bluuebunny/crossref_metadata_2025_split huggingface dataset:
Switching suicide methods as a predictor of completed suicide in individuals with repeated self-harm: A community cohort study in northern Taiwan
Authors: Wang Liang-Jen , Huang Yu-Chi , Lee Sheng-Yu , Wu Ya-Wen , Chen Chih-Ken 
Published: October 2014

Objective: Repetition of suicide attempts is common, but little is known about the relationship between switching methods of suicide attempt and the probability of completed suicide. This study aimed to determine the transition of methods chosen by individuals who repeat suicide attempts, and how the switched methods of suicide attempts influence the risk of suicide death. Method: All consecutive individuals ( n = 2052) with an episode of non-fatal suicide attempt registered in a surveillance database provided by the Department of Health of the Keelung City Government from 1 January 2006 to 31 December 2010 were enrolled and followed up until the end of 2011. The earliest attempt recorded in the database was defined as the index attempt. Data on the time of subsequent completed suicide and methods chosen for repeated self-harm during the follow-up period were analyzed by performing a Cox proportional hazards regression. Results: Of the total subjects, 374 (18.2%) had at least one other attempted suicide and 50 (2.4%) eventually died by suicide. Subjects who used highly lethal methods in the index self-harm tended to switch methods in the next suicide attempt ( p<0.001). Switching to a more lethal method was a significant predictor of completed suicide (adjusted hazard ratio (aHR) 7.05, 95% confidence interval (CI) 3.52–14.14). In addition, subjects who used charcoal-burning in the index self-harm attempt had a higher risk of subsequent suicide death (aHR 3.47, 95% CI 1.57–7.68). Conclusions: The findings in this study give us some insight into the patterns of methods in repeat suicide attempters. The intent behind switching methods of suicide attempt might be considered as an important item of clinical assessment of the seriousness of suicidal behavior.
Concordance of Pharmacist Assessment of Medication Nonadherence With a Self-Report Medication Adherence Scale
Authors: Kelly Michael S. , Moczygemba Leticia R. , Gatewood Sharon S. 
Published: October 2014

Objective: To evaluate the concordance of the Modified Morisky Scale (MMS) with a pharmacist assessment of medication adherence during a medication review. Methods: This retrospective study examined the electronic medical records (EMRs) of patients ≥18 years who received a medication review by a pharmacist from October 2008 to September 2009 at a homeless behavioral health clinic. In addition to the 6-item MMS, adherence was assessed using the first 4 items of the MMS, which comprise the original Morisky Scale. A final pharmacist assessment of adherence based upon the medication review was documented in the EMR. The McNemar test was used to assess the agreement between the MMS (6 and 4 items) and the pharmacist assessment of medication adherence. Results: A total of 288 patients were eligible for the study, which included 449 medication reviews. Nonadherence was identified in 61.7% and 49.7% of medication reviews using the 6 and 4 items of the MMS. The pharmacist assessment determined nonadherence in 23.8% of medication reviews. There were significant differences between the pharmacist adherence assessment and the 6 ( P < .0001) and 4 ( P < .0001) items of the MMS. Conclusion: A combination of methods including self-report and pharmacist assessment may provide the greatest insight into adherence.
Self-sampling for cervical screening: Could it overcome some of the barriers to the Pap test?
Authors: Mullins Robyn , Scalzo Katherine , Sultana Farhana 
Published: October 2014

Objectives To determine which groups of women would be most likely to take part in self-sampling for cervical screening, and what they perceive as the key barriers and benefits to self-sampling. Methods A random sample of 3000 women aged 18–69 in Victoria, Australia, were asked questions about “taking their own Pap test” in a telephone survey about cervical screening; 2526 answered the questions about self-sampling. The terminology “Pap test” was used in questions, due to the very low understanding of HPV and its link to cervical cancer. Results One-third of women (34.0%) indicated they would prefer to self-sample, 57.2% would not and 8.7% were unsure. Preference for self-sampling was significantly stronger among women who had not had a Pap test for more than three years (64.8%, p < .001) or who had never had one (62.1%, p < .001), compared with those up-to-date (27.0%). Convenience was a key benefit (37.8%), as was less embarrassment (31.5%). For those who did not want to self-sample or were unsure, key factors included professionals being more skilled (53.4% and 28.2% respectively), and doubts about being able to do it properly (28.9% and 23.6%). Conclusions Self-sampling was most popular among women who needed to have a Pap test, and could potentially reach some women who are not participating appropriately in cervical screening. Key barriers to participation could be addressed by providing information about the test being for HPV, and being easier to do properly than a Pap test.
Asymptomatic myocarditis during clozapine re-titration, in a patient who had previously been stable on clozapine for 10 years
Authors: Smith Leo T , Symons Evan , Hare James L , Hooper Michelle , Fitzgerald Paul B 
Published: October 2014

