bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology
Authors: John Ann , Okolie Chukwudi , Porter Alison , Moore Chris , Thomas Gareth , Whitfield Richard , Oretti Rossana , Snooks Helen 
Published: August 2016

BackgroundNon-accidental non-fatal poisoning (NANFP) is associated with high risk of repeat episodes and fatality. This cross-sectional study aims to describe the data sources and epidemiology of non-fatal poisonings (NFPs) presenting to the emergency ambulance service.MethodsWe assessed incidents of NFP across Wales from electronic ambulance call centre records and paper records completed by attending ambulance crews, December 2007 to February 2008. We descriptively analysed data completed by attending crews.Results92 331 calls were made to the ambulance call centre, of which 3923 (4.2%) were coded as ‘overdose’ or ‘poisoning’. During the same period, ambulance crews recorded 1827 attended NANFP incidents in those categories, of which 1287 (70.4%) had been identified in the call centre. 76.1% (1356/1782) were aged 15–44 years and 54.2% (991/1827) were female. 75.0% (1302/1753) of incidents occurred in areas from the lower 2 quintiles of deprivation in Wales. Substance taken was reported in 90% of cases (n=1639). Multiple ingestion was common (n=886, 54.1%). Psychotropic was the most frequently taken group of substances (n=585, 32.0%) and paracetamol (n=484, 26.5%) was the most frequently taken substance prehospital. Almost half of patients had taken alcohol alongside other substances (n=844, 46.2%). Naloxone was the most frequently administered treatment (n=137, 7.5%). Only 142/1827 (7.8%) patients were not transported to hospital, of whom 4 were recorded to have been given naloxone.ConclusionsWe report new data on the epidemiology of NFP across substance types at national level, highlighting deficiencies in information systems and high levels of multiple ingestion. In order to develop policy and practice for this patient group prehospital and further along the care pathway, information systems need to be developed to allow accurate routine monitoring of volume, presentation and outcomes.
A UK survey of driving behaviour, fatigue, risk taking and road traffic accidents
Authors: Smith Andrew P 
Published: August 2016

ObjectiveThe aim of the present research was to examine associations between poor driving behaviour (DB), driving when fatigued (DF), risk taking (RT) and road traffic accidents (RTAs).DesignThe study involved a cross-sectional online survey of clients of an insurance company. The survey measured DB (speeding, distraction, lapses of attention and aggression), RT and frequency of driving when fatigued (DF, driving late at night, prolonged driving, driving after a demanding working day and driving with a cold). Demographic, lifestyle, job characteristics and psychosocial factors were also measured and used as covariates.SettingCardiff, UK.Sample3000 clients of an insurance company agreed to participate in the study, and 2856 completed the survey (68% woman, 32% man; mean age: 34 years, range 18–74 years).Main outcome measuresThe outcomes were RTAs (requiring medical attention; not requiring medical attention), where the person was the driver.ResultsFactor analyses showed that DB, RT and fatigue loaded on independent factors. Logistic regressions showed that poor DB, frequently DF and taking risks predicted medical and non-medical RTAs. These effects were additive and those who reported poor DB, driving when fatigue and taking risks were twice as likely to have an RTA. These effects remained significant when demographic, lifestyle, medical, driving, work and psychosocial factors were covaried.ConclusionsPoor DB, DF and RT predict RTAs. There are now short measuring instruments that can assess these, and driver education programmes must increase awareness of these risk factors.
Inherent variability in airway characteristics of simulation manikins: is it time we standardised assessments of crisis management skills?
Authors: Ashokka Balakrishnan , Narendiran Krishnasamy , Bhattacharya Abhijit , Pai Dinker , Liang Shen , Subramanian Shoba , Larmie Ernest T , Chen Fun Gee 
Published: August 2016

