bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Trial of Acolbifene in Premenopausal Women at High Risk for Breast Cancer
Authors: Fabian Carol J. , Kimler Bruce F. , Zalles Carola M. , Phillips Teresa A. , Metheny Trina , Petroff Brian K. , Havighurst Thomas C. , Kim KyungMann , Bailey Howard H. , Heckman-Stoddard Brandy M. 
Published: September 2015

AbstractThe purpose of this study was to assess the feasibility of using the selective estrogen receptor modulator (SERM) acolbifene as a breast cancer prevention agent in premenopausal women. To do so, we assessed change in proliferation in benign breast tissue sampled by random periareolar fine-needle aspiration (RPFNA) as a primary endpoint, along with changes in other risk biomarkers and objective and subjective side effects as secondary endpoints. Twenty-five women with cytologic hyperplasia ± atypia and ≥2% of breast epithelial cells staining positive for Ki-67, received 20 mg acolbifene daily for 6–8 months, and then had benign breast tissue and blood risk biomarkers reassessed. Ki-67 decreased from a median of 4.6% [interquartile range (IQR), 3.1%–8.5%] at baseline to 1.4% (IQR, 0.6%–3.5%) after acolbifene (P &lt; 0.001; Wilcoxon signed-rank test), despite increases in bioavailable estradiol. There were also significant decreases in expression (RT-qPCR) of estrogen-inducible genes that code for pS2, ERα, and progesterone receptor (P ≤ 0.026). There was no significant change in serum IGF1, IGFBP3, IGF1:IGFBP3 ratio, or mammographic breast density. Subjective side effects were minimal with no significant increase in hot flashes, muscle cramps, arthralgias, or fatigue. Objective measures showed a clinically insignificant decrease in lumbar spine bone density (DEXA) and an increase in ovarian cysts but no change in endometrial thickness (sonography). In summary, acolbifene was associated with favorable changes in benign breast epithelial cell proliferation and estrogen-inducible gene expression but minimal side effects, suggesting a phase IIB placebo-controlled trial evaluating it further for breast cancer prevention. Cancer Prev Res; 8(12); 1146–55. ©2015 AACR.
Risk Stratification for Arrhythmic Events in Patients With Asymptomatic Pre-Excitation: A Systematic Review for the 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia
Authors: Al-Khatib Sana M. , Arshad Aysha , Balk Ethan M. , Das Sandeep R. , Hsu Jonathan C. , Joglar Josè A. , Page Richard L. 
Published: September 2015

Objective—
To review the literature systematically to determine whether noninvasive or invasive risk stratification, such as with an electrophysiological study of patients with asymptomatic pre-excitation, reduces the risk of arrhythmic events and improves patient outcomes.

Methods—
PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (all January 1, 1970, through August 31, 2014) were searched for randomized controlled trials and cohort studies examining noninvasive or invasive risk stratification in patients with asymptomatic pre-excitation. Studies were rejected for low-quality design or the lack of an outcome, population, intervention, or comparator of interest or if they were written in a language other than English.

Results—

Of 778 citations found, 9 studies met all the eligibility criteria and were included in this paper. Of the 9 studies, 1 had a dual design—a randomized controlled trial of ablation versus no ablation in 76 patients and an uncontrolled prospective cohort of 148 additional patients—and 8 were uncontrolled prospective cohort studies (n=1594). In studies reporting a mean age, the range was 32 to 50 years, and in studies reporting a median age, the range was 19 to 36 years. The majority of patients were male (range, 50% to 74%), and <10% had structural heart disease. In the randomized controlled trial component of the dual-design study, the 5-year Kaplan-Meier estimates of the incidence of arrhythmic events were 7% among patients who underwent ablation and 77% among patients who did not undergo ablation (relative risk reduction: 0.08; 95% confidence interval: 0.02 to 0.33;
P
<0.001). In the observational cohorts of asymptomatic patients who did not undergo catheter ablation (n=883, with follow-up ranging from 8 to 96 months), regular supraventricular tachycardia or benign atrial fibrillation (shortest RR interval >250 ms) developed in 0% to 16%, malignant atrial fibrillation (shortest RR interval ≤250 ms) in 0% to 9%, and ventricular fibrillation in 0% to 2%, most of whom were children in the last case.

Conclusions—
The existing evidence suggests risk stratification with an electrophysiological study of patients with asymptomatic pre-excitation may be beneficial, along with consideration of accessory-pathway ablation in those deemed to be at high risk of future arrhythmias. Given the limitations of the existing data, well-designed and well-conducted studies are needed.
Identifying Individuals at Risk for Cardiovascular Events Across the Spectrum of Blood Pressure Levels
Authors: Karmali Kunal N. , Ning Hongyan , Goff David C. , Lloyd‐Jones Donald M. 
Published: September 2015

Background
We determined the proportion of atherosclerotic cardiovascular disease (ASCVD) events that occur across the spectrum of systolic blood pressure (SBP) and assessed whether multivariable risk assessment can identify persons who experience ASCVD events at all levels of SBP, including those with goal levels.

