bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for 48-hours mortality after prehospital treatment of opioid overdose
Authors: Wichmann Sine , Nielsen Søren Loumann , Siersma Volkert Dirk , Rasmussen Lars S 
Published: April 2012

IntroductionOpioid overdose is commonly treated by prehospital emergency services and the majority of the patients are discharged immediately after treatment and a short observation period. There is a minor risk for rebound opioid toxicity and other life-threatening conditions might occur after such episodes. The authors describe the short-term outcome and identify risk factors for death within 48 h after prehospital treatment of opioid overdose in Copenhagen, the capital of Denmark.MethodsData on all cases of opioid overdose treated by the medical emergency care unit between 1994 and 2003 were recorded prospectively. Risk factors for death within 48 h after initial medical emergency care unit contact were analysed in a multivariable logistic regression analysis.ResultsThe authors recorded 4762 episodes of opioid overdose, covering 1967 unique identified patients. A total of 78 patients (8.4%, 95% CI 7.0 to 10.4) died within 48 h in the period 1999–2003, and 85% (66/78) of these had cardiac arrest and died. The authors found age >50 years and overdose during the weekend significantly associated with 48-h mortality. Gender, former episodes of opioid overdose, time of the day, month or year were not significantly associated with increased mortality.ConclusionsThe author found a 48-hours mortality of 8.4%. Advanced age and opioid overdose in the weekends were significant risk factors. Release on scene after treatment was associated with a very small risk.
Are the public ready for organ donation after out of hospital cardiac arrest?
Authors: Bruce Caroline M , Reed Matthew James , MacDougall Margaret 
Published: April 2012

ObjectiveTo assess Emergency Department (ED) relatives' and patients' opinions on: (1) discussing organ donation (OD) with relatives soon after ED death after cardiac arrest and (2) acceptability of organ preservation procedures both before and after discussion with relatives.MethodsQuestionnaire study; convenience sample.Results200 questionnaires were completed. 37.5% of participants were male subjects; mean age was 40.4 (SD 16.9; range 15–85) years. There was no difference in the number willing to discuss OD after brainstem death in intensive care unit compared with circulatory death in the ED (72% vs 72%; p=0.146). The majority were willing to discuss OD soon after ED death after cardiac arrest (106; 54%). 41 (21%) were not willing and 43 (22%) had no strong views (n=198). Organ preservation procedures (groin tube insertion, continuation of mechanical cardiopulmonary resuscitation and continuation of ventilator) were acceptable to between 48% and 57% of respondents if performed before discussion with family increasing to an acceptability of between 64% and 69% after discussion with family. One in four respondents felt these procedures were not acceptable regardless of the timing of discussion with family and some felt these procedures were more acceptable if the patient was a registered organ donor. 122 (61%) patients wished to donate their organs after death but only 59 (30%) were registered donors.Conclusions(1) The majority of patients and their relatives are not averse to OD being discussed shortly after ED death. (2) Organ preservation procedures are acceptable to many. Prior discussion and prior organ donor registration may improve acceptability.
Improving the quality of road injury statistics by using regression models to redistribute ill-defined events
Authors: Shahraz Saeid , Bhalla Kavi , Lozano Rafael , Bartels David , Murray Christopher J L 
Published: April 2012

ObjectiveTo test the predictive ability of multinomial regression method in obtaining category of death distribution for cases with unknown/ill-defined mortality codes.MethodsThe authors evaluated the performance of the multinomial regression model by fitting the model to trial datasets from 2004 Mexican vital registration data. To predict category of death, the regression method makes use of explanatory variables, such as gender, age, place of crash, place of residence, education and insurance type. The authors compared the results of a full model regression with those of a reduced model that only contained gender and age as explanatory variables. For this comparison, the authors constructed two forms of data: dummy variable adjustment method and case-wise deleted method. The comparison was made through estimated area under the curve (AUC) for each outcome variable.ResultsThe full model significantly outperformed the gender-age (reduced) model using both datasets. In the case-wise deleted method, the AUC was increased from 0.55 to 0.7 for the reduced model and from 0.64 to 0.84 for the full model. Improvement in AUC using the dummy variable adjustment method was less significant.ConclusionsTo predict ill-defined categories of death, adding relevant explanatory variables to gender and age is recommended. Multiple imputations may perform even better than this model especially when significant portion of the data are missing.
Postnatal contraceptive choices among women living with HIV: a decade of experience in a community-based integrated sexual health clinic
Authors: Duncan Sarah , Hawkins Fran , Desmond Noreen 
Published: April 2012

