bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trials to Improve Blood Pressure Through Adherence to Antihypertensives in Stroke/TIA: Systematic Review and Meta‐Analysis
Authors: De Simoni Anna , Hardeman Wendy , Mant Jonathan , Farmer Andrew J. , Kinmonth Ann Louise 
Published: August 2013

Background

The purpose of this study was to determine whether interventions including components to improve adherence to antihypertensive medications in patients after stroke/transient ischemic attack (
TIA
) improve adherence and blood pressure control.

Methods and Results

We searched
MEDLINE
,
EMBASE
,
CINAHL
,
BNI
, Psyc
INFO
, and article reference lists to October 2012. Search terms included stroke/
TIA
, adherence/prevention, hypertension, and randomized controlled trial (
RCT
). Inclusion criteria were participants with stroke/
TIA
; interventions including a component to improve adherence to antihypertensive medications; and outcomes including blood pressure, antihypertensive adherence, or both. Two reviewers independently assessed studies to determine eligibility, validity, and quality. Seven
RCT
s were eligible (n=1591). Methodological quality varied. All trials tested multifactorial interventions. None targeted medication adherence alone. Six trials measured blood pressure and 3 adherence. Meta‐analysis of 6 trials showed that multifactorial programs were associated with improved blood pressure control. The difference between intervention versus control in mean improvement in systolic blood pressure was −5.3 mm Hg (95%
CI
, −10.2 to −0.4 mm Hg,
P
=0.035;
I
2
=67% [21% to 86%]) and in diastolic blood pressure was −2.5 mm Hg (−5.0 to −0.1 mm Hg,
P
=0.046;
I
2
=47% [0% to 79%]). There was no effect on medication adherence where measured.

Conclusions

Multifactorial interventions including a component to improve medication adherence can lower blood pressure after stroke/
TIA
. However, it is not possible to say whether or not this is achieved through better medication adherence. Trials are needed of well‐characterized interventions to improve medication adherence and clinical outcomes with measurement along the hypothesized causal pathway.
Admission Insular Infarction >25% Is the Strongest Predictor of Large Mismatch Loss in Proximal Middle Cerebral Artery Stroke
Authors: Kamalian Shervin , Kemmling Andre , Borgie Roderick C. , Morais Livia T. , Payabvash Seyedmehdi , Franceschi Ana M. , Kamalian Shahmir , Yoo Albert J. , Furie Karen L. , Lev Michael H. 
Published: August 2013

Background and Purpose—
Previous univariate analyses have suggested that proximal middle cerebral artery infarcts with insular involvement have greater severity and are more likely to progress into surrounding penumbral tissue at risk. We hypothesized that a practical, simple scoring method to assess percent insular ribbon infarction (PIRI score) would improve prediction of penumbral loss over other common imaging biomarkers.

Methods—
Of consecutive acute stroke patients from 2003 to 2008, 45 with proximal middle cerebral artery–only occlusion met inclusion criteria, including available penumbral imaging. Infarct (diffusion-weighted imaging), tissue at risk (magnetic resonance mean transit time), and final infarct volume (magnetic resonance/computed tomography) were manually segmented. Diffusion-weighted imaging images were rated according to the 5-point PIRI score (0, normal; 1, <25%; 2, 25%–49%; 3, 50%–74%; 4, ≥75% insula involvement). Percent mismatch loss was calculated as an outcome measure of infarct progression. Receiver operating characteristic curve and multivariate analyses were performed.

Results—

Mean admission diffusion-weighted imaging infarct volume was 30.9 (±38.8) mL and median (interquartile range) PIRI score was 3 (0.75–4). PIRI score was significantly correlated with percent mismatch loss (
P
<0.0001). When percent mismatch loss was dichotomized based on its median value (30.0%), receiver operating characteristic curve area under curve was 0.89 (
P
=0.0001) with a 25% insula infarction optimal threshold. After adjusting for time to imaging and treatment, binary logistic regression, including dichotomized PIRI (25% threshold), age, National Institutes of Health Stroke Scale score, diffusion-weighted imaging infarct volume, and computed tomography angiography collateral score as covariates, revealed that only dichotomized insula score (
P
=0.03) and age (
P
=0.02) were independent predictors of large (68.2%) versus small (8.1%) mismatch loss. There was excellent interobserver agreement for dichotomized PIRI scoring (κ=0.91).

