bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interaction between air pollution exposure and genes in relation to levels of inflammatory markers and risk of myocardial infarction
Authors: Panasevich Sviatlana , Leander Karin , Ljungman Petter , Bellander Tom , de Faire Ulf , Pershagen Göran , Nyberg Fredrik 
Published: September 2013

ObjectivesAir pollution exposure induces cardiovascular effects, possibly via systemic inflammation and coagulation misbalance. Genetic variation may determine individual susceptibility. Our aim was to investigate effect modification by inflammation (Interleukin6 (IL6),tumour necrosis factor-α (TNF-α)) and coagulation (fibrinogen Bβ,plasminogen activator inhibitor-1(PAI-1)) gene variants on the effect of long-term or short-term air pollution exposure on both blood marker levels and non-fatal myocardial infarction (MI) risk.DesignPopulation-based case–control study with a nested case-crossover study. Gene-environment interactions for short-term and long-term air pollution on blood marker levels were studied in population controls, for long-term exposure on MI risk using case–control design, and for short-term exposure on MI onset using case-crossover design.SettingThe Stockholm Heart Epidemiology Programme (SHEEP) conducted in 1992–1994 in Stockholm, Sweden. Spatial modelling was used to assess long-term (up to 30 years retrospectively) air pollution exposure to traffic-NO2and heating-SO2emissions at home addresses. Urban background NO2, SO2, PM10and O3measurements were used to estimate short-term (up to 5 days) air pollution exposure.Participants1192 MI cases and 1506 population controls aged 45–70 years.OutcomesThe levels of blood markers of inflammation (IL-6, TNF-α) and coagulation (fibrinogen, PAI-1) and MI risk.ResultsWe observed gene–environment interaction for severalIL6andTNFSNPs in relation to inflammation blood marker levels. One-year traffic-NO2exposure was associated with higher IL-6 levels with each additionalIL6-174C allele, and 1-year heating-SO2exposure with higher levels of TNF-α inTNF-308AA homozygotes versus −308G carriers. Short-term air pollution exposure also interacted withIL6andTNFin relation to marker levels. The risk of MI followed the effect on blood markers in each genotype group.ConclusionsGenetic variants inIL6andTNFmay modify effects of long-term and short-term air pollution exposure on inflammatory marker levels and MI risk.
Can use of healthcare services among 15–16-year-olds predict an increased level of high school dropout? A longitudinal community study
Authors: Homlong Lisbeth , Rosvold Elin O , Haavet Ole R 
Published: September 2013

ObjectivesTo study associations between healthcare seeking in 15–16-year-olds and high school dropout 5 years later.DesignLongitudinal community study.SettingData from a comprehensive youth health survey conducted in 2000–2004, linked to data from national registries up to 2010.Participants13 964 10th grade secondary school students in six Norwegian counties.Main outcome measureLogistic regression was used to compute ORs for high school dropout.ResultsThe total proportion of students not completing high school 5 years after registering was 29% (girls 24%, boys 34%). Frequent attenders to school health services and youth health clinics at age 15–16 years had a higher dropout rate (37/48% and 45/71%), compared with those with no or moderate use. Adolescents referred to mental health services were also more likely to drop out (47/62%). Boys with moderate use of a general practitioner (GP) had a lower dropout rate (30%). A multiple logistic regression analysis, in which we adjusted for selected health indicators and sociodemographic background variables, revealed that seeking help from the youth health clinic and consulting mental health services, were associated with increased level of high school dropout 5 years later. Frequent attenders (≥4 contacts) had the highest odds of dropping out. Yet, boys who saw a GP and girls attending the school health services regularly over the previous year were less likely than their peers to drop out from high school.ConclusionsAdolescents who seek help at certain healthcare services can be at risk of dropping out of high school later. Health workers should pay particular attention to frequent attenders and offer follow-up when needed. However, boys who attended a GP regularly were more likely to continue to high school graduation, which may indicate a protective effect of having a regular and stable relationship with a GP.
Comparison of strategies to reduce meticillin-resistantStaphylococcus aureusrates in surgical patients: a controlled multicentre intervention trial
Authors: Lee Andie S , Cooper Ben S , Malhotra-Kumar Surbhi , Chalfine Annie , Daikos George L , Fankhauser Carolina , Carevic Biljana , Lemmen Sebastian , Martínez José Antonio , Masuet-Aumatell Cristina , Pan Angelo , Phillips Gabby , Rubinovitch Bina , Goossens Herman , Brun-Buisson Christian , Harbarth Stephan ,   for the MOSAR WP4 Study Group
Published: September 2013

