bluuebunny/crossref_metadata_2025_split huggingface dataset:
Achievement of Dual Low-Density Lipoprotein Cholesterol and High-Sensitivity C-Reactive Protein Targets More Frequent With the Addition of Ezetimibe to Simvastatin and Associated With Better Outcomes in IMPROVE-IT
Authors: Bohula Erin A. , Giugliano Robert P. , Cannon Christopher P. , Zhou Jing , Murphy Sabina A. , White Jennifer A. , Tershakovec Andrew M. , Blazing Michael A. , Braunwald Eugene 
Published: September 2015

Background—
Statins lower low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP); addition of ezetimibe to statins further reduces LDL-C and hs-CRP. An analysis of the relationship between achieved LDL-C and hs-CRP targets and outcomes for simvastatin and ezetimibe/simvastatin was prespecified in Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT).

Methods and Results—

The IMPROVE-IT trial randomly assigned 18 144 patients stabilized after acute coronary syndrome to simvastatin or ezetimibe/simvastatin. LDL-C and hs-CRP were measured at baseline and 1 month after randomization. Outcomes were assessed in those achieving one or both of the prespecified targets of LDL-C<70 mg/dL and hs-CRP<2 mg/L versus achieving neither target, adjusting for differences in baseline characteristics. An exploratory analysis examined targets of LDL-C<50 mg/dL and hs-CRP<1 mg/L. Patients meeting both targets at baseline, with no 1-month values, or with end points before 1 month were excluded. Of 15 179 patients, 39% achieved the dual LDL-C (<70 mg/dL) and hs-CRP (<2 mg/L) targets at 1 month, 14% met neither target, 14% met only the hs-CRP target, and 33% met only the LDL-C target. Those achieving dual targets had lower primary end point rates than those meeting neither target (cardiovascular death, major coronary event, or stroke; 38.9% versus 28.0%; adjusted hazard ratio, 0.73; 0.66–0.81;
P
<0.001). More patients treated with ezetimibe/simvastatin met dual targets than those treated with simvastatin alone (50% versus 29%,
P
<0.001). The association of dual-target attainment with improved outcomes was similar irrespective of treatment assignment (
P
-interaction=0.65). Similar findings were observed using the exploratory targets.

Conclusions—
Significantly more patients treated with ezetimibe/simvastatin met prespecified and exploratory dual LDL-C and hs-CRP targets than patients treated with simvastatin alone. Reaching both LDL-C and hs-CRP targets was associated with improved outcomes after multivariable adjustment.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
; Unique identifier: NCT00202878.
Prevalence of Stroke and Its Risk Factors in Urban Sri Lanka
Authors: Chang Thashi , Gajasinghe Seneth , Arambepola Carukshi 
Published: September 2015

Background and Purpose—
Stroke is a leading cause of disability and death worldwide. In the absence of published population-based prevalence data, we investigated the prevalence and risk factors of stroke in a population of varying urbanization in Sri Lanka.

Methods—
A population-based, cross-sectional study was conducted among 2313 adults aged ≥18 years residing in Colombo, selected using a multistage, probability proportionate-to-size, cluster sampling technique. Data were collected using an interviewer-administered questionnaire. Ever diagnosis of stroke was confirmed by medical doctors based on World Health Organization criteria and corroborated by documental evidence.

Results—
Of the total population (52.4% women; mean age, 44.2 years; SD, 16.6), the prevalence of stroke was 10.4 per 1000 (95% confidence interval, 6.3–14.5) with a 2:1 male:female ratio. Beyond the age of 65 years, the prevalence was higher by 6-fold among men and by 2-fold among women. Ninety two percent had developed hemiparesis, 58.3% had dysphasia, and 16.7% had loss of balance. Hypertension was the commonest risk factor (62.5%) followed by smoking (45.8%), excess alcohol (41.7%), diabetes mellitus (33.3%), and transient ischemic attack (29.2%); 79.2%, predominantly men, had ≥2 risk factors. A percentage of 58.3 had brain computed tomographic scans, of whom 85.7% had ischemic strokes. A percentage of 64.3 had to change or give up working because of stroke-related disability.

