bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posttreatment Ischemic Lesion Evolution Is Associated With Reduced Favorable Functional Outcome in Patients With Stroke
Authors: Konduri Praneeta , van Voorst Henk , Bucker Amber , van Kranendonk Katinka , Boers Anna , Treurniet Kilian , Berkhemer Olvert , Yoo Albert J. , van Zwam Wim , van Oostenbrugge Robert , van der Lugt Aad , Dippel Diederik , Roos Yvo , Bot Joost , Majoie Charles , Marquering Henk ,   on behalf of the MR CLEAN Trial Investigators
Published: July 2021

Background and Purpose:
Ischemic lesion volume can increase even 24 hours after onset of an acute ischemic stroke. In this study, we investigated the association of lesion evolution with functional outcome and the influence of successful recanalization on this association.

Methods:

We included patients from the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) who received good quality noncontrast CT images 24 hours and 1 week after stroke onset. The ischemic lesion delineations included infarct, edema, and hemorrhagic transformation. Lesion evolution was defined as the difference between the volumes measured on the 1-week and 24-hour noncontrast CTs. The association of lesion evolution with functional outcome was evaluated using unadjusted and adjusted logistic regression. Adjustments were made for baseline, clinical, and imaging parameters that were associated
P
<0.10) in univariate analysis with favorable functional outcome, defined as modified Rankin Scale score of ≤2. Interaction analysis was performed to evaluate the influence of successful recanalization, defined as modified Arterial Occlusion Lesion score of 3 points, on this association.

Results:

Of the 226 patients who were included, 69 (31%) patients achieved the favorable functional outcome. Median lesion evolution was 22 (interquartile range, 10–45) mL. Lesion evolution was significantly inversely correlated with favourable functional outcome: unadjusted odds ratio, 0.76 (95% CI, 0.66–0.86; per 10 mL of lesion evolution;
P
<0.01) and adjusted odds ratio: 0.85 (95% CI, 0.72–0.97; per 10 mL of lesion evolution;
P
=0.03). There was no significant interaction of successful recanalization on the association of lesion evolution and favorable functional outcome (odds ratio, 1.01 [95% CI, 0.77–1.36];
P
=0.94).

Conclusions:
In our population, subacute ischemic lesion evolution is associated with unfavorable functional outcome. This study suggests that even 24 hours after onset of stroke, deterioration of the brain continues, which has a negative effect on functional outcome. This finding may warrant additional treatment in the subacute phase.
Reasons for Not Performing Mechanical Thrombectomy: A Population-Based Study of Stroke Codes
Authors: Guisado-Alonso Daniel , Martínez-Domeño Alejandro , Prats-Sánchez Luis , Delgado-Mederos Raquel , Camps-Renom Pol , Abilleira Sònia , de la Ossa Natalia Pérez , Ramos-Pachón Anna , Cardona Pere , Rodríguez-Campello Ana , Molina Carlos A. , Rudilosso Salvatore , Martí-Fàbregas Joan , Marín Rebeca , Purroy Francisco , Serena Joaquín , Canovas David , Gómez- Choco Manuel , Ustrell Xavier , Zaragoza Josep , Krupinski Jerzy , Mas Sala Natalia , Palomeras Ernest , Cocho Dolors , Maria Aragonés Josep , López Núria , Sanjurjo Eduard , Carrión Duch Dolors , López Mercè , Almendros Rivas M.Cruz , Monedero Boado Jordi , Catena Esther , Catena Esther , Rybyeba Maria , Diaz Gloria 
Published: July 2021

Background and Purpose:
Mechanical thrombectomy (MT) is effective for acute ischemic stroke (AIS) in selected patients with large intracranial vessel occlusion. A minority of patients with AIS receive MT. We aimed to describe the reasons for excluding patients with AIS for MT.

Methods:
We evaluated patients with AIS in a prospective population-based multicenter registry (Codi Ictus Catalunya registry) that includes all stroke code activations from January to June 2018 in Catalonia, Spain. We analyzed the major reasons for not treating with MT.