IntroductionLearning of simulation-based crisis management skills involves technologically advanced manikins and use of automated scenarios. Progressions in preprogrammed scenarios require finite task completion such as successful airway intubations for achieving optimal learning outcomes aligned to curricular goals. The study was set to explore the existing variability among various simulation manikins in use at our institute for undergraduate medical education.Methods56 final-year undergraduate students, who had received prior training in airway management skills, performed intubations on each of the 5 different manikins (56×5=280 intubations). The manikins used were the Human Patient Simulator (HPS), iStan & Emergency Care Simulator (ECS) from CAE Healthcare and Mega Code Kelly (MCK) and Airway Trainer (AWTR) from Laerdal. The students’ performances were compared for success rates, ease of intubation, grade of laryngeal visualisation and presence of tooth injury on the manikins, Data from the intubations were cross-tabulated and evaluated by general estimating equation analysis using the Poisson model.ResultsiStan had the higher rates of failure to intubate (64.3%). iStan (62.5%) and HPS (57.1%) had statistically significant teeth injury (p<0.0001) compared to other manikins. HPS and AWTR had the least difficult grades of laryngeal visualisation (Cormack Lehane grades 1 and 2), while the most difficult grade of visualisation (Cormack Lehane grades 3 and 4) was reported in ECS (44.6%).ConclusionsEach of the high-technology manikins used in automated scenarios for crisis management teaching and learning has heterogeneity in airway features. Since frequent airway management is a critical component of simulation scenarios, this can affect student performance when these manikins are used for formative and summative high-stakes assessments.
Use of a Novel Nonparametric Version of DEPTH to Identify Genomic Regions Associated with Prostate Cancer Risk
Authors: MacInnis Robert J. , Schmidt Daniel F. , Makalic Enes , Severi Gianluca , FitzGerald Liesel M. , Reumann Matthias , Kapuscinski Miroslaw K. , Kowalczyk Adam , Zhou Zeyu , Goudey Benjamin , Qian Guoqi , Bui Quang M. , Park Daniel J. , Freeman Adam , Southey Melissa C. , Al Olama Ali Amin , Kote-Jarai Zsofia , Eeles Rosalind A. , Hopper John L. , Giles Graham G. 
Published: August 2016

Abstract
Background: We have developed a genome-wide association study analysis method called DEPTH (DEPendency of association on the number of Top Hits) to identify genomic regions potentially associated with disease by considering overlapping groups of contiguous markers (e.g., SNPs) across the genome. DEPTH is a machine learning algorithm for feature ranking of ultra-high dimensional datasets, built from well-established statistical tools such as bootstrapping, penalized regression, and decision trees. Unlike marginal regression, which considers each SNP individually, the key idea behind DEPTH is to rank groups of SNPs in terms of their joint strength of association with the outcome. Our aim was to compare the performance of DEPTH with that of standard logistic regression analysis.
Methods: We selected 1,854 prostate cancer cases and 1,894 controls from the UK for whom 541,129 SNPs were measured using the Illumina Infinium HumanHap550 array. Confirmation was sought using 4,152 cases and 2,874 controls, ascertained from the UK and Australia, for whom 211,155 SNPs were measured using the iCOGS Illumina Infinium array.
Results: From the DEPTH analysis, we identified 14 regions associated with prostate cancer risk that had been reported previously, five of which would not have been identified by conventional logistic regression. We also identified 112 novel putative susceptibility regions.
Conclusions: DEPTH can reveal new risk-associated regions that would not have been identified using a conventional logistic regression analysis of individual SNPs.
Impact: This study demonstrates that the DEPTH algorithm could identify additional genetic susceptibility regions that merit further investigation. Cancer Epidemiol Biomarkers Prev; 25(12); 1619–24. ©2016 AACR.
Tumor Mutational Load and Immune Parameters across Metastatic Renal Cell Carcinoma Risk Groups
Authors: de Velasco Guillermo , Miao Diana , Voss Martin H. , Hakimi A. Ari , Hsieh James J. , Tannir Nizar M. , Tamboli Pheroze , Appleman Leonard J. , Rathmell W. Kimryn , Van Allen Eliezer M. , Choueiri Toni K. 
Published: August 2016

