bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variant Aldehyde Dehydrogenase 2 (
ALDH2*2
) Is a Risk Factor for Coronary Spasm and ST‐Segment Elevation Myocardial Infarction
Authors: Mizuno Yuji , Hokimoto Seiji , Harada Eisaku , Kinoshita Kenji , Nakagawa Kazuko , Yoshimura Michihiro , Ogawa Hisao , Yasue Hirofumi 
Published: May 2016

Background

Mitochondrial aldehyde dehydrogenase 2 (
ALDH
2) plays a key role in removing toxic aldehydes. Deficient variant

ALDH
2*2

genotype is prevalent in up to 40% of the East Asians and reported to be associated with acute myocardial infarction (
AMI
). To elucidate the mechanisms underlying the association of

ALDH
2*2

with
AMI
, we compared the clinical features of
AMI
patients with

ALDH
2*2

to those with wild‐type

ALDH
2*1/*1

.

Methods and Results

The study subjects consisted of 202 Japanese patients with acute
ST‐
segment elevation myocardial infarction (
STEMI
) (156 men and 46 women; mean age, 67.3±12.0) who underwent primary percutaneous coronary intervention (
PCI
). In 85 patients, provocation test for coronary spasm was also done 6 month post‐
PCI
.

ALDH
2

genotyping was performed by direct application of the TaqMan polymerase chain system. Of the 202 patients, 103 (51.0%) were carriers of

ALDH
2*2

and 99 (49.0%) those of

ALDH
2*1/*1

. There were no differences in clinical features between

ALDH
2*2

and

ALDH
2*1/*1

carrier groups except higher frequencies of coronary spasm and alcohol flush syndrome (
AFS
) (88.6% vs 56.1%;
P
=0.001 and 94.3% vs 17.6%;
P
<0.001), less‐frequent alcohol habit (14.6% vs 51.5%;
P
<0.001), and higher peak plasma creatine phophokinase levels (2224 vs 1617 mg/
dL
;
P
=0.002) in the

ALDH
2*2

than the

ALDH
2*1/*1

carrier group.

Conclusions

ALDH
2*2

is prevalent (51.0%) among Japanese
STEMI
patients, and those with

ALDH
2*2

had higher frequencies of coronary spasm and
AFS
and more‐severe myocardial injury compared to those with

ALDH
2*1/*1

.
Social Opportunity Structures and the Escalation of Drug Market Offending
Authors: Ouellet Marie , Bouchard Martin , Malm Aili 
Published: May 2016

Objectives: This study looks at whether social opportunity structures are associated with transitions into more serious drug market offending. Our focus is on the speed at which transitions occurred, and whether variations in criminal embeddedness play a role in explaining this. Methods: A survey of 520 North American cannabis cultivators allowed us to assess one dimension of the criminal career—escalation—looking at the speed of transitions from cannabis user to grower. Our main predictor, criminal embeddedness, was measured through the presence of a cultivation mentor involved in cannabis cultivation. Results: Cox proportional hazard regression analysis demonstrated late cannabis use onset and an indicator of the number of drugs used beyond cannabis were found to accelerate transitions. In addition, within-person changes in mentorship were found to influence the timing of escalation, with meeting a mentor associated with quicker transitions into cannabis cultivation. Conclusions: Findings emphasize the role of mentors as gateways into new milieus. Results support increased attention to the immediate social networks and broader social opportunity structures in which offenders and would-be offenders are embedded as major factors driving the timing of onset into more serious criminal pathways.
Reckoning with Dictatorship in Brazil
Authors: Schneider Nina , Atencio Rebecca J. 
Published: May 2016

