Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have increasingly replaced tricyclic antidepressants (TCAs) in the treatment of depression. They appear to be safer in overdose, but there is little information on their spectrum of toxicity in overdose, or relative toxicity of each agent. OBJECTIVE: To determine the effect of SSRIs in overdose, as a group, and the relative toxicity of five different SSRIs. METHODS: A review of consecutive SSRI poisoning admissions to a single toxicology unit. Outcomes examined were length of stay [LOS], intensive care [ICU] admission rate, coma, seizures, electrocardiographic [ECG] abnormalities, and presence of serotonin syndrome [SS]. Logistic regression was used to model the outcome QTc >440 msec. RESULTS: There were 469 SSRI poisoning admissions analyzed after exclusions. The median LOS for all SSRI overdose admissions was 15.3 h (IQR: 10.5-21.3) and 30 of 469 (6.4%; 95% CI 4.3-9.0%) cases were admitted to ICU. The incidence of seizures was 1.9% and coma was 2.4%. Serotonin syndrome occurred in 14% of overdoses. Comparison of median QTc intervals of the five SSRIs was significantly different (p=0.0002); citalopram (450 IQR: 436-484) was individually different to fluoxetine (p=0.045), fluvoxamine (p=0.022), paroxetine (p=0.0002), and sertraline (p=0.001). The proportion of citalopram overdoses with a QTc >440 msec was 68%, differing significantly from sertraline (adjusted OR: 5.11 95% CI 2.32-11.27). Comparison of median QT intervals of the five SSRIs was statistically different (p=0.026); citalopram (400 IQR: 380-440) was individually different from sertraline (p=0.023). CONCLUSIONS: This study shows SSRIs are relatively safe in overdose despite serotonin syndrome being common. The exception was citalopram, which was significantly associated with QTc prolongation. We believe that cardiac monitoring should be considered in citalopram overdose, particularly with large ingestions and patients with associated cardiac disease.

The relative importance of spatial proximity, kin selection and potential ‘greenbeard’ signals on provisioning behaviour among helpers in a cooperative bird

© 2015 Springer-Verlag Berlin Heidelberg Many hypotheses have been proposed to account for cooperative behaviour, with those favouring kin selection receiving the greatest support to date. However, the importance of relatedness becomes less clear in complex societies where interactions can involve both kin and non-kin. To help clarify this, we examined the relative effect of indirect versus key direct benefit hypotheses in shaping cooperative decisions. We assessed the relative importance of likely reciprocal aid (as measured by spatial proximity between participants), kin selection (using molecular-based relatedness indices) and putative signals of relatedness (vocal similarity) on helper/helper cooperative provisioning dynamics in bell miners (Manorina melanophrys), a species living in large, complex societies. Using network analysis, we quantified the extent of shared provisioning (helping at the same nests) among individual helpers (excluding breeding pairs) over three seasons and 4290 provisioning visits, and compared these with the location of individuals within a colony and networks built using either genetic molecular relatedness or call similarity indices. Significant levels of clustering were observed in networks; individuals within a cluster were more closely related to each other than other colony members, and cluster membership was stable across years. The probability of a miner helping at another’s nest was not simply a product of spatial proximity and thus the potential for reciprocal aid. Networks constructed using helping data were significantly correlated to those built using molecular data in 5 of 10 comparisons, compared to 8 of 10 comparisons for networks constructed using call similarity. This suggests an important role of kinship in shaping helping dynamics in a complex cooperative society, apparently determined via an acoustic ‘greenbeard’ signal in this system.

Does relative age distribution influence the physical and anthropometric profiles of drafted under 18 Australian footballers? An Investigation between the 2010 to 2013 seasons

This study examined if the relative birth distribution of drafted under 18 (U18) Australian football (AF) players influenced their physical and anthropometric profile. Birthdate, physical (vertical jump, agility, 20m sprint, 20m multistage fitness test) and anthropometric (standing height, body mass) data were obtained from U18 players drafted into the Australian Football League between 2010 to 2013 (n = 212). Birth distribution did not change across quartile (χ23 = 5.09, P > 0.05) or half year (χ21= 2.50, P > 0.05). Physical and anthropometric profiles did not differ according to quartile or half year (P > 0.05). Relative birth distribution did not appear to influence draft success or physical/anthropometric profile. This study provides insight into a phenomenon not always observed in team sport.

Estimating Relative Risk Aversion, Risk-Neutral and Real-World Densities using Brazilian Real Currency Options