Methods and Results
Participants aged 45 to 64 years from the Framingham Offspring and Atherosclerosis Risk in Communities studies were stratified based on treated and untreated SBP levels (<120, 120 to 129, 130 to 139, 140 to 149, 150 to 159, ≥160 mm Hg). We determined the number of excess ASCVD events in each SBP stratum by calculating the difference between observed and expected events (ASCVD event rate in untreated SBP <120 mm Hg was used as the reference). We categorized participants into 10‐year ASCVD risk groups using the Pooled Cohort risk equations. There were 18 898 participants (78% white; 22% black) who were followed for 10 years. We estimated 427 excess ASCVD events, of which 56% (109 of 197) and 50% (115 of 230), respectively, occurred among untreated and treated participants with elevated SBP who were not recommended for antihypertensive therapy. Among untreated participants, 10‐year ASCVD risk ≥7.5% identified 64% of those who experienced an ASCVD at 10 years and 30% of those who did not. Multivariable risk assessment was less useful in baseline‐treated participants.

Conclusions
Half of excess ASCVD events occurred in persons with elevated SBP who were not currently recommended for antihypertensive therapy. Multivariable risk assessment may help identify those likely to benefit from further risk‐reducing therapies. These findings support consideration of multivariable risk in guiding prevention across the spectrum of SBP.
State Legislators’ Roll-Call Votes on Farm Animal Protection Bills: The Agricultural Connection
Authors: Tauber Steven 
Published: September 2015

AbstractNonhuman animal studies scholars have extensively investigated attitudes on animal welfare in general and farm animal welfare in particular. Thus far, this research has focused mainly on public opinion, but there has been minimal research seeking to explain the influences on actual policymakers when they vote on farm animal welfare legislation. This paper contributes to this literature by quantitatively analyzing 216 state legislators’ votes on two farm animal welfare bills. It hypothesizes that the representatives’ personal and representational connections with agriculture best explain their votes on these farm animal protection bills. This research also includes three control variables: each legislator’s gender, race/ethnicity, and political party. Logistic regression revealed that the legislators’ personal and representational connections with agriculture are significant, but political party is the strongest independent variable explaining state legislators’ farm animal welfare votes. An interaction model revealed mixed evidence that political party moderates the influence of agriculture.
Influence of the Decadal Variability of the Kuroshio Extension on the Atmospheric Circulation in the Cold Season
Authors: Révelard Adèle , Frankignoul Claude , Sennéchael Nathalie , Kwon Young-Oh , Qiu Bo 
Published: September 2015

Abstract
The atmospheric response to the Kuroshio Extension (KE) variability during 1979–2012 is investigated using a KE index derived from sea surface height measurements and an eddy-resolving ocean general circulation model hindcast. When the index is positive, the KE is in the stable state, strengthened and shifted northward, with lower eddy kinetic energy, and the Kuroshio–Oyashio Extension (KOE) region is anomalously warm. The reverse holds when the index is negative. Regression analysis shows that there is a coherent atmospheric response to the decadal KE fluctuations between October and January. The KOE warming generates an upward surface heat flux that leads to local ascending motions and a northeastward shift of the zones of maximum baroclinicity, eddy heat and moisture fluxes, and the storm track. The atmospheric response consists of an equivalent barotropic large-scale signal, with a downstream high and a low over the Arctic. The heating and transient eddy anomalies excite stationary Rossby waves that propagate the signal poleward and eastward. There is a warming typically exceeding 0.6 K at 900 hPa over eastern Asia and western United States, which reduces the snow cover by 4%–6%. One month later, in November–February, a high appears over northwestern Europe, and the hemispheric teleconnection bears some similarity with the Arctic Oscillation. Composite analysis shows that the atmospheric response primarily occurs during the stable state of the KE, while no evidence of a significant large-scale atmospheric response is found in the unstable state. Arguments are given to explain this strong asymmetry.
Cross-Level Effects Between Neurophysiology and Communication During Team Training
Authors: Gorman Jamie C. , Martin Melanie J. , Dunbar Terri A. , Stevens Ronald H. , Galloway Trysha L. , Amazeen Polemnia G. , Likens Aaron D. 
Published: September 2015

