bluuebunny/crossref_metadata_2025_split huggingface dataset:
The distance between breast cancer and the skin is associated with axillary nodal metastasis
Authors: Eom Yong Hwa , Kim Eun Jin , Chae Byung Joo , Song Byung Joo , Jung Sang Seol 
Published: April 2015

Background and ObjectivesMore superficially located tumors may be more likely than deeper tumors to metastasize to the axillary nodes via the lymphatics. The aim of this study was to determine whether breast cancer distance from the skin affects axillary node metastasis, ipsilateral breast cancer recurrence, or recurrence‐free survival.Materials and MethodsA total of 1,005 consecutive patients with breast cancer who underwent surgery between January 2003 and December 2009 were selected. The distance of the tumor from the skin was measured from the skin to the most anterior hypoechoic leading edge of the lesion.ResultsIn total, 603 (68%) patients had no axillary nodal metastasis, and 288 (32%) had axillary nodal metastasis. A breast cancer distance from the skin <3 mm induced more axillary nodal metastasis (P = 0.039). However, no significant correlation was observed between breast cancer distance from the skin <3 mm and ipsilateral breast cancer recurrence (P = 0.788) or recurrence‐free survival (P = 0.353).ConclusionsBreast cancers located closer to the skin had a higher incidence of axillary nodal metastasis. Therefore, tumor distance from the skin should be considered when evaluating a patient with breast cancer and considering the risk of nodal metastasis. J. Surg. Oncol. 2015 111:824–828. © 2014 Wiley Periodicals, Inc.
Characteristics and Treatment of Anxiety Disorders in Parkinson's Disease
Authors: Dissanayaka Nadeeka N.W. , White Elizabeth , O'Sullivan John D. , Marsh Rodney , Silburn Peter A. , Copland David A. , Mellick George D. , Byrne Gerard J. 
Published: April 2015

AbstractBackground: Anxiety disorders are common in Parkinson's disease (PD) and are undertreated. The current study investigates demographic and PD‐specific factors associated with Diagnostic and Statistical Manual (DSM‐IV) anxiety disorders and subsyndromal anxiety in PD. It also examines the use of pharmacological and nonpharmacological treatments for anxiety in PD. Methods: Ninety nondemented PD patients completed a semistructured interview. Logistic regression models were constructed examining associations between several demographic, disease‐specific, and treatment factors, as well as both current syndromal, DSM‐IV anxiety disorders, and subsyndromal anxiety. Results: Associations were found between current DSM‐IV anxiety disorder, as well as female gender, younger age, more severe stages of PD, and poor activities of daily living. Subsyndromal anxiety was related to a younger onset age of PD. Relationships were also found between both anxiety groups and more complications of PD therapy, as well as higher depression scores. There were no associations between anxiety and levodopa equivalent daily dosage, motor disability, and cognition. In our sample, 57% of patients with current DSM‐IV anxiety disorders or subsyndromal anxiety were not currently treated with pharmacotherapy. Of those who currently received such treatment, 83% still experienced current anxiety disorders. Results suggest that anxiety is poorly recognized and treated in PD. Conclusions: Clinical trials investigating the efficacy of pharmacotherapy, tailored psychotherapy, and combination therapy primarily focusing on anxiety are much needed, with the aim of establishing novel targeted treatment protocols for the management of subtypes of anxiety disorders in PD.
Number of active electrodes at time of staged tined lead interstim implant does not impact clinical outcomes
Authors: Gilleran Jason P. , Killinger Kim , Boura Judith , Peters Kenneth M. 
Published: April 2015