Conclusions—
Admission insular infarction >25% is the strongest predictor of large mismatch loss in this cohort of proximal middle cerebral artery occlusive stroke. This outcome marker may help to identify treatment-eligible patients who are in greatest need of rapid reperfusion therapy.
Explaining the Prevalence of Voluntary Associations among 351 Massachusetts Municipalities circa 1965: Testing a Theory
Authors: Smith David Horton 
Published: August 2013

Abstract
Data from an extensive research project in the state of Massachusetts (USA), collected in the 1960s and never before reported, are used to test a theory of association prevalence among 351 municipalities. The dependent variable to be explained was an Association Prevalence Index (total number existing) in each municipality. The Index was derived from Massachusetts Statehouse physical records for all incorporated Nonprofit Organizations (NPOs), and showed an average of 33 associations per municipality. Using bivariate correlations, the results confirmed the theory generally. Association prevalence (raw number of associations) in a municipality was positively and significantly related to larger population size, being a county administrative center, more business telephones, greater circulation of weekly newspapers (local newspapers), more service businesses, more state government agencies, more churches, larger percentage of African-Americans, and more halls/buildings available for association gatherings (meetings, events). Contrary to the theory, the socioeconomic status of municipalities was not significantly related to association prevalence. The Statehouse Association Prevalence Index was correlated very highly (r = .92) with an independent measure of association prevalence, derived from coding the “Yellow Pages” of phone books. This result indicates the reliability and general validity of both prevalence measures.
Polarimetric Radar Characteristics of Melting Hail. Part II: Practical Implications
Authors: Ryzhkov Alexander V. , Kumjian Matthew R. , Ganson Scott M. , Zhang Pengfei 
Published: August 2013

AbstractThe results of theoretical modeling in Part I are utilized to develop practical recommendations for developing the algorithms for hail detection and determination of its size as well as attenuation correction and rainfall estimation in the presence of hail. A new algorithm for discrimination between small hail (with maximal size of less than 2.5 cm), large hail (with diameters between 2.5 and 5.0 cm), and giant hail with size exceeding 5.0 cm is proposed and implemented for applications with the S-band dual-polarization Weather Surveillance Radar-1988 Doppler (WSR-88D) systems. The fuzzy-logic algorithm is based on the combined use of radar reflectivity Z, differential reflectivity ZDR, and cross-correlation coefficient ρhv. The parameters of the membership functions depend on the height of the radar resolution volume with respect to the freezing level, exploiting the size-dependent melting characteristics of hailstones. The attenuation effects in melting hail are quantified in this study, and a novel technique for polarimetric attenuation correction in the presence of hail is suggested. The use of a rainfall estimator that is based on specific differential phase KDP is justified on the basis of the results of theoretical simulations and comparison of actual radar retrievals at S band with gauge measurements for storms containing large hail with diameters exceeding 2.5 cm.
Examining Internal and External Contributors to Greenland Climate Variability Using CCSM3
Authors: Andres Heather J. , Peltier W. R. 
Published: August 2013

Abstract
Greenland climate variability is connected to internal and external sources of global climate forcing in six millennium simulations using Community Climate System Model, version 3. The external forcings employed are consistent with the protocols of Paleoclimate Modelling Intercomparison Project Phase 3. Many simulated internal climate modes are characterized over the years 850–1850, including the Atlantic meridional overturning circulation (AMOC), the Atlantic multidecadal oscillation (AMO), the east Atlantic pattern (EA), the El Niño–Southern Oscillation, the North Atlantic Oscillation (NAO), the North Atlantic sea ice extent, and the Pacific decadal oscillation (PDO). Lagged correlation and multivariate regression methods connect Greenland temperatures and precipitation to these internal modes and external sources of climate variability.
Greenland temperature and precipitation are found to relate most strongly to North Atlantic sea ice extent, the AMO, and the AMOC, that are themselves strongly interconnected. Furthermore, approximately half of the multidecadal variability in Greenland temperature and precipitation are captured through linear relationships with volcanic aerosol optical depth, solar insolation (including total solar irradiance and local orbital variability), the NAO, the EA, and the PDO. Relationships are robust with volcanic aerosol optical depth, solar insolation, and an index related to latitudinal shifts of the North Atlantic jet. Differences attributable to model resolution are also identified in the results, such as lower variability in the AMOC and Greenland temperature in the higher-resolution simulations. Finally, a regression model is applied to simulations of the industrial period to show that natural sources alone only explain the variability in simulated Greenland temperature and precipitation up to the 1950s and 1970s, respectively.
ENSO-Modulated Cyclogenesis over the Bay of Bengal*
Authors: Felton Clifford S. , Subrahmanyam Bulusu , Murty V. S. N. 
Published: August 2013

