bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geographic Analysis of Mobile Stroke Unit Treatment in a Dense Urban Area: The New York City METRONOME Registry
Authors: Kummer Benjamin R. , Lerario Mackenzie P. , Hunter Madeleine D. , Wu Xian , Efraim Elizabeth S. , Salehi Omran Setareh , Chen Monica L. , Diaz Ivan L. , Sacchetti Daniel , Lekic Tim , Kulick Erin R. , Pishanidar Sammy , Mir Saad A. , Zhang Yi , Asaeda Glenn , Navi Babak B. , Marshall Randolph S. , Fink Matthew E. 
Published: December 2019

Background

Mobile stroke units (
MSU
s) reduce time to intravenous thrombolysis in acute ischemic stroke. Whether this advantage exists in densely populated urban areas with many proximate hospitals is unclear.

Methods and Results

We evaluated patients from the METRONOME (Metropolitan New York Mobile Stroke) registry with suspected acute ischemic stroke who were transported by a bi‐institutional
MSU
operating in Manhattan, New York, from October 2016 to September 2017. The comparison group included patients transported to our hospitals via conventional ambulance for acute ischemic stroke during the same hours of
MSU
operation (Monday to Friday, 9
am
to 5
pm)
. Our exposure was
MSU
care, and our primary outcome was dispatch‐to‐thrombolysis time. We estimated mean differences in the primary outcome between both groups, adjusting for clinical, demographic, and geographic factors, including numbers of nearby designated stroke centers and population density. We identified 66 patients treated or transported by
MSU
and 19 patients transported by conventional ambulance. Patients receiving
MSU
care had significantly shorter dispatch‐to‐thrombolysis time than patients receiving conventional care (mean: 61.2 versus 91.6 minutes;
P
=0.001). Compared with patients receiving conventional care, patients receiving
MSU
care were significantly more likely to be picked up closer to a higher mean number of designated stroke centers in a 2.0‐mile radius (4.8 versus 2.7,
P
=0.002). In multivariable analysis,
MSU
care was associated with a mean decrease in dispatch‐to‐thrombolysis time of 29.7 minutes (95%
CI
, 6.9–52.5) compared with conventional care.

Conclusions

In a densely populated urban area with a high number of intermediary stroke centers,
MSU
care was associated with substantially quicker time to thrombolysis compared with conventional ambulance care.
Evidence‐Practice Gaps in Postdischarge Initiation With Oral Anticoagulants in Patients With Atrial Fibrillation
Authors: Schaffer Andrea L. , Falster Michael O. , Brieger David , Jorm Louisa R. , Wilson Andrew , Hay Melanie , Leeb Kira , Pearson Sallie , Nasis Arthur 
Published: December 2019

Background

Oral anticoagulant (
OAC
) therapy reduces the risk of stroke in people with atrial fibrillation (
AF
), and is considered best practice; however, there is little Australian evidence around the uptake of
OAC
s in this population.

Methods and Results

We used linked hospital admissions, pharmaceutical dispensing claims, medical services, and mortality data for people in Australia's 2 most populous states (July 2010 to June 2015). Among
OAC
‐naïve people hospitalized with
AF
, we estimated initiation of
OAC
therapy within 30 days of discharge, and persistence with therapy in the first year. We analyzed both outcomes using multivariable Cox regression. In 71 184 people with
AF
(median age 78 years, 49% female), 22.7% initiated
OAC
therapy. Initiation was lowest in July to December 2011 (17.0%) and highest in July to December 2014 (30.1%) after subsidy of the direct
OAC
s. In adjusted analyses, initiation was most likely in people with a
CHA
2
DS
2
‐
VA
score ≥7 (versus 0) (hazard ratio=6.25, 95% CI 5.08–7.69), and a history of venous thromboembolism (hazard ratio=2.65, 95% CI 2.49–2.83). Of the people who initiated
OAC
therapy, 39.9% discontinued within 1 year; a lower risk of discontinuation was associated with a
CHA
2
DS
2
‐
VA
score ≥7 (versus 0) (hazard ratio=0.22, 95% CI 0.14–0.35), or initiation on a direct
OAC
(versus warfarin) (hazard ratio=0.55, 95% CI 0.50–0.60).

