bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of childhood injuries and evidence based strategies developed using the injury surveillance system in Pasto, Colombia
Authors: Espitia-Hardeman Victoria , Borse Nagesh N , Dellinger Ann M , Betancourt Carmen Elena , Villareal Alba Nelly , Caicedo Luz Diana , Portillo Carlos 
Published: January 2011

ObjectiveThis article characterises the burden of childhood injuries and provides examples of evidence–based injury prevention strategies developed using a citywide injury surveillance system in Pasto, Colombia.MethodsFatal (2003-2007) and non-fatal (2006-2007) childhood injury data were analysed by age, sex, cause, intent, place of occurrence, and disposition.ResultsBoys accounted for 71.5% of fatal and 64.9% of non-fatal injuries. The overall fatality rate for all injuries was 170.8 per 100,000 and the non-fatal injury rate was 4,053 per 100,000. Unintentional injuries were the leading causes of fatal injuries for all age groups, except for those 15-19 years whose top four leading causes were violence-related. Among non-fatal injuries, falls was the leading mechanism in the group 0-14 years. Interpersonal violence with a sharp object was the most important cause for boys aged 15-19 years. Home was the most frequent place of occurrence for both fatal and non-fatal injuries for young children 0-4 years old. Home, school and public places became an important place for injuries for boys in the age group 5-15 years. The highest case-fatality rate was for self-inflicted injuries (8.9%).ConclusionsAlthough some interventions have been implemented in Pasto to reduce injuries, it is necessary to further explore risk factors to better focus prevention strategies and their evaluation. We discuss three evidence-based strategies developed to prevent firework-related injuries during festival, self-inflicted injuries, and road traffic-related injuries, designed and implemented based on the injury surveillance data.
Injury prevention in child death review: child pedestrian fatalities
Authors: Desapriya Ediriweera , Sones Meridith , Ramanzin Tansey , Weinstein Sara , Scime Giulia , Pike Ian 
Published: January 2011

ObjectiveThis article describes the epidemiology of child pedestrian fatalities in British Columbia using data generated by the province's Child Death Review Unit, to demonstrate the unique capacity of child death review to provide an ecological understanding of child mortality and catalyse evidence based, multi-level prevention strategies.MethodsAll child pedestrian fatalities in British Columbia from 1 January 1 2003 to 31 December 2008 were reviewed. Data on demographics, circumstance of injury, and risk factors related to the child, driver, vehicle, and physical environment were extracted. Frequency of sociodemographic variables and modifiable risk factors were calculated, followed by statistical comparisons against the general population for Aboriginal ancestry, gender, ethnicity, income assistance and driver violations using z and t tests.ResultsAnalysis of child pedestrian fatalities (n=33) found a significant overrepresentation of Aboriginal children (p=0.06), males (p<0.01), and children within low income families (p<0.01). The majority of incidents occurred in residential areas (51.5%), with a speed limit of 50 kph or higher (85.7%). Risky pedestrian behaviour was a factor in 56.7% of cases, and 33% of children under 10 years of age were not under active supervision. Drivers had significantly more driving violations than the comparison population (p<0.01).ConclusionChild pedestrian fatalities are highly preventable through the modification of behavioural, social, and environmental risk factors. This paper illustrates the ability of child death review to generate an ecological understanding of injury epidemiology not otherwise available and advance policy and programme interventions designed to reduce preventable child mortality.
Use of child death review to inform sudden unexplained infant deaths occurring in a large urban setting
Authors: Brixey Suzanne N , Kopp Brianna C , Schlotthauer Amy E , Collier Abigael , Corden Timothy E 
Published: January 2011

