bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatal Fentanyl: One Pill Can Kill
Authors: Sutter Mark E. , Gerona Roy R. , Davis M. Thais , Roche Bailey M. , Colby Daniel K. , Chenoweth James A. , Adams Axel J. , Owen Kelly P. , Ford Jonathan B. , Black Hugh B. , Albertson Timothy E. 
Published: June 2016

AbstractObjectiveThe current national opioid epidemic is a public health emergency. We have identified an outbreak of exaggerated opioid toxicity caused by fentanyl adulterated tablets purchased on the street as hydrocodone/acetaminophen.MethodsOver an 8‐day period in late March 2016, a total of 18 patients presented to our institution with exaggerated opioid toxicity. The patients provided a similar history: ingesting their “normal dose” of hydrocodone/acetaminophen tablets but with more pronounced symptoms. Toxicology testing and analysis was performed on serum, urine, and surrendered pills.ResultsOne of the 18 patients died in hospital. Five patients underwent cardiopulmonary resuscitation, one required extracorporeal life support, three required intubation, and two received bag‐valve‐mask ventilation. One patient had recurrence of toxicity after 8 hours after naloxone discontinuation. Seventeen of 18 patients required boluses of naloxone, and four required prolonged naloxone infusions (26–39 hours). All 18 patients tested positive for fentanyl in the serum. Quantitative assays conducted in 13 of the sera revealed fentanyl concentrations of 7.9 to 162 ng/mL (mean = 52.9 ng/mL). Pill analysis revealed fentanyl amounts of 600–6,900 μg/pill. The pills are virtually indistinguishable from authentic hydrocodone/acetaminophen tablets and are similar in weight. To date, our county has reported 56 cases of fentanyl opioid toxicity, with 15 fatalities. In our institution, the outbreak has stressed the capabilities and resources of the emergency department and intensive care units.ConclusionsA serious outbreak of exaggerated opioid toxicity caused by fentanyl‐adulterated tablets purchased on the street as hydrocodone/acetaminophen is under way in California. These patients required higher dosing and prolonged infusions of naloxone. Additionally, observation periods off naloxone were extended due to delayed, recurrent toxicity. The outbreak has serious ramifications for public health and safety, law enforcement, and healthcare facilities and resources.
Functional limitation and cognitive impairment among 80+ year old Chinese
Authors: Zheng Jiakun , Liu Junyi , An Ruopeng 
Published: June 2016

AimThis study examined functional limitation in relation to cognitive impairment among 80+ year old Chinese.MethodsCognitively‐intact adults ≥80 years old (n = 5161) came from the 1998 Chinese Longitudinal Healthy Longevity Survey. Cognitive impairment was assessed by Mini‐Mental State Examination. Functional limitation was assessed by Katz activities of daily living (ADLs). Cox regressions were performed to examine the relationship between functional limitation in 1998 and cognitive impairment onset during the follow‐up period of 1998–2012.ResultsCompared to those without ADLs limitation at baseline, participants with ADLs limitations were 49% more likely to develop cognitive impairment during follow‐up. A dose‐response relationship was identified – compared to those without ADLs limitation at baseline, those with one, two to five and all six ADLs limitations were 46, 50 and 180% more likely to develop cognitive impairment during follow‐up, respectively.ConclusionBaseline functional limitation strongly predicted cognitive impairment incidence in 80+ year old Chinese.
Modified internal limiting membrane peeling technique (maculorrhexis) for myopic foveoschisis surgery
Authors: Lee Chia‐Ling , Wu Wen‐Chuan , Chen Kuo‐Jen , Chiu Li‐Yi , Wu Kwou‐Yeung , Chang Yo‐Chen 
Published: June 2016

