bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep Gray Matter Iron Deposition and Its Relationship to Clinical Features in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Patients
Authors: Sun Chengyue , Wu Yue , Ling Chen , Xie Zhiying , Kong Qingle , Fang Xiaojing , An Jing , Sun Yunchuang , Zhang Wei , Yang Qi , Wang Zhaoxia , Zhang Zihao , Yuan Yun 
Published: May 2020

Background and Purpose—
Distribution patterns of iron deposition in deep gray matter and their association with clinical characteristics in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) remain unclear. We aimed to evaluate iron deposition in deep gray matter in patients with CADASIL using 7.0-T susceptibility-weighted imaging and mapping and to explore its correlations with clinical characteristics.

Methods—
Thirty-nine patients with CADASIL, confirmed via genetic analysis or skin biopsy, were enrolled. We examined patients using the Mini-Mental State Examination, modified Rankin Scale, and brain 7.0-T magnetic resonance imaging and obtained magnetic resonance imaging lesion loads, small vessel disease scores, and susceptibility mapping. The following regions of interest were selected: caudate nucleus, putamen, globus pallidus, thalamus, substantia nigra, and red nucleus. The quantitative differences in the susceptibility of deep gray matter between the CADASIL and control groups and the correlations between deep gray matter susceptibility and clinical characteristics were identified.

Results—
Compared with the control group, the CADASIL group showed significantly increased susceptibility of caudate nucleus, putamen, thalamus, substantia nigra, and red nucleus. The susceptibility of deep gray matter in basal ganglia region, including caudate nucleus, putamen, and thalamus, significantly increased with age or disease duration and positively correlated with small vessel disease scores in patients with CADASIL. Moreover, the susceptibility of thalamus positively correlated with modified Rankin Scale scores after adjusting for age and disease duration and that of putamen negatively correlated with Mini-Mental State Examination scores in patients with CADASIL after adjusting for age.

Conclusions—
Our findings indicate an association between abnormal iron deposition in deep gray matter of patients with CADASIL and their clinical characteristics. Therefore, excess iron deposition in deep gray matter, as indicated by 7.0-T susceptibility-weighted imaging and mapping, might not only be a novel magnetic resonance imaging feature but also a potential biomarker for CADASIL severity.
Influence of Preexisting Cognitive Impairment on Clinical Severity of Ischemic Stroke
Authors: Béjot Yannick , Duloquin Gauthier , Crespy Valentin , Durier Jérôme , Garnier Lucie , Graber Mathilde , Giroud Maurice 
Published: May 2020

Background and Purpose—
The ongoing ageing population is associated with an increasing number of patients with stroke who have preexisting cognitive impairment. This study aimed to evaluate clinical severity in patients with ischemic stroke according to prestroke cognitive status.

Methods—
Patients with ischemic stroke were prospectively identified among residents of Dijon, France using a population-based registry (2013–2017). Prestroke cognitive status (no impairment, mild cognitive impairment [MCI], or dementia) was recorded, and severity at stroke onset was measured using the National Institutes of Health Stroke Scale (NIHSS) score. Association between prestroke cognitive status and severity was evaluated using ordinal regression analysis models in which the NIHSS score was considered as a categorical variable.

Results—

Among the 1048 patients (mean age, 76.3±15.2 years; 54.0% women), a greater severity was observed in those with MCI (n=132; median NIHSS: 6; interquartile range, 2–15), and those with dementia (n=164; median NIHSS: 7; interquartile range, 3–16), than in patients without cognitive impairment (n=752; median NIHSS: 3; interquartile range, 1–9). MCI (odds ratio [OR], 1.70 [95% CI, 1.21–2.38];
P
=0.002) and dementia (OR, 2.24 [95% CI, 1.65–3.04];
P
<0.001) were both associated with a greater severity at onset. The association was still observed after adjustment for clinical variables and proximal arterial occlusion (OR, 1.52 [95% CI, 1.02–2.28];
P
=0.04 for MCI; OR, 2.16 [95% CI, 1.45–3.22];
P
<0.001 dementia). Further adjustment for prestroke handicap slightly reduced the magnitude of the association (OR, 1.49 [95% CI, 0.98–2.25];
P
=0.06 for MCI, and OR, 1.98 [95% CI, 1.26–3.12];
P
=0.02 for dementia). The greater severity in patients with prestroke cognitive impairment was not specifically driven by a more severe impairment of either motor or language function.