Abstract
Patients with metastatic renal cell carcinoma (mRCC) have better overall survival when treated with nivolumab, a cancer immunotherapy that targets the immune checkpoint inhibitor programmed cell death 1 (PD-1), rather than everolimus (a chemical inhibitor of mTOR and immunosuppressant). Poor-risk mRCC patients treated with nivolumab seemed to experience the greatest overall survival benefit, compared with patients with favorable or intermediate risk, in an analysis of the CheckMate-025 trial subgroup of the Memorial Sloan Kettering Cancer Center (MSKCC) prognostic risk groups. Here, we explore whether tumor mutational load and RNA expression of specific immune parameters could be segregated by prognostic MSKCC risk strata and explain the survival seen in the poor-risk group. We queried whole-exome transcriptome data in renal cell carcinoma patients (n = 54) included in The Cancer Genome Atlas who ultimately developed metastatic disease or were diagnosed with metastatic disease at presentation and did not receive immune checkpoint inhibitors. Nonsynonymous mutational load did not differ significantly by the MSKCC risk group, nor was the expression of cytolytic genes—granzyme A and perforin—or selected immune checkpoint molecules different across MSKCC risk groups. In conclusion, this analysis revealed that mutational load and expression of markers of an active tumor microenvironment did not correlate with MSKCC risk prognostic classification in mRCC. Cancer Immunol Res; 4(10); 820–2. ©2016 AACR.
Validation of a rapid, automated method for the measurement of ethylene glycol in human plasma
Authors: Robson Anna F , Lawson Alexander J , Lewis Laura , Jones Alan , George Stephen 
Published: August 2016

BackgroundEthylene glycol is a highly toxic compound found in various household products. Cases of poisoning are rare but may be fatal unless diagnosed and treated promptly. Early recognition of poisoning is critical for the management and recovery of patients. Indirect testing is not specific for the presence of ethylene glycol. Therefore, urgent and accurate measurement should be sought if ingestion is suspected in order to determine the need for treatment with an antidote. Here, we present the validation of an automated assay for measurement of ethylene glycol on an Abbott Architect using a commercially available kit (Catachem).MethodsAnalytical parameters of imprecision, linearity, stability and bias were determined using spiked human plasma samples processed on both the Catachem assay and on an in-house gas chromatography-mass spectrometry method. Interference was assessed using samples collected into a variety of sample collection tubes and spiked with a number of alcohols.ResultsExcellent agreement was observed between the two methodologies with the enzymatic assay demonstrating linearity and precision across the relevant clinical range (50–3000 mg/L). In addition, the Catachem assay displayed no interference from a number of different sample tubes and alcohols. However, propylene glycol interference was observed at concentrations associated with excessive use (>1 g/L) and 2,3-butanediol interference observed at concentrations associated with butanone ingestion. Inspection of the enzymatic reaction profile was found to differentiate between alcohols.ConclusionsThis automated assay is suitable for the diagnosis of ethylene glycol poisoning and is now in routine use, enabling the laboratory to provide a rapid 24 h service with support by gas chromatography-mass spectrometry as necessary.
Mycophenolic acid exposure and complement fraction C3 influence inosine 5′-monophosphate dehydrogenase activity in systemic lupus erythematosus
Authors: Mino Yasuaki , Naito Takafumi , Shimoyama Kumiko , Ogawa Noriyoshi , Kawakami Junichi 
Published: August 2016

BackgroundMycophenolate mofetil has recently been reported to be effective against systemic lupus erythematosus. The influence of the pharmacokinetics of mycophenolic acid, the active form of mycophenolate mofetil and the major inactive mycophenolic acid phenolic glucuronide on the activity of the target enzyme inosine 5′-monophosphate dehydrogenase, is expected to be revealed. The aim of this study was to identify the factors associated with inosine 5′-monophosphate dehydrogenase activity in systemic lupus erythematosus patients.MethodsFifty systemic lupus erythematosus patients in remission maintenance phase (29 received mycophenolate mofetil [MMF+] and 21 did not [MMF−]) were enrolled. Median and interquartile range of dose of mycophenolate mofetil were 1500 and 1000–1500 mg/day, respectively. Stepwise multiple linear regression analysis was performed to assess the dependence between inosine 5′-monophosphate dehydrogenase activity and 25 predictor values including predose plasma concentrations of free mycophenolic acid and mycophenolic acid phenolic glucuronide.ResultsMedian and interquartile range of predose total plasma concentrations of mycophenolic acid and mycophenolic acid phenolic glucuronide were 2.73 and 1.43–5.73 and 25.5 and 13.1–54.7  µg/mL, respectively. Predose inosine 5′-monophosphate dehydrogenase activity was significantly higher in MMF+ than MMF− patients (median 38.3 and 20.6 nmoL xanthosine 5′-monophosphate/g haemoglobin/h, P<0.01). The plasma concentration of free mycophenolic acid phenolic glucuronide, complement fraction C3 and body weight were significant predictors accounting for interindividual variability in the inosine 5′-monophosphate dehydrogenase activity (adjusted R2 = 0.52, P < 0.01) in a multivariate analysis.ConclusionsPredose inosine 5′-monophosphate dehydrogenase activity was higher in systemic lupus erythematosus patients receiving mycophenolate mofetil therapy. Inosine 5′-monophosphate dehydrogenase activity may be determined by mycophenolic acid exposure and complement fraction C3 in systemic lupus erythematosus patients.
Parenting as a Protective Factor against Criminogenic Settings? Interaction Effects between Three Aspects of Parenting and Unstructured Socializing in Disordered Areas
Authors: Janssen Heleen J. , Weerman Frank M. , Eichelsheim Veroni I. 
Published: August 2016