AbstractPurposeMyopic foveoschisis occurs in 9–34% of highly myopic eyes with posterior staphyloma. The pathogenesis is still not fully understood. But the relative inflexibility of the inner retina and a tangential traction induced inward traction force in the posterior staphyloma are possible mechanisms. Conventional internal limiting membrane (ILM) peeling generally yields good results. However, a postoperative full‐thickness macular hole happens in 13–28% of cases. Therefore, this study describes a modified ILM peeling technique named ‘ILM maculorrhexis’ to minimize the occurrence of postoperative macular hole in patients with foveoschisis.MethodsThis retrospective case review that included 10 eyes of 10 consecutive patients who underwent vitrectomy with ILM maculorrhexis to treat myopic foveoschisis was studied. After surgery, complete ophthalmic examination and SD‐optic coherence tomographic examinations were performed 1, 3, 6, 9 and 12 months postoperatively.ResultsAfter surgical intervention, the foveoschisis resolved dramatically in all 10 eyes. The mean central foveal thickness decreased significantly from 840 μ to 273 μ at 12 months postoperatively. Mean LogMAR best‐corrected visual acuity improved from 1.04 preoperatively to 0.59 12 months postoperatively. After the follow‐up time of at least 12 months, all 10 eyes remained fovea attached, and none of the 10 eyes developed macular hole.ConclusionsThis technique minimizes traction force over the extremely thinned foveal tissue in highly myopic eyes. In the long‐term follow‐up of at least 12 months, all 10 cases had good anatomic and visual results. But we still need a larger case number and longer follow‐up for further evaluation.
Self‐refraction, ready‐made glasses and quality of life among rural myopic Chinese children: a non‐inferiority randomized trial
Authors: Zhou Zhongqiang , Chen Tingting , Jin Ling , Zheng Dongxing , Chen Shangji , He Mingguang , Silver Josh , Ellwein Leon , Moore Bruce , Congdon Nathan G. 
Published: June 2016

AbstractPurposeTo study, for the first time, the effect of wearing ready‐made glasses and glasses with power determined by self‐refraction on children's quality of life.MethodsThis is a randomized, double‐masked non‐inferiority trial. Children in grades 7 and 8 (age 12–15 years) in nine Chinese secondary schools, with presenting visual acuity (VA) ≤6/12 improved with refraction to ≥6/7.5 bilaterally, refractive error ≤−1.0 D and <2.0 D of anisometropia and astigmatism bilaterally, were randomized to receive ready‐made spectacles (RM) or identical‐appearing spectacles with power determined by: subjective cycloplegic retinoscopy by a university optometrist (U), a rural refractionist (R) or non‐cycloplegic self‐refraction (SR). Main study outcome was global score on the National Eye Institute Refractive Error Quality of Life‐42 (NEI‐RQL‐42) after 2 months of wearing study glasses, comparing other groups with the U group, adjusting for baseline score.ResultsOnly one child (0.18%) was excluded for anisometropia or astigmatism. A total of 426 eligible subjects (mean age 14.2 years, 84.5% without glasses at baseline) were allocated to U [103 (24.2%)], RM [113 (26.5%)], R [108 (25.4%)] and SR [102 (23.9%)] groups, respectively. Baseline and endline score data were available for 398 (93.4%) of subjects. In multiple regression models adjusting for baseline score, older age (p = 0.003) and baseline spectacle wear (p = 0.016), but not study group assignment, were significantly associated with lower final score.ConclusionQuality of life wearing ready‐mades or glasses based on self‐refraction did not differ from that with cycloplegic refraction by an experienced optometrist in this non‐inferiority trial
Gender, Sibling Order, and Differences in the Quantity and Quality of Education: Evidence from Japanese Twins*
Authors: Vu Tien Manh , Matsushige Hisakazu 
Published: June 2016

AbstractUsing information on 1045 pairs of Japanese monozygotic twins, we examined differences in education by considering both the years of schooling (quantity) and the reputation of the last attended school (quality). We found that a difference in learning performance at 15 years of age is one of the key factors determining the differences. We also found that a female eldest child in the family from the 1950s and 1960s birth cohorts averaged 0.54 years less schooling than did her ‘younger’ twin. However, for the same birth cohorts, a male eldest child in the family generally had access to higher‐quality education than his ‘younger’ twin. Nonetheless, as the Japanese economy matured in the 1970s and thereafter, educational differences between twins disappeared, regardless of gender and sibling order.
Petersen Estimator, Chapman Adjustment, List Effects, and Heterogeneity
Authors: Mao Chang Xuan , Huang Ruochen , Zhang Sijia 
Published: June 2016

SUMMARYWe use a nonparametric mixture model for the purpose of estimating the size of a population from multiple lists in which both the individual effects and list effects are allowed to vary. We propose a lower bound of the population size that admits an analytic expression. The lower bound can be estimated without the necessity of model-fitting. The asymptotical normality of the estimator is established. Both the estimator itself and that for the estimable bound of its variance are adjusted. These adjusted versions are shown to be unbiased in the limit. Simulation experiments are performed to assess the proposed approach and real applications are studied.
Exploring Women's Preferences for the Mode of Delivery in Twin Gestations: Results of the Twin Birth Study
Authors: Murray‐Davis Beth , McVittie Jennifer , Barrett Jon F. , Hutton Eileen K. ,   the Twin Birth Study Collaborative Group
Published: June 2016