Conclusions

We found that
OAC
therapy was severely underutilized in people hospitalized with
AF
, even among high‐risk individuals. Reasons for this underuse, whether patient, prescriber, or hospital related, should be identified and addressed to reduce stroke‐related morbidity and mortality in people with
AF
.
RNA-Sequencing Highlights Inflammation and Impaired Integrity of the Vascular Wall in Brain Arteriovenous Malformations
Authors: Hauer Allard J. , Kleinloog Rachel , Giuliani Fabrizio , Rinkel Gabriël J.E. , de Kort Gerard A. , Berkelbach van der Sprenkel Jan Willem , van der Zwan Albert , Gosselaar Peter H. , van Rijen Peter C. , de Boer-Bergsma Jelkje J. , Deelen Patrick , Swertz Morris A. , De Muynck Louis , Van Damme Philip , Veldink Jan H. , Ruigrok Ynte M. , Klijn Catharina J.M. 
Published: December 2019

Background and Purpose—
Interventional treatment of unruptured brain arteriovenous malformations (BAVMs) has become increasingly controversial. Because medical therapy is still lacking, we aimed to obtain insight into the disease mechanisms implicated in BAVMs and to identify potential targets for medical treatment to prevent rupture of a BAVM.

Methods—

We used next-generation RNA sequencing to identify differential expression on a transcriptome-wide level comparing tissue samples of 12 BAVMs to 16 intracranial control arteries. We identified differentially expressed genes by negative binominal generalized log-linear regression (false discovery rate corrected
P
<0.05). We selected 10 genes for validation using droplet digital polymerase chain reaction. We performed functional pathway analysis accounting for potential gene-length bias, to establish enhancement of biological pathways involved in BAVMs. We further assessed which Gene Ontology terms were enriched.

Results—

We found 736 upregulated genes in BAVMs including genes implicated in the cytoskeletal machinery and cell-migration and genes encoding for inflammatory cytokines and secretory products of neutrophils and macrophages. Furthermore, we found 498 genes downregulated including genes implicated in extracellular matrix composition, the binary angiopoietin-TIE system, and TGF (transforming growth factor)-β signaling. We confirmed the differential expression of top 10 ranked genes. Functional pathway analysis showed enrichment of the protein digestion and absorption pathway (false discovery rate-adjusted
P
=1.70×10
−2
). We identified 47 enriched Gene Ontology terms (false discovery rate-adjusted
P
<0.05) implicated in cytoskeleton network, cell-migration, endoplasmic reticulum, transmembrane transport, and extracellular matrix composition.

Conclusions—
Our genome-wide RNA-sequencing study points to involvement of inflammatory mediators, loss of cerebrovascular quiescence, and impaired integrity of the vascular wall in the pathophysiology of BAVMs. Our study may lend support to potential receptivity of BAVMs to medical therapeutics, including those promoting vessel maturation, and anti-inflammatory and immune-modifying drugs.
Predictors of Early Neurologic Deterioration in Acute Pontine Infarction
Authors: Li Haiyan , Dai Yongqiang , Wu Haotian , Luo Lingyun , Wei Lei , Zhou Li , Lin Yinyao , Wang Qiujing , Lu Zhengqi 
Published: December 2019

Background and Purpose—
The relationship between infarct dimensions and neurological progression in patients with acute pontine infarctions remains unclear. This study aimed to investigate the morphometric predictive value of magnetic resonance imaging for early neurological deterioration (END) in acute pontine infarction.

Methods—
We included all patients admitted to our department having an acute ischemic stroke in the pons. The ventrodorsal length multiplied by thickness was measured as parameters of infarct size. END was defined as an incremental increase in the National Institutes of Health Stroke Scale score by ≥1 point in motor power, or ≥2 points in the total score within the first week after admission.

Results—
We enrolled 407 patients, and 114 (28.0%) patients were diagnosed with END. Adjusted logistic regression analyses showed the maximum length multiplied by thickness was independently associated with END (odds ratio, 4.580 [95% CI, 2.909–7.210]). The sensitivity, specificity, and area under the curve were 77.2%, 79.2%, and 0.843, respectively, in the receiver operating characteristic curve analysis of maximum length multiplied by thickness for predicting END.