BackgroundEstablishing effective postnatal contraception is essential for HIV-seropositive women to avoid the risk of unwanted pregnancy and minimise HIV transmission to HIV-seronegative partners. The authors describe their experience of providing postnatal contraception to HIV-seropositive women who attend a community-based integrated sexual health clinic.MethodsThe authors performed a retrospective case note review of all women who received care for HIV in pregnancy to term at their clinic from September 2000 to October 2010.ResultsA total of 107 pregnancies among 95 women were eligible for review. Attendance for contraceptive advice within 4 weeks of delivery occurred in 82/107 (77%) pregnancies. Depo-Provera® was prescribed in 21 (21/82, 26%) cases; an intrauterine contraceptive was arranged in 22/82 (27%) cases and sterilisation had occurred as part of a Caesarean delivery in 10/82 (12%) cases. In seven women who discontinued antiretroviral therapy at delivery one subdermal implant was fitted and the combined contraceptive pill was prescribed six times. In 17/82 (21%) cases women opted to use condoms alone. Attendance for postpartum contraceptive advice was missed following 21/107 (20%) pregnancies.ConclusionsUptake of a second contraceptive method in addition to condoms is high among women who attend clinic for contraceptive advice in the immediate postnatal period. However, 20% of women did not attend and their contraceptive choices remain unknown. These women are at risk of unwanted pregnancy and transmission of HIV to seronegative partners if appropriate contraceptive methods are not re-established postpartum.
Cell-Mediated Autophagy Promotes Cancer Cell Survival
Authors: Buchser William J. , Laskow Thomas C. , Pavlik Philip J. , Lin Hui-Min , Lotze Michael T. 
Published: April 2012

Abstract
Immune effector cells integrate signals that define the nature and magnitude of the subsequent response. Experimental measures for immune cell–mediated lysis of tumors or virally infected targets rely on average responses of permeability or apoptotic changes within a population of targets. Here, we examined individual target cells following interaction with lymphoid effectors. We found that human peripheral blood lymphocytes not only provide lytic signals but also promote autophagy in the remaining cells. At high effector-to-target ratios, autophagy was induced in several human tumors, as assessed by induction of LC3 puncta and diminished p62. Natural killer cells are a primary mediator of this process. In addition, target cell autophagy was enhanced by provision of interleukin (IL)-2, whereas IL-10 attenuated this effect, and cell-to-cell contact strongly enhanced lymphocyte-mediated autophagy. Although IFN-γ can induce autophagy in target cells, IFN-α acted directly on the targets or in concert with lymphocytes to diminish target autophagy in some cell types. Importantly, cell-mediated autophagy promoted resistance from treatment modalities designed to eradicate tumor cells. Our findings therefore show that the lymphocyte-induced cell-mediated autophagy promotes cancer cell survival and may represent an important target for development of novel therapies. Cancer Res; 72(12); 2970–9. ©2012 AACR.
ESE3/EHF Controls Epithelial Cell Differentiation and Its Loss Leads to Prostate Tumors with Mesenchymal and Stem-like Features
Authors: Albino Domenico , Longoni Nicole , Curti Laura , Mello-Grand Maurizia , Pinton Sandra , Civenni Gianluca , Thalmann George , D'Ambrosio Gioacchino , Sarti Manuela , Sessa Fausto , Chiorino Giovanna , Catapano Carlo V. , Carbone Giuseppina M. 
Published: April 2012