ObjectiveTo compare the effect of two strategies (enhanced hand hygiene vs meticillin-resistantStaphylococcus aureus(MRSA) screening and decolonisation) alone and in combination on MRSA rates in surgical wards.DesignProspective, controlled, interventional cohort study, with 6-month baseline, 12-month intervention and 6-month washout phases.Setting33 surgical wards of 10 hospitals in nine countries in Europe and Israel.ParticipantsAll patients admitted to the enrolled wards for more than 24 h.InterventionsThe two strategies compared were (1) enhanced hand hygiene promotion and (2) universal MRSA screening with contact precautions and decolonisation (intranasal mupirocin and chlorhexidine bathing) of MRSA carriers. Four hospitals were assigned to each intervention and two hospitals combined both strategies, using targeted MRSA screening.Outcome measuresMonthly rates of MRSA clinical cultures per 100 susceptible patients (primary outcome) and MRSA infections per 100 admissions (secondary outcome). Planned subgroup analysis for clean surgery wards was performed.ResultsAfter adjusting for clustering and potential confounders, neither strategy when used alone was associated with significant changes in MRSA rates. Combining both strategies was associated with a reduction in the rate of MRSA clinical cultures of 12% per month (adjusted incidence rate ratios (aIRR) 0.88, 95% CI 0.79 to 0.98). In clean surgery wards, strategy 2 (MRSA screening, contact precautions and decolonisation) was associated with decreasing rates of MRSA clinical cultures (15% monthly decrease, aIRR 0.85, 95% CI 0.74 to 0.97) and MRSA infections (17% monthly decrease, aIRR 0.83, 95% CI 0.69 to 0.99).ConclusionsIn surgical wards with relatively low MRSA prevalence, a combination of enhanced standard and MRSA-specific infection control approaches was required to reduce MRSA rates. Implementation of single interventions was not effective, except in clean surgery wards where MRSA screening coupled with contact precautions and decolonisation was associated with significant reductions in MRSA clinical culture and infection rates.Trial registrationclinicaltrials.gov identifier:NCT00685867
Suicide-related events in young people following prescription of SSRIs and other antidepressants: a self-controlled case series analysis
Authors: Wijlaars Linda P M M , Nazareth Irwin , Whitaker Heather J , Evans Stephen J W , Petersen Irene 
Published: September 2013

