bluuebunny/crossref_metadata_2025_split huggingface dataset:
HbA1c (Glycated Hemoglobin) Levels and Clinical Outcome Post-Mechanical Thrombectomy in Patients With Large Vessel Occlusion
Authors: Choi Kang-Ho , Kim Ja-Hae , Kang Kyung-Wook , Kim Joon-Tae , Choi Seong-Min , Lee Seung-Han , Park Man-Seok , Kim Byeong-Chae , Kim Myeong-Kyu , Cho Ki-Hyun 
Published: December 2018

Background and Purpose—
We analyzed the relationship between HbA1c (glycated hemoglobin) levels and clinical outcomes in patients with large vessel occlusion treated with mechanical thrombectomy (MT).

Methods—
A total of 534 patients with acute ischemic stroke (AIS) treated with MT were enrolled in this prospective cohort study. The primary outcome measured was the modified Rankin Scale score at 3 months, according to HbA1c level. High HbA1c levels were defined as a plasma level of HbA1c >6.5%. Favorable outcomes were defined as functional independence, with modified Rankin Scale scores of 0 to 2. Secondary functional outcomes included mortality, early clinical outcomes, and intracranial hemorrhage.

Results—

The number of patients with a favorable outcome was significantly lower in patients with HbA1c >6.5% than in those with HbA1c ≤6.5% (28.8% versus 42.1%;
P
=0.006). In multivariate analysis, high HbA1c levels (especially >7.0% HbA1c) were significantly associated with poor functional outcomes 3 months after AIS in patients with large vessel occlusion treated with MT. High HbA1c was also significantly associated with increased mortality and worse early clinical outcomes after AIS in patients treated with MT. Subgroup analyses showed that HbA1c >6.5% was associated with significantly lower odds of functional independence at 3 months after AIS, when comparing the recanalized group with nonrecanalized patients.

Conclusions—
These results suggest that high HbA1c level is an independent predictor of a poor outcome at 3 months after AIS in patients with large vessel occlusion treated with MT, particularly in those with recanalization, and may augment the risk of mortality and early clinical worsening after AIS.
Decreasing Fear of Falling in Chronic Stroke Survivors Through Cognitive Behavior Therapy and Task-Oriented Training
Authors: Liu Tai-Wa , Ng Gabriel Y.F. , Chung Raymond C.K. , Ng Shamay S.M. 
Published: December 2018

Background and Purpose—
Research has shown that balance training is effective for reducing the fear of falling in individuals with a history of stroke. In this study, we evaluated (1) whether cognitive behavior therapy could augment the beneficial effects of task-oriented balance training (TOBT) in reducing the fear of falling in chronic stroke survivors and (2) whether it could, in turn, reduce fear-avoidance behavior and improve related health outcomes.

Methods—
Eighty-nine cognitively intact subjects with mildly impaired balance ability were randomized into the following 2 groups that underwent 90-minutes interventions 2 days per week for 8 weeks: (1) cognitive behavior therapy + TOBT or (2) general health education + TOBT (control). The primary outcome was the fear of falling, and the secondary outcomes were fear-avoidance behavior, balance, fall risk, independent daily living, community integration, and health-related quality of life. The outcomes were assessed at baseline, after 4 and 8 weeks of intervention, and 3 and 12 months after completing the intervention.

Results—
Eighty-two subjects completed the intervention and follow-up assessments. From postintervention to 12 months after completing the intervention, the cognitive behavior therapy + TOBT participants reported greater reduction in the fear of falling and fear-avoidance behavior and greater improvements in balance and independent daily living than the general health education + TOBT participants.

Conclusions—
Cognitive behavior therapy should be considered as an adjuvant therapy to standard physiotherapy for cognitively intact individuals with a history of stroke.

