bluuebunny/crossref_metadata_2025_split huggingface dataset:
Legal authorized representative experience with smartphone-based electronic informed consent in an acute stroke trial
Authors: Haussen Diogo C , Craft Leah , Doppelheuer Shannon , Rodrigues Gabriel Martins , Al-Bayati Alhamza R , Ravindran Krishnan , Schultz Meagan , Sutherly Loretta , Schindler Kiva M , Frankel Michael R , Nogueira Raul G 
Published: September 2019

BackgroundThe pilot use of a smartphone platform for electronic informed consent (e-Consent) in large vessel occlusion acute stroke (LVOS) trials has recently been reported. The degree of satisfaction from Legal Authorized Representatives (LARs) with regard to this process remains to be established.MethodsA single-center study evaluating the experience of LARs with the use of e-Consent in a LVOS randomized trial of an investigational drug administered within 12 hours of last known normal was carried out. A structured survey was used to evaluate the experience of the LARs with the e-consenting process.ResultsFrom February to November 2018, 60 consecutive patients were e-Consented. Of these, 53 LARs completed the survey. The median (IQR) age of the patients was 63 (53–70) years, baseline/discharge National Institutes of Health Stroke Scale score was 17 (12–20)/3(1–12), and 45% were independent at discharge. The survey was applied in person in 43% of cases and via telephone in 57%. Median LAR age was 48 (39–59) years, 64% were female, and a multi-ethnic composition was observed. Forty percent of LARs had less than tertiary level of education (high-school or less). Regarding the e-Consent, 98% of LARs reported to be ‘clear’ and 83% felt ‘very comfortable’ in signing. The overall experience was ‘excellent/good’ in 91%. Despite the positive general impression regarding the use of e-Consent, 12 LARs (22%) would have preferred paper consent. Multivariable regression indicated that lower educational status (tertiary education or less: OR 5.09, 95% CI 1.02 to 25.48; p=0.04) and lower baseline ASPECTS score (OR 0.63, 95% CI 0.41 to 0.96; p=0.03) were independently associated with preference for paper consent.Conclusionse-Consent was overall very well perceived by LARs in a randomized clinical trial of LVOS. A minority of proxies, who were more commonly less formally educated, would have preferred paper consenting.
Paratuberculosis in dairy goat flocks from southern Spain: risk factors associated with seroprevalence
Authors: Barrero‐Domínguez Belén , Luque Inmaculada , Huerta Belen , Gomez‐Laguna Jaime , Galán‐Relaño Ángela , Gómez‐Gascón Lidia , Sánchez Manuel , Astorga Rafael Jesus 
Published: September 2019

BackgroundParatuberculosis (PTB) is a chronic, enteric wasting disease of ruminants caused by Mycobacterium avium subspecies paratuberculosis (MAP), with a worldwide distribution. Andalusia, located in southern Spain, is one of the European regions with the highest goat census and the highest milk production; however, current data on the prevalence of MAP in this species are not available.MethodsA cross‐sectional study was performed to determine the seroprevalence and risk factors associated with PTB in dairy goat flocks from southern Spain. A total of 3312 serum samples were collected from 48 flocks located in three different geographical areas. Health and productive parameters were surveyed during the visit to the herds.ResultsA total of 511 goats were seropositive, with overall true seroprevalence of 22.54 per cent (95 per cent confidence interval (CI95) 21.12–23.97). Of the goat herds, 87.50 per cent (CI9578.14–96.98) were seropositive. The intraherd seroprevalence was 25.43±31.71, distributed as follows: 22 flocks with a seroprevalence under 10 per cent; 18 flocks between 10 per cent and 50 per cent; and eight flocks with a frequency over 50 per cent. Multivariate logistic regression showed significant association between PTB seropositivity and the following variables: intensive production system, lack of management by batches, inappropriate ventilation and seropositivity to c aprine a rthritis e ncephalitis v irus ( CAEV ).ConclusionsThe results indicate a widespread PTB infection in goat herds in southern Spain. Thus, control programmes must include management and sanitary measures to reduce the prevalence. Further experimental studies are necessary to determine the influence of CAEV‐PTB coinfection on immune status.
Influence of sex gap on muscle strength and functional mobility in patients with cystic fibrosis
Authors: Martínez-García María del M. , Rodríguez-Juan Juan J. , Ruiz-Cárdenas Juan D. 
Published: September 2019