Conclusions—
These results suggest that the maximum length multiplied by thickness may be a possible predictor in the evaluation of progression with isolated acute pontine infarction. The extent of the pontine infarction along the conduction tract may contribute to deterioration.
Consciousness, Being and Life: Phenomenological Approaches to Mindfulness
Authors: Bitbol Michel 
Published: December 2019

Abstract
A phenomenological view of contemplative disciplines is presented. However, studying mindfulness by phenomenology is at odds with both neurobiological and anthropological approaches. It involves the first-person standpoint, the openness of being-in-the-world, the umwelt of the meditator, instead of assessing her neural processes and behaviors from a neutral, distanced, third-person standpoint. It then turns out that phenomenology cannot produce a discourse about mindfulness. Phenomenology rather induces a cross-fertilization between the state of mindfulness and its own methods of mental cultivation. A comparison between the epochè, the phenomenological reduction, and the practice of mindfulness, is then undertaken.
The Principles of Honor, Virtue, Leadership, and Ethics: Medieval Epics Speak Out against the Political Malaise in the Twenty-First Century
Authors: Classen Albrecht 
Published: December 2019

Abstract
One of our central challenges as medievalists consists of how to respond to the question regarding the relevance of medieval literature and other documents. This article suggests that we can easily draw from medieval heroic literature where ideal and also negative examples of successful/failed leadership are provided. The MHG Nibelungenlied, at least in the first part, illustrates dramatically the consequences of a weak, indecisive, impulsive, and manipulable ruler, whose actions ultimately trigger a whole sequence of hatred, violence, and slaughter. The Old Spanish El Poema de Mío Cid sets out almost at the same point, with the protagonist being exiled because of malignment, but in the course of events, he demonstrates convincingly what makes a true, honorable, admirable, and worthy leader. These two epic poems can serve powerfully as illustrations of failed and successful leadership, and can thus offer significant instructions for modern concerns in politics, business, administration, the church, schools, and universities.
The Forced Response of the El Niño–Southern Oscillation–Indian Monsoon Teleconnection in Ensembles of Earth System Models
Authors: Bódai Tamás , Drótos Gábor , Herein Mátyás , Lunkeit Frank , Lucarini Valerio 
Published: December 2019

AbstractWe study the teleconnection between El Niño–Southern Oscillation (ENSO) and the Indian summer monsoon (IM) in large ensemble simulations, the Max Planck Institute Earth System Model (MPI-ESM), and the Community Earth System Model (CESM1). We characterize ENSO by the June–August Niño-3 box-average SST and the IM by the June–September average precipitation over India, and define their teleconnection in a changing climate as an ensemble-wise correlation. To test robustness, we also consider somewhat different variables that can characterize ENSO and the IM. We utilize ensembles converged to the system’s snapshot attractor for analyzing possible changes in the teleconnection. Our main finding is that the teleconnection strength is typically increasing on the long term in view of appropriately revised ensemble-wise indices. Indices involving a more western part of the Pacific reveal, furthermore, a short-term but rather strong increase in strength followed by some decrease at the turn of the century. Using the station-based Southern Oscillation index (SOI) as opposed to area-based indices leads to the identification of somewhat more erratic trends, but the turn-of-the-century “bump” is well detectable with it. All this is in contrast, if not in contradiction, to the discussion in the literature of a weakening teleconnection in the late twentieth century. We show here that this discrepancy can be due to any of three reasons: 1) ensemble-wise and temporal correlation coefficients used in the literature are different quantities; 2) the temporal moving correlation has a high statistical variability but possibly also persistence; or 3) MPI-ESM does not represent the Earth system faithfully.
The “Caring Giver”: Emotional Caregiving in the Setting of Essential Tremor
Authors: Hickman Ruby , Zdrodowska Maria Anna , Kellner Sarah , Cersonsky Tess E. K. , Trujillo Diaz Daniel , Louis Elan D. , Monin Joan K. 
Published: December 2019

