bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bactericidal Activities of Health‐Promoting, Food‐Derived Powders Against the Foodborne Pathogens Escherichia coli, Listeria monocytogenes, Salmonella enterica, and Staphylococcus aureus
Authors: Friedman Mendel , Henika Philip R. , Levin Carol E. 
Published: January 2013

AbstractWe evaluated the relative bactericidal activities (BA50) of 10 presumed health‐promoting food‐based powders (nutraceuticals) and, for comparison, selected known components against the following foodborne pathogens: Escherichia coli O157:H7, Salmonella enterica, Listeria monocytogenes, and Staphylococcus aureus. The relative activities were evaluated using quantitative bactericidal activity [(BA50 value, defined as the percentage of the sample in the assay mixture that resulted in a 50% decrease in colony forming units]. The BA50 values were determined by fitting the data to a sigmoidal curve by regression analysis using concentration–antimicrobial response data. Antimicrobial activity is indicated by a low BA50 value; meaning less material is needed to kill 50% of the bacteria. Olive pomace, olive juice powder, and oregano leaves were active against all 4 pathogens, suggesting that they behave as broad‐spectrum antimicrobials. All powders exhibited strong antimicrobial activity against S. aureus. The following powders showed exceptionally high activity against S. aureus (as indicated by the low BA50 values shown in parentheses): apple skin extract (0.002%); olive pomace (0.008%); and grape seed extract (0.016%). Listeria bacteria were also highly susceptible to apple skin extract (0.007%). The most active substances provide candidates for the evaluation of antimicrobial effectiveness in human food and animal feed.Practical Application: Plant‐derived health‐promoting food supplements, high in bioactive compounds, are candidates for use as antimicrobials in food.
Emergency Research: Using Exception from Informed Consent, Evaluation of Community Consultations
Authors: Govindarajan Prasanthi , Dickert Neal W. , Meeker Michele , De Souza Natalie , Harney Deneil , Hemphill Claude J. , Pentz Rebecca 
Published: January 2013

AbstractBackgroundIn 1996, the U.S. Food and Drug Administration approved regulations authorizing an exception from informed consent (EFIC) for research conducted in emergency settings when obtaining prospective informed consent is not possible due to the potential subject's critical illness or injury. The regulations require that investigators conduct community consultation (CC) efforts before initiating a study and require that institutional review boards review the results of CC prior to approving a study. However, little is known about how communities view EFIC research or the CC process.ObjectivesThe objective was to assess the views of CC meeting attendees regarding the CC process, their understanding and views of EFIC research relating to the specific research trial under discussion, and their level of trust in physician‐investigators.MethodsFollowing CC meetings at two study sites (San Francisco and Atlanta) for the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART), an active comparison, randomized trial of prehospital treatment for status epilepticus, the authors administered a pair of surveys to participants. One survey focused on CC experiences (CC survey) and trust in physician‐investigators; the second assessed participants' understanding of EFIC and the RAMPART clinical trial design (EFIC survey).ResultsA total of 317 individuals participated in one of the two most popular types of CC meetings (group meetings and focus group sessions) at both sites. A total of 189 participants (59%) completed the CC survey and trust questions, and 297 (92%) completed the EFIC survey. Of those who completed the CC survey, 173 of 189 (92%) were very satisfied with the meeting, and 174 of 189 (92%) felt that they learned a lot about research at the meeting. A total of 169 of 189 participants (88%) felt that researchers heard the community's concerns, while only 106 of 189 (56%) said researchers would be willing to make changes to the study based on their concerns. Of those who completed the EFIC survey, 261 of 297 (88%) supported the study, 207 of 297 (70%) said they would agree to participate in the study, and 203 of 297 (68%) reported that they would agree to consent a loved one into the study. On a recently validated scale measuring trust in physician‐investigators, participants at both sites seemed to have higher levels of trust in physician‐investigators than the validation study population.ConclusionsOverall, members of these two communities expressed satisfaction with the CC session and had relatively high levels of support for the study and trust in physician‐investigators.
Primary Versus Secondary Closure of Cutaneous Abscesses in the Emergency Department: A Randomized Controlled Trial
Authors: Singer Adam J. , Taira Breena R. , Chale Stuart , Bhat Rahul , Kennedy David , Schmitz Gillian 
Published: January 2013

