bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Cancer Risk Prediction Using Clinical Models and 77 Independent Risk-Associated SNPs for Women Aged Under 50 Years: Australian Breast Cancer Family Registry
Authors: Dite Gillian S. , MacInnis Robert J. , Bickerstaffe Adrian , Dowty James G. , Allman Richard , Apicella Carmel , Milne Roger L. , Tsimiklis Helen , Phillips Kelly-Anne , Giles Graham G. , Terry Mary Beth , Southey Melissa C. , Hopper John L. 
Published: December 2015

Abstract
Background: The extent to which clinical breast cancer risk prediction models can be improved by including information on known susceptibility SNPs is not known.
Methods: Using 750 cases and 405 controls from the population-based Australian Breast Cancer Family Registry who were younger than 50 years at diagnosis and recruitment, respectively, Caucasian and not BRCA1 or BRCA2 mutation carriers, we derived absolute 5-year risks of breast cancer using the BOADICEA, BRCAPRO, BCRAT, and IBIS risk prediction models and combined these with a risk score based on 77 independent risk-associated SNPs. We used logistic regression to estimate the OR per adjusted SD for log-transformed age-adjusted 5-year risks. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC). Calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test. We also constructed reclassification tables and calculated the net reclassification improvement.
Results: The ORs for BOADICEA, BRCAPRO, BCRAT, and IBIS were 1.80, 1.75, 1.67, and 1.30, respectively. When combined with the SNP-based score, the corresponding ORs were 1.96, 1.89, 1.80, and 1.52. The corresponding AUCs were 0.66, 0.65, 0.64, and 0.57 for the risk prediction models, and 0.70, 0.69, 0.66, and 0.63 when combined with the SNP-based score.
Conclusions: By combining a 77 SNP-based score with clinical models, the AUC for predicting breast cancer before age 50 years improved by &gt;20%.
Impact: Our estimates of the increased performance of clinical risk prediction models from including genetic information could be used to inform targeted screening and prevention. Cancer Epidemiol Biomarkers Prev; 25(2); 359–65. ©2015 AACR.
QT Adaptation and Intrinsic QT Variability in Congenital Long QT Syndrome
Authors: Seethala Srikanth , Singh Prabhpreet , Shusterman Vladimir , Ribe Margareth , Haugaa Kristina H. , Němec Jan 
Published: December 2015

Background

Increased variability of
QT
interval (
QTV
) has been linked to arrhythmias in animal experiments and multiple clinical situations. Congenital long
QT
syndrome (
LQTS
), a pure repolarization disease, may provide important information on the relationship between delayed repolarization and
QTV
.

Methods and Results

Twenty‐four‐hour Holter monitor tracings from 78 genotyped congenital
LQTS
patients (52 females; 51
LQT
1, 23
LQT
2, 2
LQT
5, 2
JLN
, 27 symptomatic; age, 35.2±12.3 years) were evaluated with computer‐assisted annotation of
RR
and
QT
intervals. Several models of
RR
‐
QT
relationship were tested in all patients. A model assuming exponential decrease of past
RR
interval contributions to
QT
duration with 60‐second time constant provided the best data fit. This model was used to calculate
QT
c and residual “intrinsic”
QTV
, which cannot be explained by heart rate change. The intrinsic
QTV
was higher in patients with long
QT
c (
r
=0.68;
P
<10
−4
), and in
LQT
2 than in
LQT
1/5 patients (5.65±1.28 vs 4.46±0.82;
P
<0.0002). Both
QT
c and intrinsic
QTV
were similar in symptomatic and asymptomatic patients (467±52 vs 459±53 ms and 5.10±1.19 vs 4.74±1.09, respectively).

Conclusions

In
LQTS
patients,
QT
interval adaptation to heart rate changes occurs with time constant ≈60 seconds, similar to results reported in control subjects. Intrinsic
QTV
correlates with the degree of repolarization delay and might reflect action potential instability observed in animal models of
LQTS
.
Left Atrial Inexcitability in Children With Congenital Lupus‐Induced Complete Atrioventricular Block
Authors: Abadir Sylvia , Fournier Anne , Vobecky Suzanne J. , Rohlicek Charles V. , Romeo Philippe , Khairy Paul 
Published: December 2015

Background
Congenital atrioventricular block is a well‐established immunologic complication of maternal systemic lupus erythematosus. We sought to further characterize the electrophysiological manifestations of maternal systemic lupus erythematosus on neonatal atria.

