bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemoprevention of Colon and Small Intestinal Tumorigenesis in APCmin/+ Mice By SHetA2 (NSC721689) without Toxicity
Authors: Benbrook Doris Mangiaracina , Guruswamy Suresh , Wang Yuhong , Sun Zhongjie , Mohammed Altaf , Zhang Yuting , Li Qian , Rao Chinthalapally V. 
Published: July 2013

Abstract
The occurrence of intestinal polyps in people at high risk for developing colorectal cancer provides an opportunity to test the efficacy of chemoprevention agents. In this situation of treating otherwise healthy people, the potential for toxicity must be minimal. The small-molecule flexible heteroarotinoid (Flex-Het), called SHetA2, has chemoprevention activity in organotypic cultures in vitro and lack of toxicity at doses capable of inhibiting xenograft tumor growth in vivo. The objective of this study was to evaluate SHetA2 chemoprevention activity and toxicity in the APCmin/+ murine model. Oral administration of SHetA2 at 30 and 60 mg/kg five days per week for 12 weeks significantly reduced development of intestinal polyps by 40% to 60% depending on the dose and sex of the treatment group. Immunohistochemical and Western blot analysis of polyps showed reduced levels of cyclin D1 and proliferating cell nuclear antigen in both SHetA2 treatment groups. Western blot analysis also showed SHetA2 induction of E-cadherin, Bax, and caspase-3 cleavage along with reduction in Bcl-2, COX-2, and VEGF, consistent with SHetA2 regulation of apoptosis, inflammation, and angiogenesis. Neither dose caused weight loss nor gross toxicity in APCmin/+ or wild-type littermates. Magnetic resonance imaging (MRI) of cardiac function showed no evidence of SHetA2 toxicity. SHetA2 did not alter left ventricular wall thickness. In summary, SHetA2 exerts chemoprevention activity without overt or cardiac toxicity in the APCmin/+ model. SHetA2 modulation of biomarkers in colon polyps identifies potential pharmacodynamic endpoints for SHetA2 clinical trials. Cancer Prev Res; 6(9); 908–16. ©2013 AACR.
Elderly Patients With Acute Coronary Syndromes Managed Without Revascularization
Authors: Roe Matthew T. , Goodman Shaun G. , Ohman E. Magnus , Stevens Susanna R. , Hochman Judith S. , Gottlieb Shmuel , Martinez Felipe , Dalby Anthony J. , Boden William E. , White Harvey D. , Prabhakaran Dorairaj , Winters Kenneth J. , Aylward Philip E. , Bassand Jean-Pierre , McGuire Darren K. , Ardissino Diego , Fox Keith A. A. , Armstrong Paul W. 
Published: July 2013

Background—
Dual antiplatelet therapy in older versus younger patients with acute coronary syndromes is understudied. Low-dose prasugrel (5 mg/d) is recommended for younger, lower-body-weight patients and elderly patients with acute coronary syndromes to mitigate the bleeding risk of standard-dose prasugrel (10 mg/d).

Methods and Results—

A total of 9326 medically managed patients with acute coronary syndromes from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial (<75 years of age, n=7243; ≥75 years of age, n=2083) were randomized to prasugrel (10 mg/d; 5 mg/d for those ≥75 or <75 years of age and <60 kg in weight) or clopidogrel (75 mg/d) plus aspirin for ≤30 months. A total of 515 participants ≥75 years of age (25% of total elderly population) had serial platelet reactivity unit measurements in a platelet-function substudy. Cumulative risks of the primary end point (cardiovascular death/myocardial infarction/stroke) and Thrombolysis in Myocardial Infarction (TIMI) major bleeding increased progressively with age and were ≥2-fold higher in older participants. Among those ≥75 years of age, TIMI major bleeding (4.1% versus 3.4%; hazard ratio, 1.09; 95% confidence interval, 0.57–2.08) and the primary end point rates were similar with reduced-dose prasugrel and clopidogrel. Despite a correlation between lower 30-day on-treatment platelet reactivity unit values and lower weight only in the prasugrel group, there was a nonsignificant treatment-by-weight interaction for platelet reactivity unit values among participants ≥75 years of age in the platelet-function substudy (
P
=0.06). No differences in weight were seen in all participants ≥75 years of age with versus without TIMI major/minor bleeding in both treatment groups.