ObjectiveTo illustrate the benefits and utility of the child death review (CDR) reporting system when examining risk factors associated with infant death occurring within two subgroups of sudden unexpected infant deaths (SUID)—unintentional suffocation and sudden infant death syndrome (SIDS)—in a large urban county in Wisconsin.DesignRetrospective CDR data were analysed, 2007–2008, for Milwaukee County, Wisconsin.Patients or subjectsUnintentional suffocation and SIDS infant deaths under 1 year of age in Milwaukee County, Wisconsin, 2007–2008, with a CDR record indicating a death in a sleep environment.Main outcome measureStudy examined demographic characteristics, bed-sharing, incident sleep location, position of child when put to sleep, position of child when found, child's usual sleep place, crib in home, and other objects found in sleep environment.ResultsUnintentional suffocation (n=11) and SIDS (n=40) classified deaths with CDR data made up 18% (51/283) of all infant deaths in Milwaukee County from 2007 to 2008. The majority of infants who died of unintentional suffocation (n=9, 81.8%) or SIDS (n=26, 65.0%) were black and under the age of 3 months. Bed-sharing was involved in most of the unintentional suffocation deaths (n=10, 90.9%) and the SIDS deaths (n=28, 70.0%). All unintentional suffocation deaths (n=11, 100%) and the majority of SIDS deaths (n=31, 77.5%) took place in a non-crib sleeping environment.ConclusionsThe study demonstrates how CDR provides enhanced documentation of risk factors to help steer prevention efforts regarding SUID deaths in a community and reaffirms infants in an unsafe sleep environment have an increased risk of death.
Social inequalities in residential exposure to road traffic noise: An environmental justice analysis based on the RECORD Cohort Study
Authors: Havard Sabrina , Reich Brian J , Bean Kathy , Chaix Basile 
Published: January 2011

ObjectivesTo explore social inequalities in residential exposure to road traffic noise in an urban area.MethodsEnvironmental injustice in road traffic noise exposure was investigated in Paris, France, using the RECORD Cohort Study (n=2130) and modelled noise data. Associations were assessed by estimating noise exposure within the local area around participants' residence, considering various socioeconomic variables defined at both individual and neighbourhood level, and comparing different regression models attempting or not to control for spatial autocorrelation in noise levels.ResultsAfter individual-level adjustment, participants' noise exposure increased with neighbourhood educational level and dwelling value but also with proportion of non-French citizens, suggesting seemingly contradictory findings. However, when country of citizenship was defined according to its human development level, noise exposure in fact increased and decreased with the proportions of citizens from advantaged and disadvantaged countries, respectively. These findings were consistent with those reported for the other socioeconomic characteristics, suggesting higher road traffic noise exposure in advantaged neighbourhoods. Substantial collinearity between neighbourhood explanatory variables and spatial random effects caused identifiability problems that prevented successful control for spatial autocorrelation.ConclusionsContrary to previous literature, this study shows that people living in advantaged neighbourhoods were more exposed to road traffic noise in their residential environment than their deprived counterparts. This case study demonstrates the need to systematically perform sensitivity analyses with multiple socioeconomic characteristics to avoid incorrect inferences about an environmental injustice situation and the complexity of effectively controlling for spatial autocorrelation when fixed and random components of the model are correlated.
Use of briefings and debriefings as a tool in improving team work, efficiency, and communication in the operating theatre
Authors: Bethune Robert , Sasirekha Govindarajulu , Sahu Ajay , Cawthorn Simon , Pullyblank Anne 
Published: January 2011

ABSTRACT

Introduction
Team work, communication, and efficiency in the operating theatre are widely recognised to be suboptimal. Poor communication is the single biggest cause of medical error. The surgical operating theatre is a potentially highly stressed environment where poor communication can lead to fatal errors. The objectives of this study were to assess the effects briefings and debriefings had on theatre start time, list lengths, and the staff's impression of these meetings.

Materials and methods
Briefings and debriefings were conducted before the start of theatre lists over a 6 month period in 2007 in a district general hospital in north Bristol, UK. Both quantitative and qualitative data were collected. Using the hospital theatre database, theatre start and finish time was found and list length calculated. A questionnaire was devised and used to assess staff attitude to the briefings and debriefings.

Results
Staff felt that the briefings highlighted potential problems, improved the team culture, and led to organisational change. Theatre start times tended to be earlier and lists lengths were shorter when briefings were conducted, although this only reached statistical significance on one type of list.

