bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified Citrus Pectin Prevents Blood-Brain Barrier Disruption in Mouse Subarachnoid Hemorrhage by Inhibiting Galectin-3
Authors: Nishikawa Hirofumi , Liu Lei , Nakano Fumi , Kawakita Fumihiro , Kanamaru Hideki , Nakatsuka Yoshinari , Okada Takeshi , Suzuki Hidenori
Published: October 2018

Background and Purpose—

Plasma levels of galectin-3—a matricellular protein—are increased after aneurysmal subarachnoid hemorrhage (SAH), but the functional significance remains undetermined. This study was conducted to evaluate whether modified citrus pectin (MCP; galectin-3 inhibitor) prevents post-SAH early brain injury, focusing on blood-brain barrier disruption.

Methods—

C57BL/6 male adult mice (n=251) underwent sham or filament perforation SAH modeling, followed by a random intracerebroventricular injection of vehicle or drug at 30 minutes post-modeling. First, vehicle-treated and 0.8, 4, 16, or 32 µg MCP-treated mice were assessed by neuroscore and brain water content at 24 and 48 hours post-modeling. Second, Evans blue extravasation, Western blotting, coimmunoprecipitation and immunostaining were performed in vehicle-treated or 4 µg MCP-treated mice at 24 hours post-modeling. Third, vehicle or R-galectin-3 (recombinant galectin-3) was administered to SAH mice simultaneously with vehicle or MCP, and neuroscore and Evans blue extravasation were evaluated at 24 hours post-modeling. Fourth, vehicle or R-galectin-3 was administered to MCP-treated SAH mice at 24 hours, and neuroscore and IgG immunostaining were evaluated at 48 hours post-SAH.

Results—

Among tested dosages, 4 µg MCP showed the best neuroprotective effects as to preventing neurological impairments and brain edema at 24 to 48 hours post-SAH. Four micrograms MCP attenuated post-SAH blood-brain barrier disruption and galectin-3 upregulation in brain capillary endothelial cells, associated with inactivation of ERK (extracellular signal-related kinase) 1/2, STAT (signal transducer and activator of transcription)-3, and MMP (matrix metalloproteinase)-9, and the consequent preservation of a tight junction protein ZO-1 (zonula occludens-1). Coimmunoprecipitation assay demonstrated physical interactions between galectin-3 and TLR (Toll-like receptor) 4. R-galectin-3 blocked the neuroprotective effects of MCP.

Conclusions—

MCP prevents post-SAH blood-brain barrier disruption possibly by inhibiting galectin-3, of which the mechanisms may include binding to TLR4 and activating ERK1/2, STAT-3, and MMP-9. This study suggests galectin-3 to be a novel therapeutic target against post-SAH early brain injury.
Is Functional Outcome Different in Posterior and Anterior Circulation Stroke?
Authors: Sommer Peter , Posekany Alexandra , Serles Wolfgang , Marko Martha , Scharer Sebastian , Fertl Elisabeth , Ferrari Julia , Lang Wilfried , Vosko Milan , Szabo Simon , Kiechl Stefan , Knoflach Michael , Greisenegger Stefan ,   on behalf of the Austrian Stroke Unit Registry Collaborators
Published: October 2018

Background and Purpose—

Posterior circulation stroke (PCS) account for 20% of all ischemic strokes. There is limited evidence whether functional outcome of PCS is comparable to that of anterior circulation stroke (ACS). We aimed to analyze whether 3-month functional outcome is different in PCS and ACS.

Methods—

Patients with acute ischemic stroke prospectively enrolled within the Austrian Stroke Unit Registry were stratified by infarct localization according to the Oxfordshire Community Stroke Project Classification. Propensity score matching was used to control for covariate imbalances and to match patients with PCS and ACS. Patients were matched for stroke severity, recombinant tissue-type plasminogen activator treatment, and demographic and vascular risk factors. Main outcomes were the distribution of modified Rankin Scale after 3 months and multiple proportional odds models to estimate the influence of the infarct localization on the functional outcome.

Results—

From a total of 90 484 patients enrolled within the Austrian Stroke Unit Registry, 9208 (4604 PCS/4604 ACS) were matched, of those 954 (477 in each group) were treated with recombinant tissue-type plasminogen activator. We detected a significant shift towards better 3-month functional outcome in patients with ACS compared with PCS (odds ratio [OR], 1.19; 95% CI, 1.1–1.28;
P
<0.0001). In particular, functional outcome was worse in PCS with onset-to-door-time >270 minutes (OR, 1.34; 95% CI, 1.17–1.54;
P
<0.0001) and in PCS with unknown onset-to-door-time (OR, 1.26; 95% CI, 1.13–1.42;
P
<0.0001); however, we did not detect any difference in functional outcome between ACS and PCS in patients with an onset-to-door-time ≤270 minutes (1–180 minutes: OR, 0.92, 95% CI, 0.78–1.09,
P
=0.3554; 181–270 minutes: OR, 1.04, 95% CI, 0.79–1.37,
P
=0.7689). In patients treated with recombinant tissue-type plasminogen activator, functional outcome was not significantly different between PCS and ACS.

Conclusions—

PCS was associated with worse outcome compared with ACS in patients arriving later than 4.5 hours at hospital or in those with unknown onset of symptoms. Our results urge for implementation of symptoms found in the posterior circulation into preclinical patient-triage tools.
Cardioembolic Stroke Risk and Recovery After Anticoagulation-Related Intracerebral Hemorrhage
Authors: Murphy Meredith P. , Kuramatsu Joji B. , Leasure Audrey , Falcone Guido J. , Kamel Hooman , Sansing Lauren H. , Kourkoulis Christina , Schwab Kristin , Elm Jordan J. , Gurol M. Edip , Tran Huy , Greenberg Steven M. , Viswanathan Anand , Anderson Christopher D. , Schwab Stefan , Rosand Jonathan , Shi Fu-Dong , Kittner Steven J. , Testai Fernando D. , Woo Daniel , Langefeld Carl D. , James Michael L. , Koch Sebastian , Huttner Hagen B. , Biffi Alessandro , Sheth Kevin N.
Published: October 2018

Background and Purpose—

Whether to resume oral anticoagulation treatment after intracerebral hemorrhage (ICH) remains an unresolved question. Previous studies focused primarily on recurrent stroke after ICH. We sought to investigate the association between cardioembolic stroke risk, oral anticoagulation therapy resumption, and functional recovery among ICH survivors in the absence of recurrent stroke.

