Machine learning identifies suicidal youth

Machine learning identifies suicidal youth Suicide is a major public health concern. Over 40,000 people nationwide die by suicide each year. Suicide was the second leading cause of death in 2015 for young adults aged 18 to 26. Knowing who is at risk for suicide may help reduce the suicide rate.

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Scientists have been testing several approaches to try to predict suicide risk. A research team led by Dr. Marcel Just at Carnegie Mellon University and Dr. David Brent at the University of Pittsburgh used fMRI to look for signatures of brain activity among young adults with suicidal thoughts. They focused on the networks of activity that represent concepts and the emotions they evoke. Their study was funded by NIH’s National Institute of Mental Health (NIMH). It appeared online in Nature Human Behaviour on October 30, 2017.

The team recruited 38 young adults with current suicidal thoughts and 41 healthy controls with no history of a psychiatric disorder or suicide attempt. While in an fMRI scanner, the participants were shown 30 words for 3 seconds each related to suicide (e.g., “death,” funeral,” hopeless”), positive ideas (“bliss,” “carefree,” “comfort”), and negative ideas (“boredom, “gloom,” “worried”).

The scientists used data from 33 participants to train a machine-learning system to spot differences in networks of brain activity. They then tested it on brain images from 34 participants. The system correctly identified 15 of 17 suicidal people and 16 of 17 controls—an accuracy of 91%. The strongest differences between the groups, in order, were for the words “death”, “carefree,” “good,” “cruelty,” “praise,” and “trouble.” Within the group of 17 people with suicidal thoughts, the system was also able to distinguish the 9 who had previously made a suicide attempt from the 8 who hadn’t with an accuracy of 94% (16 out of 17). Discriminating regions were spread across several areas of the brain.

The researchers also tested the approach on brain images from 21 people with suicidal thoughts who had lower quality scan data. The system could still distinguish these suicidal people from control participants with 87% accuracy.

Previous studies have identified signatures of brain activity with different emotions. The researchers found that the neural signatures of the emotions sadness, shame, anger, and pride differed between people with suicidal thoughts and healthy controls for the six discriminating words. Among the 34 participants, a machine-learning system could distinguish between the groups based on emotional signatures with an accuracy of 85%.

“People with suicidal thoughts experience different emotions when they think about some of the test concepts,” Just explains. “For example, the concept of ‘death’ evoked more shame and more sadness in the group that thought about suicide. This extra bit of understanding may suggest an avenue to treatment that attempts to change the emotional response to certain concepts.”

“Further testing of this approach in a larger sample will determine its generalizability and its ability to predict future suicidal behavior, and could give clinicians in the future a way to identify, monitor, and perhaps intervene with the altered and often distorted thinking that so often characterizes seriously suicidal individuals,” Brent says.

The researchers are also investigating other methods that correlate with the fMRI signatures but may be easier to implement in clinical settings.

—by Harrison Wein, Ph.D.

Info by : nih.gov/news-events

Medical Care

Info Medical Care More Patients Are Having a Say in Their Medical Care U.S. doctors and patients are making more decisions together, which looks like a win-win for both, researchers say.

A new analysis of national survey data found that shared decision-making between doctors and patients rose 14 percent between 2002 and 2014.

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Patients said doctors have become more likely to: ask them to help make medical decisions; listen to them carefully; show respect for what they said; spend enough time with them; and provide easy-to-understand information.

"There has been increased attention among clinicians and health systems to involve patients in decision-making," said Dr. Jeffrey Linder, co-lead author of the study. He's chief of general internal medicine and geriatrics at Northwestern University Feinberg School of Medicine in Chicago.

"Patients who have engaged in shared decision-making understand their condition and options better. They feel less uncertain about a chosen course of action," Linder said in a university news release.

Shared decision-making can lead to better-informed patients, he added. For example, they may decide against treatments that have little or no benefit.

Also, doctors are realizing that patients will not necessarily comply with recommendations blindly, said study co-lead author Dr. David Levine, an instructor in medicine at Harvard Medical School. "Moving the conversation to a space where it is a shared decision likely improves adherence."

Still, the study also found that more than 30 percent of Americans felt their doctor did not always listen to them, and more than 40 percent felt their doctor did not always spend enough time with them.

Shared decision-making was lower among patients in poor health and those of a different race/ethnicity than their doctor, according to the study.

The study involved about 10,000 survey respondents a year from 2002 to 2014. The results were published in the November/December issue of the journal Annals of Family Medicine.

Medical Care in Emergency Rooms

Emergency Room For what reason Do So Many People Still Go to the Emergency Room? When Americans need healthcare, about half the time they’ll head to the emergency room.

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That’s the finding of a new study by researchers at the University of Maryland School of Medicine.

The researchers examined data from several national healthcare databases covering all 50 states and the District of Columbia between 1996 and 2010.

In 2010, they found there were almost 130 million emergency department visits in the United States.

Over the 14-year period examined in the study, emergency room visits increased by 44 percent.

“Emergency care plays a significant role in healthcare delivery. We found that half of all hospital-associated medical care provided between 1996 and 2010 was provided in emergency departments,” Dr. David Marcozzi, an author of the study and associate professor in the University of Maryland School of Medicine Department of Emergency Medicine, told Healthline.