Introduction: Essential tremor (ET) is a common neurological disorder associated with functional impairment. Emerging evidence shows that some ET caregivers experience burden, but the unique interpersonal aspects of caregiving in the context of ET have not been fully examined. Research design: Open-ended questions were administered to 98 ET care-recipient–caregiver dyads. Responses were analyzed using conventional content analysis. Results: The unique visibility of disability and feelings of embarrassment that occur with ET prompts caregivers to be highly attuned to care-recipient emotions. Providing companionship, promoting independence, and reducing embarrassment are three themes we found that describe the ET caregiving experience. Discussion: Caregiving in ET often goes beyond aiding with activities of daily living; it has a significant emotional component especially in relation to independence and embarrassment. Future studies on caregiving in ET and conditions in which disability is visible should consider using a definition of caregiving that includes emotional caregiving.
Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire
Authors: Brunet-Gouet Eric , Urbach Mathieu , Ramos Veronica , Ehrminger Mickael , Aouizerate Bruno , Brunel Lore , Capdevielle Delphine , Chereau Isabelle , Dubertret Caroline , Dubreucq Julien , Fond Guillaume , Lançon Christophe , Leignier Sylvain , Mallet Jasmina , Misdrahi David , Pires Sylvie , Schneider Priscille , Schürhoff Franck , Yazbek Hanan , Zinetti-Bertschy Anna , Bazin Nadine , Passerieux Christine , Roux Paul 
Published: December 2019

Objectives: The aim of this study is to design a questionnaire, the Versailles Metacognitive Strategies Evaluation Questionnaire, for assessing the use of metacognitive and help-seeking strategies in three key-domains of impaired daily functioning in schizophrenia. To evaluate its psychometric properties (internal consistency, factor structure, convergent and divergent validity, and stability). Design: Development of a questionnaire and psychometric validation procedure in patients with schizophrenia compared with healthy controls. Stability over one year was assessed in the patient group. Setting: Schizophrenia Centers of Expertise (French FondaMental Network). Subjects: A total of 141 patients with schizophrenia, among whom 77 participated in the second evaluation; 97 healthy subjects. Main measures: The Versailles Metacognitive Strategies Evaluation Questionnaire, Positive and Negative Symptoms Scale, Personal and Social Performance Scale, Evaluation of Cognitive Processes involved in Disability in Schizophrenia Scale, Schizophrenia Quality of Life Questionnaire, and Stages of Recovery Instrument. Results: From the 36-items version, stepwise exploratory factor analysis (oblimin) produced a 25-items scale which had a 3-factors structure (hygiene concern, social relationships, and hygiene help-seeking). Cronbach’s were respectively equal to 0.91, 0.82, and 0.78. One-year stability was good (intra-class correlation coefficient = 0.7). The three factors showed good convergent validity with measures of quality of life (rho = 0.34, P ⩽ 0.001). The first two factors correlated with recovery ( N = 34, rho = 0.53, P ⩽ 0.001). On the contrary, the factors exhibited divergent validity, with no significant correlation, with symptoms and cognitive and psychosocial functioning ( P > 0.05). Factor structure in healthy controls did not match with that of patients, all items but one were found significantly different among groups. Conclusion: The Versailles Metacognitive Strategies Evaluation Questionnaire provides a simple and valid means to assess metacognitive strategies in individuals with schizophrenia.
The measurement of ultrasonographic optic nerve sheath diameter in patients with hyperglycemia
Authors: Erol Eda , Kozaci Nalan , Avci Mustafa 
Published: December 2019

Background:Diabetes mellitus is a disease associated with several complications in its acute and chronic stages.Objective:The aim of the study was to determine the treatment‐associated changes in optic nerve sheath diameter in patients admitted to the emergency department due to one of the acute hyperglycemic complications of diabetes mellitus.Materials and method:Diabetic patients with serum glucose levels of 250 mg/dL or higher were included in the study. Healthy volunteers were included in the control group. Optic nerve sheath diameter was measured at 0th hour and at the end of the second hour. Blood samples were collected simultaneously with optic nerve sheath diameter measurements.Results:The study included 100 individuals. Group 1 included 50 patients and Group 2 included 50 healthy adults. Optic nerve sheath diameter was 4.5 ± 0.4 mm in Group 1 and 4.4 ± 0.5 mm in Group 2 in 0th hour, and no statistical difference was found between the groups (p = 0.162). In Group 1, optic nerve sheath diameter increased 0.6 ± 0.4 mm after the treatment. Of the patients in Group 1, 22 (44%) patients with diabetic ketoacidosis or hyperosmolar hyperglycemic state were assigned to Group 1A and 28 (56%) patients with isolated hyperglycemia were assigned to Group 1B. There was not a difference between the pre‐ and post‐treatment optic nerve sheath diameter values of the patients in Group 1A and Group 1B. Optic nerve sheath diameter was observed to enlarge after treatment. The difference in optic nerve sheath diameter was 0.6 ± 0.4 mm in Group 1A and 0.5 ± 0.4 mm in Group 1B (p = 0.294).Conclusion:Pre‐treatment optic nerve sheath diameter values of the patients who were diagnosed with one of the acute hyperglycemic complications of diabetes mellitus are not different from healthy adults. Furthermore, optic nerve sheath diameter values do not change with the severity of the disease. However, optic nerve sheath diameter values change with treatment. For this reason, optic nerve sheath diameter can be used to following the development of brain edema.
Analysis of the Prevalence and Incidence of Cleft Lip and Palate in Colombia
Authors: Alonso Rengifo Reina Herney , Brigetty Guarnizo Peralta Stefany 
Published: December 2019