Objectives: We examined the extent to which different aspects of parenting are able to moderate the association between spending time unstructured socializing (US) in urban areas with high disorder and adolescent delinquency. Methods: We used detailed data on time use, disorder in neighborhoods, parenting, and delinquency among 603 adolescents (aged 11–17 at T1) from the study of peers, activities, and neighborhoods, a two-wave longitudinal study with an interval of two years between measurements. Longitudinal multilevel analyses were used to examine interactions effects between parenting aspects and mean differences as well as individual changes in time spent unstructured socializing in areas with high disorder. Results: We did not find between-person level interaction effects between parenting and time spent in criminogenic settings. Our cross-level analyses, however, indicated that levels of parental monitoring as well as the quality of the parent–adolescent relationship mitigated the effects of changes in time spent in criminogenic settings. Conclusions: Whether increases in time spent in criminogenic settings are related to increases in delinquency seems to be conditional on the level of parental monitoring and the quality of the parent–adolescent relationship. If these aspects of parenting are sufficient, changes in time spent in criminogenic settings are not necessarily detrimental.
Influence of Surgeon Volume on Inpatient Complications, Cost, and Length of Stay Following Total Ankle Arthroplasty
Authors: Basques Bryce A. , Bitterman Adam , Campbell Kevin J. , Haughom Bryan D. , Lin Johnny , Lee Simon 
Published: August 2016

Background: Increased surgeon volume may be associated with improved outcomes following operative procedures. However, there is a lack of information on the effect of surgeon volume on inpatient adverse events and resource utilization following total ankle arthroplasty (TAA). Methods: A retrospective cohort study of TAA patients was performed using the Nationwide Inpatient Sample (NIS) from 2003 to 2009. High-volume surgeons were considered as those with volume ≥90th percentile of surgeons performing TAA. Multivariate regression was used to compare the rates of adverse events, hospital length of stay, and total hospital charges between surgeon volume categories. Results: A total of 4800 TAA patients were identified. The 90th percentile for surgeon volume was 21 cases per year. Mean length of stay was 2.8 ± 2.3 days and mean hospital charges were $45 963 ± $43 983. On multivariate analysis, high-volume surgeons had decreased overall complications (OR 0.5, P = .034) and rate of medial malleolus fracture (OR 0.1, P = .043), decreased length of stay (–0.9 days, P < .001), and decreased hospital charges (–$20 904, P < .001). Conclusions: Surgeons with volume ≥90th percentile had a decreased rate of complications, decreased length of stay, and reduced hospital charges compared to other surgeons. Level of Evidence: Level III, comparative study.
Maropitant administered orally 2–2.5 h prior to morphine and dexmedetomidine reduces the incidence of emesis in cats
Authors: Martin-Flores Manuel , Mastrocco Alicia , Lorenzutti Augusto M , Campoy Luis , Kirch Pati , Stone Marisa , Learn McKenzie M , Boesch Jordyn M 
Published: August 2016