Methods—

We conducted a joint analysis of 3 observational studies: (1) the multicenter RETRACE study (German-Wide Multicenter Analysis of Oral Anticoagulation Associated Intracerebral Hemorrhage); (2) the Massachusetts General Hospital ICH study (n=166); and (3) the ERICH study (Ethnic/Racial Variations of Intracerebral Hemorrhage; n=131). We included 941 survivors of ICH in the setting of active oral anticoagulation therapy for prevention of cardioembolic stroke because of nonvalvular atrial fibrillation and without evidence of ischemic stroke and recurrent ICH at 1 year from the index event. We created univariable and multivariable models to explore associations between cardioembolic stroke risk (based on CHA
2
DS
2
-VASc scores) and functional recovery after ICH, defined as achieving modified Rankin Scale score of ≤3 at 1 year for participants with modified Rankin Scale score of >3 at discharge.

Results—

In multivariable analyses, the CHA
2
DS
2
-VASc score was associated with a decreased likelihood of functional recovery (odds ratio, 0.83 per 1 point increase; 95% CI, 0.79–0.86) at 1 year. Anticoagulation resumption was independently associated with a higher likelihood of recovery, regardless of CHA
2
DS
2
-VASc score (odds ratio, 1.89; 95% CI, 1.32–2.70). We found an interaction between CHA
2
DS
2
-VASc score and anticoagulation resumption in terms of association with increased likelihood of functional recovery (interaction
P
=0.011).

Conclusions—

Increasing cardioembolic stroke risk is associated with a decreased likelihood of functional recovery at 1 year after ICH, but this association was weaker among participants resuming oral anticoagulation therapy. These findings support, including recovery metrics, in future studies of anticoagulation resumption after ICH.
Thrombus Permeability in Admission Computed Tomographic Imaging Indicates Stroke Pathogenesis Based on Thrombus Histology
Authors: Berndt Maria , Friedrich Benjamin , Maegerlein Christian , Moench Sebastian , Hedderich Dennis , Lehm Manuel , Zimmer Claus , Straeter Alexandra , Poppert Holger , Wunderlich Silke , Schirmer Lucas , Oberdieck Paul , Kaesmacher Johannes , Boeckh-Behrens Tobias
Published: October 2018

Background and Purpose—

Intracranial thrombi can be characterized according to their permeability as measured by contrast agent penetration. Thrombus composition and its associated pathogenesis are important factors affecting treatment and secondary prevention. We aimed to explore the histopathologic factors explaining the heterogeneity of thrombus permeability measures and evaluated potential correlations with stroke pathogenesis.

Methods—

Thrombus densities were measured in thin-slice noncontrast computed tomography and automatically aligned computed tomographic angiography images of 133 patients with large-vessel occlusions of the middle cerebral artery. Change in thrombus attenuation (Δ
t
) and corrected void fraction (ε; attenuation increase corrected for contralateral artery densities) were calculated. First, these thrombus perviousness measures were correlated with histological thrombus components (especially fractions of fibrin-platelet accumulation and red blood cells) and stroke pathogenesis (n=32). For validation, an association between perviousness and pathogenesis was assessed in a second, independent cohort (n=101).

Results—

Thrombus perviousness estimates were correlated with both fibrin/platelets fractions (Δ
t
: r=0.43,
P
=0.016/ε: r=0.45,
P
=0.01) and inversely with red blood cells counts (Δ
t
: r=−0.46,
P
=0.01/ε: r=−0.49,
P
=0.006). In the first cohort, Δ
t
was substantially higher in samples from patients with cardioembolic stroke pathogenesis as compared with noncardioembolic-derived thrombi (
P
=0.026). In the validation cohort, thrombus perviousness measures differed significantly between cardioembolic (Δ
t
: median [ interquartile range]=12.53 [8.70–17.90]; ε: median [interquartile range]=0.054 [0.036–0.082]) and noncardioembolic thrombi (Δ
t
: median [interquartile range]=3.2 [2.17–6.44],
P
<0.001; ε: median [interquartile range]=0.020 [0.011–0.027],
P
<0.001) and were associated with pathogenesis (Δ
t
: β=0.45,
P
=0.016/ε: β=83.6,
P
=0.013) in a binary logistic regression model.

Conclusions—

Permeable thrombi showed a strong correlation with lower fractions of red blood cells counts and more fibrin/platelets conglomerations, concurrent with an association with cardioembolic origin. This novel information about thrombus perviousness may be valuable as a new and simple to acquire imaging marker for identifying stroke pathogenesis using early and readily available imaging.
Risk of Nursing Home Admission in Cerebral Small Vessel Disease
Authors: Bergkamp Mayra I. , Wissink Joost G.J. , van Leijsen Esther M.C. , Ghafoorian Mohsen , Norris David G. , van Dijk Ewoud J. , Platel Bram , Tuladhar Anil M. , de Leeuw Frank-Erik
Published: October 2018

Background and Purpose—

Since cerebral small vessel disease (SVD) is associated with cognitive and motor impairment and both might ultimately lead to nursing home admission, our objective was to investigate the association of SVD markers with nursing home admission.

Methods—

The RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort) is a prospective cohort of 503 independent living individuals with SVD. Date of nursing home admission was retrieved from the Dutch municipal personal records database. Risk of nursing home admission was calculated using a competing risk analysis, with mortality as a competing risk.

Results—

During follow-up (median 8.7 years, interquartile range 8.5–8.9), 31 participants moved to a nursing home. Before nursing home admission, 19 participants were diagnosed with dementia, 6 with parkinsonism, and 10 with stroke. Participants with the lowest white matter volume had an 8-year risk of nursing home admission of 13.3% (95% CI, 8.6–18.9), which was significantly different from participants with middle or highest white matter volume (respectively, 4.8% [95% CI, 2.3–8.8] and 0%;
P
<0.001). After adjusting for baseline age and living condition, the association of white matter volume and total brain volume with nursing home admission was significant, with, respectively, hazard ratios of 0.88 [95% CI, 0.84–0.95] (
P
value 0.025) and 0.92 [95% CI, 0.85–0.98] (
P
<0.001) per 10 mL. The association of white matter hyperintensities and lacunes with nursing home admission was not significant.

