bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Significance of Marijuana Use Among Alcohol‐using Adolescent Emergency Department Patients
Authors: Chun Thomas H. , Spirito Anthony , Hernández Lynn , Fairlie Anne M. , Sindelar‐Manning Holly , Eaton Cheryl A. , Lewander William J. 
Published: January 2010

AbstractObjectives:  The objective was to determine if adolescents presenting to a pediatric emergency department (PED) for an alcohol‐related event requiring medical care differ in terms of substance use, behavioral and mental health problems, peer relationships, and parental monitoring based on their history of marijuana use.Methods:  This was a cross‐sectional comparison of adolescents 13–17 years old, with evidence of recent alcohol use, presenting to a PED with a self‐reported history of marijuana use. Assessment tools included the Adolescent Drinking Inventory, Adolescent Drinking Questionnaire, Young Adult Drinking and Driving Questionnaire, Center for Epidemiologic Studies Depression Scale, Behavioral Assessment System for Children, and Peer Substance Use and Tolerance of Substance Use Scale.Results:  Compared to adolescents using alcohol only (AO), adolescents who use alcohol and marijuana (A+M) have higher rates of smoking (F = 23.62) and binge drinking (F = 11.56), consume more drinks per sitting (F = 9.03), have more externalizing behavior problems (F = 12.53), and report both greater peer tolerance of substance use (F = 12.99) and lower parental monitoring (F = 7.12).Conclusions:  Adolescents who use A+M report greater substance use and more risk factors for substance abuse than AO‐using adolescents. Screening for a history of marijuana use may be important when treating adolescents presenting with an alcohol‐related event. A+M co‐use may identify a high‐risk population, which may have important implications for ED clinicians in the care of these patients, providing parental guidance, and planning follow‐up care.ACADEMIC EMERGENCY MEDICINE 2010; 17:63–71 © 2010 by the Society for Academic Emergency Medicine
Emergency Physicians’ Risk Attitudes in Acute Decompensated Heart Failure Patients
Authors: McCausland Julie B. , Machi Mari S. , Yealy Donald M. 
Published: January 2010

AbstractObjectives:  Despite the existence of various clinical prediction rules, no data exist defining what frequency of death or serious nonfatal outcomes comprises a realistic “low‐risk” group for clinicians. This exploratory study sought to identify emergency physicians’ (EPs) definition of low‐risk acute decompensated heart failure (ADHF) emergency department (ED) patients.Methods:  Surveys were mailed to full‐time physicians (n = 88) in a multihospital EP group in southwestern Pennsylvania between December 2004 and February 2005. Participation was voluntary, and each EP was asked to define low risk (low risk of all‐cause 30‐day death and low risk of either hospital death or other serious medical complications) and choose a risk threshold at which they might consider outpatient management for those with ADHF. A range of choices was offered (<0.5, <1, <2, <3, <4, and <5%), and demographic data were collected.Results:  The response rate was 80%. Physicians defined low risk both for all‐cause 30‐day death and for hospital death or other serious complications, at <1% (38.8 and 40.3%, respectively). The decision threshold to consider outpatient therapy was <0.5% risk both for all‐cause 30‐day death (44.6%) and for hospital death or serious medical complications (44.4%).Conclusions:  Emergency physicians in this exploratory study define low‐risk ADHF patients as having less than a 1% risk of 30‐day death or inpatient death or complications. They state a desire to have and use an ADHF clinical prediction rule that can identify low‐risk ADHF patients who have less than a 0.5% risk of 30‐day death or inpatient death or complications.ACADEMIC EMERGENCY MEDICINE 2010; 17:108–110 © 2010 by the Society for Academic Emergency Medicine
Does the Early Administration of Beta‐blockers Improve the In‐hospital Mortality Rate of Patients Admitted with Acute Coronary Syndrome?
Authors: Brandler Ethan , Paladino Lorenzo , Sinert Richard 
Published: January 2010