Abstract
The role of the El Niño–Southern Oscillation (ENSO) on the modulation of tropical cyclone activity over the Bay of Bengal (BoB) for the 1979–2011 period is examined. It is shown that Niño-3.4 sea surface temperature (SST) anomalies are negatively correlated with the BoB tropical cyclone activity to a statistically significant percentage by a lead time of 5 months. Composites of 10-m zonal winds exhibit greater variance during La Niña events, favoring the development of low-level cyclonic vorticity. Low vertical wind shear over the central and northern BoB also aids in the development of tropical cyclones during La Niña events. Increased relative humidity is the result of enhanced moisture transport and higher precipitable water under La Niña conditions. Furthermore, storm-relative composites of relative humidity show stronger moisture pulses over the BoB during La Niña. The enhanced moisture associated with tropical cyclogenesis likely aids in the development and strengthening of the systems. ENSO forces modulations in oceanic conditions as well. The observed negative (positive) SST anomalies during La Niña (El Niño) could be seen as the result of increased (decreased) net heat flux across the sea surface. Tropical cyclone activity varies between El Niño and La Niña as a result of anomalous wind and moisture patterns during each ENSO phase.
Thoughts in Flight
Authors: Casner Stephen M. , Schooler Jonathan W. 
Published: August 2013

Objective: The objective was to examine the relationship between cockpit automation use and task-related and task-unrelated thought among airline pilots. Background: Studies find that cockpit automation can sometimes relieve pilots of tedious control tasks and afford them more time to think ahead. Paradoxically, automation has also been shown to lead to lesser awareness. These results prompt the question of what pilots think about while using automation. Method: A total of 18 airline pilots flew a Boeing 747-400 simulator while we recorded which of two levels of automation they used. As they worked, pilots were verbally probed about what they were thinking. Pilots were asked to categorize their thoughts as pertaining to (a) a specific task at hand, (b) higher-level flight-related thoughts (e.g., planning ahead), or (c) thoughts unrelated to the flight. Pilots’ performance was also measured. Results: Pilots reported a smaller percentage of task-at-hand thoughts (27% vs. 50%) and a greater percentage of higher-level flight-related thoughts (56% vs. 29%) when using the higher level of automation. However, when all was going according to plan, using either level of automation, pilots also reported a higher percentage of task-unrelated thoughts (21%) than they did when in the midst of an unsuccessful performance (7%). Task-unrelated thoughts peaked at 25% when pilots were not interacting with the automation. Conclusion: Although cockpit automation may provide pilots with more time to think, it may encourage pilots to reinvest only some of this mental free time in thinking flight-related thoughts. Application: This research informs the design of human–automation systems that more meaningfully engage the human operator.
Utility of MRI and PET/CT after neoadjuvant chemotherapy in breast cancer patients: correlation with pathological response grading system based on tumor cellularity
Authors: Kim Taehee , Kang Doo Kyoung , An Young-Sil , Yim Hyunee , Jung Yong Sik , Kim Ku Sang , Kang Seok Yun , Kim Tae Hee 
Published: August 2013

