bluuebunny/crossref_metadata_2025 huggingface dataset:
Post‐junctional interactions between neuromuscular blocking agents and ethanol at the mouse neuromuscular junction
Authors: Searl TJ , Silinsky EM
Published: June 2010

BACKGROUND AND PURPOSEEthanol is known to have both pre‐synaptic and post‐synaptic effects at a range of loci in the mammalian nervous system, including the neuromuscular junction. However, the effects of ethanol on evoked synaptic transmission have not been previously studied at the mouse neuromuscular junction. Here, we report on the effects of ethanol on evoked neuromuscular transmission and the interaction of ethanol with non‐depolarizing blocking drugs.

EXPERIMENTAL APPROACHElectrophysiological techniques to measure synaptic potentials and synaptic currents were employed in this study.

KEY RESULTSEthanol (≥100 mM) produced increases in the amplitudes of both spontaneous and evoked synaptic events. Under conditions in which neuromuscular transmission was blocked by (+)‐tubocurarine, ethanol (12–100 mM) produced greater increases in evoked response amplitude than in spontaneous response amplitude recorded in the absence of (+)‐tubocurarine. Ethanol (100 mM) did not affect evoked neurotransmitter release in low‐calcium/high‐magnesium solutions. With respect to the clinically used neuromuscular blocking drugs, ethanol (100 mM) interfered with the blocking action of vecuronium, but not cisatracurium.

CONCLUSIONS AND IMPLICATIONSUnder these conditions, the stimulant effect of ethanol on neuromuscular transmission is exclusively on the post‐junctional elements, both to enhance transmission through nicotinic receptors and also via interactions with neuromuscular blocking agents. These actions of ethanol on neuromuscular transmission may affect the dosage of neuromuscular blockers required in patients who have imbibed significant amounts of alcohol.
Resolvin D1 attenuates activation of sensory transient receptor potential channels leading to multiple anti‐nociception
Authors: Bang S , Yoo S , Yang TJ , Cho H , Kim YG , Hwang SW
Published: June 2010

BACKGROUND AND PURPOSETemperature‐sensitive transient receptor potential ion channels (thermoTRPs) expressed in primary sensory neurons and skin keratinocytes play a crucial role as peripheral pain detectors. Many natural and synthetic ligands have been found to act on thermoTRPs, but little is known about endogenous compounds that inhibit these TRPs. Here, we asked whether resolvin D1 (RvD1), a naturally occurring anti‐inflammatory and pro‐resolving lipid molecule is able to affect the TRP channel activation.

EXPERIMENTAL APPROACHWe examined the effect of RvD1 on the six thermoTRPs using Ca2+imaging and whole cell electrophysiology experiments using the HEK cell heterologous expression system, cultured sensory neurons and HaCaT keratinocytes. We also checked changes in agonist‐specific acute licking/flicking or flinching behaviours and TRP‐related mechanical and thermal pain behaviours using Hargreaves, Randall‐Selitto and von Frey assay systems with or without inflammation.

KEY RESULTSRvD1 inhibited the activities of TRPA1, TRPV3 and TRPV4 at nanomolar and micromolar levels. Consistent attenuations in agonist‐specific acute pain behaviours by immediate peripheral administration with RvD1 were also observed. Furthermore, local pretreatment with RvD1 significantly reversed mechanical and thermal hypersensitivity in inflamed tissues.

CONCLUSIONS AND IMPLICATIONSRvD1 was a novel endogenous inhibitor for several sensory TRPs. The results of our behavioural studies suggest that RvD1 has an analgesic potential via these TRP‐related mechanisms.
Interpreting Territory and Power
Authors: Bevir Mark
Published: June 2010

The article offers an interpretive approach to understanding Jim Bulpitt'sTerritory and Power in the United Kingdom. The first two parts interpret Bulpitt's text by locating it respectively in its historical and contemporaneous contexts. It argues thatTerritory and Powerbelongs in a broader movement to rethink the state in a way that accommodates the rise of new behavioural topics.Territory and Poweralso defends modernist empiricist approaches to institutions and other mid-level topics against the positivism and general theories of behaviouralism. The final part points to an interpretive approach to the state as an alternative to the behaviouralism and institutionalism that lurk behind Bulpitt's ideas. A thoroughly interpretive approach would decentre territory and power, revealing them to be contingent and shifting products of struggles over meanings.
The FDA Alert on Serotonin Syndrome With Use of Triptans Combined With Selective Serotonin Reuptake Inhibitors or Selective Serotonin‐Norepinephrine Reuptake Inhibitors: American Headache Society Position Paper
Authors: Evans Randolph W. , Tepper Stewart J. , Shapiro Robert E. , Sun‐Edelstein Christina , Tietjen Gretchen E.
Published: June 2010

(Headache 2010;50:1089‐1099)

Background.— In 2006, a US Food and Drug Administration (FDA) alert warned about the potential life‐threatening risk of serotonin syndrome when triptans are used in combination with selective serotonin reuptake inhibitors (SSRIs) or selective serotonin/norepinephrine reuptake inhibitors (SNRIs). This American Headache Society Position Paper further reviews the available evidence of the potential risk of combining triptans with other serotonergic agents.

Methods.— Using the Sternbach Criteria or the Hunter Serotonin Toxicity Criteria, the 29 cases used as the basis for the FDA alert were assessed in addition to a more recently published clinical review of 11 case reports of serotonin syndrome resulting from monotherapy, and one report of combination serotonergic agents. Evidence was evaluated according to the American Academy of Neurology Clinical Practice Guideline Process Manual.

