bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bystander first aid in trauma – prevalence and quality: a prospective observational study
Authors: Bakke H. K. , Steinvik T. , Eidissen S.‐I. , Gilbert M. , Wisborg T. 
Published: June 2015

BackgroundBystander first aid and basic life support can likely improve victim survival in trauma. In contrast to bystander first aid and out‐of‐hospital cardiac arrest, little is known about the role of bystanders in trauma response. Our aim was to determine how frequently first aid is given to trauma victims by bystanders, the quality of this aid, the professional background of first‐aid providers, and whether previous first‐aid training affects aid quality.MethodsWe conducted a prospective 18‐month study in two mixed urban–rural Norwegian counties. The personnel on the first ambulance responding to trauma calls assessed and documented first aid performed by bystanders using a standard form.ResultsA total of 330 trauma calls were included, with bystanders present in 97% of cases. Securing an open airway was correctly performed for 76% of the 43 patients in need of this first‐aid measure. Bleeding control was provided correctly for 81% of 63 patients for whom this measure was indicated, and prevention of hypothermia for 62% of 204 patients. Among the first‐aid providers studied, 35% had some training in first aid. Bystanders with documented first‐aid training gave better first aid than those where first‐aid training status was unknown.ConclusionsA majority of the trauma patients studied received correct pre‐hospital first aid, but still there is need for considerable improvement, particularly hypothermia prevention. Previous first‐aid training seems to improve the quality of first aid provided. The effect on patient survival needs to be investigated.
The paraventricular nucleus of the thalamus is differentially recruited by stimuli conditioned to the availability of cocaine versus palatable food
Authors: Matzeu Alessandra , Cauvi Gabrielle , Kerr Tony M. , Weiss Friedbert , Martin‐Fardon Rémi 
Published: June 2015

AbstractThe paraventricular nucleus of the thalamus (PVT) is not traditionally considered part of the brain addiction neurocircuitry but has received growing attention with regard to a role in the modulation of drug‐seeking behavior. This study sought to establish the pattern of neural activation induced by a response‐reinstating discriminative stimulus (SD) conditioned to either cocaine (COC) or a conventional reinforcer using a palatable food substance, sweetened condensed milk (SCM). Male Wistar rats were trained to associate one SD (S+; COC or SCM availability) and a distinctly different SD (S−; non‐reward; i.e. the availability of saline or the absence of SCM). Following extinction of COC‐ and SCM‐reinforced responding, rats were presented with the respective S+ or S− alone and tested for the reinstatement of reward seeking. The COC S+ and SCM S+ elicited identical reinstatement, whereas the non‐reward S− was behaviorally ineffective. PVT sections were obtained following completion of the reinstatement tests and labeled for Fos. The number of Fos+ neurons was compared among rats that were presented with the COC S+, SCM S+ or S−. Rats that were presented with the COC S+ exhibited a significant increase in Fos expression compared with rats that were presented with the S−. Moreover, Fos expression was significantly correlated with the number of reinstatement responses that were induced by the COC S+. In contrast, the SCM S+ and S− produced identical increases in Fos expression, without behaviorally relevant correlations. The findings implicate the PVT as an important site that is selectively recruited during COC‐seeking behavior.
Adding urine and saliva toxicology to SBIRT for drug screening of new patients
Authors: Magura Stephen , Achtyes Eric D. , Batts Kristin , Platt Thomas , Moore Thomas L. 
Published: June 2015

Background and ObjectivesTo determine illicit drug use among new patients in primary medical care who denied using “street drugs” during Screening, Brief Intervention and Referral to Treatment (SBIRT).Methods96 new patients who denied use of “street drugs” were tested for drugs as part of routine SBIRT screening.ResultsOf those tested, 14.6% of those with urine specimens and 4.1% of those with saliva specimens tested positive for illicit drugs.Discussion and ConclusionsDrug toxicology can detect unreported illicit drug use during SBIRT screening, with urine being superior to saliva.Scientific SignificanceDrug toxicology can increase the effectiveness of SBIRT screening in primary care medical clinics. (Am J Addict 2015;24:396 –399)
Ara h 2 and Ara 6 are the best predictors of severe peanut allergy: a double‐blind placebo‐controlled study
Authors: Kukkonen A. K. , Pelkonen A. S. , Mäkinen‐Kiljunen S. , Voutilainen H. , Mäkelä M. J. 
Published: June 2015