AbstractObjectives:  Beta‐blockade is currently recommended in the early management of patients with acute coronary syndromes (ACS). This was a systematic review of the medical literature to determine if early beta‐blockade improves the outcome of patients with ACS.Methods:  The authors searched the PubMed and EMBASE databases for randomized controlled trials from 1965 through May 2009 using a search strategy derived from the following PICO formulation of our clinical question: Patients included adults (18+ years) with an acute or suspected myocardial infarction (MI) within 24 hours of onset of chest pain. Intervention included intravenous or oral beta‐blockers administered within 8 hours of presentation. The comparator included standard medical therapy with or without placebo versus early beta‐blocker administration. The outcome was the risk of in‐hospital death in the intervention groups versus the comparator groups. The methodologic quality of the studies was assessed. Qualitative methods were used to summarize the study results. In‐hospital mortality rates were compared using a forest plot of relative risk (RR; 95% confidence interval [CI]) between beta‐blockers and controls. Statistical analysis was done with Review Manager V5.0.Results:  Eighteen articles (total N = 72,249) met the inclusion/exclusion criteria. For in‐hospital mortality, RR = 0.95 (95% CI, 0.90–1.01). In the largest of these studies (n = 45,852), a significantly higher rate (p < 0.0001) of cardiogenic shock was observed in the beta‐blocker (5.0%) versus control group (3.9%).Conclusions:  This systematic review failed to demonstrate a convincing in‐hospital mortality benefit for using beta‐blockers early in the course of patients with an acute or suspected MI.ACADEMIC EMERGENCY MEDICINE 2010; 17:1–10 © 2010 by the Society for Academic Emergency Medicine
Diagnostic Accuracy of Emergency Doppler Echocardiography for Identification of Acute Left Ventricular Heart Failure in Patients with Acute Dyspnea: Comparison with Boston Criteria and N‐terminal Prohormone Brain Natriuretic Peptide
Authors: Nazerian Peiman , Vanni Simone , Zanobetti Maurizio , Polidori Gianluca , Pepe Giuseppe , Federico Roberto , Cangioli Elisabetta , Grifoni Stefano 
Published: January 2010

AbstractObjectives:  Echocardiography is a fundamental tool in the diagnosis of acute left ventricular heart failure (aLVHF). However, a consultative exam is not routinely available in every emergency department (ED). The authors investigated the diagnostic performance of emergency Doppler echocardiography (EDecho) performed by emergency physicians (EPs) for the diagnosis of aLVHF in patients with acute dyspnea.Methods:  A convenience sample of acute dyspneic patients was evaluated. For each patient, the Boston criteria score for heart failure was calculated, and N‐terminal prohormone brain natriuretic peptide (NT‐proBNP) and EDecho were contemporaneously performed. Four investigators, after a limited echocardiography course, performed EDechos and evaluated for a “restrictive” pattern on pulsed Doppler analysis of mitral inflow and reduced left ventricular (LV) ejection fraction. The final diagnosis, established after reviewing all patient clinical data except NT‐proBNP and EDecho results, served as the criterion standard.Results:  Among 145 patients, 64 (44%) were diagnosed with aLVHF. The median time needed to perform EDecho was 4 minutes. Pulsed Doppler analysis was feasible in 125 patients (84%). The restrictive pattern was more sensitive (82%) and specific (90%) than reduced LV ejection fraction and more specific than the Boston criteria and NT‐proBNP for the diagnosis of aLVHF. Considering noninterpretable values of the restrictive pattern and uncertain values (“gray areas”) of Boston criteria (4 < Boston criteria score < 7) and of NT‐proBNP (300 < NT‐proBNP < 2,200 pg/mL) as false results, the accuracy of the restrictive pattern in the overall population was 75%, compared with accuracy of 49% for both NT‐proBNP and Boston criteria.Conclusions:  EDecho, particularly pulsed Doppler analysis of mitral inflow, is a rapid and accurate diagnostic tool in the evaluation of patients with acute dyspnea.ACADEMIC EMERGENCY MEDICINE 2010; 17:18–26 © 2010 by the Society for Academic Emergency Medicine
Association between use of asthma drugs and prevalence of demarcated opacities in permanent first molars in 6‐to‐8‐year‐old Danish children
Authors: Wogelius P. , Haubek D. , Nechifor A. , Nørgaard M. , Tvedebrink T. , Poulsen S. 
Published: January 2010