Clinical Trial Registration—

URL:
https://clinicaltrials.gov
. Unique identifier: NCT02937532.
Less Than Ideal
Authors: Lin Amy M. , Lin Michelle P. , Markovic Daniela , Ovbiagele Bruce , Sanossian Nerses , Towfighi Amytis 
Published: December 2018

Background and Purpose—
The American Heart Association’s Life’s Simple 7 (LS7) defines ideal cardiovascular health by 7 metrics: not smoking, regular physical activity, normal body mass index, blood pressure, plasma glucose, and total cholesterol levels, and a healthy diet. We assessed prevalence and predictors of ideal LS7 among US stroke survivors.

Methods—
Among 67 514 participants in the National Health and Nutrition Examination Surveys from 1988 to 1994 and 1999 to 2014, 1597 adults (≥18 years) had self-reported history of stroke. LS7 metrics were categorized as poor, intermediate, and ideal; ideal LS7 scores were calculated (1 point for each ideal metric met). Trends in poor, intermediate, and ideal cardiovascular health were assessed. Odds of low (0–1) versus high (≥4) ideal LS7 scores were assessed according to sex, race, poverty income ratio, and education level, before and after adjusting for covariates.

Results—

Only 1 participant met all ideal LS7 metrics. The proportion with low LS7 score increased from 17.9% in 1988 to 1994 to 35.4% in 2011 to 2014 (
P
<0.001). Over that time frame, prevalence of poor blood pressure (≥140/90 mm Hg) and poor cholesterol (≥240 mg/dL) decreased (45.2%–26.5% and 37.2%–10.3%), whereas prevalence of poor body mass index (≥30 kg/m
2
), poor diet (healthy eating index score <50), and poor physical activity (0 minutes moderate/vigorous activity per week) increased (26.9%–39.0%; 14.2%–50.6%; 44.6%–70.9%; all
P
<0.05). After adjustment, black race (odds ratio, 2.29; 95% CI, 1.17–4.48), poverty income ratio ≤200% (odds ratio, 2.20, 95% CI, 1.11–4.36), and ≤12th grade education (odds ratio, 4.50; 95% CI, 2.27–8.92) were associated with low ideal LS7 scores.

Conclusions—
Over the past 3 decades, blood pressure and cholesterol control among stroke survivors improved, but rates of obesity, poor diet, and physical inactivity increased. Stroke survivors who are black, poor, or less educated are less likely to have ideal cardiovascular health.
Long-Term Survival and Function After Stroke
Authors: Sennfält Stefan , Norrving Bo , Petersson Jesper , Ullberg Teresa 
Published: December 2018

Background and Purpose—
Longitudinal long-term prognostic data after stroke based on large cohorts are sparse. We report recent survival and functional outcome data on ischemic stroke (IS) and intracerebral hemorrhage (ICH) for up to 5 years poststroke from the Swedish Stroke Register (Riksstroke).

Methods—
Beyond Riksstroke’s regular follow-up surveys at 3 and 12 months, additional surveys were conducted in 2016 on 2 one-year cohorts with stroke 3 and 5 years earlier. Functional dependency was defined as modified Rankin Scale ≥3. Mortality data of the original cohorts were obtained from the Swedish Causes of Death Register. Multiple imputation was used to estimate functional status in nonresponders.

Results—

The study included 22 929 patients, 87.5% with IS and 12.5% with ICH. Loss to follow-up in the 4 surveys was 12.8% to 21.2%. Thirty-day mortality was higher for ICH than for IS (30.7% versus 11.1%;
P
<0.01), whereas for 30-day survivors, 5-year mortality did not differ significantly (
P
=0.858). Functional outcome was less favorable for ICH at all follow-up points. At 5 years, poor outcome (death or dependency) was 79% in ICH and 70.6% in IS (including imputed data;
P
<0.01). Favorable outcome was less common with increasing age and in patients with prestroke functional dependency.