AbstractObjectiveThe Twin Birth Study, an international, multi‐center randomized controlled trial was conducted to compare the risks of planned cesarean with planned vaginal delivery for twin pregnancies. The aim of this component of the trial was to understand participants' perspectives of study participation and preferences for the mode of delivery.MethodsA mixed‐methods questionnaire was distributed to study participants 3 months after giving birth. The questionnaire contained Likert scales and open‐ended questions about the experience of being enrolled in a clinical trial and of childbirth, including the mode of delivery. Quantitative data were analyzed using SAS to generate descriptive statistics. Qualitative data were analyzed to identify categories and themes.ResultsNinety‐one percent of trial participants completed the questionnaire. Across all groups, the majority of women would participate in a study like this one again if given the opportunity. Main benefits of participating were as follows: benefits to one and one's babies, altruism, and receiving quality care. Randomization for the mode of delivery was challenging for women because of the desire to be involved in decision‐making. Findings related to childbirth experience and the mode of delivery demonstrated a preference for vaginal birth across all groups. Those who had a vaginal birth were more satisfied with their birth experience.ConclusionsThis study provides evidence to inform practitioners about what women who have twin pregnancies like or dislike about birth and their desire for involvement in decision‐making. Vaginal birth was preferred across all study groups and was associated with greater satisfaction with childbirth experience.
What is the outcome of paediatric gastrocystoplasty when the patients reach adulthood?
Authors: Boissier Romain , Di Crocco Eugenie , Faure Alice , Hery Geraldine , Delaporte Véronique , Lechevallier Eric , Mouriquand Pierre D. E. , Guys Jean‐Michel , Karsenty Gilles 
Published: June 2016

ObjectiveTo document the long‐term outcomes of paediatric augmentation gastrocystoplasty (AGC) in terms of preservation of renal function and maintenance of dryness, and to analyse the rate of complications.Patients and methodsThe medical records of children who had undergone AGC between 1992 and 2000 (minimum time interval of 15 years) were reviewed retrospectively. The following data were collected: age at surgery, the cause of bladder dysfunction, functioning of the AGC, any complications, and the long‐term outcome of the patients. All of the patients were re‐contacted by telephone.ResultsA total of 11 AGCs were carried out between 1992 and 2000, at a median (range) age of 11 (6.5–14) years. The diagnosis of patients undergoing AGC included myelomeningocele (four), bladder exstrophy (four), posterior urethral valves (one), irradiated bladder (one), and Prune Belly syndrome (one). The median [interquartile range (IQR)] follow‐up was 17 (15–19.5) years. Renal function was preserved or improved in seven of the 11 patients and nine patients were dry after AGC. Seven of the 11 patients reported symptoms linked to haematuria‐dysuria syndrome, which was resistant to treatment in one case and requiring excision of the gastric patch. Three of the 11 patients developed a tumour on the gastric graft after a median (range) delay of 20 (11–22) years after the initial procedure. All had gastric adenocarcinoma of which two were metastatic at the time of diagnosis requiring pelvectomy with pelvic lymph node dissection and adjuvant chemotherapy. Seven of the 11 patients underwent excision of the gastric patch after a median (IQR) time of 11 (8.5–20.5) years.ConclusionsOur long‐term data confirmed that most patients undergoing AGC had preservation of their renal function and were continent. However, long‐term, AGC was associated with a significant risk of malignant transformation and a high rate of surgical re‐intervention involving removal of the gastric patch. These results question the use of this technique for bladder augmentation, irrespective of the indication. We highlight the importance of strict endoscopic follow‐up of all patients already having undergone an AGC and the need to inform and educated patients about tumour‐related symptoms.
Spatial data issues in geographical zoonoses research
Authors: Robertson Colin , Yee Lauren , Metelka Julia , Stephen Craig 
Published: June 2016