Conclusions—
Older age is associated with substantially increased long-term cardiovascular risk and bleeding among patients with medically managed acute coronary syndromes, with no differences in ischemic or bleeding outcomes with reduced-dose prasugrel compared with clopidogrel in elderly patients. No significant interactions among weight, pharmacodynamic response, and bleeding risk were observed between reduced-dose prasugrel and clopidogrel in elderly patients.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov/ct2/home
. Unique identifier: NCT0069999.
Challenges to Understanding the Dynamic Response of Greenland's Marine Terminating Glaciers to Oceanic and Atmospheric Forcing
Authors: Straneo Fiammetta , Heimbach Patrick , Sergienko Olga , Hamilton Gordon , Catania Ginny , Griffies Stephen , Hallberg Robert , Jenkins Adrian , Joughin Ian , Motyka Roman , Pfeffer W. Tad , Price Stephen F. , Rignot Eric , Scambos Ted , Truffer Martin , Vieli Andreas 
Published: July 2013

The recent retreat and speedup of outlet glaciers, as well as enhanced surface melting around the ice sheet margin, have increased Greenland's contribution to sea level rise to 0.6 ± 0.1 mm yr−1 and its discharge of freshwater into the North Atlantic. The widespread, near-synchronous glacier retreat, and its coincidence with a period of oceanic and atmospheric warming, suggests a common climate driver. Evidence points to the marine margins of these glaciers as the region from which changes propagated inland. Yet, the forcings and mechanisms behind these dynamic responses are poorly understood and are either missing or crudely parameterized in climate and ice sheet models. Resulting projected sea level rise contributions from Greenland by 2100 remain highly uncertain.
This paper summarizes the current state of knowledge and highlights key physical aspects of Greenland's coupled ice sheet–ocean–atmosphere system. Three research thrusts are identified to yield fundamental insights into ice sheet, ocean, sea ice, and atmosphere interactions, their role in Earth's climate system, and probable trajectories of future changes: 1) focused process studies addressing critical glacier, ocean, atmosphere, and coupled dynamics; 2) sustained observations at key sites; and 3) inclusion of relevant dynamics in Earth system models.
Understanding the dynamic response of Greenland's glaciers to climate forcing constitutes both a scientific and technological frontier, given the challenges of obtaining the appropriate measurements from the glaciers' marine termini and the complexity of the dynamics involved, including the coupling of the ocean, atmosphere, glacier, and sea ice systems. Interdisciplinary and international cooperation are crucial to making progress on this novel and complex problem.
Zonal Oscillation of Western Pacific Subtropical High and Subseasonal SST Variations during Yangtze Persistent Heavy Rainfall Events
Authors: Ren Xuejuan , Yang Xiu-Qun , Sun Xuguang 
Published: July 2013

AbstractThis study examines the relationship between the zonal oscillation of the western Pacific subtropical high (WPSH) and underneath sea surface temperature (SST) variation on a subseasonal time scale, associated with the persistent heavy rainfall (PHR) events over the middle and lower reaches of the Yangtze River valley (MLYRV) in China. A total of 76 PHR events and 45 break events in the summers of 1979–2011 are first identified over the MLYRV and divided into early and late summer groups. During the PHR events over the MLYRV for both groups, the WPSH stretches more westward, accompanied by the positive anomalies of the 500-hPa geopotential height field over East Asia and its coastal region south of 30°N and the subseasonal warmer SSTs beneath the WPSH western edge. The time-lagged composites suggest that the WPSH western edge exhibits westward-then-eastward migration on a subseasonal time scale for the PHR events. The zonal changes of the WPSH and anomalous circulation and SST anomaly (SSTA) signals for break events is almost the mirror image of that for the PHR events for the early summer group. Accompanied by the WPSH westward extension, the increased incident solar radiation and decreased latent heat flux over the coastal region of East Asia contribute to the positive SSTAs beneath the western part of the WPSH. The positive SSTAs construct a convective instability that provides an adverse condition for maintaining the anticyclonic anomalies in the mid–lower levels. The persistent SST warming is also favorable to the transition of low-level circulation from anticyclonic to cyclonic anomalies over the coastal region. As a result, the WPSH withdraws eastward after the peak of the rainfall events over the MLYRV.
Monumental Italians: Machiavelli, Risorgimento and nation-building in Chile
Authors: Vilches Patricia 
Published: July 2013