AbstractBackgroundComponent‐resolved diagnostics offers a modern tool in peanut allergy, but studies applying consistently double‐blind placebo‐controlled challenges are lacking. We aimed to optimize diagnostics for moderate‐to‐severe peanut allergy in a birch‐endemic region and to create an oral‐peanut challenge with its allergen activity characterized.MethodsWe performed double‐blind placebo‐controlled peanut challenges for a referred sample of 6‐ to 18‐year‐olds with peanut sensitization or a high suspicion of peanut allergy, including anaphylaxis. We measured specific IgE (sIgE) to Ara h 1, 2, 3, 6, 8, and 9. Testing of allergen activity of the challenge products was by IgE microarray inhibition.ResultsOf the 102 patients, 69 were challenge positive: 25 (36%) had severe, 36 (52%) moderate, and 8 (12%) mild symptoms; 38 (37%) received adrenalin. SIgE to Ara h 6 AUC 0.98 (95%CI, 0.96–1.00) was the best marker of moderate‐to‐severe allergy. When sIgE to Ara h 2 and Ara h 6 was measured together, all (100%) severe reactions at low doses were successfully diagnosable. SIgE to Ara h 8 had no diagnostic value, AUC 0.42 (95%CI, 0.30–0.52). Both nonroasted and roasted peanut inhibited 100% of IgE binding to Ara h 1, 2, 3, and 6. Nonroasted peanut inhibited 87% of IgE binding to Ara h 8, roasted inhibited 30%. The products lacked Ara h 9 activity.ConclusionCo‐sensitization to Ara h 2 and Ara h 6 was associated with severe reactions distinguishing severe allergy from mild symptoms. SIgE to Ara h 8 added no diagnostic value. Component‐resolved diagnostics reduce the need for oral challenges in peanut allergy.
The ‘four‐hour target’ and the impact on Australian metropolitan acute surgical services
Authors: Perera Marlon L. , Gnaneswaran Neiraja , Roberts Matthew J. , Giles Marian , Liew Danny , Ritchie Peter , Chan Steven T. F. 
Published: June 2015

AbstractBackgroundThe National Emergency Access Targets (NEAT), introduced in 2012, guides the clearance of emergency department (ED) presentations within 4 h of initial presentation. We aim to assess the impact of NEAT on acute surgical services at a large metropolitan centre.MethodsA retrospective cohort study was performed and data were collected from electronic patient management systems. The control group was represented by ED presentations between June and September 2011, 1 year prior to the introduction of NEAT. The two study groups consisted of ED presentations between June and September 2012 and 2013 respectively. Outcome measures included time to appendicectomy and cholecystectomy, inpatient length of stay (IPLOS) (for operative and non‐operative cases), out‐of‐hours operating and hospital mortality rates.ResultsIn total, 2619 inpatient episodes were included, with a trend showing increasing admissions throughout the study periods (P < 0.001). Time to surgical review and ED length of stay decreased significantly (P < 0.001). Time from emergency presentation to emergency appendicectomy and cholecystectomy remained unchanged and procedures performed out‐of‐hours increased significantly from 20.9% to 42.9% (P < 0.001). Median IPLOS for operative and non‐operative patients was reduced during the study from 2.05 to 1.84 days (P < 0.001). Inter‐unit transfers within 48 h of presentation increased significantly from 5.3% to 14.7% (P < 0.001).ConclusionsThe early results following the implementation of NEAT have been correlated with increased efficiency in ED clearance and increased burden on surgical operative and inpatient outcomes. While improvements in IPLOS were observed, they must be considered in the context of increased lower‐acuity admissions and out‐of‐hours operating.
Progression of visual field in patients with primary open‐angle glaucoma – ProgF study 1
Authors: Aptel Florent , Aryal‐Charles Nishal , Giraud Jean‐Marie , El Chehab Hussam , Delbarre Maxime , Chiquet Christophe , Romanet Jean‐Paul , Renard Jean‐Paul 
Published: June 2015