Key Messages

Spatial data are of increasing use in the investigation of emerging zoonoses.
Due to the heterogeneity of required data sources, issues of scale misalignment, data linkage, and access to data are found to be important factors.
Geographers can make significant contributions to zoonoses research through their expertise in evaluating, integrating, and modelling spatial data.
Pursuing performance and maintaining compliance: Balancing performance improvement and accountability in Ontario's public health system
Authors: Price Alex , Schwartz Robert , Cohen Joanna , Scott Fran , Manson Heather 
Published: June 2016

AbstractThis article examines the compatibility between performance improvement and compliance‐based accountability in the implementation of a new system of public health performance management in Ontario. Findings from this mixed‐method study show that only minor elements of performance improvement get incorporated into pre‐existing compliance‐based accountability structures, that reinforcement of accountability structures works to the detriment of performance improvement intentions, and that limiting managerial influence in developing performance measures and targets diminish the utility of information for improvement. The study concludes that achieving a better balance requires an alternative to top‐down decision making that goes beyond consultation to include partnership.
Pre‐existing condition: Taking media coverage into account when preparing for H1N1
Authors: Quigley Kevin , Macdonald Colin , Quigley John 
Published: June 2016

AbstractThis article examines the claim that the media exaggerated the threat of H1N1, prompting an immediate demand for limited vaccine. We compareThe Australian's and theDaily Telegraph's coverage of H1N1 with that ofThe Globe and Mail, which was comparatively critical of government performance. The events of October 2009 underscore the difficulty and importance of responding to media coverage of “uncertain risks” (Renn), risks for which there is a lack of scientific basis for decision making and potentially generate anxious public responses.
Effect of teriparatide treatment on endothelial function, glucose metabolism and inflammation markers in patients with postmenopausal osteoporosis
Authors: Celer Ozgen , Akalın Aysen , Oztunali Cigdem 
Published: June 2016

SummaryObjectiveTeriparatide, an anabolic agent used in the treatment of postmenopausal osteoporosis, can induce effects similar to primary hyperparathyroidism. Our objective was to evaluate the effects of teriparatide on endothelial functions, glucose metabolism and inflammation markers in patients diagnosed with postmenopausal osteoporosis.Design, patients and measurementsThis was a single‐centre, single‐arm, 6‐month prospective study. Twenty‐three postmenopausal women over 65 years old with a lumbar spine or femoral neck T‐score of −4·0 or lower and having at least two compression fractures in thoracic or lumbar spine were studied. Low‐dose intermittent teriparatide (20 μg/day) was supplemented with calcium carbonate (1000 mg elemental calcium) and 880IUcholecalciferol for 6 months. The biochemical parameters for glucose metabolism, inflammation and atherosclerosis were determined. For the assessment of vascular endothelial function, carotid intima‐media thickness (CIMT), brachial artery intima‐media thickness (BIMT), per cent change in flow‐mediated dilation (FMD%) and nitroglycerine‐induced dilations (NID%) were measured on ultrasonography.ResultsThe fasting plasma glucose, homoeostatic model assessment of insulin resistance, fibrinogen, homocysteine and high‐density lipoprotein cholesterol increased significantly with teriparatide treatment (P < 0·05 for all). BaselineCIMTandBIMTdid not change significantly with 6 months of teriparatide treatment (P > 0·05); however,FMD% andNID% showed significant decrease after treatment (P < 0·01 for both).ConclusionsIntermittent teriparatide treatment may adversely affect some parameters of glucose metabolism, inflammation and endothelial function. On the basis of our findings, further large‐scale and controlled studies are needed to clarify the exact effect of teriparatide treatment on glucose metabolism, inflammation and endothelial function.
Tolerogenic Vaccination with MOG/VitD Overcomes Aggravating Effect of C. albicans in Experimental Encephalomyelitis
Authors: Fraga‐Silva Thais F.C. , Mimura Luiza A.N. , Zorzella‐Pezavento Sofia F.G. , Ishikawa Larissa L.W. , França Thais G.D. , Thomé Rodolfo , Verinaud Liana , Arruda Maria S.P. , Sartori Alexandrina 
Published: June 2016