‘Thus, one should not let this opportunity pass, for Italy, after so much time, to see her redeemer. I cannot express with what love he would be received in all those provinces that have suffered from these floods from outside’ (Machiavelli and Mansfield, 1998: 105). Using the theories of Niccolò Machiavelli, I study in this article, from a transatlantic perspective, Italians who helped build the Chilean nation. Italians did not emigrate to Chile on a grand scale; however, the success of those immigrants is a study in fortuna and virtù. Those honored by Chile with ‘monuments,’ or those who built edifices of their own, such as Pastene, Rondizzoni and Toesca, among others, can be called ‘monuments of Italian identity’ in Chile. In this context, Machiavelli's oeuvre serves as a rhetorical framework for understanding the actions of Italians who fought for and helped shape the Chilean nation.
Prevalence of Diabetes Mellitus and Its Impact on Disease Severity in Adult Recurrent Respiratory Papillomatosis
Authors: Lee Chia‐Jung , Allen Clint T. , Merati Albert L. 
Published: July 2013

ObjectivesFollowing human papilloma virus (HPV) infection, recurrent respiratory papillomatosis (RRP) develops secondary to dysfunction of innate and adaptive immune responses. Diabetes mellitus (DM) is a common medical disorder; these patients are considered to be relatively immunocompromised. It is hypothesized that comorbid DM occurs more frequently than expected in a cohort of adult RRP patients and that RRP patients with DM have more severe disease than those without DM.Study DesignRetrospective cohort study.SettingTertiary care laryngology practice, 5‐year period.Subjects and MethodsAdult‐onset RRP patients from 2007 to 2012 at the University of Washington were reviewed. The gender, age of onset of RRP, number of interventions, pathology, presence or absence of DM, and calculated anatomic Derkay severity score were recorded.ResultsEighty‐four adult RRP patients were characterized; 64 male (76%) and 20 female (24%). Six of 84 patients (7.1%) had DM; this prevalence was not higher than an age‐matched general population. The number of interventions required for disease control did not significantly differ (P =. 13) between adult RRP patients with DM (avg 2.6/yr, median 2.3/year) and those without DM (avg 1.9/yr, median 1.3/yr). There was no significant difference in anatomic Derkay score at the time of intervention (P =. 26) or presence of dysplasia in biopsy specimens (P =. 49) between RRP patients with and without DM.ConclusionsIn this large series of adult RRP patients, DM does not appear to have a higher prevalence than that seen in age‐matched controls, nor do RRP patients with DM appear to have more severe disease.
The Utility of the KJOC Score in Professional Baseball in the United States
Authors: Franz Justin O. , McCulloch Patrick C. , Kneip Chris J. , Noble Philip C. , Lintner David M. 
Published: July 2013

Background: The Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow questionnaire has been shown by previous studies to be more sensitive than other validated subjective measurement tools in the detection of upper extremity dysfunction in overhead-throwing athletes. Purpose: The primary objective was to establish normative data for KJOC scores in professional baseball players in the United States. The secondary objectives were to evaluate the effect of player age, playing position, professional competition level, history of injury, history of surgery, and time point of administration on the KJOC score. Study Design: Cross-sectional study; Level of evidence, 3. Methods: From 2011 to 2012, a total of 203 major league and minor league baseball players within the Houston Astros professional baseball organization completed the KJOC questionnaire. The questionnaire was administered at 3 time points: spring training 2011, end of season 2011, and spring training 2012. The KJOC scores were analyzed for significant differences based on player age, injury history, surgery history, fielding position, competition level, self-reported playing status, and time point of KJOC administration. Results: The average KJOC score among healthy players with no history of injury was 97.1 for major league players and 96.8 for minor league players. The time point of administration did not significantly affect the final KJOC score ( P = .224), and KJOC outcomes did not vary with player age ( r = −0.012; P = .867). Significantly lower average KJOC scores were reported by players with a history of upper extremity injury (86.7; P < .001) and upper extremity surgery (75.4; P < .0001). The KJOC results did vary with playing position ( P = .0313), with the lowest average scores being reported by pitchers (90.9) and infielders (91.3). Conclusion: This study establishes a quantitative baseline for the future evaluation of professional baseball players with the KJOC score. Age and time of administration had no significant effect on the outcome of the KJOC score. Missed practices or games within the previous year because of injury were the most significant demographic predictors of lower KJOC scores. The KJOC score was shown to be a sensitive measurement tool for detecting subtle changes in the upper extremity performance of the professional baseball population studied.
The Effect of the Pressure–Volume Curve for Positive End-Expiratory Pressure Titration on Clinical Outcomes in Acute Respiratory Distress Syndrome
Authors: Hata J. Steven , Togashi Kei , Kumar Avinash B. , Hodges Linda D. , Kaiser Eric F. , Tessmann Paul B. , Faust Christopher A. , Sessler Daniel I. 
Published: July 2013