Wogelius P, Haubek D, Nechifor A, Nørgaard M, Tvedebrink T, Poulsen S. Association between use of asthma drugs and prevalence of demarcated opacities in permanent first molars in 6‐to‐8‐year‐old Danish children. Community Dent Oral Epidemiol 2010. © 2009 John Wiley & Sons A/SAbstract –  Objectives:  Demarcated opacities in permanent first molars are common developmental tooth defects, characterized by areas with insufficient mineralization of the enamel. The defects present clinically as a continuum from creamy‐white demarcated opacities, yellowish‐brown demarcated opacities to macroscopic loss of tooth substance. The etiology is sparsely elucidated, but asthma drugs have been suspected to increase the prevalence. The aim of this study was to examine the prevalence of demarcated opacities in permanent first molars among 6‐to‐8‐year‐old children with prescriptions and without prescriptions for asthma drugs.Methods:  In a cross‐sectional study in two Danish municipalities, all children aged 6–8 years (n = 891) were included. A total of 745 (83.6%) went through a dental examination during which demarcated opacities and tooth substance loss due to these were recorded. The analyses were restricted to 647 children in whom all four permanent first molars had erupted. Data on use of asthma drugs from birth until the time of the dental examination were obtained from a population‐based pharmaco‐epidemiological prescription database.Results:  Among 47 children with prescriptions for both inhaled β2‐agonists and inhaled corticosteroids before the age of 3 years, 15 (31.9%) had demarcated opacities of any type, and six children (12.8%) had opacity‐related loss of tooth substance. Among 264 children with no prescriptions for either inhaled or oral asthma drugs from birth until the date of the dental examination, 96 (36.4%) had demarcated opacities of any type, and 13 (4.9%) had opacity‐related loss of tooth substance. The odds ratio (OR) of any demarcated opacity, and of opacity‐related loss of tooth substance in children with prescriptions for both inhaled β2‐agonists and inhaled corticosteroids before the age of 3 years was 0.82 (95% CI: 0.39–1.65), and 2.42 (95% CI: 0.70–7.43).Conclusions:  Children with prescriptions for inhaled asthma drugs before the age of 3 years did not have an overall increased risk of demarcated opacities in first permanent molar but they seemed to have an increased risk of the severe demarcated opacities, i.e. opacities resulting in macroscopic loss of tooth substance, and possibly a need for restorative care.
Dental caries risk indicators among Australian Aboriginal young adults
Authors: Jamieson Lisa M. , Roberts‐Thomson KF , Sayers SM 
Published: January 2010

Jamieson LM, Roberts‐Thomson KF, Sayers SM. Dental caries risk indicators among Australian Aboriginal young adults. Community Dent Oral Epidemiol 2010; 38: 213–221. © 2009 John Wiley & Sons A/SAbstract –  Objectives:  To determine dental caries risk indicators among a birth cohort of Australian Aboriginal young adults (n = 442).Methods:  Data were from the Aboriginal Birth Cohort study, a prospective longitudinal investigation of Aboriginal individuals born 1987–1990 at an Australian regional hospital. Models representing demographic, socioeconomic, behavioural, dental service utilization and clinical oral health variables were tested using multivariate regression.Results:  The percent DT > 0 was 72.9 (95% CI 68.7–77.1), mean DT was 4.19 (95% CI 3.8–4.6), percent DMFT > 0 was 77.4 (95% CI 73.5–81.3) and mean DMFT was 4.84 (95% CI 4.4–5.3). After controlling for other covariates, risk indicators for percent DT > 0 included soft drink consumption every day or a few times a week (PR 1.25, 95% CI 1.08–1.45), not consuming milk every day or a few times a week (PR 1.16, 95% CI 1.04–1.30) and sweet consumption every day or a few times a week (PR 1.18, 95% CI 1.04–1.33). Risk indicators for mean DT included sweet consumption every day or a few times a week (B = 1.14, 95% CI 0.27–2.02), nonownership of a toothbrush (B = 0.91, 95% CI 0.10–1.87) and presence of plaque (B = 2.46, 95% CI 0.96–3.96). Those with 4 +  occupants in their house the previous night had 1.2 times the prevalence of having DMFT > 0 than their counterparts with less household occupants (95% CI 1.01–1.49). Percent DMFT > 0 was also associated with consumption of soft drink every day or a few times a week (PR 1.18, 95% CI 1.04–1.34) and consumption of sweets every day or a few times a week (PR 1.23, 95% CI 1.10–1.37). Mean DMFT was higher among those who consumed sweets every day or a few times a week (B = 0.13, 95% CI 0.05–0.22) and who had dental anxiety (B = 0.10, 95% CI 0.01–0.19).Conclusions:  In an Australian Aboriginal young adult cohort, risk indicators for dental caries included social determinants such as household size, dietary behaviours such as regular consumption of soft drink and sweets, dental behaviour such as nonownership of a toothbrush and dental anxiety.
ORIGINAL ARTICLE: The Persistence of Paternal Antigens in the Maternal Body is Involved in Regulatory T‐Cell Expansion and Fetal‐Maternal Tolerance in Murine Pregnancy
Authors: Zenclussen Maria Laura , Thuere Catharina , Ahmad Nadja , Wafula Paul O. , Fest Stefan , Teles Ana , Leber Anne , Casalis Pablo A. , Bechmann Ingo , Priller Josef , Volk Hans‐Dieter , Zenclussen Ana Claudia 
Published: January 2010

