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Ipratropium bromide (0.5 mg) and fenoterol (2 mg) produced equivalent peak bronchodilatation between 1 and 2 h after administration to eight patients with chronic partially reversible airways obstruction. The duration of action compared with saline was 6 h for ipratropium and 4 h for fenoterol. Both drugs in combination produced greater bronchodilatation than either drug alone. The increase in FVC was disproportionately greater than FEV1 with both drugs and saline, suggesting relief of obstruction of small airways. [ABSTRACT FROM AUTHOR]

Aim. To examine the efficacy of a six-month Kung Fu (KF) program on physical fitness in overweight/obese adolescents. Methods. Subjects were randomly assigned to the KF or sham exercise (Tai Chi, TC) control group. Physical measurements in cardiovascular fitness and muscle fitness occurred at baseline and after 6 months of training thrice weekly. Results. Twenty subjects were recruited. One subject was lost to follow-up, although overall compliance to the training sessions was 46.7 +/- 27.8%. At follow-up, the cohort improved in absolute upper (P = .002) and lower (P = .04) body strength, and upper body muscle endurance (P = .02), without group differences. KF training resulted in significantly greater improvements in submaximal cardiovascular fitness (P = .03), lower body muscle endurance (P = .28; significant 95% CI: 0.37-2.49), and upper body muscle velocity (P = .03) relative to TC training. Conclusions. This short-term KF program improved submaximal cardiovascular fitness, lower body muscle endurance, and muscle velocity, in overweight/obese adolescents with very low baseline fitness. [ABSTRACT FROM AUTHOR]

Objectives: To improve the accuracy of classification of deaths of undetermined intent and to examine racial differences in misclassification., Methods: We used natural language processing and statistical text analysis on restricted-access case narratives of suicides, homicides, and undetermined deaths in 37 states collected from the National Violent Death Reporting System (NVDRS) (2017). We fit separate race-specific classification models to predict suicide among undetermined cases using data from known homicide cases (true negatives) and known suicide cases (true positives)., Results: A classifier trained on an all-race dataset predicts less than half of these cases as suicide. Importantly, our analysis yields an estimated suicide rate for the Black population comparable with the typical detection rate for the White population, indicating that misclassification excess is endemic for Black suicide. This problem may be mitigated by using race-specific data. Our findings, based on the statistical text analysis, also reveal systematic differences in the phrases identified as most predictive of suicide., Conclusions: This study highlights the need to understand the reasons underlying suicide rate differences and for further testing of strategies to reduce misclassification, particularly among people of color., (© 2022 The American Association of Suicidology.)

Objective: To estimate the prevalence and associated risk factors of perinatal depression in Pakistan., Methods: We conducted a systematic search of Medline, PsycINFO, CINAHL, EMBASE, and Global health, up through May 31, 2019. Studies reporting on the prevalence of perinatal depression in Pakistan with or without associated risks factors were included., Results: Forty-three studies reporting data from 17 544 women met the eligibility criteria and were included. Overall, the pooled prevalence of antenatal depression was 37% (95% CI: 30-44), while that of postnatal depression was 30% (95% CI: 25-36). The prevalence of perinatal depression in women residing in urban areas and those living in rural settings was not significantly different. The most frequently reported risk factors for antenatal depression were intimate partner violence and poor relationship with spouse, and that reported for postnatal depression was low-income level. An unintended pregnancy was significantly associated with perinatal depression in Pakistan., Conclusions: We identified variability in prevalence rate of perinatal depression in Pakistan. It is difficult to gauge the true magnitude of this problem potentially due to differing risk factors between the antenatal and postnatal periods and the lack of uniformity of data collection protocols and procedures. The high prevalence rates of 30%-37% compared to global estimates suggest policy makers and stakeholders should direct additional resources toward improving perinatal mental health in Pakistan., (© 2021 Wiley Periodicals LLC.)

Automation, machine learning, and artificial intelligence (AI) are changing the landscape of echocardiography providing complimentary tools to physicians to enhance patient care. Multiple vendor software programs have incorporated automation to improve accuracy and efficiency of manual tracings. Automation with longitudinal strain and 3D echocardiography has shown great accuracy and reproducibility allowing the incorporation of these techniques into daily workflow. This will give further experience to nonexpert readers and allow the integration of these essential tools into more echocardiography laboratories. The potential for machine learning in cardiovascular imaging is still being discovered as algorithms are being created, with training on large data sets beyond what traditional statistical reasoning can handle. Deep learning when applied to large image repositories will recognize complex relationships and patterns integrating all properties of the image, which will unlock further connections about the natural history and prognosis of cardiac disease states. The purpose of this review article was to describe the role and current use of automation, machine learning, and AI in echocardiography and discuss potential limitations and challenges of in the future., (© 2018 Wiley Periodicals, Inc.)