ABSTRACTObjectivesTo determine: (1) if obtaining motor response on <4 tined lead electrodes at time of placement affects subjective and objective clinical outcome and (2) voltage requirements to elicit motor response at implant and first postoperative visit number based on number of responding electrodes.MethodsWe reviewed our prospective neuromodulation database to identify patients with unilateral S3 lead placement and motor response (bellows ± toe flexion) on stimulation of 1–4 electrodes, then grouped by number of active electrodes at lead placement. Stage 1 success, reoperation and reprogramming rates, mean voltage at implant and first postoperative visit, and Interstitial Cystitis Symptom/Problem Indices (ICSI‐PI) were analyzed using Pearson's Chi‐square, Fisher's exact, Kruskal–Wallis or Wilcoxon rank tests.ResultsTwo hundred forty four patients met inclusion criteria, categorized into 1–2 (n = 25), 3 (n = 48), and 4 active electrodes (n = 171). There were no significant differences between groups in terms of age, indications for neuromodulation, or stage 1 success. At implant, patients with <4 active electrodes required higher mean voltages for motor responses (5.9, 4.9, and 3.9 volts for each group respectively; P < 0.0001). Mean voltages for sensory threshold at first postoperative programming were 1.5 ± 1.5, 0.9 ± 1.0, and 0.8 ± 1.0, respectively (P = 0.08). Overall reoperation rates, and reprogramming sessions at 24 months did not differ (P = 0.72 and P = 0.50). ICSI‐PI scores improved similarly in all groups.ConclusionsMotor response on four electrodes is not necessary for successful stage 1 trial. Despite higher voltage requirements in those with <4 active electrodes at implant, this difference was not observed at initial postoperative programming. Neurourol. Urodynam. 35:625–629, 2016. © 2015 Wiley Periodicals, Inc.
Uncovering the genomic heterogeneity of multifocal breast cancer
Authors: Desmedt Christine , Fumagalli Debora , Pietri Elisabetta , Zoppoli Gabriele , Brown David , Nik‐Zainal Serena , Gundem Gunes , Rothé Françoise , Majjaj Samira , Garuti Anna , Carminati Enrico , Loi Sherene , Van Brussel Thomas , Boeckx Bram , Maetens Marion , Mudie Laura , Vincent Delphine , Kheddoumi Naima , Serra Luigi , Massa Ilaria , Ballestrero Alberto , Amadori Dino , Salgado Roberto , de Wind Alexandre , Lambrechts Diether , Piccart Martine , Larsimont Denis , Campbell Peter J , Sotiriou Christos 
Published: April 2015

AbstractMultifocal breast cancer (MFBC), defined as multiple synchronous unilateral lesions of invasive breast cancer, is relatively frequent and has been associated with more aggressive features than unifocal cancer. Here, we aimed to investigate the genomic heterogeneity between MFBC lesions sharing similar histopathological parameters. Characterization of different lesions from 36 patients with ductal MFBC involved the identification of non‐silent coding mutations in 360 protein‐coding genes (171 tumour and 36 matched normal samples). We selected only patients with lesions presenting the same grade, ER, and HER2 status. Mutations were classified as ‘oncogenic’ in the case of recurrent substitutions reported in COSMIC or truncating mutations affecting tumour suppressor genes. All mutations identified in a given patient were further interrogated in all samples from that patient through deep resequencing using an orthogonal platform. Whole‐genome rearrangement screen was further conducted in 8/36 patients. Twenty‐four patients (67%) had substitutions/indels shared by all their lesions, of which 11 carried the same mutations in all lesions, and 13 had lesions with both common and private mutations. Three‐quarters of those 24 patients shared oncogenic variants. The remaining 12 patients (33%) did not share any substitution/indels, with inter‐lesion heterogeneity observed for oncogenic mutation(s) in genes such as PIK3CA, TP53, GATA3, and PTEN. Genomically heterogeneous lesions tended to be further apart in the mammary gland than homogeneous lesions. Genome‐wide analyses of a limited number of patients identified a common somatic background in all studied MFBCs, including those with no mutation in common between the lesions. To conclude, as the number of molecular targeted therapies increases and trials driven by genomic screening are ongoing, our findings highlight the presence of genomic inter‐lesion heterogeneity in one‐third, despite similar pathological features. This implies that deeper molecular characterization of all MFBC lesions is warranted for the adequate management of those cancers. © 2015 The Authors. Pathological Society of Great Britain and Ireland.
Incorporation of dried blood alpha fetoprotein into traditional first trimester Down syndrome screening service
Authors: Carmichael Jonathan , Krantz David , Liu Hsiao‐Pin , Janik David , Hallahan Terrence 
Published: April 2015

