Miracle-dz/UniFAR-FTUs huggingface dataset:
Emergency Department Opioid Misuse Diagnoses Increasing in Adolescents and Young Adults.

Around 2 years ago, Veerajalandhar Allareddy, MD, and colleagues at the University of Iowa Stead Family Children’s Hospital started noticing a disturbing trend. An increasing number of teenagers and young adults admitted to the hospital from the emergency department (ED) were testing positive for opioids. After a physician-ordered urine or blood test revealed the drug use, the young patients often disclosed using prescription or nonprescription opioids to get high. Allareddy, who runs the pediatric and cardiac intensive care units (ICUs) at the hospital, decided to quantify the problem at a national level using the Nationwide Emergency Department Sample (NEDS), the largest allpayer ED database in the United States. Allareddy and researchers from the University of Iowa College of Dentistry and the University of Nebraska Medical Center started by looking back to 2008, the first year all patientand hospital-level metrics were available in the NEDS data set, which includes 945 hospitals. “We were very surprised to find that several thousand kids coming to the ED for any cause were diagnosed to have opioid abuse or dependence,” Allareddy said. In fact, there were 32 235 ED visits with diagnosis codes for opioid dependence or abuse (OD/OA) among patients up to and including 21 years old in 2008. The finding prompted the researchers to see how things had evolved since then. They learned the problem was growing. In 2013, the most recent year for which data were available at the time of their analysis, there were 49 626 ED visits with OD/OA in patients in the same age range. From 2008 through 2013, there were a total of 257 165 such visits. “We were totally shocked by the numbers that we saw,” Allareddy said. He put the increase in startling context: “The number of kids being diagnosed has gone up from 88 kids a day in 2008 to 136 kids a day in 2013. ” Almost all of the diagnoses were in young adults and adolescents: 88.3% of those diagnosed were 18 through 21 years old and 8.4% were 16 through 17 years old. Allareddy recently presented the findings at the annual meeting of the American Academy of Pediatrics (AAP) and published them in a letter in Pediatric Research in which he and his coauthors called opioid use disorder in children “an emerging public health crisis. ” The study “alerts us that youth are not exempt from what we’ve been seeing as a national problem related to morbidity and mortality from opioids,” said Wilson Compton, MD, deputy director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health, who was not involved with the work.
Aging Parents’ Daily Support Exchanges With Adult Children Suffering Problems

OBJECTIVES When adult children incur life problems (e.g., divorce, job loss, health problems), aging parents generally report providing more frequent support and experiencing poorer well-being. Yet, it is unclear how adult children's problems may influence aging parents' daily support exchanges with these children or the parents' daily mood. METHODS Aging parents from the Family Exchanges Study Wave 2 (N = 207, Mage = 79.86) reported providing and receiving emotional support, practical support, and advice from each adult child each day for 7 days. Parents also rated daily positive and negative mood. RESULTS Multilevel models showed that aging parents were more likely to provide emotional and practical support to adult children incurring life problems than children not suffering problems. Parents were also more likely to receive emotional support and advice from these children with problems. Further, parents reported less negative mood on days when providing practical support to children with problems. DISCUSSION Examining daily support exchanges adds to our understanding of how children's problems influence parent-child ties in late life. Prior research suggests that children's problems upset parents. In this study, however, it appears that supporting adult children who suffer problems may alleviate aging parents' distress regarding such children.
Anti-inflammatory effects of mesenchymal stem cells: novel concept for future therapies

Background: Mesenchymal stem cells (MSC) are multipotent cells that can be isolated from the bone marrow and expanded in culture relatively easily. Culture-expanded MSC have been used in clinical settings to enhance hematopoietic stem cell engraftment in bone marrow transplant patients and in tissue regeneration therapy. More recently, the anti-inflammatory effects of MSC have generated a great deal of interest. Objective/methods: In this review we describe in vitro assays that have demonstrated how MSC regulate immune cell proliferation, differentiation and phenotype. We also highlight effector molecules produced by MSC that drive this function. In addition, we focus on animal models of lung injury, in which administration of MSC attenuates inflammation, and injury revealing a central role for MSC in mitigating pro-inflammatory networks and amplifying anti-inflammatory signals. Conclusions: The discoveries described herein have contributed to the novel concept of MSC as a therapeutic modality in inflammatory diseases, including acute lung injury.
A novel software-based technique for quantifying placental calcifications and infarctions from ultrasound