Conclusions—
Patients with preexisting cognitive impairment suffered more severe ischemic stroke. This result could reflect a lower brain tolerance of acute ischemia. Further studies are needed to explore the underlying mechanisms that could be targeted from therapeutic perspectives focusing on neuroprotection.
2B, 2C, or 3
Authors: LeCouffe Natalie E. , Kappelhof Manon , Treurniet Kilian M. , Lingsma Hester F. , Zhang Guang , van den Wijngaard Ido R. , van Es Adriaan C.G.M. , Emmer Bart J. , Majoie Charles B.L.M. , Roos Yvo B.W.E.M. , Coutinho Jonathan M. ,   on behalf of the MR CLEAN Registry Investigators*
Published: May 2020

Background and Purpose—
A score of ≥2B on the modified Thrombolysis in Cerebral Infarction scale is generally regarded as successful reperfusion after endovascular treatment for ischemic stroke. The extended Thrombolysis in Cerebral Infarction (eTICI) includes a 2C grade, which indicates near-perfect reperfusion. We investigated how well the respective eTICI scores of 2B, 2C, and 3 correlate with clinical outcome after endovascular treatment.

Methods—
We used data from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry, a prospective, nationwide registry of endovascular treatment in the Netherlands. We included patients with a proximal intracranial occlusion of the anterior circulation for whom final antero-posterior and lateral digital subtraction angiography imaging was available. Our primary outcome was the distribution on the modified Rankin Scale at 90 days per eTICI grade. We performed (ordinal) logistic regression analyses, using eTICI 2B as reference group, and adjusted for potential confounders.

Results—

In total, 2807/3637 (77%) patients met the inclusion criteria. Of these, 17% achieved reperfusion grade eTICI 0 to 1, 14% eTICI 2A, 25% eTICI 2B, 12% eTICI 2C, and 32% eTICI 3. Groups differed in terms of age (
P
<0.001) and occlusion location (
P
<0.01). Procedure times decreased with increasing reperfusion grades. We found a positive association between reperfusion grade and functional outcome, which continued to increase after eTICI 2B (adjusted common odds ratio, 1.22 [95% CI, 0.96–1.57] for eTICI 2C versus 2B; adjusted common odds ratio, 1.33 [95% CI, 1.09–1.62] for eTICI 3 versus 2B).

Conclusions—
Our results indicate a continuous relationship between reperfusion grade and functional outcome, with eTICI 3 leading to the best outcomes. Although this implies that interventionists should aim for the highest possible reperfusion grade, further research on the optimal strategy is necessary.
Low-Frequency Vibrations Enhance Thrombolytic Therapy and Improve Stroke Outcomes
Authors: Dhanesha Nirav , Schnell Thomas , Rahmatalla Salam , DeShaw Jonathan , Thedens Daniel , Parker Bradley M. , Zimmerman M. Bridget , Pieper Andrew A. , Chauhan Anil K. , Leira Enrique C. 
Published: May 2020

Background and Purpose—
We aim to determine the potential impact on stroke thrombolysis of drip-and-ship helicopter flights and specifically of their low-frequency vibrations (LFVs).

Methods—
Mice with a middle cerebral artery autologous thromboembolic occlusion were randomized to receive rtPA (recombinant tissue-type plasminogen activator; or saline) 90 minutes later in 3 different settings: (1) a motion platform simulator that reproduced the LFV signature of the helicopter, (2) a standardized actual helicopter flight, and (3) a ground control.

