bluuebunny/crossref_metadata_2025 huggingface dataset:
Acrylate/Nanofibrillated Cellulose Nanocomposites and Their Use for Paper Coating
Authors: Hassan Mohammad L. , Fadel Shaimaa M. , Hassan Enas A.
Published: December 2018

Nanofibrillated cellulose (NFC) isolated from TEMPO-oxidized rice straw was used to improve thermal and tensile strength properties of acrylate polymer films. Acrylate/NFC mixture containing 15% NFC was used for paper coating, and properties of paper sheets including tensile strength, water absorption, and microscopic structure were investigated. The results showed that the presence of NFC in the acrylate matrix significantly improved tensile strength properties and thermomechanical properties of the acrylate polymer and caused moderate increase in its moisture sorption. The presence of NFC in acrylate emulsion caused significant increase in its viscosity. Paper sheets coated with different thin layers (from 0.2 to 6 microns) of acrylate/NFC showed improvement in tensile strength and decrease of water absorption.
The Biological Role of Klotho Protein in the Development of Cardiovascular Diseases
Authors: Olejnik Agnieszka , Franczak Aleksandra , Krzywonos-Zawadzka Anna , Kałużna-Oleksy Marta , Bil-Lula Iwona
Published: December 2018

Klotho is a membrane-bound or soluble antiaging protein, whose protective activity is essential for a proper function of many organs. In 1997, an accidental insertion of a transgene led to creation of transgenic mice with several age-related disorders. In Klotho-deficient mice, the inherited phenotypes closely resemble human aging, while in an animal model of Klotho overexpression, the lifespan is extended. Klotho protein is detected mainly in the kidneys and brain. It is a coreceptor for fibroblast growth factor and hence is involved in maintaining endocrine system homeostasis. Furthermore, an inhibition of insulin/insulin-like growth factor-1 signaling pathway by Klotho regulates oxidative stress and reduces cell death. The association between serum Klotho and the classic risk factors, as well as the clinical history of cardiovascular disease, was also shown. There are a lot of evidences that Klotho deficiency correlates with the occurrence and development of coronary artery disease, atherosclerosis, myocardial infarction, and left ventricular hypertrophy. Therefore, an involvement of Klotho in the signaling pathways and in regulation of a proper cell metabolism could be a crucial factor in the cardiac and vascular protection. It is also well established that Klotho protein enhances the antioxidative response via augmented production of superoxide dismutase and reduced generation of reactive oxygen species. Recent studies have proven an expression of Klotho in cardiomyocytes and its increased expression in stress-related heart injury. Thus, the antioxidative and antiapoptotic activity of Klotho could be considered as the novel protective factor in cardiovascular disease and heart injury.
A Point Cloud Registration Algorithm Based on Feature Extraction and Matching
Authors: Liu Yongshan , Kong Dehan , Zhao Dandan , Gong Xiang , Han Guichun
Published: December 2018

The existing registration algorithms suffer from low precision and slow speed when registering a large amount of point cloud data. In this paper, we propose a point cloud registration algorithm based on feature extraction and matching; the algorithm helps alleviate problems of precision and speed. In the rough registration stage, the algorithm extracts feature points based on the judgment of retention points and bumps, which improves the speed of feature point extraction. In the registration process, FPFH features and Hausdorff distance are used to search for corresponding point pairs, and the RANSAC algorithm is used to eliminate incorrect point pairs, thereby improving the accuracy of the corresponding relationship. In the precise registration phase, the algorithm uses an improved normal distribution transformation (INDT) algorithm. Experimental results show that given a large amount of point cloud data, this algorithm has advantages in both time and precision.
The Impact of IL-16 3′UTR Polymorphism rs859 on Lung Carcinoma Susceptibility among Chinese Han Individuals
Authors: Zhuo Manyun , Zhuang Xiaohong , Tang Wenjun , Xu Junnv , Zhang Chengsheng , Qian Xiaoying , Wang Jie , Liu Hui , Liu Yueli , Chen Zhong , Lin Haifeng
Published: December 2018

Lung carcinoma is the most common cancer and cause of cancer deaths among both males and females in China. Previously, genetic variants located in gene untranslated region have been well established as interfering factors in mRNA translation and confirmed playing critical roles in lung oncogenesis. However, the correlation between polymorphisms in gene 3′ untranslated region and lung cancer risk is less reported in China Han population. In this study, polymorphisms in 3′-untranslated region of IL-16, CYP24A1, and FBN1 were determined in 322 lung cancer patients and 384 healthy controls with the usage of Sequenom MassARRAY. The correlation between selected variants and lung cancer risk was examined by unconditional logistic regression analysis with or without adjustments for age, gender, smoking status, and alcohol drinking status. Additionally, stratification analysis was applied to detect the associations of SNPs with lung cancer in different subgroups. As the results, significant relationships were found between IL-16 rs859 and lung cancer susceptibility in recessive model (OR= 0.65, 95% CI: 0.44-0.96, P= 0.029) and log-additive model (OR= 0.76, 95% CI: 0.60-0.96, P= 0.019). Moreover, adjusted stratified analysis also revealed the important effects of IL-16 rs859 on lung cancer risk among individuals aged older than 50, males, and nondrinkers. IL-16 rs859 showed statistically significant evidence associated with susceptibility to lung adenocarcinoma and lung small cell carcinoma in Chinese Han population as well. Our research demonstrated that genetic variant rs859 of IL-16 3′UTR was associated with lung cancer risk in Chinese Han population and the result might be exploited as a new biomarker for lung cancer assessment and prevention.
Effectiveness of Subconjunctival 0.5% Bupivacaine for Postoperative Analgesia after Intravitreal Silicon Oil Removal Surgery
Authors: Tantri Aida Rosita , Firdaus Riyadh , Elvioza  , Budiman Immaculata Astrid
Published: December 2018