Conclusions—

This study demonstrates that in SVD patients, independent from age and living condition, a lower white matter volume and a lower total brain volume is associated with an increased risk of nursing home admission. Nursing home admission is a relevant outcome in SVD research since it might be able to combine both cognitive and functional consequences of SVD in 1 outcome.
TLR7 (Toll-Like Receptor 7) Facilitates Heme Scavenging Through the BTK (Bruton Tyrosine Kinase)–CRT (Calreticulin)–LRP1 (Low-Density Lipoprotein Receptor–Related Protein-1)–Hx (Hemopexin) Pathway in Murine Intracerebral Hemorrhage
Authors: Wang Gaiqing , Guo Zhenni , Tong Lusha , Xue Fang , Krafft Paul R. , Budbazar Enkhjargal , Zhang John H. , Tang Jiping
Published: October 2018

Background and Purpose—

Heme and iron are considered to be key factors responsible for secondary insults after intracerebral hemorrhage (ICH). Our previous study showed that LRP1 (low-density lipoprotein receptor–related protein-1)–Hx (hemopexin) facilitates removal of heme. The TLR7 (Toll-like receptor 7)–BTK (Bruton tyrosine kinase)–CRT (calreticulin) pathway regulates the expression of LRP1-Hx. This study is designed to clarify whether TLR7 activation facilitates heme scavenging and to establish the potential role of the BTK-CRT-LRP1-Hx signaling pathway in the pathophysiology of ICH.

Methods—

ICH was induced by stereotactic, intrastriatal injection of type VII collagenase. Mice received TLR7 agonist (imiquimod) via intraperitoneal injection after ICH induction. TLR7 inhibitor (ODN2088), BTK inhibitor (LFM-A13), and CRT agonist (thapsigargin) were given in different groups to further evaluate the underlying pathway. Mice were randomly divided into sham, ICH+vehicle (normal saline), ICH+Imiquimod (2.5, 5, and 10 μg/g), ICH+ODN2088, ICH+LFM-A13, ICH+thapsigargin, and ICH+ODN2088+thapsigargin. Imiquimod was administered twice daily starting at 6 hours after ICH; ODN2088 was administered by intracerebroventricular injection at 30 minutes, and LFM-A13 or thapsigargin was administered by intraperitoneal injection at 3 hours after ICH induction. Neurological scores, cognitive abilities, as well as brain edema, blood-brain barrier permeability, hemoglobin level, brain expression of TLR7/BTK/CRT/LRP1/Hx were analyzed.

Results—

Low dosage imiquimod significantly attenuated hematoma volume, brain edema, BBB permeability, and neurological deficits after ICH. Imiquimod also increased protein expressions of TLR7, BTK, CRT, LRP1, and Hx; ODN2088 reduced TLR7, BTK, CRT, LRP1, and Hx expressions.

Conclusions—

TLR7 plays an important role in heme scavenging after ICH by modulating the BTK-CRT-LRP1-Hx pathway. TLR7 may offer protective effects by promoting heme resolution and reduction of brain edema after ICH.
Impact of Hyperglycemia According to the Collateral Status on Outcomes in Mechanical Thrombectomy
Authors: Kim Joon-Tae , Liebeskind David S. , Jahan Reza , Menon Bijoy K. , Goyal Mayank , Nogueira Raul G. , Pereira Vitor M. , Gralla Jan , Saver Jeffrey L.
Published: October 2018

Background and Purpose—

Understanding the influence of hyperglycemia on outcomes in terms of the pretreatment collateral status might contribute to the achievement of case-specific glucose management in acute ischemic stroke. We sought to investigate whether the glucose level can influence the pretreatment collateral status and functional outcomes of endovascular thrombectomy in acute ischemic stroke and whether the impact of hyperglycemia on outcomes can be modified by the pretreatment collateral status.

Methods—

We analyzed the Triple-S database, which includes individual patient data pooled from 3 prospective Solitaire stent retriever studies (SWIFT [Solitaire With the Intention for Thrombectomy], SWIFT PRIME [SWIFT as Primary Endovascular Treatment], and STAR [Solitaire Flow Restoration Thrombectomy for Acute Revascularization]). Patients were eligible if they had acute ischemic stroke with moderate to severe neurological deficits, harbored angiographically confirmed large vessel occlusion, and were treatable by endovascular thrombectomy within 8 hours of onset. Pretreatment catheter angiograms were scored for collateral grades by a core imaging laboratory. The main outcome was 3-month good outcome (modified Rankin Scale score of 0–2).

Results—

Angiographic data on collaterals were available in 309 patients (age, 67±12 years; glucose, 131±55 mg/dL). Overall, the glucose level at presentation was not associated with pretreatment collateral status but was significantly lower in patients with a good outcome at 90 days (124 versus 140 mg/dL). Collateral grades modified the effect of glucose on good outcomes at 90 days (
P
int
=0.03). Among patients with poor collaterals (collateral grades, 0–2), higher glucose levels did not alter the outcome, whereas among patients with good collaterals (3–4), higher glucose levels reduced the likelihood of a good outcome at 90 days (per 10 mg/dL increase: odds ratio, 0.81; 95% CI, 0.69–0.95).

Conclusions—

Our study revealed that higher glucose levels reduce the likelihood of a good outcome among patients with good collaterals, but their effects on the outcome are less significant for patients with poor collaterals. The results suggest that good collaterals at presentation may be targets for more intensive glucose control and future studies relating to glucose management.
Ischemic Stroke Increases Heart Vulnerability to Ischemia-Reperfusion and Alters Myocardial Cardioprotective Pathways
Authors: Meloux Alexandre , Rigal Eve , Rochette Luc , Cottin Yves , Bejot Yannick , Vergely Catherine
Published: October 2018

Background and Purpose—

For years, the relationship between cardiac and neurological ischemic events has been limited to overlapping pathophysiological mechanisms and common risk factors. However, acute stroke may induce dramatic changes in cardiovascular function. The aim of this study was to evaluate how prior cerebrovascular lesions affect myocardial function and signaling in vivo and ex vivo and how they influence cardiac vulnerability to ischemia-reperfusion injury.

