SSRI'S and other antidepressant use during pregnancy and potential neonatal adverse effects: Impact of a public health advisory and subsequent reports in the news media

BACKGROUND: On Aug 9(th )2004 Health Canada released an advisory, which followed a similar one from the FDA regarding the use of SSRI's and other antidepressants during pregnancy and potential adverse effects on newborns. In neither advisory was it stated that women should discontinue their antidepressant. In the seven days following the release of this advisory, The Motherisk Program received 49 calls from anxious women in response to the media reporting of this information. OBJECTIVE: To examine the impact of the advisory and subsequent reporting in the media, on the decision-making of women, currently taking an antidepressant, who called The Motherisk Program after becoming aware of this information. METHODS: We attempted to follow up all the women who had called us who were alarmed by this advisory and asked them to complete a specially designed questionnaire. RESULTS: We were able to complete 43/49 (88%) follow-ups of the women who contacted us. All of the callers reported that the messages in the media caused a great deal of anxiety. Seven misunderstood the advisory, ie their children were more than 1 year old, five had discontinued their antidepressant (3 abruptly (2 later restarted after speaking with Motherisk counsellors)and 2 with some form of tapering off) and(6) were considering discontinuation, but decided to continue following reassurance from Motherisk CONCLUSION: Medical information regarding fetal and infant safety, disseminated in the public domain, should be transferred in a way that does not influence a pregnant woman to make decisions that may not be in the best interest of hers or her child's health

A Novel Actinic Keratosis Field Assessment Scale For Grading Actinic Keratosis Disease Severity

Actinic keratosis (AK) lesions are surrounded by field cancerization (areas of subclinical, non-visible sun damage). Existing AK grading tools rely on AK counts, which are not reproducible. An Actinic Keratosis Field Assessment Scale (AK-FAS) for grading the severity of AK/field was developed. Standardized photographs of patients representing the full range of AK severity were collected. Six investigators independently rated each photograph according to 3 criteria: AK area (total skin area affected by AK lesions), hyperkeratosis and sun damage. Inter-rater reproducibility was good for all 3 criteria. Validation of the AK-FAS showed good reproducibility for AK area and hyperkeratosis, even for dermatologists untrained on use of the scale. In conclusion, the AK-FAS is objective, easy to use and implement, and reproducible. It incorporates assessment of the entire field affected by AK instead of relying on lesion counts. Use of the AK-FAS may standardize AK diagnosis, making it relevant to routine clinical practice

Extending the spectrum of Ellis van Creveld syndrome: a large family with a mild mutation in the EVC gene

<p>Abstract</p> <p>Background</p> <p>Ellis-van Creveld (EvC) syndrome is characterized by short limbs, short ribs, postaxial polydactyly, dysplastic nails and teeth and is inherited in an autosomal recessive pattern. We report a family with complex septal cardiac defects, rhizomelic limb shortening, and polydactyly, without the typical lip, dental, and nail abnormalities of EvC. The phenotype was inherited in an autosomal recessive pattern, with one instance of pseudodominant inheritance.</p> <p>Methods</p> <p>Because of the phenotypic overlap with EvC, microsatellite markers were used to test for linkage to the <it>EVC/EVC2 </it>locus. The results did not exclude linkage, so samples were sequenced for mutations.</p> <p>Results</p> <p>We identified a c.1868T>C mutation in <it>EVC</it>, which predicts p.L623P, and was homozygous in affected individuals.</p> <p>Conclusion</p> <p>We conclude that this <it>EVC </it>mutation is hypomorphic and that such mutations can cause a phenotype of cardiac and limb defects that is less severe than typical EvC. <it>EVC </it>mutation analysis should be considered in patients with cardiac and limb malformations, even if they do not manifest typical EvC syndrome.</p

Extending the spectrum of Ellis van Creveld syndrome: a large family with a mild mutation in the EVC gene