A conventional approach that takes into account only official reckonings might lead one to believe that Brazil has lacked a culture of memory of the military regime, at least until recently. Widening the scope to include cultural production, however, provides a different view: one of a long tradition of reckoning with the dictatorship. In postauthoritarian Brazil, the process of transition has been marked by a disjuncture between the profusion of cultural responses to the dictatorship era and the legalistic silence resulting from the 1979 amnesty law, which continues to grant impunity to former human rights perpetrators. An approach that, instead of emphasizing political measures, asks how cultural production may have impacted Brazil’s particular way of approaching its violent past helps to answer such questions as how to reconcile the lack of popular mobilization in the 1980s with the fact that guerrilla memoirs turned out to be best sellers and whether culture served as a catalyst for debates about the authoritarian past. In the Brazilian context cultural production appears to strengthen the amnesty framework (“reconciliation”) rather than to undermine or overcome it (mobilizing for punishment). The function of cultural and memory work is double-edged, requiring a close reading of both the portrayal of violence in each cultural work and the larger historical and political context of each country case. Estudos convencionais sobre o processo de acerto de contas no Brasil, que somente consideram mecanismos institucionais, podem dar a impressão de que ao país tem faltado uma cultura de memória sobre o regime militar, pelo menos até recentemente. Contudo, ao ampliar o escopo da análise para englobar a produção cultural, percebe-se uma ótica diferente: uma longa tradição de embates e reflexões sobre a ditadura militar. No Brasil pós-ditatorial o processo de transição tem sido caracterizado por um desalinhamento entre as várias respostas culturais aos crimes da ditadura e o silêncio jurídico resultante da anistia de 1979, que continua agraciando com impunidade os agentes que outrora violaram direitos humanos. Um tratamento que, ao invés de enfatizar medidas políticas, questiona de que maneira a produção cultural pode ter impactado a forma específica em que o Brasil lidou com seu passado violento ajuda a explicar como se reconcilia a falta de mobilização popular nos anos 80 com a transformação de certas memórias de ex-guerrilheiros em verdadeiros best sellers no mesmo período. Ademais, permite avaliar se a produção cultural serviu como catalisador de debates sobre o passado autoritário. No contexto brasileiro, a produção cultural tende a reforçar a moldura reconciliadora criada pela anistia. A função da cultura é uma faca de dois gumes: requer uma leitura meticulosa tanto da retratação da violência em cada obra cultural como dos contexto histórico e político do país em questão.
Design summer year weather – outdoor warmth ranking metrics and their numerical verification
Authors: Ji Yingchun , Zhang Yi , Korolija Ivan , Futcher Julie 
Published: May 2016

The existing methods of selecting design summer year weather data rely on the outdoor dry bulb temperature without considering solar radiation and wind which can impact on indoor thermal conditions. This research sets out to examine the existing outdoor warmth ranking metrics and proposes a new warmth ranking metric (solar air temperature), which takes into account not only dry bulb temperature but also solar and wind conditions. Parametric study was carried out using five typical UK dwelling models, by varying parameters associated with building design and operation, a large model population were generated to statistically determine how well the outdoor warmth ranking metrics correlate the predicted indoor warmth. The outdoor warmth ranking was made for the 20 years source weather data (1976–1995) in London and both CIBSE single temperature criterion and BS EN 15251 adaptive criteria were used to judge overheating in buildings. It is found that the predicted indoor warmth are mostly arbitrary in nature and none of the existing and newly proposed outdoor warmth ranking metrics can strictly correlate. The research also discovers the significant differences between the predicted overheating occurrence and severity in the warmth ranking of weather years. Practical application: The parametric methods described in the paper will facilitate academics and industry researchers to assess design summer year weather generated by various methods. The research also provides guidance on assessing both overheating occurrence and severity in buildings to assist decision making.
Pilot study of sphenopalatine injection of onabotulinumtoxinA for the treatment of intractable chronic migraine
Authors: Bratbak Daniel Fossum , Nordgård Ståle , Stovner Lars Jacob , Linde Mattias , Dodick David W , Aschehoug Irina , Folvik Mari , Tronvik Erling 
Published: May 2016