Background. Intravitreal silicon oil removal surgery can cause mild-to-moderate postoperative pain and discomfort in most patients. Postoperative pain can be managed by using many methods, including a local anesthetic drug. One of the common local anesthetic drugs is 0.5% bupivacaine. The application techniques also vary, such as subconjunctival application. It was a good alternative for postoperative analgesia in the ophthalmic surgery because of its minimal risks and complications. The purpose of this research was to measure the effectiveness of subconjunctival 0.5% bupivacaine for postoperative analgesia in silicon oil removal surgery. Method. This was a double-blind randomized clinical study in patients undergoing elective intravitreal silicon oil removal surgery at Cipto Mangunkusumo Hospital. Thirty consecutive patients, enrolled from October 2016 to February 2017, were randomized to receive subconjunctival 0.5% bupivacaine or subconjunctival placebo (0.9% NaCl) at the end of the surgery. The primary outcome was the pain score 24 hours after surgery, using a 100 mm Visual Analogue Scale (VAS). Intravenous injection of tramadol 50 mg was given if the VAS >4. Secondary outcomes were the time to first analgesic requirement and the incidence of nausea/vomiting. Statistical analysis was conducted to measure the difference between 24 h pain score in the bupivacaine group (B) and that in the placebo group (NS). Result. The overall 24 hours’ postoperative pain score was significantly different between the bupivacaine group and the placebo group (p=0.001). In the 24 hours after surgery, there were only five patients needing additional analgesia in the placebo group. The time to first analgesic requirement was significantly different between the two groups (p=0.042). Nausea/vomiting only happened in the placebo group with proportions 6% and 3%, respectively. Conclusion. Subconjunctival 0.5% bupivacaine was effective for postoperative analgesia in intravitreal silicon oil removal surgery.
Early Subclinical Atherosclerosis in Gestational Diabetes: The Predictive Role of Routine Biomarkers and Nutrigenetic Variants
Authors: Franzago Marica , Fraticelli Federica , Di Nicola Marta , Bianco Francesco , Marchetti Daniela , Celentano Claudio , Liberati Marco , De Caterina Raffaele , Stuppia Liborio , Vitacolonna Ester
Published: December 2018

Gestational diabetes mellitus (GDM) can be considered a silent risk for out-of-pregnancy diabetes mellitus (DM) and cardiovascular disease (CVD) later in life. We aimed to assess the predictive role of 3rd trimester lipid profile during pregnancy for the susceptibility to markers of subclinical atherosclerosis (CVD susceptibility) at 3 years in a cohort of women with history of GDM. A secondary aim is to evaluate the usefulness of novel nutrigenetic markers, in addition to traditional parameters, for predicting early subclinical atherosclerosis in such women in order to plan adequate early prevention interventions. We assessed 28 consecutive GDM women in whom we collected socio-demographic characteristics and clinical and anthropometric parameters at the 3rd trimester of pregnancy. In a single blood sample, from each patient, we assessed 9 single nucleotide polymorphisms (SNPs) from 9 genes related to nutrients and metabolism, which were genotyped by High Resolution Melting analysis. All women then attended a 3-year-postpartum follow-up and on that occasion performed an oral glucose tolerance test (OGTT, with 75 g oral glucose), the measurement of carotid artery intima-media thickness (cIMT), and analyses of metabolic parameters. In addition, we evaluated the physical activity level and the adherence to Mediterranean diet (MedDiet) using the International Physical Activity Questionnaire (IPAQ-short version) and PREDIMED questionnaires. We found an association between 3rd trimester triglycerides and cIMT (p=0.014). We also found significant associations between the APOA5 CC genotype and cIMT after adjustments for age and body mass index (p=0.045) and between the interaction CC APOA5/CC LDLR and cIMT (p=0.010). At the follow-up, the cohort also featured a mean BMI in the overweight range and a high mean waist circumference. We found no difference in the MedDiet adherence, physical activity, and smoking but an inverse correlation between the PREDIMED and the IPAQ scores with the IMT. In conclusion, this preliminary study provides insight into the predictive role of lipid profile during pregnancy and of some genetic variants on cIMT taken as a parameter of subclinical CVD susceptibility in GDM.
Experimental Investigation of Vibration Characteristics in a Centrifugal Pump with Vaned Diffuser
Authors: Wang Kai , Lu Xin , He Xianghui
Published: December 2018

In order to investigate the vibration characteristics of centrifugal pump, a centrifugal pump with vaned diffuser whose specific speed is 190 was chosen for this research. Both the experiments of energy performance and vibration characteristics of the pump were performed. The results indicate that when flow rate of the pump is 270 m3/h, the head is 15.03 m and the efficiency is 71.47%. The maximum efficiency is 71.71% when the flow rate of the pump is 233 m3/h and the head is 16.92 m. And a wide frequency band of vibration appears at 600 Hz at outlet flange of the pump. The vibration intensity at the outlet flange is largest. The vibration intensities at both sides of bearing casing are slighter than those at outlet flange and larger than those at motor base. The vibration intensity at the motor base is larger than that at pump base, and the vibration intensity at the pump body is the lowest. The vibration intensity of monitoring point M4 in the X direction under 0.8Qd is 1.27 mm/s, which is the maximum under three flow rates.
Alda-1 Ameliorates Liver Ischemia-Reperfusion Injury by Activating Aldehyde Dehydrogenase 2 and Enhancing Autophagy in Mice
Authors: Li Meng , Xu Min , Li Jichang , Chen Lili , Xu Dongwei , Tong Ying , Zhang Jianjun , Wu Hailong , Kong Xiaoni , Xia Qiang
Published: December 2018