Methods and Results

Cases of isolated congenital atrioventricular block treated at our center over the past 41 years were identified. Data were extracted from clinical charts, pacemaker interrogations, ECGs, echocardiograms, and histopathological reports, when available. Of 31 patients with isolated congenital atrioventricular block, 18 were negative for maternal antibodies and had normal epicardial atrial sensing and pacing thresholds. In contrast, 12 of 13 patients with positive maternal antibodies had epicardial pacemakers, 5 (42%) of whom had left atrial (
LA
) inexcitability and/or atrial conduction delay. In 3 patients, the
LA
could not be captured despite high‐output pacing. The fourth patient had acutely successful
LA
appendage and left ventricular lead placement. At early follow‐up, an increased delay between the surface P‐wave and intracardiac atrial depolarization was observed, indicative of atrial conduction delay. The fifth patient exhibited
LA
lead dysfunction, with atrial under‐sensing and an increased capture threshold, 2 weeks after implantation. Biopsies of
LA
appendages performed in 2 patients showed no evidence of atrial fibrosis or loss of atrial myocytes.

Conclusions

Herein, we report previously undescribed yet prevalent electrophysiological ramifications of maternal systemic lupus erythematosus, which extend beyond congenital atrioventricular block to encompass alterations in
LA
conduction, including
LA
inexcitability. These manifestations can complicate epicardial pacemaker implantation in newborns. In the absence of histological evidence of extensive atrial fibrosis, immune‐mediated functional impairment of electrical activity is suspected.
Semantics of the Visual Environment Encoded in Parahippocampal Cortex
Authors: Bonner Michael F. , Price Amy Rose , Peelle Jonathan E. , Grossman Murray 
Published: December 2015

Abstract
Semantic representations capture the statistics of experience and store this information in memory. A fundamental component of this memory system is knowledge of the visual environment, including knowledge of objects and their associations. Visual semantic information underlies a range of behaviors, from perceptual categorization to cognitive processes such as language and reasoning. Here we examine the neuroanatomic system that encodes visual semantics. Across three experiments, we found converging evidence indicating that knowledge of verbally mediated visual concepts relies on information encoded in a region of the ventral-medial temporal lobe centered on parahippocampal cortex. In an fMRI study, this region was strongly engaged by the processing of concepts relying on visual knowledge but not by concepts relying on other sensory modalities. In a study of patients with the semantic variant of primary progressive aphasia (semantic dementia), atrophy that encompassed this region was associated with a specific impairment in verbally mediated visual semantic knowledge. Finally, in a structural study of healthy adults from the fMRI experiment, gray matter density in this region related to individual variability in the processing of visual concepts. The anatomic location of these findings aligns with recent work linking the ventral-medial temporal lobe with high-level visual representation, contextual associations, and reasoning through imagination. Together, this work suggests a critical role for parahippocampal cortex in linking the visual environment with knowledge systems in the human brain.
On the Nature of Temporal Variability of the Gulf Stream Path from 75° to 55°W
Authors: Gangopadhyay Avijit , Chaudhuri Ayan H. , Taylor Arnold H. 
Published: December 2015

AbstractThe response of the Gulf Stream (GS) system to atmospheric forcing is generally linked either to the basin-scale winds on the subtropical gyre or to the buoyancy forcing from the Labrador Sea. This study presents a multiscale synergistic perspective to describe the low-frequency response of the GS system. The authors identify dominant temporal variability in the North Atlantic Oscillation (NAO), in known indices of the GS path, and in the observed GS latitudes along its path derived from sea surface height (SSH) contours over the period 1993–2013. The analysis suggests that the signature of interannual variability changes along the stream’s path from 75° to 55°W. From its separation at Cape Hatteras to the west of 65°W, the variability of the GS is mainly in the near-decadal (7–10 years) band, which is missing to the east of 60°W, where a new interannual (4–5 years) band peaks. The latter peak (4–5 years) was missing to the west of 65°W. The region between 65° and 60°W seems to be a transition region. A 2–3-yr secondary peak was pervasive in all time series, including that for the NAO. This multiscale response of the GS system is supported by results from a basin-scale North Atlantic model. The near-decadal response can be attributed to similar forcing periods in the NAO signal; however, the interannual variability of 4–5 years in the eastern segment of the GS path is as yet unexplained. More numerical and observational studies are warranted to understand such causality.
Topiramate, zonisamide and weight loss in children and adolescents prescribed psychiatric medications
Authors: Shapiro Michael , Reid Adam , Olsen Brian , Taasan Michael , McNamara Joseph , Nguyen Mathew 
Published: December 2015