Objective: We investigated cross-level effects, which are concurrent changes across neural and cognitive-behavioral levels of analysis as teams interact, between neurophysiology and team communication variables under variations in team training. Background: When people work together as a team, they develop neural, cognitive, and behavioral patterns that they would not develop individually. It is currently unknown whether these patterns are associated with each other in the form of cross-level effects. Method: Team-level neurophysiology and latent semantic analysis communication data were collected from submarine teams in a training simulation. We analyzed whether (a) both neural and communication variables change together in response to changes in training segments (briefing, scenario, or debriefing), (b) neural and communication variables mutually discriminate teams of different experience levels, and (c) peak cross-correlations between neural and communication variables identify how the levels are linked. Results: Changes in training segment led to changes in both neural and communication variables, neural and communication variables mutually discriminated between teams of different experience levels, and peak cross-correlations indicated that changes in communication precede changes in neural patterns in more experienced teams. Conclusion: Cross-level effects suggest that teamwork is not reducible to a fundamental level of analysis and that training effects are spread out across neural and cognitive-behavioral levels of analysis. Cross-level effects are important to consider for theories of team performance and practical aspects of team training. Application: Cross-level effects suggest that measurements could be taken at one level (e.g., neural) to assess team experience (or skill) on another level (e.g., cognitive-behavioral).
Completion Lymph Node Dissection Based on Risk of Nonsentinel Metastasis in Cutaneous Melanoma of the Head and Neck
Authors: Fritsch Valerie A. , Cunningham Joan E. , Lentsch Eric J. 
Published: September 2015

ObjectiveTheoretically, completion lymph node dissection (CNLD) should have the lowest benefit in the absence of nonsentinel lymph node (NSLN) metastases. For this reason, substantial research efforts have attempted to define specific criteria that are associated with a low‐enough risk of NSLN positivity so that CLND can be deferred. Our objectives were (1) to identify features associated with low risk of NSLN positivity in sentinel lymph node–positive cutaneous melanoma of the head and neck (CMHN) and (2) to analyze the effect of CLND on 5‐year disease‐specific survival (DSS) among subgroups stratified by risk of NSLN metastasis.Study DesignRetrospective analysis of population‐based data.SettingSEER database.Subjects and MethodsPatients with sentinel lymph node–positive CMHN were categorized according to lymph node treatment following sentinel lymph node biopsy (SLNB): 210 underwent CLND and 140 deferred. Clinicopathologic characteristics and survival were compared between SLNB+CLND and SLNB‐only groups. Survival analyses were stratified by age and characteristics associated with NSLN positivity.ResultsMinimal tumor thickness and nonulceration were associated with lowest risk of positive NSLN (P <. 025). In the subgroup with the lowest risk of metastasis, patients aged <60 years who underwent CLND+SLNB had markedly better DSS than those receiving SLNB only (>90% vs <25%; P <. 0025). Paradoxically, in subgroups with a higher risk of NSLN metastasis, DSS was similar whether CLND was performed or not (P >. 25).ConclusionsSelecting patients for CLND according to risk of NSLN metastasis may be a suboptimal strategy for improving DSS. We believe that CLND should not be withheld on the basis of “low risk” features in CMHN.
Hepatopulmonary shunting after surgical, interventional and systemic therapy in patients with liver malignancies scheduled for radioembolization
Authors: Erxleben Christoph , Scheurig-Münkler Christian , Geisel Dominik , Hamm Bernd , Gebauer Bernhard , Powerski Maciej Janusz 
Published: September 2015

Background Hepatopulmonary shunts (HPS) lead to radiation exposure of the lungs in patients undergoing radioembolization (RE) of malignant liver tumors. Purpose To retrospectively analyze how HPS is affected by prior systemic or local therapy of the liver. Material and Methods The percentage HPS was calculated from SPECT/CT scans obtained after technetium-99 m macroaggregated albumin administration into hepatic arteries in 316 patients evaluated for RE. Results Patients with partial liver resection ( n = 80) did not differ in HPS from the remaining patient population ( n = 236) (HPS (median [range]) = 10.2 [2.1–48.3]resection% vs. 8.9 [2.3–32.9]no resection%; P = 0.527). In patients undergoing sequential RE, HPS was significantly higher in the liver lobe treated second ( n = 10; HPS = 6.4 [2.1–10.2]firstlobe/session% vs. 12.0 [2.0–24.6]second lobe/session%; P = 0.019). (Chemo-)embolization ( n = 19; HPS = 11.0 [2.8–48.3]%) or transcutaneous ablation ( n = 63; HPS = 8.8 [3.0–32.9]%) had no effect on HPS compared to patients without prior interventions (no (chemo-)embolization: n = 297; HPS = 9.3 [2.1–47.3]%; P = 0.489; no ablation: n = 253; HPS = 9.5 [2.1–48.3]%; P = 0.382). Pretreatment with sorafenib (HPS = 9.5 [2.3–35.9]yes% vs. 10.2 [2.8–42.0]no%; P = 0.777) orbevacizumab (HPS = 10.7 [2.1–30.6]yes% vs. 9.0 [3.9–23.3]no%; P = 0.870) had no effect on HPS. Conclusion Sequential RE results in an increase in the HPS in the contralateral liver lobe at the time of the second RE session. Other investigated therapy do not affect HPS.
Dissociative identity disorder (DID) in clinical practice – what you don’t see may hurt you
Authors: Leonard David , Tiller John 
Published: September 2015