The objectives of this study were to determine whether there were differences in handgrip strength and functional mobility between patients with cystic fibrosis (CF) and healthy controls with regard to sex and to ascertain whether these differences were related to lung function. Thirty-eight patients with CF (21 women) and 38 healthy controls aged 18–65 years were included. Muscle weakness and functional mobility were assessed through handgrip strength; walking speed; and time, velocity, and power derived from a single sit-to-stand (STS) test. Patients with CF showed differences for STS variables and walking speed but not for handgrip strength, compared with healthy controls. Considering sex differences, female patients showed differences for all variables analyzed while males with CF only exhibited differences for STS variables, compared with healthy controls. Females with CF showed moderate relationship between muscle weakness, functional mobility, and lung function (|r| = 0.45–0.49; p ≤ 0.05) whereas no relationships were observed for males with CF. The influence of chronic infection with Pseudomonas aeruginosa and pancreatic insufficiency on muscle weakness and functional mobility was similar in both sexes. Differences in muscle strength and functional mobility were predominantly observed in females with CF. These results suggest an important effect of sex gap on muscle weakness and functional mobility in patients with CF. Novelty The influence of sex gap on muscle weakness in CF has been shown. Muscle weakness was predominantly observed in females with CF.
Heritage stones in India
Authors: Sharma Vinod K. 
Published: September 2019

Abstract
India has a great variety of natural stones that have been extensively used as dimension, ornamental and sculptural stone for numerous temples and monuments over many centuries. These temples and monuments, now heritage sites, have a major role in showcasing India's natural stone resources that occur in diverse geological formations of different geological systems across the Indian subcontinent. The formations contain a variety of stone, with colours and textures produced by varied geological processes thus providing a storehouse of diverse stone resources. This paper outlines four potential Global Heritage Stone Provinces where natural stones have been used in heritage monuments: the North and Northwestern Province, the Central and Western Peninsular Province, the Southern Peninsular Province and the Eastern and Northeastern Province. The geotechnical and aesthetic characteristics of the stones, and their response to weathering are discussed.
Physical Activity, Sedentary Leisure Time, Circulating Metabolic Markers, and Risk of Major Vascular Diseases
Authors: Pang Yuanjie , Kartsonaki Christiana , Du Huaidong , Millwood Iona Y. , Guo Yu , Chen Yiping , Bian Zheng , Yang Ling , Walters Robin , Bragg Fiona , Lv Jun , Yu Canqing , Chen Junshi , Peto Richard , Clarke Robert , Collins Rory , Bennett Derrick A. , Li Liming , Holmes Michael V. , Chen Zhengming 
Published: September 2019

Background:
Physical inactivity and sedentary behavior are associated with higher risk of cardiovascular disease (CVD). Little is known about the relevance of circulating metabolites for these associations.

Methods:
A nested case-control study within the prospective China Kadoorie Biobank included 3195 incident CVD cases (2057 occlusive CVD and 1138 intracerebral hemorrhage) and 1465 controls aged 30 to 79 years without prior CVD or statin use at baseline. Nuclear magnetic resonance spectroscopy was used to measure 225 metabolic markers and derived traits in baseline plasma samples. Linear regression was used to relate self-reported physical activity and sedentary leisure time to biomarkers, adjusting for potential confounders. These were contrasted with associations of biomarkers with occlusive CVD risk.

Results:
Physical activity and sedentary leisure time were associated with >100 metabolic markers, with patterns of associations generally mirroring each other. Physical activity was inversely associated with very low and low-density and positively with large and very large HDL (high-density lipoprotein) particle concentrations. Physical activity was also inversely associated with alanine, glucose, lactate, acetoacetate, and the inflammatory marker glycoprotein acetyls. In general, associations of physical activity and sedentary leisure time with specific metabolic markers were directionally consistent with the associations of these metabolic markers with occlusive CVD risk. Overall, metabolic markers potentially explained ≈70% of the protective associations of physical activity and ≈50% of the positive associations of sedentary leisure time with occlusive CVD.