Aldehyde dehydrogenase 2 (ALDH2) is a key enzyme for metabolism of reactive aldehydes, but its role during liver ischemia-reperfusion injury (IRI) remains unclear. In the present study, we investigated the effects of the ALDH2 activator, Alda-1, in liver IRI and elucidated the underlying mechanisms. Mice were pretreated with Alda-1 and subjected to a 90 min hepatic 70% ischemia model, and liver tissues or serum samples were collected at indicated time points after reperfusion. We demonstrated that Alda-1 pretreatment had a hepatoprotective role in liver IRI as evidenced by decreased liver necrotic areas, serum ALT/AST levels, and liver inflammatory responses. Mechanistically, Alda-1 treatment enhanced ALDH2 activity and subsequently reduced the accumulation of reactive aldehydes and toxic protein adducts, which result in decreased hepatocyte apoptosis and mitochondrial dysfunction. We further demonstrated that Alda-1 treatment could activate AMPK and autophagy and that AMPK activation was required for Alda-1-mediated autophagy enhancement. These findings collectively indicate that Alda-1-mediated ALDH2 activation could be a promising strategy to improve liver IRI by clearance of reactive aldehydes and enhancement of autophagy.
Inhibition of Dipeptidyl Peptidase-4 Accelerates Epithelial–Mesenchymal Transition and Breast Cancer Metastasis via the CXCL12/CXCR4/mTOR Axis
Authors: Yang Fan , Takagaki Yuta , Yoshitomi Yasuo , Ikeda Takayuki , Li Jinpeng , Kitada Munehiro , Kumagai Asako , Kawakita Emi , Shi Sen , Kanasaki Keizo , Koya Daisuke
Published: December 2018

Dipeptidyl peptidase (DPP)-4 is a multifunctional glycoprotein involved in various biological and pathologic processes. DPP-4 has been widely recognized as a therapeutic target for type 2 diabetes mellitus but is also implicated in the development of human malignancies. Here, we show that inhibition of DPP-4 accelerates breast cancer metastasis via induction of CXCL12/CXCR4, which activates mTOR to promote epithelial–mesenchymal transition (EMT). In cultured cells, DPP-4 knockdown induced EMT and cell migration. Treatment with the DPP-4 inhibitor KR62436 (KR) promoted primary tumor growth and lung metastasis in a 4T1 tumor allograft mouse model; DPP-4 knockdown in 4T1 cells displayed similar phenotypes in vivo and in vitro. KR treatment enhanced the levels of CXCL12/CXCR4 and phosphorylated mTOR, which were associated with the induction of EMT in metastatic cancer cells. KR-induced EMT in cancer cells was inhibited by treatment with the CXCR4 inhibitor AMD3100 or the mTOR inhibitor rapamycin, and AMD3100 suppressed KR-induced metastasis in vivo. Our findings suggest that DPP-4 plays a significant role in cancer biology and that inhibition of DPP-4 promotes cancer metastasis via induction of the CXCL12/CXCR4/mTOR/EMT axis.

Significance:

These findings reveal that inhibition of DPP-4 increases the metastatic potential of breast cancer. This is especially important given the potential use of DPP-4 inhibition as a therapeutic strategy for type 2 diabetes.
Vitamin K Status, Warfarin Use, and Arterial Stiffness in Heart Failure
Authors: Hashmath Zeba , Lee Jonathan , Gaddam Swetha , Ansari Bilal , Oldland Garrett , Javaid Khuzaima , Mustafa Anique , Vasim Izzah , Akers Scott , Chirinos Julio A.
Published: December 2018

Large artery stiffening contributes to the pathophysiology of heart failure (HF) and associated comorbidities. MGP (matrix Gla-protein) is a potent inhibitor of vascular calcification. MGP activation is vitamin K–dependent. We aimed (1) to compare dp-ucMGP (dephospho-uncarboxylated MGP) levels between subjects with HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) and subjects without HF; (2) to assess the relationship between dp-ucMGP levels and arterial stiffness; and (3) to assess the relationship between warfarin use, dp-ucMGP levels, and arterial stiffness in HF. We enrolled 348 subjects with HFpEF (n=96), HFrEF (n=53), or no HF (n=199). Carotid-femoral pulse wave velocity, a measure of large artery stiffness, was measured with arterial tonometry. Dp-ucMGP was measured with ELISA. Dp-ucMGP levels were greater in both HFrEF (582 pmol/L; 95% CI, 444–721 pmol/L) and HFpEF (549 pmol/L; 95% CI, 455–643 pmol/L) compared with controls (426 pmol/L; 95% CI, 377–475 pmol/L; ANCOVA
P
=0.0067). Levels of dp-ucMGP were positively associated with carotid-femoral pulse wave velocity (standardized β, 0.31; 95% CI, 0.19–0.42;
P
<0.0001), which was also true in analyses restricted to patients with HF (standardized β, 0.34; 95% CI, 0.16–0.52;
P
=0.0002). Warfarin use was significantly associated with carotid-femoral pulse wave velocity (standardized β, 0.13; 95% CI, 0.004–0.26;
P
=0.043), but this relationship was eliminated after adjustment for dp-ucMGP. In conclusion, levels of dp-ucMGP are increased in HFpEF and HFrEF and are independently associated with arterial stiffness. Future studies should investigate whether vitamin K supplementation represents a suitable therapeutic strategy to prevent or reduce arterial stiffness in HFpEF and HFrEF.
Hemodynamic Markers in the Anterior Circulation as Predictors of Recurrent Stroke in Patients With Intracranial Stenosis
Authors: Wabnitz Ashley M. , Derdeyn Colin P. , Fiorella David J. , Lynn Michael J. , Cotsonis George A. , Liebeskind David S. , Waters Michael F. , Lutsep Helmi , López-Cancio Elena , Turan Tanya N. , Montgomery Jean , Janis L. Scott , Lane Bethany , Chimowitz Marc I. ,   for the SAMMPRIS Investigators
Published: December 2018