AbstractObjectivesCutaneous abscesses have traditionally been treated with incision and drainage (I&D) and left to heal by secondary closure. The objective was to compare the healing rates of cutaneous abscesses following I&D after primary or secondary closure.MethodsThis was a randomized, controlled, trial, balanced by center, with blocked randomization created by a random‐number generator. One urban and one suburban academic emergency department (ED) participated. Subjects were randomized to primary or secondary wound closure following I&D of the abscess. Main outcome measures were the percentage of healed wounds (wound was completely closed by visual inspection; a 40% difference in wound healing was sought) and overall failure rate (need for additional intervention including suture removal, additional drainage, antibiotics, or admission within 7 days after drainage).ResultsFifty‐six adult patients with simple localized cutaneous abscesses were included; 29 were randomized to primary closure, and 27 were randomized to secondary closure. Healing rates at 7 days were similar between the primary and secondary closure groups (69.6%, 95% confidence interval [CI] = 49.1% to 84.4% vs. 59.3%, 95% CI = 40.7% to 75.5%; difference 10.3%, 95% CI = −15.8% to 34.1%). Overall failure rates at 7 days were also similar between the primary and secondary closure groups (30.4%, 95% CI = 15.6% to 50.9% vs. 28.6%, 95% CI = 15.2% to 47.1%; difference 1.8%, 95% CI = −24.2% to 28.8%).ConclusionsThe rates of wound healing and treatment failure following I&D of simple abscesses in the ED are similar after primary or secondary closure. The authors did not detect a difference of at least 40% in healing rates between primary and secondary closure.
Frequent Emergency Department Use Among Released Prisoners With Human Immunodeficiency Virus: Characterization Including a Novel Multimorbidity Index
Authors: Meyer Jaimie P. , Qiu Jingjun , Chen Nadine E. , Larkin Gregory L. , Altice Frederick L. 
Published: January 2013

AbstractObjectivesThe objective was to characterize the medical, social, and psychiatric correlates of frequent emergency department (ED) use among released prisoners with human immunodeficiency virus (HIV).MethodsData on all ED visits by 151 released prisoners with HIV on antiretroviral therapy (ART) were prospectively collected for 12 months. Correlates of frequent ED use, defined as having two or more ED visits postrelease, were described using univariate and multivariate models and generated medical, psychiatric, and social multimorbidity indices.ResultsForty‐four (29%) of the 151 participants were defined as frequent ED users, accounting for 81% of the 227 ED visits. Frequent ED users were more likely than infrequent or nonusers to be female; have chronic medical illnesses that included seizures, asthma, and migraines; and have worse physical health‐related quality of life (HRQoL). In multivariate Poisson regression models, frequent ED use was associated with lower physical HRQoL (odds ratio [OR] = 0.95, p = 0.02) and having not had prerelease discharge planning (OR = 3.16, p = 0.04). Frequent ED use was positively correlated with increasing psychiatric multimorbidity index values.ConclusionsAmong released prisoners with HIV, frequent ED use is driven primarily by extensive comorbid medical and psychiatric illness. Frequent ED users were also less likely to have received prerelease discharge planning, suggesting missed opportunities for seamless linkages to care.
Diagnostic Accuracy of History, Physical Examination, and Bedside Ultrasound for Diagnosis of Extremity Fractures in the Emergency Department: A Systematic Review
Authors: Joshi Nikita , Lira Alena , Mehta Ninfa , Paladino Lorenzo , Sinert Richard 
Published: January 2013

