bluuebunny/crossref_metadata_2025_split huggingface dataset:
Which Acute Ischemic Stroke Patients Are Fast Progressors?
Authors: Ospel Johanna M. , Hill Michael D. , Kappelhof Manon , Demchuk Andrew M. , Menon Bijoy K. , Mayank Arnuv , Dowlatshahi Dar , Frei Don , Rempel Jeremy L. , Baxter Blaise , Goyal Mayank 
Published: April 2021

Background and Purpose:
Fast infarct progression in acute ischemic stroke has a severe impact on patient prognosis and benefit of endovascular thrombectomy. In this post hoc analysis of the ESCAPE trial (Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke), we identified acute ischemic stroke patients with rapid infarct growth and investigated their baseline clinical and imaging characteristics.

Methods:
Control arm patients were included if they had follow-up imaging at 2-8 hours without substantial recanalization, and if their baseline Alberta Stroke Program Early CT Score was ≥9. Fast infarct progression was defined as Alberta Stroke Program Early CT Score decay ≥3 points from baseline to 2- to 8-hour follow-up imaging. Clinical and imaging baseline characteristics were compared between fast progressors and other patients, and occlusion site and collateral flow patterns were assessed in detail.

Results:

Fast infarct progression occurred in 15 of 43 included patients (34.9%). Fast progressors had worse collaterals (poor in 3/15 [20%] versus 0/28 patients,
P
=0.021) and more carotid-T or -L occlusions (8/15 [53.4%] versus 3/28[10.7%],
P
=0.021). In 8 out of 15 (53.3%), occlusion site and circle of Willis configuration prevented collateral flow via the anterior or posterior cerebral artery.

Conclusions:
Most patients with fast infarct progression had terminal carotid occlusions and impaired collateral flow via the anterior or posterior cerebral artery, indicating that occlusion location and intracranial vascular anatomy are relevant for infarct progression.
Possibilities for Justice and Equity in Human Rights and Climate Law: Benefit-Sharing in Climate Finance
Authors: Bouwer Kim 
Published: April 2021

Abstract
This article examines benefit-sharing in the context of climate finance. Both benefit-sharing and climate finance are complex, heterogeneous, and fast-developing fields, where the interaction of international human rights law and climate law can create both clarity and confusion. Benefit-sharing as a means for greater equity and fairness is increasingly used or included in materials on climate finance, despite lacking clear conceptualization in this context. The article does three things. First, it establishes benefit-sharing as an emerging obligation in human rights law and environmental law. Second, it explores how benefit-sharing appears in the climate regime, with a view to determining whether benefit-sharing has a distinct meaning in this context – and, if so, what it is. The article argues that both the meaning and the practice of benefit-sharing in climate finance are incoherent. Third, the article interrogates the possibilities and problems of adopting universalized norms of benefit-sharing in this context, and suggests some places where norms might be beneficial.
Impacts of Detoured Madden-Julian Oscillations on the South Pacific Convergence Zone
Authors: Zhou Lei , Ruan Ruomei , Murtugudde Raghu 
Published: April 2021

AbstractMadden-Julian Oscillations (MJOs) are a major component of tropical intraseasonal variabilities. There are two paths for MJOs across the Maritime Continent; one is a detoured route into the Southern Hemisphere and the other one is around the equator across the Maritime Continent. Here, it is shown that the detoured and non-detoured MJOs have significantly different impacts on the South Pacific convergence zone (SPCZ). The detoured MJOs trigger strong cross-equatorial meridional winds from the Northern Hemisphere into the Southern Hemisphere. The associated meridional moisture and energy transports due to the background states carried by the intraseasonal meridional winds are favorable for reinforcing the SPCZ. In contrast, the influences of non-detoured MJOs on either hemisphere or the meridional transports across the equator are much weaker. The detoured MJOs can extend their impacts to the surrounding regions by shedding Rossby waves. Due to different background vorticity during detoured MJOs in boreal winter, more ray paths of Rossby waves traverse the Maritime Continent connecting the southern Pacific Ocean and the eastern Indian Ocean, but far fewer Rossby wave paths traverse Australia. Further studies on such processes are expected to contribute to a better understanding of extreme climate and natural disasters on the rim of the southern Pacific and Indian Oceans.
Interaction of near-inertial waves with an anticyclonic vortex
Authors: Kafiabad Hossein A. , Vanneste Jacques , Young William R. 
Published: April 2021