Conclusions:
Among Chinese adults, physical activity and sedentary behavior have opposing associations with a diverse range of circulating metabolites, which may partially explain their associations with CVD risk.
Aortic Arch Atherosclerosis in Patients With Embolic Stroke of Undetermined Source
Authors: Ntaios George , Pearce Lesly A. , Meseguer Elena , Endres Matthias , Amarenco Pierre , Ozturk Serefnur , Lang Wilfried , Bornstein Natan M. , Molina Carlos A. , Pagola Jorge , Mundl Hardi , Berkowitz Scott D. , Liu Yan Yun , Sen Souvik , Connolly Stuart J. , Hart Robert G. ,   on behalf of the NAVIGATE ESUS Investigators
Published: September 2019

Background and Purpose—
Aortic arch atherosclerosis (AAA) is a possible source of embolism in patients with embolic stroke of undetermined source. Previous studies reported high rates of embolic events in patients with AAA, especially those with high-risk AAA. This exploratory analysis of NAVIGATE ESUS (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source) focused on patients with AAA and assessed their characteristics, stroke recurrence rates, and response to treatment.

Methods—
The detection of AAA and the assessment of its features were based on transesophageal echocardiography that was done in 19% of participants. AAA plaques were considered to have complex features when reported as complex or ulcerated or were ≥4 mm in thickness or had a mobile thrombus present.

Results—

Among 1382 participants who had transesophageal echocardiography, 397 (29%) had AAA and 112 (8%) had complex AAA. Mean (SD) age (63 [10] versus 67 [9] versus 69 [9];
P
<0.001), prevalence of diabetes mellitus (19% versus 26%, versus 32%;
P
=0.002), and aortic valvulopathy (10 versus 20 versus 20;
P
<0.001) increased across no versus noncomplex versus complex AAA, respectively. In multivariable analyses, increasing age, diabetes mellitus, aortic valvulopathy, statin use before randomization, chronic infarcts on imaging, and region were independently associated with any AAA versus no AAA and also with complex AAA versus no AAA. Multiterritorial qualifying infarcts rather than single-territory infarcts were observed in 21% with complex AAA versus 17% noncomplex versus 13% no AAA (
P
=0.07). Annualized rates of ischemic stroke recurrence were 7.2% versus 4.2% versus 5.6% for complex versus noncomplex versus no AAA, respectively. While prevalence of complex AAA increased with increasing risk score, after adjusting for risk score, we did not observe increased risk of recurrent stroke for patients with complex AAA (hazard ratio, 1.1; 95% CI, 0.53–2.4), although the number of outcomes was limited. In patients with complex AAA, 4 strokes occurred among rivaroxaban-assigned patients and 4 strokes among aspirin-assigned patients.

Conclusions—
Complex AAA is prevalent in embolic stroke of undetermined source patients and is associated with atherosclerotic burden. Whether complex AAA independently increases recurrent stroke risk and whether a non-vitamin-K oral anticoagulant as compared with aspirin may be effective for reducing recurrent stroke requires additional study.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02313909.
Neighborhood Socioeconomic Status and Trajectories of Physical Health-Related Quality of Life Among Stroke Survivors
Authors: Twardzik Erica , Clarke Philippa , Elliott Michael R. , Haley William E. , Judd Suzanne , Colabianchi Natalie 
Published: September 2019

Background and Purpose—
Stroke is the leading cause of serious, long-term disability in the United States, and the number of stroke survivors is projected to rise. Physical functioning status may be compromised in survivors living in low socioeconomic status environments in comparison to higher socioeconomic status environments. Higher socioeconomic status environments may include benefits in the built environment such as sidewalks, accessible transit, or low traffic volume. Investigation is needed to understand the effects of the socioenvironmental context on trajectories of stroke survivors’ physical health-related quality of life (PH-QOL) over time.