In obstetrics, antenatal ultrasound assessment of placental morphology comprises an important part of the estimation of fetal health. Ultrasound analysis of the placenta may reveal abnormalities such as placental calcification and infarcts. Current methods of quantification of these abnormalities are subjective and involve a grading system of Grannum stages I-III. The aim of this project is to develop a software tool that quantifies semi-automatically placental ultrasound images and facilitates the assessment of placental morphology. We have developed a 2D ultrasound imaging software tool that allows the obstetrician or sonographer to define the placental region of interest. A secondary reference map is created for use in our quantification algorithm. Using a slider technique the user can easily define an upper threshold based on high intensity for calcification classification and a lower threshold to define infarction regions based on low intensity within the defined region of interest. The percentage of the placental area that is calcified and also the percentage of infarction is calculated and this is the basis of our new metric. Ultrasound images of abnormal and normal placentas have been acquired to aid our software development. A full clinical prospective evaluation is currently being performed and we are currently applying this technology to the three-dimensional ultrasound domain. We have developed a novel software-based technique for calculating the extent of placental calcification and infarction, providing a new metric in this field. Our new metric may provide a more accurate measurement of placental calcification and infarction than current techniques.
Cut-off Points of Waist Circumference for Defining Abdominal Obesity in the Korean Population

Center for Obesity, Nutrition and Metabolism, Pusan National University Hospital1; Department of Family Medicine, Ulsan University College of Medicine2; Department of Family Medicine, Korea University College of Medicine3; Department of Internal Medicine, The Catholic University of Korea, College of Medicine4; Department of Family Medicine, Seoul Municipal Dong-Bu Hospital5; Department of Internal Medicine, Ajou University, College of Medicine6, Health Center, Guro-gu, Seoul7; Department of Family Medicine, Eulji University College of Medicine8; Department of Internal Medicine, Hallym University, College of Medicine9; Department of Internal Medicine, Kyung Hee University, College of Medicine10; Department of Internal Medicine, Hanyang University, College of Medicine11; Department of Family Medicine, The Catholic University of Korea, College of Medicine12; Department of Family Medicine, Ilsan Paik Hospital, Inje University13; Department of Internal Medicine, Inha University, College of Medicine14
Morphologic studies on dental plaque formation: Summary

The present summary and the following papers (I-VII) are submitted in partial fulfillment of the requirements for the degree of Doctor Odontologiae at the University of Bergen.I: Growth of dental plaque on hydroxyapatite splints. A method of studying early plaque morphology. J. Periodontal Res. 1974, 9, 135-146II: Pellicle formation on hydroxyapatite splints attached to the human dentition: Morphologic confirmation of the concept of adsorption. Arch. Oral Biol. 1975, 20, 739-742III: Scanning and transmission electron microscope study of pellicle morphogenesis. Scand. J. Dent. Res. 1977, 85, 217-231IV: Early dental plaque morphogenesis. A scanning electron microscope study using the hydroxyapatite splint model and a low-sucrose diet. J. Periodontal Res. 1977, 12, 73-89V: Ultrastructural study of early dental plaque formation. J. Periodontal Res. 1978, 13, 391-409VI: Dental plaque morphology as revealed by direct observation and by replicating techniques. Acta Odontol. Scand. 1978, 36, 279-288 Co-author: F.
Association of Short-term Exposure to Air Pollution With Mortality in Older Adults