AbstractObjectivesUnderstanding history, physical examination, and ultrasonography (US) to diagnose extremity fractures compared with radiography has potential benefits of decreasing radiation exposure, costs, and pain and improving emergency department (ED) resource management and triage time.MethodsThe authors performed two electronic searches using PubMed and EMBASE databases for studies published between 1965 to 2012 using a strategy based on the inclusion of any patient presenting with extremity injuries suspicious for fracture who had history and physical examination and a separate search for US performed by an emergency physician (EP) with subsequent radiography. The primary outcome was operating characteristics of ED history, physical examination, and US in diagnosing radiologically proven extremity fractures. The methodologic quality of the studies was assessed using the quality assessment of studies of diagnostic accuracy tool (QUADAS‐2).ResultsNine studies met the inclusion criteria for history and physical examination, while eight studies met the inclusion criteria for US. There was significant heterogeneity in the studies that prevented data pooling. Data were organized into subgroups based on anatomic fracture locations, but heterogeneity within the subgroups also prevented data pooling. The prevalence of fracture varied among the studies from 22% to 70%. Upper extremity physical examination tests have positive likelihood ratios (LRs) ranging from 1.2 to infinity and negative LRs ranging from 0 to 0.8. US sensitivities varied between 85% and 100%, specificities varied between 73% and 100%, positive LRs varied between 3.2 and 56.1, and negative LRs varied between 0 and 0.2.ConclusionsCompared with radiography, EP US is an accurate diagnostic test to rule in or rule out extremity fractures. The diagnostic accuracy for history and physical examination are inconclusive. Future research is needed to understand the accuracy of ED US when combined with history and physical examination for upper and lower extremity fractures.
Risk Factors for Radiocontrast Nephropathy After Emergency Department Contrast‐enhanced Computerized Tomography
Authors: Traub Stephen J. , Kellum John A. , Tang Aimee , Cataldo Lauren , Kancharla Adarsh , Shapiro Nathan I. 
Published: January 2013

AbstractObjectivesRadiocontrast nephropathy (RCN) is a known complication of procedures in which intravascular iodinated contrast material is used. The authors sought to determine the risk factors for RCN after emergency department (ED) contrast‐enhanced computerized tomography (CECT).MethodsThis was a retrospective case–control study of patients presenting to a tertiary care ED between January 1, 2004, and December 31, 2006. Inclusion criteria were CECT performed in the ED, serum creatinine measured prior to CECT, and serum creatinine measured 48 to 96 hours after CECT. Exclusion criterion was dialysis‐dependent renal failure prior to CECT. The outcome of RCN was defined as an absolute creatinine increase of greater than or equal to 0.5 mg/dL, or a 25% increase above baseline. The charts of all RCN patients and a random sample of non‐RCN patients were reviewed to document the presence or absence of potential risk factors. Univariate analysis was performed using chi‐square and multiple logistic regression applying a weighted technique to account for sampling of non‐RCN patients.ResultsAmong the 5,006 patients meeting inclusion criteria, 349 (7%) developed RCN. Multiple regression analysis demonstrated that serum creatinine > 2 mg/dL, liver disease, heart failure, hematocrit < 30%, hypertension, and diabetes were risk factors for RCN, whereas age > 75 years, vascular disease, and serum creatinine > 1.5 mg/dL were not. The area under the curve (AUC) for the model was 0.65. Although the risk of RCN increased with the number of risk factors present, we could not develop a model with sufficient diagnostic accuracy to guide clinical decision‐making.ConclusionsThe authors report risk factors for RCN in a large case–control study, but could not develop an accurate decision tool to identify patients at increased risk for RCN after ED CECT.
Comparison of Clinical Features and Outcomes of Hospitalized Adult Patients With Novel Influenza A (H1N1) Pneumonia and Other Pneumonia
Authors: Sohn Chang Hwan , Ryoo Seung Mok , Yoon Ji Young , Seo Dong Woo , Lim Kyoung Soo , Kim Sung Han , Hong Sang Bum , Lim Chae Man , Koh Youn Suck , Kim Won Young 
Published: January 2013