Methods—

Cerebral embolization was performed in adult Wistar male rats through the injection of microspheres into the left or right internal carotid artery. Stroke lesions were evaluated by microsphere counting, tissue staining, and assessment of neurological deficit 2 hours, 24 hours, and 7 days after surgery. Cardiac function was evaluated in vivo by echocardiography and ex vivo in isolated perfused hearts. Heart vulnerability to ischemia-reperfusion injury was investigated ex vivo at different times post-embolization and with varying degrees of myocardial ischemia. Left ventricles (LVs) were analyzed with Western blotting and quantitatve real-time polymerase chain reaction.

Results—

Our stroke model produced large cerebral infarcts with severe neurological deficit. Cardiac contractile dysfunction was observed with an early but persistent reduction of LV fractional shortening in vivo and of LV developed pressure ex vivo. Moreover, after 20 or 30 minutes of global cardiac ischemia, recovery of contractile function was poorer with impaired LV developed pressure and relaxation during reperfusion in both stroke groups. Following stroke, circulating levels of catecholamines and GDF15 (growth differentiation factor 15) increased. Cerebral embolization altered nitro-oxidative stress signaling and impaired the myocardial expression of ADRB1 (adrenoceptor β1) and cardioprotective Survivor Activating Factor Enhancement signaling pathways.

Conclusions—

Our findings indicate that stroke not only impairs cardiac contractility but also worsens myocardial vulnerability to ischemia. The underlying molecular mechanisms of stroke-induced myocardial alterations after cerebral embolization remain to be established, insofar as they may involve the sympathetic nervous system and nitro-oxidative stress.
Outcomes of Endovascular Treatment for Acute Intracranial Atherosclerosis–Related Large Vessel Occlusion
Authors: Baek Jang-Hyun , Kim Byung Moon , Heo Ji Hoe , Kim Dong Joon , Nam Hyo Suk , Kim Young Dae
Published: October 2018

Background and Purpose—

Endovascular treatment for acute intracranial atherosclerosis–related large vessel occlusion (ICAS [+]-LVO) is one of the challenging issues in modern mechanical thrombectomy era. We evaluated procedural and clinical outcomes of endovascular treatment for the ICAS (+)-LVO. We also compared their outcomes with those of large vessel occlusion not associated with intracranial atherosclerosis (ICAS [−]-LVO).

Methods—

We retrospectively reviewed consecutive patients with acute stroke who underwent endovascular treatment for LVO. Patients were assigned to the ICAS (+)-LVO group or the ICAS (−)-LVO group primarily based on catheter angiogram. Procedural and clinical outcomes were compared between the ICAS (+)-LVO and ICAS (−)-LVO groups.

Results—

The present study included 318 patients. Fifty-six patients (17.6%) had an ICAS (+)-LVO. Recanalization was achieved in 45 patients in the ICAS (+)-LVO group (80.4%), which was comparable with the ICAS (−)-LVO group (88.5%;
P
=0.097). However, recanalization using a stent retriever was less successful in the ICAS (+)-LVO (28.9%) than the ICAS (−)-LVO group (93.5%). Of the remaining patients in the ICAS (+)-LVO group, 84.3% of patients required specific rescue treatments appropriate for ICAS, including balloon angioplasty, stenting, and intra-arterial glycoprotein IIb/IIIa inhibitor infusion. The rates of favorable outcomes (46.4% versus 46.9%), death, and symptomatic intracranial hemorrhage were not significantly different between the 2 groups. Glycoprotein IIb/IIIa inhibitor use was not significantly associated with symptomatic intracranial hemorrhage.

Conclusions—

ICAS (+)-LVO was often refractory to mechanical thrombectomy. With specific rescue treatments appropriate for ICAS, patients in the ICAS (+)-LVO group had a recanalization rate comparable with patients in the ICAS (−)-LVO. With comparable recanalization rate, the clinical outcomes did not differ between patients with ICAS (+)-LVO and ICAS (−)-LVO.
Troponin Improves the Yield of Transthoracic Echocardiography in Ischemic Stroke Patients of Determined Stroke Subtype
Authors: Yaghi Shadi , Chang Andrew D. , Cutting Shawna , Jayaraman Mahesh , McTaggart Ryan A. , Ricci Brittany A. , Dakay Katarina , Narwal Priya , Grory Brian Mac , Burton Tina , Reznik Michael , Silver Brian , Gupta Ajay , Song Christopher , Mehanna Emile , Siket Matthew , Lerario Michael P. , Saccetti Daniel C. , Merkler Alexander E. , Kamel Hooman , Elkind Mitchell S.V. , Furie Karen
Published: October 2018

Background and Purpose—

Transthoracic echocardiography (TTE) is widely used in the ischemic stroke setting. In this study, we aim to investigate the yield of TTE in patients with ischemic stroke and known subtype and whether the admission troponin level improves the yield of TTE.

Methods—

Data were abstracted from a single-center prospective ischemic stroke database for 18 months and included all patients with ischemic stroke whose etiologic subtype could be obtained without the need of TTE. Unadjusted and adjusted regression models were built to determine whether positive cardiac troponin levels (≥0.1 ng/mL) improve the yield of TTE, adjusting for demographic and clinical characteristics.

Results—

We identified 578 patients who met the inclusion criteria. TTE changed clinical management in 64 patients (11.1%), but intracardiac thrombus was detected in only 4 patients (0.7%). In multivariable models, there was an association between TTE changing management and positive serum troponin level (adjusted odds ratio, 4.26; 95% CI, 2.17–8.34;
P
<0.001).

Conclusions—

In patients with ischemic stroke, TTE might lead to a change in clinical management in ≈1 of 10 patients with known stroke subtype before TTE but changed acute treatment decisions in <1 percent of patients. Serum troponin levels improved the yield of TTE in these patients.
Dynamic Cerebral Autoregulation Is an Independent Functional Outcome Predictor of Mild Acute Ischemic Stroke
Authors: Chi Nai-Fang , Hu Han-Hwa , Wang Cheng-Yen , Chan Lung , Peng Chung-Kang , Novak Vera , Hu Chaur-Jong
Published: October 2018

Background and Purpose—

Cerebral autoregulation is impaired in patients with acute ischemic stroke. The purpose of this study was to investigate whether dynamic cerebral autoregulation (dCA) indices constitute an independent functional outcome predictor of acute ischemic stroke.

Methods—

In this study, 86 patients at days 3 to 7 after acute ischemic stroke and 40 age- and sex-matched controls were enrolled for assessing their dCA indices under spontaneous hemodynamic fluctuations. The dCA indices of patients with favorable outcomes (modified Rankin Scale score ≤1 at 3 months, n=65), patients with unfavorable outcomes (modified Rankin Scale score ≥2 at 3 months, n=21), and controls were compared.