Importance The US Environmental Protection Agency is required to reexamine its National Ambient Air Quality Standards (NAAQS) every 5 years, but evidence of mortality risk is lacking at air pollution levels below the current daily NAAQS in unmonitored areas and for sensitive subgroups. Objective To estimate the association between short-term exposures to ambient fine particulate matter (PM2.5) and ozone, and at levels below the current daily NAAQS, and mortality in the continental United States. Design, Setting, and Participants Case-crossover design and conditional logistic regression to estimate the association between short-term exposures to PM2.5 and ozone (mean of daily exposure on the same day of death and 1 day prior) and mortality in 2-pollutant models. The study included the entire Medicare population from January 1, 2000, to December 31, 2012, residing in 39 182 zip codes. Exposures Daily PM2.5 and ozone levels in a 1-km × 1-km grid were estimated using published and validated air pollution prediction models based on land use, chemical transport modeling, and satellite remote sensing data. From these gridded exposures, daily exposures were calculated for every zip code in the United States. Warm-season ozone was defined as ozone levels for the months April to September of each year. Main Outcomes and Measures All-cause mortality in the entire Medicare population from 2000 to 2012. Results During the study period, there were 22 433 862 million case days and 76 143 209 control days. Of all case and control days, 93.6% had PM2.5 levels below 25 &mgr;g/m3, during which 95.2% of deaths occurred (21 353 817 of 22 433 862), and 91.1% of days had ozone levels below 60 parts per billion, during which 93.4% of deaths occurred (20 955 387 of 22 433 862). The baseline daily mortality rates were 137.33 and 129.44 (per 1 million persons at risk per day) for the entire year and for the warm season, respectively. Each short-term increase of 10 &mgr;g/m3 in PM2.5 (adjusted by ozone) and 10 parts per billion (10−9) in warm-season ozone (adjusted by PM2.5) were statistically significantly associated with a relative increase of 1.05% (95% CI, 0.95%-1.15%) and 0.51% (95% CI, 0.41%-0.61%) in daily mortality rate, respectively. Absolute risk differences in daily mortality rate were 1.42 (95% CI, 1.29-1.56) and 0.66 (95% CI, 0.53-0.78) per 1 million persons at risk per day. There was no evidence of a threshold in the exposure-response relationship. Conclusions and Relevance In the US Medicare population from 2000 to 2012, short-term exposures to PM2.5 and warm-season ozone were significantly associated with increased risk of mortality. This risk occurred at levels below current national air quality standards, suggesting that these standards may need to be reevaluated.
Feasibility and Prognostic Value of Stress Echocardiography in Obese, Morbidly Obese, and Super Obese Patients Referred for Bariatric Surgery

Stress echocardiography (SE) is clinically used in the risk stratification and prognosis of patients with coronary artery disease. Due to multiple comorbidities, obese patients have increased risk of adverse cardiovascular events perioperatively in noncardiac surgery. The aim of this study was to investigate the feasibility of SE in morbidly obese patients undergoing bariatric surgery.
Making sense of intimate partner violence in late life: comments from online news readers.

PURPOSE The purpose of this study was to gain insight into public awareness of intimate partner violence (IPV) in late life by how individuals respond to incidents of IPV reported in the newspaper. DESIGN AND METHODS Using grounded theory techniques, online news items covering 24 incidents of IPV in late life, and the reader comments posted to them were analyzed. The news items were examined for incident details, story framing, and reporting style. An open coding process (Charmaz, K. [2006]. Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage Publications.) was used to generate a comprehensive understanding of themes and patterns in the comments posted by readers. RESULTS Few posters indicated that incidents were episodes of IPV. As many posters struggled to make sense of incidents, they attempted to remove guilt from the perpetrator by assigning blame elsewhere. Comments were influenced by personal assumptions and perspectives about IPV, relationships, and old age; reporting style of the news items; and comments posted by other posters. IMPLICATIONS Altering public views of IPV in late life requires raising awareness through education, reframing the ways in which information is presented, and placing greater emphasis on the context of the violence. By engaging interactive news media, reporters, participatory journalists, and policymakers can enhance public recognition and understanding of IPV in late life.
FP862SERUM OSTEOPROTEGERIN LEVELS ASSOCIATED WITH AORTIC AUGMENTATION INDEX IN RENAL TRANSPLANT RECIPIENTS