Conclusions—
Despite advances in stroke care, long-term prognosis remains a cause for concern. At 5 years after stroke over 2 in 3 patients with IS, and over 3 in 4 patients with ICH, were dead or dependent. We present robust long-term prognostic data to serve as a reference for further development of healthcare and research in stroke.
Impact of Microbleeds on Outcome Following Recanalization in Patients With Acute Ischemic Stroke
Authors: Choi Kang-Ho , Kim Ja-Hae , Kang Kyung-Wook , Kim Joon-Tae , Choi Seong-Min , Lee Seung-Han , Park Man-Seok , Kim Byeong-Chae , Kim Myeong-Kyu , Cho Ki-Hyun 
Published: December 2018

Background and Purpose—
We analyzed the association between cerebral microbleeds (CMBs) and clinical outcome in acute ischemic stroke patients and especially in a subgroup of patients with successful recanalization.

Methods—
A total of 1532 acute ischemic stroke patients treated with intravenous thrombolysis or mechanical thrombectomy were enrolled in this prospective cohort study. The primary outcome was measured using the modified Rankin Scale at 3 months, according to the CMB status based on magnetic resonance imaging at admission. Favorable outcome was defined as functional independence with modified Rankin Scale scores of 0 to 2. Secondary outcomes included the occurrence of symptomatic intracranial hemorrhage.

Results—

There was no statistically significant association between the presence of CMB and favorable outcome at 3 months when considering all patients (44.3% versus 37.6%;
P
=0.121). In patients with recanalization, the number of patients with favorable outcomes was significantly higher in the CMB-negative than in the CMB-positive group (57.0% versus 36.0%;
P
<0.001). In the final multivariate analysis, the presence of CMB, and in particular high CMB burden (≥5), and lobar location, were significantly associated with less favorable 3-month outcomes (odds ratio=0.57; 95% CI, 0.33−0.97;
P
=0.038) and symptomatic intracranial hemorrhage (odds ratio=3.21; 95% CI, 1.37−7.49;
P
=0.007) in patients with recanalization. In the analysis of subgroups, a statistically significant interaction was found between CMB presence and recanalization in predicting functional outcomes at 3 months.

Conclusions—
These results indicate that the presence of CMBs, and especially high burden and lobar location, are independent predictors of poor 3-month clinical outcomes and may increase symptomatic intracranial hemorrhage risk in acute ischemic stroke patients with recanalization. Our findings suggest that CMBs lead to more unfavorable effects in patients with recanalization after large vessel occlusion than in those without recanalization.
Anatomical Venous Variants in Children With Cerebral Sinovenous Thrombosis
Authors: Kouzmitcheva Elizabeth , Andrade Andrea , Muthusami Prakash , Shroff Manohar , MacGregor Daune L. , deVeber Gabrielle , Dlamini Nomazulu , Moharir Mahendranath 
Published: December 2018

Background and Purpose—
Literature is sparse on the frequency and significance of anatomical venous variants (AVVs) in pediatric cerebral sinovenous thrombosis (CSVT).

Methods—
We retrospectively reviewed children with CSVT and controls undergoing computed tomography/magnetic resonance venography from January 2008 to 2014. Clinical features examined included raised intracranial pressure, risk factors, and treatment. Radiological features examined included CSVT location, presence and type of AVVs, hemorrhagic venous infarction, and venous collateralization. Clinical outcome was measured by the pediatric stroke outcome measure and radiological outcome by thrombus recanalization.

Results—
Fifty-one children with CSVT were identified. Twenty-two (43%) had AVVs at presentation. Nineteen (86%) had hypoplasia/absence of major dural sinus, 5 (23%) had persistent fetal structures, 3 (14%) had duplications/fenestrations, and 1 (5%) had disconnected superficial and deep venous systems. Controls had a slightly higher but nonsignificant prevalence 26 (51%) of AVVs. No significant clinical and radiological differences were observed between children with CSVT and AVVs compared with those with typical venous anatomy.

Conclusions—
AVVs are seen in many children with and without CSVT and do not seem to alter the presentation or clinical course. The influence of these variations on the brain’s ability to tolerate venous congestion because of thrombosis merits further study.
Altered Fibrin Clot Properties Predict Stroke and Bleedings in Patients With Atrial Fibrillation on Rivaroxaban
Authors: Janion-Sadowska Agnieszka , Chrapek Magdalena , Konieczyńska Małgorzata , Undas Anetta 
Published: December 2018

Background and Purpose—
We investigated whether clot permeability can predict clinically relevant outcomes in patients with atrial fibrillation (AF) treated with rivaroxaban.