AbstractAnticyclonic vortices focus and trap near-inertial waves so that near-inertial energy levels are elevated within the vortex core. Some aspects of this process, including the nonlinear modification of the vortex by the wave, are explained by the existence of trapped near-inertial eigenmodes. These vortex eigenmodes are easily excited by an initialwave with horizontal scale much larger than that of the vortex radius. We study this process using a wave-averaged model of near-inertial dynamics and compare its theoretical predictions with numerical solutions of the three-dimensional Boussinesq equations. In the linear approximation, the model predicts the eigenmode frequencies and spatial structures, and a near-inertial wave energy signature that is characterized by an approximately time-periodic, azimuthally invariant pattern. The wave-averaged model represents the nonlinear feedback of the waves on the vortex via a wave-induced contribution to the potential vorticity that is proportional to the Laplacian of the kinetic energy density of the waves. When this is taken into account, the modal frequency is predicted to increase linearly with the energy of the initial excitation. Both linear and nonlinear predictions agree convincingly with the Boussinesq results.
Best Practices for Comparing Ocean Turbulence Measurements across Spatiotemporal Scales
Authors: Whalen Caitlin B. 
Published: April 2021

AbstractThe turbulent energy dissipation rate in the ocean can be measured by using rapidly sampling microstructure shear probes, or by applying a finescale parameterization to coarser-resolution density and/or shear profiles. The two techniques require measurements that are on different spatiotemporal scales and generate dissipation rate estimates that also differ in spatiotemporal scale. Since the distribution of the measured energy dissipation rate is closer to lognormal than normal and fluctuates with the strength of the turbulence, averaging the two approaches on equivalent spatiotemporal scales is critical for accurately comparing the two methods. Here, microstructure data from the 1997 Brazil Basin Tracer Release Experiment (BBTRE) is used to demonstrate that comparing averages of the dissipation rate on different spatiotemporal scales can generate spurious discrepancies of up to a factor of order 10 in regions of strong turbulence and smaller biases of up to a factor of 2 in the presence of weaker turbulence.
Love and basketball: Audience response to a professional athlete’s mental health proclamation
Authors: Pavelko Rachelle L , Wang Tianjiao (Grace) 
Published: April 2021

Objective: On 6 March 2018, the Cleveland Cavaliers power forward Kevin Love penned an op-ed for The Players’ Tribune. In big, bold letters, the title, ‘Everyone Is Going Through Something’ gave way to his proclamation of personal mental health struggles. This study assessed the impact of Love’s personal mental health testimony on the audience. Design: Content analysis of Instagram user’s responses to Love’s 2018 announcement of panic disorder. Setting: Data were collected on 19 June 2018. Comments on Love’s post were manually copied into an Excel spreadsheet. Due to Instagram’s ‘top comments’ and ‘newest first’ algorithms that determine both the visibility and order of user responses, not all comments were accessible for analysis. A total of 1,234 comments served as the sample. Method: Two trained coders analysed the comments for exhibitions of audience involvement with Love, emotional responses and perceptions of social biases surrounding mental illness. Results: Social media users who expressed hope were more likely to share their own mental health experiences. In addition, users who expressed hope were significantly more likely to mention wanting to reduce social bias surrounding discussion of mental health than posts without hope. Conclusion: Building on previous work that determined social media users can respond to a celebrity’s physical health testimonial with positive, future-oriented emotions, this study established that the same response can exist when analysing a celebrity’s mental health testimonial.
Postinflammatory Medial Meatal Fibrosis: Histopathologic Features and Outcomes of Surgical Management
Authors: Mantsopoulos Konstantinos , Thimsen Vivian , Müller Sarina Katrin , Sievert Matti , Goncalves Miguel , Iro Heinrich , Agaimy Abbas , Hornung Joachim 
Published: April 2021