“I believe the surprisingly high proportion of medical care being delivered by emergency departments stems from multiple factors: access to healthcare, consumer-driven needs, an appreciation for the comprehensive care delivered by emergency departments, and the ability of emergency departments to fill a critical gap with regard to care delivered to vulnerable populations,” he said.

Who’s most likely to visit the ER

Those in the “other” insurance category, including people without insurance, were the most likely to visit emergency rooms.

People living in the South were also more likely to visit the emergency department when compared with other areas of the country.

African-American patients were significantly more likely to visit the emergency department than other racial groups.

In 2010, African-American patients used the emergency department 54 percent of the time. In urban areas, the rate was higher, at 59 percent.

Marcozzi says the study draws attention to health disparities experienced by certain communities in the United States.

He believes emergency departments are bridging a gap in care for such communities.

“As health literacy or healthcare access during business hours are often barriers to care, emergency departments open 24/7 fill the gap and support that individual or family in need of medical evaluation and treatment,” he said. “[Emergency departments] accept this role and responsibility, but also recognize that seamless connectivity to outpatient physician and services could be better coordinated and optimized. This is an area ripe for improvement, and should be a focus of attention.”

Situation may not change soon

Given the structure of the healthcare system in the United States and systemic issues surrounding lack of access to healthcare — in particular for vulnerable groups — Marcozzi says the rate of emergency department visits is unlikely to decrease soon.

This is cause for concern, he says.

“As emergency departments struggle with the burden of increasing numbers of patients, the number of emergency departments in the United States is decreasing, and providers are more challenged to provide optimal, timely care. This divergence puts increasing strain on an already challenged emergency care system,” Marcozzi said.

“Efforts are needed to modify healthcare delivery systems so that this care is more seamlessly connected to the larger health delivery system. This is critical to our nation’s health and resilience,” he added.

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More women are surviving breast cancer

Good News, Bad News on Breast Cancer Survival Rate More women are surviving breast cancer, but more than 40,000 will still die from the disease this year. Living with it hasn’t gotten much easier, either.

Early detection and better treatments helped prevent 322,000 breast cancer deaths between 1989 and 2015.

A new American Cancer Society (ACS) report shows that the breast cancer death rate decreased by 39 percent during those years.

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It’s encouraging news.

But breast cancer remains a significant health problem.

It’s second only to lung cancer as the leading cause of cancer deaths among women in the United States.

The disease affects women and men of all ages.

About 81 percent of diagnoses occur in women aged 50 and up. About 89 percent of breast cancer deaths also occur in this age group.

The ACS estimates there’ll be more than 252,000 new cases of invasive breast cancer in women this year. And more than 40,000 will die of the disease.

Stubborn disparities

Dr. John A. P. Rimmer, a bosom tumor specialist in Florida, disclosed to Healthline that various components cooperating for as long as 30 years added to the enhanced survival rate. 

Among them are better indicative apparatuses and surgical systems, and in addition more current chemotherapy regimens and focused on treatments. 

The ACS report takes note of that not all ladies have profited from these enhancements. 

The general occurrence rate was 2 percent bring down in non-Hispanic dark ladies, contrasted with non-Hispanic white ladies. 

In any case, from 2011 through 2015, the demise rate was 42 percent higher in dark ladies. This is a little change from 2011, when it was 44 percent higher. 

The most reduced frequency and passing rates are among Asian and Pacific Islander ladies. 

The report shows that biologic, social, and basic factors all add to these incongruities. 

These incorporate stage at analysis, other medical problems, and access and adherence to treatment. 

Likewise, dark ladies have a higher rate of triple-negative bosom malignancy, an especially forceful type of the illness. 

Variations differ from state to state. Access to medicinal services is as yet an issue. 

"Bosom malignancy is exceptionally mind boggling socially and inwardly," said Rimmer. 

In his training, Rimmer has seen ladies who skipped screening or didn't at first look for therapeutic care because of absence of medical coverage. 

Deferred finding and treatment influences odds of survival. 

Others deny all or part of treatment because of social contrasts or misinterpretations. What's more, there are some who pick nonconventional medications that essentially don't work. 

Rimmer said that individuals aren't continually anticipated about the reasons why they don't appear for treatment.

how feel to live with breast cancer

At the start of 2016, there were more than 3.5 million breast cancer survivors in the United States.

“If we treat you and you’re alive, it’s a good thing. But there’s nothing good about breast cancer,” said Rimmer.

He added that survivors often experience long-term consequences of chemotherapy, surgery, and radiation treatments.

Laura Holmes Haddad, author of “This Is Cancer,” is one of those survivors.

The California mother of two received a diagnosis of stage 4 inflammatory breast cancer in 2012.

She was 37 years old.

To say her life changed would be an understatement.

“When I look back, I think about how naïve I was. The things I thought would be the hardest, like being bald, were actually the easiest for me. But the things I thought I would breeze through, like having both breasts removed and having breast reconstruction, were the hardest,” Haddad told Healthline.

“Physically, I faced pain and discomfort and physical changes I couldn’t have imagined,” she continued.