Background Childhood obesity is a growing epidemic that is contributed to by the use of psychopharmacological agents, such as antipsychotics. This study represents a preliminary investigation into the effectiveness of two anticonvulsants that were hypothesized to reduce weight in a pediatric sample seeking treatment at a psychiatric clinic. Methods The electronic medical records of a university-based child and adolescent psychiatric clinic were reviewed for patients who were first prescribed either topiramate or zonisamide between 1 July 2011 and 30 June 2013. Based on inclusionary criteria, the review identified 47 children or adolescents. Results Multilevel modeling was utilized for study analyses. Including the full sample and controlling for confounders, anticonvulsant dosage was uniquely associated with an average reduction in body mass index of 1.3 (dosages above 200 mg) to 4.1 (dosages below 50 mg) every six months of treatment. Exlucing patients whose baseline body mass index was below 25.0 and controlling for confounders, anticonvulsant dosage was uniquely associated with an average reduction in body mass index of 3.2 (dosages above 200 mg) to 6.1 (dosages below 50 mg) every six months of treatment. Weight reduction was not statistically different between topiramate or zonisamide. Anticonvulsants were associated with an increase in body mass index, yet the benefits of the two anticonvulsants on weight loss remained despite the counteractive effects of antipsychotics. Conclusions Results provide preliminary evidence that topiramate and zonisamide may be utilized for weight loss in a pediatric psychopharmacological treatment seeking sample, even if antipsychotics are also prescribed. A randomized controlled trial investigating the impact of topiramate and zonisamide on weight reduction is warranted.
A process evaluation of a home-based occupational therapy intervention for Parkinson’s patients and their caregivers performed alongside a randomized controlled trial
Authors: Sturkenboom Ingrid HWM , Nijhuis-van der Sanden Maria WG , Graff Maud JL 
Published: December 2015

Objective: To evaluate fidelity, treatment enactment and the experiences of an occupational therapy intervention in Parkinson’s disease, to identify factors that affect intervention delivery and benefits. Design: Mixed methods alongside a randomized controlled trial. Subjects: These include 124 home-dwelling Parkinson’s disease patients and their primary caregivers (recipients), and 18 occupational therapists. Intervention: Ten-week home-based intervention according to the Dutch guidelines for occupational therapy in Parkinson’s disease. Main measures: Data were collected on intervention dose, protocol process, content of treatment (fidelity), offered and performed strategies (treatment enactment), and recipients’ experiences. Therapists’ experiences were collected through case note analyses and focus group interviews. Results: Mean intervention dose was 9.3 (SD 2.3) hours. Mean protocol process adherence was high (93%; SD 9%), however the intervention did not (fully) address the goal for 268 of 617 treatment goals. Frequencies of offered and performed strategies appeared similar, apart from ‘using other tools and materials’ which showed a drop from 279 advised to 149 used. The recipients were satisfied overall with the intervention (mean score 8 out of 10). The therapists noted positive or negative influencing factors on both process and benefits: the research context, the socio-political healthcare context, the recipients’ personal and contextual factors, and the therapists’ competence. Conclusion: We found some prerequisite factors in equipment provision and available dose important for treatment delivery. Other elicited factors related to, or affected, the required professional competencies and tools to tailor interventions to the complexity of interacting personal and contextual factors of patients and caregivers.
Medications, “Natural” Products, and Pharmacovigilance during Breastfeeding
Authors: Colaceci Sofia , Giusti Angela , De Angelis Alessia , Della Barba Maria Ida , De Vincenti Annie Yasmine , Vellone Ercole , Alvaro Rosaria 
Published: December 2015