Objective The main objective of this pilot study was to investigate the safety of administering onabotulinumtoxinA towards the sphenopalatine ganglion in 10 patients with intractable chronic migraine with an open, uncontrolled design. We also collected efficacy data to provide an indication as to whether future placebo-controlled studies should be performed. Method In a prospective, open-label, uncontrolled study after one-month baseline, we performed bilateral injections of 25 IU onabotulinumtoxinA (total dose 50 IU) toward the sphenopalatine ganglion in a single outpatient session in 10 patients with intractable migraine with a follow-up of 12 weeks. The primary outcome was adverse events and the main efficacy outcome was frequency of moderate and severe headache days in month 2 post-treatment compared to baseline. Results All 10 patients experienced a total of 25 adverse events. The majority of these were different types of local discomfort in the face and jaw, and none were classified as serious. In an intention-to-treat analysis of the main efficacy outcome, a statistically significant reduction of moderate and severe headache days in baseline versus month 2 was observed (16.3 ± 6.2 days baseline versus 7.6 ± 7.6 days month 2, p = 0.009). Eight out of 10 patients experienced an at least 50% reduction of moderate and severe headache days compared to baseline. Conclusion The result warrants randomised, placebo-controlled studies to establish both safety and efficacy of this potential novel treatment of chronic migraine.
Predictors of Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers
Authors: Whiteside David , Martini Douglas N. , Lepley Adam S. , Zernicke Ronald F. , Goulet Grant C. 
Published: May 2016

Background: Ulnar collateral ligament (UCL) reconstruction surgeries in Major League Baseball (MLB) have increased significantly in recent decades. Although several risk factors have been proposed, a scientific consensus is yet to be reached, providing challenges to those tasked with preventing UCL injuries. Purpose: To identify significant predictors of UCL reconstruction in MLB pitchers. Study Design: Case control study; Level of evidence, 3. Methods: Demographic and pitching performance data were sourced from public databases for 104 MLB pitchers who underwent UCL reconstruction surgery and 104 age- and position-matched controls. These variables were compared between groups and inserted into a binary logistic regression to identify significant predictors of UCL reconstruction. Two machine learning models (naïve Bayes and support vector machine) were also employed to predict UCL reconstruction in this cohort. Results: The binary linear regression model was statistically significant (χ2(12) = 33.592; P = .001), explained 19.9% of the variance in UCL reconstruction surgery, and correctly classified 66.8% of cases. According to this model, (1) fewer days between consecutive games, (2) a smaller repertoire of pitches, (3) a less pronounced horizontal release location, (4) a smaller stature, (5) greater mean pitch speed, and (6) greater mean pitch counts per game were all significant predictors of UCL reconstruction. More specifically, an increase in mean days between consecutive games (odds ratio [OR], 0.685; 95% CI, 0.542-0.865) or number of unique pitch types thrown (OR, 0.672; 95% CI, 0.492-0.917) was associated with a significantly smaller likelihood of UCL reconstruction. In contrast, an increase in mean pitch speed (OR, 1.381; 95% CI, 1.103-1.729) or mean pitches per game (OR, 1.020; 95% CI, 1.007-1.033) was associated with significantly higher odds of UCL reconstruction surgery. The naïve Bayes classifier predicted UCL reconstruction with an accuracy of 72% and the support vector machine classifier with an accuracy of 75%. Conclusion: This study identified 6 key performance factors that may present significant risk factors for UCL reconstruction in MLB pitchers. These findings could help to enhance the prevention of UCL reconstruction surgery in MLB pitchers and shape the direction of future research in this domain.
Comparative Effectiveness of Second Vasoactive Agents in Septic Shock Refractory to Norepinephrine
Authors: Nguyen H. Bryant , Lu Samantha , Possagnoli Isabella , Stokes Phillip 
Published: May 2016