Objective: We present a case of confirmed clozapine-induced myocarditis in a patient who was not naïve to the drug. Method: This patient, who had been stable on clozapine for 10 years, relapsed following self-cessation. Asymptomatic throughout inpatient re-titration, serum cardiac enzymes were nonetheless routinely taken. Results: Occult myocarditis was only discovered due to an elevated Troponin I, and was confirmed by cardiac imaging. Conclusions: Once thought to be the preserve of initial exposure to the medication, clozapine-induced myocarditis can occur at any re-titration point if the immunological milieu permits. We therefore recommend routine monitoring of serum cardiac enzymes with all patients undergoing titration of clozapine, regardless of whether they have previously been stable on the drug.
How do people with chronically painful joint hypermobility syndrome make decisions about activity?
Authors: Schmidt Anne , Corcoran Kelley , Grahame Rodney , de C Williams Amanda C 
Published: October 2014

Background: The model of activity avoidance prompted by fear of increased pain and/or harm dominates understanding and research into activity limitation in chronic pain. Yet, the accounts of people with chronic pain on decisions about activity limitation are rarely heard beyond the confines of fear and avoidance questionnaires. Methods: We used semi-structured interviews to explore the decisions of 11 women attending a pain management clinic with chronically painful Joint Hypermobility Syndrome (JHS). Results: Six themes emerged from Interpretative Phenomenological Analysis: the overall aim of keeping pain to a manageable level, considering whether the planned activity was worth it and, running through all judgements, the influence of pain intensity. The decision was tipped towards avoidance by unpredictability of pain and by high emotional cost and towards going ahead with the activity by the wish to exert control and by low emotional cost. Many accounts described a specifiable cost–benefit analysis of individual decisions, weighing the importance of each activity against its potential aversive consequences, which only in a minority of cases was dominated by fear of pain or injury. Conclusion: Assumptions of fear as the basis of activity avoidance should not be used uncritically in clinical settings. Decisions about activity should explore beyond pain expectancy, incorporating goals, values, and decision processes. Summary points The model of fear of pain or re/injury and associated avoidance, an important insight that has generated effective therapeutic interventions, risks being over-applied and assumed rather than demonstrated. Patients’ own accounts, using qualitative analysis of interview in 11 women with long term chronic pain associated with joint hypermobility, give a more nuanced description of complex decision-making around activity. While a few activities were unquestionably avoided because of such fears, others were undertaken when benefits (according to personal values, such as children’s needs) outweighed costs in pain and distress. We suggest that activity needs to be discussed with patients beyond asking about avoidance and in the context of their lifestyle choices.
Update on intravitreal anti-tumor necrosis factor alpha therapies for ocular disorders
Authors: Pascual-Camps Isabel , Hernández-Martínez Pablo , Monje-Fernández Laura , Dolz-Marco Rosa , Gallego-Pinazo Roberto , Wu Lihteh , Arévalo J Fernando , Díaz-Llopis Manuel 
Published: October 2014

Abstract
Tumor necrosis factor alpha (TNF-?) is an important pro-inflammatory cytokine associated with a variety of ocular diseases. The currently available TNF-? inhibitors are etanercept, infliximab, adalimumab, golimumab, and certolizumab. Experimental and clinical studies on the intravitreal use of these agents have been reported with etanercept, infliximab, and adalimumab: etanercept has shown limited efficacy in scarce reports; infliximab has been associated with local safety concerns but appears to benefit certain cases; adalimumab has shown no efficacy in cases of age-related macular degeneration (AMD) or diabetic macular edema (DME), but the combination with bevacizumab may be effective in refractory cases of macular diseases. Further preclinical and clinical studies are warranted in order to be able to obtain a more robust conclusion on the use of intravitreal TNF-? inhibitors.
Novel clinical therapeutics targeting the epithelial to mesenchymal transition
Authors: Kothari Anai N , Mi Zhiyong , Zapf Matthew , Kuo Paul C 
Published: October 2014