Results—

The dCA indices, namely the phase shift at very low frequency band (phase_VLF), in the patients with unfavorable outcomes were significantly worse than those in the patients with favorable outcomes. However, the phase_VLF in the patients with favorable outcomes did not differ from those in the controls. Impaired dCA was associated with elevated mean arterial pressure and large infarction volume but was also present in patients with normal mean arterial pressure or small infarction volume. Phase_VLF was a predictor of outcomes in the receiver operating characteristic analysis (area under the curve: 0.722;
P
<0.001). Multivariate analysis revealed that a phase_VLF value of <61° was independently associated with unfavorable outcomes (odds ratio=4.90;
P
=0.024).

Conclusions—

Phase_VLF is an independent functional outcome predictor of acute ischemic stroke.
Antiphospholipid Syndrome With Isolated Isotype M Anticardiolipin and/or Anti-B2GPI Antibody Is Associated With Stroke
Authors: Urbanski Geoffrey , Yelnik Cécile Marie , Maillard Hélène , Launay David , Dubucquoi Sylvain , Hachulla Eric , Hatron Pierre-Yves , Lambert Marc
Published: October 2018

Background and Purpose—

International classification criteria for antiphospholipid syndrome (APS) include IgM (immunoglobulin M), aCL (anticardiolipin), and aB2GPI (anti-β2-glycoprotein-I) antibodies, but their relevance is still debated. We aimed to assess whether patients with isolated IgM aCL and/or aB2GPI at diagnosis have specific characteristics and outcomes.

Methods—

We retrospectively included APS patients with isolated IgM antiphospholipid antibodies (isolated-IgM-APS) and compared them to APS patients with IgG and IgM, or IgG alone and/or lupus anticoagulant (nonisolated-IgM-APS).

Results—

Among the 168 APS patients included, 24 (14.3%) had isolated IgM. Median follow-up was 92.5 months (36–151.5). Isolated-IgM-APS patients were 9.5 years older. At diagnosis, stroke was more frequent in isolated-IgM-APS after adjustment for cardiovascular risk factors (odds ratio, 3.8; 95% CI, 1.3–11.5). IgM isotype remained isolated in 17 of 24 (70.8%) patients over time. Global relapse-free survival did not differ between the two groups. In thrombotic APS, monotherapy with antiplatelet agents was more frequently used in isolated-IgM-APS group with 14 of 20 versus 28 of 134 patients (
P
<0.0001), with a higher relapse rate with antiplatelet agent alone compared to vitamin K antagonists, especially for patients presenting with a stroke (hazard ratio, 7.37; 95% CI, 1.19–19.0).

Conclusions—

Isolated IgM APS patients should not be disregarded because they represent 14.3% of an APS population. They have some characteristics: older age at diagnosis and a strong association with stroke. Clinicians must be aware of this situation because antiplatelet agent do not seem to well prevent relapses compared to vitamin K antagonist.
Abnormal Blood Flow on Transcranial Duplex Sonography Predicts Poor Outcome After Stroke Thrombectomy
Authors: Kneihsl Markus , Niederkorn Kurt , Deutschmann Hannes , Enzinger Christian , Poltrum Birgit , Horner Susanna , Thaler Daniela , Kraner Julia , Fandler Simon , Colonna Isabella , Fazekas Franz , Gattringer Thomas
Published: October 2018

Background and Purpose—

Hemodynamic changes following mechanical thrombectomy for large vessel occlusion stroke could be associated with complications and might affect prognosis. We investigated postinterventional middle cerebral artery blood flow on transcranial duplex sonography (TCD) and its prognostic value for anterior large vessel occlusion stroke patients.

Methods—

We identified all ischemic stroke patients who had undergone mechanical thrombectomy for anterior circulation large vessel occlusion from 2010 onwards. Postinterventional middle cerebral artery flow was graded according to the sonographic Thrombolysis in Brain Ischemia score and related to patient outcome stratified by the angiographic Thrombolysis in Cerebral Infarction reperfusion status.

Results—

Of 215 large vessel occlusion stroke patients, 193 patients (90%) showed successful angiographic recanalization (Thrombolysis in Cerebral Infarction grade 2b-3). Of those, 69 (36%) patients had abnormal sonographic middle cerebral artery blood flow (Thrombolysis in Brain Ischemia grade 0–4) within 72 hours after mechanical thrombectomy, which was an independent predictor for poor 90-day outcome.

Conclusions—

TCD indicates abnormal middle cerebral artery hemodynamics in a substantial proportion of patients with angiographically defined successful mechanical thrombectomy of the anterior cerebral circulation. Such changes are associated with poor short-term outcome.
NEO-LİBERALİZM, KÜRESEL KRİZ VE EMEK PİYASASINDA YAŞANAN DÖNÜŞÜMLER: GÜNEY AVRUPA BAĞLAMINDA BİR DEĞERLENDİRME
Authors: BAKIR Hasan
Published: October 2018

2008

küresel krizi sonrasında neo-liberalizmin eleştirilmesi beklenirken gelinen

noktada kriz sürecinden daha fazla neo-liberalizm ile çıkılacağı beklentisi

yaratılmıştır. Nitekim 2008 krizinden ciddi anlamda etkilenen Avrupa Birliği’ne

üye ülkelerin neo-liberal politikaları uygulamaya zorlanması ve bu doğrultuda

emek piyasalarının esnekleştirilerek neo-liberalizmin yarattığı krize çare

bulunacağı beklentisi oldukça dikkat çekicidir. Bu süreç neo-liberalizmin

Avrupa’yı nasıl etkisi altına aldığını göstermesi açısından da oldukça

önemlidir. Bu çalışmanın amacı Avrupa Birliği’nin çevresini oluşturan ve

krizden en yoğun şekilde etkilenen Güney Avrupa ülkelerinin emek piyasalarını

analiz ederek Avrupa Birliği’nde yaşanan neo-liberalleşme sürecini ortaya

koymaktır.
KURUMLAR VERGİSİ ORANI-HASILAT İLİŞKİSİ: OECD ÖRNEĞİ
Authors: DÖKMEN Gökhan
Published: October 2018