Objective: We aim to identify the appropriate vasoactive agent in patients with septic shock who are refractory to optimal doses of norepinephrine. Methods: In this retrospective observational cohort study over a 4-year period, patients who received norepinephrine within 24 hours of ICU admission and a second agent within 48 hours were enrolled. Results: Among 2640 patients screened, 234 patients were enrolled, aged 60.8 ± 17.8 years, Acute Physiology and Chronic Health Evaluation IV 98.3 ± 27.5, 81.6% mechanically ventilated, and 65.8% in-hospital mortality. Within 96 hours, 2.8 ± 1.0 vasoactive agents were administered. Fifty, 50, 66, and 68 patients received dobutamine, dopamine, phenylephrine, and vasopressin as the second agent, with crude in-hospital mortality 40.0%, 66.0%, 74.2%, and 76.5%, respectively, P < .001. Survival analysis showed a statistically significant difference in survival time by second vasoactive agent, P < .001. After adjusting for confounding variables, dobutamine showed significant decreased odds ratio (OR) for mortality compared to vasopressin: OR 0.34 (95% confidence interval 0.14-0.84, P = .04). The relative risk of dying was 55.8% lower in patients receiving dobutamine versus vasopressin, P < .01. Conclusion: Dobutamine is associated with decreased mortality compared to other second vasoactive agents in septic shock when norepinephrine is not sufficient. A prospective randomized trial examining the outcome impact of the second vasoactive agent is needed.
Biotinidase deficiency mimicking neuromyelitis optica beginning at the age of 4: A treatable disease
Authors: Girard Barbara , Bonnemains Chrystèle , Schmitt Emmanuelle , Raffo Emmanuel , Bilbault Claire 
Published: May 2016

Background: Metabolic and inflammatory conditions may lead to neurological disorders. Neuromyelitis optica spectrum disorders (NMOSDs) refer to a rare group of demyelinating diseases of the central nervous system which essentially involve the optic nerves and spinal cord. Methods: We report a case of biotinidase deficiency (BD) initially misdiagnosed as NMOSD in a pediatric patient. Results: An 8-year-old girl was initially diagnosed with NMOSD on the basis of optic neuritis (ON) associated with three episodes of longitudinally extensive transverse myelitis (LETM). Intravenous high-dose corticosteroids were effective during the first two episodes of LETM. The third acute episode which resulted in tetraplegia, respiratory distress, and blindness was refractory to corticosteroids, plasmapheresis, and rituximab. The unusual clinical course and persistent high levels of plasma and cerebrospinal fluid (CSF) lactate led to additional metabolic investigations being performed. Acylcarnitine profile revealed increased C5-OH acylcarnitine suggestive of BD. Diagnosis was confirmed by direct assessment of plasma enzyme activity (quantified as 5% of the control value). Genetic analysis revealed two mutations, c.643C>T (p.L215F) and c.1612C>T (p.R538C), in the BTD gene (3p25). Dramatic clinical improvement occurred after long-term oral biotin treatment. Conclusion: BD is a treatable condition that may closely mimic the neurological findings of LETM and NMOSD.
Higher mortality rates amongst emergency patients admitted to hospital at weekends reflect a lower probability of admission
Authors: Meacock Rachel , Anselmi Laura , Kristensen Søren Rud , Doran Tim , Sutton Matt 
Published: May 2016