ObjectivesWe aimed to examine the temporal association between selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressant (TCA) prescriptions and suicide-related events in children and adolescents.DesignSelf-controlled case series.SettingElectronic health records were used from 479 general practices in The Health Improvement Network (THIN) UK primary care database from 1995 to 2009.Participants81 young people aged 10–18 years with a record of completed suicide, 1496 who attempted suicide, 1178 with suicidal ideation and 2361 with intentional self-harm.Main outcome measuresIncidence Rate Ratios (IRRs) for completed and attempted suicide, suicidal ideation and intentional self-harm.ResultsFor non-fatal suicide-related behaviour, IRRs were similar for the time the person was prescribed either SSRIs or TCAs: IRRs increased during pre-exposure, peaked on prescription day, were stable up to the fourth prescription-week, and decreased after the prescriptions were stopped. For both types of antidepressants, IRRs were lower or similar to pre-exposure levels during the period of prescription. For SSRIs, there was an increase in the IRR for completed suicide on the day of prescription (N=5; IRR=42.5, 95% CI 4.5 to 403.4), and during the fourth week of SSRI prescription (N=2; IRR=11.3, 95% CI 1.1 to 115.6).ConclusionsWe found that a very small number of young people were prescribed antidepressants and that there was an absence of a sustained increase in rates of suicide-related events in this group. There were no systematic differences between the association of TCAs and SSRIs and the incidence risk ratios for attempted suicide, suicidal ideation or intentional self-harm and, apart from the day of prescription, rates did not exceed pre-exposure levels. The pattern of IRR for suicide for SSRIs was similar to that found in non-fatal suicide-related events. Our results warrant a re-evaluation of the current prescription of SSRIs in young people. We recommend the creation of a pragmatic registry for active pharmacovigilance.
Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study
Authors: Dorado-García Alejandro , Bos Marian EH , Graveland Haitske , Van Cleef Brigitte AGL , Verstappen Koen M , Kluytmans Jan AJW , Wagenaar Jaap A , Heederik Dick JJ 
Published: September 2013

ObjectivesLivestock-associated methicillin-resistantStaphylococcus aureus(LA-MRSA) emergence is a major public health concern. This study was aimed at assessing risk factors for persistently carrying MRSA in veal calf farmers and their family members. We also evaluate the dynamics of MRSA environmental load during the veal-calf production cycle.DesignObservational, longitudinal, repeated cross-sectional study.Setting52 veal calf farms in the Netherlands.ParticipantsFrom the end of 2010 to the end of 2011, a total of 211 farmers, family members and employees were included in the study.Primary outcome and secondary outcome measuresNasal swabs were taken from participants on days 0, 4, 7 and week 12. A persistent MRSA carrier was defined as a person positive for MRSA on days 0, 4 and 7. Participants filled in an extensive questionnaire to identify potential risk factors and confounders. For estimation of MRSA prevalence in calves and environmental contamination, animal nasal swabs and Electrostatic Dust Collectors were taken on day 0 and week 12.ResultsThe presence of potential animal reservoirs (free-ranging farm cats and sheep) and the level of contact with veal calves was positively associated with persistent MRSA carriage. Interestingly, at the end of the study (week 12), there was a twofold rise in animal prevalence and a significantly higher MRSA environmental load in the stables was found on farms with MRSA carriers.ConclusionsThis study supports the hypothesis that environmental contamination with MRSA plays a role in the acquisition of MRSA in farmers and their household members and suggests that other animal species should also be targeted to implement effective control strategies.
Ten years of asthma admissions to adult critical care units in England and Wales
Authors: Gibbison Ben , Griggs Kathryn , Mukherjee Mome , Sheikh Aziz 
Published: September 2013

ObjectivesTo describe the patient demographics, outcomes and trends of admissions with acute severe asthma admitted to adult critical care units in England and Wales.Design10-year, retrospective analysis of a national audit database.SettingSecondary care: adult, general critical care units in the UK.Participants830 808 admissions to adult, general critical care units.Primary and secondary outcome measuresDemographic data including age and sex, whether the patient was invasively ventilated or not, length of stay (LOS; both in the critical care unit and acute hospital), survival (both critical care unit and acute hospital) and time trends across the 10-year period.ResultsOver the 10-year period, there were 11 948 (1.4% of total) admissions with asthma to adult critical care units in England and Wales. Among them 67.5% were female and 32.5% were male (RR F:M 2.1; 95% CI 2.0 to 2.1). Median LOS in the critical care unit was 1.8 days (IQR 0.9–3.8). Median LOS in the acute hospital was 7 days (IQR 4–14). Critical care unit survival rate was 95.5%. Survival at discharge from hospital was 93.3%. There was an increase in admissions to adult critical care units by an average of 4.7% (95% CI 2.8 to 6.7)/year.ConclusionsAcute asthma represents a modest burden of work for adult critical care units in England and Wales. Demographic patterns for admission to critical care unit mirror those of severe asthma in the general adult community. The number of critical care admissions with asthma are rising, although we were unable to discern whether this represents a true increase in the incidence of acute asthma or asthma severity.
A survey of TB knowledge among medical students in Southwest China: is the information reaching the target?
Authors: Zhao Ying , Ehiri John , Li Daikun , Luo Xingneng , Li Ying 
Published: September 2013