Background and Purpose—

Although aggressive medical therapy was superior to stenting in the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis), the stroke rate in the medical arm was still high. The aim of this study was to determine the association between hemodynamic markers (borderzone infarct pattern and impaired collateral flow on baseline imaging) and rates of recurrent stroke in patients treated medically in SAMMPRIS.

Methods—

This was a post hoc analysis of patients whose qualifying event for SAMMPRIS was an infarct in the territory of a stenotic middle cerebral artery or intracranial carotid artery. Infarcts were adjudicated as involving primarily internal or cortical borderzone territories, the core middle cerebral artery territory, or perforator territories, and collateral flow was assessed according to a standard scale (American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology). Log-rank tests and χ
2
tests were performed to assess associations of infarct patterns and collateral flow with rates of recurrent stroke.

Results—

Of 101 patients who qualified, 14 of 53 (26.4%) with borderzone infarcts, 2 of 24 (8.3%) with core middle cerebral artery infarcts, and 3 of 24 (12.5%) with perforator infarcts had a recurrent stroke in the territory (
P
=0.14 for comparing the 3 groups,
P
=0.052 for borderzone versus nonborderzone). Of 82 patients with collateral flow assessment, 30 of 43 (70%) with borderzone infarcts, 7 of 19 (37%) with core middle cerebral artery infarcts, and 11 of 20 (55%) with perforator infarcts had impaired collateral flow distal to the stenosis (
P
=0.049). Patients with borderzone infarcts and impaired collateral flow had the highest risk of recurrent stroke (37%).

Conclusions—

Borderzone infarcts and impaired collateral flow identify a subgroup of patients with intracranial stenosis who are at particularly high risk of recurrent stroke on medical treatment.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
.

Unique identifier: NCT00576693.
CHA
2
DS
2
-VASc Score and Stroke Prediction in Atrial Fibrillation in Whites, Blacks, and Hispanics
Authors: Chen Lin Y. , Norby Faye L. , Chamberlain Alanna M. , MacLehose Richard F. , Bengtson Lindsay G.S. , Lutsey Pamela L. , Alonso Alvaro
Published: December 2018

Background and Purpose—

Despite modest predictive ability for ischemic stroke (IS), the CHA
2
DS
2
-VASc score is widely used for stroke prediction in atrial fibrillation. Among patients with atrial fibrillation, we aimed to (1) compare the IS or transient ischemic attack (TIA) incidence by CHA
2
DS
2
-VASc in blacks and Hispanics versus whites; (2) compare predictive ability of CHA
2
DS
2
-VASc score for IS or TIA in blacks and Hispanics versus whites; and (3) determine improvement in predictive ability of CHA
2
DS
2
-VASc score from addition of race/ethnicity.

Methods—

Using data from Optum Clinformatics, a large administrative claims database, we analyzed patients with atrial fibrillation enrolled in commercial and Medicare Advantage health plans from 2009 to 2015. We computed IS or TIA incidence rates, improvement in C statistic, continuous and categorical net reclassification improvement, and relative integrated discrimination improvement from addition of race/ethnicity to CHA
2
DS
2
-VASc.

Results—

A total of 267 419 patients (mean age, 73.1 [SD, 12.3] years; 46.6% women; 84.2% white, 8.5% black, 7.3% Hispanic) were studied. After a mean follow-up of 22 months, there were 6202 IS or TIA events. IS or TIA incidence rates were higher in blacks than Hispanics or whites (1.65, 1.40, and 1.22 cases per 100 person-years, respectively) and increased with higher CHA
2
DS
2
-VASc, with no race/ethnicity-based differences (
P
for interaction=0.17). The CHA
2
DS
2
-VASc and CHA
2
DS
2
-VASc+race/ethnicity C statistic (95% CI) were 0.679 (0.670–0.686) and 0.679 (0.671–0.688). The CHA
2
DS
2
-VASc C statistic in the 3 groups were comparable. With addition of race/ethnicity, the categorical net reclassification improvement, continuous net reclassification improvement, and relative integrated discrimination improvement were −0.045 (95% CI, −0.067 to −0.025), 0.045 (95% CI, 0.025–0.068), and 0.016 (95% CI, 0.014–0.018).