Purpose Methods to optimize positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) remain controversial despite decades of research. The pressure–volume curve (PVC), a graphical ventilator relationship, has been proposed for prescription of PEEP in ARDS. Whether the use of PVC’s improves survival remains unclear. Methods In this systematic review, we assessed randomized controlled trials (RCTs) comparing PVC-guided treatment with conventional PEEP management on survival in ARDS based on the search of the National Library of Medicine from January 1, 1960, to January 1, 2010, and the Cochrane Central Register of Controlled Trials. Three RCTs were identified with a total of 185 patients, 97 with PVC-guided treatment and 88 with conventional PEEP management. Results The PVC-guided PEEP was associated with an increased probability of 28-day or hospital survival (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.5, 4.9) using a random-effects model without significant heterogeneity ( I2 test: P = .75). The PVC-guided ventilator support was associated with reduced cumulative risk of mortality (−0.24 (95% CI −0.38, −0.11). The PVC-managed patients received greater PEEP (standardized mean difference [SMD] 5.7 cm H2O, 95% CI 2.4, 9.0) and lower plateau pressures (SMD −1.2 cm H2O, 95% CI −2.2, −0.2), albeit with greater hypercapnia with increased arterial pCO2 (SMD 8 mm Hg, 95% CI 2, 14). Weight-adjusted tidal volumes were significantly lower in PVC-guided than conventional ventilator management (SMD 2.6 mL/kg, 95% CI −3.3, −2.0). Conclusion This analysis supports an association that ventilator management guided by the PVC for PEEP management may augment survival in ARDS. Nonetheless, only 3 randomized trials have addressed the question, and the total number of patients remains low. Further outcomes studies appear required for the validation of this methodology.
“Lost Milk?”
Authors: Smith J. P. 
Published: July 2013

Background: The contribution of breastfeeding and mothers milk to the economy is invisible in economic statistics. Objective: This article demonstrates how the economic value of human milk production can be included in economic statistics such as gross domestic product (GDP) and provides estimates for Australia, the United States, and Norway. Methods: The contribution of human milk and lactation to GDP in these countries is estimated using United Nations (System of National Accounting) guidelines and conventional economic valuation approaches to measuring production in GDP. Results: In Australia, current human milk production levels exceed $3 billion annually. The United States has the potential to produce human milk worth more than US$110 billion a year, but currently nearly two thirds of this value is lost due to premature weaning. In Norway, production valued at US$907 million annually is 60% of its potential value. Conclusions: The potential loss of economic value from not protecting women’s lactation and milk production from competing market pressures is large. Failure to account for mothers’ milk production in GDP and other economic data has important consequences for public policy. The invisibility of human milk reduces the perceived importance of programs and regulations that protect and support women to breastfeed. The value of human milk can be measured using accepted international guidelines for calculating national income and production. It is quantitatively nontrivial and should be counted in GDP.
Neighborhood Context and Breastfeeding Behaviors among Urban Mothers
Authors: Burdette Amy M. 
Published: July 2013