AbstractPurposeTo evaluate the visual field rate of progression of patients with treated ocular hypertension (OHT) and primary open‐angle glaucoma (POAG) in clinical practice, using the mean deviation (MD) and the visual field index (VFI).MethodsNon‐interventional cohort study. From a large multicentre database representative of the French population, 441 eyes of 228 patients with treated OHT or POAG followed up at least 6 years with Humphrey 24.2 Sita‐Standard visual field examination at least twice a year were identified. From initial data, eyes were classified in five groups: 121 with OHT, 188 with early glaucoma (MD greater than −6 dB), 45 with moderate glaucoma (MD −6 to −12 dB), 41 with advanced glaucoma (MD −12 to −18 dB) and 46 with severe glaucoma (MD less than −18 dB). Rate of progression during the follow‐up period was calculated using the trend analysis of the Guided Progression Analysis software.ResultsThe mean duration of follow‐up was 8.4 ± 2.7 years and the mean number of visual field, 18.4 ± 3.5. In eyes with OHT, rate of progression was −0.09 dB/year (−0.17%VFI/year). In eyes with POAG, rate of progression was −0.32 dB/year (−0.83%VFI/year) in eyes with early glaucoma, −0.52 dB/year (−1.81%VFI/year) in moderate glaucoma, −0.54 dB/year (−2.35%VFI/year) in advanced glaucoma and −0.45 dB/year (−1.97%VFI/year) in severe glaucoma. In eyes with POAG, a significant progression (p < 0.05) was detected in 159 of 320 eyes (49.7%) with trend analysis and 117 of 320 eyes (36.6%, likely progression) or 183 of 320 eyes (57.2%, possible and likely progression) with event analysis.ConclusionsPrimary open‐angle glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow‐up. The rate of progression varies greatly among subjects.
Pseudoexfoliation and cataract surgery: a population‐based 30‐year follow‐up study
Authors: Ekström Curt , Botling Taube Amelie 
Published: June 2015

AbstractPurposeTo study the relationship between pseudoexfoliation (PEX) and cataract surgery in a population in which PEX is a common finding.MethodsSurvival analyses were performed in a cohort of 760 residents 65–74 years of age, examined in a population survey in the municipality of Tierp, Sweden, during 1984–1986. To expand the cohort, participants in other studies in Tierp were enrolled. Additionally, subjects were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978–2007. In total, the cohort comprised 1471 individuals, representing more than 15 900 person‐years of risk. Information on cataract surgery was obtained from the glaucoma case records and from medical records.ResultsBy the end of the study in August 2014, 564 subjects had undergone cataract surgery. Of these cases, 224 were affected by PEX at baseline. In multivariate analyses, PEX was the second most important predictor for cataract surgery after lens opacities, accounting for a 2.38‐fold (95% confidence interval 2.01–2.84) increased risk.ConclusionThe results strongly suggest that PEX is a predictor for cataract surgery in the population under study.
Adolescents who were born extremely preterm demonstrate modest decreases in exercise capacity
Authors: Clemm Hege H. , Vollsæter Maria , Røksund Ola D. , Markestad Trond , Halvorsen Thomas 
Published: June 2015

AbstractAimWe aimed to investigate exercise capacity in adolescents who were born extremely preterm and to study changes through puberty and associations with neonatal data, exercise habits and lung function.MethodsThis Norwegian population‐based controlled cohort study focused on all infants (n = 35) born at a gestational age of ≤28 weeks or with a birthweight of ≤1000 grams in 1991–1992, together with matched term‐born controls. Participants underwent spirometry and a maximal cardiopulmonary treadmill exercise test at 10 and 18 years.ResultsAt 18 years of age, mean (95% confidence interval) peak oxygen consumption (peak VO2) was 42.3 (39.2–45.4) vs 45.3 (41.3–49.3) mL/kg/min in the preterm‐ and term‐born groups, while the completed treadmill distance was 915 (837–992) vs 1017 (912–1122) metres. Peak VO2 was unrelated to neonatal factors and current lung function. Changes between 10 and 18 were similar in the two groups, and positive associations between exercise habits and peak VO2 developed during the period.ConclusionExercise capacity was modestly reduced in adolescents born extremely preterm, but the values were considered normal in most participants. Changes during puberty were similar to those observed for term controls, and the findings suggest similar trainability.
Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care
Authors: Onwuneme Chike , Carroll Aoife , Doherty Dermot , Bruell Heike , Segurado Ricardo , Kilbane Mark , Murphy Nuala , McKenna Malachi J. , Molloy Eleanor J. 
Published: June 2015