Background: Friendships play an important role in the development of school involvement and academic performance during adolescence. This study examined the interdependence of depressive symptoms, school involvement, and academic performance between adolescent same-sex friends., Aims: Using cross-sectional data, we examined whether the link between depressive symptoms and academic performance would be mediated by school involvement at the intrapersonal (actor) and interpersonal (partner) levels., Sample: Data came from 155 pairs of same-sex adolescent friends (80 boys; M(age) = 16.17, SD = 0.44). The actor-partner interdependence model was used to examine the dyadic data and mediation hypotheses., Results: Mediated actor effects showed that adolescents who had more depressive symptoms reported lower academic performance, and such an association was mediated by their own and their friend's lower school involvement. Mediated partner effects showed that adolescents who had more depressive symptoms also had a friend with lower academic performance, and such an association was mediated by both individuals' lower school involvement., Conclusions: This study provided evidence to support the broader interpersonal framework for understanding school involvement and academic performance. The current findings also have potential practical implications, especially for programmes targeted at addressing adolescents' school problems., (© 2015 The British Psychological Society.)

Aim: To compare the patterns of Type 1 sensitization of common food and aeroallergens among infants and older patients with atopic dermatitis (AD)., Methods: All skin prick tests (SPTs) performed over a 6-month period were examined, and patients with urticaria were used for comparison., Results: Dust mite was the most common aeroallergen and dog dander the least common. Egg white was the most common food allergen and beef the least common. Dust mite and peanut sensitization was more prevalent in AD than in urticaria. Dust mite sensitization was more prevalent in older children than infants with AD. Cow's milk sensitization only occurred in one-tenth of these patients. Prevalence of sensitization to common aeroallergens, but not food allergens, was generally higher in children beyond 5 years of age., Conclusion: Milk sensitization is far less prevalent than egg white, and the prevalence does not change beyond infancy. There is no significant change in prevalence in many of the common food allergens beyond infancy. Many infants with AD develop eczema before they show atopy to the common food and aeroallergens. The SPT information is useful in reassuring parents of the unlikelihood of severe Type 1 immediate IgE reaction to some of the common food and aeroallergens, so that empirical and multiple food avoidance/restriction can be avoided.

Sprague-Dawley rats were reared in enriched (EC; group housing, exposure to stimulating objects, frequent handling) or restricted (RC; individual housing, no exposure to stimulating objects, minimal handling) environments starting on day 23 of life. At six months of age, they underwent behavioural tests to assess 'cognitive' and 'stimulus-response' memory, selective attention, and inflammatory pain processing. Alterations in synapses and cell survival may occur as a result of environment differences; therefore we assessed the brain levels of several proteins implicated in neurite outgrowth, synaptogenesis, and cell survival. Brains were dissected and analysed for amyloid precursor protein (APP) and other synaptic and cytoskeletal proteins using Western blotting. The performance of EC animals in a hidden platform water maze task, and in a test of selective attention (both of which are thought to involve the hippocampus) was superior to that of RC animals. In contrast, performance of RC animals on two stimulus-response tasks, the visible platform water maze test and simple visual discrimination (both of which are thought to be hippocampal independent) was indistinguishable from that of EC animals. Male EC rats displayed a different behavioural response to formalin during the inflammatory phase of nociception--the phase affected by hippocampal processing; a similar trend was observed in females. Female but not male RC rats exhibited elevated plasma corticosterone levels; adrenal weights were unaffected by environmental conditions. Region-specific increases in brain levels of APP, neurofilament-70 (NF-70), and platelet-activating factor receptor (PAF-R) were found in EC rats. These data suggest that enriched animals manifest enhanced functioning of certain hippocampus-mediated behaviours when compared with that of their restricted counterparts; and that brain levels of various synaptic and structural proteins involved in neurite outgrowth, cell survival, and synaptogenesis, are affected by environmental factors.

Background: Acute ascending aortic dissection is a surgical emergency that requires expeditious diagnosis and prompt surgical intervention. In many centers, transesophageal echocardiography (TEE) is the test of choice on which surgical decisions are based. Echocardiographic false-positive diagnoses are rare but can occur with potentially severe consequences., Case Report: Two clinical cases where ascending aortic dissections were falsely diagnosed by TEE are presented., Discussion: Recent literature comparing the diagnostic accuracy of TEE and other imaging techniques are reviewed. Anatomical limitations of TEE and potential causes of false-positive results are discussed. Multiplane probe reduces, but does not eliminate, the occurrence of false-positive findings. To improve diagnostic specificity without undue delays in the course of clinical decision making, we recommend dividing positive TEE findings into "definite" and "probable" categories. Such subclassification is helpful in identifying cases where additional confirmatory tests are desirable in situations of uncertain diagnosis.