Results:
Stroke code was activated in 3060 patients. Excluding 355 intracranial hemorrhages and 502 stroke mimics, resulted in 2203 patients with AIS (mean age 72.8±13.8 years; 44.6% were women). Of the patients with AIS, 405 (18.4%) were treated with MT. We analyzed the reasons for not treating with MT. The following reasons were considered not modifiable: absence of large intracranial vessel occlusion (922, 41.9%), transient ischemic attack (206, 9.4%), and more than one cause (124, 5.6%). The potentially modifiable reasons for not performing MT by changing selection criteria were as follows: an intracranial artery occlusion that was considered inaccessible or not indicated (48, 2.2%); clinical presentation that was considered too mild to be treated (222, 10.1%); neuroimaging criteria (129, 5.9%), age/prior modified Rankin Scale score/medical comorbidities (129, 5.9%), and therapeutic time window >8 hours (16, 0.7%).

Conclusions:
In our area, considering all potentially modifiable causes for not performing MT, the percentage of patients with AIS eligible for MT could increase from 18.4% to a maximum of 43.1%. The clinical benefit of this increase is still uncertain and should be confirmed in future trials. Criteria for stroke code activation must be considered for the generalizability of these results.
Congolese Child Soldier Narratives for Global and Local Audiences
Authors: Gehrmann Susanne 
Published: July 2021

Abstract
The article examines narratives by and about former child soldiers in the Democratic Republic of the Congo, a hitherto neglected corpus despite the topicality of child soldiering in African literatures after 2000. Critical readings of three testimonial texts that have been published in France are juxtaposed with the analysis of one testimonial narrative and one youth novel that have been published in Kinshasa. The editorial framing and narrative strategies that speak to different audiences located in different literary fields are identified. The popularity of testimonial narratives in the West relies on the depiction of violence and the iconic function of the child soldier in medial and human rights discourses. By contrast, narratives about the reconciliation and the reintegration of child soldiers prevail in the DRC. Thus, the different functions of global and local narratives on the sensitive issue of children at war are exposed.
Figuring Africa and China
Authors: Yoon Duncan M. 
Published: July 2021

Abstract
This article asks how China has figured as a trope in Congolese literature from the Cold War and to the present. To do so, I analyze three texts: V.Y. Mudimbe’s Entre les eaux (Between Tides) (1973), In Koli Jean Bofane’s Congo Inc. (2014), and Fiston Mwanza Mujila’s Tram 83 (2014). I also examine how Mobutu interpolated Maoism into his dictatorship. I argue that whereas the Cold War produces figures such as the Maoist guerrilla, the radical intellectual, and the authoritarian leader, Chinese investment in the DRC facilitates the rise of new figures such as the mondialiste and the economic tourist. As a result, Third Worldism is ironically recast through the lens of a mutual “win-win” for development. This lens masks a new era of extractivism that produces its own social dislocations, which lends Pierre Mulélé’s Maoist-inspired rebellion a paradoxical relevance to DRC-PRC relations at the beginning of the twenty-first century.
Congolese Literature as Part of Planetary Literature
Authors: Riva Silvia 
Published: July 2021

Abstract
Historically and economically, the Congo has been considered one of the most internationalized states of Africa. The idea that African cultural plurality was minimized during the colonial era has to be reconsidered because textual negotiations and exchanges (cosmopolitan and vernacular, written and oral) have been frequent during and after colonization, mostly in urban areas. Through multilingual examples, this paper aims to question the co-construction of linguistic and literary pluralism in Congo and to advocate for the necessity of a transdisciplinary and collaborative approach, to understand the common life of African vernacular and cosmopolitan languages. I show that world literature models based on Pierre Bourdieu’s notion of negotiation between center and periphery thus have to be replaced by a concept of multilingual global history. Finally, I propose the notion of “planetary literature” as a new way of understanding the interconnection between literatures taking care of the world.
Changing Impact of ENSO Events on the Following Summer Rainfall in Eastern China since the 1950s
Authors: Sun Linyuan , Yang Xiu-Qun , Tao Lingfeng , Fang Jiabei , Sun Xuguang 
Published: July 2021