Discussion
Briefings and debriefings had a positive impact on teamwork and communication. The lists ran more efficiently and briefings did not delay the theatre start times—in fact, the lists tended to start earlier.
Prescribing in pregnancy and during breast feeding: using principles in clinical practice
Authors: Henderson Emma , Mackillop Lucy 
Published: January 2011

ABSTRACT
Prescribing in pregnancy often causes uncertainty and anxiety for the clinician and may lead to the omission of necessary treatment. Many drugs have inadequate data to assure safety, and therefore the clinician is left with a dilemma as to where the balance of risks and benefits lie with respect to the mother and her fetus. Understanding under what circumstances women can be prescribed medication and using principles of prescribing in pregnancy to further clarify the potential risks will aid good clinical decision-making. An appreciation of the available resources and the conviction to find the best available evidence will best serve the patient and her fetus. Teratogenicity refers to the potential for a drug to cause fetal malformations and affects the embryo 3–8 weeks after conception. Teratogenic drugs are associated with an increased risk of malformations, but the majority of babies are born with no abnormalities. In addition, approximately 2–3% of infants are born with major malformations with no association with maternal medication, and this and other confounding factors need to be addressed during counselling of a woman. Fetotoxicity refers to the functional changes that can occur to the fetus as a result of medication in the second and third trimesters. These effects are more subtle and more difficult to assess and therefore there are fewer data to support or refute these types of associations. For the majority of drugs, the neonatal dose from breast feeding is a fraction of the dose exposure in utero.
Comparison of aortic dissection in Chinese patients with and without Marfan syndrome
Authors: Linggen Gao , Lin Zhang , Xiaohan Fan , Haiying Wu , Xianliang Zhou , Rutai Hui 
Published: January 2011

ABSTRACT

Background
Aortic dissection is a life-threatening cardiovascular disease with high mortality. Little is known about comparisons of the clinical characteristics or the factors that influence the long-term prognosis of Chinese patients with aortic dissection with and without Marfan syndrome (MFS).

Methods
The authors studied the data of 246 patients with aortic dissection. The patients were hospitalised for aortic abnormalities from 2004 to 2008 in Fuwai Hospital. Medical charts were reviewed to obtain clinical data using a standardised data collection sheet.

Results
Of the 246 patients with acute aortic dissection, 56 had MFS. Compared with the non-MFS patients, those with MFS were considerably younger (mean±SD age 35.27±11.11 vs 54.11±11.96 years, p&lt;0.001) and had pre-existing hypertension much less commonly (5.4% vs 80.0%, p&lt;0.001). The patients with MFS presented with a wider ascending aorta diameter (63.60±9.00 vs 38.55±9.44 mm, p&lt;0.001) and a lower body mass index (20.14±2.00 vs 25.62±3.41, p&lt;0.001) than the non-MFS patients. Overall, 91.1% of the MFS patients underwent surgical treatment, whereas 55.78% of the non-MFS patients accepted medical treatment. However, mortality in the two groups did not differ significantly (6 vs 17, p=0.527). Multivariate analysis showed that the aortic diameter (OR=1.072) was a risk factor and surgical treatment (OR=0.006) was a protective factor for the survival of MFS patients with aortic dissection. With increased diastolic blood pressure, mortality decreased in non-MFS patients with aortic dissection (OR=0.905).

Conclusions
These clinical results could be useful for rapid assessment of the treatment and prognosis of patients with aortic dissection.
The efficacy of strabismus surgery in adults: a review for primary care physicians
Authors: Kushner Burton J 
Published: January 2011

ABSTRACT
Many adult patients with strabismus are under the misconception that nothing can be done to correct the problem or that treatment is associated with a high degree of risk. Moreover, many optometrists, comprehensive ophthalmologists and primary care physicians are similarly misinformed. In fact, most adult patients with strabismus can be successfully treated, with ∼80% of patients achieving satisfactory alignment with one surgical procedure. In addition, adult strabismus surgery carries a relatively low risk, with serious complications being anecdotal and rare. The majority of adults will experience some improvement in binocular function after strabismus surgery even if the strabismus has been longstanding. Most commonly this takes the form of an expansion of binocular visual fields; however, some patients may also regain stereopsis. Consequently, strabismus surgery in adults is not merely cosmetic in most cases. There are many psychological and interpersonal benefits to adult strabismus surgery. These benefits are highlighted by the finding that the majority of adults with strabismus would trade a portion of their life expectancy to be rid of their ocular misalignment. Although adult strabismus surgery has been shown to be highly cost-effective, many adults with strabismus can be successfully managed by non-surgical means. If an adult with strabismus is under the impression, or was told, they cannot be treated, or that treatment is risky, they should consider a referral to an ophthalmologist specifically specialising in strabismus.
Histamine Deficiency Decreases Atherosclerosis and Inflammatory Response in Apolipoprotein E Knockout Mice Independently of Serum Cholesterol Level
Authors: Wang Ke-Yong , Tanimoto Akihide , Guo Xin , Yamada Sohsuke , Shimajiri Shohei , Murata Yoshitaka , Ding Yan , Tsutsui Masato , Kato Seiya , Watanabe Teruo , Ohtsu Hiroshi , Hirano Ken-Ichi , Kohno Kimitoshi , Sasaguri Yasuyuki 
Published: January 2011