ObjectivesTuberculosis (TB) control in schools is a concern in low-income and middle-income countries with high TB burdens. TB knowledge is recognised as important for TB control in China, which has one of the highest TB prevalence in the world. Accordingly, National TB Control Guideline in China emphasised TB-health education in schools as one of the core strategies for improving TB knowledge among the population. It was important to assess the level of TB knowledge in schools following 5-year implementation of the guideline, to determine whether the information was reaching the targets.DesignA cross-sectional study.Methods and study settingThis survey assessed TB knowledge and access to TB-health information by questionnaire survey with 1486 undergraduates from two medical universities in Southwest China.ResultsOverall, the students had inadequate TB knowledge. Only 24.1%, 27.2% and 34.1% of the students had knowledge of TB symptoms of cough/blood-tinged sputum, their local TB dispensaries and free TB treatment policy, respectively. Very few (14.5%) had heard about the Directly Observed Therapy Short Course (DOTS), and only about half (54%) had ever accessed TB-health education information. Exposure to health education messages was significantly associated with increased knowledge of the five core TB knowledge as follows: classic TB symptoms of cough/blood-tinged sputum (OR (95% CI) 0.5(0.4 to 0.7)), TB modes of transmission (OR (95% CI) 0.4(0.3 to 0.5)), curability of TB (OR (95% CI) 0.6(0.5 to 0.7)), location and services provided by TB local dispensaries (OR (95% CI) 0.6(0.5 to 0.8)) and the national free TB treatment policy (OR (95% CI) 0.7(0.5 to 0.8)).ConclusionsThe findings pose the question of whether it is time for a rethink of the current national and global approach to TB-health education/promotion which favours promotion of awareness on World TB Days rather than regular community sensitisation efforts.
Safety during night shifts: a cross-sectional survey of junior doctors’ preparation and practice
Authors: Jackson Emma J , Moreton Adam 
Published: September 2013

ObjectivesWe aimed to determine whether junior doctors and trusts in the region make use of published evidence relating to best practice during night shift work that can safeguard alertness, reduce fatigue and limit mistakes. We surveyed junior doctors’ preparation for and practice during night shifts, and the working and living conditions offered by hospitals for junior doctors carrying out night duties.DesignCross-sectional survey.SettingAn anonymous online questionnaire was sent to junior doctors training within Health Education North West from 13 December 2012 to 14 February 2013.Participants32% (16/42) of trusts within Health Education North West sent the survey to 2139 junior doctor email addresses; 24.5% (524/2139) entered data into the survey.Results91.6% of surveyed junior doctors worked night shifts. Prior to starting night shifts, 65% do not have a ‘prophylactic’ afternoon nap. At work, half (49%) can access a room with a reclining chair while 24% have a room with a bed. 37% ‘never’ achieve a ‘natural break’ on night shift; 53% ‘never’ achieve the recommended 20–45 min nap. 91% of respondents were unaware of the duration of sleep inertia that can affect alertness upon waking. When converting between day/night shifts, 2% use light lamps and 6% use non-benzodiazepine sedatives. Principal themes from free text analysis were feeling lethargic or unwell during night shifts, concern for patient and personal safety and inability to rest or take breaks.ConclusionsThe trainees surveyed find night shifts difficult, yet do not/are unable to implement evidence-based recommendations to limit fatigue. Results suggest those surveyed experience a lack of rest facilities within their place of work and a demanding workload. The results may indicate the need to increase awareness of the potential benefits associated with different interventions that can help mitigate the fatigue associated with rotating shift work.
Asthma related to cleaning agents: a clinical insight
Authors: Vandenplas Olivier , D'Alpaos Vinciane , Evrard Geneviève , Jamart Jacques , Thimpont Joel , Huaux François , Renauld Jean-Christophe 
Published: September 2013