Results—

Mice assigned to the LFV simulation while receiving tPA had smaller infarctions (31.6 versus 54.9 mm
3
;
P
=0.007) and increased favorable neurological outcomes (86% versus 28%;
P
=0.0001) when compared with ground controls. Surprisingly, mice receiving tPA in the helicopter did not exhibit smaller infarctions (47.8 versus 54.9 mm
3
;
P
=0.58) nor improved neurological outcomes (37% versus 28%;
P
=0.71). This could be due to a causative effect of the 20- to 30-Hz band, which was inadvertently attenuated during actual flights. Mice using saline showed no differences between the LFV simulator and controls with respect to infarct size (80.9 versus 95.3;
P
=0.81) or neurological outcomes (25% versus 11%;
P
=0.24), ruling out an effect of LFV alone. There were no differences in blood-brain barrier permeability between LFV simulator or helicopter, compared with controls (2.45–3.02 versus 4.82 mm
3
;
P
=0.14).

Conclusions—
Vibration in the low-frequency range (0.5–120 Hz) is synergistic with rtPA, significantly improving the effectiveness of thrombolysis without impairing blood-brain barrier permeability. Our findings reveal LFV as a novel, safe, and simple-to-deliver intervention that could improve the outcomes of patients.

Visual Overview—

An online
visual overview
is available for this article.
Prehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic
Authors: Goyal Mayank , Ospel Johanna M. , Southerland Andrew M. , Wira Charles , Amin-Hanjani Sepideh , Fraser Justin F. , Panagos Peter ,   on behalf of the AHA/ASA Stroke Council Science Subcommittees: Emergency Neurovascular Care (ENCC), the Telestroke and the Neurovascular Intervention Committees
Published: May 2020

Abstract:
The coronavirus disease 2019 (COVID-19) pandemic has broad implications on stroke patient triage. Emergency medical services providers have to ensure timely transfer of patients while minimizing the risk of infectious exposure for themselves, their co-workers, and other patients. This statement paper provides a conceptual framework for acute stroke patient triage and transfer during the COVID-19 pandemic and similar healthcare emergencies in the future.
On the Path to Becoming
Authors: Sarabi Niloo E. 
Published: May 2020

Abstract
In this article, I undertake a critical analysis of Marzieh Meshkini’s 2000 directorial debut, The Day I Became a Woman, which won multiple awards at the Toronto and Venice Film Festivals, and I investigate the manner in which Meshkini’s visual aesthetics enable her to enrich vital debates about the veil, gender socialization and social mobility as well as female pleasure and jouissance in contemporary Iranian society and abroad. Through a close reading of the figurative film language and innovative cinematography in Meshkini’s film, including its novel play with different temporalities and its artistic approach to mise-en-scène and framing of various shots, I examine the extent to which Meshkini succeeds in conveying her compelling social message in terms of Iranian women’s experiences, more than two decades after the Islamic revolution.
Edge Detection Reveals Abrupt and Extreme Climate Events
Authors: Bathiany Sebastian , Hidding Johan , Scheffer Marten 
Published: May 2020

AbstractThe most discernible and devastating impacts of climate change are caused by events with temporary extreme conditions (“extreme events”) or abrupt shifts to a new persistent climate state (“tipping points”). The rapidly growing amount of data from models and observations poses the challenge to reliably detect where, when, why, and how these events occur. This situation calls for data-mining approaches that can detect and diagnose events in an automatic and reproducible way. Here, we apply a new strategy to this task by generalizing the classical machine-vision problem of detecting edges in 2D images to many dimensions (including time). Our edge detector identifies abrupt or extreme climate events in spatiotemporal data, quantifies their abruptness (or extremeness), and provides diagnostics that help one to understand the causes of these shifts. We also publish a comprehensive toolset of code that is documented and free to use. We document the performance of the new edge detector by analyzing several datasets of observations and models. In particular, we apply it to all monthly 2D variables of the RCP8.5 scenario of the Coupled Model Intercomparison Project (CMIP5). More than half of all simulations show abrupt shifts of more than 4 standard deviations on a time scale of 10 years. These shifts are mostly related to the loss of sea ice and permafrost in the Arctic. Our results demonstrate that the edge detector is particularly useful to scan large datasets in an efficient way, for example multimodel or perturbed-physics ensembles. It can thus help to reveal hidden “climate surprises” and to assess the uncertainties of dangerous climate events.
An Overview of the Extratropical Storm Tracks in CMIP6 Historical Simulations
Authors: Priestley Matthew D. K. , Ackerley Duncan , Catto Jennifer L. , Hodges Kevin I. , McDonald Ruth E. , Lee Robert W. 
Published: May 2020