Conclusions—

The predictive ability of CHA
2
DS
2
-VASc for IS or TIA in atrial fibrillation is comparable among whites, blacks, and Hispanics; hence, it can be used in the latter 2 groups. Addition of race/ethnicity to the CHA
2
DS
2
-VASc does not improve its predictive ability.
HbA1c (Glycated Hemoglobin) Levels and Clinical Outcome Post-Mechanical Thrombectomy in Patients With Large Vessel Occlusion
Authors: Choi Kang-Ho , Kim Ja-Hae , Kang Kyung-Wook , Kim Joon-Tae , Choi Seong-Min , Lee Seung-Han , Park Man-Seok , Kim Byeong-Chae , Kim Myeong-Kyu , Cho Ki-Hyun
Published: December 2018

Background and Purpose—

We analyzed the relationship between HbA1c (glycated hemoglobin) levels and clinical outcomes in patients with large vessel occlusion treated with mechanical thrombectomy (MT).

Methods—

A total of 534 patients with acute ischemic stroke (AIS) treated with MT were enrolled in this prospective cohort study. The primary outcome measured was the modified Rankin Scale score at 3 months, according to HbA1c level. High HbA1c levels were defined as a plasma level of HbA1c >6.5%. Favorable outcomes were defined as functional independence, with modified Rankin Scale scores of 0 to 2. Secondary functional outcomes included mortality, early clinical outcomes, and intracranial hemorrhage.

Results—

The number of patients with a favorable outcome was significantly lower in patients with HbA1c >6.5% than in those with HbA1c ≤6.5% (28.8% versus 42.1%;
P
=0.006). In multivariate analysis, high HbA1c levels (especially >7.0% HbA1c) were significantly associated with poor functional outcomes 3 months after AIS in patients with large vessel occlusion treated with MT. High HbA1c was also significantly associated with increased mortality and worse early clinical outcomes after AIS in patients treated with MT. Subgroup analyses showed that HbA1c >6.5% was associated with significantly lower odds of functional independence at 3 months after AIS, when comparing the recanalized group with nonrecanalized patients.

Conclusions—

These results suggest that high HbA1c level is an independent predictor of a poor outcome at 3 months after AIS in patients with large vessel occlusion treated with MT, particularly in those with recanalization, and may augment the risk of mortality and early clinical worsening after AIS.
Decreasing Fear of Falling in Chronic Stroke Survivors Through Cognitive Behavior Therapy and Task-Oriented Training
Authors: Liu Tai-Wa , Ng Gabriel Y.F. , Chung Raymond C.K. , Ng Shamay S.M.
Published: December 2018

Background and Purpose—

Research has shown that balance training is effective for reducing the fear of falling in individuals with a history of stroke. In this study, we evaluated (1) whether cognitive behavior therapy could augment the beneficial effects of task-oriented balance training (TOBT) in reducing the fear of falling in chronic stroke survivors and (2) whether it could, in turn, reduce fear-avoidance behavior and improve related health outcomes.

Methods—

Eighty-nine cognitively intact subjects with mildly impaired balance ability were randomized into the following 2 groups that underwent 90-minutes interventions 2 days per week for 8 weeks: (1) cognitive behavior therapy + TOBT or (2) general health education + TOBT (control). The primary outcome was the fear of falling, and the secondary outcomes were fear-avoidance behavior, balance, fall risk, independent daily living, community integration, and health-related quality of life. The outcomes were assessed at baseline, after 4 and 8 weeks of intervention, and 3 and 12 months after completing the intervention.

Results—

Eighty-two subjects completed the intervention and follow-up assessments. From postintervention to 12 months after completing the intervention, the cognitive behavior therapy + TOBT participants reported greater reduction in the fear of falling and fear-avoidance behavior and greater improvements in balance and independent daily living than the general health education + TOBT participants.

Conclusions—

Cognitive behavior therapy should be considered as an adjuvant therapy to standard physiotherapy for cognitively intact individuals with a history of stroke.

Clinical Trial Registration—

URL:
https://clinicaltrials.gov
. Unique identifier: NCT02937532.
Less Than Ideal
Authors: Lin Amy M. , Lin Michelle P. , Markovic Daniela , Ovbiagele Bruce , Sanossian Nerses , Towfighi Amytis
Published: December 2018

Background and Purpose—

The American Heart Association’s Life’s Simple 7 (LS7) defines ideal cardiovascular health by 7 metrics: not smoking, regular physical activity, normal body mass index, blood pressure, plasma glucose, and total cholesterol levels, and a healthy diet. We assessed prevalence and predictors of ideal LS7 among US stroke survivors.

Methods—

Among 67 514 participants in the National Health and Nutrition Examination Surveys from 1988 to 1994 and 1999 to 2014, 1597 adults (≥18 years) had self-reported history of stroke. LS7 metrics were categorized as poor, intermediate, and ideal; ideal LS7 scores were calculated (1 point for each ideal metric met). Trends in poor, intermediate, and ideal cardiovascular health were assessed. Odds of low (0–1) versus high (≥4) ideal LS7 scores were assessed according to sex, race, poverty income ratio, and education level, before and after adjusting for covariates.

Results—

Only 1 participant met all ideal LS7 metrics. The proportion with low LS7 score increased from 17.9% in 1988 to 1994 to 35.4% in 2011 to 2014 (
P
<0.001). Over that time frame, prevalence of poor blood pressure (≥140/90 mm Hg) and poor cholesterol (≥240 mg/dL) decreased (45.2%–26.5% and 37.2%–10.3%), whereas prevalence of poor body mass index (≥30 kg/m
2
), poor diet (healthy eating index score <50), and poor physical activity (0 minutes moderate/vigorous activity per week) increased (26.9%–39.0%; 14.2%–50.6%; 44.6%–70.9%; all
P
<0.05). After adjustment, black race (odds ratio, 2.29; 95% CI, 1.17–4.48), poverty income ratio ≤200% (odds ratio, 2.20, 95% CI, 1.11–4.36), and ≤12th grade education (odds ratio, 4.50; 95% CI, 2.27–8.92) were associated with low ideal LS7 scores.