AbstractObjectiveThe aim of this study was to determine whether incorporation of dried blood alpha fetoprotein (AFP) into first trimester screening using the biochemical markers free Beta human chorionic gonadotropin (hCG) and pregnancy‐associated plasma protein A (PAPP‐A) can improve screening performance.MethodsA retrospective study of 34 Down syndrome and 1185 unaffected dried blood specimens. First trimester dried blood AFP was performed using in‐house immunofluorometric time‐resolved assay. False positive and detection rates were determined from modeling.ResultsThe multiple of the median in Down syndrome cases was 0.73. At a fixed 5% false positive rate, incorporating AFP into a free Beta hCG, PAPP‐A, and nuchal translucency protocol adds 2% detection resulting in detection rates of 92% to 94% depending on the gestational age of the blood draw. At a fixed 90% detection rate, AFP reduced the false positive rate by 1.0 to 1.6 percentage points depending on gestational age. Using a cutoff of 1/1000, the combination of free beta hCG, PAPP‐A, AFP, and nuchal translucency achieved a detection rate of 96% with a false positive rate of 8.4% to 9.9%. Adding in nasal bone increased detection to 98% while reducing false positive rates to 4.1% to 4.7%.ConclusionInclusion of dried blood AFP into traditional first trimester screening improves detection while optimizing contingent protocols so that cell‐free fetal DNA testing may be offered in a more cost effective manner. © 2015 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.
Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process
Authors: Farmer Carrie M. , Lindsay Dawn , Williams Jessica , Ayers Amanda , Schuster James , Cilia Alyssa , Flaherty Michael T. , Mandell Todd , Gordon Adam J. , Stein Bradley D. 
Published: April 2015

Background Although the number of physicians credentialed to prescribe buprenorphine has increased over time, many credentialed physicians may be reluctant to treat individuals with opioid use disorders due to discomfort with prescribing buprenorphine. Although prescribing physicians are required to complete a training course, many have questions about buprenorphine and treatment guidelines have not been updated to reflect clinical experience in recent years. We report on an expert panel process to update and expand buprenorphine guidelines. Methods We identified candidate guidelines through expert opinion and a review of the literature and used a modified RAND/UCLA Appropriateness Method to assess the validity of the candidate guidelines. An expert panel completed 2 rounds of rating, with a meeting to discuss the guidelines between the first and second ratings. Results Through the rating process, expert panel members rated 90 candidate guideline statements across 8 domains, including candidacy for buprenorphine treatment, dosing of buprenorphine, psychosocial counseling, and treatment of co-occurring depression and anxiety. A total of 65 guideline statements (72%) were rated as valid. Expert panel members had agreement in some areas, such as the treatment of co-occurring mental health problems, but disagreement in others, including the appropriate dosing of buprenorphine given patient complexities. Conclusions Through an expert panel process, we developed an updated and expanded set of buprenorphine treatment guidelines; this additional guidance may increase credentialed physicians’ comfort with prescribing buprenorphine to patients with opioid use disorders. Future efforts should focus on appropriate dosing guidance and ensuring that guidelines can be adapted to a variety of practice settings.
Efficacy of Intravenous Mannitol in the Management of Orbital Compartment Syndrome: A Nonhuman Primate Model
Authors: Johnson Davin , Winterborn Andrew , Kratky Vladimir 
Published: April 2015

Purpose:
To report the efficacy of intravenous mannitol in the treatment of orbital compartment syndrome.

Methods:
An experimental study was conducted on 4 nonhuman primates (8 orbits). Orbital compartment syndrome was simulated by injecting autologous blood into both orbits of each nonhuman primate until a pressure of 80 mm Hg was reached (time 0). After 10 minutes, nonhuman primates were randomized to receive an infusion of either mannitol or saline, given over 15 minutes. Five minutes after the infusion was complete, lateral canthotomy and cantholysis was performed on both orbits in isolated steps every 5 minutes. During the study protocol, orbital and intraocular pressures were recorded every 5 minutes, with a final set of measurements at 60 minutes. The primary outcome measures were the mean change in pressure from time 0 to 60 minutes, as well as the mean change in pressure during the infusion period.

Results:
There was no statistically significant difference in the mean changes in orbital or intraocular pressure from time 0 to 60 minutes of the protocol. However, during the infusion period there was significantly greater decrease in both orbital and intraocular pressure in the mannitol compared with saline group (-34.0 vs. -9.3 mm Hg for orbital pressure [p = 0.03]; -34.8 vs. -9.7 mm Hg for intraocular pressure [p = 0.04]).