Objective Patients admitted as emergencies to hospitals at the weekend have higher death rates than patients admitted on weekdays. This may be because the restricted service availability at weekends leads to selection of patients with greater average severity of illness. We examined volumes and rates of hospital admissions and deaths across the week for patients presenting to emergency services through two routes: (a) hospital Accident and Emergency departments, which are open throughout the week; and (b) services in the community, for which availability is more restricted at weekends. Method Retrospective observational study of all 140 non-specialist acute hospital Trusts in England analyzing 12,670,788 Accident and Emergency attendances and 4,656,586 emergency admissions (940,859 direct admissions from primary care and 3,715,727 admissions through Accident and Emergency) between April 2013 and February 2014.Emergency attendances and admissions to hospital and deaths in any hospital within 30 days of attendance or admission were compared for weekdays and weekends. Results Similar numbers of patients attended Accident and Emergency on weekends and weekdays. There were similar numbers of deaths amongst patients attending Accident and Emergency on weekend days compared with weekdays (378.0 vs. 388.3). Attending Accident and Emergency at the weekend was not associated with a significantly higher probability of death (risk-adjusted OR: 1.010). Proportionately fewer patients who attended Accident and Emergency at weekend were admitted to hospital (27.5% vs. 30.0%) and it is only amongst the subset of patients attending Accident and Emergency who were selected for admission to hospital that the probability of dying was significantly higher at the weekend (risk-adjusted OR: 1.054). The average volume of direct admissions from services in the community was 61% lower on weekend days compared to weekdays (1317 vs. 3404). There were fewer deaths following direct admission on weekend days than weekdays (35.9 vs. 80.8). The mortality rate was significantly higher at weekends amongst direct admissions (risk-adjusted OR: 1.212) due to the proportionately greater reduction in admissions relative to deaths. Conclusions There are fewer deaths following hospital admission at weekends. Higher mortality rates at weekends are found only amongst the subset of patients who are admitted. The reduced availability of primary care services and the higher Accident and Emergency admission threshold at weekends mean fewer and sicker patients are admitted at weekends than during the week. Extending services in hospitals and in the community at weekends may increase the number of emergency admissions and therefore lower mortality, but may not reduce the absolute number of deaths.
New relationships and intimacy in long-term care: The views of relatives of residents with dementia and care home staff
Authors: Wiskerke Esther , Manthorpe Jill 
Published: May 2016

Background There is limited research on what family members and frontline care home staff consider to be the best responses to the sexual expression of a person with dementia, whilst at the same time respecting relatives’ feelings, managing their possible distress and conflict. Methods This exploratory study investigated the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia, whilst still married to another person. It reports the themes that emerged in qualitative interviews with eight relatives of people with dementia and with 12 frontline care home staff working in two English care homes. Interviews took place in 2015 using a hypothetical vignette that unfolded in four stages. Thematic analysis was used to analyse the data. Findings The views of care home staff and relatives had similarities in general terms regarding the problems arising around expressions of sexuality in care homes: indicting that a light-hearted or non-physical connection between residents is deemed acceptable, but the moment it becomes a sexual relationship then decision making becomes more complicated. Staff were inclined to turn to managers for advice and to consider separating residents. They expressed familiarity with distracting residents from situations that were of concern. Relatives were considerate of the difficulties and dilemmas faced by care home staff. Conclusion The use of a vignette facilitated discussion of a potentially sensitive topic. Areas for further research are identified.
Paediatric electronic infusion calculator: An intervention to eliminate infusion errors in paediatric critical care
Authors: Venkataraman Aishwarya , Siu Emily , Sadasivam Kalaimaran 
Published: May 2016

Introduction Medication errors, including infusion prescription errors are a major public health concern, especially in paediatric patients. There is some evidence that electronic or web-based calculators could minimise these errors. Aims To evaluate the impact of an electronic infusion calculator on the frequency of infusion errors in the Paediatric Critical Care Unit of The Royal London Hospital, London, United Kingdom. Method We devised an electronic infusion calculator that calculates the appropriate concentration, rate and dose for the selected medication based on the recorded weight and age of the child and then prints into a valid prescription chart. Electronic infusion calculator was implemented from April 2015 in Paediatric Critical Care Unit. A prospective study, five months before and five months after implementation of electronic infusion calculator, was conducted. Data on the following variables were collected onto a proforma: medication dose, infusion rate, volume, concentration, diluent, legibility, and missing or incorrect patient details. Results A total of 132 handwritten prescriptions were reviewed prior to electronic infusion calculator implementation and 119 electronic infusion calculator prescriptions were reviewed after electronic infusion calculator implementation. Handwritten prescriptions had higher error rate (32.6%) as compared to electronic infusion calculator prescriptions (<1%) with a p < 0.001. Electronic infusion calculator prescriptions had no errors on dose, volume and rate calculation as compared to handwritten prescriptions, hence warranting very few pharmacy interventions. Conclusions Use of electronic infusion calculator for infusion prescription significantly reduced the total number of infusion prescribing errors in Paediatric Critical Care Unit and has enabled more efficient use of medical and pharmacy time resources.