bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tetanus: A Potential Public Health Threat in Times of Disaster
Authors: Finkelstein Paige , Teisch Laura , Allen Casey J. , Ruiz Gabriel 
Published: February 2017

AbstractBackground:Tetanus is a potentially fatal condition that is rare in urban environments but is seen in developing countries and post-natural-disaster. Therefore, the purpose of this report was to review the epidemiology, pathogenesis, and management of tetanus in the trauma patient.Methods:A thorough literature review was conducted to look for the most current and thorough guidelines on the prophylaxis and treatment of tetanus. PUBMED (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), MEDLINE (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), and Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom) databases were searched for articles in English, published from 2005 to 2015, using the keywords “Tetanus,” “Trauma/Surgery,” and “Disaster.” Controlled trials, randomized controlled trials, trials of adult patients, published guidelines, expert opinions, and review articles were selected and extracted.Results:Current vaccination schedules in developed countries provide prophylaxis for tetanus. However, when severe natural disasters occur, many patients may not be able to provide a reliable vaccination history. In these situations, tetanus immune globulin (TIG) is indicated; if resources are not limited, both tetanus toxoid and TIG should be given to those with high-risk wounds. If resources are limited, TIG should be reserved for those that would benefit most or those least likely to have the protective antibodies.Conclusions:Although tetanus is a disease that has a low incidence in the developed world due to high rates of immunization, during large-scale natural disasters, compounding factors like the types of injuries, lack of medical services and supplies, and the delay in treatment associated with an already low immunization rate result in an increased incidence and outbreaks of the disease that has higher mortality in an underdeveloped society. It is important for the urban physician that cares for trauma and critical patients to become familiar with the protocols for treatment and immunization of patients that have tetanus-prone wounds, as well as recognize the potential for outbreaks in the settings of major natural disasters.FinkelsteinP, TeischL, AllenCJ, RuizG. Tetanus: a potential public health threat in times of disaster. Prehosp Disaster Med. 2017;32(3):339–342.
High School Cardiac Emergency Response Plans and Sudden Cardiac Death in the Young
Authors: White Michelle J. , Loccoh Emefah C. , Goble Monica M. , Yu Sunkyung , Odetola Folafoluwa O. , Russell Mark W. 
Published: February 2017

AbstractIntroductionSudden cardiac death (SCD) is responsible for 5%-10% of all deaths among children 5-19 years-of-age. The incidence of SCD in youth in Michigan (USA) and nationwide is higher in racial/ethnic minorities and in certain geographic areas. School cardiac emergency response plans (CERPs) increase survival after cardiac arrest. However, school cardiac emergency preparedness remains variable. Studying population-level factors associated with school cardiac emergency preparedness and incidence of SCD in the young may improve understanding of disparities in the incidence of SCD.Hypothesis/ProblemThe objective of this pilot study was to determine the association of elements of high school cardiac emergency preparedness, including Automated External Defibrillator (AED) distribution and the presence of CERPs with county sociodemographic characteristics and county incidence of SCD in the young.MethodsSurveys were sent to representatives from all public high schools in 30 randomly selected Michigan counties. Counties with greater than 50% response rate were included (n=19). Association of county-level sociodemographic characteristics with incidence of SCD in the young and existence of CERPs were evaluated using Spearman correlation coefficient.ResultsFactors related to the presence of AEDs were similar across counties. Schools in counties of lower socioeconomic status (SES; lower-median income, lower per capita income, and higher population below poverty level) were less likely to have a CERP than those with higher SES (all P<.01). Lack of a CERP was associated with a higher incidence of SCD in youth (r=-0.71; P=.001). Overall incidence of SCD in youth was higher in lower SES counties (r=-0.62 in median income and r=0.51 in population below poverty level; both P<.05).ConclusionCounty SES is associated with the presence of CERPs in schools, suggesting a link between school cardiac emergency preparedness and county financial resources. Additionally, counties of lower SES demonstrated higher incidence of SCD in the young. Statewide and national studies are required to further explore the factors relating to geographic and socioeconomic differences in cardiac emergency preparedness and the incidence of SCD in the young.WhiteMJ, LoccohEC, GobleMM, YuS, OdetolaFO, RussellMW. High school cardiac emergency response plans and sudden cardiac death in the young. Prehosp Disaster Med. 2017;32(3):269–272.
Music Genre as a Predictor of Resource Utilization at Outdoor Music Concerts
Authors: Westrol Michael S. , Koneru Susmith , McIntyre Norah , Caruso Andrew T. , Arshad Faizan H. , Merlin Mark A. 
Published: February 2017