AbstractThe representation of the winter and summer extratropical storm tracks in both hemispheres is evaluated in detail for the available models in phase 6 of the Coupled Model intercomparison Project (CMIP6). The state of the storm tracks from 1979 to 2014 is compared to that in ERA5 using a Lagrangian objective cyclone tracking algorithm. It is found that the main biases present in the previous generation of models (CMIP5) still persist, albeit to a lesser extent. The equatorward bias around the SH is much reduced and there appears to be some improvement in mean biases with the higher-resolution models, such as the zonal tilt of the North Atlantic storm track. Low-resolution models have a tendency to underestimate the frequency of high-intensity cyclones with all models simulating a peak intensity that is too low for cyclones in the SH. Explosively developing cyclones are underestimated across all ocean basins and in both hemispheres. In particular the models struggle to capture the rapid deepening required for these cyclones. For all measures, the CMIP6 models exhibit an overall improvement compared to the previous generation of CMIP5 models. In the NH most improvements can be attributed to increased horizontal resolution, whereas in the SH the impact of resolution is less apparent and any improvements are likely a result of improved model physics.
Assessment of Precipitating Marine Stratocumulus Clouds in the E3SMv1 Atmosphere Model: A Case Study from the ARM MAGIC Field Campaign
Authors: Zheng X. , Klein S. A. , Ghate V. P. , Santos S. , McGibbon J. , Caldwell P. , Bogenschutz P. , Lin W. , Cadeddu M. P. 
Published: May 2020

AbstractThis paper presents a process-oriented evaluation of precipitating stratocumulus and its transition to cumulus in version 1 of the Energy Exascale Earth System Model (E3SMv1) using comprehensive case-study observations from a field campaign of the Atmospheric Radiation Measurement program (ARM). The E3SMv1 single-column model (SCM) of the marine boundary layer and its low clouds and precipitation are compared to observations including subcloud drizzle retrievals from a combination of Doppler radar and lidar backscatter measurements. The SCM is also compared to a large-eddy simulation (LES) of the same case. The combination of advanced remote sensing observations and LES is a powerful framework to evaluate the physical parameterizations of large-scale models. Given the observed large-scale environment, the E3SMv1 SCM realistically represents the evolution of clouds and boundary layer structure during the stratocumulus-to-cumulus transition. The model well simulates the liquid water path and its diurnal cycle in the stratocumulus period as well as the two-layer vertical thermodynamic structure and lower cloud fraction in the transition period. E3SMv1’s success in simulating the cloud in the stratocumulus period permitted examination of its precipitation processes. Here problems were identified with E3SMv1 producing an unrealistically small subcloud precipitation fraction, an unrealistic double peak in the vertical profiles of precipitation mass, and drizzle that evaporates too close to the surface. Further model diagnostics determined that these unrealistic characteristics resulted from an overly long microphysics time step and an unrealistic parameterization of the precipitation fraction. These results imply that careful consideration of these issues is needed in order to better simulate precipitation processes in marine stratocumulus.
Using a WRF-ADCIRC Ensemble and Track Clustering to Investigate Storm Surge Hazards and Inundation Scenarios Associated with Hurricane Irma
Authors: Kowaleski Alex M. , Morss Rebecca E. , Ahijevych David , Fossell Kathryn R. 
Published: May 2020