Objective—
Histamine and histamine receptors are found in atherosclerotic lesions, and their signaling and subsequent proatherogenic or proinflammatory gene expression are involved in atherogenesis. In the present study, we generated apolipoprotein E (apoE) and histamine synthesizing histidine decarboxylase double knockout (DKO) mice on a C57BL/6J (wild-type mice) background to clarify the roles of histamine in atherosclerosis.

Methods and Results—
Wild-type, apoE knockout (KO), and DKO mice were fed a high-cholesterol diet to analyze hyperlipidemia-induced atherosclerosis. Compared with wild-type mice, apoE-KO mice showed increased expression of histamine and its receptors, corresponding to increased atherosclerotic lesion areas and expression of inflammatory regulators, such as nuclear factor-κB, scavenger receptors, inflammatory cytokines, and matrix metalloproteinases. Histamine deficiency after deletion of histidine decarboxylase reduced atherosclerotic areas and expression of a range of the inflammation regulatory genes, but serum cholesterol levels of DKO mice were higher than those of apoE-KO mice.

Conclusion—
These results indicate that histamine is involved in the development of atherosclerosis in apoE-KO mice by regulating gene expression of inflammatory modulators, an action that appears to be independent of serum cholesterol levels. In addition to acute inflammatory response, histamine participates in chronic inflammation, such as hyperlipidemia-induced atherosclerosis, and might be a novel therapeutic target for the treatment of atherosclerosis.
RhoA-Mediated Signaling in Notch-Induced Senescence-Like Growth Arrest and Endothelial Barrier Dysfunction
Authors: Venkatesh Deepak , Fredette Natalie , Rostama Bahman , Tang Yuefeng , Vary Calvin P.H. , Liaw Lucy , Urs Sumithra 
Published: January 2011

Objective—
Notch signaling has a critical role in vascular development and morphogenesis. Activation of Notch in endothelial cells led to a senescence-like phenotype with loss of barrier function. Our objective was to understand the molecular pathways mediating this phenotype.

Methods and Results—
Human primary endothelial cells increase expression of Notch receptors and ligands during propagation in vitro toward natural senescence. This senescence was induced at low passage with Notch activation. We characterized the pathways activated downstream of Notch signaling. Notch was activated by Delta-like 4 ligand or constitutively active Notch receptors and measured for cell proliferation, migration, and sprouting. Notch signaling triggered early senescence in low-passage cells, characterized by increased p53 and p21 expression. The senescence phenotype was associated with hyperpermeability of the monolayer, with disrupted vascular endothelial cadherin and β-catenin levels and localization. Consistent with changes in cell shape and contact, we demonstrated that Notch activation increases myosin light chain phosphorylation by activating Rho kinase. Inhibition of Rho abrogated Notch-induced myosin light chain phosphorylation and led to enhanced barrier function by reorganizing F-actin to β-catenin-containing cell-cell adherens junctions.

Conclusion—
Our findings show that RhoA/Rho kinase regulation by Notch signaling in endothelial cells triggers a senescence phenotype associated with endothelial barrier dysfunction.
Genetic Inactivation of Prokineticin Receptor-1 Leads to Heart and Kidney Disorders
Authors: Boulberdaa Mounia , Turkeri Gulen , Urayama Kyoji , Dormishian Mojdeh , Szatkowski Cécilia , Zimmer Luc , Messaddeq Nadia , Laugel Virginie , Dollé Pascal , Nebigil Canan G. 
Published: January 2011

Objective—
Prokineticins are potent angiogenic hormones that use 2 receptors, prokineticin receptor-1 (PKR1) and PKR2, with important therapeutic use in anticancer therapy. Observations of cardiac and renal toxicity in cancer patients treated with antiangiogenic compounds led us to explore how PKR1 signaling functioned in heart and kidney in vivo.