AbstractObjectivesThe aim of this study was to examine the various modern music genres and their effect on the utilization of medical resources with analysis and adjustment for potential confounders.MethodsA retrospective review of patient logs from an open-air, contemporary amphitheater over a period of 10 years was performed. Variables recorded by the medical personnel for each concert included the attendance, description of the weather, and a patient log in which nature and outcome were recorded. The primary outcomes were associations of genres with the medical usage rate (MUR). Secondary outcomes investigated were the association of confounders and the influences on the level of care provided, the transport rate, and the nature of medical complaint.ResultsA total of 2,399,864 concert attendees, of which 4,546 patients presented to venue Emergency Medical Services (EMS) during 403 concerts with an average of 11.4 patients (annual range 7.1-17.4) each concert. Of potential confounders, only the heat index ≥90°F (32.2°C) and whether the event was a festival were significant (P=.027 and .001, respectively). After adjustment, the genres with significantly increased MUR in decreasing order were: alternative rock, hip-hop/rap, modern rock, heavy metal/hard rock, and country music (P<.05). Medical complaints were significantly increased with alternative rock or when the heat index was ≥90°F (32.2°C; P<.001). Traumatic injuries were most significantly increased with alternative rock (P<.001). Alcohol or drug intoxication was significantly more common in hip-hop/rap (P<.001). Transport rates were highest with alcohol/drug intoxicated patients (P<.001), lowest with traumatic injuries (P=.004), and negatively affected by heat index ≥90°F (32.2°C; P=.008), alternative rock (P=.017), and country music (P=.033).ConclusionAlternative rock, hip-hop/rap, modern rock, heavy metal/hard rock, and country music concerts had higher levels of medical resource utilization. High heat indices and music festivals also increase the MUR. This information can assist event planners with preparation and resource utilization. Future research should focus on prospective validation of the regression equation.Westrol MS, KoneruS, McIntyreN, Caruso AT, ArshadFH, MerlinMA. Music genre as a predictor of resource utilization at outdoor music concerts. Prehosp Disaster Med. 2017;32(3):289–296.
Early Psychosis: Where we've been, where we still have to go
Authors: Killackey Eóin , Yung Alison R. , McGorry Patrick D. 
Published: February 2017

AbstractEarly intervention in psychosis, while not a new concept, has seen great development over the last 15 years. Growth in this time has occurred in a number of areas and has attracted a broad coalition of researchers, consumers, clinicians, carers and policy makers. In this time the concept of early intervention has moved from the fringes to the mainstream of clinical approaches to psychosis in many places, and is doing so in even more. After a decade and a half, this paper reviews some of the key issues that have been addressed and points to areas where further growth and reform is still required. Some issues that have created controversy are examined here including pre-onset intervention and identification, the relationship of duration of untreated psychosis (DUP) to outcome and whether or not early intervention is an effective and economically viable model. Areas that are only now developing or which require further investigation are considered, including the concept of stages of mental illness and concomitant interventions, closing the efficacy-effectiveness gap and an increased focus on functioning as part of the recovery process. Early intervention in psychosis started as a reformist movement, agitating for change from outside the mainstream. Change has occurred and now early intervention is part of the mainstream approach to psychotic illness. In order to continue to develop, while enjoying the benefits of being a mainstream intervention, early intervention must not stray too far from its reformist roots.
Longitudinal research on bipolar disorders
Authors: Salvatore Paola , Tohen Mauricio , Kaur Khalsa Hari-Mandir , Baethge Christopher , Tondo Leonardo , Baldessarini Ross J. 
Published: February 2017