AbstractThis article investigates combining a WRF-ADCIRC ensemble with track clustering to evaluate how uncertainties in tropical cyclone–induced storm tide (surge + tide) predictions vary in space and time and to explore whether this method can help elucidate inundation hazard scenarios. The method is demonstrated for simulations of Hurricane Irma (2017) initialized at 1200 UTC 5 September, approximately 5 days before Irma’s Florida landfalls, and 1200 UTC 8 September. Mixture models are used to partition the WRF ensemble tracks from 5 and 8 September into six and five clusters, respectively. Inundation is evaluated in two affected regions: southwest (south and west Florida) and northeast (northeast Florida through South Carolina). For the 5 September simulations, inundation in the southwest region varies significantly across the ensemble, indicating low forecast confidence. However, clustering highlights the areas of inundation risk in south and west Florida associated with different storm tracks. In the northeast region, every cluster has high inundation probabilities along a similar coastal stretch, indicating high confidence at a ~5-day lead time that this area will experience inundation. For the 8 September simulations, track and inundation in both regions vary less across the ensemble, but clustering remains useful for distinguishing among flooding scenarios. These results demonstrate the potential of dynamical TC–surge ensembles to illuminate important aspects of storm surge risk, including highlighting regions of high forecast confidence where preparations can reliably be initiated early. The analysis also shows how clustering can augment probabilistic hazard forecasts by elucidating inundation scenarios and variability across a surge ensemble.
Assessment of Cloud Retrieval for IASI 1D-Var Cloudy-Sky Assimilation and Improvement with an ANN Approach
Authors: Lee Ahreum , Sohn Byung-Ju , Pavelin Ed , Kim Yoonjae , Kang Hyun-Suk , Saunders Roger , Noh Young-Chan 
Published: May 2020

AbstractThe Unified Model (UM) data assimilation system incorporates a 1D-Var analysis of cloud variables for assimilating hyperspectral infrared radiances. For the Infrared Atmospheric Sounding Interferometer (IASI) radiance assimilation, a first guess of cloud top pressure (CTP) and cloud fraction (CF) is estimated using the minimum residual (MR) method, which simultaneously obtains CTP and CF by minimizing radiance difference between observation and model simulation. In this study, we examined how those MR-based cloud retrievals behave, using “optimum” CTP and CF that yield the best 1D-Var analysis results. It is noted that the MR method tends to overestimate cloud top height while underestimating cloud fraction, compared to the optimum results, necessitating an improved cloud retrieval. An artificial neural network (ANN) approach was taken to estimate CTP as close as possible to the optimum value, based on the hypothesis that CTP and CF closer to the optimum values will bring in better 1D-Var results. The ANN-based cloud retrievals indicated that CTP and CF biases shown in the MR method are much reduced, giving better 1D-Var analysis results. Furthermore, the computational time can be substantially reduced by the ANN method, compared to the MR method. The evaluation of the ANN method in a global weather forecasting system demonstrated that it helps to use more temperature channels in the assimilation, although its impact on UM forecasts was found to be near neutral. It is suggested that the neutral impact may be improved when error covariances for the cloudy sky are employed in the UM assimilation system.
Perspectives on Literacy by Four Adolescents, Their Teachers, and Family Members
Authors: Rosenblum L. Penny , Herzberg Tina S. 
Published: May 2020

Introduction: To better understand the process students with visual impairments experience in learning and using braille as a literacy medium, the researchers conducted interviews. The role of technology in the literacy experiences of the students was also examined. Methods: Individual interviews were conducted with four triads (a student, a teacher, and a family member). Five themes were identified across the interviews. Results: There were similarities and differences in how braille was introduced and taught to each student. None of the four students had a braille reading speed of more than 30 words per minute, and each struggled to use braille and technology to keep up with academic classes. Students and family members reported an emotional effect in regard to the loss of vision and the need to transition from print to braille. Discussion: Although instructional approaches differed, the teachers used strategies and materials based on their students’ interests and abilities. Family members were supportive of their children learning braille and using technology. The students recognized that their braille reading was slow and that there was much to learn in order to succeed academically both now and in the future. Implications for practitioners: Today’s students with visual impairments need multiple methods to complete literacy tasks. Practitioners must design programs that allow students to gain necessary skills with braille and technology so that they can meaningfully integrate braille and technology as tools in their literacy toolbox.