Conclusions:
While the definitive treatment of orbital compartment syndrome is lateral canthotomy and cantholysis, mannitol results in a rapid and clinically meaningful drop in orbital and intraocular pressure. The authors believe that their data support the routine use of mannitol in orbital compartment syndrome, especially when there is a delay in timely surgical management.
Delineating structures controlling sandstone‐hosted base‐metal deposits using high‐resolution multicomponent seismic and radio‐magnetotelluric methods: a case study from Northern Sweden
Authors: Malehmir Alireza , Wang Shunguo , Lamminen Jarkko , Brodic Bojan , Bastani Mehrdad , Vaittinen Katri , Juhlin Christopher , Place Joachim 
Published: April 2015

ABSTRACTOver the past few decades seismic methods have increasingly been used for the exploration of mineral, geothermal, and groundwater resources. Nevertheless, there have only been a few cases demonstrating the advantages of multicomponent seismic data for these purposes. To illustrate some of the benefits of three‐component data, a test seismic survey, using 60 digital three‐component sensors spaced between 2 m and 4 m and assembled in a 160 m‐long prototype landstreamer, was carried out over shallow basement structures underlying mineralized horizons and over a magnetic lineament of unknown origin. Two different types of seismic sources, i.e., explosives and a sledgehammer, were used to survey an approximately 4 km‐long seismic profile. Radio‐magnetotelluric measurements were also carried out to provide constraints on the interpretation of the seismic data over a portion of the profile where explosive sources were used. Good quality seismic data were recorded on all three components, particularly when explosives were used as the seismic source. The vertical component data from the explosive sources image the top of the crystalline basement and its undulated/faulted surface at a depth of about 50 m–60 m. Supported by the radio‐magnetotelluric results, however, shallower reflections are observed in the horizontal component data, one of them steeply dipping and associated with the magnetic lineament. The vertical component sledgehammer data also clearly image the crystalline basement and its undulations, but significant shear‐wave signals are not present on the horizontal components. This study demonstrates that multicomponent seismic data can particularly be useful for providing information on shallow structures and in aiding mineral exploration where structural control on the mineralization is expected.
Dispersal mode mediates the effect of patch size and patch connectivity on metacommunity diversity
Authors: Jones Natalie T. , Germain Rachel M. , Grainger Tess N. , Hall Aaron M. , Baldwin Lyn , Gilbert Benjamin 
Published: April 2015

Summary

Metacommunity theory predicts that increasing patch size and patch connectivity can alter local species diversity by affecting either colonization rates, extinction rates or both. Although species’ dispersal abilities or ‘dispersal mode’ (e.g. gravity‐, wind‐ or animal‐dispersed seeds) can mediate the effects of patch size and connectivity on diversity, these important factors are frequently overlooked in empirical metacommunity work.

We use a natural metacommunity of aspen stands within a grassland matrix to determine whether dispersal mode alters the influence of stand size and connectivity on understorey plant diversity. We sampled the same area in each patch, controlled for the presence of matrix species in aspen stands, and tested for the effects of size, connectivity and dispersal mode on metacommunity richness. Because dispersal groups responded differently to patch size and connectivity, we created a null model and assessed ungulate activity to explore whether competitive dynamics or herbivory were driving diversity patterns.

Animal‐dispersed species and species with no dispersal aid had higher diversity per unit area in larger stands, likely because large stands can both support larger populations that are less prone to extinction and may also attract seed‐dispersing animals such as birds and small mammals that are sensitive to edge effects. Consistent with other empirical work, we found a positive relationship between diversity and connectivity for wind‐dispersed species. However, we detected a negative effect of stand connectivity on the diversity of species with no dispersal aid, possibly due to the presence of other highly competitive species groups dominating well‐connected patches, as our null model results suggest. We found no evidence for higher ungulate activity in highly connected patches, suggesting that herbivory may not be driving the decline in diversity of plants with no dispersal aid.

Synthesis. Overall, we see a positive effect of stand area on diversity for most groups despite sampling equal area in all stands, which is a prediction of metacommunity theory that is normally overlooked. Our results demonstrate the importance of considering variation in the dispersal modes of focal species for explaining the diversity patterns of natural metacommunities.
Effects of pre‐eclampsia and fetal growth restriction on C‐type natriuretic peptide
Authors: Espiner EA , Prickett TCR , Taylor RS , Reid RA , McCowan LM 
Published: April 2015