AbstractEl Niño–Southern Oscillation (ENSO) events, which generally mature in winter, profoundly affect the following summer rainfall in eastern China (ECSR), but such an impact can change significantly with decadal background. This study examines how the impact has changed since the 1950s by running correlation and regression analyses. It is found that ENSO’s impact on ECSR has undergone two decadal shifts, one in the late 1970s and the other in the 1990s. Sequentially, three distinct ENSO-induced ECSR anomaly patterns are categorized, which exhibit both robust and changeable sides. The robust side manifests generally as more precipitation in the Yangtze River basin affected by the anomalous tropical western North Pacific anticyclone (WNPAC) in the post–El Niño summer. The changeable side is reflected in the more variable ENSO-induced rainfall anomalies north of the Yangtze River, due to the different ENSO-induced East Asian midlatitude circulation anomalies. Meanwhile, the El Niño–induced drought in South China has been enhanced since the late 1970s with the intensification of the anomalous WNPAC. ENSO’s changing impact on the ECSR stems from the changes of ENSO-induced tropical and midlatitude circulation anomalies over East Asia, which are associated with different zonal (from the tropical Pacific to the Indian Ocean) and meridional (from the tropical Pacific to the midlatitude North Pacific) teleconnections of ENSO-induced SST anomalies. The former affects the intensity and location of the anomalous WNPAC by affecting the Indian Ocean capacitor effect and convection anomalies over the tropical Indo-western Pacific. The latter modulates the ocean-to-atmosphere feedback in the midlatitude North Pacific, contributes to different local geopotential anomaly sources, and then directly or indirectly through the Rossby wave train affects the East Asian midlatitude circulation.
Ultrasound-guided ethanol sclerotherapy for multifocal unilateral Warthin’s tumor after partial parotidectomy
Authors: Lee Esther , Badger Christopher , Mamidi Ishwarya S , Benito Daniel A , Li Lilun , Goodman Joseph F , Thakkar Punam G , Joshi Arjun 
Published: July 2021

Introduction Warthin’s tumor, also known as papillary cystadenoma lymphomatosum, is one of the most common benign salivary gland neoplasms. The current first-line treatment for Warthin’s tumor is parotidectomy. However, surgical resection has the risk of complications including facial nerve weakness and Frey’s syndrome. Recently, ultrasound-guided ethanol sclerotherapy (UGES) has been found to be efficacious in the treatment of a variety of head and neck lesions. Case report We present a patient with multifocal Warthin’s tumor who was managed with partial parotidectomy and two cycles of ultrasound-guided ethanol sclerotherapy. Discussion Ethanol sclerotherapy has been used as a minimally invasive alternative to surgical excision or observation alone for a variety of head and neck masses. To our knowledge, this is the first case presented in the literature where sclerotherapy was used in conjunction with a partial parotidectomy. Minimizing the extent of surgical resection can reduce the risk of facial nerve weakness and Frey’s syndrome and negate the need for fat grafting for defect reconstruction. Conclusion UGES may serve as a safe and reliable procedure that can be performed in conjunction with partial parotidectomy for patients who wish to achieve definitive diagnosis while also minimizing the risk of complications associated with extensive parotidectomy.
Spreading Environmental Awareness Through Environmental Education in Schools: The Case Study of a Sikkimese Green School
Authors: Thapa Jwala D. 
Published: July 2021