Conclusions—

Over the past 3 decades, blood pressure and cholesterol control among stroke survivors improved, but rates of obesity, poor diet, and physical inactivity increased. Stroke survivors who are black, poor, or less educated are less likely to have ideal cardiovascular health.
Long-Term Survival and Function After Stroke
Authors: Sennfält Stefan , Norrving Bo , Petersson Jesper , Ullberg Teresa
Published: December 2018

Background and Purpose—

Longitudinal long-term prognostic data after stroke based on large cohorts are sparse. We report recent survival and functional outcome data on ischemic stroke (IS) and intracerebral hemorrhage (ICH) for up to 5 years poststroke from the Swedish Stroke Register (Riksstroke).

Methods—

Beyond Riksstroke’s regular follow-up surveys at 3 and 12 months, additional surveys were conducted in 2016 on 2 one-year cohorts with stroke 3 and 5 years earlier. Functional dependency was defined as modified Rankin Scale ≥3. Mortality data of the original cohorts were obtained from the Swedish Causes of Death Register. Multiple imputation was used to estimate functional status in nonresponders.

Results—

The study included 22 929 patients, 87.5% with IS and 12.5% with ICH. Loss to follow-up in the 4 surveys was 12.8% to 21.2%. Thirty-day mortality was higher for ICH than for IS (30.7% versus 11.1%;
P
<0.01), whereas for 30-day survivors, 5-year mortality did not differ significantly (
P
=0.858). Functional outcome was less favorable for ICH at all follow-up points. At 5 years, poor outcome (death or dependency) was 79% in ICH and 70.6% in IS (including imputed data;
P
<0.01). Favorable outcome was less common with increasing age and in patients with prestroke functional dependency.

Conclusions—

Despite advances in stroke care, long-term prognosis remains a cause for concern. At 5 years after stroke over 2 in 3 patients with IS, and over 3 in 4 patients with ICH, were dead or dependent. We present robust long-term prognostic data to serve as a reference for further development of healthcare and research in stroke.
Impact of Microbleeds on Outcome Following Recanalization in Patients With Acute Ischemic Stroke
Authors: Choi Kang-Ho , Kim Ja-Hae , Kang Kyung-Wook , Kim Joon-Tae , Choi Seong-Min , Lee Seung-Han , Park Man-Seok , Kim Byeong-Chae , Kim Myeong-Kyu , Cho Ki-Hyun
Published: December 2018

Background and Purpose—

We analyzed the association between cerebral microbleeds (CMBs) and clinical outcome in acute ischemic stroke patients and especially in a subgroup of patients with successful recanalization.

Methods—

A total of 1532 acute ischemic stroke patients treated with intravenous thrombolysis or mechanical thrombectomy were enrolled in this prospective cohort study. The primary outcome was measured using the modified Rankin Scale at 3 months, according to the CMB status based on magnetic resonance imaging at admission. Favorable outcome was defined as functional independence with modified Rankin Scale scores of 0 to 2. Secondary outcomes included the occurrence of symptomatic intracranial hemorrhage.

Results—

There was no statistically significant association between the presence of CMB and favorable outcome at 3 months when considering all patients (44.3% versus 37.6%;
P
=0.121). In patients with recanalization, the number of patients with favorable outcomes was significantly higher in the CMB-negative than in the CMB-positive group (57.0% versus 36.0%;
P
<0.001). In the final multivariate analysis, the presence of CMB, and in particular high CMB burden (≥5), and lobar location, were significantly associated with less favorable 3-month outcomes (odds ratio=0.57; 95% CI, 0.33−0.97;
P
=0.038) and symptomatic intracranial hemorrhage (odds ratio=3.21; 95% CI, 1.37−7.49;
P
=0.007) in patients with recanalization. In the analysis of subgroups, a statistically significant interaction was found between CMB presence and recanalization in predicting functional outcomes at 3 months.

Conclusions—

These results indicate that the presence of CMBs, and especially high burden and lobar location, are independent predictors of poor 3-month clinical outcomes and may increase symptomatic intracranial hemorrhage risk in acute ischemic stroke patients with recanalization. Our findings suggest that CMBs lead to more unfavorable effects in patients with recanalization after large vessel occlusion than in those without recanalization.
Anatomical Venous Variants in Children With Cerebral Sinovenous Thrombosis
Authors: Kouzmitcheva Elizabeth , Andrade Andrea , Muthusami Prakash , Shroff Manohar , MacGregor Daune L. , deVeber Gabrielle , Dlamini Nomazulu , Moharir Mahendranath
Published: December 2018

Background and Purpose—

Literature is sparse on the frequency and significance of anatomical venous variants (AVVs) in pediatric cerebral sinovenous thrombosis (CSVT).

Methods—

We retrospectively reviewed children with CSVT and controls undergoing computed tomography/magnetic resonance venography from January 2008 to 2014. Clinical features examined included raised intracranial pressure, risk factors, and treatment. Radiological features examined included CSVT location, presence and type of AVVs, hemorrhagic venous infarction, and venous collateralization. Clinical outcome was measured by the pediatric stroke outcome measure and radiological outcome by thrombus recanalization.