AbstractObjectivesA novel swine‐origin influenza A (H1N1) virus caused worldwide outbreaks starting in April 2009. The aim of this study was to evaluate the clinical characteristics and outcomes of pandemic 2009 H1N1 pneumonia by comparing to community‐acquired pneumonia (CAP) of other origin.MethodsThe authors conducted a prospective cohort study of consecutive adult (over 15 years old) patients with suspected CAP requiring admission to a tertiary university‐affiliated hospital during the second wave of pandemic 2009 H1N1 influenza. Based on the results of real‐time reverse transcriptase–polymerase chain reaction (RT‐PCR) analysis, the staff completed a standard assessment form and managed the patients according to a uniform protocol. Clinical characteristics, as well as laboratory and radiologic findings, were collected and compared between pandemic 2009 H1N1 pneumonia and CAP of other origin. The primary outcome was in‐hospital mortality and secondary outcomes were duration of hospitalization, duration of intensive care unit (ICU) stay, and requirement of mechanical ventilation.ResultsA total of 135 patients with suspected CAP were included in the study. Of these, 59 patients were RT‐PCR positive for H1N1 virus, and 76 patients were RT‐PCR negative. Patients with H1N1 pneumonia were significantly younger than those with CAP of other origin (46.0 years vs. 68.0 years, p < 0.01) and more frequently had nonspecific symptoms (p < 0.01), initial leukopenia (8.5% vs. 0.0%, p = 0.01), lymphopenia (45.8% vs. 26.3%, p = 0.02), low values of C‐reactive protein (CRP; 5.2 mg/dL vs. 13.4 mg/dL, p = 0.02), bilateral abnormalities (57.7% vs. 29.7%, p < 0.01) on chest radiography, ground glass opacities (43.9% vs. 12.8%, p < 0.01) on chest computed tomography, and low values of pneumonia severity index (PSI) score (56.0 vs. 91.0, p < 0.01) than those with CAP of other origin. However, there were no significant differences in infection severity, clinical outcome, length of ICU stay, requirement for mechanical ventilation, and mortality between the two groups.ConclusionsThis study shows that clinical characteristics and outcomes of 2009 H1N1 pneumonia are comparable to those of CAP of other origin. However, some characteristics, including younger age, nonspecific symptoms (including headache, leukopenia, and fatigue), lymphopenia, lower initial CRP and PSI score, and radiologic findings (including bilateral abnormalities and ground glass opacities), may help clinicians to diagnostically differentiate between H1N1 pneumonia and CAP of other origin before the result of RT‐PCR are obtained.
A Regional Survey to Determine Factors Influencing Patient Choices in Selecting a Particular Emergency Department for Care
Authors: Grafstein Eric , Wilson Danielle , Stenstrom Rob , Jones Catherine , Tolson Margreth , Poureslami Iraj , Scheuermeyer Frank Xavier 
Published: January 2013

AbstractObjectivesIncreases in regional emergency department (ED) efficiencies might be obtained by shifting patients to less crowded EDs. The authors sought to determine factors associated with a patient's decision to choose a specific regional ED. Based on prior focus group discussions with volunteers, the hypothesis was that distance to a specific ED and perceived ED wait times would be important.MethodsA cross‐sectional survey was developed using qualitative focus group methodology. The resulting survey was composed of 17 questions relating to patient decisions in choosing a specific ED and was administered in each of six EDs in a single urban Canadian health region at all hours of the day. Ambulatory patients with a Canadian Triage and Acuity Scale (CTAS) level 3 to 5 and aged ≥19 years were surveyed. The primary outcome was the proportion of patients whose main motivation for attending a specific ED was either distance traveled to reach the ED or perceived ED waiting time. Multivariable logistic regression was performed to assess factors influencing both of these reasons.ResultsA total of 757 patients were approached and 634 surveys (83.8%) were completed. Distance from the ED (named by 44.0% of respondents as their primary reason) and perceived ED wait times (9.3%) were the main motivations for patients to attend a specific ED. Multivariable analysis of factors associated with choosing distance revealed that ED distance < 10 km (adjusted odds ratio [OR] = 2.20, 95% confidence interval [CI] = 1.45 to 3.33; p = 0.001) and age ≥ 60 years (adjusted OR = 1.58, 95% CI = 1.12 to 2.26; p = 0.04) were significant in choosing a particular ED. Multivariable analysis of factors influencing wait times demonstrated that having a painful complaint (adjusted OR = 1.42, 95% CI = 1.05 to 1.98; p = 0.047) and age < 60 years (OR = 1.47, 95% CI = 1.02 to 2.14; p = 0.049) were significant in choosing a particular ED.ConclusionsIn a multicenter survey of patients from an urban health region, distance to a specific ED and perceived ED wait times were the most important reasons for choosing that ED. Younger patients and those with painful conditions appear to place greater priority on wait times.
Alcohol Outlet Densities and Alcohol Price: TheBritishColumbia Experiment in the Partial Privatization of Alcohol Sales Off‐Premise
Authors: Treno Andrew J. , Ponicki William R. , Stockwell Tim , Macdonald Scott , Gruenewald Paul J. , Zhao Jinhui , Martin Gina , Greer Alissa 
Published: January 2013