Objectives: The aims of our study were to investigate the clinical and audiometric outcome of the surgical treatment of postinflammatory medial meatal fibrosis (PIMMF) and to review the histopathologic changes in the specimens of the fibrotic plug, in order to try to shed light on the pathogenesis of the disease. Materials and Methods: The clinical records and the histopathologic specimens of all patients who underwent tympanomeatoplasty for PIMMF at the ENT Clinic of the University of Erlangen between 2006 and 2020 were evaluated retrospectively. Results: Thirty-four patients (41 primary surgical procedures) made up our study cohort. Of this, 28 cases were managed by means of meatoplasty and 13 cases with tympanomeatoplasty. The mean preoperative air–bone gap (ABG) was 27.8 dB (10-44 dB). Postoperative ABG was significantly improved compared to preoperative values at both short- and long-term follow-ups ( P < .001 for both). No significant difference was noted between short-term and long-term ABG ( P = .240). An ABG ≤20 dB was achieved in 65.8% of patients (short term) and 50% (long term). The overall rate of revision surgery for restenosis was 29.3% (12/41). Histopathologic reevaluation of the fibrotic plugs revealed a mosaic of patterns with frequent occurrence of secondary cholesteatoma-like lesions and keloid-like tissue changes. Lichenoid submucosal inflammation and increased ectopic ceruminous gland lobules were seen less frequently. Discussion: The moderate long-term outcome of surgical management and the identification of histologic changes with therapeutic implications might pave the way for alternative nonsurgical treatment options.
Stigma in Bipolar Affective Disorder: A Systematic Quantitative Literature Review of Indian Studies
Authors: Pal Arghya , Saxena Vrinda , Avinash Priyaranjan 
Published: April 2021

Background: Bipolar affective disorder (BPAD) is one of the most common severe mental illnesses that cause morbidity. Stigma can negatively influence the disease experience in patients with BPAD. Significant differences are observed in the attributes of stigma across the various sociocultural milieus. The current review was thus conducted to compile the evidence regarding the burden and correlates of various forms of stigma in BPAD in India. Methods: An exhaustive literature review was conducted in PubMed, MedIND, and Google Scholar to identify Indian studies conducted on stigma in BPAD. The broad themes in various forms of stigma were identified (qualitative analysis). Quantitative analysis of measures of stigma was done, calculating the effect size in BPAD and comparator groups (schizophrenia and anxiety disorders) using standardized mean difference. Results: Overall, 12 studies could be identified for qualitative analysis, and 5 were used for quantitative analysis. Overall, the current evidence points out that the stigma in BPAD is less than that in schizophrenia but more than that in anxiety disorders. Internalized stigma in BPAD is correlated with poor self-esteem, reduced community participation, and low quality of life. Caregivers of patients with BPAD also experience significant stigma. Conclusions: The review shows that stigma in BPAD is substantial. It also draws attention to the fact that the research regarding stigma in BPAD is lagging behind. This review also provides a platform to develop an intervention in the Indian scenario, where further research should be carried out.
Hemodynamic impact of molecular adsorbent recirculating system in refractory vasoplegic shock due to calcium channel blocker poisoning
Authors: Beyls Christophe , Malaquin Stéphanie , Huette Pierre , Mary Aurélien , Besserve Patricia , Roger Pierre-Alexandre , Bernasinski Michaël , Guilbart Mathieu , Abou-Arab Osama , Dupont Hervé , Mahjoub Yazine 
Published: April 2021

Objective: To report the hemodynamic effect of to the molecular adsorbent recirculating system (MARS™) therapy for patients in refractory vasoplegic shock due to calcium channel blocker (CCB) poisoning Methods: We report a retrospective cohort of patients who were hospitalized for CCB poisoning with refractory vasoplegic shock and treated by MARS therapy, at Amiens Hospital University, from January 2010 to December 2019. Improvement in hemodynamic was assessed by dynamic changes in mean arterial pressure (MAP) and norepinephrine levels over a 24-h period after MARS therapy. Cardiac function was assessed by transthoracic echocardiography. Results: MARS therapy was performed on seven patients for CCB poisoning. CCB poisoning included nicardipine ( n = 3, 43%) amlodipine ( n = 3, 43%), and verapamil ( n = 1, 14%). The median time to start MARS therapy was 24 [14–27] h after drug ingestion and 6 [2–9] h after ICU admission. Cardiac output was preserved for all patients. MAP values improved from 56 [43–58] to 65 [61–78] 16 mmHg ( p = 0.005). Norepinephrine dose significantly decreased from 3.2 [0.8–10] µg/kg/min to 1.2 [0.1–1.9] µg/kg/min ( p = 0.008) and lactate level decreased from 3.2 [2.4–3.4] mmol/l−1 to 1.6 [0.9–2.2] mmol/l−1 ( p = 0.008). The median length of ICU stay was 4 (2–7) days and hospital stay was 4 (4–16) days. No complication related to the MARS therapy were reported. No patient died and all were discharged from the hospital. Conclusion: We reported the largest case-series of MARS therapy for refractory vasoplegic shock due to CCB poisoning. We observed that MARS therapy was associated with an improvement of hemodynamic parameters.
Impact of a Rapid Blood Culture Diagnostic Panel on Time to Optimal Antimicrobial Therapy at a Veterans Affairs Medical Center
Authors: Chiasson Jordan M. , Smith Winter J. , Jodlowski Tomasz Z. , Kouma Marcus A. , Cutrell James B. 
Published: April 2021