Results—

Fifty-one children with CSVT were identified. Twenty-two (43%) had AVVs at presentation. Nineteen (86%) had hypoplasia/absence of major dural sinus, 5 (23%) had persistent fetal structures, 3 (14%) had duplications/fenestrations, and 1 (5%) had disconnected superficial and deep venous systems. Controls had a slightly higher but nonsignificant prevalence 26 (51%) of AVVs. No significant clinical and radiological differences were observed between children with CSVT and AVVs compared with those with typical venous anatomy.

Conclusions—

AVVs are seen in many children with and without CSVT and do not seem to alter the presentation or clinical course. The influence of these variations on the brain’s ability to tolerate venous congestion because of thrombosis merits further study.
Altered Fibrin Clot Properties Predict Stroke and Bleedings in Patients With Atrial Fibrillation on Rivaroxaban
Authors: Janion-Sadowska Agnieszka , Chrapek Magdalena , Konieczyńska Małgorzata , Undas Anetta
Published: December 2018

Background and Purpose—

We investigated whether clot permeability can predict clinically relevant outcomes in patients with atrial fibrillation (AF) treated with rivaroxaban.

Methods—

In the cohort study, we enrolled 232 consecutive patients with AF on rivaroxaban 20 mg/d (76.3%) or 15 mg/d (23.7%) for at least 3 months. Plasma clot permeability (K
s
), a measure of fibrin network density, was determined 24 to 30 hours since the intake of rivaroxaban at undetectable drug’s levels. Ischemic cerebrovascular events and bleedings were recorded.

Results—

During a median follow-up of 48 months, patients with K
s
below median (6.8 cm
2
·10
−9
) had higher prevalence of stroke (5.84 versus 0.88% per year;
P
<0.0001) and relevant bleeding (7.06 versus 0.88% per year;
P
<0.0001) compared with those above median. The mortality rate was 1.53% per year and was not associated with K
s
. Lower K
s
predicted cerebrovascular ischemic events (hazard ratio, 6.64; 95% CI, 2.2–20.1) and relevant bleedings (hazard ratio, 7.38; 95% CI, 2.58–21.10). Minor bleeds (32.8% of patients) were observed more often in patients with K
s
above median (50.9 versus 14.7%;
P
<0.0001). Multivariate Cox regression analysis showed that in AF patients on rivaroxaban lower K
s
increased the risk of stroke (hazard ratio, 6.51; 95% CI, 2.14–19.75) and relevant bleedings (hazard ratio, 9.68; 95% CI, 3.21–29.18).

Conclusions—

Decreased clot permeability in AF patients can predict thromboembolic and clinically relevant bleeding events during therapy with rivaroxaban, while looser clot networks predispose to minor bleeds.
Workshop series for occupational therapists using the US Agency for Healthcare Research and Quality’s Health Literacy Universal Precautions Toolkit and other supported tools
Authors: Koenig Virginia E , Provident Ingrid M
Published: December 2018

Objective:

Health literacy is the ability to access, understand, evaluate and communicate information in a manner that promotes, maintains and improves health care in a variety of settings across the life span. Health professionals, including occupational therapists (OTs), need to consider health literacy in order to optimise client-centred interventions that promote self-management of chronic conditions, health and wellness. The goal of this small-scale cohort study was to determine if a health literacy workshop series for OTs could improve their working knowledge of health literacy, and increase their self-perceived ability to identify, assess and implement client-centred interventions to at-risk patients.

Design:

Over a 6-week period, six OT professionals participated in a customised workshop series, incorporating elements of the US Agency for Healthcare Research and Quality’s (AHRQ) Health Literacy Universal Precautions Toolkit (the Toolkit) and other AHRQ-supported health literacy resources.

Method:

A one-group, pre–posttest mixed methods design was used to measure outcomes.

Results:

Results of this study suggests that participation in a health literacy education programme featuring the Toolkit and other AHRQ-supported tools can improve OTs’ self-perceived ability to identify, assess and provide client-centred services to their patients. Responses to open-ended questions both pre-and post-intervention align with the literature in that health care professionals, like OTs, can benefit from customised health literacy training to improve client-centred care by implementing specific health literacy strategies into their clinical practice.
Development and validation of recycled carbon fiber-based binder tapes for automated tape laying processes
Authors: Rimmel Oliver , May David , Goergen Christian , Poeppel Artur , Mitschang Peter
Published: December 2018

The current growth in use of fiber reinforced polymer composites causes a strongly increasing amount of waste. Current approaches for fiber reinforced polymer composites recycling usually not exploit the potential of endless fibers as they are shortened during recycling and will not be properly aligned in the final product. Considering this, the present work aimed at the development of a recycling process for long recycled carbon fibers, where fiber length is preserved and load-related fiber orientation is possible. The starting point for the presented work was so-called slivers, which are long bundles of fibers resulting from a carding process that has been applied to fiber scrap. The main focus of this work was on the development of a binder mesh application rig that processes the sliver to a binder tape, processable in an automated tape laying process, which in turn required modifications to adapt to the novel tape. The functionality of the binder tape manufacturing process was validated with long recycled carbon fibers slivers with linear density of 4 g/m and fiber lengths between 70 and 120 mm. With the binder tape preform manufactured this way, two alternative routes for composite manufacturing were tested. First, the amount of binder was set so high that direct thermoplastic pressing of the preforms was possible. Second, the amount of binder was minimized, and the preforms were infiltrated with a thermoset resin system via resin transfer molding. While the thermoplastic route showed very deficient fiber–matrix adhesion, with the thermoset route, ≈68% of stiffness and ≈31% of strength of virgin fiber-based composites could be achieved in fiber direction in a unidirectional lay-up.
Aspiration Squeeze: The Struggle of Children to Positively Selected Immigrants
Authors: Engzell Per
Published: December 2018