Küreselleşme

sürecinde hükümetler, özellikle 1980'lerden sonra, yabancı sermayeyi çekmek

için kurumlar vergisi oranlarını düşürmüştür. Ancak kurumlar vergisi

oranlarında yaşanan azalmaya rağmen kurumlar vergisi gelirleri nispeten

istikrarlı hatta artma eğilimi sergilemiştir. Literatürde “kurumlar vergisi

oranı-gelir paradoksu” olarak adlandırılan bu durum, şirketlerin kurumsallaşma

düzeylerinde artma ve gelir vergisinden kurumlar vergisine doğru bir kaymayla

açıklanmıştır. Kurumlar vergisi oranı ile hasılat arasındaki ters yönlü ilişki,

vergi sistemlerinin tasarımı etkilemektedir. Nitekim günümüzdeki birçok ülke

gelir vergisi ile kurumlar vergisi arasında bir tercih yapma ve vergi

sistemlerini bu tercihe göre yeniden düzenleme eğilimdedir. Bu nedenle kurumlar

vergisi paradoksunun geçerliliği ülkelerin vergi politikalarını etkileyen önemli

bir konudur. Bu önemden dolayı bu çalışmada kurumlar vergi paradoksunun

geçerliliği incelenmektedir. Çalışmada, bu paradoksal ilişkiyi incelemek için

doğrusal olmayan regresyon tekniği kullanılmıştır. Analiz sonuçlarına göre,

Laffer eğrisinin kurumlar vergisi açısından geçerli olduğu tespit edilmiş ve

kurumlar vergisi gelirlerini maksimize eden oranın %34 seviyesinde olduğu

belirlenmiştir. Bu sonuç, kurumlar vergisi alanında son dönemde yaşanan

değişimlerin ampirik açıdan teyit edilmesi açısından ve vergi politikasının

tasarımı şekillendirme açısından oldukça önemlidir. 
KAMU ÇALIŞANLARINDA İŞ TATMİNİ, DUYGUSAL EMEK VE İŞ STRESİ: KONYA’DA BİR ARAŞTIRMA
Authors: KARAKAŞ Ayhan , GÖKMEN Gökhan
Published: October 2018

Bu çalışma memurların iş

yaşamında sürekli olarak karşılaştıkları duygusal emek iş tatmini ve iş stresi

değişkenleri arasındaki ilişkiyi incelemek amacıyla gerçekleştirilmiştir. Araştırmada

kullanılmak üzere üç ölçekli anket formu oluşturulmuş ve bu anket formu ile söz

konusu değişkenlerin ölçülmesi amaçlanmıştır. Çalışma Konya ilinde istihdam

eden memurlar üzerinde gerçekleştirilmiştir. Elde edilen veriler paket

programlar aracılığı ile frekans analizi, t- testi, korelasyon analizi ve

regresyon analizi analizleri uygulanmıştır. Araştırma sonucunda duygusal emek

davranışının iş stresini negatif yönde etkilediği, duygusal emeğin yüzeysel

davranış boyutunun iş stresini pozitif yönde etkilediği saptanmıştır. Aynı

zamanda duygusal emek davranışının iş tatminini pozitif yönde etkilediği

sonucuna ulaşılmıştır.
MOBİL SAĞLIK UYGULAMALARININ GÜVENLİĞİNE İLİŞKİN HABERLER ARACILIĞIYLA YAŞANAN ETİK SORUNLARIN DEĞERLENDİRİLMESİ
Authors: EKE Erdal , ÇETİN Rukiye , ÇETİN Burhan
Published: October 2018

Mobil sağlık uygulamaları, ihtiyaç duyulan bilgiye erişimi kolaylaştıran ve söz konusu verilerin kayıt altına alınmasına imkân veren, hasta izleme cihazları, mobil telefonlar ve daha kompleks cihazları içeren sağlık uygulamalarıdır. Çalışmanın amacı, henüz yeni olan mobil sağlık uygulamalarının yol açtığı etik sorunları tespit etmek ve bu noktada öneriler geliştirebilmektir. Çalışmanın problemi ise verilerin toplanması ve ilgililere iletilmesinde mahrem bilgilerin hastaların rıza göstermeyeceği şekilde depolanıp erişime açık hale getirilerek etik sorunların ortaya çıkmasıdır. Çalışmada nitel bir yöntem olan doküman incelemesi kapsamında pasif analiz de denilen ikincil veri araştırması yapılmış ve veri toplama aracı olarak internet haberleri ele alınmıştır. Çalışma kapsamında incelenen haber metinlerinde 4 ana tema tespit edilmiş ve mahremiyet anlamında zayıf olan mobil sağlık uygulamalarının birçok etik soruna yol açabileceği anlaşılmıştır. Çalışma sonunda hastadan alınan tıbbi bilgilerin hasta mahremiyetini ihlal edecek şekilde kullanıma açık olduğu ve kullanılan sistemlerin bu bilgileri korumada yetersiz kaldığı, dijital ortamların veri saklamada yetersiz olduğu, mobil cihazların saldırılara açık olduğu gibi bulgulara ulaşılmıştır. 
DEĞERLERİN BİREYLERARASI SAPMA DAVRANIŞLARI ÜZERİNDEKİ ETKİSİ: AKADEMİSYENLER ÜZERİNDE BİR ARAŞTIRMA
Authors: ÖZYER Kubilay , YALAP Osman , SOBACI Fatih
Published: October 2018

Değerler,

bireylerin hayatına ve bakış açısına yön veren, daha ziyade manevi, birer yön

levhası olarak işlev görmektedir. Değerlerin örgütleri verimlilik ve rekabet

üstünlüğü gibi konularda sekteye uğratan olumsuzlukların çözümünde önemli rol

oynayacağı düşünülmektedir. Bu olumsuzlukların en önemlilerinden biri bireylerarası

sapma davranışları olarak değerlendirilebilir. Bu kapsamda çalışmanın amacı,

değerler ile bireylerarası sapma davranışları arasındaki ilişkileri ortaya

koymaktır. Bir üniversitede görev yapmakta olan 105 öğretim elemanından

toplanan verilerin analizinde fark testleri ile korelasyon ve regresyon

analizleri kullanılmıştır. Araştırma sonuçları akademisyenlerin değer

algılamaları ile bireylerarası sapma davranışları arasında orta düzeyde,

negatif ve anlamlı bir ilişki olduğunu; ayrıca değerler algısının,

bireylerarası sapma davranışları üzerinde negatif etkiye sahip olduğunu ortaya

koymuştur. Çalışmanın, ulusal literatürde değerler ile bireylerarası sapma

davranışları arasındaki ilişkileri bir arada inceleyen ilk çalışma olması

sebebiyle literatüre katkı sağlayacağı düşünülmektedir.
BANKALARDAKİ KURUMSAL SOSYAL SORUMLULUK FAALİYETLERİNİN MARKA DEĞERİ ALGISINA ETKİSİ: BİR ALAN ARAŞTIRMASI
Authors: PARILTI Nurettin , CAN İlknur , BARDAKÇI Sait
Published: October 2018