<p>Abstract</p> <p>Background</p> <p>Ellis-van Creveld (EvC) syndrome is characterized by short limbs, short ribs, postaxial polydactyly, dysplastic nails and teeth and is inherited in an autosomal recessive pattern. We report a family with complex septal cardiac defects, rhizomelic limb shortening, and polydactyly, without the typical lip, dental, and nail abnormalities of EvC. The phenotype was inherited in an autosomal recessive pattern, with one instance of pseudodominant inheritance.</p> <p>Methods</p> <p>Because of the phenotypic overlap with EvC, microsatellite markers were used to test for linkage to the <it>EVC/EVC2 </it>locus. The results did not exclude linkage, so samples were sequenced for mutations.</p> <p>Results</p> <p>We identified a c.1868T>C mutation in <it>EVC</it>, which predicts p.L623P, and was homozygous in affected individuals.</p> <p>Conclusion</p> <p>We conclude that this <it>EVC </it>mutation is hypomorphic and that such mutations can cause a phenotype of cardiac and limb defects that is less severe than typical EvC. <it>EVC </it>mutation analysis should be considered in patients with cardiac and limb malformations, even if they do not manifest typical EvC syndrome.</p

Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Low back pain (LBP), with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI) of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design: The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP.Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days), Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB) and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP) and 12 months (evaluate the outcomes at long term. Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion: We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration: ISRCTN: ISRCTN5871969

Unified management of multi-model data : (Vision paper)

Peer reviewe

A vector-valued ground motion intensity measure incorporating normalized spectral area

A vector-valued intensity measure is presented, which incorporates a relative measure represented by the normalized spectral area. The proposed intensity measure is intended to have high correlation with specific relative engineering demand parameters, which collectively can provide information regarding the damage state and collapse potential of the structure. Extensive dynamic analyses are carried out on a single-degree-of-freedom system with a modified Clough–Johnston hysteresis model, using a dataset of 40 ground motions, in order to investigate the proposed intensity measure characteristics. Response is expressed using the displacement ductility, and the normalized hysteretic energy, both of which are relative engineering demand parameters. Through regression analysis the correlation between the proposed intensity measure and the engineering demand parameters is evaluated. Its domain of applicability is investigated through parametric analysis, by varying the period and the strain-hardening stiffness. Desirable characteristics such as efficiency, sufficiency, and statistical independence are examined. The proposed intensity measure is contrasted to another one, with respect to its correlation to the engineering demand parameters. An approximate procedure for estimating the optimum normalized spectral area is also presented. It is demonstrated that the proposed intensity measure can be used in intensity-based assessments, and, with proper selection of ground motions, in scenario-based assessments

A Novel, Single Algorithm Approach to Predict Acenocoumarol Dose Based on CYP2C9 and VKORC1 Allele Variants

The identification of CYP2C9 and VKORC1 genes has strongly stimulated the research on pharmacogenetics of coumarins in the last decade. We assessed the combined influence of CYP2C9 *2 and *3, and VKORC1 c.-1639G>A, 497C>G, and 1173C>T variants, on acenocoumarol dosage using a novel algorithm approach, in 193 outpatients who had achieved stable anticoagulation. We constructed an “acenocoumarol-dose genotype score” (AGS, maximum score = 100) based on the number of alleles associated with higher acenocoumarol dosage carried by each subject for each polymorphism. The mean AGS was higher in the high-dose (>28mg/week) compared with the low-dose (<7mg/week) group (mean(SEM) of 84.1±3.4 vs. 62.2±4.8, P = 0.008). An AGS>70 was associated with an increased odds ratio (OR) of requiring high acenocoumarol dosage (OR: 3.347; 95%CI: 1.112–10.075; P = 0.032). In summary, although more research is necessary in other patient cohorts, and this algorithm should be replicated in an independent sample, our data suggest that the AGS algorithm could be used to help discriminating patients requiring high acenocoumarol doses to achieve stable anti-coagulation

Magnetic and Electrical Properties of Ordered 112-type Perovskite LnBaCoMnO5+\delta (Ln = Nd, Eu)

