50 research outputs found
Prenatal exposure to antipsychotic medication and use of primary health care system in childhood: a population-based cohort study in Denmark
No full textAnne Mette Lund Würtz,1,2 Claus Høstrup Vestergaard,1 Dorte Rytter,2 Merete Juul Sørensen,3 Jakob Christensen,4 Mogens Vestergaard,1,5 Bodil Hammer Bech1,2 1Research Unit for General Practice, 2Section for Epidemiology, Department of Public Health, Aarhus University, 3Regional Centre for Child and Adolescent Psychiatry, 4Department of Neurology, Aarhus University Hospital, 5Section for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark Background: Antipsychotic (AP) medication is increasingly used for many health conditions. Prenatal exposure to AP medication has been associated with several adverse outcomes, but the findings remain inconsistent.Purpose: We aimed to investigate prenatal exposure to AP medication and the use of primary health care system in childhood.Subjects and methods: All live-born singletons in Denmark during 1997–2012 were identified in the nationwide Danish National Patient Register and followed until December 31, 2013 (n = 963,010). Information on prenatal exposure to AP medication was obtained from the Danish Register of Medicinal Product Statistics. Contacts to the general practitioner (GP) were used as a proxy for the overall health of the children. Negative binomial regression was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between prenatal exposure to AP medication and number and type of GP contacts, excluding routine well-child visits and vaccinations. The models were adjusted for sex and birth date of the child, maternal age, parity, cohabitation status, income, education, smoking status, diagnosis of substance abuse, severe psychiatric disorder, depression and epilepsy as well as the use of antiepileptic drugs, antidepressants, benzodiazepines and insulin.Results: The prenatally AP-exposed children had 7% more GP contacts than unexposed children, IRR: 1.07 (95% CI: 1.03, 1.11). The association was slightly stronger among children of mothers with no diagnosis of severe psychiatric disorder (IRR: 1.08, 95% CI: 1.04–1.13) than among children of mothers with severe psychiatric disorder (IRR: 1.03, 95% CI: 0.96–1.11), but the difference was not statistically significant. We found no difference between prenatally AP-exposed children and their unexposed siblings, IRR: 1.00 (95% CI: 0.97–1.04) for total contacts.Conclusion: Children of women using AP medication in pregnancy had more GP contacts in childhood than children of mothers not using AP medication. However, this might be explained by confounding from maternal behavior and mental illness. Keywords: antipsychotic medication, prenatal drug exposure, primary health care, general practitioner 
Psychiatric conditions and general practitioner attendance prior to HPV vaccination and the risk of referral to a specialized hospital setting because of suspected adverse events following HPV vaccination: a register-based, matched case–control study
No full textTina Hovgaard Lützen,1 Bodil Hammer Bech,2 Jesper Mehlsen,3 Claus Høstrup Vestergaard,1 Lene Wulff Krogsgaard,1 Jørn Olsen,4 Mogens Vestergaard,1 Oleguer Plana-Ripoll,5 Dorte Rytter2 1Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark; 2Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark; 3Coordinating Research Centre, Frederiksberg Hospital, Frederiksberg, Denmark, 4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; 5National Center for Register-based Research, Aarhus University, Aarhus V, Denmark Aim: No association between human papilloma virus (HPV) vaccination and numerous diseases has been found. Still, a large number of Danish women are reporting suspected adverse events. Other factors may play a role, and the aim of this study is to examine the association between psychiatric conditions, general practitioner (GP) attendance and indicators of psychological symptoms prior to HPV vaccination and the risk of referral to an HPV center following vaccination. Study design and setting: Register-based, matched case–control study. Cases were identified from five Danish, regional HPV centers, and health data for cases and controls were obtained from national registries. Participants: Cases were defined as women referred to an HPV center between January 1, 2015 and December 31, 2015 (n=1,496). Each case was matched with five controls on age, region and time of first vaccine registration. The total study population consisted of 8,976 women. Results: Overall, women above 18 years who had been referred to an HPV center were more likely to have used psychiatric medication (odds ratio [OR]: 1.88 [95% CI 1.48–2.40]) or to have been hospitalized because of a psychiatric disorder