Purpose: Utilization of rapid diagnostic testing alongside intensive antimicrobial stewardship interventions improves patient outcomes. We sought to determine the clinical impact of a rapid blood culture identification (BCID) panel in an established Antimicrobial Stewardship Program (ASP) with limited personnel resources. Methods: A single center retrospective pre- and post-intervention cohort study was performed following the implementation of a BCID panel on patients admitted with at least 1 positive blood culture during the study period. The primary outcome was time to optimal therapy from blood culture collection. Secondary outcomes included days of therapy (DOT), length of stay, and 30-day mortality and readmission rates. Results: 277 patients were screened with 180 patients included, with 82 patients in the pre-BCID and 98 in the post-BCID arms. Median time to optimal therapy was 73.8 hours (IQR; 1.1-79.6) in the pre-BCID arm and 34.7 hours (IQR; 10.9-71.6) in the post-BCID arm (p ≤ 0.001). Median DOT for vancomycin was 4 and 3 days (p ≤ 0.001), and for piperacillin-tazobactam was 3.5 and 2 days (p ≤ 0.007), for the pre-BCID and post-BCID arms, respectively. Median length of hospitalization was decreased from 11 to 9 days (p = 0.031). No significant change in 30-day readmission rate was noted, with a trend toward lower mortality (12% vs 5%; p = 0.086). Conclusion: Introduction of BCID into the daily workflow resulted in a significant reduction in time to optimal therapy for bloodstream infections and DOT for select broad-spectrum antibiotics, highlighting the potential benefits of rapid diagnostics even in settings with limited personnel resources.
Transitioning From Consult-Based to Automatic Pharmacy-Driven Vancomycin Management: Results From a Single, Primary Care Center
Authors: Cole Jennifer L. , O’Glee Russell , Clark Michael , White Meredith 
Published: April 2021

Objective: The transition to area under the curve (AUC) vancomycin monitoring requires substantial updates in pharmacy policies and procedures. The study facility was tasked with transitioning from a consult-based collaborative agreement to an automatic pharmacist management policy on all intravenous (IV) vancomycin orders. The purpose of this quality assessment (QA) study was to evaluate the effectiveness of this transition. Methods: The primary outcome was the proportion of patients with pharmacist assessment of pharmacokinetics and dosing with documentation in IV vancomycin treated patients from January-June 2020. Secondary outcomes included the proportion of AUC24 levels within therapeutic range, the incidence of acute kidney injury (AKI) and treatment failures in patients treated ≥72 hours compared to a historical, trough-based cohort. Results: There were 88 patients in the QA analysis with 100% having a pharmacist assessment with documentation. There were 34 patients treated ≥72 hours in the AUC group, 36 in the trough-based group. AUC24 fell within desired range in 45% of monitored patients. Rates of AKI (9% vs 11%, p = 0.75) and treatment failures were similar (3% vs 0%, p = 0.3). Conclusion: The transition from consult-based to an automatic pharmacy management agreement was successful with similar safety and efficacy compared to a historical trough-based cohort.
Cultural Beliefs on the Causes of Cleft Lip and/or Palate in Malaysia: A Multicenter Study
Authors: Hussin Ilyasak , Halim Ahmad Sukari , Ibrahim Mohd Ismail , Markos Zara Octavia , Effendie Eryana Susantri A. Bakar 
Published: April 2021