AbstractLongitudinal assessment of the course of major psychiatric disorders has been advanced by studies from onset, but only rarely have large numbers of patients with a range of psychotic and major affective disorders been studied simultaneously and systematically from illness-onset. The decade-long McLean-Harvard First Episode Project & International Consortium for Bipolar Disorder Research has systematically followed-up large numbers of patients with DSM-IV bipolar or psychotic disorders from first hospitalization. Major findings among patients with bipolar I disorder include: [a] full functional recovery from initial episodes was uncommon, and full symptomatic recovery, much slower than early syndromal recovery; [b] risks of relapse, recurrence, and switching were very high in the first two years; [c] most early morbidity was depressive-dysphoric, as reported in mid-course; [d] initial depression or mixed-states predicted more later depressive and overall morbidity, whereas initial mania or psychosis predicted later mania and a better prognosis; [e] based on within-subject modeling, most patients did not show progressive cycling over time, and illness-course was rather chaotic within and among patients; [f] treatment-latency or episode-counts were unassociated with responsiveness to long-term mood-stabilizing treatment; [g] very high rates of suicidal behavior and accidents occurred early; [h] early substance-use comorbidity associated with anxiety; [i] factor-analysis of prodromal symptoms predicted bipolar disorder much better than non-affective psychotic disorders. Project findings indicate that the course of bipolar I disorder is much less favorable than had been believed formerly, despite clinical treatment with modern mood-stabilizing and other treatments.
Some trends in 50 years of Italian Psychiatry (in Italian)
Authors: Jervis Giovanni 
Published: February 2017

SUMMARYSeveral discernible trends have changed the outlook of psychiatric resources available to the general public during the last 50 years in Western countries and particularly in Italy. Among these trends, two conflicting issues are here outlined. On the one side, evidence based medicine is the core of a methodological revolution, which asks for a deeper criticism of subjective judgements in clinical matters; on the other side, the study of emotions and attitudes has stressed the outstanding importance of conscious and unconscious expectations both in patients and in caregivers. Moreover, popular psychology has altered the way mental disorder is commonly perceived and treated. A comprehensive way of taking into account these three diverse trends seems to be still lacking.
Is Computerized Cognitive Testing Useful in Children and Adolescents with Moderate-to-Severe Traumatic Brain Injury?
Authors: Plourde Vickie , Brooks Brian L. 
Published: February 2017

AbstractObjectives:Children and adolescents with moderate-to-severe traumatic brain injury (TBI) present with short and long-term neuropsychological deficits following their injury. The aim of this study was to investigate the utility of a brief computerized test battery for evaluating cognitive functioning sub-acutely following a TBI.Methods:Participants (n=33) sustained a moderate-to-severe TBI, were between 8 and 18 years old, and were assessed using CNS Vital Signs (CNSVS) within 6 months post-injury (median=0.6 month). Participants with TBI were matched to 33 healthy controls based on age, sex, and handedness to compare their cognitive functioning on the CNSVS battery.Results:Children and adolescents with moderate-to-severe TBI had significantly lower scores and large effect sizes on Reaction Time, Complex Attention, and Cognitive Flexibility domains, as well as medium effect sizes on two Visual Memory test scores and one Psychomotor Speed test score. A significantly higher percentage of participants with TBI had cognitive impairment on Reaction Time domain score compared to the control group. Finally, CNSVS domain scores correctly categorized 76% of participants as either group with TBI or control group.Conclusions:CNSVS may be a useful tool for screening cognitive abilities in children and adolescents who are early in their recovery from a moderate-to-severe TBI, particularly when a rapid screening evaluation can help guide management, interventions, and track recovery. (JINS, 2017,23, 304–313)
Performance, nutrient digestibility and intestinal disaccharidase activity of weaner/grower pigs given diets containing extruded Chinese stored brown rice with exogenous enzyme supplements
Authors: Li Junbo , Li Defa , Yin Y. -L. , Piao X. S. , He J. H. , Chen G. P. , Shu J. C. 
Published: February 2017