Conclusions—
Age-adjusted stroke prevalence in urban Sri Lanka lies between high-income and low-/middle-income countries. The prevalence of stroke and its risk factors were higher among men.
Predictors of Good Outcome After Stent-Retriever Thrombectomy in Acute Basilar Artery Occlusion
Authors: Yoon Woong , Kim Seul Kee , Heo Tae Wook , Baek Byung Hyun , Lee Yun Young , Kang Heoung Keun 
Published: September 2015

Background and Purpose—
Factors related to prognosis after a modern mechanical thrombectomy in patients with acute basilar artery occlusion remain unclear. This study investigated the prognostic factors for patients with acute basilar artery occlusion who underwent a stent-retriever thrombectomy.

Methods—
We analyzed clinical and pretreatment diffusion-weighted imaging (DWI) data in 50 consecutive patients with acute basilar artery occlusion treated with stent-retriever thrombectomy. A good outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The association between clinical and DWI parameters and functional outcome was evaluated with logistic regression analysis.

Results—

In a univariate analysis, the following variables were significantly associated with outcome: age, hypertension, baseline National Institutes of Health Stroke Scale, posterior circulation Acute Stroke Prognosis Early CT Score on a pretreatment DWI, posterior circulation Acute Stroke Prognosis Early CT Score of ≥7 (versus <7), thalamic infarction, and bilateral thalamic infarction. In a multivariate model, only a low initial National Institutes of Health Stroke Scale score (odds ratio, 0.82; 95% confidence interval, 0.709–0.949;
P
=0.008) and high DWI posterior circulation Acute Stroke Prognosis Early CT Score (odds ratio, 1.854; 95% confidence interval 1.012–3.397;
P
=0.045) were significant independent predictors of good outcome. In a univariate analysis, bilateral thalamic infarction was associated with a poor outcome (odds ratio, 1.993; 95% confidence interval, 1.187–3.346;
P
=0.035) but not with a unilateral thalamic infarction (
P
=0.525).

Conclusions—
This study suggested that initial infarction severity and posterior circulation Acute Stroke Prognosis Early CT Score on a pretreatment DWI are independent predictors of clinical outcome after stent-retriever thrombectomy in patients with acute basilar artery occlusion.
Positive Feedback in Climate: Stabilization or Runaway, Illustrated by a Simple Experiment
Authors: Dufresne Jean-Louis , Saint-Lu Marion 
Published: September 2015

Abstract
The response of the various climatic processes to climate change can amplify (positive feedback) or damp (negative feedback) the initial temperature perturbation. An example of a positive feedback is the surface albedo feedback: when the surface temperature rises, part of the ice and snow melts, leading to an increase in the solar radiation absorbed by the surface and to an enhanced surface warming. Positive feedbacks can lead to instability. On Venus, for example, a positive feedback is thought to have evolved into a runaway greenhouse effect. However, positive feedbacks can exist in stable systems. This paper presents a simple representation of a positive feedback in both a stable and an unstable system. A simple experimental device based on a scale principle is introduced to illustrate the positive feedback and its stabilization or runaway regimes. Stabilization can be achieved whether the amplitude of the positive feedback declines (e.g., “saturation” of the feedback) or remains constant. The device can also be used to illustrate the existence of tipping points, which are threshold values beyond which the amplification due to feedbacks or the stability of the system suddenly changes. The physical equations of the device are established in the framework of the feedback analysis. Key features to understand why a positive feedback does not necessarily lead to a runaway effect are described. The analogy between the different components of the device and those of the climate system is established. Finally, the contribution of individual feedbacks to the total climate response is addressed.
Extreme Precipitation Indices over China in CMIP5 Models. Part I: Model Evaluation
Authors: Jiang Zhihong , Li Wei , Xu Jianjun , Li Laurent 
Published: September 2015