The subject of environmental education (EE) in India, also known as environment studies (EVS), was introduced through the intervention of the Supreme Court of India (SC). At that time, there was also global recognition towards the creation of ‘environmental citizens’ through inculcating environmental awareness in school-going children, with the motto of ‘catch them young’. Since then, EE in India has seen an evolution in itself through enveloping the studies of various topics related to the natural environment. However, one of the concerns has been that it is taught in a theoretical manner and that since it is not treated as a graded subject, schools have not given it the importance it deserves. However, the study of a green school of the Himalayan state of Sikkim shows that active participation of state machinery, coupled with a practical interpretation of its principles, can lead to positive results. It also shows that the creation of environmental citizens needs a holistic approach, through both amalgamation of theory with practice and syllabus with stringent state intervention and results-oriented action. This article, which uses doctrinal, as well as field research, techniques of interview and observation, looks into these aspects through studying a school in a mountain village of West Sikkim in India.
Use of the Keystone Perforator Flap Closure for the Anterolateral Thigh Free Flap Donor Site
Authors: Kumbla Pallavi A. , Thorburn Ashley Q. , Makwana Shreyas , Mino Matthew , Zakhary Joseph , Myers René P. 
Published: July 2021

Objective: The anterolateral thigh (ALT) flap is a workhorse in microsurgical reconstruction. However, a flap width greater than 8 centimeters limits primary closure and discourages some surgeons from using this flap for larger defects to avoid a large and unsightly skin grafted donor site. ALT donor site closure can be made even more challenging when a more circular shaped flap is required. Methods: This study examines the use of the keystone perforator flap to close large ALT free flap donor sites in 6 patients who underwent reconstruction for various purposes who otherwise would have required donor site skin grafting. Results: Average flap dimensions were 10.5 cm × 17 cm and mean keystone flap dimensions were 12.2 cm × 22.5 cm. Average operative time of cases was 528.3 minutes and average BMI of patients was 24.8 kg/m2. There was 1 case of partial keystone flap dehiscence that required local wound care, and 1 case of drain replacement for thigh seroma. Conclusions: This series demonstrates that keystone perforator flap closure allows the thigh to maintain a relatively normal appearance, reduces postoperative pain associated with skin grafting, and can be performed in higher BMI patients with minimal complications and without increasing operative time or sensory or motor deficits. This series to date also has the largest defects closed with keystone flaps demonstrating the feasibility of this type of closure in very large ALT donor sites.
Platelet EVs contain an active proteasome involved in protein processing for antigen presentation via MHC-I molecules
Authors: Marcoux Genevieve , Laroche Audrée , Hasse Stephan , Bellio Marie , Mbarik Maroua , Tamagne Marie , Allaeys Isabelle , Zufferey Anne , Lévesque Tania , Rebetz Johan , Karakeussian-Rimbaud Annie , Turgeon Julie , Bourgoin Sylvain G. , Hamzeh-Cognasse Hind , Cognasse Fabrice , Kapur Rick , Semple John W. , Hébert Marie-Josée , Pirenne France , Overkleeft Herman S. , Florea Bogdan I. , Dieude Mélanie , Vingert Benoît , Boilard Eric 
Published: July 2021

AbstractIn addition to their hemostatic role, platelets play a significant role in immunity. Once activated, platelets release extracellular vesicles (EVs) formed by the budding of their cytoplasmic membranes. Because of their heterogeneity, platelet EVs (PEVs) are thought to perform diverse functions. It is unknown, however, whether the proteasome is transferred from platelets to PEVs or whether its function is retained. We hypothesized that functional protein processing and antigen presentation machinery are transferred to PEVs by activated platelets. Using molecular and functional assays, we found that the active 20S proteasome was enriched in PEVs, along with major histocompatibility complex class I (MHC-I) and lymphocyte costimulatory molecules (CD40L and OX40L). Proteasome-containing PEVs were identified in healthy donor blood, but did not increase in platelet concentrates that caused adverse transfusion reactions. They were augmented, however, after immune complex injections in mice. The complete biodistribution of murine PEVs after injection into mice revealed that they principally reached lymphoid organs, such as spleen and lymph nodes, in addition to the bone marrow, and to a lesser extent, liver and lungs. The PEV proteasome processed exogenous ovalbumin (OVA) and loaded its antigenic peptide onto MHC-I molecules, which promoted OVA-specific CD8+ T-lymphocyte proliferation. These results suggest that PEVs contribute to adaptive immunity through cross-presentation of antigens and have privileged access to immune cells through the lymphatic system, a tissue location that is inaccessible to platelets.
Novel mechanisms of action contributing to benralizumab's potent anti-eosinophilic activity
Authors: Dagher Rania , Kumar Varsha , Copenhaver Alan M. , Gallagher Sandra , Ghaedi Mahboobe , Boyd Jonathan , Newbold Paul , Humbles Alison A. , Kolbeck Roland 
Published: July 2021