AbstractOne performance and one ileal apparent digestibility (IAD) trial were conducted to investigate the performance, nutrient digestibility and intestinal disaccharidase activity of weaner/grower pigs given diets containing Chinese stored brown rice (CSBR) extruded and with exogenous enzyme supplements. In experiment 1, 96 crossbred (Duroc X Landrace X Large White) piglets weaned at 24 days of age were randomly divided into four groups according to a 2 X 2 factorial design. The animals were given four diets: (1) CSBR without enzyme supplementation, (2) CSBR supplemented with 625 mg a-amylase (2509 enzyme activity units) and 200 mg glucoamylase per kg (20018 enzyme activity units) per kg diet, (3) a normal temperature extruded CSBR (NTECSBR) without enzyme supplementation, and (4) NTECSBR supplemented with 625 mg a-amylase (2508 enzyme activity units) and 200 mg glucoamylase (20010 enzyme activity units) per kg diet. Growth, food consumption and specific activity of disaccharides in sections of the digestive tract were measured. In experiment 2, six male grower pigs with a mean initial body weight 21 kg, fitted with a simple ‘T’ cannula at the terminal ileum were used in a 6X6 Latin-square design. In addition to CSBR and NTECSBR diets with and without enzymes, a low temperature extruded diet LTECSBR with and without enzymes (as for other diets) was introduced. IAD of nutrients was measured. Extrusion resulted in a poorer (P < 0.05) food/gain for weaned pigs. Extrusion and enzyme supplementation had no influence (P > 0.05) on average daily food intake and average daily gain. Extrusion tended to improve (P = 0.075) IAD of starch but IAD of energy, dry matter, crude protein and amino acids were not influenced (P > 0.05). Enzyme supplementation had no effect on IAD of amino acids (P > 0.05), except for increasing IAD of lysine, threonine and isoleucine (P < 0.05). Extrusion and enzyme supplementation resulted in a higher (P < 0.05) maltase activity in the duodenum at day 14 of the trial. However, extrusion decreased (P < 0.05) the activity of maltase, isomaltase, sucrase and lactase in the jejunum at day 28. Enzyme supplementation increased (P < 0.05) the activities of maltase, isomaltase, trehalase and lactase in the jejunum at day 28. There was a positive extrusion X enzyme interaction (P < 0.05) for the activity of maltase and trehalase in the duodenum at day 14; a negative interaction was observed for the activity of lactase, maltase, isomaltase and trehalase in the jejunum at day 28. The results suggest that neither extrusion nor enzyme supplementation are necessary for CSBR to be used in pig diets.
Effects of high dietary concentration of lactose and increased soya-bean meal inclusion in starter diets for piglets
Authors: Pierce K. M. , Callan J. J. , McCarthy P. , Doherty J. V. O'. 
Published: February 2017

AbstractA 3 X 2 factorial experiment was conducted to investigate the interactions between lactofeed 70 (LF70) (860 g/kg whey permeate, 140 g/kg soya-bean meal; Volac International, UK) and soya-bean meal (SBM) or dried skim milk (DSM) in piglet diets. Three hundred and thirty-six piglets were selected after weaning at 21 days with an initial live weight of 6-35 kg. They were blocked on the basis of live weight and within each block assigned to one of six dietary treatments. The pigs were offered the following starter diets : (1) 300 g/kg LF70 with 215 g/kg SBM and 100 g/kg DSM; (2) 200 g/kg LF70 with 215 g/kg SBM and 100 g/kg DSM; (3) 100 g/kg LF70 with 215 g/kg SBM and 100 g/kg DSM; (4) 300 g/kg LF70 with 325 g/kg DSM; (5) 200 g/kg LF70 with 325 g/kg DSM; (6) 100 g/kg LF70 with 325 g/kg DSM. The starter diets were offered for 25 days. Following this, a weaner diet (14 g/kg lysine, 14-5 MJ/kg digestible energy) was given for a period of 12 days. There was a significant interaction between LF70 level and protein source on average daily gain (ADG P < 0.001) and food conversion ratio (FCR P < 0.05) during the starter period. There was a linear increase in ADG and a linear improvement in FCR with increasing LF70 levels in diets with SBM. However, there was a linear decrease in ADG with increasing LF70 levels in diets with DSM. There was a significant interaction (P < 0.001) between LF70 level and protein source on average daily food intake (ADFI) during the starter period. At high LF70 levels, the inclusion of DSM reduced ADFl compared with SBM. However, there was no difference between DSM and SBM at the medium and low LF70 levels. There was a significant interaction between LF70 level and protein source in organic matter digestibility (OMD) (P < 0.01) and gross energy digestibility (GED) (P < 0.01). The pigs offered diets containing DSM had a significantly lower OMD and GED at low LF70 levels compared with pigs offered diets containing SBM. However, the inclusion of DSM had no significant effect on OMD or GED at the medium and high LF70 levels. There was a quadratic response in nitrogen digestibility (ND) with increasing concentrations of LF70 (P < 0.05). There was an increase in ND to 200 g/kg LF70 inclusion, however there was no further increase in ND above 200 g/kg LF70 inclusion. In conclusion, increasing the inclusion of lactofeed from 100 g/kg to 300 g/kg in starter diets where soya-bean meal comprised the principle protein source improved food efficiency and increased daily gain and daily food intake when compared with diets where dried skim milk comprised the principle protein source.
In situ degradability of dry matter and neutral-detergent fibre of thorn scrubland forage consumed by goats in the semi-arid region of north Mexico
Authors: Juárez R. A. S. , Montoya E. R. , Nevarez C. G. , Cerrillo S. M. A. , Mould F. L. 
Published: February 2017