ObjectiveTo determine changes in plasma C–type natriuretic peptide (CNP), a paracrine product of the vascular endothelium, in pregnancies with vascular disorders, and relate these to time of presentation and severity.DesignRetrospective nested cases and controls.SettingCommunity study, Auckland New Zealand.PopulationScreening for Pregnancy Endpoints (SCOPE) data and bio‐bank of maternal plasma.MethodsMaternal plasma amino terminal proCNP (NTproCNP) was measured by radioimmunoassay in early (14–16 weeks of gestation, and again at 19–21 weeks of gestation) and late (34–36 weeks of gestation) pregnancy in three groups of women (20 per group): pre‐eclampsia (pre‐eclampsia); gestational hypertension (GHT) with small for gestational age (SGA); and uncomplicated pregnancy.Main outcome measuresChange in NTproCNP and associations with concurrent blood pressure, time of case presentation, severity, and infant birthweight.ResultsPlasma NTproCNP in early pregnancy in women with vascular disorders did not differ from those found in controls. In late pregnancy, levels in pre‐eclampsia (28.8 ± 2.3 pM) and in GHT with SGA (28.6 ± 4.8 pM) were significantly increased (P = 0.01 and 0.027, respectively) compared with controls (21.3 ± 1 pM). In pre‐eclampsia, levels were significantly higher (P < 0.03) at 14–16 weeks of gestation in women diagnosed prior to 34 weeks of gestation. Combining all three groups, associations of NTproCNP with concurrent diastolic and mean arterial pressure were found at 34–36 weeks of gestation (r = 0.46). No significant associations were identified with birthweight.ConclusionsCNP secretion during gestation is responsive to vascular stress. Plasma NTproCNP measurements may have clinical application in late pregnancy in defining the different phenotypes associated with pre‐eclampsia.Tweetable abstractPlasma NTproCNP is raised in women diagnosed with PET in a case–controlled study using SCOPE data and biobank.
Dual‐System Use and Intermediate Health Outcomes among Veterans Enrolled in Medicare Advantage Plans
Authors: Cooper Alicia L. , Jiang Lan , Yoon Jean , Charlton Mary E. , Wilson Ira B. , Mor Vincent , Kizer Kenneth W. , Trivedi Amal N. 
Published: April 2015

ObjectiveThe concurrent use of multiple health care systems may duplicate or fragment care. We assessed the characteristics of veterans who were dually enrolled in both the Veterans Affairs (VA) health care system and a Medicare Advantage (MA) plan, and compared intermediate quality outcomes among those exclusively receiving care in the VA with those receiving care in both systems.Data Sources/Study SettingVA and MA quality and administrative data from 2008 to 2009.Study DesignWe used propensity score methods to test the association between dual use and five intermediate outcome quality measures. Outcomes included control of cholesterol, blood pressure, and glycosylated hemoglobin among persons with coronary heart disease (CHD), hypertension, and diabetes.Data Collection/Extraction MethodsVA and MA data were merged to identify VA‐only users (n = 1,637) and dual‐system users (n = 5,006).Principal FindingsWe found no significant differences in intermediate outcomes between VA‐only and dual‐user populations. Differences ranged from a 3.2 percentage point (95 percent CI: −1.8 to 8.2) greater rate of controlled cholesterol among VA‐only users with CHD to a 2.2 percentage point (95 percent CI: −2.4 to 6.6) greater rate of controlled blood pressure among dual users with diabetes.ConclusionsFor the five measures studied, we did not find evidence that veterans with dual use of VA and MA care experienced improved or worsened outcomes as compared with veterans who exclusively used VA care.
Novel Antifungal Peptides Produced by Leuconostoc mesenteroides DU15 Effectively Inhibit Growth of Aspergillus niger
Authors: Muhialdin Belal J. , Hassan Zaiton , Abu Bakar Fatimah , Algboory Hussein L. , Saari Nazamid 
Published: April 2015

AbstractThe ability of Leuconostoc mesenteroides DU15 to produce antifungal peptides that inhibit growth of Aspergillus niger was evaluated under optimum growth conditions of 30 °C for 48 h. The cell‐free supernatant showed inhibitory activity against A. niger. Five novel peptides were isolated with the sequences GPFPL, YVPLF, LLHGVPLP, GPFPLEMTLGPT, and TVYPFPGPL as identified by de novo sequencing using PEAKS 6 software. Peptide LLHGVPLP was the only positively charged (cationic peptides) and peptide GPFPLEMTLGPT negatively charged (anionic), whereas the rest are neutral. The identified peptides had high hydrophobicity ratio and low molecular weights with amino acids sequences ranging from 5 to 12 residues. The mode of action of these peptides is observed under the scanning electron microscope and is due to cell lysis of fungi. This work reveals the potential of peptides from L. mesenteroides DU15 as natural antifungal preservatives in inhibiting the growth of A. niger that is implicated to the spoilage during storage.