Investigation of the oxygen-deficient 112-type ordered oxides of the type LnBaCoMnO5+\delta (Ln = Nd, Eu) evidences certain unusual magnetic behavior at low temperatures, compared to the LnBaCo2O5+\delta cobaltites. One observes that the substitution of manganese for cobalt suppresses the ferromagnetic state and induces strong antiferromagnetic interactions. Importantly, NdBaCoMnO5.9 depicts a clear paramagnetic to antiferromagnetic type transition around 220 K, whereas for EuBaCoMnO5.7 one observes an unusual magnetic behavior below 177 K which consists of ferromagnetic regions embedded in an antiferromagnetic matrix. The existence of two sorts of crystallographic sites for Co/Mn and their mixed valence states favor the ferromagnetic interaction whereas antiferromagnetism originates from the Co3+-O-Co3+ and Mn4+-O-Mn4+ interactions. Unlike the parent compounds, the present Mn-substituted phases do not exhibit prominent magnetoresistance effects in the temperature range 75-400K.Comment: 23 pages including figure

Effect of microalgae addition on mineral content, colour and mechanical properties of breadsticks

[EN] Microalgae has recently attracted considerable attention due to its potential as a high source of proteins, lipids, vitamins, minerals and phytochemicals. Hence, it can be a useful ingredient intended to increase the nutritional and technological value of food products. The aim of the present study was to evaluate the effect of the addition of microalgae biomass (Chlorella vulgaris and Arthrospira platensis) on mineral content, colour and mechanical properties of breadsticks, and the colour, texture and rheology of doughs. Microalgae were shown to affect texture and rheology in doughs showing greater hardness values, although, a decrease in hardness, toughness, crispiness and brittleness parameters was seen in breadsticks. The main effects observed with microalgae addition were changes in dough colour, with visual colour perception, in all cases, of distinguished green colour tones. Breadstick colour was evaluated over 15 days of storage and showed colour stability. Furthermore, the mineral content of breadsticks increased, specifically, iron and selenium, both important compounds involved in human body functions. The incorporation of Chlorella or Spirulina in the formulation allows for the production of breadsticks classed as "high in iron and selenium food" and more stable in colour and texture.Uribe-Wandurraga, ZN.; Igual Ramo, M.; García-Segovia, P.; Martínez Monzó, J. (2019). Effect of microalgae addition on mineral content, colour and mechanical properties of breadsticks. Food & Function. 10(8):4685-4692. https://doi.org/10.1039/c9fo00286cS46854692108Volk, R.-B. (2008). A newly developed assay for the quantitative determination of antimicrobial (anticyanobacterial) activity of both hydrophilic and lipophilic test compounds without any restriction. Microbiological Research, 163(2), 161-167. doi:10.1016/j.micres.2006.03.015Ibañez, E., & Cifuentes, A. (2013). Benefits of using algae as natural sources of functional ingredients. 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Impact of Chlorella vulgaris on the rheology of wheat flour dough and bread texture. LWT, 89, 466-474. doi:10.1016/j.lwt.2017.11.024Bodart, M., de Peñaranda, R., Deneyer, A., & Flamant, G. (2008). Photometry and colorimetry characterisation of materials in daylighting evaluation tools. Building and Environment, 43(12), 2046-2058. doi:10.1016/j.buildenv.2007.12.006Gouveia, L., Batista, A. P., Miranda, A., Empis, J., & Raymundo, A. (2007). Chlorella vulgaris biomass used as colouring source in traditional butter cookies. Innovative Food Science & Emerging Technologies, 8(3), 433-436. doi:10.1016/j.ifset.2007.03.026Batista, A. P., Niccolai, A., Fradinho, P., Fragoso, S., Bursic, I., Rodolfi, L., … Raymundo, A. (2017). Microalgae biomass as an alternative ingredient in cookies: Sensory, physical and chemical properties, antioxidant activity and in vitro digestibility. Algal Research, 26, 161-171. doi:10.1016/j.algal.2017.07.017García-Segovia, P., Pagán-Moreno, M. J., Lara, I. F., & Martínez-Monzó, J. (2017). Effect of microalgae incorporation on physicochemical and textural properties in wheat bread formulation. Food Science and Technology International, 23(5), 437-447. doi:10.1177/1082013217700259M. C. Latham , in Nutrición humana en el mundo en desarrollo , FAO , New York, USA , 2002 , ch. 10World Health Organization , Iron Deficiency Anemia: Assessment, Prevention, and Control , WHO/UNICEF/UNU , Geneva, Switzerland , 2001Rayman, M. P. (2000). The importance of selenium to human health. The Lancet, 356(9225), 233-241. doi:10.1016/s0140-6736(00)02490-