Günümüzde gelişen pazarlama stratejileriyle birlikte kurumların
gerçekleştirdiği sosyal sorumluluk faaliyetlerinin marka değeri algısı
üzerindeki etkisi önem kazanmıştır. Çalışmada kurumsal sosyal sorumluluk (KSS)
faaliyetlerinin marka değeri algısı üzerinde yarattığı etkiler incelenmektedir.
Bu çerçevede Cumhuriyet Üniversitesi ve Gazi Üniversitesi Bankacılık bölümü
öğrencilerinin kurumsal sosyal sorumluluğa verdikleri önem ve üniversitelerinin
anlaşmalı oldukları bankalarının sosyal sorumluluk faaliyetlerinin marka değeri
algılarına etkisi ölçülmek istenmektedir. Bu amaçla 353 üniversite öğrencisine
yüz yüze anket çalışması uygulanmış ve anketler kontrol edildikten sonra
analize uygun görülenler değerlendirilmiştir. Anket verilerinin analizinde
frekans dağılımları, güvenilirlik analizi, t-testi, ANOVA testi ve regresyon
analizi yapılmıştır. Yapılan analizler neticesinde üniversite öğrencilerinin
demografik değişkenlerden cinsiyet, hane geliri ve üniversite farkının hizmet
aldıkları bankaların KSS projelerini algılamalarında etkili olmadığı sonucuna
ulaşılmıştır. Ayrıca öğrencilerin genel marka değeri algısı ile marka
farkındalığı değerleri cinsiyete göre anlamlı bir farklılık göstermezken marka
sadakatleri ve algılanan kalite değerleri anlamlı bir farklılık göstermektedir.
Korelasyon ve regresyon analizi sonuçlarına göre öğrencilerin algıladıkları KSS
düzeyleri arttıkça marka değeri algıları da olumlu yönde artmaktadır.
İSTİHDAM ve ENERJİ DESTEKLERİNİN BOLU DÜZCE İLLERİNDEKİ YATIRIMLARA ETKİSİ
Authors: LÖK Hasan
Published: October 2018

Bölgesel kalkınma amaçlı olarak 2004 yılında

ülkemizin 49 ilinde yatırım teşviklerine istihdam ve enerji destekleri ilave

edilmiştir. Bolu ve Düzce illeri aynı coğrafi konumda ve ekonomik göstergeleri

birlikte olmasına rağmen bu düzenlemeden eşit şartlarda yararlandırılmamıştır.

Düzce ili enerji ve istihdam desteğinden yararlanan 49 il içerisine alınırken,

Bolu ili bu kapsama alınmamıştır.

2012 yılında yatırım teşvik sisteminde köklü

değişiklikler yapılarak Bolu 2. derece, Düzce ili ise 4. derece bölge

desteklerinden yararlandırılmıştır. Bu düzenlemeler çerçevesinde ikinci kez

Bolu, Düzce iline göre daha az devlet teşviklerinde yararlandırılmıştır.

2004 yılından itibaren uygulanan teşvik politikaları

açısından Bolu ve Düzce illerindeki yatırımların gelişimi ve yatırımların bölge

istihdamı ve yatırımlarına etkisi bu makalede ortaya konmaktadır. 
EL SANATLARININ TURİZME ETKİSİ: GAZİANTEP ÖRNEĞİ
Authors: AKIN Aliye
Published: October 2018

Geleneksel el sanatları özünü, değerini geçmişten alan, toplumun duyguları ve sanatsal beğenileri ile kültürel zenginliklerini yansıtan değerlerdir. Turizm ise, ülkelerin geçmişten günümüze yaşayan bu değerlerini tanıtmada önemli bir unsurdur. Dolayısıyla, Gaziantep’in geleneksel el sanatlarını tanıtmak ve bu el sanatı ürünlerinin turizm endüstrisinde meydana getirdiği etkiyi tespit etmek amacıyla gerçekleştirilen bu araştırma önem taşımaktadır. Bu süreçte Gaziantep İl Kültür Turizm Müdürlüğü, Gaziantep Valiliği, Esnaf ve Sanatkârlar Odası Başkanı ve el sanatkârları ile yüz yüze görüşmeler yapılmış ve yarı yapılandırılmış görüşme formlarından yararlanılarak verilere ulaşılmıştır. Nitel araştırma yönteminin kullanıldığı bu çalışmada elde edilen verilere analizler yapılarak çalışma sonuçlandırılmıştır. Araştırma sonucunda, geleneksel el sanatlarının Gaziantep turizminin gelişiminde, şehrin tanıtımında ve turizm faaliyetlerinin tüm yıla yayılmasında önemli bir etken olduğu tespit edilmiştir.
MÜLKİYE MEKTEBİ MECMUASINDA HİLMİ ZİYA ÜLKEN’İN İNSANİ VATANCILIK KAVRAMI ÜZERİNE BİR İNCELEME (1931-1935)
Authors: BİÇER Baykal , DEMİR Gönül Türkan
Published: October 2018

1901-1974 yılları arasında yaşayan Hilmi Ziya

Ülken çok yönlü akademik anlayışıyla pek çok araştırmaya konu edilmiş bir

isimdir. Bu çalışmada Ülken’in Mülkiye Mektebi Mecmuası’nın ilk beş yılında

yayınlanmış olan yazılarında önemle üzerinde durduğu İnsani Vatancılık kavramını

ele alış şekli incelenmiştir. Çalışmada, 1931 yılında Mülkiye Mektebi Talebe

Cemiyeti tarafından yayınlanan Mülkiye Mektebi Mecmuasının 1931-1935 yılları

arasında yayınlanan 35 sayısı incelenmiştir. Tarama yöntemiyle gerçekleştirilen

bu çalışmada ulaşılan toplam 288 makaleden 18’inin Ülken’e ait olduğu, bu

makalelerden de altı tanesinin İnsani Vatancılık kavramıyla ilgili olduğu

tespit edilmiştir. Ülken tarafından ortaya konulan İnsani Vatancılık kavramının

içeriği ve kavrama yüklenen anlam bu çalışmanın konusunu oluşturmaktadır.