Results.— Collectively, 40 case reports are available in the literature for subjects receiving either combination or monotherapy of serotonin agonists, all of which are limited to Class IV level of evidence. Of the 29 cases used as the basis for the FDA alert, 10 cases actually met the Sternbach Criteria for diagnosing serotonin syndrome. No cases fulfilled the Hunter Criteria for serotonin toxicity. One case published since the original report does not meet either criteria, and subsequently reported cases involving triptan monotherapy include insufficient details to confirm a diagnosis of serotonin syndrome.

Recommendations.— With only Class IV evidence available in the literature and available through the FDA registration of adverse events, inadequate data are available to determine the risk of serotonin syndrome with the addition of a triptan to SSRIs/SNRIs or with triptan monotherapy. The currently available evidence does not support limiting the use of triptans with SSRIs or SNRIs, or the use of triptan monotherapy, due to concerns for serotonin syndrome (Level U). However, given the seriousness of serotonin syndrome, caution is certainly warranted and clinicians should be vigilant to serotonin toxicity symptoms and signs to insure prompt treatment. Health care providers should report potential cases to MedWatch and consider submitting them for publication.
Implanted Auriculotemporal Nerve Stimulator for the Treatment of Refractory Chronic Migraine
Authors: Simopoulos Thomas , Bajwa Zahid , Lantz George , Lee Steve , Burstein Rami
Published: June 2010

Objective.— To report a case of improved pain control and function in a patient with chronic migraine after treatment with auriculotemporal nerve stimulation.

Methods.— The patient is a 52‐year‐old woman with refractory pain in the bilateral temporal distribution and marked phonophobia as a result of chronic migraine.

Results.— After a successful trial period, the patient underwent implantation of bilateral peripheral nerve stimulators targeting the auriculotemporal nerves. At 16 months of follow up, her average pain intensity declined from 8‐9/10 on the numeric rating scale to 5/10. Her function improved as assessed by the Migraine Disability Assessment, from total disability (grade IV) to mild disability (grade II). Her phonophobia became far less debilitating.

Conclusion.— Auriculotemporal nerve stimulation may be useful tool in the treatment of refractory pain in the temporal distribution due to chronic migraine.
Dihydroergotamine and Its Use in Migraine With Posterior Fossa Symptoms
Authors: Whyte Chad A. , Stillman Mark J. , Tepper Stewart J.
Published: June 2010

Background.— Dihydroergotamine (DHE) has been used for decades to treat migraine, but is currently contraindicated in patients with hemiplegic migraine and basilar‐type migraine (BTM).

Objective.— To assess the safety of DHE in patients with symptoms of BTM that do not meet criteria for BTM.

Methods.— Retrospective analysis of patients admitted to an outpatient infusion room at a tertiary care center caring for patients with headache disorders. Incidence and types of adverse events as well as pain levels were reviewed and analyzed. Pain was assessed via the visual analog scale (VAS).

Results.— Fifty consecutive patient records were reviewed. Mean age was 38.42. All patients met International Classification of Headache Disorders‐II (ICHD‐II) criteria for migraine and reported 1 posterior fossa symptom as defined by the ICHD‐II criteria for BTM. Patients did not necessarily have a posterior fossa symptom in the attack treated. Eighteen percent (9/50) patients had adverse events, and only 3 of these halted DHE infusion. No patients had neurologic or cardiologic events. The mean decrease in pain was 3 points on the VAS (P < .0001). Sixty‐two percent of patients achieved complete relief of headache with co‐administration of DHE and other medications.

Conclusion.— Dihydroergotamine showed no serious adverse events in patients with 1 posterior fossa symptom and migraine. Larger, adequately powered, controlled, prospective trials are indicated to assess safety of DHE in BTM.
Rates and Predictors of Starting a Triptan: Results From the American Migraine Prevalence and Prevention Study
Authors: Bigal Marcelo E. , Buse Dawn C. , Chen Ya‐Ting , Golden Wendy , Serrano Daniel , Chu Min Kyung , Lipton Richard B.
Published: June 2010

Background.— Although diagnostic rates for migraine have increased over the past 5 years, the proportion of migraine sufferers using triptans has remained essentially stable.

Objectives.— To assess the rate of onset of new triptan prescriptions among persons with migraine and the predictors of initiating therapy.

Methods.— The American Migraine Prevalence and Prevention Study is a longitudinal study conducted in a representative sample of headache sufferers in the US population. Episodic migraineurs not using triptans in 2005 who continued to have migraine and provided treatment data in 2006 (n = 6865) were included. We assessed predictors of triptan use in univariate and multivariate analyses, including 3 nested models. In Model 1, we adjusted for demographic variables. Model 2 added headache‐related disability and cutaneous allodynia. Model 3 added depression and use of preventive headache medications.

Results.— Among individuals not using triptans in 2005, triptan use in 2006 occurred in 4.9% of the sample. In unadjusted analyses, gender and race were not associated with use of triptan. Use was lower in those aged 60 years or more vs those 18‐29 (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.2‐0.7, P = .001). Taking individuals with no disability as the reference, mild (OR = 1.44, 95% CI = 1.03‐2.01, P = .03), moderate (OR = 1.54, 95% CI = 1.1‐2.2, P = .01) and severe disability (OR = 2.19, 95% CI = 1.55‐3.09, P < .0001) predicted triptan use. In the adjusted models, age, income, insurance, disability and preventive medication use were associated with triptan use. Gender, race, education and depression were not.