Methods—
Participants from the REGARDS (REasons for Geographic and Racial Differences in Stroke) study enrolled in the ancillary Caring for Adults Recovering from the Effects of Stroke project completed the SF-12 around 6 to 12, 18, 27, and 36 months poststroke. Measures of area-level income, wealth, education, and employment at the census tract level were combined to represent participants’ neighborhood socioeconomic status. Linear mixed models were used to predict trajectories of PH-QOL over time, controlling for individual characteristics.

Results—
The average trajectory of PH-QOL was flat over time. However, women and younger stroke survivors had better trajectories over time than men and older stroke survivors. Higher neighborhood socioeconomic status was significantly associated with better PH-QOL across all time points (β=1.73; 95% CI, 0.17–3.30), after controlling for demographic variables and severity of stroke.

Conclusions—
Our findings demonstrate that neighborhood socioeconomic status, sex, and age are associated with the poststroke recovery process. The results of this study suggest the importance of evaluating the environment surrounding stroke survivors when they return to their home communities. Future research should identify specific features of the environment within different socioeconomic status neighborhoods to better understand how they contribute to PH-QOL among stroke survivors.
Serum Anti-NMDA (N-Methyl-D-Aspartate)-Receptor Antibodies and Long-Term Clinical Outcome After Stroke (PROSCIS-B)
Authors: Sperber Pia S. , Siegerink Bob , Huo Shufan , Rohmann Jessica L. , Piper Sophie K. , Prüss Harald , Heuschmann Peter U. , Endres Matthias , Liman Thomas G. 
Published: September 2019

Background and Purpose—
NMDAR1-abs (anti-N-Methyl-D-Aspartate receptor GluN1 antibodies), predominantly known in the context of autoimmune encephalitis, have been observed in serum of healthy individuals. A previous study found smaller stroke magnetic resonance imaging lesion growth in seropositive patients, suggesting a neuroprotective effect of these antibodies. The impact of NMDAR1-abs seropositivity on long-term functional outcome and recurrent vascular events and death after first-ever stroke remains unclear.

Methods—
Data from the Prospective Cohort with Incident Stroke—Berlin were used. NMDAR1-abs (ie, IgM, IgA, and IgG) were measured in serum within 7 days after first stroke. Outcomes of interest included modified Rankin Scale at one year and the time-to-event of a combined end point (recurrent stroke, myocardial infarction, and all-cause mortality) within 3 years. We calculated odds ratios from adjusted partial proportional odds models and subsequently compared outcome of patients with low titers (1:10; 1:32; and 1:100), and high titers (1:320; 1:1000) to seronegative patients. Furthermore, we estimated hazard ratios for a secondary vascular event or death in NMDAR1-abs seropositive compared to seronegative patients in models adjusted for confounders.

Results—
The analyses included 583 patients with antibody measurements (39% female, median National Institutes of Health Stroke Scale:2, IQR:1-4), and NMDAR1-abs were observed in 76 (13%) patients. NMDAR1-abs seroprevalence was not associated with functional outcome (odds ratio=1.27; 95% CI, 0.77–2.09); sub-group analyses, however, showed worse outcome in patients with high titers (odds ratio=3.47; 95% CI, 1.54–7.80). Seropositive patients had an increased risk for a secondary vascular event or death (hazard ratios =1.83, 95% CI, 1.10–3.05).

Conclusions—
In our study, NMDAR1-abs seropositivity was not associated with functional outcome at one year after stroke, however, high titers (≥1:320) were associated with poor functional outcome. Furthermore, NMDAR1-abs seropositivity was associated with increased cardiovascular risk within 3 years after first stroke, independently from other risk factors.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01363856.
Cloud and Weather Symbols in the Historic Language of Weather Map Plotters
Authors: Houze Robert A. , Houze Rebecca 
Published: September 2019