Vatandaşlık kavramına yeni bir boyut kazandıran Ülken’in bu konudaki görüşleri

dönemin şartlarıyla beraber düşünüldüğünde önem arz etmektedir. Sonuç olarak

Ülken bu makalelerinde, vatanseverlik ve insancılık arasında temelde bir farklılığın

olmadığı, bu kavramların milliyetçilik ekseninde şekillendiği ve batı tarzı

milliyetçiliğin bu bağlamdan uzak olduğu gibi tespitlerde bulunmaktadır.
Emotion Reactivity and Regulation in Adolescent Girls Following an Interpersonal Rejection
Authors: Miller Adam Bryant , Prinstein Mitchell J. , Munier Emily , Machlin Laura S. , Sheridan Margaret A.
Published: October 2018

Failures in emotion regulation, especially as a result of interpersonal stress, are implicated as transdiagnostic risk factors for psychopathology. This study examines the effects of an experimentally timed targeted interpersonal rejection on emotion reactivity and regulation in typically developing adolescent girls. Girls ( n = 33, ages 9–16 years, M = 12.47, SD = 2.20) underwent fMRI involving a widely used emotion regulation task. The emotion task involves looking at negative stimuli and using cognitive reappraisal strategies to decrease reactions to negative stimuli. Participants also engaged in a social evaluation task, which leads participants to believe a preselected peer was watching and evaluating the participant. We subsequently told participants they were rejected by this peer and examined emotion reactivity and regulation before and after this rejection. Adolescent girls evidence greater reactivity via higher self-reported emotional intensity and greater amygdala activation to negative stimuli immediately after (compared with before) the rejection. Self-reported emotional intensity differences before and after rejection were not observed during regulation trials. However, on regulation trials, girls exhibited increased prefrontal activation in areas supporting emotion regulation after compared with before the rejection. This study provides evidence that a targeted rejection increases self-report and neural markers of emotion reactivity and that girls increase prefrontal activation to regulate emotions after a targeted rejection.
Model of Muslim Religious Spirituality: Impact of Muslim Experiential Religiousness on Religious Orientations and Psychological Adjustment among Iranian Muslims
Authors: Ghorbani Nima , Watson P. J. , Gharibi Hamid Reza , Chen Zhuo Job
Published: October 2018

Previous research indicates that spirituality expressed in tradition-specific terms may initiate, invigorate, and integrate Muslim religious commitments, suggesting a 3-I Model of Religious Spirituality. In a test of this model, Islamic seminarians, university students, and office workers in Iran ( N = 604) responded to Muslim Experiential Religiousness (MER), Religious Orientation, and mental health scales. The tradition- specific spirituality of MER displayed correlation, moderation, and mediation results with Intrinsic and Extrinsic Personal Religious Orientations that pointed toward initiation, invigoration, and integration effects, respectively. MER also clarified the ambiguous implications of the Extrinsic Social Religious Orientation. These data most generally confirmed the heuristic potential of the 3-I Model.
Temporal Cognition Can Affect Spatial Cognition More Than Vice Versa: The Effect of Task-Related Stimulus Saliency
Authors: Homma Chizuru T. , Ashida Hiroshi
Published: October 2018

Cognition of space and time affect each other; a line with longer length appears to be longer in exposure duration (space on time), and a line with longer exposure duration appears to be longer in length (time on space). This cognitive interaction is known to be asymmetric; the effect of space on time is larger than that of time on space. We conjectured that this asymmetry is not intrinsic but may depend on the saliency of relevant signals. Participants were asked to judge the visual exposure duration of lines that varied in length or the lengths of the lines with different exposure times. The ranges of task-relevant and -irrelevant stimulus values were the same in the spatial and temporal tasks. Task difficulty was also evaluated by subjective rating. We found that duration affected the judgment of length more than vice versa, when the spatial task was significantly more difficult than the temporal task. Together with our previous results that showed the opposite effect, our conjecture is supported that the saliency of stimuli should affect the balance of interactions.
Three new species of Collembola (Arthropoda: Hexapoda) from Central Brazilian shallow caves: side effects of long term application of environmental law on conservation
Authors: ZEPPELINI DOUGLAS , BRITO RONIERE A. , LIMA ESTEVAM C. A.
Published: October 2018

Three new species of Collembola are described from small shallow caves in Southeastern Brazil: Arrhopalites glabrofasciatus sp. nov., Pseudosinella ambigua sp. nov. and Pseudosinella guanhaensis sp. nov. The species were found in surveys performed as part of the process to accomplish the permits for high impact enterprising. The change in the legislation is discussed and a suggestion is made to improve the process. The long term effects of the law resulted in the discovery of many new species and genera, most of them being (or to be) described.
Networks Created Within Exhibition: The Curators’ Effect on Historical Recognition
Authors: Braden L. E. A.
Published: October 2018

This research examines artist networks created by shared museum exhibition. While previous research on artistic careers assesses self-cultivated networks, historical recognition may be further influenced by connections created by important others, such as museum curators and art historians. I argue when museum exhibitions show artists together, curators are creating symbolic associations between artists that signal the artist’s import and contextualization within his or her peer group. These exhibition-created associations, in turn, influence historians who must choose a small selection of artists to exemplify a historical cohort. The research tests this idea through a cohort of 125 artists’ exhibition networks in the Museum of Modern Art, New York, from 1929 to 1968 (996 exhibitions). Individual network variables, such as number and quality of connections, are examined for impact on an artist’s recognition in current art history textbooks (2012-2014). Results indicate certain connections created by exhibition have a positive effect on historical recognition, even when controlling for individual accomplishments of the artist (such as solo exhibitions). Artists connected with prestigious artists through “strong symbolic ties” (i.e., repeated exhibition) tend to garner the most historical recognition, suggesting robust associations with historical peers may signify an artist’s exemplary status within his or her cohort, and consequent “good fit” into the historical narrative.