Building Risk-Neutral Densities (RND) from options data can provide market-implied expectations about the future behavior of a financial variable. And market expectations on financial variables may influence macroeconomic policy decisions. It can be useful also for corporate and financial institutions decision making. This paper uses the Liu et all (2007) approach to estimate the option-implied Risk-neutral densities from the Brazilian Real/US Dollar exchange rate distribution. We then compare the RND with actual exchange rates, on a monthly basis, in order to estimate the relative risk-aversion of investors and also obtain a Real-world density for the exchange rate. We are the first to calculate relative risk-aversion and the option-implied Real World Density for an emerging market currency. Our empirical application uses a sample of Brazilian Real/US Dollar options traded at BM&F-Bovespa from 1999 to 2011. The RND is estimated using a Mixture of Two Log-Normals distribution and then the real-world density is obtained by means of the Liu et al. (2007) parametric risktransformations. The relative risk aversion is calculated for the full sample. Our estimated value of the relative risk aversion parameter is around 2.7, which is in line with other articles that have estimated this parameter for the Brazilian Economy, such as Araújo (2005) and Issler and Piqueira (2000). Our out-of-sample evaluation results showed that the RND has some ability to forecast the Brazilian Real exchange rate. Abe et all (2007) found also mixed results in the out-of-sample analysis of the RND forecast ability for exchange rate options. However, when we incorporate the risk aversion into RND in order to obtain a Real-world density, the out-of-sample performance improves substantially, with satisfactory results in both Kolmogorov and Berkowitz tests. Therefore, we would suggest not using the “pure” RND, but rather taking into account risk aversion in order to forecast the Brazilian Real exchange rate.

Board of directors and top management team: a study on CEO relative power and financial return

Best corporate governance practices published in the primers of Brazilian Securities and Exchange Commission and the Brazilian Corporate Governance Institute promote board independence as much as possible, as a way to increase the effectiveness of governance mechanism (Sanzovo, 2010). Therefore, this paper aims at understanding if what the managerial literature portraits as being self-evident - stricter governance, better performance - can be observed in actual evidence. The question answered is: do companies with a stricter control and monitoring system perform better than others? The method applied in this paper consists on comparing 116 companies in respect to the their independence level between top management team and board directors– being that measured by four parameters, namely, the percentage of independent outsiders in the board, the separation of CEO and chairman, the adoption of contingent compensation and the percentage of institutional investors in the ownership structure – and their financial return measured in terms return on assets (ROA) from the latest Quarterly Earnings release of 2012. From the 534 companies listed in the Stock Exchange of Sao Paulo – Bovespa – 116 were selected due to their level of corporate governance. The title “Novo Mercado” refers to the superior level of governance level within companies listed in Bovespa, as they have to follow specific criteria to assure shareholders ´protection (BM&F, 2011). Regression analyses were conducted in order to reveal the correlation level between two selected variables. The results from the regression analysis were the following: the correlation between each parameter and ROA was 10.26%; the second regression analysis conducted measured the correlation between the independence level of top management team vis-à-vis board directors – namely, CEO relative power - and ROA, leading to a multiple R of 5.45%. Understanding that the scale is a simplification of the reality, the second part of the analysis transforms all the four parameters into dummy variables, excluding what could be called as an arbitrary scale. The ultimate result from this paper led to a multiple R of 28.44%, which implies that the combination of the variables are still not enough to translate the complex reality of organizations. Nonetheless, an important finding can be taken from this paper: two variables (percentage of outside directors and percentage of institutional investor ownership) are significant in the regression, with p-value lower than 10% and with negative coefficients. In other words, counter affirming what the literature very often portraits as being self-evident – stricter governance leads to higher performance – this paper has provided evidences to believe that the increase in the formal governance structure trough outside directors in the board and ownership by institutional investor might actually lead to worse performance. The section limitations and suggestions for future researches presents some reasons explaining why, although supported by strong theoretical background, this paper faced some challenging methodological assumptions, precluding categorical statements about the level of governance – measured by four selected parameters – and the financial return in terms of financial on assets.

Changes in test scores distribution for students of the fourth grade in Brazil: a relative distribution analysis for the years 1997 to 2005

To assess the quality of school education, much of educational research is concerned with comparisons of test scores means or medians. In this paper, we shift this focus and explore test scores data by addressing some often neglected questions. In the case of Brazil, the mean of test scores in Math for students of the fourth grade has declined approximately 0,2 standard deviation in the late 1990s. But what about changes in the distribution of scores? It is unclear whether the decline was caused by deterioration in student performance in upper and/or lower tails of the distribution. To answer this question, we propose the use of the relative distribution method developed by Handcock and Morris (1999). The advantage of this methodology is that it compares two distributions of test scores data through a single distribution and synthesizes all the differences between them. Moreover, it is possible to decompose the total difference between two distributions in a level effect (changes in median) and shape effect (changes in shape of the distribution). We find that the decline of average-test scores is mainly caused by a worsening in the position of all students throughout the distribution of scores and is not only specific to any quantile of distribution.

Brazilian Federal Universities : relative efficiency evaluation and data envelopment analysis

The papers aims at considering the issue of relative efficiency measurement in the context of the public sector. In particular, we consider the efficiency measurement approach provided by Data Envelopment Analysis (DEA). The application considered the main Brazilian federal universities for the year of 1994. Given the large number of inputs and outputs, this paper advances the idea of using factor analysis to explore common dimensions in the data set. Such procedure made possible a meaningful application of DEA, which finally provided a set of efficiency scores for the universities considered .