Conclusions.— New use of triptans is low in the population. Because adequacy of care was not assessed, future studies should focus on investigating whether this low rate of triptan start is proper or if it reflects an unmet treatment need.
Binge Drinking and Suboptimal Self‐Rated Health Among Adult Drinkers
Authors: Tsai James , Ford Earl S. , Li Chaoyang , Pearson William S. , Zhao Guixiang
Published: June 2010

Background:  Binge drinking accounts for more than half of the 79,000 annual deaths in the United States that are owing to excessive drinking. The overall objective of our study was to examine the prevalence of binge drinking and consumption levels associated with suboptimal self‐rated health among the general population of adult drinkers in all 50 states and territories in the United States.

Methods:  The study included a total of 200,587 current drinkers who participated in the 2008 Behavioral Risk Factor Surveillance System (BRFSS) survey. We estimated the prevalence of binge drinking (i.e., ≥5 drinks on 1 occasion for men or ≥4 drinks on 1 occasion for women) and heavy drinking (i.e., an average of >14 drinks per week for men or >7 drinks per week for women), as well as the average number of binge episodes per person during a 30‐day period. Odds ratios were produced with multivariate logistic regression models using binge‐drinking levels as a predictor; status of suboptimal self‐rated health was used as an outcome variable while controlling for sociodemographic, health, and behavioral risk factors.

Results:  We estimate that 34.7 million adult drinkers in the United States engaged in binge drinking in 2008, including an estimated 42.2% who reported either heavy drinking or at least 4 binge‐drinking episodes in a 30‐day period. Binge drinking with such levels was associated with a 13–23% increased likelihood of reporting suboptimal self‐rated health, when compared to the nonbinge drinkers.

Conclusions:  Binge drinking continues to be a serious public health concern. Frequent binge drinkers or binge drinkers who consume alcohol heavily are especially at risk of suboptimal self‐rated health. Our findings underscore the importance of broad‐based implementation in health care settings of screening for and brief interventions to address alcohol misuse, as well as the continuing need to implement effective population‐based prevention strategies to reduce alcohol‐related morbidity and mortality.
Trends in Alcohol‐Related Traffic Risk Behaviors Among College Students
Authors: Beck Kenneth H. , Kasperski Sarah J. , Caldeira Kimberly M. , Vincent Kathryn B. , O’Grady Kevin E. , Arria Amelia M.
Published: June 2010

Background:  Alcohol‐impaired driving is a major public health problem. National studies indicate that about 25% of college students have driven while intoxicated in the past month and an even greater percentage drive after drinking any alcohol and/or ride with an intoxicated driver. The purpose of this investigation was to examine the change in these various alcohol‐related traffic risk behaviors as students progressed through their college experience.

Methods:  A cohort of 1,253 first‐time first‐year students attending a large, mid‐Atlantic university were interviewed annually for 4 years. Repeated measures analyses were performed using generalized estimating equations to evaluate age‐related changes in prevalence and frequency of each behavior (i.e., ages 19 to 22).

Results:  At age 19, 17%wt of students drove while intoxicated, 42%wt drove after drinking any alcohol, and 38%wt rode with an intoxicated driver. For all 3 driving behaviors, prevalence and frequency increased significantly at age 21. Males were more likely to engage in these behaviors than females. To understand the possible relationship of these behaviors to changes in drinking patterns, a post hoc analysis was conducted and revealed that while drinking frequency increased every year, frequency of drunkenness was stable for females, but increased for males.

Conclusions:  Alcohol‐related traffic risk behaviors are quite common among college students and take a significant upturn when students reach the age of 21. Prevention strategies targeted to the college population are needed to prevent serious consequences of these alcohol‐related traffic risk behaviors.
Disparities in Influenza Vaccine Coverage in the United States, 2008
Authors: Linn Shauna T. , Guralnik Jack M. , Patel Kushang V.
Published: June 2010

OBJECTIVES: To determine the distribution of influenza vaccine coverage in the United States in 2008.

DESIGN: Cross‐sectional analysis.

SETTING: The 2008 Behavioral Risk Factor Surveillance Survey, which employs random‐digit dialing to interview noninstitutionalized adults in the United States and territories.

PARTICIPANTS: Two hundred forty‐nine thousand seven hundred twenty‐three persons aged 50 and older.

MEASUREMENTS: Participants were asked whether they had had an influenza vaccination during the previous 12 months.

RESULTS: In 2008, 42.0% of adults aged 50 to 64 and 69.5% of adults aged 65 and older reported receiving an influenza vaccination in the past 12 months. Vaccine coverage generally increased with advancing age (P<.001), higher levels of education (P<.001) and total household income (P<.001), and greater morbidity (P<.001). In participants aged 50 to 64, vaccine prevalence was lower in men (39.9%) than in women (44.1%; P<.001), although no significant differences were observed in older adults. Within each 5‐year interval of age, non‐Hispanic blacks and Hispanics had significantly lower vaccine prevalence than non‐Hispanic whites (P<.001 for all comparisons). For participants aged 65 and older, non‐Hispanic blacks and Hispanics were 56% (adjusted prevalence ratio (PR)=1.56, 95% confidence interval (CI)=1.48, 1.64) and 44% (adjusted PR=1.44, 95% CI=1.35, 1.54) more likely, respectively, to be unvaccinated than non‐Hispanic whites, adjusting for age and sex. Racial and ethnic disparities in vaccine coverage narrowed with increasing number of diseases, although these disparities remained significant in older adults with two or more diseases (P<.05).