within 5 years prior to the first vaccine registration (OR: 2.13 [95% CI 1.59–2.86]). Specifically, referred women were more likely to have used antipsychotics, antidepressants, attention deficit hyperactivity disorder (ADHD) medication or anxiolytics, and to have been hospitalized for affective disorders or anxiety, but not to have been hospitalized for schizoid, ADHD or eating disorders. In addition, they were more likely to have had talk therapy or psychometric test performed prior to vaccination (OR: 1.72 [95% CI 0.1.35–2.18] and OR: 1.67 [95% CI 1.30–2.13], respectively). Referred women of all ages had higher use of GP before vaccination. Population attributable fraction analyses indicated that psychiatric medication, hospitalization due to a psychiatric disorder and use of talk therapy, or psychometric test “explained” 13%, 10%, 12% and 11% of the referrals, respectively. Results did not change substantially when adjusted for potential confounders. Conclusion: Women referred to HPV centers because of suspected adverse events after vaccination more often had preexisting psychiatric conditions, psychological symptoms or frequent GP attendance prior to HPV vaccination. Keywords: papillomavirus vaccines, adverse drug events, psychoactive drugs, general practic
The XMM-Newton long look of NGC 1365: uncovering of the obscured X-ray source
No full textWe present an analysis of the extreme obscuration variability observed during an XMM–Newton 5-d continuous monitoring of the active galactic nuclei (AGN) in NGC 1365. The source was in a reflection-dominated state in the first ∼1.5 d, then a strong increase in the 7–10 keV emission was observed in ∼10 h, followed by a symmetric decrease. The spectral analysis of the different states clearly shows that this variation is due to an uncovering of the X-ray source. From this observation, we estimate a size of the X-ray source DS < 1013 cm, a distance of the obscuring clouds R∼ 1016 cm and a density n∼ 1011 cm−3. These values suggest that the X-ray absorption/reflection originates from the broad-line region clouds. This is also supported by the resolved width of the iron narrow Kα emission line, consistent with the width of the broad Hβ line
Discovery of a single faint AGN in a large sample of z > 5 Lyman break galaxies
No full textAs part of a large spectroscopic survey of z > 5 Lyman break galaxies (LBGs), we have identified a single source which is clearly hosting an active galactic nucleus (AGN). Out of a sample of more than 50 spectroscopically confirmed R-band dropout galaxies at z∼ 5 and above, only J104048.6−115550.2 at z= 5.44 shows evidence for a high ionization potential emission line indicating the presence of a hard ionizing continuum from an AGN. Like most objects in our sample the rest-frame-UV spectrum shows the UV continuum breaking across a Lyα line. Uniquely within this sample of LBGs, emission from N V is also detected, a clear signature of AGN photoionization. The object is spatially resolved in Hubble Space Telescope (HST) imaging. This, and the comparatively high Lyα/N V flux ratio indicates that the majority of the Lyα (and the UV continuum longward of it) originates from stellar photoionization, a product of the ongoing starburst in the LBG. Even without the AGN emission, this object would have been photometrically selected and spectroscopically confirmed as a Lyman break in our survey. The measured optical flux (IAB= 26.1) is therefore an upper limit to that from the AGN and is of order 100 times fainter than the majority of known quasars at these redshifts. The detection of a single object in our survey volume is consistent with the best current models of high redshift AGN luminosity function, providing a substantial fraction of such AGN is found within luminous starbursting galaxies. We discuss the cosmological implications of this discovery
Point-of-care testing and antibiotics prescribing in out-of-hours general practice: a register-based study in Denmark
No full textAbstract Background Point-of-care testing may reduce diagnostic uncertainty in case of suspicion of bacterial infection, thereby contributing to prudent antibiotic prescribing. We aimed to study variations in the use of point-of-care tests (C-reactive protein test, rapid streptococcal antigen detection test, and urine dipstick) among general practitioners (GPs) and the potential association between point-of-care testing and antibiotic prescribing in out-of-hours general practice. Methods We conducted a population-based observational register-based study, based on patient contacts with out-of-hours general practice in the Central Denmark Region in 2014–2017. The tendency of GPs to use point-of-care testing was calculated, and the association between the use