Relative abundance and population biology of the non-indigenous crab Charybdis hellerii (Crustacea: Brachyura: Portunidae) in a southwestern Atlantic estuary-bay complex

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relative potency of ketamine and S(+)-ketamine in dogs

The aim of this study was to determine the relative potency of racemic ketamine and S(+)-ketamine for the hypnotic effect and to evaluate the clinical anesthesia produced by equianesthetic doses of these two substances in dogs. One hundred and eight dogs were allocated in groups R2, R2.5, R3, R6, R9, R12, S2, S2.5, S3, S6, S9, and S12, to receive by intravenous route 2, 2.5, 3, 6, 9, and 12 mg/kg of ketamine or S(+)-ketamine, respectively. A dose-effect curve was drawn with the dose logarithm and the percentage of dogs that presented hypnosis in each group. The curve was used to obtain a linear regression, to determine the effective doses 100 and the potency relationship. In another experimental phase, eight groups of five dogs received 3, 6, 9 and 12 mg/kg of ketamine or S(+)-ketamine to evaluate the periods of latency, hypnosis, and total recovery. The times in which the dogs reached the sternal position, attempted to stand up for the first time, recovered the standing position, and started to walk were also recorded. The hypnotic dose for ketamine was 9.82 +/- 3.02 (6.86-16.5) mg/kg and for S(+)-ketamine was 7.76 +/- 2.17 (5.86-11.5) mg/kg. The time of hypnosis was longer in R3 and the first attempt to stand up occurred early in R6 when compared with S3 and S6 respectively. When R9 (100% of hypnosis with ketamine) and S6 [100% of hypnosis with S(+)-ketamine] were compared (1:1.5 ratio), the time to sternal position (12 +/- 2.5 and 20.2 +/- 5.6 min respectively) and the total recovery time (45 +/- 5.5 and 60.2 +/- 5.2 min respectively) were significantly shorter with S(+)-ketamine. It was concluded that the potency ratio between ketamine and S(+)-ketamine in dogs is smaller than the one reported in other species, and that the dose obtained after a reduction of 50%, as usually performed in humans, would not be enough to obtain equianesthetic effects in dogs.

Relative development of tissues, commercial meat cuts and live weight components in Saanen goats

Objetivando avaliar o desenvolvimento relativo dos componentes do peso vivo (PV), dos cortes comerciais e dos tecidos da carcaça, utilizaram-se 40 cabritos Saanen. Os animais foram abatidos ao atingir 5,0; 12,5; 20,0; 27,5 e 35,0 kg de PV e a carcaça foi seccionada em paleta, pescoço, 1ª a 5ª costelas, 6ª a 13ª costelas, peito/fralda, lombo e perna. A perna foi dissecada em ossos, músculos e gordura. Utilizou-se a equação alométrica Y=aXb para estimar o desenvolvimento relativo. O crescimento do tecido ósseo foi precoce, o do tecido muscular intermediário e o da gordura crescimento tardio, uma vez que a gordura subcutânea é depositada mais tardiamente. Os cortes comerciais apresentaram coeficiente de alometria isogônico, com exceção do corte da 6ª a 13ª costelas e do peito/fralda. O desenvolvimento da carcaça e dos não-componentes da carcaça acompanhou o peso de corpo vazio. Cabritos com 35 kg de PV possuem proporção de músculos e relação músculo:osso adequadas, mas apresentam proporção de gordura maior que a observada nos animais abatidos com 20 kg de PV.

Wavelet shrinkage: High frequency multipath reduction from GPS relative positioning

The wavelet transform is used to reduce the high frequency multipath of pseudorange and carrier phase GPS double differences (DDs). This transform decomposes the DD signal, thus separating the high frequencies due to multipath effects. After the decomposition, the wavelet shrinkage is performed by thresholding to eliminate the high frequency component. Then the signal can be reconstructed without the high frequency component. We show how to choose the best threshold. Although the high frequency multipath is not the main multipath error component, its correction provides improvements of about 30% in pseudorange average residuals and 24% in carrier phases. The results also show that the ambiguity solutions become more reliable after correcting the high frequency multipath.

Analysis of relative humidity sensors at the WMO Radiosonde intercomparison experiment in Brazil

The quality of the vertical distribution measurements of humidity in the atmosphere is very important in meteorology due to the crucial role that water vapor plays in the earth's energy budget. The radiosonde is the humidity measurement device that provides the best vertical resolution. Also, radiosondes are the operational devices that are used to measure the vertical profile of atmospheric water vapor. The World Meteorological Organization (WMO) has carried out several intercomparison experiments at different climatic zones in order to identify the differences between the available commercial sensors. This article presents the results of an experiment that was carried out in Brazil in 2001 in which major commercial radiosonde manufacturers [e.g., Graw Radiosondes GmbH & Co., KG (Germany); MODEM (France); InterMet Systems (United States); Sippican, Inc. (United States); and Vaisala (Finland)] were involved. One of the main goals of this experiment was to evaluate the performance of the different humidity sensors in a tropical region. This evaluation was performed for different atmospheric layers and distinct periods of the day. It also considers the computation of the integrated water vapor (IWV). The results showed that the humidity measurements achieved by the different sensors were quite similar in the low troposphere (the bias median value regarding the RS80 was around 1.8%) and were quite dispersed in the superior layers (the median rms regarding the RS80 was around 14.9%).