Objectives: Arterial stiffness is recognized as an independent risk factor for cardiovascular morbidity and mortality. Recent studies found that osteoprotegerin (OPG) is associated with arterial stiffness and may reflect endothelial dysfunction. The aim of this study was to evaluate the relationship between fasting serum OPG levels and the aortic augmentation index (AIx) in renal transplant recipients. Materials and methods: Fasting blood samples were obtained from 66 renal transplant recipients. The aortic AIx was measured using a validated tonometry system (SphygmoCor). Serum OPG levels were measured using a commercial enzyme-linked immunosorbent assay kit. Results: Univariate linear analysis of the aortic AIx in renal transplant recipients revealed that body fat mass (r 1⁄4 0.377, p 1⁄4 0.002), aortic diastolic blood pressure (DBP; r 1⁄4 0.307, p 1⁄4 0.020), triglycerides (r 1⁄4 0.260, p 1⁄4 0.035), and logarithmically transformed OPG (log-OPG, r 1⁄4 0.402, p < 0.001) were positively correlated, whereas height (r 1⁄4 0.361, p 1⁄4 0.004) and body weight (r 1⁄4 0.212, p 1⁄4 0.041) were negatively correlated with the aortic AIx in renal transplant recipients. Multivariate forward stepwise linear regression analysis of the factors significantly associated with the aortic AIx showed that log-OPG (R2 1⁄4 0.213, p < 0.001), height (R2 1⁄4 0.081, p 1⁄4 0.009), and aortic DBP (R2 1⁄4 0.058, p 1⁄4 0.022) were independent predictors of the aortic AIx in renal transplant recipients. Conclusion: These results suggest that the serum fasting OPG level is associated with the aortic AIx in renal transplant recipients. Copyright © 2016, Buddhist Compassion Relief Tzu Chi Foundation. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
Guidelines for the Content of Statistical Analysis Plans in Clinical Trials

Importance While guidance on statistical principles for clinical trials exists, there is an absence of guidance covering the required content of statistical analysis plans (SAPs) to support transparency and reproducibility. Objective To develop recommendations for a minimum set of items that should be addressed in SAPs for clinical trials, developed with input from statisticians, previous guideline authors, journal editors, regulators, and funders. Design Funders and regulators (n = 39) of randomized trials were contacted and the literature was searched to identify existing guidance; a survey of current practice was conducted across the network of UK Clinical Research Collaboration–registered trial units (n = 46, 1 unit had 2 responders) and a Delphi survey (n = 73 invited participants) was conducted to establish consensus on SAPs. The Delphi survey was sent to statisticians in trial units who completed the survey of current practice (n = 46), CONSORT (Consolidated Standards of Reporting Trials) and SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guideline authors (n = 16), pharmaceutical industry statisticians (n = 3), journal editors (n = 9), and regulators (n = 2) (3 participants were included in 2 groups each), culminating in a consensus meeting attended by experts (N = 12) with representatives from each group. The guidance subsequently underwent critical review by statisticians from the surveyed trial units and members of the expert panel of the consensus meeting (N = 51), followed by piloting of the guidance document in the SAPs of 5 trials. Findings No existing guidance was identified. The registered trials unit survey (46 responses) highlighted diversity in current practice and confirmed support for developing guidance. The Delphi survey (54 of 73, 74% participants completing both rounds) reached consensus on 42% (n = 46) of 110 items. The expert panel (N = 12) agreed that 63 items should be included in the guidance, with an additional 17 items identified as important but may be referenced elsewhere. Following critical review and piloting, some overlapping items were combined, leaving 55 items. Conclusions and Relevance Recommendations are provided for a minimum set of items that should be addressed and included in SAPs for clinical trials. Trial registration, protocols, and statistical analysis plans are critically important in ensuring appropriate reporting of clinical trials.
A Qualitative Study Examining Factors Related to Treatment Adherence in Persons with Long QT Syndrome