BackgroundBenralizumab is a humanised, anti-interleukin-5 receptor α monoclonal antibody with anti-eosinophilic activity. Lack of fucose (afucosylation) increases its affinity to CD16a and significantly enhances antibody-dependent cell-mediated cytotoxicity by natural killer (NK) cells. Although benralizumab proved clinically efficacious in clinical trials for patients with severe asthma and hypereosinophilic syndrome, in-depth characterisation of its anti-eosinophilic mechanisms of action remains elusive.MethodsHere, we further investigated the mechanisms involved in benralizumab's anti-eosinophilic activities by employing relevant primary human autologous cell co-cultures and real-time-lapse imaging combined with flow cytometry.ResultsIn the presence of NK cells, benralizumab induced potent eosinophil apoptosis as demonstrated by the upstream induction of Caspase-3/7 and upregulation of cytochromec. In addition, we uncovered a previously unrecognised mechanism whereby benralizumab can induce eosinophil phagocytosis/efferocytosis by macrophages, a process called antibody-dependent cellular phagocytosis. Using live cell imaging, we unravelled the stepwise processes leading to eosinophil apoptosis and uptake by activated macrophages. Through careful observations of cellular co-culture assays, we identified a novel role for macrophage-derived tumour necrosis factor (TNF) to further enhance benralizumab-mediated eosinophil apoptosis through activation of TNF receptor 1 on eosinophils. TNF-induced eosinophil apoptosis was associated with cytochromecupregulation, mitochondrial membrane depolarisation and increased Caspase-3/7 activity. Moreover, activated NK cells were found to amplify this axis through the secretion of interferon-γ, subsequently driving TNF expression by macrophages.ConclusionsOur data provide deeper insights into the timely appearance of events leading to benralizumab-induced eosinophil apoptosis and suggest that additional mechanisms may contribute to the potent anti-eosinophilic activity of benralizumabin vivo. Importantly, afucosylation of benralizumab strongly enhanced its potency for all mechanisms investigated.
Feasibility and clinical utility of ambulatory cough monitoring in an outpatient clinical setting: a real-world retrospective evaluation
Authors: Vertigan Anne E. , Kapela Sarah L. , Birring Surinder S. , Gibson Peter G. 
Published: July 2021

Research questionObjective quantification of cough is rarely utilised outside of research settings and the role of cough frequency monitoring in clinical practice has not been established. This study examined the clinical utility of cough frequency monitoring in an outpatient clinical setting.MethodsThe study involved a retrospective review of cough monitor data. Participants included 174 patients referred for treatment of cough and upper airway symptoms (103 chronic cough; 50 inducible laryngeal obstruction; 21 severe asthma) and 15 controls. Measures, taken prior to treatment, included 24-h ambulatory cough frequency using the Leicester Cough Monitor, the Leicester Cough Questionnaire and Laryngeal Hypersensitivity Questionnaire. Post-treatment data were available for 50 participants. Feasibility and clinical utility were also reported.ResultsAnalysis time per recording was up to 10 min. 75% of participants could use the monitors correctly, and most (93%) recordings were interpretable. The geometric mean cough frequency in patients was 10.1±2.9 (mean±sd) compared to 2.4±2.0 for healthy controls (p=0.003). There was no significant difference in cough frequency between clinical groups (p=0.080). Cough frequency decreased significantly following treatment (p<0.001). There was a moderate correlation between cough frequency and both cough quality of life and laryngeal hypersensitivity. Cough frequency monitoring was responsive to therapy and able to discriminate differences in cough frequency between diseases.ConclusionWhile ambulatory cough frequency monitoring remains a research tool, it provides useful clinical data that can assist in patient management. Logistical issues may preclude use in some clinical settings, and additional time needs to be allocated to the process.