Haddad lists nerve pain, nausea, sensory issues, and being bedridden among the physical side effects of treatment.

Then there’s the mental and emotional toll.

“I felt angry and bitter at first, and sad. And then I felt guilty and helpless. And I tried to feel hopeful and I tried to laugh when I could, because everything just gets so absurd that you just have to laugh to relieve the darkness. I felt lonely and isolated, and that was tough. And then I felt grief and then I finally hit acceptance. And that felt good,” explained Haddad.

For her family, it was a month after month marathon of logistical and emotional challenges.

Her husband helped as much as he could. But he also had to continue working to keep up with health insurance and mounting cancer-related expenses.

To get through it all, they relied on help from their extended family, friends, and community.

Congenital Adrenal Hyperplasia-Genetic Disorders In Children

Congenital adrenal hyperplasia is a group of genetic disorders in which the two adrenal glands do not work properly. Children inherit one gene that causes the disorder from each of their parents. The adrenal glands, located above each kidney, make hormones that are essential for body functions.

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People with congenital adrenal hyperplasia, a shortage of one of the enzymes needed for proper function of the adrenal glands. (An enzyme is a protein that causes chemical changes in the body.) Without the enzyme, the adrenal glands produce too little of the hormone cortisone and/or Alston and too much androgen. Congenital adrenal hyperplasia can be severe or mild.

How is congenital adrenal hyperplasia diagnosed?

In the United States and in many other countries, newborns with congenital adrenal hyperplasia checking blood tests. Diagnosis in infancy may include:

Further blood I'd like testGenetic,testsPhysical history

Sometimes, when there is a family history of congenital adrenal hyperplasia has ever had, the fetus is diagnosed before birth. Treatment of congenital adrenal hyperplasia Prenatal is experimental, and experts recommend it is done only in the context of clinical trials (research studies involving people).

Classic congenital adrenal hyperplasia, usually first found in infancy or early childhood, congenital adrenal hyperplasia type is the most severe. In one form of congenital adrenal hyperplasia Classics (body trouble keeping the right amount of salt in the blood), the adrenal glands do not produce enough cortison and alston If left untreated, adrenal hyperplasia congenital classic can cause shock, coma, and death. In other forms of adrenal hyperplasia congenital enzyme deficiencies, the classic is not severe. The adrenal glands make enough I'd like enough Cortisol If there are symptoms in your child's immediate consultation with a doctor .

Inpatient Alcohol Rehab

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Alcoholism affects all segments of American life. The National Institute of Drug Abuse reports that in 2009, an expected 6.8 percent of Americans had devoured at least five beverages on no less than five events inside the month going before their overview. What's more, the National Center for Biotechnology Information reports that an expected one out of six Americans has a drinking issue. 

In the event that you have built up a drinking issue, understanding your alternatives for treatment is vital. Liquor recovery focuses can offer you the therapeutic consideration and bolster you require get your drinking issue under control so you can recover your life. 

Liquor restoration focuses offer both inpatient and outpatient treatment. Outpatient treatment is useful for individuals who have built up a drinking issue however are not yet dependent on liquor. These individuals might be social consumers who drink more than they ought to and experience issues halting. They have a greater amount of a passionate connection to liquor. Heavy drinkers should look for treatment from an inpatient treatment office. They have built up a physical dependence on liquor. On the off chance that they go a brief span without drinking, their body responds contrarily to the absence of liquor, making it hard for them to appropriately work.

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Basics of Treatment

All alcohol rehab centers offer confidential treatment, so you do not need to worry about anyone whom you may not want to know about your treatment finding out. These centers do everything they can to make your stay as private and comfortable as possible. If you are concerned about having a roommate during treatment, be aware that many clinics require this. However, this helps promote positive behavior and keeps patients from becoming isolated during treatment.

Treatment occurs in periods of 30, 60 and 90 days. Thirty days is the minimum amount of time needed for treatment to be effective. Longer stays are required for worse cases of addiction, but they are recommended for anyone who wants to experience the full benefits of treatment. Longer stays in alcohol rehab centers provide an environment free from the temptation to drink, and allow for more in-depth treatment of the behavioral issues that alcoholism causes.

When you first enter treatment, you will receive a medical and psychological evaluation. You must be honest about your drinking habits and other drug use. The center will use the data you provide to build a treatment program designed for your needs and habits. After you are admitted, you will begin the process of detox, or getting your body used to being without alcohol. You are given medications, nutritious meals and rest during this time to help you withdraw as smoothly as possible.

After detox, you will begin your therapy. Group therapy among peers is considered one of the best treatment options for alcoholism. It allows you to open up about your addiction to other people who are experiencing a similar struggle. Many alcohol rehab centers also offer individual therapy, where you can talk with a professional about your addiction.

Choosing between alcohol rehab centers can be difficult. It is important to find a clinic at which you feel comfortable. Many clinics offer specialized care for certain religions, age, genders or other groups.

Paying for treatment can seem overwhelming, but many insurance plans cover some of the cost of rehab. If insurance does not cover enough and you cannot afford the rest of the bill, many alcohol rehab centers offer financing options.