we identify caregivers, and how we conceptualise a caregiver from the perspective of health service providers and researchers. We consider caregiver roles across cultures and settings. We then describe the challenges to selecting appropriate outcomes and what our expectations should be for intervention studies in terms of effectiveness, and the tools we use to assess and measure caregiver needs. We conclude with recommendations for future outcomes research.
Gröbner Bases over Galois Rings with an Application to Decoding Alternant Codes

We develop a theory of Grobner bases over Galois rings, following the usual formulation for Grobner bases over finite fields. Our treatment includes a division algorithm, a characterization of Grobner bases, and an extension of Buchberger? s algorithm. One application is towards the problem of decoding alternant codes over Galois rings. To this end we consider the module M= {(a, b) :aS? b modxr} of all solutions to the so-called key equation for alternant codes, where S is a syndrome polynomial. In decoding, a particular solution (? , ? ) ? M is sought satisfying certain conditions, and such a solution can be found in a Grobner basis of M. Applying techniques introduced in the first part of this paper, we give an algorithm which returns the required solution.
A 50,000-Year Record of Climate Oscillations from Florida and Its Temporal Correlation with the Heinrich Events

Oscillations of Pinus (pine) pollen in a 50,000-year sequence from Lake Tulane, Florida, indicate that there were major vegetation shifts during the last glacial cycle. Episodes of abundant Pinus populations indicate a climate that was more wet than intervening phases dominated by Quercus (oak) and Ambrosia-type (ragweed and marsh-elder). The Pinus episodes seem to be temporally correlated with the North Atlantic Heinrich events, which were massive, periodic advances of ice streams from the eastern margin of the Laurentide Ice Sheet. Possible links between the Tulane Pinus and Heinrich events include hemispheric cooling, the influences of Mississippi meltwater on sea-surface temperatures in the Gulf of Mexico, and the effects of North Atlantic thermohaline circulation on currents in the Gulf.
Chicxulub Multiring Impact Basin: Size and Other Characteristics Derived from Gravity Analysis

The buried Chicxulub impact structure in Mexico, which is linked to the Cretaceous- Tertiary (K-T) boundary layer, may be significantly larger than previously suspected. Reprocessed gravity data over Northern Yucatan reveal three major rings and parts of a fourth ring, spaced similarly to those observed at multiring impact basins on other planets. The outer ring, probably corresponding to the basin's topographic rim, is almost 300 kilometers in diameter, indicating that Chicxulub may be one of the largest impact structures produced in the inner solar system since the period of early bombardment ended nearly 4 billion years ago.
Early Marriage and Childbearing Remain Common in Much of Developing World, Even as Fertility Falls

A review of the findings of a 25 country analysis of Demographic and Health Survey data of rates of childbearing is presented. It is pointed that only in sub Saharan Africa is teenage childbearing (15-19) year olds) high at 103-209 live births/1000 women. The fertility trends showed wide variation among regions. Sub-Saharan Africa had the highest rates with >6 children/woman. 3 Asian countries had the lowest at 2-4 births/women. Intermediate levels of 4-5 were found in north Africa and in Latin America and the Caribbean except Guatemala 15%. Sub-Saharan Africa declines ranged from 6. Survival rates were lowest in sub-Saharan Africa (90% surviving) but ranged from 6%-39% of children lost to women 45-49 years. The common range was 82-89%. The median age at 1st birth ranged from 18.3-23.1 years with sub-Saharan African women showing a 2 years younger age at 1st birth. It was at last 20 years in the other countries but 2. Comparison of women aged 25-29 and 40-44 and 1st birth varied by region.
PERINATAL FACTORS AFFECTING HUMAN DEVELOPMENT (PAHO Scientific Publication No. 185)

This book is a veritable treasure trove of up-to-the-minute information on perinatal factors affecting the immediate and long-term outcome of pregnancy and their relation to prevention of pregnancy wastage. The text comprises a series of short papers and formal discussions presented at a special session of the PAHO Advisory Committee on Medical Research. The participants, an internationally distinguished group of clinicians and investigators, represent the disciplines of obstetrics, pediatrics, neonatal and perinatal physiology, and pathology. Data are analyzed from prospective and retrospective studies on both animal and human subjects covering a chronology of factors affecting pregnancy, the fate and state of the fetus in utero, as well as early neonatal and infant growth and development. Some of the more provocative subjects covered are: relationships of maternal nutrition to fetal intrauterine growth and its subsequent neurological growth and development; the role of twinning, rapidly succeeding pregnancies and complications of pregnancy on intrauterine growth, and postneonatal neurological growth and development; assessment of the fetus in utero by means of contemporary monitoring techniques such as ultrasound (sonography), arteriography (to study utero-placental circulation), electroencephalography, electrocardiography, and fetal scalp blood sampling (to assess fetal acid-base status during labor). Finally, fetal asphyxia and perinatal brain damage are explored from the viewpoints of prevention, diagnosis, and treatment. These proceedings are an important contribution to the prevention of perinatal mortality and postperinatal morbidity. The reviewer enthusiastically recommends inclusion of this volume in the library of the obstetrician, pediatrician, neonatologist, and all health professionals whose major interests lie in the field of maternal and child health.