Abstract
Compared to precipitation extremes calculated from a high-resolution daily observational dataset in China during 1960–2005, simulations in 31 climate models from phase 5 of the Coupled Model Intercomparison Project (CMIP5) have been quantitatively assessed using skill-score metrics. Four extreme precipitation indices, including the total precipitation (PRCPTOT), maximum consecutive dry days (CDD), precipitation intensity (SDII), and fraction of total rainfall from heavy events (R95T) are analyzed. Results show that CMIP5 models still have wet biases in western and northern China. Especially in western China, the models’ median relative error is about 120% for PRCPTOT; the 25th and 75th percentile errors are of 70% and 220%, respectively. However, there are dry biases in southeastern China, where the underestimation of PRCPTOT reach 200 mm. The performance of CMIP5 models is quite different between western and eastern China. The simulations are more reliable in the east than in the west in terms of spatial pattern and interannual variability. In the east, precipitation indices are more consistent with observations, and the spread among models is smaller. The multimodel ensemble constructed from a selection of the most skillful models shows improved behavior compared to the all-model ensemble. The wet bias in western and northern China and dry bias over southeastern China are all decreased. The median of errors for PRCPTOT has a decrease of 69% and 17% in the west and east, respectively. The good reproduction of the southwesterlies along the east coast of the Arabian Peninsula is revealed to be the main factor explaining the improvement of precipitation patterns and extreme events.
Understanding of Interdecadal Changes in Variability and Predictability of the Northern Hemisphere Summer Tropical–Extratropical Teleconnection
Authors: Lee June-Yi , Ha Kyung-Ja 
Published: September 2015

Abstract
Two dominant global-scale teleconnections—namely, western North Pacific–North American (WPNA) and circumglobal teleconnection (CGT)—in the Northern Hemisphere (NH) extratropics during boreal summer (June–August) have been identified as important sources for NH summer climate variability and predictability. An interdecadal shift in interannual variability and predictability of the WPNA and CGT that occurred around the late 1970s was investigated using reanalysis data and six coupled models’ retrospective forecast with a 1 May initial condition for the period 1960–79 (P1) and 1980–2005 (P2). The WPNA had a tight relationship with the decaying phase of El Niño–Southern Oscillation (ENSO) in P1, whereas it had a remarkably enhanced linkage with western North Pacific (WNP) summer monsoon rainfall in P2. The correlation coefficient between the WPNA and preceding ENSO (WNP monsoon rainfall) was reduced (increased) from −0.69 (0.1) in P1 to −0.60 (0.5) in P2. The CGT had a considerable connection with Indian summer monsoon rainfall (ISMR) in P1, whereas it had a strengthened relationship with the developing ENSO in P2. The correlation coefficient between the CGT and simultaneous ENSO (ISMR) was increased (decreased) from −0.41 (0.47) in P1 to −0.59 (0.24) in P2. Although dynamical models have difficulties in capturing the observed interdecadal changes, they are able to predict the interannual variation of the WPNA and CGT one month ahead, to some extent. The prediction skill of six models’ multimodel ensemble (MME) decreased (increased) from 0.78 (0.23) to 0.67 (0.67) for the WPNA (CGT) interannual variation. It is also noted that the spatial distribution of predictability and MME skill for 200-hPa geopotential height has been changed in relation to the changes in the WPNA and CGT.
Good sinners and exemplary heretics: The sociopolitical implications of love and acceptance in the Gospel of Luke
Authors: Miller Amanda C. 
Published: September 2015