AbstractThe epithelial to mesenchymal transition (EMT) is implicated in many processes, ranging from tissue and organogenesis to cancer and metastatic spread. Understanding the key regulatory mechanisms and mediators within this process offers the opportunity to develop novel therapeutics with broad clinical applicability. To date, several components of EMT already are targeted using pharmacologic agents in fibrosis and cancer. As our knowledge of EMT continues to grow, the potential for novel therapeutics will also increase. This review focuses on the role of EMT both as a necessary part of development and a key player in disease progression, specifically the similarity in pathways used during both processes as targets for drug development. Also, the key role of the tumor microenvironment with EMT is outlined, focusing on both co‐factors and cell types with the ability to modulate the progression of EMT in cancer and metastatic disease. Lastly, we discuss the current status of clinical therapies both in development and those progressed to clinical trial specifically targeting pathologic EMTs including small molecule inhibitors, non‐coding RNAs, exogenous co‐factors, and adjunctive therapies to current chemotherapeutics.
Intense Androgen-Deprivation Therapy With Abiraterone Acetate Plus Leuprolide Acetate in Patients With Localized High-Risk Prostate Cancer: Results of a Randomized Phase II Neoadjuvant Study
Authors: Taplin Mary-Ellen , Montgomery Bruce , Logothetis Christopher J. , Bubley Glenn J. , Richie Jerome P. , Dalkin Bruce L. , Sanda Martin G. , Davis John W. , Loda Massimo , True Lawrence D. , Troncoso Patricia , Ye Huihui , Lis Rosina T. , Marck Brett T. , Matsumoto Alvin M. , Balk Steven P. , Mostaghel Elahe A. , Penning Trevor M. , Nelson Peter S. , Xie Wanling , Jiang Zhenyang , Haqq Christopher M. , Tamae Daniel , Tran NamPhuong , Peng Weimin , Kheoh Thian , Molina Arturo , Kantoff Philip W. 
Published: October 2014

Purpose Cure rates for localized high-risk prostate cancers (PCa) and some intermediate-risk PCa are frequently suboptimal with local therapy. Outcomes are improved by concomitant androgen-deprivation therapy (ADT) with radiation therapy, but not by concomitant ADT with surgery. Luteinizing hormone–releasing hormone agonist (LHRHa; leuprolide acetate) does not reduce serum androgens as effectively as abiraterone acetate (AA), a prodrug of abiraterone, a CYP17 inhibitor that lowers serum testosterone (< 1 ng/dL) and improves survival in metastatic PCa. The possibility that greater androgen suppression in patients with localized high-risk PCa will result in improved clinical outcomes makes paramount the reassessment of neoadjuvant ADT with more robust androgen suppression. Patients and Methods A neoadjuvant randomized phase II trial of LHRHa with AA was conducted in patients with localized high-risk PCa (N = 58). For the first 12 weeks, patients were randomly assigned to LHRHa versus LHRHa plus AA. After a research prostate biopsy, all patients received 12 additional weeks of LHRHa plus AA followed by prostatectomy. Results The levels of intraprostatic androgens from 12-week prostate biopsies, including the primary end point (dihydrotestosterone/testosterone), were significantly lower (dehydroepiandrosterone, Δ4-androstene-3,17-dione, dihydrotestosterone, all P < .001; testosterone, P < .05) with LHRHa plus AA compared with LHRHa alone. Prostatectomy pathologic staging demonstrated a low incidence of complete responses and minimal residual disease, with residual T3- or lymph node–positive disease in the majority. Conclusion LHRHa plus AA treatment suppresses tissue androgens more effectively than LHRHa alone. Intensive intratumoral androgen suppression with LHRHa plus AA before prostatectomy for localized high-risk PCa may reduce tumor burden.
Exercise and Risk of Major Cardiovascular Events in Adult Survivors of Childhood Hodgkin Lymphoma: A Report From the Childhood Cancer Survivor Study
Authors: Jones Lee W. , Liu Qi , Armstrong Gregory T. , Ness Kirsten K. , Yasui Yutaka , Devine Katie , Tonorezos Emily , Soares-Miranda Luisa , Sklar Charles A. , Douglas Pamela S. , Robison Leslie L. , Oeffinger Kevin C. 
Published: October 2014