AbstractWeather mapping began in the nineteenth century when telegraphs began sending simultaneous observations of conditions at the surface of Earth to weather stations around the world. Indicating the complexity of the clouds and weather seen at a site needed a common naming system and simple symbols that were independent of language, since telegraph signals crossed international borders. The first symbols representing clouds were abstracted and stylized versions of their artistic representations in naturalistic drawings and paintings. By the end of the nineteenth century, however, photography began to replace hand-drawn illustrations. Before the advent of color film, black and white photographs were sometimes even reproduced in colored inks using new mechanical printing processes. Nineteenth-century meteorologists developed symbols for various cloud types in the form of simple lines and curves suggestive of the pictures. In contrast, weather symbols (for rain, snow, fog, hail, etc.) were drawn largely from a lexicon of nonalphabetic written symbols, such as punctuation marks. Skilled map plotters used these simple symbols, suggestive of complex weather and clouds, to transfer telegraph and Teletype codes to visually meaningful hand-produced maps. The craft of manual weather map plotting reached an apex in the 1940s–60s. With advances in digital and satellite technology and automation of surface weather observations, the symbols used in traditional weather mapping have largely disappeared from daily use.
ENSO Modulation of the QBO: Results from MIROC Models with and without Nonorographic Gravity Wave Parameterization
Authors: Kawatani Yoshio , Hamilton Kevin , Sato Kaoru , Dunkerton Timothy J. , Watanabe Shingo , Kikuchi Kazuyoshi 
Published: September 2019

AbstractObservational studies have shown that, on average, the quasi-biennial oscillation (QBO) exhibits a faster phase progression and shorter period during El Niño than during La Niña. Here, the possible mechanism of QBO modulation associated with ENSO is investigated using the MIROC-AGCM with T106 (~1.125°) horizontal resolution. The MIROC-AGCM simulates QBO-like oscillations without any nonorographic gravity wave parameterizations. A 100-yr integration was conducted during which annually repeating sea surface temperatures based on the composite observed El Niño conditions were imposed. A similar 100-yr La Niña integration was also conducted. The MIROC-AGCM simulates realistic differences between El Niño and La Niña, notably shorter QBO periods, a weaker Walker circulation, and more equatorial precipitation during El Niño than during La Niña. Near the equator, vertical wave fluxes of zonal momentum in the uppermost troposphere are larger and the stratospheric QBO forcing due to interaction of the mean flow with resolved gravity waves (particularly for zonal wavenumber ≥43) is much larger during El Niño. The tropical upwelling associated with the Brewer–Dobson circulation is also stronger in the El Niño simulation. The effects of the enhanced tropical upwelling during El Niño are evidently overcome by enhanced wave driving, resulting in the shorter QBO period. The integrations were repeated with another model version (MIROC-ECM with T42 horizontal resolution) that employs a parameterization of nonorographic gravity waves in order to simulate a QBO. In the MIROC-ECM the average QBO periods are nearly identical in the El Niño and La Niña simulations.
Using Observed Signals from the Arctic Stratosphere and Indian Ocean to Predict April–May Precipitation in Central China
Authors: Xie Fei , Ma Xuan , Li Jianping , Tian Wenshou , Ruan Chengqing , Sun Cheng 
Published: September 2019

AbstractA linear regression model is constructed to predict the April–May precipitation in central China (PCC) with a lead time of 1–2 months. This model not only reproduces the historical April–May PCC from 1985 to 2006 but also demonstrates strong robustness and reliability during the independent test period of 2007–16. Two preceding factors are selected to build the model, the February–March Arctic stratospheric ozone (ASO) and Indian Ocean sea surface temperature (IOSST), indicating a synergistic impact of Arctic and tropical signals on the midlatitude climate. A possible mechanism of ASO changes affecting Chinese precipitation is that the stratospheric circulation anomalies related to ASO changes may downward influence circulation over North Pacific, and then extend westward to influence East Asia, leading to changes in Chinese precipitation. Anomalies of the other predictor, IOSST, are associated with a baroclinic structure over central China. For example, warm IOSST causes anomalous convection over central China and affects the warm and humid airstream flowing from the Pacific to China. These processes related to the two predictors result in the April–May PCC anomalies. Sensitivity experiments and a transient experiment covering a longer period than the observations/reanalysis support the results from our statistical analysis based on observations. It implies that this statistical model could be applied to the output of seasonal forecasts from observations and improve the forecasting ability of April–May PCC in the future.