of point-of-care testing and antibiotic prescribing was evaluated with the use of binomial regression. Results Out-of-hours general practice conducted 794,220 clinic consultations from 2014 to 2017, of which 16.1% resulted in an antibiotic prescription. The GP variation in the use of point-of-care testing was largest for C-reactive protein tests, with an observed variation (p90/p10 ratio) of 3.0; this means that the GPs in the 90th percentile used C-reactive protein tests three times as often as the GPs in the 10th percentile. The observed variation was 2.1 for rapid streptococcal antigen detection tests and 1.9 for urine dipsticks. The GPs who tended to use more point-of-care tests prescribed significantly more antibiotics than the GPs who tended to use fewer point-of-care tests. The GPs in the upper quintile of the tendency to use C-reactive protein test prescribed 22% more antibiotics than the GPs in the lowest quintile (21% for rapid streptococcal antigen detection tests and 8% for urine dipsticks). Up through the quintiles, this effect exhibited a positive linear dose–response correlation. Conclusion The GPs varied in use of point-of-care testing. The GPs who tended to perform more point-of-care testing prescribed more antibiotics compared with the GPs who tended to perform fewer of these tests
Canyons, deltas and plains: towards a unified sculptural model of location-based hypertext
No full textWith the growing ubiquity of mobile devices, new ways of sensing context and the emergence of the mobile Web, digital storytelling is escaping the confines of the desktop and intertwinging in new and interesting ways with the physical world. Mobile, location aware, narrative systems are being applied to a range of areas including tour guides, educational tools and interactive fiction. Despite this there is little understanding of how these applications are related or how they link with existing hypertext models and theory.We argue that location aware narrative systems tend to follow three patterns (canyons, deltas and plains) and that it is possible to represent all of these patterns in a conceptual sculptural hypertext model. Our model builds on a general sculptural mechansim (of pre-conditions and behaviours) to include locality and narrative transitions as first class elements, opening the possibility of standardised viewers, formats, and hybrid stories. We show how existing structures can be mapped onto this conceptual sculptural model, and how narratives defined in the model can take advantage of open data sources and sensed contextual data. To demonstrate this we present the GeoYarn system, a prototype which implements the model to create interactive, location aware narratives, using all three patterns
External validation of anti-Müllerian hormone based prediction of live birth in assisted conception
No full text<p>Background - Chronological age and oocyte yield are independent determinants of live birth in assisted conception. Anti-Müllerian hormone (AMH) is strongly associated with oocyte yield after controlled ovarian stimulation. We have previously assessed the ability of AMH and age to independently predict live birth in an Italian assisted conception cohort. Herein we report the external validation of the nomogram in 822 UK first in vitro fertilization (IVF) cycles.</p>
<p>Methods - Retrospective cohort consisting of 822 patients undergoing their first IVF treatment cycle at Glasgow Centre for Reproductive Medicine. Analyses were restricted to women aged between 25 and 42 years of age. All women had an AMH measured prior to commencing their first IVF cycle. The performance of the model was assessed; discrimination by the area under the receiver operator curve (ROCAUC) and model calibration by the predicted probability versus observed probability.</p>
<p>Results - Live births occurred in 29.4% of the cohort. The observed and predicted outcomes showed no evidence of miscalibration (p = 0.188). The ROCAUC was 0.64 (95% CI: 0.60, 0.68), suggesting moderate and similar discrimination to the original model. The ROCAUC for a continuous model of age and AMH was 0.65 (95% CI 0.61, 0.69), suggesting that the original categories of AMH were appropriate.</p>
<p>Conclusions - We confirm by external validation that AMH and age are independent predictors of live birth. Although the confidence intervals for each category are wide, our results support the assessment of AMH in larger cohorts with detailed baseline phenotyping for live birth prediction.</p>
Recommended from our members
A Symposium Associated with the Opening of the Play Copenhagen in Washington