CONCLUSION: There were large disparities in influenza vaccine coverage in 2008, particularly across race and ethnicity and socioeconomic position. Accordingly, more targeted interventions are needed to improve vaccine delivery to disadvantaged segments of the U.S. population.
Age‐Varying Association Between Statin Use and Incident Alzheimer's Disease
Authors: Li Ge , Shofer Jane B. , Rhew Isaac C. , Kukull Walter A. , Peskind Elaine R. , McCormick Wayne , Bowen James D. , Schellenberg Gerard D. , Crane Paul K. , Breitner John C.S. , Larson Eric B.
Published: June 2010

OBJECTIVES: To determine whether risk reduction of statins for Alzheimer's disease (AD) varies by age or presence of apolipoprotein E (APOE) ɛ4 allele.

DESIGN: A cohort of cognitively intact elderly participants was assessed biennially for dementia and AD.

SETTING: Community based.

PARTICIPANTS: Three thousand three hundred ninety‐two members of a health maintenance organization (HMO) aged 65 and older and without dementia.

MEASUREMENTS: Statin use was identified from the HMO pharmacy database, and proportional hazards models were applied with statin use as a time‐dependent covariate to assess the association between statins and AD and the modifying effects of age and the APOE ɛ4 allele.

RESULTS: Over an average of 6.1 years of follow‐up of 3,099 participants, 263 participants developed probable AD. The adjusted hazard ratio (aHR) for statin use was 0.62 (95% confidence interval (CI)=0.40–0.97) for AD in models including demographic characteristics and vascular risk factors as covariates. The strength of the association between statins and AD diminished with age (statin‐by–age at entry interaction P=.04); the aHR in those younger than 80 was 0.44 (95% CI=0.25–0.78), versus 1.22 (95% CI=0.61–2.42) for aged 80 and older. The interaction term for statin use–by–APOE ɛ4 was not significant (P=.65).

CONCLUSION: This enlarged study confirms earlier findings that statin therapy in early old age, but not in late age, may be associated with a lower risk of AD. The relationship between statin use and AD was consistent across APOE genotypes.
Incidence and Risk Factors for Fecal Incontinence in Black and White Older Adults: A Population‐Based Study
Authors: Markland Alayne D. , Goode Patricia S. , Burgio Kathryn L. , Redden David T. , Richter Holly E. , Sawyer Patricia , Allman Richard M.
Published: June 2010

OBJECTIVES: To determine the incidence of fecal incontinence (FI) in community‐dwelling older adults and identify risk factors associated with incident FI.

DESIGN: Planned secondary analysis of a longitudinal, population‐based cohort study.

SETTING: Three rural and two urban Alabama counties (in‐home assessments 2000–2005).

PARTICIPANTS: Stratified random sample of 1,000 Medicare beneficiaries: 25% African‐American men, 25% white men, 25% African‐American women, 25% white women, aged 65 and older. Eligible participants for this analysis were continent at baseline and community‐dwelling 4 years later (n=557).

MEASUREMENTS: FI was defined as any loss of control of bowels occurring during the previous year. Independent variables were sociodemographics, Charlson comorbidity counts, self‐reported bowel symptoms (chronic diarrhea and constipation), depression, and body mass index (BMI). Multivariable logistic regression models were constructed using incident FI as the dependent variable.

RESULTS: The incidence rate of FI at 4 years was 17% (95% confidence interval (CI)=13.7–20.1), with 6% developing FI at least monthly (95% CI=4.0–8.3). White women were more likely to have incident FI (22%) than African‐American women (13%, P=.04); no racial differences were observed in men. Controlling for age, comorbidity count, and BMI, significant independent risk factors for incident FI in women were white race, depression, chronic diarrhea, and urinary incontinence (UI). UI was the only significant risk factor for incident FI in men.

CONCLUSION: The occurrence of new FI is common in men and women aged 65 and older, with a 17% incidence rate over 4 years. FI and UI may share common pathophysiologic mechanisms and need regular assessment in older adults.
Outcomes Associated with Opioid Use in the Treatment of Chronic Noncancer Pain in Older Adults: A Systematic Review and Meta‐Analysis
Authors: Papaleontiou Maria , Henderson, Jr Charles R. , Turner Barbara J. , Moore Alison A. , Olkhovskaya Yelena , Amanfo Leslie , Reid M. Carrington
Published: June 2010