Abstract
Cancer stem cells (CSC) play a significant role in tumor progression, disease recurrence, and treatment failure. Here, we show that the endogenously expressed ETS transcription factor ESE3/EHF controls prostate epithelial cell differentiation and stem-like potential. We found that loss of ESE3/EHF induced epithelial-to-mesenchymal transition (EMT), stem-like features, and tumor-initiating and metastatic properties in prostate epithelial cells, and reexpression of ESE3/EHF inhibited the stem-like properties and tumorigenic potential of prostate cancer cells. Mechanistically, ESE3/EHF repressed the expression of key EMT and CSC genes, including TWIST1, ZEB2, BMI1, and POU5F1. Analysis of human tissue microarrays showed that reduced ESE3/EHF expression is an early event in tumorigenesis, frequently occurring independently of other ETS gene alterations. Additional analyses linked loss of ESE3/EHF expression to a distinct group of prostate tumors with distinctive molecular and biologic characteristics, including increased expression of EMT and CSC genes. Low ESE3/EHF expression was also associated with increased biochemical recurrence of prostate cancer and reduced overall survival after prostatectomy. Collectively, our findings define a key role for ESE3/EHF in the development of a subset of prostate tumors and highlight the clinical importance of identifying molecularly defined tumor subgroups. Cancer Res; 72(11); 2889–900. ©2012 AACR.
Analysis of Fcγ Receptor IIIa and IIa Polymorphisms: Lack of Correlation with Outcome in Trastuzumab-Treated Breast Cancer Patients
Authors: Hurvitz Sara A. , Betting David J. , Stern Howard M. , Quinaux Emmanuel , Stinson Jeremy , Seshagiri Somasekar , Zhao Ying , Buyse Marc , Mackey John , Driga Adrian , Damaraju Sambasivarao , Sliwkowski Mark X. , Robert Nicholas J. , Valero Vicente , Crown John , Falkson Carla , Brufsky Adam , Pienkowski Tadeusz , Eiermann Wolfgang , Martin Miguel , Bee Valerie , Marathe Omkar , Slamon Dennis J. , Timmerman John M. 
Published: April 2012

AbstractPurpose: The mechanisms by which trastuzumab imparts clinical benefit remain incompletely understood. Antibody-dependent cellular cytotoxicity via interactions with Fcγ receptors (FcγR) on leukocytes may contribute to its antitumor effects. Single-nucleotide polymorphisms (SNP) in FCGR3A and FCGR2A genes lead to amino acid substitutions at positions 158 and 131, respectively, and affect binding of antibodies to FcγR such that 158V/V and 131H/H bind with highest affinity. This study aimed to determine whether high-affinity SNPs are associated with disease-free survival (DFS) among patients with HER2-positive nonmetastatic breast cancer.Experimental Design: Genomic DNA was isolated from 1,286 patients enrolled in a trial of adjuvant trastuzumab-based chemotherapy. Genotyping was conducted using Sanger sequencing and Sequenom mass spectrometry.Results: Patient samples (N = 1,189) were successfully genotyped for FCGR3A and 1,218 for FCGR2A. Compared with the overall results of the BCIRG006 study, in the subset of patients genotyped in this analysis, a less robust improvement in DFS was observed for the trastuzumab arms than control arm (HR, 0.842; P = 0.1925). When stratified for prognostic features, the HR in favor of trastuzumab was consistent with that of the overall study (HR, 0.74; P = 0.036). No correlation between DFS and FCGR3A/2A genotypes was seen for trastuzumab-treated patients (158V/V vs. V/F vs. F/F, P = 0.98; 131H/H vs. H/R vs. R/R, P = 0.76; 158V/V and/or 131H/H vs. others, P = 0.67).Conclusion: This analysis evaluating the association between FCGR3A/2A genotypes and trastuzumab efficacy in HER2-positive breast cancer did not show a correlation between FCGR3A-V/F and FCGR2A-H/R SNPs and DFS in patients treated with trastuzumab. Clin Cancer Res; 18(12); 3478–86. ©2012 AACR.
A Common Variant in the
PTPN11
Gene Contributes to the Risk of Tetralogy of Fallot
Authors: Goodship Judith A. , Hall Darroch , Topf Ana , Mamasoula Chrysovalanto , Griffin Helen , Rahman Thahira J. , Glen Elise , Tan Huay , Palomino Doza Julian , Relton Caroline L. , Bentham Jamie , Bhattacharya Shoumo , Cosgrove Catherine , Brook David , Granados-Riveron Javier , Bu'Lock Frances A. , O'Sullivan John , Stuart A. Graham , Parsons Jonathan , Cordell Heather J. , Keavney Bernard 
Published: April 2012

Background—
Tetralogy of Fallot (TOF) is the commonest cyanotic form of congenital heart disease. In 80% of cases, TOF behaves as a complex genetic condition exhibiting significant heritability. As yet, no common genetic variants influencing TOF risk have been robustly identified.