Citation Zenclussen ML, Thuere C, Ahmad N, Wafula PO, Fest S, Teles A, Leber A, Casalis PA, Bechmann I, Priller J, Volk H‐D, Zenclussen AC. The persistence of paternal antigens in the maternal body is involved in regulatory T‐cell expansion and fetal‐maternal tolerance in murine pregnancy. Am J Reprod Immunol 2010; 63: 200–208Problem  Mammalian pregnancy is a state of immunological tolerance and CD4+ CD25+ regulatory T cells (Treg) contribute to its maintenance. Knowing that Treg act in an antigen‐specific way during pregnancy, we hypothesized that they are generated after maternal immune cells encounter paternal antigens.Method of study  We mated wild type females with transgenic green fluorescent protein (GFP) males in an allogenic setting and killed them on different days of pregnancy.Results  Presence of paternal and maternal MHC class II+ cells in vaginal lavage on day 0.5 of pregnancy was confirmed. Thus, antigen presentation may take place early during pregnancy in the periphery either by the direct or indirect pathways. Foxp3+ cells known to have regulatory activity could be detected on day 2 of pregnancy in lymph nodes and shortly after implantation at the fetal‐maternal interface.Conclusion  Our data suggest that paternal antigens are processed early during pregnancy, which leads to the generation of Treg. The continuous release of placental antigens into the maternal circulation allows the maintenance of a Treg population which is specific for paternal antigens and mediates tolerance toward the semi‐allogeneic fetus until the time point of birth.
X‐ray crystallographic and NMR studies of pantothenate synthetase provide insights into the mechanism of homotropic inhibition by pantoate
Authors: Chakrabarti Kalyan Sundar , Thakur Krishan Gopal , Gopal B. , Sarma Siddhartha P. 
Published: January 2010

The structural basis for the homotropic inhibition of pantothenate synthetase by the substrate pantoate was investigated by X‐ray crystallography and high‐resolution NMR spectroscopic methods. The tertiary structure of the dimeric N‐terminal domain of Escherichia coli pantothenate synthetase, determined by X‐ray crystallography to a resolution of 1.7 Å, showed a second molecule of pantoate bound in the ATP‐binding pocket. Pantoate binding to the ATP‐binding site induced large changes in structure, mainly for backbone and side chain atoms of residues in the ATP binding HXGH(34–37) motif. Sequence‐specific NMR resonance assignments and solution secondary structure of the dimeric N‐terminal domain, obtained using samples enriched in 2H, 13C, and 15N, indicated that the secondary structural elements were conserved in solution. Nitrogen‐15 edited two‐dimensional solution NMR chemical shift mapping experiments revealed that pantoate, at 10 mm, bound at these two independent sites. The solution NMR studies unambiguously demonstrated that ATP stoichiometrically displaced pantoate from the ATP‐binding site. All NMR and X‐ray studies were conducted at substrate concentrations used for enzymatic characterization of pantothenate synthetase from different sources [Jonczyk R & Genschel U (2006) J Biol Chem 281, 37435–37446]. As pantoate binding to its canonical site is structurally conserved, these results demonstrate that the observed homotropic effects of pantoate on pantothenate biosynthesis are caused by competitive binding of this substrate to the ATP‐binding site. The results presented here have implications for the design and development of potential antibacterial and herbicidal agents.Structured digital abstract
MINT‐7301221: PS (uniprotkb:P31663) and PS (uniprotkb:P31663) bind (MI:0407) by x‐ray crystallography (MI:0114)
MINT‐7301241: PS (uniprotkb:P31663) and PS (uniprotkb:P31663) bind (MI:0407) by nuclear magnetic resonance (MI:0077)
ORIGINAL RESEARCH—ANATOMY/PHYSIOLOGY: Genetic and Environmental Influences on self-reported G-Spots in Women: A Twin Study
Authors: Burri Andrea Virginia , Cherkas Lynn , Spector Timothy D. 
Published: January 2010