This systematic review summarizes existing evidence regarding the efficacy, safety, and abuse and misuse potential of opioids as treatment for chronic noncancer pain in older adults. Multiple databases were searched to identify relevant studies published in English (1/1/80–7/1/09) with a mean study population age of 60 and older. Forty‐three articles were identified and retained for review (40 reported safety and efficacy data, the remaining 3 reported misuse or abuse outcome data). The weighted mean subject age was 64.1 (mean age range 60–73). Studies enrolled patients with osteoarthritis (70%), neuropathic pain (13%), and other pain‐producing disorders (17%). The mean duration of treatment studies was 4 weeks (range 1.5−156 weeks), and only five (12%) lasted longer than 12 weeks. In meta‐analyses, effect sizes were −0.557 (P<.001) for pain reduction, −0.432 (P<.001) for physical disability reduction, and 0.859 (P=.31) for improved sleep. The effect size for the Medical Outcomes Study 36‐item Health Survey was 0.191 (P=.17) for the physical component score and −0.220 (P=.04) for the mental component score. Adults aged 65 and older were as likely as those younger than 65 to benefit from treatment. Common adverse events included constipation (median frequency of occurrence 30%), nausea (28%), and dizziness (22%) and prompted opioid discontinuation in 25% of cases. Abuse and misuse behaviors were negatively associated with older age. In older adults with chronic pain and no significant comorbidity, short‐term use of opioids is associated with reduction in pain intensity and better physical functioning but poorer mental health functioning. The long‐term safety, efficacy, and abuse potential of this treatment practice in diverse populations of older persons remain to be determined.
Gerontologic Biostatistics: The Statistical Challenges of Clinical Research with Older Study Participants
Authors: Van Ness Peter H. , Charpentier Peter A. , Ip Edward H. , Leng Xiaoyan , Murphy Terrence E. , Tooze Janet A. , Allore Heather G.
Published: June 2010

The medical and personal circumstances of older persons present challenges for designing and analyzing clinical research studies in which they participate. These challenges that elderly study samples present are not unique, but they are sufficiently distinctive to warrant deliberate and systematic attention. Their distinctiveness originates in the multifactorial etiologies of geriatric health syndromes and the multiple morbidities accruing with aging at the end of life. The objective of this article is to identify a set of statistical challenges arising in research with older persons that should be considered conjointly in the practice of clinical research and addressed systematically in the training of biostatisticians intending to work with gerontologists, geriatricians, and older study participants. The statistical challenges include design and analytical strategies for multicomponent interventions, multiple outcomes, state transition models, floor and ceiling effects, missing data, and mixed methods. The methodological and pedagogical themes of this article will be integrated by a description of a proposed subdiscipline of “gerontologic biostatistics” and supported by the introduction of new set of statistical resources for researchers working in this area. These conceptual and methodological resources have been developed in the context of several collaborating Claude D. Pepper Older Americans Independence Centers.
An International Model for Geriatrics Program Development in China: The Johns Hopkins–Peking Union Medical College Experience
Authors: Leng Sean X. , Tian Xinping , Liu Xiaohong , Lazarus Gerald , Bellantoni Michele , Greenough William , Fried Linda P. , Shen Ti , Durso Samuel C.
Published: June 2010

China has the world's largest and most rapidly growing older adult population. Recent dramatic socioeconomic changes, including a large number of migrating workers leaving their elderly parents and grandparents behind and the 4:2:1 family structure caused by the one‐child policy, have greatly compromised the traditional Chinese family support for older adults. These demographic and socioeconomic factors, the improved living standards, and the quest for higher quality of life are creating human economic pressures. The plight of senior citizens is leading to an unprecedented need for geriatrics expertise in China. To begin to address this need, the Johns Hopkins University School of Medicine (JHU) and Peking Union Medical College (PUMC) have developed a joint international project aimed at establishing a leadership program at the PUMC Hospital that will promote quality geriatrics care, education, and aging research for China. Important components of this initiative include geriatrics competency training for PUMC physicians and nurses in the Division of Geriatric Medicine and Gerontology at JHU, establishing a geriatrics demonstration ward at the PUMC Hospital, faculty exchange between JHU and PUMC, and on‐site consultation by JHU geriatrics faculty. This article describes the context and history of this ongoing collaboration and important components, progress, challenges, and future prospects, focusing on the JHU experience. Specific and practical recommendations are made for those who plan such international joint ventures. With such unique experiences, it is hoped that this will serve as a useful model for international geriatrics program development for colleagues in the United States and abroad.
Cross‐Cultural Differences in Mental Representations of Time: Evidence From an Implicit Nonlinguistic Task
Authors: Fuhrman Orly , Boroditsky Lera
Published: June 2010

Across cultures people construct spatial representations of time. However, the particular spatial layouts created to represent time may differ across cultures. This paper examines whether people automatically access and use culturally specific spatial representations when reasoning about time. In Experiment 1, we asked Hebrew and English speakers to arrange pictures depicting temporal sequences of natural events, and to point to the hypothesized location of events relative to a reference point. In both tasks, English speakers (who read left to right) arranged temporal sequences to progress from left to right, whereas Hebrew speakers (who read right to left) arranged them from right to left, replicating previous work. In Experiments 2 and 3, we asked the participants to make rapid temporal order judgments about pairs of pictures presented one after the other (i.e., to decide whether the second picture showed a conceptually earlier or later time‐point of an event than the first picture). Participants made responses using two adjacent keyboard keys. English speakers were faster to make “earlier” judgments when the “earlier” response needed to be made with the left response key than with the right response key. Hebrew speakers showed exactly the reverse pattern. Asking participants to use a space‐time mapping inconsistent with the one suggested by writing direction in their language created interference, suggesting that participants were automatically creating writing‐direction consistent spatial representations in the course of their normal temporal reasoning. It appears that people automatically access culturally specific spatial representations when making temporal judgments even in nonlinguistic tasks.
Composition in Distributional Models of Semantics
Authors: Mitchell Jeff , Lapata Mirella
Published: June 2010