This article pairs discussion of the polarization of contemporary American politics with an exploration of the Gospel of Luke’s call to radical hospitality across and in spite of earthly societal divisions. Amanda C. Miller argues that the Lukan Jesus demonstrates a way of living in the world that extends acceptance to all people regardless of ethnic, socioeconomic, political, or religious labels, and focuses instead on their actions toward God and other human beings. The narrative of the Third Gospel strongly alls for love, justice, and hospitality to be enacted, embodied, and demonstrated in how one treats other people. Miller begins with an overview of the extreme polarization of political views in the 21st-century United States, and a brief look at Jesus’ ethic of acceptance and the conflict such actions will inevitably provoke (e.g., in the call of Levi the tax collector in 5:27–32 and Jesus’ Nazareth proclamation and subsequent rejection in 4:16–30). She then examines in some detail two stories in Luke that show active, engaged relationship between people who, for various societal reasons, would not normally like each other, much less help one another. The parable of the Good Samaritan (10:25–37) demonstrates this boundary-crossing hospitality in the conversation between Jesus and the Torah scholar, and the interaction in the parable between the Samaritan and the wounded man. Likewise, the story of Zacchaeus (19:1–10) shows how a simple invitation to eat together offered by Jesus to a wealthy tax collector transforms Zacchaeus so dramatically that he, in turn, extends radical generosity to those whom he used to oppress and defraud. These two stories demonstrate the power of active acceptance and relationship between those who differ, over and against the dehumanizing labels humans use to divide themselves from one another.
Ha Nāḡîḏ: A Machiavellian Reading of King David in the Deuteronomistic History
Authors: Holtmeyer Taylor Robyn 
Published: September 2015

Explorations of political theory, law, power and the people who wield it have existed throughout a majority of human history. From the Code of Hammurabi to Plato’s The Republic to Machiavelli’s The Prince to Hobbes’ Leviathan, people from various times and cultures have debated the importance of government and its role in the lives of citizens. The Deuteronomist, the anonymous redactor(s) of the Deuteronomistic History (Joshua-2 Kings, with Deuteronomy affixed as a prologue), has also contributed to this vast tradition of political debate. With the retelling of the Law, the Deuteronomist uses the Book of Deuteronomy as a measure to judge the actions and efficacy of later characters according to the standards set by Yahweh. Deuteronomist 16:18–18:22 is a passage that specifically focuses on the paradigmatic governmental structure that Israel should adopt once they are situated in the Promised Land. The excerpt organizes the government into four branches – priests, judges, monarchs, and prophets – and it severely restricts the power of the chief leader, the king. Yet when Israel’s most famous king is evaluated against the rigorous criteria of the Deuteronomist, he falls short. With his aspiring nature and political desires, David instead calls to mind another political ideal – Machiavelli’s hypothetical prince. In short, Machiavelli argues, a prince must manipulate Fortune and Virtue in order to keep and maintain power, for the end justifies the means. It appears that throughout his life, David endeavors to control these two entities for political gain, and his yearning to rule over Israel and Judah justifies his actions along the way. This article will examine some of those actions, specifically those relating to his ambition, his manipulation of the people, and his exploitation of the cult, through a Machiavellian perspective. The article will then argue that David’s politics are more consistent with Machiavelli’s pragmatism than with the Deuteronomist’s Yahwism.
A systematic review of the impact of stroke on social support and social networks: associated factors and patterns of change
Authors: Northcott Sarah , Moss Becky , Harrison Kirsty , Hilari Katerina 
Published: September 2015