Methods and Results—
We generated mice with a conditional disruption of the PKR1 gene. We observed that PKR1 loss led to cardiomegaly, severe interstitial fibrosis, and cardiac dysfunction under stress conditions, accompanied by renal tubular dilation, reduced glomerular capillaries, urinary phosphate excretion, and proteinuria at later ages. Abnormal mitochondria and increased apoptosis were evident in both organs. Perturbation of capillary angiogenesis in both organs was restored at the adult stage potentially via upregulation of hypoxia-inducible factor-1 and proangiogenic factors. Compensatory mechanism could not revoke the epicardial and glomerular capillary networks, because of increased apoptosis and reduced progenitor cell numbers, consistent with an endogenous role of PKR1 signaling in stimulating epicardin+ progenitor cell proliferation and differentiation.

Conclusion—
Here, we showed for the first time that the loss of PKR1 causes renal and cardiac structural and functional changes because of deficits in survival signaling, mitochondrial, and progenitor cell functions in found both organs.
Innovative Approaches Helpful to Enhance Knowledge on Weather-Related Stroke Events Over a Wide Geographical Area and a Large Population
Authors: Morabito Marco , Crisci Alfonso , Vallorani Roberto , Modesti Pietro Amedeo , Gensini Gian Franco , Orlandini Simone 
Published: January 2011

Background and Purpose—
Results on the effect of weather on stroke occurrences are still confusing and controversial. The aim of this study was to retrospectively investigate in Tuscany (central Italy) the weather-related stroke events through the use of an innovative source of weather data (Reanalysis) together with an original statistical approach to quantify the prompt/delayed health effects of both cold and heat exposures.

Methods—
Daily stroke hospitalizations and meteorologic data from the Reanalysis 2 Achieve were obtained for the period 1997 to 2007. Generalized linear and additive models and an innovative modeling approach, the constrained segmented distributed lag model, were applied.

Results—
Both daily averages and day-to-day changes of air temperature and geopotential height (a measure that approximates the mean surface pressure) were selected as independent predictors of all stroke occurrences. In particular, a 5°C temperature decrease was associated with 16.5% increase of primary intracerebral hemorrhage of people ≥65 years of age. A general short-term cold effect on hospitalizations limited to 1 week after exposure was observed and, for the first time, a clear harvesting effect (deficit of hospitalization) for cold-related primary intracerebral hemorrhage was described. Day-to-day changes of meteorologic parameters disclosed characteristic U- and J-shaped relationships with stroke occurrences.

Conclusions—
Thanks to the intrinsic characteristic of Reanalysis, these results might simply be implemented in an operative forecast system regarding weather-related stroke events with the aim to develop preventive health plans.
Changes in Intracortical Excitability After Transient Ischemic Attack Are Associated With ABCD
2
Score
Authors: Edwards Jodi D. , Meehan Sean K. , Levy Adrian R. , Teal Philip A. , Linsdell Meghan A. , Boyd Lara A. 
Published: January 2011

Background and Purpose—
A transient ischemic attack (TIA) is a brief ischemic episode characterized by rapid clinical resolution and not associated with permanent cerebral infarction. Whether changes in intracortical excitability persist and are related to clinical predictors of stroke risk after TIA remains unknown.

Methods—

Participants were individuals with clinically resolved motor TIA with no structural lesions and healthy age-matched control participants. Single and paired-pulse transcranial magnetic stimulation was used to measure intracortical excitability. Recruitment curves for percent inhibition and facilitation were used to derive excitability thresholds. Correlations between threshold asymmetries and ABCD
2
score were performed.

Results—

Results showed a significant 3-way interaction with reduced inhibition and enhanced facilitation in the affected compared with unaffected hemisphere after TIA. No significant differences were present in healthy participants. Asymmetries in intracortical inhibition and facilitation were significantly correlated with ABCD
2
score.

Conclusions—

The present study is the first, to our knowledge, to demonstrate altered intracortical inhibition and facilitation in the affected hemisphere after TIA. These changes occurred on average 2 weeks after clinical signs of TIA resolved and in the absence of structural lesions and were not present in healthy age-matched control participants. Furthermore, this study is the first, to our knowledge, to report that changes in intracortical excitability after TIA are associated with ABCD
2
score.