Objectives: To identify problems that interfere with the recognition, diagnosis and management of people with dissociative identity disorder (DID) presenting to psychiatric outpatient and inpatient services and suggest solutions. Method: Problems and suggested solutions associated with clinical presentations and management of people with DID are outlined with references to relevant literature. Results: Problems in the recognition and management of DID are described. These lead to delays in diagnosis and costly, inappropriate management, destructive to services, staff and patients alike. Problems include lack of understanding and experience and scepticism about the disorder, resulting in failure to provide appropriate treatment. Some suggestions to improve recognition and management are included. Conclusion: Better recognition, diagnosis and management of DID will lead to better and more cost effective outcomes.
C-reactive protein: an early critical sign of clozapine-related myocarditis
Authors: Fehily Sasha R , Forlano Rosaria , Fitzgerald Paul B 
Published: September 2015

Objective: We present a case of clozapine-related myocarditis, with a rising C-reactive protein as the only initial evidence supporting the diagnosis. Method: An otherwise healthy young male presenting with treatment-resistant schizophrenia was started on clozapine. Monitoring was performed. Results: At day 18 he developed fever, tachycardia and a raised C-reactive protein, while troponin levels and echocardiogram remained normal. Conclusions: Current protocols monitoring for myocarditis have their limitations and can often only be used to support a presumptive diagnosis of myocarditis. In keeping with the current clozapine monitoring guidelines, we demonstrate that a rise in C-reactive protein levels can be a critical early sign of myocarditis warranting close monitoring and serious consideration for cessation of clozapine.
Apparent nutrient digestibility of two raw diets in domestic kittens
Authors: Hamper Beth A , Kirk Claudia A , Bartges Joseph W 
Published: September 2015

Objectives The aim of the study was to evaluate overall dry matter, organic matter, crude protein, crude fat and gross energy digestibility of a feline commercial raw diet and a homemade raw diet compared with a canned, heat-processed diet. Methods Six domestic shorthair kittens (20–28 weeks old) were fed three different diets in a Latin square crossover design. Diet A was a commercially available, canned, heat-processed diet. Diet B was a complete commercial, prefrozen, raw diet (commercial raw), and diet C was a raw diet supplement mixed with ground raw meat obtained locally (homemade raw). Both diets A and B were formulated to meet nutritional profile levels for cats at all life stages. Kittens were given specific diet amounts to maintain a 2–4% weight increase per week. Food was measured before and after feedings to determine the amount eaten, and all feces were collected, weighed and frozen prior to submission. Composite food samples and all feces were submitted to a national laboratory for proximate analysis of crude protein, crude fiber, ash, crude fat, moisture and caloric density. Results Significantly higher digestibility of dry matter ( P <0.001), organic matter ( P <0.001), crude protein ( P <0.001) and gross energy ( P <0.001) was seen in the raw diets compared with the heat-processed diets. This difference resulted in significantly less fecal matter ( P <0.001) despite similar levels of intake and kcal ingested, and evidence of no difference in fecal scores. Conclusions and relevance Higher dry matter, organic matter and protein digestibility was seen in two commercial raw diets compared with a heat-processed diet. Digestibility differences could have been due to variance in dietary protein, fat and carbohydrate concentrations between the diets, variance in dietary ingredients or quality, alterations in protein structure secondary to heat processing, as well as alterations in gastrointestinal flora. Future research examining digestibility in diets with the same macronutrient proportions and ingredients, and mechanisms for any differences, is warranted.
Research on grammatical gender and thought in early and emergent bilinguals
Authors: Bassetti Bene , Nicoladis Elena 
Published: September 2015

Aims and objectives/purpose/research questions: This article reviews recent research on how speaking a language that marks gender grammatically might affect thinking, and on the relationship between grammatical gender knowledge of more than one language, and thinking, in both early and emergent bilinguals. Design/methodology/approach: The paper provides a comprehensive review of previous research, as well as an introduction to, and an evaluation of, the articles in this special issue. Findings/conclusions: Several themes emerge in the research on grammatical gender and thinking in bilinguals. First, knowledge of more than one language could reduce the effects of grammatical gender on thinking. Second, these effects may depend on the combination of languages being acquired. Third, researchers are starting to identify other variables that might affect when and how grammatical gender influences thinking, including proficiency and the choice of tasks. Originality: This manuscript synthesises the previously scattered research on grammatical gender and thinking in bilinguals. Significance/implications: This is the first full-length overview paper about the relationship between grammatical gender and thinking in speakers of more than one language.