Methods—

In the cohort study, we enrolled 232 consecutive patients with AF on rivaroxaban 20 mg/d (76.3%) or 15 mg/d (23.7%) for at least 3 months. Plasma clot permeability (K
s
), a measure of fibrin network density, was determined 24 to 30 hours since the intake of rivaroxaban at undetectable drug’s levels. Ischemic cerebrovascular events and bleedings were recorded.

Results—

During a median follow-up of 48 months, patients with K
s
below median (6.8 cm
2
·10
−9
) had higher prevalence of stroke (5.84 versus 0.88% per year;
P
<0.0001) and relevant bleeding (7.06 versus 0.88% per year;
P
<0.0001) compared with those above median. The mortality rate was 1.53% per year and was not associated with K
s
. Lower K
s
predicted cerebrovascular ischemic events (hazard ratio, 6.64; 95% CI, 2.2–20.1) and relevant bleedings (hazard ratio, 7.38; 95% CI, 2.58–21.10). Minor bleeds (32.8% of patients) were observed more often in patients with K
s
above median (50.9 versus 14.7%;
P
<0.0001). Multivariate Cox regression analysis showed that in AF patients on rivaroxaban lower K
s
increased the risk of stroke (hazard ratio, 6.51; 95% CI, 2.14–19.75) and relevant bleedings (hazard ratio, 9.68; 95% CI, 3.21–29.18).

Conclusions—
Decreased clot permeability in AF patients can predict thromboembolic and clinically relevant bleeding events during therapy with rivaroxaban, while looser clot networks predispose to minor bleeds.
Workshop series for occupational therapists using the US Agency for Healthcare Research and Quality’s Health Literacy Universal Precautions Toolkit and other supported tools
Authors: Koenig Virginia E , Provident Ingrid M 
Published: December 2018

Objective: Health literacy is the ability to access, understand, evaluate and communicate information in a manner that promotes, maintains and improves health care in a variety of settings across the life span. Health professionals, including occupational therapists (OTs), need to consider health literacy in order to optimise client-centred interventions that promote self-management of chronic conditions, health and wellness. The goal of this small-scale cohort study was to determine if a health literacy workshop series for OTs could improve their working knowledge of health literacy, and increase their self-perceived ability to identify, assess and implement client-centred interventions to at-risk patients. Design: Over a 6-week period, six OT professionals participated in a customised workshop series, incorporating elements of the US Agency for Healthcare Research and Quality’s (AHRQ) Health Literacy Universal Precautions Toolkit (the Toolkit) and other AHRQ-supported health literacy resources. Method: A one-group, pre–posttest mixed methods design was used to measure outcomes. Results: Results of this study suggests that participation in a health literacy education programme featuring the Toolkit and other AHRQ-supported tools can improve OTs’ self-perceived ability to identify, assess and provide client-centred services to their patients. Responses to open-ended questions both pre-and post-intervention align with the literature in that health care professionals, like OTs, can benefit from customised health literacy training to improve client-centred care by implementing specific health literacy strategies into their clinical practice.
Providing exercise instructions using multimedia may improve adherence but not patient outcomes: a systematic review and meta-analysis
Authors: Emmerson Kellie B , Harding Katherine E , Taylor Nicholas F 
Published: December 2018