ABSTRACTIntroductionThere is an ongoing debate around the existence of the G-spot—an allegedly highly sensitive area on the anterior wall of the human vagina. The existence of the G-spot seems to be widely accepted among women, despite the failure of numerous behavioral, anatomical, and biochemical studies to prove its existence. Heritability has been demonstrated in all other genuine anatomical traits studied so far.AimTo investigate whether the self-reported G-spot has an underlying genetic basis.Methods1804 unselected female twins aged 22–83 completed a questionnaire that included questions about female sexuality and asked about the presence or absence of a G-spot. The relative contribution of genetic and environmental factors to variation in the reported existence of a G-spot was assessed using a variance components model fitting approach.Main Outcome MeasuresGenetic variance component analysis of self-reported G-spot.ResultsWe found 56% of women reported having a G-spot. The prevalence decreased with age. Variance component analyses revealed that variation in G-spot reported frequency is almost entirely a result of individual experiences and random measurement error (&gt;89%) with no detectable genetic influence. Correlations with associated general sexual behavior, relationship satisfaction, and attitudes toward sexuality suggest that the self-reported G-spot is to be a secondary pseudo-phenomenon.ConclusionsTo our knowledge, this is the largest study investigating the prevalence of the G-spot and the first one to explore an underlying genetic basis. A possible explanation for the lack of heritability may be that women differ in their ability to detect their own (true) G-spots. However, we postulate that the reason for the lack of genetic variation—in contrast to other anatomical and physiological traits studied—is that there is no physiological or physical basis for the G-spot.
Job satisfaction of advanced practice nurses in the Veterans Health Administration
Authors: Faris Judith A. , Douglas Marilyn K. , Maples Deanna C. , Berg Laurie R. , Thrailkill Ann 
Published: January 2010

Abstract Purpose: The purpose of this study was to describe the level of job satisfaction and barriers to practice for advanced practice nurses (APNs) employed by the Veterans Health Administration (VHA). Data sources: The Misener Nurse Practitioner Job Satisfaction Survey (MNPJSS) and an investigator‐developed questionnaire were completed by a self‐selected, convenience sample of 1,983 APNs who responded to an internal VHA email invitation (61% response rate) to participate in an anonymous on‐line survey. Conclusions: Respondents reported being minimally satisfied with their job overall, most satisfied with their benefits and least satisfied with professional growth and intrapractice collegiality. They scored lower than their private sector peers for total job satisfaction and all subscales except benefits, as compared to samples of three smaller studies. Clinical nurse specialists reported greater job satisfaction then NPs. The most frequently cited barriers to practice were: too many non‐APN tasks, lack of administrative support, and inadequate time to do research. Implications for practice: Strategies for improving professional growth and intra‐practice collegiality are needed. APNs' job satisfaction may be improved in these areas by mentoring of new APN graduates and administrative approval for participating in research. Additional administrative support is needed to decrease the amount of non‐APN tasks and clerical duties.
Implementation of cancer pain guidelines by acute care nurse practitioners using an audit and feedback strategy
Authors: Dulko Dorothy , Hertz Elisheva , Julien Jerelyn , Beck Susan , Mooney Kathi 
Published: January 2010

Purpose: Despite the availability of clinical practice guidelines (CPGs) for cancer pain, consistent integration of these principles into practice has not been achieved. The optimal method for implementing CPGs and the impact of guidelines on healthcare outcomes remain uncertain. This study evaluated the effect of an audit and feedback (A/F) intervention on nurse practitioner (NP) implementation of cancer pain CPGs and on hospitalized patients' self‐report of pain and satisfaction with pain relief. Data sources: Eight NPs and two groups of 96 patients were the sources of data. Eligible patients in both groups completed the Brief Pain Inventory‐Short Form (BPI‐SF) within 24 h of admission and every 48 h until discharge. During A/F, NPs received weekly feedback on pain scores and guideline adherence. Conclusions: Nurse practitioner adherence to CPGs increased during A/F. Pain intensity did not significantly differ between groups. Intervention group patients reported significantly less overall pain interference (p < .0001), interference with general activity (p = .0003), and sleep (p = .006). Satisfaction with pain relief increased from 68.4% to 95.1% during A/F (p < .0001). Implications for practice: A/F is an effective strategy to promote CPG use. Improved functional status in the absence of decreased pain severity underscores the need to consider symptom clusters when studying pain.