Vector‐based models of word meaning have become increasingly popular in cognitive science. The appeal of these models lies in their ability to represent meaning simply by using distributional information under the assumption that words occurring within similar contexts are semantically similar. Despite their widespread use, vector‐based models are typically directed at representing words in isolation, and methods for constructing representations for phrases or sentences have received little attention in the literature. This is in marked contrast to experimental evidence (e.g., in sentential priming) suggesting that semantic similarity is more complex than simply a relation between isolated words. This article proposes a framework for representing the meaning of word combinations in vector space. Central to our approach is vector composition, which we operationalize in terms of additive and multiplicative functions. Under this framework, we introduce a wide range of composition models that we evaluate empirically on a phrase similarity task.
Hospital Costs and Revenue Are Similar for Resuscitated Out‐of‐hospital Cardiac Arrest and ST‐segment Acute Myocardial Infarction Patients
Authors: Swor Robert , Lucia Victoria , McQueen Kelly , Compton Scott
Published: June 2010

Objectives:  Care provided to patients who survive to hospital admission after out‐of‐hospital cardiac arrest (OOHCA) is sometimes viewed as expensive and a poor use of hospital resources. The objective was to describe financial parameters of care for patients resuscitated from OOHCA.

Methods:  This was a retrospective review of OOHCA patients admitted to one academic teaching hospital from January 2004 to October 2007. Demographic data, length of stay (LOS), and discharge disposition were obtained for all patients. Financial parameters of patient care including total cost, net revenue, and operating margin were calculated by hospital cost accounting and reported as median and interquartile range (IQR). Groups were dichotomized by survival to discharge for subgroup analysis. To provide a reference group for context, similar financial data were obtained for ST‐segment elevation myocardial infarction (STEMI) patients admitted during the same time period, reported with medians and IQRs.

Results:  During the study period, there were 72 admitted OOCHA patients and 404 STEMI patients. OOCHA and STEMI groups were similar for age, sex, and insurance type. Overall, 27 (38.6%) OOHCA patients survived to hospital discharge. Median LOS for OOHCA patients was 4 days (IQR = 1–8 days), with most of those hospitalized for ≤4 days (n = 34, 81.0% dying or discharged to hospice care). Median net revenue ($17,334 [IQR $7,015–$37,516] vs. $16,466 [IQR = $14,304–$23,678], p = 0.64) and operating margin ($7,019 [IQR = $1,875–$15,997] vs. $7,098 [IQR = $3,767–$11,138], p = 0.83) for all OOHCA patients were not different from STEMI patients. Net income for OOCHA patients was not different than for STEMI patients (–$322 vs. $114, p = 0.72).

Conclusions:  Financial parameters for OOHCA patients are similar to those of STEMI patients. Financial issues should not be a negative incentive to providing care for these patients.

ACADEMIC EMERGENCY MEDICINE 2010; 17:612–616 © 2010 by the Society for Academic Emergency Medicine
Augmentation of the Cooling Capacity of Refrigerated Fluid by Minimizing Heat Gain of the Fluid Using a Simple Method of Cold Insulation
Authors: Lee Byung Kook , Jeung Kyung Woon , Lee Seung Cheol , Min Yong Il , Ryu Hyun Ho , Kim Mu Jin , Lee Hyoung Youn , Heo Tag
Published: June 2010

Objectives:  This study was undertaken to determine how rapidly refrigerated fluids gain heat during bolus infusion and to determine whether the refrigerated fluids could be kept cold by a simple cold‐insulation method.

Methods:  One liter of refrigerated fluid was run through either a 16‐gauge catheter (16G(–) and 16G(+) groups) or an 18‐gauge catheter (18G(–) and 18G(+) groups) while monitoring the temperature in the fluid bag and the outflow site. In the 16G(+) and the 18G(+) groups, the fluid bag was placed with an ice pack inside an insulating sleeve during the fluid run.

Results:  In the 16G(–) and the 18G(–) groups, the outflow temperature increased to 10–12°C during the fluid run. Meanwhile, outflow temperatures in the 16G(+) and the 18G(+) groups remained below 4.6 and 6.8°C, respectively. The temperatures differed significantly between the 16G(–) and the 16G(+) groups (p < 0.001) and between the 18G(–) and the 18G(+) groups (p < 0.001), respectively.

Conclusions:  Substantial heat gain occurred in the refrigerated fluid even during the relatively short duration of bolus infusion. The heat gain could, however, be easily minimized by cold insulation of the fluid bag.

ACADEMIC EMERGENCY MEDICINE 2010; 17:673–675 © 2010 by the Society for Academic Emergency Medicine
Factors Associated With Positive D‐dimer Results in Patients Evaluated for Pulmonary Embolism
Authors: Kabrhel Christopher , Mark Courtney D. , Camargo Carlos A. , Plewa Michael C. , Nordenholz Kristen E. , Moore Christopher L. , Richman Peter B. , Smithline Howard A. , Beam Daren M. , Kline Jeffrey A.
Published: June 2010

Objectives:  Available D‐dimer assays have low specificity and may increase radiographic testing for pulmonary embolism (PE). To help clinicians better target testing, this study sought to quantify the effect of risk factors for a positive quantitative D‐dimer in patients evaluated for PE.