Purpose Survivors of Hodgkin lymphoma (HL) are at increased risk of treatment-related cardiovascular (CV) events; whether exercise modifies this risk is unknown. Methods Survivors of HL (n = 1,187; median age, 31.2 years) completed a questionnaire evaluating vigorous-intensity exercise behavior. CV events were collected in follow-up questionnaires and graded according to Common Terminology Criteria for Adverse Events (version 4.03). The primary end point was incidence of any major (grade 3 to 5) CV event. Poisson regression analyses were used to estimate the association between exercise exposure (metabolic equivalent [MET] hours/week−1) and risk of major CV events after adjustment for clinical covariates and cancer treatment. Results Median follow-up was 11.9 years (range, 1.7 to 14.3 years). Cumulative incidence of any CV event was 12.2% at 10 years for survivors reporting 0 MET hours/week−1 compared with 5.2% for those reporting ≥ 9 MET hours/week−1. In multivariable analyses, the incidence of any CV event decreased across increasing MET categories (Ptrend = .002). Compared with survivors reporting 0 MET hours/week−1, the adjusted rate ratio for any CV event was 0.87 (95% CI, 0.56 to 1.34) for 3 to 6 MET hours/week−1, 0.45 (95% CI, 0.26 to 0.80) for 9 to 12 MET hours/week−1, and 0.47 (95% CI, 0.23 to 0.95) for 15 to 21 MET hours/week−1. Adherence to national vigorous intensity exercise guidelines (ie, ≥ 9 MET hours/week−1) was associated with a 51% reduction in the risk of any CV event in comparison with not meeting the guidelines (P = .002). Conclusion Vigorous exercise was associated with a lower risk of CV events in a dose-dependent manner independent of CV risk profile and treatment in survivors of HL.
Relationship Between 17-Hydroxyprogesterone Responses to Human Chorionic Gonadotropin and Markers of Ovarian Follicle Morphology in Women With Polycystic Ovary Syndrome
Authors: Maas Kevin H. , Chuan Sandy S. , Cook-Andersen Heidi , Su H. Irene , Duleba A. , Chang R. Jeffrey 
Published: October 2014

Abstract

Context:
Women with polycystic ovary syndrome (PCOS) have increased 17-hydroxyprogesterone (17-OHP) responses to gonadotropin stimulation although individual variability is substantial, as reflected by exaggerated as well as normal responses. The relationship between 17-OHP responses to gonadotropin stimulation and markers of ovarian function has not been assessed.

Objective:
To determine whether 17-OHP responses are associated with antral follicle count (AFC), anti-Mullerian hormone (AMH), or inhibin B (Inh B) levels in PCOS and normal women.

Design:
Prospective study.

Setting:
Research center at an academic medical center.

Participants:
Women with PCOS (n = 18) and normal controls (n = 18).

Interventions:
Blood samples were obtained before and 24 hours after administration of 25 μg recombinant-human chorionic gonadotropin. Ovarian imaging was conducted with three-dimensional pelvic ultrasound.

Main Outcome Measures:
Basal and stimulated levels of 17-OHP, androgens, estrogen, AMH, Inh B, and AFC.

Results:
In women with PCOS, 17-OHP responses were heterogeneous and inversely correlated with AMH and Inh B levels, but not AFC. In a subgroup of PCOS women with exaggerated 17-OHP responses, AMH levels were equivalent to that of normal women. In PCOS women with normal 17-OHP responses, AMH levels were markedly elevated.