Objective: Identify what factors are associated with functional social support and social network post stroke; explore stroke survivors’ perspectives on what changes occur and how they are perceived. Data sources: The following electronic databases were systematically searched up to May 2015: Academic Search Complete; CINAHL Plus; E-journals; Health Policy Reference Centre; MEDLINE; PsycARTICLES; PsycINFO; and SocINDEX. Review methods: PRISMA guidelines were followed in the conduct and reporting of this review. All included studies were critically appraised using the Critical Appraisal Skills Program tools. Meta-ethnographic techniques were used to integrate findings from the qualitative studies. Given the heterogeneous nature of the quantitative studies, data synthesis was narrative. Results: Seventy research reports met the eligibility criteria: 22 qualitative and 48 quantitative reporting on 4,816 stroke survivors. The qualitative studies described a contraction of the social network, with non-kin contact being vulnerable. Although family were more robust network members, significant strain was observed within the family unit. In the quantitative studies, poor functional social support was associated with depression (13/14 studies), reduced quality of life (6/6 studies) and worse physical recovery (2/2 studies). Reduced social network was associated with depression (7/8 studies), severity of disability (2/2 studies) and aphasia (2/2 studies). Although most indicators of social network reduced post stroke (for example, contact with friends, 5/5 studies), the perception of feeling supported remained relatively stable (4/4 studies). Conclusion: Following a stroke non-kin contact is vulnerable, strain is observed within the family unit, and poor social support is associated with depressive symptoms.
An international comparison of costs of end-of-life care for advanced lung cancer patients using health administrative data
Authors: Bremner Karen E , Krahn Murray D , Warren Joan L , Hoch Jeffrey S , Barrett Michael J , Liu Ning , Barbera Lisa , Yabroff K Robin 
Published: September 2015

Background: Patterns of end-of-life cancer care differ in Canada and the United States; yet little is known about differences in service-specific and overall costs. Aim: The aim of this study was to compare end-of-life costs in Ontario, Canada, and the United States, using administrative health data. Design: Advanced-stage nonsmall cell lung cancer patients who died from cancer at age ⩾65.5 years in 2001–2005 were selected from the US Surveillance, Epidemiology, and End Results–Medicare database ( N = 16,858) and the Ontario Cancer Registry ( N = 8643). We estimated total and service-specific costs (2009 US dollars) in each of the last 6 months of life from the public payer perspectives for short-term and long-term survivors (lived <180 and ⩾180 days post-diagnosis, respectively). Services were defined for comparisons between systems. Results: Mean monthly costs increased as death approached, were higher in short-term than long-term survivors, and were generally higher in the United States than in Ontario until the month before death, when they were similar (long-term survivors: US$10,464 and US$10,094 ( p = 0.53), short-term survivors US$14,455 and US$12,836 ( p = 0.11), in Surveillance, Epidemiology, and End Results–Medicare and Ontario, respectively). Costs for Medicare hospice and Ontario’s palliative care components were similar and increased closer to death. Inpatient hospitalization was the main cost driver with similar costs in both cohorts, despite lower utilization in the United States. The compositions of many services and costs differed. Conclusion: Costs for nonsmall cell lung cancer patients were slightly higher in the United States than Ontario until 1 month before death. Administrative data allow exploration and international comparisons of reimbursement policies, health-care delivery, and costs at the end of life.
Does the use of specialist palliative care services modify the effect of socioeconomic status on place of death? A systematic review
Authors: Chen Hong , Nicolson Donald J , Macleod Una , Allgar Victoria , Dalgliesh Christopher , Johnson Miriam 
Published: September 2015

Background: Cancer patients in lower socioeconomic groups are significantly less likely to die at home and experience more barriers to access to palliative care. It is unclear whether receiving palliative care may mediate the effect of socioeconomic status on place of death. Aim: This review examines whether and how use of specialist palliative care may modify the effect of socioeconomic status on place of death. Design: A systematic review was conducted. Eligible papers were selected and the quality appraised by two independent reviewers. Data were synthesised using a narrative approach. Data sources: MEDLINE, Embase, CINAHL, PsycINFO and Web of Knowledge were searched (1997–2013). Bibliographies were scanned and experts contacted. Papers were included if they reported the effect of both socioeconomic status and use of specialist palliative care on place of death for adult cancer patients. Results: Nine studies were included. All study subjects had received specialist palliative care. With regard to place of death, socioeconomic status was found to have (1) no effect in seven studies and (2) an effect in one study. Furthermore, one study found that the effect of socioeconomic status on place of death was only significant when patients received standard specialist palliative care. When patients received more intense care adapted to their needs, the effect of socioeconomic status on place of death was no longer seen. Conclusion: There is some evidence to suggest that use of specialist palliative care may modify the effect of socioeconomic status on place of death.