Background MRI and PET/CT are useful for assessing breast cancer patients after neoadjuvant chemotherapy (NAC). Purpose To investigate the utility of MRI and PET/CT in the prediction of pathologic response to neoadjuvant chemotherapy using Miller-Payne grading system in patients with breast cancer. Material and Methods From January 2008 to December 2010, 59 consecutive patients with pathologically proven breast cancer, who underwent neoadjuvant chemotherapy followed by surgery were retrospectively enrolled. The maximal diameter decrease rate and volume reduction rate by three-dimensional (3D) MRI and standardized uptake value (SUV) reduction rate by PET/CT were calculated and correlated with the Miller-Payne grading system using the Spearman rank correlation test. Patients with Miller-Payne grades 1 or 2 were classified into the non-responder group and patients with grades 3, 4, and 5 were in the responder group. To differentiate between responders and non-responders, receiver-operating characteristic (ROC) analysis was performed. Results The volume reduction rate was 64.87 ± 46.95, diameter decrease rate was 48.09 ± 35.02, and SUV decrease rate was 62.10 ± 32.17. Among three parameters, the volume reduction rate was most correlated with histopathologic grades of regression (ρ = 0.755, P <0.0001) followed by diameter decrease rate (ρ = 0.660, P < 0.0001), and SUV decrease rate of primary breast mass (ρ = 0.561, P = 0.0002). The area under the ROC curve (Az) value was largest in the volume reduction rate (Az = 0.9), followed by SUV decrease rate (Az = 0.875), and diameter decrease rate (Az = 0.849). The best cut-offs for differentiating responders from non-responders in the ROC curve analysis were a 50% decrease in diameter, 68.9% decrease in volume, and 60.1% decrease in SUV after NAC. Conclusion Volumetric measurement using 3D MRI combined with conventional diameter measurement may be more accurate to evaluate pathologic response after NAC.
Effects of Mn-DPDP and manganese chloride on hemodynamics and glucose tolerance in anesthetized rats
Authors: Gao Xiang , Sandberg Monica , Quach My , Bodin Birgitta , Johansson Lars , Jansson Leif 
Published: August 2013

Background Previous studies have demonstrated that magnetic resonance imaging may be a method of choice to visualize transplanted pancreatic islets. However, contrast agents may interfere with microcirculation and affect graft function. Purpose To evaluate the effects manganese-containing contrast media on regional blood flow and glucose tolerance. Material and Methods Anesthetized rats were injected intravenously with MnCl2 (10 µM/kg body weight) or Mn-DPDP (Teslascan™; 5 µM/kg body weight). Blood flow measurements were made with a microsphere technique 10 min later. In separate animals vascular arteriolar reactivity in isolated, perfused islets was examined. Furthermore, an intraperitoneal glucose tolerance test was performed in separate rats. Results Glucose tolerance was unaffected by both agents. No changes in regional blood flow were seen after administration of Mn-DPDP, except for an increase in arterial liver blood flow. MnCl2 increased all blood flow values except that of the kidney. MnCl2, but not Mn-DPDP, caused a vasoconstriction in isolated rat islet arterioles but only at very high doses. Conclusion Mn-DPDP administration does not affect glucose tolerance or regional blood flow, besides an increase in arterial hepatic blood flow, and may therefore be suitable for visualization of islets.
More Than Just T4
Authors: Peterson Mark E 
Published: August 2013

Clinical challenges: In older cats presenting with clinical features of hyperthyroidism, confirmation of a diagnosis of thyroid disease is usually straightforward. However, the potential for false-negative and false-positive results exists with all thyroid function tests (especially in the context of routine screening of asymptomatic cats) and leads to clinical dilemmas. For example, a high serum T4 value may be found in a cat that lacks clinical signs of hyperthyroidism, or hyperthyroidism may be suspected in a cat with normal total T4 concentrations. Practical relevance: To avoid unnecessary treatment and potentially adverse effects in a euthyroid cat, thyroid function tests must always be interpreted in the light of the cat’s history, clinical signs, physical examination findings and other laboratory findings. Evidence base: In this article the author reviews the use of commonly recommended thyroid function tests, focusing on clinical scenarios that present diagnostic difficulties. In doing so, he draws on the veterinary and comparative literature, his own clinical experience, and data, unpublished to date, obtained from a series of 100 hyperthyroid cats consecutively diagnosed at his clinic.
Feline Non-Flea Induced Hypersensitivity Dermatitis
Authors: Favrot Claude 
Published: August 2013