Objective: To analyze the population prevalence and birth prevalence of oral clefts in Colombia from 2009 to 2017. Methods: A cross-sectional study using information from the National Administrative Records of Colombia. The data came from 2 types of administrative records (Surveillance System and the Individual Registry of Service Provision) and the oral health national survey. Population prevalence and birth prevalence by type of cleft lip and/or cleft (CL/P) ratios were calculated using Poisson distribution for count data and to assess stationary tests on time series (Dickey-Fuller) and (Phillips-Perron) was used. Results: Population prevalence in Colombia was 3.27 per 10 000 inhabitants (95% confidence interval [CI], 3.21-3.32) and birth prevalence was 6.0 per 10 000 live births (95% CI, 5.67-6.35). Bogotá have the highest population prevalence with CL/P. In the analysis of trends for the prevalence proportion by type of clefts in newborn babies with cleft, it was observed that the highest proportion was for babies with CLP. Cleft lip (CL) has increased from 17.4% in 2014 to 34.2% in 2017, cleft palate (CP) has decreased from 32.9% to 20.2%; and CLP changed from 49.6% to 45.5% in the same period. Conclusions: The population prevalence was 3.27 per 10 000 inhabitants. Births prevalence was 6.0 per 10 000 live births, and Orinoquia and Amazonia have higher rates than the national average. The administrative registers are adequate systems to know the behavior of oral clefts. The CL/P had a nonstationary trend during the period 2014 to 2017.
SB5 shows cross-immunogenicity to adalimumab but not infliximab: results in patients with inflammatory bowel disease or rheumatoid arthritis
Authors: Goncalves Joao , Myung Gihyun , Park MinJeong , Jeong Deokyoon , Ghil Jeehoon 
Published: December 2019

Background: The primary objective of this study was to analyze the cross-reactivity of antidrug antibodies to reference adalimumab (ADL) and SB5 (adalimumab biosimilar) in patients with inflammatory bowel disease (IBD) or rheumatoid arthritis (RA). Methods: Sera from patients with IBD and RA with or without antibodies to adalimumab (ATA+ or ATA–, respectively) were tested for cross-reactivity with SB5 and ADL. Functional inhibition of tumor necrosis factor-α binding was measured. Sera from patients with antibodies to reference infliximab (ATI+) were examined for cross-reactivity to SB5. Sera were tested by enzyme-linked immunosorbent assay. Results: All 30 anti-ADL ATA+ sera from patients with IBD and all 4 anti-SB5 ATA+ sera from patients with RA were cross-reactive with ADL and SB5 (range of mean concentrations: IBD, 20.99–21.31 μg/ml; RA, 16.46–17.48 μg/ml). In general, there was no significant difference between mean ATA titers. A strong correlation was detected in all ATA+ samples (rho = 0.997 to >0.999; p < 0.001 each). However, ATA– sera were not reactive to either ADL or SB5. anti-ADL ATA+ sera similarly neutralized functional activity of ADL and SB5; no functional inhibition was observed with ATA– sera. ATI+ sera did not cross-react with SB5. Conclusions: ADL and SB5 show cross-immunogenicity in sera from patients with IBD or RA, supporting shared immune-dominant epitopes. ATI+ sera did not cross-react with SB5, suggesting different immunogenic epitopes between infliximab and SB5.