Background: In cases of pharmacotherapy, mothers are confronted with the dilemma of breastfeeding and giving up the medication or discontinuing breastfeeding in order to take the drug, thus avoiding any potential risk for the infants. Objective: This study aimed to describe women’s opinions on the use of medications and “natural” products during breastfeeding, pharmacovigilance and phytosurveillance, and the management of breastfeeding. Methods: This was a mixed-methods study with a sequential exploratory design. In the first qualitative phase, we conducted focus groups and in-depth interviews with 25 mothers attending community services. Coding and content analysis were carried out using NVivo9. We identified 4 main categories, and on this basis, we built a questionnaire administered to 248 pregnant women and new mothers attending 2 third-level hospitals. We conducted a descriptive and bivariate analysis ( P ≤ .05) using Epi-Info v.7. Results: Women show 3 main attitudes: (1) to discontinue breastfeeding in order to take the medication, (2) to “endure the pain,” or (3) to use so-called natural products, perceived safer than drugs. Women expressing an “endure the pain” opinion and women who considered natural products to be safer than medications had a higher probability of knowing that babies should be exclusively breastfed for the first 6 months (respectively, odds ratio [OR] = 2.24; 95% confidence interval [CI], 1.26-3.97; OR = 4.77; 95% CI, 2.56-8.88). Conclusion: In the dilemma of the mothers needing drug treatment, health professionals play a crucial role. They should convey evidence-based information on the compatibility of drugs with breastfeeding and provide individualized treatments, tailored to the single mother–baby case.
Development and evaluation of a novel product to remove surface contamination of hazardous drugs
Authors: Cox Joshua , Speed Vonni , O’Neal Sara , Hasselwander Terry , Sherwood Candice , Eckel Stephen F , Zamboni William C 
Published: December 2015

Background Even while following best practices, surface exposures of hazardous drugs (HDs) are high and numerous. Thus, it is important to develop new products to reduce the surface contamination of HDs. Hazardous Drug Clean (HDClean™) was developed to decontaminate and remove HDs from various types of surfaces and overcome the problems associated with other cleaning products. Methods HDClean was evaluated to remove mock surface exposures of HDs (docetaxel, paclitaxel, ifosfamide, cyclophosphamide, 5-FU, and cisplatin) from various types of surfaces. In two separate cancer centers, studies were performed to evaluate HDClean in reducing surface contamination of HDs in the pharmacy departments where no closed system transfer device (CSTD) was used. In a third cancer center, studies were performed comparing the effectiveness of a CSTD + Surface Safe compared with CSTD + HDClean to remove HDs. Results HDClean was able to completely remove mock exposures of a wide range of HDs from various surfaces (4 and 8 sq ft areas). Daily use of HDClean was equal to or more effective in reducing surface contamination of HDs in two pharmacies compared with a CSTD. HDClean was significantly more effective in removing HDs, especially cisplatin, compared with Surface Safe and does not have the problems associated with decontamination solutions that contain sodium hypochlorite. Conclusion These studies support HDClean as an effective decontaminating product, that HDClean is more effective than Surface Safe in removing HDs and is equal to or more effective than CSTD in controlling HD surface exposures.
Clinical Recognition of Melanoma in Dermatologists and Nondermatologists
Authors: Martinka Michal J. , Crawford Richard I. , Humphrey Shannon 
Published: December 2015

Background: The incidence of melanoma is increasing annually in Canada. Objectives: This retrospective study was designed to assess the ability of physicians of different specialties to accurately recognize melanoma. Methods: Pathology reports of biopsies submitted to Vancouver Coastal Health with clinical diagnoses of melanoma were reviewed (January to July 2013). The clinical diagnoses made by dermatologists, general practitioners and family physicians, and all other specialists were correlated with the final histopathologic diagnoses. Results: The dermatologists, general practitioners and family physicians, and all other specialists achieved diagnostic accuracies of 24.75%, 3.52%, and 12.75%, respectively. Conclusions: Although the diagnostic accuracy of dermatologists was significantly better than that the other practitioners, the majority of patients with suspicious skin lesions present to family physicians or general practitioners first. Thus, there is considerable value in providing more training and education to nondermatologists, because it can have a meaningful impact on patient care.
A New mHealth application to support treatment of sleep apnoea patients
Authors: Isetta Valentina , Torres Marta , González Kevin , Ruiz Concepción , Dalmases Mireia , Embid Cristina , Navajas Daniel , Farré Ramon , Montserrat Josep M 
Published: December 2015