Methods and Results—

Two hundred and seven haplotype-tagging single nucleotide polymorphisms in 22 candidate genes were genotyped in a test cohort comprising 362 nonsyndromic British white patients with TOF together with 717 unaffected parents of patients and 183 unrelated healthy controls. Single nucleotide polymorphisms with suggestive evidence of association in the test cohort (
P
<0.01) were taken forward for genotyping in an independent replication cohort comprising 392 cases of TOF, 218 unaffected parents of patients, and 1319 controls. Significant association was observed for 1 single nucleotide polymorphism, rs11066320 in the
PTPN11
gene, in both the test and the replication cohort. Genotype at rs11066320 was associated with a per-allele odds ratio of 1.34 (95% confidence interval [CI], 1.19 to 1.52;
P
=2.9×10
−6
) in the total cohort of TOF cases and controls; this remained highly significant after Bonferroni correction for 207 analyses (corrected
P
=0.00061). Genotype at rs11066320 was responsible for a population-attributable risk of TOF of approximately 10%.

Conclusions—

Common variation in the linkage disequilibrium block including the
PTPN11
gene contributes to the risk of nonsyndromic TOF. Rare mutations in
PTPN11
are known to cause the autosomal dominant condition Noonan syndrome, which includes congenital heart disease, by upregulating Ras/mitogen-activated protein kinase (MAPK) signaling. Our results suggest a role for milder perturbations in
PTPN11
function in sporadic, nonsyndromic congenital heart disease.
Warming of Western North Pacific Ocean and Energetics of Transient Eddy Activity
Authors: Heo Ki-Young , Ha Kyung-Ja , Lee Sun-Seon 
Published: April 2012

Abstract
This study examines the increase in the sea surface temperature (SST) in the western North Pacific Ocean (WNPO) during December–February for the period 1959–2008. The relationship of this SST increase with significant interdecadal changes in the baroclinicity and the energetics of transient eddy activity is also examined. These results show that the interannual variations of the WNPO SST and atmospheric conditions including baroclinicity and turbulent heat flux are responses to the upstream atmospheric forcings associated with the East Asian winter monsoon (EAWM). For the interdecadal variations, the intensified baroclinicity downstream of the Pacific storm-track activity is responsible for an increase in the baroclinic energy conversion (BCEC) from the mean available potential energy (MAPE) to the eddy available potential energy (EAPE) to the east of 180°. This in turn increases the BCEC from the EAPE to the eddy kinetic energy (EKE) over this region. The BCEC and generation of EAPE by diabatic heating are enhanced to the east of 180° as a result of the intensified baroclinicity. This could be responsible for the development of transient eddy activity downstream of the Pacific storm track over the North Pacific.
Reading the New Testament Household Codes in Light of New Research on Children and Childhood in the Roman World
Authors: MacDonald Margaret Y. 
Published: April 2012

The references to children and the child–parent relationship in the New Testament household codes (Col 3:20–21; Eph 6:1–4) have received little attention from scholars. Yet recent, cross-disciplinary interest in the study of children and childhood invites us to consider these exhortations afresh. In particular, current research in Roman Family Studies has led to greater appreciation of the multifaceted circumstances of children, raising new questions about the children who were addressed directly in the household codes of Colossians and Ephesians. Two themes are especially important to consider: (1) overlapping categories of identity tied especially to the complex structures of a slave-holding society; and (2) the household as a locus for education throughout the life course. Informed by current research on children and childhood, the household codes appear to be even more significant than was previously thought for understanding the place of house churches in the Roman imperial world. Les références aux enfants et la relation parent-enfant dans les codes domestiques du Nouveau Testament (Col 3.20–21; Ép 6.1–4) ont reçu peu d’attention des chercheurs. Pourtant, récemment, l’intérêt interdisciplinaire dans l’étude des enfants et de l’enfance nous invite à reconsidérer ces exhortations. En particulier, la recherche actuelle en études familiales romaines a conduit à une plus grande appréciation de la situation des enfants à multiples facettes, ce qui soulève de nouvelles questions sur les enfants qui ont été adressées directement dans les codes domestiques de Colossiens et Ephésiens. Deux thèmes sont particulièrement importants à considérer: (1) catégories qui se recoupent d’identité liée en particulier aux structures complexes d’une société esclavagiste, et (2) la maison comme un lieu d’éducation tout au long du cycle de la vie. Informé par la recherche actuelle sur les enfants et l’enfance, les codes domestiques semblent être encore plus importants qu’on ne le pensait pour comprendre la place des églises de maison dans le monde romain impérial.
Outcome of Nonoperative Treatment for Humeral Medial Epicondylar Fragmentation Before Epiphyseal Closure in Young Baseball Players
Authors: Harada Mikio , Takahara Masatoshi , Hirayama Tomoyuki , Sasaki Junya , Mura Nariyuki , Ogino Toshihiko 
Published: April 2012