Methods:  This was a prospective, multicenter, observational study. Emergency department (ED) patients evaluated for PE with a quantitative D‐dimer were eligible for inclusion. The main outcome of interest was a positive D‐dimer. Odds ratio (ORs) and 95% confidence intervals (CIs) were determined by multivariable logistic regression. Adjusted estimates of relative risk were also calculated.

Results:  A total of 4,346 patients had D‐dimer testing, of whom 2,930 (67%) were women. A total of 2,500 (57%) were white, 1,474 (34%) were black or African American, 238 (6%) were Hispanic, and 144 (3%) were of other race or ethnicity. The mean (±SD) age was 48 (±17) years. Overall, 1,903 (44%) D‐dimers were positive. Model fit was adequate (c‐statistic = 0.739, Hosmer and Lemeshow p‐value = 0.13). Significant positive predictors of D‐dimer positive included female sex; increasing age; black (vs. white) race; cocaine use; general, limb, or neurologic immobility; hemoptysis; hemodialysis; active malignancy; rheumatoid arthritis; lupus; sickle cell disease; prior venous thromboembolism (VTE; not under treatment); pregnancy and postpartum state; and abdominal, chest, orthopedic, or other surgery. Warfarin use was protective. In contrast, several variables known to be associated with PE were not associated with positive D‐dimer results: body mass index (BMI), estrogen use, family history of PE, (inactive) malignancy, thrombophilia, trauma within 4 weeks, travel, and prior VTE (under treatment).

Conclusions:  Many factors are associated with a positive D‐dimer test. The effect of these factors on the usefulness of the test should be considered prior to ordering a D‐dimer.

ACADEMIC EMERGENCY MEDICINE 2010; 17:589–597 © 2010 by the Society for Academic Emergency Medicine
External Validation of the Clinical Dehydration Scale for Children With Acute Gastroenteritis
Authors: Bailey Benoit , Gravel Jocelyn , Goldman Ran D. , Friedman Jeremy N. , Parkin Patricia C.
Published: June 2010

Objectives:  The objective was to validate the clinical dehydration scale (CDS) for children with gastroenteritis in a different pediatric emergency department (ED) from where it was initially derived and validated.

Methods:  A prospective cohort study was performed in a tertiary care pediatric ED over a 1‐year period. A sample of triage nurses were trained in applying the CDS. The CDS consists of four clinical characteristics (general appearance, eyes, mucous membranes, and tears), each of which are scored 0, 1, or 2 for a total score of 0 to 8, with 0 representing no dehydration; 1 to 4, some dehydration; and 5 to 8, moderate/severe dehydration. Children 1 month to 5 years of age with vomiting and/or diarrhea who had the CDS documented at triage and a final diagnosis of gastroenteritis, gastritis, or enteritis were enrolled. Exclusion criteria included a chronic disease, treatment with intravenous (IV) rehydration within the previous 24 hours, visit to the ED for the same illness in the 7 days prior to arrival, and diarrhea of more than 10 days’ duration. The primary outcome was the length of stay (LOS) in the ED from the time of seeing a physician to discharge, analyzed with a Kruskal‐Wallis test.

Results:  From April 2008 to March 2009, 150 patients with a mean (±SD) age of 22 (±14) months (range = 4 months to 4 years) were enrolled. Fifty‐six patients had no dehydration, 74 had some dehydration, and 20 had moderate/severe dehydration. The median LOS in the ED after being seen by a physician was significantly longer as children appeared more dehydrated according to the CDS: 54 minutes (interquartile range [IQR] = 26–175 minutes), 128 minutes (IQR = 25–334 minutes), and 425 minutes (IQR = 218–673 minutes) for the no, some, and moderate/severe dehydration groups, respectively (p < 0.001).

Conclusions:  The CDS has been further validated in children with gastroenteritis in a different pediatric center than the original one where it was developed. It is a good predictor of LOS in the ED after being seen by a physician.

ACADEMIC EMERGENCY MEDICINE 2010; 17:583–588 © 2010 by the Society for Academic Emergency Medicine
Murder Followed by Suicide: A Newspaper Surveillance Study Using the New York Times Index
Authors: Warren‐Gordon Kiesha , Byers Bryan D. , Brodt Stephen J. , Wartak Melissa , Biskupski Brian
Published: June 2010

Abstract:  Murder–suicide is a relatively uncommon event but as reported by the New York Times, it has occurred and continues to occur yearly. Previous research has indicated that those who commit murder–suicides tend to be men, are in or have been in an intimate relationship with the victim, victims tend to be women, and a firearm is most likely to be used. This study uses a newspaper surveillance methodology to examine such cases. Articles from the New York Times as found in the New York Times Index were coded, analyzed, and examined. The cases, 166 in total, support the findings from prior research. The trend data was examined by cross tabulations and chi‐square analysis. The findings suggest that murder–suicides are rare events and when they occur they usually involve a male perpetrator and an intimate partner victim who is either a wife or girlfriend with the event occurring in a private home. A firearm is the most commonly used method for both murders and suicides, particularly if there was more than one murder victim. The authors conclude by suggesting that future research should focus on using the forthcoming data resource in the CDC’s National Violent Death Reporting System (NVDRS) to examine the occurrence of murder–suicide.
Recovery of Latent Fingerprints and DNA on Human Skin*
Authors: Färber Doris , Seul Andrea , Weisser Hans‐Joachim , Bohnert Michael
Published: June 2010