Introduction Continuous positive airway pressure (CPAP) is the first-choice treatment for obstructive sleep apnoea (OSA), but adherence is frequently suboptimal. Innovative, patient-centred interventions are, therefore, needed to enhance compliance. Due to its low cost and ubiquity, mobile health (mHealth) technology seems particularly suited for this purpose. We endeavoured to develop an mHealth application called “APPnea,” aimed at promoting patient self-monitoring of CPAP treatment. We then assessed the feasibility and acceptability of APPnea in a group of OSA patients. Methods Consecutive OSA patients used APPnea for six weeks. APPnea gave patients daily reminders to answer three questions about their OSA treatment (CPAP use, physical activity, and diet) and prompted them to upload their body weight weekly. Answers were saved to a secure server for further analysis. After completing the study, patients gave their anonymous opinions about APPnea. Results We enrolled 60 patients with OSA receiving CPAP treatment. The mean age was 56 ± 10 years and the apnoea–hypopnea index was 47 ± 25 events/hour. In total, 63% of participants completed the daily questionnaire for more than 66% of the study period. Objective CPAP compliance was generally high (5.3 ± 1.6 hours/night). In a subset of 38 patients naïve to CPAP, those who used APPnea regularly had significantly higher CPAP compliance. Satisfaction levels were high for the majority of users. Conclusion This mHealth intervention is not only feasible but also satisfactory to patients. Although larger randomized trials and cost-effectiveness studies should be performed, this study shows that APPnea could promote participation and improve compliance among patients with OSA, thereby improving outcomes.
Pre-existing, incidental and hemorrhagic AVMs in pregnancy and postpartum: Gestational age, morbidity and mortality, management and risk to the fetus
Authors: Lv Xianli , Liu Peng , Li Youxiang 
Published: December 2015

Objective The objective of this article is to analyze the maternal and fetal outcomes of pregnancies that present with arteriovenous malformations (AVMs). Methods A literature review was performed that analyzed 65 cases of AVM during pregnancy previously reported in English literature. Results Sixty-five cases of pregnancy-associated AVM were identified. The patients’ ages ranged from 16 to 45 years, with a mean of 28 ± 4.9 years. Sixteen cases (24.6%) were pre-existing AVMs. There were 54 cases (83.1%) of AVM ruptured during pregnancy and postpartum: Six cases (11.1%) were in the first trimester, 24 (44.4%) were in the second, 22 (40.7%) were in the third trimester and two (3.7%) were postpartum. Unfavorable maternal clinical outcome (modified Rankin Scale (mRS) ≥ 2) was identified in 20 cases (30.8%) and abortion occurred in 10 cases (15.4%). There were three maternal deaths, yielding a case mortality rate of 4.6%. Fifty-three fetuses were born via cesarean section in 42 cases and vaginal delivery in 10 cases; 48 were in good health, three were temporarily intubated, one was macrosomic and one died. In univariate analysis, AVM hemorrhage presentation was significantly associated with a poor maternal outcome (mRS ≥ 2) ( p = 0.030); however, not significantly associated with fetus risk ( p = 0.864). Gestational age was not significantly associated with poor maternal outcome ( p = 0.875) or fetal risk ( p = 0.790). Conclusion AVM hemorrhage presentation was significantly associated with poor maternal outcome. Pre-existing ruptured AVM may not be associated with fetal risk. Gestational age of AVM rupture was not significantly associated with poor maternal outcome or fetal risk.
The historical association between measles and pertussis: A case of immune suppression?
Authors: Coleman Stephen 
Published: December 2015

Objectives: According to historical medical reports, many children with measles subsequently contracted pertussis, often with fatal results. The likelihood of a child contracting pertussis after a measles infection is increased by its immune-suppressing effects. This research aims to verify the historical reports. Methods: The analysis examines statistically the historical relationship between average measles and pertussis incidence rates in the United States from 1938 to 1954 at the state level and in average weekly rates. Analysis of incidence rates is cross-sectional at the state level using public health data. Results: The results show that, on average and over time, states with higher measles rates have higher pertussis rates, and the peaks and nadirs of average weekly incidence rates of pertussis lag measles by a delay of about 3–4 weeks, well within the duration of immune suppression. Measles and pertussis have similar geographical distributions. Conclusion: The research tentatively supports the hypothesis that because of its immune-suppressing effects, measles causes an increase in pertussis, but other factors may be involved. Epidemic models should give more attention to the possibility of immune suppression for diseases such as measles where that might be a risk factor. The findings reemphasize the importance of measles vaccination for the prevention of other diseases.