Conclusion:
Based on heterogeneous 17-OHP responses to human chorionic gonadotropin in women with PCOS, AMH levels are inversely linked to ovarian androgen production while positively correlated with AFC. These findings suggest that in PCOS, AMH production may reflect redistribution of the follicle population or regulation by intraovarian mechanisms.
Antimicrobial Stewardship in a Community Hospital: Attacking the More Difficult Problems
Authors: Smith Terri , Philmon Carla L. , Johnson Gregory D. , Ward William S. , Rivers Latoya L. , Williamson Sharon A. , Goodman Edward L. 
Published: October 2014

Background Antibiotic stewardship has been proposed as an important way to reduce or prevent antibiotic resistance. In 2001, a community hospital implemented an antimicrobial management program. It was successful in reducing antimicrobial utilization and expenditure. In 2011, with the implementation of a data-mining tool, the program was expanded and its focus transitioned from control of antimicrobial use to guiding judicious antimicrobial prescribing. Objective To test the hypothesis that adding a data-mining tool to an existing antimicrobial stewardship program will further increase appropriate use of antimicrobials. Design Interventional study with historical comparison. Methods Rules and alerts were built into the data-mining tool to aid in identifying inappropriate antibiotic utilization. Decentralized pharmacists acted on alerts for intravenous (IV) to oral conversion, perioperative antibiotic duration, and restricted antimicrobials. An Infectious Diseases (ID) Pharmacist and ID Physician/Hospital Epidemiologist focused on all other identified alert types such as antibiotic de-escalation, bug-drug mismatch, and double coverage. Electronic chart notes and phone calls to physicians were utilized to make recommendations. Results During 2012, 2,003 antimicrobial interventions were made with a 90% acceptance rate. Targeted broad-spectrum antimicrobial use decreased by 15% in 2012 compared to 2010, which represented cost savings of $1,621,730. There were no statistically significant changes in antimicrobial resistance, and no adverse patient outcomes were noted. Conclusions The addition of a data-mining tool to an antimicrobial stewardship program can further decrease inappropriate use of antimicrobials, provide a greater reduction in overall antimicrobial use, and provide increased cost savings without negatively affecting patient outcomes.
De la resistencia al duelo: las ficciones sobre las dictaduras realizadas en Argentina y Chile entre 1973 y 1990/From resistance to mourning: The fiction films about dictatorships made in Argentina and Chile between 1973 and 1990
Authors: Lusnich Ana Laura 
Published: October 2014

Abstract
Allegorical and metaphorical fiction has been a highly productive tendency in Chilean and Argentinean film-making during the recent military dictatorships in both countries. The main goal of this article is to understand the dimensions and characteristics of this tendency in recent years. Its specific goals are to identify and analyse two different variants of this tendency, each of which is definable in relation to the deployment of the narrative system and the mise-en-scène; to analyse the ways in which fiction films about dictatorships sought to denounce and resist the social norms and practices instituted by the de facto governments of Argentina and Chile.
El mito reformado: la oblicua visión oficialista en el filme mexicano Miguel Hidalgo: la historia jamás contada
Authors: Rodríguez Alan 
Published: October 2014

2010 fue el año en que México hizo particular contacto con su historia, al conmemorar los episodios más heroicos de la nación. Promovido por el gobierno, el llamado Bicentenario de la Independencia de México fue un plan de festividades desarrollado ese año en todo el país para conmemorar dos siglos del inicio de la lucha armada por la Independencia, en 1810. Estos festejos además se empalmaron con los del Centenario de la Revolución Mexicana, cuyo origen data de 1910.En el marco de esa alargada fiesta patriótica, el gobierno financió filmes con temáticas nacionalistas. Uno de ellos es Hidalgo: la historia jamás contada (Antonio Serrano, 2010), que ofrece una perspectiva totalmente inusual de la vida del héroe insurgente Miguel Hidalgo y Costilla. El presente artículo propone la tesis de que filmes como éste fueron financiados con el ánimo de (re)apreciar símbolos históricos ante la crisis de identidad, valores y seguridad nacional que aqueja al país. En el caso de Hidalgo… fue un intento por reimpulsar a un personaje mítico que ayudase a enaltecer nuevamente lo idealizadamente mexicano.
Reflections on some aspects of infinite groups
Authors: Fine Benjamin , Gaglione Anthony , Rosenberger Gerhard , Spellman Dennis 
Published: October 2014

AbstractIn this paper we survey and reflect upon several aspects of the theory of infinite finitely generated and finitely presented groups that were originally motivated by work of Gilbert Baumslag. All but the last of the topics we have chosen are all related in one way or another to the theory of limit groups and the solution of the Tarski problems. These include the residually free and fully residually free properties and the big powers condition; Baumslag doubles and extensions of centralizers; residually-𝒳 groups and extensions of results of Benjamin Baumslag and finally the relationship between CT and CSA groups.