Objectives The main goal of this study was to test the antiemetic effects of maropitant administered orally 2–2.5 h prior to morphine and dexmedetomidine in cats. Methods Eighty-three healthy female cats were randomized to receive maropitant (8 mg orally; n = 39) or no treatment (control; n = 44), 2–2.5 h prior to morphine 0.1 mg/kg and dexmedetomidine 20 µg/kg intramuscularly. The incidence of sialorrhea, lip licking, retching and vomiting were recorded after morphine/dexmedetomidine injection. Results There were no differences between groups in terms of age or weight. The treated group received a mean ± SD dose of maropitant of 2.9 ± 0.6 mg/kg. The incidence of sialorrhea and lip licking was no different between groups. The incidence of retching (control 36% vs maropitant 13%; P = 0.012) and emesis (control 32% vs maropitant 13%; P = 0.03) was significantly reduced in cats treated with maropitant. Conclusions and relevance Maropitant 8 mg (total dose) administered orally 2–2.5 h prior to morphine and dexmedetomidine significantly reduced, but did not eliminate, the incidences of retching and vomiting. Maropitant did not decrease the occurrence of sialorrhea and lip licking, signs that may be indicative of nausea. Maropitant might be useful for morning administration to prevent emesis in outpatient cats requiring sedation or anesthesia; however, dose regimens or interval of administration might require improvement.
Cutting Corners
Authors: Mayo Rachel , Parker Veronica G. , Sherrill Windsor W. , Coltman Kinneil , Hudson Matthew F. , Nichols Christina M. , Yates Adam M. , Pribonic Anne Paige 
Published: August 2016

Introduction: This study assessed health providers’ perceptions of factors related to professional interpretation services and the association between these factors and the potential use of ad hoc interpreters. Method: Data were collected from a convenience sample of 150 health services providers at a large, regional health system in South Carolina. Results: Providers rated “ability to communicate effectively during a clinical encounter” as paramount regarding the use of interpretation services. The most important factors related to the likely use of ad hoc interpreters (cutting corners) included locating a qualified interpreter, having to wait for a qualified interpreter, and technical difficulties regarding phone and video technology. Conclusion: Health care organizations may benefit from increasing staff awareness about patient safety and legal and regulatory risks involved with the use of ad hoc interpreters.
Ethnoracial Variation in Depression Symptoms
Authors: Montalvo-Liendo Nora , Grogan-Kaylor Andrew , Graham-Bermann Sandra 
Published: August 2016

Introduction: While there is a long-standing tradition of research on the predictors of depression among women exposed to violence, little of this research has been conducted across ethnic and racial groups. Method: A cross-sectional study comparing a total of 191 women with a history of intimate partner violence were recruited from commercial, medical, and educational settings and by contact with agencies serving the needs of abused women, for example, shelters, community outreach. The study examined intimate partner violence and the adjustment of mothers of children ages 5 to 12 to explore both commonalities and differences in the ways in which four groups of women (African American, Biracial, Latina, and White women) cope with violence in their lives. In addition to demographic information, depression symptoms were assessed by self-report with the Center for Epidemiologic Studies Depression scale. Results: The findings indicate that Latina women had significantly higher depression symptoms than did African American and White women. Conclusion: While it is important to assess the mental health needs of all abused women, these results show additional need for Latina women, those with low income and high violence exposure.
Excessive Daytime Sleepiness as an Indicator of Depression in Hispanic Americans
Authors: Nuyen Brian A. , Fox Rina S. , Malcarne Vanessa L. , Wachsman Solenne I. , Sadler Georgia Robins 
Published: August 2016

Introduction: Excessive daytime sleepiness (EDS) has been shown to be associated with depression; however, this relationship has not been confirmed among Hispanic Americans. Method: This study examined the link between EDS and depression among Hispanic Americans ( N = 411) and explored the potential moderating roles of age, gender, income, education, health status, and acculturation. The Epworth Sleepiness Scale and Patient Health Questionnaire–9 measured EDS and depression, respectively. Results: Hierarchical linear regression demonstrated that EDS was significantly related to depression. Receiver operating characteristic curve analysis suggested that the Epworth Sleepiness Scale discriminated with adequate sensitivity and specificity between participants with moderately severe depression and those with less severe symptoms. No sociodemographic variables moderated the EDS–depression relationship. Conclusion: These findings suggest that depression should be considered when Hispanic Americans present with EDS.