No full textOn March 2, 2002 a special all day symposium was held in conjunction with the opening of the play Copenhagen in Washington. The play Copenhagen reenacts the 1941 visit of Werner Heisenberg, who was then in charge of the Nazi nuclear power program, to Niels Bohr, his mentor, and collaborator in creating quantum mechanics, complementarity, and the uncertainty principle, in German-occupied Denmark. The symposium entitled: THE COPENHAGEN INTERPRETATION: SCIENCE AND HISTORY ON STAGE was presented at the Baird Auditorium, in the National Museum of Natural History of the Smithsonian Institution. The program consisted of three two-hour sessions: (1) The Science of Copenhagen and its Influence of the 20th Century. (2) Bohr and Heisenberg: A strong Interaction. (3) Theater as Science ??? Science as Theater. The speakers included: Robert C. Card, Under Secretary of Energy; Ulrik Federspiel, Danish Ambassador to the US; John Marburger, III, Science Advisor President Bush; Jerome I. Friedman, MIT; Lene Vestergaard Hau, Harvard University; Richard Rhodes, Author; Rita Colwell, Director, NSF; Jeremy Bernstein, Author; Jochen H. Heisenberg, University of New Hampshire; Finn Aaserud, Director of the Niels Bohr Archive; Vilhelm A. Bohr, NIH; Thomas Powers, Author; Paul Lawrence Rose, Penn State University; Steven Barfield, University of Westminster, Jennifer Uphoff Gray, Associate Director, Copenhagen; Elizabeth Ireland McCann, Producer, Copenhagen; Lloyd Rose, Washington Post. Details of he program and useful information on the play Copenhagen are available on the web site http://web.gc.cuny.edu/ashp/nml/artsci/copenhagen.shtml . The complete symposium was video recorded and the set of 3 two-hour tapes can be obtained through the web site. The symposium was organized by Brian Schwartz, The Graduate Center, CUNY, Harry Lustig, Provost Emeritus at the City College of New York and Arthur Molella, Director, Lemelson Center, Smithsonian Institution. For further information contact Brian Schwartz [email protected]
Analysis of the contour structural irregularity of skin lesions using wavelet decomposition
No full textThe boundary irregularity of skin lesions is of clinical significance for the early detection of
malignant melanomas and to distinguish them from other lesions such as benign moles. The
structural components of the contour are of particular importance. To extract the structure from
the contour, wavelet decomposition was used as these components tend to locate in the lower
frequency sub-bands. Lesion contours were modeled as signatures with scale normalization to
give position and frequency resolution invariance. Energy distributions among different wavelet
sub-bands were then analyzed to extract those with significant levels and differences to enable
maximum discrimination.
Based on the coefficients in the significant sub-bands, structural components from the original
contours were modeled, and a set of statistical and geometric irregularity descriptors researched
that were applied at each of the significant sub-bands. The effectiveness of the descriptors was
measured using the Hausdorff distance between sets of data from melanoma and mole contours.
The best descriptor outputs were input to a back projection neural network to construct a
combined classifier system. Experimental results showed that thirteen features from four
sub-bands produced the best discrimination between sets of melanomas and moles, and that a
small training set of nine melanomas and nine moles was optimum
Evoking the Possibility of Presence:Textual and Ideological Effects of Linguistic Negation in Written Discourse
No full textThis thesis explores the textual and ideological effects of linguistic negation in written texts. It argues that when language users process negation, understanding its use in context is as much about the possibility of presence as it is about the actuality of absence. This gives rise to a variety of effects in texts from contributing to the construction of fictional characters to potentially influencing readers’/hearers’ view of the world they inhabit. This thesis brings together research on the theoretical aspects of how negation works to present a new approach to linguistic negation in written discourse. It also demonstrates how this approach can be applied in the analysis of the conceptual practice of negating. The approach presented is made up of three main elements; negation is presuppositional, is realised through a wide variety of linguistic forms beyond the morphosyntactic core forms (not, no, never, none, un-, in-, and so on) and includes semantic and pragmatically implied forms. These two elements combine to give rise to implied meaning in context. Having outlined this approach to negation, it is then applied in the analysis of literary and non-literary texts to explain the textual and ideological effects that arise from its use