AbstractAimThis study aimed to assess vitamin D status, and its determinants, in paediatric patients with suspected sepsis who were admitted to a paediatric intensive care unit (PICU). We also investigated the association between vitamin D status and clinical outcomes.MethodsSerum 25‐hydroxy vitamin D (25OHD) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU. The relationship between 25OHD and clinical outcomes was evaluated. Vitamin D status was also assessed in control children of a similar age.ResultsWe enrolled 120 children with suspected sepsis admitted to the PICU and 30 paediatric controls. 25OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25OHD was strongly associated with culture positive sepsis (p < 0.001), the paediatric index of mortality (p = 0.026) and the duration of mechanical ventilation (p = 0.008). There was a negative correlation between 25OHD and C‐reactive protein (CRP): each 0.1% decrease in 25OHD increased CRP (p = 0.04).ConclusionChildren admitted to the PICU with suspected sepsis had lower 25OHD than controls and inadequate 25OHD status was associated with confirmed sepsis and poor outcomes.
Sinonasal yolk sac (Endodermal sinus) tumor in an adult female – A case report and review of the literature
Authors: Mei Xianglin , Xia Yang , Sasano Hironobu , Gao Hongwen 
Published: June 2015

Yolk sac tumor (YST), also known as endodermal sinus tumor, is a highly malignant germ cell tumor that is extremely rare in the sinonasal region, especially in adults. To the best of our knowledge, only five such cases have been reported till date (four men, one woman). We present a case of sinonasal YST admixed with transitional cell carcinoma in a 58‐year‐old female. Magnetic resonance imaging revealed a mass in the right ethmoid fissure infiltrating into the posterior and anterior ethmoid sinuses and nasopharynx. Positron emission tomography examination showed a maximum standardized uptake value of 6.8. Histological examination of the biopsy specimen revealed two distinct features, YST and transitional cell carcinoma, with evidence of mutual transition that indicated the composite nature of the tumor. Immunohistochemical analysis revealed positive immunoreactivity for Sal‐like protein 4, α‐fetoprotein and glypican3, and negative immunoreactivity for placental alkaline phosphatase, CD30 and CD117 in the YST component. P40 and P63 were detected only in transitional cell carcinoma component. The tumor was subsequently excised and four cycles of adjuvant chemotherapy at intervals of 3 weeks were administered. At 8 months after surgery, there was no evidence of tumor recurrence or metastasis. We have also presented a literature review on YST in sinusoids.
Risk factors contributing to postoperative delirium in geriatric patients postorthopedic surgery
Authors: Wang Juan , Li Zhiwei , Yu Yu , Li Bo , Shao Gaohai , Wang Qunbo 
Published: June 2015

AbstractIntroductionPostoperative delirium is a common clinical manifestation in geriatric patients, resulting in prolonged hospitalization and increased economic burden, in addition to higher morbidity and mortality rates. Therefore, identifying non‐obvious risk factors that contribute to the development of postoperative delirium in geriatric patients is crucial.MethodsFrom January 2011 to June 2013, 200 geriatric patients of over 65 years of age scheduled for orthopedic surgery were randomly selected and statistically analyzed with respect to the effects of the following 12 factors on postoperative delirium: sex, age, anesthesia type, surgical type (i.e. spine, hip replacement, and pelvic or femoral fracture repair), operative duration, intraoperative hypoxia, intraoperative hypercapnia, intraoperative hypotension, intraoperative blood loss, preoperative affective state, postoperative sleep disorders, and underlying disease (i.e. hypertension, coronary heart disease, diabetes, hyperlipidemia, and chronic bronchitis).ResultsSeven factors – age, anesthesia type, duration of operation, intraoperative hypercapnia, intraoperative hypotension, preoperative affective state, and postoperative sleep disorders – were found to be significantly differentiated, suggesting that these factors have an impact on the development of postoperative delirium. Sex, surgical type, intraoperative hypoxia, intraoperative blood loss (with 300 ml as a cutoff value), and underlying disease were not directly related to the development of postoperative delirium.DiscussionAdvanced age (>70 years), the use of general anesthesia, longer surgical duration (>3 hours), the presence of intraoperative hypercapnia and hypotension, the presence of preoperative affective dysfunction, and the presence of postoperative sleep disorders appear to be associated with the development of postoperative delirium in geriatric patients after orthopedic surgery.
Maternal Physical Health Symptoms in the First 8 Weeks Postpartum Among Primiparous Australian Women
Authors: Cooklin Amanda R. , Amir Lisa H. , Jarman Jennifer , Cullinane Meabh , Donath Susan M. ,   The CASTLE Study Team
Published: June 2015