Practical relevance: Hypersensitivity dermatitis (HD) is often suspected in cats and is mostly caused by insect bites, food or environmental allergens. Cats with non-flea induced HD are reported to present frequently with one or more of the following cutaneous reaction patterns: miliary dermatitis, eosinophilic dermatitis, self-induced symmetrical alopecia or head and neck excoriations/pruritus. Clinical challenges: None of the above patterns are, however, pathognomonic for non-flea induced HD and the diagnosis of this condition is based on exclusion of diseases presenting similarly and an adequate response to treatment. Therapeutic approaches to affected cats include use of immunomodulatory drugs (ciclosporin, glucocorticoids, antihistamines), hypoallergenic diets and allergen-specific immunotherapy. Evidence base: This review provides an update on the clinical signs, diagnosis and treatment of feline non-flea induced HD. It draws on the findings of a recent large-scale study that described the clinical signs of numerous cats with non-flea HD and has proposed criteria to facilitate the diagnosis of the condition.
The tolerability and safety of DPP-4 inhibitors for the treatment of older people with type 2 diabetes mellitus: an observational study
Authors: Viljoen Adie , Meek Claire L , Gadsby Roger , Viljoen Sumarie , Langerman Haya , Sinclair Alan J 
Published: August 2013

Aims/introduction: Despite type 2 diabetes mellitus being up to five times more prevalent in patients aged ≥65 years compared with patients <65 years of age, this population is surprisingly less well studied. Dipeptidyl peptidase (DPP)-4 inhibitor treatment is an option for this older patient group, but clinical practice data for this drug class are sparse in this population. The study examined the efficacy and tolerability of DPP-4 inhibitors in older patients with type 2 diabetes whilst focusing on particular pertinent aspects relevant to care of older persons. Materials and methods: The medical records of 431 randomly selected patients (median age 74 years) were reviewed and two cohorts (DPP-4-inhibitor-treated and non-DPP-4-inhibitors-treated) were compared. Results: Both groups had a similar duration of diabetes (8 years) and comparable glycated haemoglobin A1C concentrations (7.4% and 7.2%). Hypoglycaemia was less common in the DPP-4 inhibitor group (3%) compared with the medically treated non-DPP-4 inhibitor group (8%), p<0.02. Despite significantly more patients in the non-DPP-4 inhibitor group living in cared accommodation (9% vs. 2%) this group received significantly more insulin (30% vs. 7%). Conclusion: Clinicians need to consider the specific clinical issues relevant to older diabetic patients when taking complex treatment decisions.
Ascertaining cause of death among men in the Prostate Cancer Intervention Versus Observation Trial
Authors: Barry Michael J , Andriole Gerald L , Culkin Daniel J , Fox Steven H , Jones Karen M , Carlyle Maureen H , Wilt Timothy J 
Published: August 2013

Background The Prostate Cancer Intervention Versus Observation Trial (PIVOT) randomized 731 men with localized prostate cancer to radical prostatectomy or observation. Purpose We describe the methods and results for cause-of-death assignments in PIVOT, and compare them to alternative strategies for ascertaining prostate cancer–specific mortality, as well as to the methods and results in the similar Scandinavian Prostate Cancer Group Study 4 (SPCG-4) trial. Methods Three PIVOT Endpoints Committee members, blinded to randomized treatment assignments, reviewed medical records and death certificates when available to assign a cause of death using a primary and a secondary adjudication question. Initial disagreements were resolved through discussion. The level of initial agreement among committee members was examined, as well as guesses at randomized treatment assignments for a convenience sample of cases. Final cause of death determinations were compared to death certificates. Results Complete agreement on cause of death by all three committee members before any discussion was achieved in 200/354 (56%) cases on the primary and 209/354 (59%) cases on the secondary. However, complete agreement on the primary rose to 306/354 (86%) when ‘definite’ and ‘probably’ categories were collapsed, as planned a priori. The three committee members’ proportions of correct guesses of randomized treatment assignment were 82/121 (68%), 113/148 (76%), and 99/134 (74%). Using the committee’s final adjudications as a gold standard, death certificates had suboptimal sensitivities, specificities, or predictive values depending on how they were used to determine cause of death. Limitations There was no separate ‘gold standard’ by which to judge the accuracy of the final endpoints committee adjudications, and useful death certificates could not be obtained on about a third of PIVOT participants who died. Conclusions The low level of initial agreement on cause of death among endpoint committee members and the potential for biased determinations due to partial unblinding to treatment assignment raise methodologic concerns about using prostate cancer mortality as an endpoint in clinical trials like PIVOT.