AbstractThree goats provided with oesophageal and ruminal cannulae were used to determine variations in dry matter (DM) and neutral-detergent fibre (NDF) degradability of the forage consumed when grazing thorn scrubland in the semi-arid region of north Mexico, during two consecutive dry and wet periods. Ingesta samples were incubated intraruminally, the data were fitted to the exponential equation P = a + b (l - e-ct) and statistically analysed using a randomized-block design. Organic matter and crude protein (CP) contents were higher (P < 0.05) in the wet seasons. Values of NDF were similar in dry and wet season of both years whereas higher numerical values of acid-detergent fibre (ADF), lignin and cellulose were registered in the dry seasons. DM and NDF degradabilities after 24 and 48 h of ruminal incubation were higher (P < 0.05) in the wet seasons. Higher values (P < 0.05) in DM and NDF bag losses at zero time (A fraction) were registered in the two wet seasons. The insoluble but fermentable DM and NDF (B fractions) were higher (P < 0.05) in the 1999 wet season and variable in the rest of the studied period. Numerically higher values of DM and NDF c fraction were found in wet periods, whereas DM and NDF potential degradabilities were higher (P < 0.05) in the wet season in 1999 and similar across seasons in 2000. Lowest (P < 0.05) contents of CP in grazed forage, DM and NDF degradabilities after 48 h of ruminal incubation, and A, and B, and c fractions were observed in the dry seasons. Thus, these results may be related to both the lower feeding value of forage consumed by the animals and lower performance of livestock during this period. Then, the DM and NDF degradability after 48 h, together with the insoluble but fermentable matter and the c fraction permit the nutritive value of the forage consumed by grazing goats to be accurately described.
Health team for the elderly: a feasibility study for preventive home visits
Authors: Seiger Cronfalk Berit , Fjell Astrid , Carstens Nina , Rosseland Lars Malvin Kvinge , Rongve Arvid , Rönnevik Dag-Helge , Seiger Åke , Skaug Knut , Ugland Vae Karen Johanne , Hauge Wennersberg Marianne , Boström Anne-Marie 
Published: February 2017

The aim was to describe the development, utilization and feasibility of a model of preventive home visits, in an urban and a rural municipality in Norway.BackgroundOlder people &gt;65 years will rise significantly in coming years. Increased age is associated with risk of disability, illness and need for public health services. Preventive home visits is assumed to help older people to maintain their functional level longer, delaying disease and thus delaying the need for health care.MethodDescriptive explorative design describing the development, utilization and feasibility of preventive home visits in two different settings. All 77-year-old persons living at home in an urban municipality and all 75 years and older in a rural municipality were invited to participate. A questionnaire including a substantial number of tests concerning; fall, nutrition, polypharmacy and cognitive impairment was used by Health Team Nurses as base for a risk assessment. Pilot studies were conducted to validate the questionnaire including an inter-rater reliability study of the risk assessment tool. A multiprofessional team, Health Team for the Elderly met each week to evaluate risk assessments and make recommendations to be sent to each respective general practitioner. Data were analysed using descriptive and inferential statistics. In total, 167 persons (109 from the urban municipality and 58 from the rural municipality) participated, corresponding to 60% of the approached individuals. The mean time for the visits was 108 minutes (SD 20). Missing data were identified for; Do you feel safe in your municipality (17.5%) and Are you looking forward to ageing (11.4%). In total, 36 persons (21.7%) were identified with increased risk for developing illness. We suggest that a structured model of preventive home visits and collaboration between highly specialized health care professionals are important factors for reliable health promoting risk assessments of elderly home dwellers.