ObjectiveTo determine the agents causing asthmatic reactions during specific inhalation challenges (SICs) in workers with cleaning-related asthma symptoms and to assess the pattern of bronchial responses in order to identify the mechanisms involved in cleaning-related asthma.DesignA retrospective case series analysis.SettingThe study included all participants who completed an SIC procedure with the cleaning/disinfection products suspected of causing work-related asthma over the period 1992–2011 in a tertiary centre, which is the single specialised centre of the French-speaking part of Belgium where all participants with work-related asthma are referred to for SIC.ResultsThe review identified 44 participants who completed an SIC with cleaning/disinfection agents. Challenge exposure to the suspected cleaning agents elicited a ≥20% fall in forced expiratory volume in 1 s (FEV1) in 17 (39%) participants. The cleaning products that induced a positive SIC contained quaternary ammonium compounds (n=10), glutaraldehyde (n=3), both of these agents (n=1) and ethanolamines (n=2). Positive SICs were associated with a significant decrease in the median (IQR) value of the provocative concentration of histamine causing a 20% fall in FEV1(PC20) from 1.4 (0.2–4.2) mg/mL at baseline to 0.5 (0.4–3.0) mg/mL after the challenge and a significant increase in sputum eosinophils from 1.8 (0.8–7.2)% at baseline to 10.0 (4.1–15.9)% 7 h after the challenge exposure while these parameters did not significantly change in participants with a negative SIC. Overall, 11 of 17 participants with positive SICs showed greater than threefold decrease in postchallenge histamine PC20value, a >2% increase in sputum eosinophils, or both of these outcomes.ConclusionsThese data indicate that a substantial proportion of workers who experience asthma symptoms related to cleaning materials show a pattern of bronchial reaction consistent with sensitiser-induced occupational asthma. The results also suggest that quaternary ammonium compounds are the principal cause of sensitiser-induced occupational asthma among cleaners.
Cortical β-amyloid levels and neurocognitive performance after cardiac surgery
Authors: Klinger Rebecca Y , James Olga G , Wong Terence Z , Newman Mark F , Doraiswamy P Murali , Mathew Joseph P 
Published: September 2013

IntroductionNeurological and neurocognitive dysfunction occurs frequently in the large number of increasingly elderly patients undergoing cardiac surgery every year. Perioperative cognitive deficits have been shown to persist after discharge and up to several years after surgery. More importantly, perioperative cognitive decline is predictive of long-term cognitive dysfunction, reduced quality of life and increased mortality. The proposed mechanisms to explain the cognitive decline associated with cardiac surgery include the neurotoxic accumulation of β-amyloid. This study will be the first to provide molecular imaging to assess the relationship between neocortical β-amyloid deposition and postoperative cognitive dysfunction.Methods and analysis40 patients providing informed consent for participation in this Institutional Review Board-approved study and undergoing cardiac (coronary artery bypass graft (CABG), valve or CABG+valve) surgery with cardiopulmonary bypass will be enrolled based on defined inclusion and exclusion criteria. At 6 weeks after surgery, participants will undergo18F-florbetapir positron emission tomography imaging to assess neocortical β-amyloid burden along with a standard neurocognitive battery and blood testing for apolipoprotein E ε-4 genotype.ResultsThe results will be compared to those of 40 elderly controls and 40 elderly patients with mild cognitive impairment who have previously completed18F-florbetapir imaging.Ethics and disseminationThis study has been approved by the Duke University Institutional Review Board. The results will provide novel mechanistic insights into postoperative cognitive dysfunction that will inform future studies into potential treatments or preventative therapies of long-term cognitive decline after cardiac surgery.