Background: Research consistently shows that breastfeeding behaviors vary according to individual-level sociodemographic characteristics, yet few studies examine contextual variations in breastfeeding. Objective: The purpose of this study is to examine the association between neighborhood context and breastfeeding among a sample of predominately unmarried urban mothers, a group with relatively low rates of breastfeeding. Methods: This study combines census tract information with data from 2 waves of the Fragile Families and Child Wellbeing Study (n = 4228) to predict the odds of initiating and sustaining breastfeeding. Results: Findings indicate that neighborhood socioeconomic composition, rather than racial or ethnic concentration, is associated with breastfeeding behaviors. More specifically, living in a highly educated neighborhood is associated with higher odds of initiating and sustaining breastfeeding. Conclusion: These results suggest that the breastfeeding behaviors of urban mothers vary according to neighborhood educational context. Understanding how breastfeeding behaviors are shaped by one’s neighborhood environment will allow public health initiatives to more effectively target vulnerable populations.
Patency in Arteriovenous Grafts in Hemodialysis Patients
Authors: Mousa Albeir Y. , Patterson William , Abu-Halimah Shadi , Hass Stephen M. , Alhalbouni Saadi , Sadek Betro T. , Nanjundappa Aravinda , Modak Asmita , Stone Patrick A. , Emmett Mary , AbuRahma Ali F. 
Published: July 2013

Objective: It is difficult to maintain a working access for patients on hemodialysis. Despite current Dialysis Outcome Quality Initiatives recommendations of “Fistula First,” not everyone qualifies for a fistula, and those patients undergoing the alternative treatment, a graft, can experience graft failure. This study examines factors associated with arteriovenous graft (AVG) patency. Methods: A retrospective analysis was completed for all the patients who had an AVG during 2005 to 2010. Data were collected from electronic medical records, including date of first and subsequent interventions, salvage technique (surgical vs percutaneous), medical comorbidities, and use of antiplatelet medications (aspirin and clopidogrel). Continuous variables were compared with 2 sample t tests, and categorical variables with chi-square/Fisher exact test. Logistic regression was used to determine the odds ratio for risk factors associated with patency. A P value of <.05 was considered significant. All analyses were done using SAS 9.2 (SAS Institute Inc, Cary, North Carolina). Results: A total of 193 unique patients had an AVG. Of the 193 patients, 64% were female, 83% were hypertensive, and 64% were diabetic. The locations of the grafts were 80% arm, 15% forearm, and 5% thigh. Configurations, including loop and straight, were 34% and 63%, respectively. Comorbidities were not associated with patency. Primary patency was not found to be different with respect to location and configuration of graft and type of intervention. Primary patency for patients taking only aspirin (n = 43) and only clopidogrel (n = 17) were significantly different from patients on a combination of aspirin and clopidogrel (n = 7), with a P = .0051 and P = .0447, respectively. Conclusion: Neither location nor configuration affects the primary patency of AVGs. Aspirin alone is not inferior to aspirin and clopidogrel. Further prospective studies may be warranted to establish a consensus regarding medications and patency with AVGs.
An Analysis of the Factors Influencing Radiation Dose and Fluoroscopic Time During Renal Artery Stent Placement
Authors: McBride J. , Schueler B. , Oderich G. , Misra S. 
Published: July 2013

Purpose: To determine the factors that affect mean absorbed dose and fluoroscopic times during renal artery stent placement. Materials and Methods: After institutional review board approval, the HI-IQ database was queried for patients undergoing renal artery stent placement only from January 2007 to June 2010. Procedures that were performed as part of other procedures such as iliac artery stents were excluded. The HI-IQ data included fluoroscopy time ( f) and radiation dose (mGy). Demographic, medical history, procedural details, and advanced preprocedural renal artery stent imaging were obtained. Variables (number of stents, average body mass index , number of stents placed per year and number of years’ service of an interventional physician, pre-procedural imaging, and use of embolic protection device) were analyzed using a t test after log transformation and testing for variance with an F test. Results: A total of 134 patients (75 males, 70.6 ± 10.5 years old) underwent the placement of 177 renal artery stents (unilateral [n = 95], average stent per patient = 1.3). Mean fluoroscopy time was 15.6 minutes and mean absorbed dose to the patient was 1729 mGy. The average fluoroscopic time and absorbed dose was significantly higher with bilateral stent placement compared to unilateral placement (13.8 vs 19.7 minutes, P = .002; 1803 vs 2380 mGy, P = .03). The average fluoroscopic time was significantly higher in patients undergoing abdominal aortogram prior to renal artery selection and stent placement. Conclusion: The placement of more than 1 stent with an abdominal angiogram prior to renal artery stent placement results in increased fluoroscopic time and mean absorbed dose.