BackgroundAlcohol beverage prices or taxes have been shown to be related to alcohol sales and use and related problems. What is not clear are the mechanisms underlying these relationships.MethodsThis study examines the relationship between alcohol outlet density under conditions of the partial privatization of off‐premise consumption inBritishColumbia (BC) occurring over the past decade. Two hypotheses are tested. First, reflecting basic supply–demand principles, greater geographic densities of alcohol outlets will be directly related to reductions in beverage prices in response to greater competition. Second, reflecting the effects of niche marketing and resulting market stratification, increased densities of private liquor stores will be especially related to reductions in beverage prices within this outlet category. Data were collected from: (i) a survey ofBCprivate store prices and practices, (ii) alcohol outlet location information, and (iii) data on demographic characteristics. Multilevel models examine the relationships between prices at individual private liquor stores and the densities of government liquor stores, private liquor stores, bars, and restaurants, controlling for background demographics and geographic unit level effects. Spatial dependencies were also examined.ResultsIncreased densities of private liquor stores were associated with lower mean prices of beer and all alcohol aggregated across brands at the store level. There appeared to be no outlet level effect on discounting patterns, however, with the mean price differences apparently reflecting differences in the quality of brands carried rather than unequal prices for any given brand.ConclusionsIncreased densities of private off‐sale alcohol outlets appear to result in lower prices charged at said establishments independently of other types of alcohol outlets suggesting that they represent an emerging marketing niche in the context of off‐sale outlet privatization.
Childhood sexual abuse and early substance use in adolescent girls: the role of familial influences
Authors: Sartor Carolyn E. , Waldron Mary , Duncan Alexis E. , Grant Julia D. , McCutcheon Vivia V. , Nelson Elliot C. , Madden Pamela A. F. , Bucholz Kathleen K. , Heath Andrew C. 
Published: January 2013

AbstractAimTo assess the extent to which the association between childhood sexual abuse (CSA) and early use of alcohol, cigarettes and cannabis in adolescent girls is mediated by risk factors that tend to cluster in families where CSA occurs.DesignAn abridged version of the Semi‐Structured Assessment for the Genetics of Alcoholism (SSAGA) was administered by telephone.ParticipantsA total of 3761 female twins aged 18–29 (14.6% African American, 85.4% European American).MeasurementsCSA experiences and history of substance use were queried in the SSAGA‐based interviews.FindingsAfter controlling for familial influences on early substance use by including co‐twin early use status in models, separate Cox proportional hazards regression analyses predicting onset of alcohol, cigarette and cannabis use revealed a significant association with CSA. The effect was observed to age 19 years for cigarettes and to age 21 years for cannabis, but was limited to age 14 years or younger for alcohol, with the most pronounced risk before age 10 [hazard ratio (HR) = 4.59; confidence interval (CI): 1.96–10.74]. CSA‐associated risk for initiation of cigarette and cannabis use was also highest in the youngest age range, but the decline with age was much more gradual and the hazard ratios significantly lower (HR: 1.70; CI: 1.13–2.56 for cigarettes and HR: 2.34, CI: 1.57–3.48 for cannabis).ConclusionsChildhood sexual abuse history is a distinct risk factor for use of cigarettes and cannabis, and a very strong predictor of early age at first drink.