Long QT syndrome (LQTS) is an electrophysiological disorder of the heart affecting as many as 1 in 2,000 persons. LQTS can result in potentially catastrophic and fatal arrhythmias in infants, children, adolescents, and adults. Maintaining adherence to treatment can decrease these negative outcomes and result in favorable quality of life in this population. The present study utilized a qualitative research design to examine and understand nonadherent and adherent behaviors in persons with LQTS. This study was part of a larger study and used a sample from an existing online LQTS user group message board consisting of 780 international members. A total of 68 messages were analyzed, representing 37 global participants. It was found that the overall vagueness in diagnosis and treatment of LQTS and a resulting feeling of loss of control negatively impacted adherent behavior. In addition, it was theorized that several subtypes of compliance may be relevant: precompliance, hypercompliance, and pseudocompliance. vi LQTS NONADHERENCE
Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood.

BACKGROUND The risk of type 2 diabetes mellitus is increased in people who have low birth weights and who subsequently become obese as adults. Whether their obesity originates in childhood and, if so, at what age are unknown. Understanding the origin of obesity may be especially important in developing countries, where type 2 diabetes is rapidly increasing yet public health messages still focus on reducing childhood "undernutrition. " METHODS We evaluated glucose tolerance and plasma insulin concentrations in 1492 men and women 26 to 32 years of age who had been measured at birth and at intervals of three to six months throughout infancy, childhood, and adolescence in a prospective, population-based study. RESULTS The prevalence of impaired glucose tolerance was 10.8 percent, and that of diabetes was 4.4 percent. Subjects with impaired glucose tolerance or diabetes typically had a low body-mass index up to the age of two years, followed by an early adiposity rebound (the age after infancy when body mass starts to rise) and an accelerated increase in body-mass index until adulthood. However, despite an increase in body-mass index between the ages of 2 and 12 years, none of these subjects were obese at the age of 12 years. The odds ratio for disease associated with an increase in the body-mass index of 1 SD from 2 to 12 years of age was 1.36 (95 percent confidence interval, 1.18 to 1.57; P<0.001). CONCLUSIONS There is an association between thinness in infancy and the presence of impaired glucose tolerance or diabetes in young adulthood. Crossing into higher categories of body-mass index after the age of two years is also associated with these disorders.
Transcoronary transplantation of progenitor cells after myocardial infarction.

BACKGROUND Pilot studies suggest that intracoronary transplantation of progenitor cells derived from bone marrow (BMC) or circulating blood (CPC) may improve left ventricular function after acute myocardial infarction. The effects of cell transplantation in patients with healed myocardial infarction are unknown. METHODS After an initial pilot trial involving 17 patients, we randomly assigned, in a controlled crossover study, 75 patients with stable ischemic heart disease who had had a myocardial infarction at least 3 months previously to receive either no cell infusion (23 patients) or infusion of CPC (24 patients) or BMC (28 patients) into the patent coronary artery supplying the most dyskinetic left ventricular area. The patients in the control group were subsequently randomly assigned to receive CPC or BMC, and the patients who initially received BMC or CPC crossed over to receive CPC or BMC, respectively, at 3 months' follow-up. RESULTS The absolute change in left ventricular ejection fraction was significantly greater among patients receiving BMC (+2.9 percentage points) than among those receiving CPC (-0.4 percentage point, P=0.003) or no infusion (-1.2 percentage points, P<0.001). The increase in global cardiac function was related to significantly enhanced regional contractility in the area targeted by intracoronary infusion of BMC. The crossover phase of the study revealed that intracoronary infusion of BMC was associated with a significant increase in global and regional left ventricular function, regardless of whether patients crossed over from control to BMC or from CPC to BMC. CONCLUSIONS Intracoronary infusion of progenitor cells is safe and feasible in patients with healed myocardial infarction. Transplantation of BMC is associated with moderate but significant improvement in the left ventricular ejection fraction after 3 months.