Abstract: The project “Latent Fingerprints and DNA on Human Skin” was the first systematic research in Europe dealing with detection of fingerprints and DNA left by offenders on the skin of corpses. One thousand samples gave results that allow general statements on the materials and methods used. The tests were carried out according to a uniform trial structure. Fingerprints were deposited by natural donors on corpses. The latent fingerprints were treated with magnetic powder or black fingerprint powder. Afterward, they were lifted with silicone casting material (Isomark®) or gelatine foil. All lifts were swabbed to recover DNA. It was possible to visualize comparable and identifiable fingerprints on the skin of corpses (16%). In the same categories, magnetic powder (18.4%) yielded better results than black fingerprint powder (13.6%). The number of comparable and identifiable fingerprints decreased on the lifts (12.7%). Isomark®(14.9%) was the better lifting material in comparison with gelatine foil (10.1%). In one‐third of the samples, DNA could be extracted from the powdered and lifted latents. Black fingerprint powder delivered the better result with a rate of 2.2% for full DNA profiles and profiles useful for exclusion in comparison with 1.8% for the magnetic powder traces. Isomark®(3.1%) yielded better results than gelatine foil (0.6%).
Root caries risk indicators: a systematic review of risk models
Authors: Ritter André V. , Shugars Daniel A. , Bader James D.
Published: June 2010

Ritter AV, Shugars DA, Bader JD. Root caries risk indicators: a systematic review of risk models. Community Dent Oral Epidemiol 2010; 38: 383–397. © 2010 John Wiley & Sons A/S

Abstract – 

Objective:  To identify risk indicators that are associated with root caries incidence in published predictive risk models.

Methods:  Abstracts (n = 472) identified from a MEDLINE, EMBASE, and Cochrane registry search were screened independently by two investigators to exclude articles not in English (n = 39), published prior to 1970 (none), or containing no information on either root caries incidence, risk indicators, or risk models (n = 209). A full‐article duplicate review of the remaining articles (n = 224) selected those reporting predictive risk models based on original/primary longitudinal root caries incidence studies. The quality of the included articles was assessed based both on selected criteria of methodological standards for observational studies and on the statistical quality of the modeling strategy. Data from these included studies were extracted and compiled into evidence tables, with information about the cohort location, incidence period, sample size, age of the study participants, risk indicators included in the model, root caries incidence, modeling strategy, significant risk indicators/predictors, and parameter estimates and statistical findings.

Results:  Thirteen articles were selected for data extraction. The overall quality of the included articles was poor to moderate. Root caries incidence ranged from 12% to 77% (mean ± SD = 45 ± 17%); follow‐up time of the published studies was ≤ 10 years (range = 9; median = 3); sample size ranged from 23‐723 (mean ± SD = 264 ± 203; median = 261); person‐years ranged from 23 to 1540 (mean ± SD = 760 ± 556; median = 746). Variables most frequently tested and significantly associated with root caries incidence were (times tested; % significant; directionality): baseline root caries (12; 58%; positive); number of teeth (7; 71%; three times positive, twice negative), and plaque index (4; 100%; positive). Ninety‐two other clinical and nonclinical variables were tested: 27 were tested three times or more and were significant between 9% and 100% of the times tested; and 65 were tested but never significant.

Conclusions:  The root caries incidence indicators/predictors most frequently reported were root caries prevalence at baseline, number of teeth, and plaque index. This finding can guide targeted root caries prevention. There was substantial variation among published models of root caries risk in terms of variable selection, sample size, cohort location, assessment methods, incidence periods, association directionality, and analytical techniques. Future studies should emphasize variables frequently tested and often significant, and validate existing models in independent databases.
Tattoo inks contain polycyclic aromatic hydrocarbons that additionally generate deleterious singlet oxygen
Authors: Regensburger Johannes , Lehner Karin , Maisch Tim , Vasold Rudolf , Santarelli Francesco , Engel Eva , Gollmer Anita , König Burkhard , Landthaler Michael , Bäumler Wolfgang
Published: June 2010

Please cite this paper as: Tattoo inks contain polycyclic aromatic hydrocarbons that additionally generate deleterious singlet oxygen. Experimental Dermatology 2010; 19: e275–e281.

Abstract:  In the past years, tattoos have become very popular worldwide, and millions of people have tattoos with mainly black colours. Black tattoo inks are usually based on soot, are not regulated and may contain hazardous polycyclic aromatic hydrocarbons (PAHs). Part of PAHs possibly stay lifelong in skin, absorb UV radiation and generate singlet oxygen, which may affect skin integrity. Therefore, we analysed 19 commercially available tattoo inks using HPLC and mass spectrometry. The total concentrations of PAHs in the different inks ranged from 0.14 to 201 μg/g tattoo ink. Benz(a)pyrene was found in four ink samples at a mean concentration of 0.3 ± 0.2 μg/g. We also found high concentrations of phenol ranging from 0.2 to 385 μg/g tattoo ink. PAHs partly show high quantum yields of singlet oxygen (ΦΔ) in the range from 0.18 to 0.85. We incubated keratinocytes with extracts of different inks. Subsequent UVA irradiation decreased the mitochondrial activity of cells when the extracts contained PAHs, which sufficiently absorb UVA and show simultaneously high ΦΔ value. Tattooing with black inks entails an injection of substantial amounts of phenol and PAHs into skin. Most of these PAHs are carcinogenic and may additionally generate deleterious singlet oxygen inside the dermis when skin is exposed to UVA (e.g. solar radiation).