Background: Nonoperative treatment for humeral medial epicondylar fragmentation in baseball players, involving prohibition and limitation of throwing, has been reported to give good results. However, in some cases, such nonoperative treatment fails to yield an acceptable outcome. Hypothesis: In nonoperative treatment for patients with medial epicondylar fragmentation, achievement of bone union of the fragmentation provides better clinical outcomes compared with those of patients with delayed bone union or nonunion. Study Design: Cohort study; Level of evidence, 3. Methods: Fifty-five young baseball players with medial epicondylar fragmentation before epiphyseal closure, aged between 9 and 13 years (mean, 11.0 years), participated in this study. They belonged to baseball teams in a youth league and underwent nonoperative treatment involving prohibition of throwing for an average of 2.0 months and subsequent limitation of throwing for an average of 1.8 months. We investigated whether achievement of bone union of the fragmentation was associated with better clinical outcomes. Results: Bone union was achieved in 40 (73%) of 55 participants at 6 months after initial presentation, 31 (76%) of 41 participants at 1 year, and 32 (94%) of 34 participants at 2 years. Elbow pain was present in 7 participants (17%) at 1 year after initial presentation and in 6 participants (18%) at 2 years. At 1 year after initial presentation, statistical analysis showed that most participants with elbow pain had significant fragmentation ( P = .0055). At 2 years after initial presentation, there was no significant relationship between elbow pain and medial epicondylar fragmentation ( P = .32). Statistical analysis also showed that, at both 6 months and 1 year after initial presentation, bone union was significantly delayed in most participants who had not accepted nonoperative treatment and consequently resumed throwing vigorously before bone union. Conclusion: At 1 year after initial presentation, bone union of the medial epicondylar fragmentation was correlated with a decreased prevalence of elbow pain. At 6 months and 1 year after initial presentation, delayed bone union of the medial epicondylar fragmentation was associated with resumption of throwing at maximum strength before bone union had occurred.
Multiprofessional Interventions to Improve Patient Adherence to Cardiovascular Medications
Authors: Mansoor Sarab M. , Krass Ines , Aslani Parisa 
Published: April 2012

Background: Poor adherence to medications is a significant health care issue, particularly among cardiovascular patients. A variety of interventions have been tested by researchers in an effort to identify the most effective approach to improving adherence. Interventions delivered by multiple health care professionals (HCPs) may have an impact on improving adherence to medications in patients with chronic conditions, although the evidence to support this is still limited. Objective: To investigate the impact of interventions delivered by HCPs within a multiprofessional team to improve patients’ adherence to cardiovascular disease medications in community settings. Search strategy: The search strategy involved the use of the following data bases: Google scholar, PubMed, Medline, Cinahl, Embase, IPA, and Cochrane Library, from 1994 to 2010. Search was restricted to articles published in English. Selection criteria: Cluster randomized trials, controlled randomized clinical trials, prospective randomized trials, and nonrandomized studies were included. We considered any intervention designed to enhance adherence to medication directed by more than 1 HCP. Results: We included 17 studies testing 3 different types of interventions directed by more than 1 HCP. The HCPs received a variety of training via educational lectures or interactive workshops. Informational, behavioral, and combined interventions were delivered to cardiovascular patients. The majority of studies using only informational interventions or a combination of behavioral and informational interventions showed improvements in clinical outcomes (ie, blood pressure and total cholesterol lowering). However, only 2 studies measured improvements in adherence but the results were not significant. In contrast, all interventions based on the behavior change strategies improved both clinical outcomes and adherence to medication. Conclusions: Behavioral interventions delivered by a multiprofessional team appear to offer the best opportunity to improve clinical outcomes through improvements in adherence. However, whether interventions delivered by a multiprofessional team are more clinically effective than those delivered by a single HCP remain to be tested.