Why is it that children of immigrants often outdo their ethnic majority peers in educational aspirations yet struggle to keep pace with their achievements? This article advances the explanation that many immigrant communities, while positively selected on education, still have moderate absolute levels of schooling. Therefore, parents’ education may imbue children with high expectations but not always the means to fulfill them. Swedish data on children of immigrants from over 100 countries of origin support this view: Net of parents’ absolute years of schooling, a high rank in the sending country benefits children’s aspirations, attitudes, and educational choices but not their test scores or school grades. The upshot is an ‘‘aspiration squeeze’’ where to emulate their parents’ relative place in the education distribution, children are left struggling against the momentous tide of educational expansion.
Through the Gate: The implementation, management and delivery of resettlement service provision for short-term prisoners
Authors: Millings Matthew , Taylor Stuart , Burke Lol , Ragonese Ester
Published: December 2018

This paper draws upon research documenting the implementation, management and delivery of Through the Gate service provision in one case study area across an 18-month period. In referring to interviews and focus groups with professionals, male prisoners, and the families of these men, the paper provides a critical examination of the practice implications of administering Through the Gate provision in a resettlement prison. In doing so we reflect upon the changes in organisational structures, the evolution of occupational culture(s), and on the impact on multi-agency partnership working practice evident within this Transforming Rehabilitation led period of transitional change.
Providing exercise instructions using multimedia may improve adherence but not patient outcomes: a systematic review and meta-analysis
Authors: Emmerson Kellie B , Harding Katherine E , Taylor Nicholas F
Published: December 2018

Objective:

To determine whether patients have better outcomes when exercise instructions are provided using multimedia approaches compared with verbal or written instructions.

Data sources:

Electronic databases (MEDLINE, EMBASE, CINAHL, and PsychInfo) searched up to October 2018.

Study selection:

Randomized controlled trials exploring exercise-based interventions for health conditions, and comparing instructions provided using multimedia approaches with conventional verbal or written instructions.

Results:

Fourteen trials from seven countries were included, with a total of 2156 participants. Diagnoses included orthopaedic, neurological, pulmonary, cardiac, and women’s health conditions. A meta-analysis of three trials (140 participants) provided very low-quality evidence that multimedia exercise instructions may be more effective than written instructions in improving exercise adherence (standardized mean difference (SMD) 0.60, 95% confidence interval (CI) –0.06 to 1.25). Two of nine trials that could not be included in the meta-analysis for adherence due to heterogeneity reported that multimedia exercise instructions were more effective than written instructions in improving exercise adherence. Four other meta-analyses (three trials each) found low- to high-quality evidence that provision of exercise instructions using multimedia is no more beneficial than paper-based instructions for patient-related outcomes of pain intensity (SMD 0.09, 95% CI –0.47 to 0.28); uptake of physical activity (SMD 0.07, 95% CI −0.08 to 0.23); or physical (SMD 0.21, –0.21 to 0.64) or emotional (SMD 0.16, 95% CI −0.04 to 0.36) domains of health-related quality of life.

Conclusion:

Multimedia approaches to exercise instruction may result in increased adherence compared with instructions provided in written or verbal format, but there is insufficient evidence to determine whether this results in improved patient outcomes.
History and philosophy of geography III: The haunted, the reviled, and the plural
Authors: Keighren Innes M.
Published: December 2018

This report takes a new English-language translation of Friedrich Ratzel’s infamous essay Der Lebensraum (1901) as a prompt to consider the ethical questions that are raised by revisiting geography’s dangerous ideas and discredited practitioners. Attending to a series of recent interventions that offer new readings of Ratzel and his essay, I consider how historiographical practice and moral obligation intersect in the process of making sense of, and coming to terms with, disciplinary pasts that haunt the present. The report concludes by considering the future of the series of which it forms part and argues that the task of narrating progress in the history and philosophy of geography should be assumed by a more diverse range of authors than has heretofore been the case.
Support for conditional unemployment benefit in European countries: The role of income inequality
Authors: Carriero Renzo , Filandri Marianna
Published: December 2018

This article investigates attitudes towards the conditionality of benefits targeted to a specific needy group, the unemployed, and analyses their relationship with the structure of income inequality. The focus is on the deservingness of welfare recipients. The public seems to use five criteria to define deservingness and, consequently, the conditionality to which public support is subjected: need, attitude (i.e. gratefulness), control (over neediness), reciprocity (of giving and receiving) and identity, that is the similarity or proximity between the providers of public support (the taxpayers) and the people who should receive it. People’s willingness to help depends on how close they consider benefit recipients to be to themselves (i.e. the extent to which they belong to the same in-group). The identity criterion is the main object of our investigation. We argue that the operation of this criterion at the micro-level can be affected by macro-level variables. Specifically, we focus on different measures of the structure of income inequality which are indicators of the social distance between welfare recipients and taxpayers. Based on data from three waves of the European Values Study (1990–2008) collected in 30 countries, the study offers a comparative and longitudinal analysis. The picture emerging from the within-country analysis – which removed much of the between-country heterogeneity − shows that when the social distance grows, it is more difficult for the majority of citizens (upper and middle classes) to identify with the unemployed.