AbstractBackgroundTo describe prospectively the extent, onset, and persistence of maternal physical health symptoms (cesarean delivery pain, perineal pain, back pain, constipation, hemorrhoids, urinary incontinence, bowel incontinence, and fatigue) in the first 8 weeks postpartum.MethodsA prospective cohort of 229 primiparous women was recruited antenatally from a public and a private maternity hospital, Melbourne, Australia, between 2009 and 2011. Data were collected by self‐report questionnaires at weeks 1, 2, 3, 4, and 8.Main outcome measures were a checklist of maternal health symptoms and a standardized assessment of fatigue symptoms.ResultsBirth‐related pain was common at week 1 (n = 80/88, 91% cesarean delivery pain; n = 92/125, 74% perineal pain), and still present for one in five women who had a cesarean birth (n = 17, 18%) at week 8. Back pain was reported by approximately half the sample at each study interval, with 25 percent (n = 48) reporting a later onset at week 2 or beyond. Fatigue was not relieved between 4 and 8 weeks.ConclusionsWomen experience significant morbidity in the early weeks postpartum, the extent of which may have been underestimated in previous research relying on retrospective recall. Findings contribute to the growing body of evidence that supports early identification, treatment, and support for women's physical health problems in the postpartum.
Immunotherapy with CpG‐ODN in neoplastic meningitis: A phase I trial
Authors: Ursu Renata , Taillibert Sophie , Banissi Claire , Vicaut Eric , Bailon Olivier , Le Rhun Emilie , Guillamo Jean‐Sebastien , Psimaras Dimitri , Tibi Annick , Sacko Adama , Marantidou Athina , Belin Catherine , Carpentier Antoine F. 
Published: June 2015

TLR‐9 agonists are immunostimulating agents that have antitumor effects in animal models. A phase I trial was conducted to define the safety profile of subcutaneous injections, combined with intrathecally administration of CpG‐28, a TRL 9 agonist, in patients with neoplastic meningitis (NM). Cohorts of 3–6 patients with NM were treated for 5 weeks with escalating doses of CpG‐28. The primary endpoint was tolerance. Secondary endpoints were progression free survival (PFS) and overall survival (OS). Twenty‐nine patients were treated with CpG‐28. The primary cancers were malignant glioma, lung carcinoma, breast cancer, melanoma or melanocytoma, ependymoma, and colorectal cancer. The median age was 56 years and median Karnovsky Performance status (KPS) was 70%. The treatment was well tolerated. Adverse effects that were possibly or probably related to the studied drug were grade 2 lymphopenia, anemia and neutropenia, local erythema at injection sites, fever and seizure. There were five serious adverse events: two confusions, two infections of ventricular devices and one grade 4 thrombopenia and neutropenia. The median PFS was 7 weeks and median OS was 15 weeks. Interestingly, the median survival was slightly (but not significantly) higher in the eight patients who were concomitantly treated with bevacizumab (19 weeks vs 15 weeks; P = 0.11). CpG‐28 was well tolerated at doses up to 0.3 mg/kg subcutaneously and 18 mg intrathecally. Additional trials are warranted.
Is the association between socioeconomic status and nonreplaced extracted teeth mediated by dental care behaviours in adults?
Authors: Ghorbani Zahra , Peres Karen G. 
Published: June 2015

AbstractObjectiveTo investigate whether the association between socioeconomic status (SES) and number of nonreplaced extracted teeth (NRET) is mediated by dental care behaviours (DCBs) in adults.MethodsA random sample of adults, who participated in the 2010 dental telephone survey (n = 1100) in Tehran, Iran, was investigated. The outcome was self‐reported NRET due to dental caries or periodontal diseases. The main exposures were wealth index and education; and the potential mediators were the frequency of tooth brushing and flossing, and dental visiting in the previous year of the study. Multivariable regression analysis was applied to test mediation using the count ratios (CR) and 95% confidence intervals (CI).ResultsThe response rate was 73%. The mean age was 38.99 (SD=13.83), and 50.8% were female. The mean NRET were 1.28 (95% CI 1.14; 1.41). NRET were greater among participants who had less than 12 years of schooling [CR = 4.26 (95% CI 3.52; 5.52)] and those in the poorest quintile [CR = 1.89 (95% CI 1.36; 2.61)] compared with those in the most educated and wealthiest groups, respectively. People who brushed their teeth less than twice a day [CR = 1.38 (95% CI 1.17; 1.62)] and did not use dental floss daily [CR = 1.47 (95% CI 1.24; 1.75)] were more likely to present NRET. After controlling for DCBs, a slight decrease in the CRs was observed for both the poorest (13.3%) and the less than 12 years of schooling (7.6%) groups compared to the reference groups.ConclusionsAlthough DCBs were associated with both SES and NRET, they could only be partially accountable for the observed socioeconomic inequalities in NRET.