SummaryAimsMultiple sclerosis (MS) is an immune‐mediated demyelinating disorder of the central nervous system (CNS). We described that Candida albicans (Ca) aggravates experimental autoimmune encephalomyelitis (EAE) that is a model to study MS. We also observed that vaccination with a myelin peptide (MOG) in the presence of vitamin D (VitD) protected mice against EAE. In this work, we investigated whether Ca infection interferes with the efficacy of this vaccine.MethodsEAE was induced in C57BL/6 female mice previously vaccinated with MOG+VitD and then infected 3 days before encephalomyelitis induction.ResultsVaccination was able to control EAE development in infected mice. These animals gained weight, and only a few progressed to very low clinical scores. Protection was confirmed by a lower inflammatory infiltration in the CNS and was also associated with a reduced production of encephalitogenic cytokines by spleen and CNS cell cultures. The elevated percentage of CD25+FoxP3+ cells suggests that regulatory T cells are involved in the protection. Adoptive transfer of splenocytes from mice vaccinated with MOG+VitD supports the view that protection is mediated by immunoregulatory cells.ConclusionTogether, these experiments provide evidence demonstrating that EAE can be prevented by the inverse vaccination with MOG+VitD even in the presence of a disease‐aggravating infectious agent.
Functional Genomic Analyses Identify Pathways Dysregulated in Animal Model of Autism
Authors: Huang Ji‐Yun , Tian Yun , Wang Hui‐Juan , Shen Hong , Wang Huan , Long Sen , Liao Mei‐Hua , Liu Zhi‐Rong , Wang Ze‐Ming , Li Dan , Tao Rong‐Rong , Cui Tian‐Tian , Moriguchi Shigeki , Fukunaga Kohji , Han Feng , Lu Ying‐Mei 
Published: June 2016

SummaryBackgroundAutism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental disorders that display complicated behavioral symptoms.MethodsUsing gene expressing profiling and the weighted gene co‐expression network analysis (WGCNA), we studied genes coregulated by similar factors such as genetic variants or environmental effects in the hippocampus in an animal model of autism.ResultsFrom microarray data, we identified 21,388 robustly expressed genes of which 721 genes were found to be differently expressed in the valproic acid‐treated group compared to the control group. WGCNA identified multiple co‐expression modules known to associate with cognitive function, inflammation, synaptic, and positive regulation of protein kinase activating. Many of these modules, however, have not been previously linked to autism spectrum disorders which included G‐protein signaling, immunity, and neuroactive ligand–receptor interaction pathway. The downregulation of the highly connected (hub) genes Taar7h and Taar7b in neuroactive ligand–receptor interaction pathway was validated by qRT‐PCR. Immunoblotting and immunohistochemistry further showed that TAAR7 expression was downregulated not only in valproic acid‐treated animals, but also BTBR T+tf/J mice.ConclusionsThis study highlights the advantages of gene microarrays to uncover co‐expression modules associated with autism and suggests that Taars and related gene regulation networks may play a significant role in autism.
Does neoadjuvant therapy increase the incidence of anastomotic leakage after anterior resection for mid and low rectal cancer? A systematic review and meta‐analysis
Authors: Hu M.‐H. , Huang R.‐K. , Zhao R.‐S. , Yang K.‐L. , Wang H. 
Published: June 2016

AbstractAimThe aim was to evaluate the association of neoadjuvant therapy with increases in the incidence of anastomotic leakage (AL) after middle and low rectal anterior resection.MethodThe electronic databases of PubMed, Web of Science, Scopus and Ovid were searched between 1980 and 2015. The random effects model was used to model the pooled data to determine the odds ratio with 95% confidence interval. Heterogeneity was evaluated using the Q test and I2 statistics. Subgroup, sensitivity and meta‐regression analysis was conducted to explore heterogeneity.ResultsNeoadjuvant therapy was not shown to increase the incidence of postoperative AL as demonstrated by an OR of 1.16 [95% CI 0.99–1.36; P = 0.07 (random effects model)]. The subgroup analysis of neoadjuvant radiotherapy using the random effects model suggested that it did not increase the rate of postoperative AL (OR = 1.24, 95% CI 0.97–1.58; P = 0.08). The subgroup analysis of neoadjuvant chemoradiotherapy indicated that the rate of postoperative AL again did not increase with an OR = 1.06 [95% CI 0.86–1.30; P = 0.59 (random effects model)]. The interval to surgery after neoadjuvant therapy and preoperative radiotherapy (short or long course) was not associated with an increased incidence of postoperative AL.ConclusionNeoadjuvant therapy does not appear to increase the incidence of postoperative AL after anterior resection for mid and low rectal cancer. In addition, neither the interval to surgery after neoadjuvant therapy nor the radiotherapy regimen increases the rate of postoperative AL.