Objective: To identify the cultural beliefs about the causes of cleft among parents of patients with nonsyndromic cleft lip and/or palate in a multiethnic society in Malaysia and the difficulties encountered in receiving cleft treatment. Design: A descriptive cross-sectional multicenter study based on a study questionnaire was conducted of parents of patients with cleft lip and/or palate. Setting: Three centers providing cleft care from different regions in Malaysia: the national capital of Kuala Lumpur, east coast of peninsular Malaysia, and East Malaysia on the island of Borneo. Participants: Parents/primary caregivers of patients with cleft lip and/or palate. Results: There were 295 respondents from different ethnic groups: Malays (58.3%), indigenous Sabah (30.5%), Chinese (7.1%), Indian (2.4%), and indigenous Peninsular Malaysia and Sarawak (1.7%). Malay participants reported that attributing causes of cleft to God’s will, superstitious beliefs that the child’s father went fishing when the mother was pregnant or inheritance. Sabahans parents reported that clefts are caused by maternal antenatal trauma, fruit picking, or carpentry. The Chinese attribute clefts to cleaning house drains, sewing, or using scissors. Cultural background was reported by 98.3% of participants to pose no barrier in cleft treatment. Those from lower socioeconomic and educational backgrounds were more likely to encounter difficulties while receiving treatment, which included financial constraints and transportation barriers. Conclusion: There is a wide range of cultural beliefs in the multiethnic society of Malaysia. These beliefs do not prevent treatment for children with cleft. However, they face challenges while receiving cleft treatment, particularly financial constraints and transportation barriers. Such barriers are more likely experienced by parents from lower income and lower education backgrounds.
Low-frequency sound absorption of a tunable multilayer composite structure
Authors: Shao Hanbo , He Jincheng , Zhu Jiang , Chen Guoping , He Huan 
Published: April 2021

Our work investigates a tunable multilayer composite structure for applications in the area of low-frequency absorption. This acoustic device is comprised of three layers, Helmholtz cavity layer, microperforated panel layer, and the porous material layer. For the simulation and experiment in our research, the absorber can fulfill a twofold requirement: the acoustic absorption coefficient can reach near 0.8 in very low frequency (400 Hz) and the range of frequency is very wide (400–3000 Hz). In all its absorption frequency, the average of the acoustic absorption coefficient is over 0.9. Besides, the absorption coefficient can be tunable by the scalable cavity. The multilayer composite structure in our article solved the disadvantages in single material. For example, small absorption coefficient in low frequency in traditional material such as microperforated panel and porous material and narrow reduction frequency range in acoustic metamaterial such as Helmholtz cavity. The design of the composite structure in our article can have more wide application than single material. It can also give us a novel idea to produce new acoustic devices.
Comparison of preserved bimatoprost 0.01% with preservative-free tafluprost: A randomised, investigator-masked, 3-month crossover, multicentre trial, SPORT II
Authors: Lemmens Sophie , Rossetti Luca , Oddone Francesco , Sunaric-Mégevand Gordana , Hommer Anton , Vandewalle Evelien , Francesca Cordeiro Maria , McNaught Andrew , Montesano Giovanni , Stalmans Ingeborg 
Published: April 2021

Importance: This study compares the efficacy and tolerability of a preservative-free prostaglandin analogue (tafluprost 15 mg/ml) to a prostaglandin analogue that uses 0.02% of benzalkonium chloride (bimatoprost 0.1 mg/ml). Background: Different prostaglandin analogues have been commercially approved, with differences in tolerability. Design: Prospective, randomised, investigator-masked, 3-month crossover, multicentre trial. Participants: Sixty-four patients with ocular hypertension or open-angle glaucoma were randomised to two groups, after a 4-week washout period from their current topical drop regimen. Methods: Participants were randomised to tafluprost (Group 1; n = 33) or bimatoprost (Group 2; n = 31). At month 3, each group switched to the opposite treatment. IOP was evaluated at multiple timepoints. Main outcome measures: The primary outcome was difference in mean IOP between the two groups at the final visit. Secondary outcomes included change from baseline IOP at month 3 and month 6, difference in mean IOP at month 3 and difference in IOP at all timepoints. Safety outcomes included best-corrected visual acuity (BCVA), adverse events, ocular tolerability, optic nerve assessment and slit lamp biomicroscopy. Results: Both medications significantly lowered IOP at month 6 compared to baseline: 5.4 mmHg (27%) for tafluprost and 6.8 mmHg (33%) for bimatoprost ( p < 0.0001). No significant differences in any of the safety measures (including conjunctival hypearemia) were detected. Conclusions and relevance: Bimatoprost produced a statistically significant greater IOP reduction compared to tafluprost with minimal to no difference in side effects. This should be borne in mind when weighing up the pros and cons of preserved versus preservative-free prostaglandin analogue therapy. ClinicalTrials.gov Identifier NCT02471105.