Objective: To determine whether patients have better outcomes when exercise instructions are provided using multimedia approaches compared with verbal or written instructions. Data sources: Electronic databases (MEDLINE, EMBASE, CINAHL, and PsychInfo) searched up to October 2018. Study selection: Randomized controlled trials exploring exercise-based interventions for health conditions, and comparing instructions provided using multimedia approaches with conventional verbal or written instructions. Results: Fourteen trials from seven countries were included, with a total of 2156 participants. Diagnoses included orthopaedic, neurological, pulmonary, cardiac, and women’s health conditions. A meta-analysis of three trials (140 participants) provided very low-quality evidence that multimedia exercise instructions may be more effective than written instructions in improving exercise adherence (standardized mean difference (SMD) 0.60, 95% confidence interval (CI) –0.06 to 1.25). Two of nine trials that could not be included in the meta-analysis for adherence due to heterogeneity reported that multimedia exercise instructions were more effective than written instructions in improving exercise adherence. Four other meta-analyses (three trials each) found low- to high-quality evidence that provision of exercise instructions using multimedia is no more beneficial than paper-based instructions for patient-related outcomes of pain intensity (SMD 0.09, 95% CI –0.47 to 0.28); uptake of physical activity (SMD 0.07, 95% CI −0.08 to 0.23); or physical (SMD 0.21, –0.21 to 0.64) or emotional (SMD 0.16, 95% CI −0.04 to 0.36) domains of health-related quality of life. Conclusion: Multimedia approaches to exercise instruction may result in increased adherence compared with instructions provided in written or verbal format, but there is insufficient evidence to determine whether this results in improved patient outcomes.
Molecular tools to create new strains for mosquito sexing and vector control
Authors: Häcker Irina , Schetelig Marc F. 
Published: December 2018

AbstractVector control programs based on population reduction by matings with mass-released sterile insects require the release of only male mosquitoes, as the release of females, even if sterile, would increase the number of biting and potentially disease-transmitting individuals. While small-scale releases demonstrated the applicability of sterile males releases to control the yellow fever mosquito Aedes aegypti, large-scale programs for mosquitoes are currently prevented by the lack of efficient sexing systems in any of the vector species.Different approaches of sexing are pursued, including classical genetic and mechanical methods of sex separation. Another strategy is the development of transgenic sexing systems. Such systems already exist in other insect pests. Genome modification tools could be used to apply similar strategies to mosquitoes. Three major tools to modify mosquito genomes are currently used: transposable elements, site-specific recombination systems, and genome editing via TALEN or CRISPR/Cas. All three can serve the purpose of developing sexing systems and vector control strains in mosquitoes in two ways: first, via their use in basic research. A better understanding of mosquito biology, including the sex-determining pathways and the involved genes can greatly facilitate the development of sexing strains. Moreover, basic research can help to identify other regulatory elements and genes potentially useful for the construction of transgenic sexing systems. Second, these genome modification tools can be used to apply the gained knowledge to build and test mosquito sexing strains for vector control.
Navigating conservation strategies: linking material research on alum-treated wood from the Oseberg collection to conservation decisions
Authors: Braovac Susan , McQueen Caitlin M. A. , Sahlstedt Malin , Kutzke Hartmut , Łucejko Jeannette J. , Klokkernes Torunn 
Published: December 2018

Abstract
From the mid-1800s to the late 1950s, conservation by alum salts (aluminum potassium sulfate dodecahydrate)—with some variations—was a routine method for treating highly deteriorated waterlogged archaeological wood in many countries, especially in Scandinavia. It was eventually replaced by newer methods in the 1960s, such as that using polyethylene glycol. Accordingly, the signs of deterioration in such collections and the reasons behind them are not well known among current preservation specialists. The research in the Saving Oseberg project (2014–2019) has shed light on the consequences of this treatment and reasons behind the severe deterioration observed today in many objects of the Oseberg Viking Age wooden finds, which were conserved in the early 1900s. Saving Oseberg aims to provide research-based recommendations for the future preservation of the finds, and as such, a large part of the project is aimed at improving our understanding of this complex material. Here the consequences of the method are summarized, drawing on the research to date. Chemical analyses of the Oseberg wood showed its current condition to be highly degraded: little polysaccharide content is left and the lignin is significantly oxidized and extensively depolymerized. The conservation implications are also discussed.
Multi-instrumental approach with archival research to study the Norwich textile industry in the late eighteenth and early nineteenth centuries: the example of a Norwich pattern book dated c. 1790–1793
Authors: Alcántara-García Jocelyn , Nix Michael 
Published: December 2018

Abstract
Merchant-manufacturers in Norwich, a major centre for textile production in England, used pattern books and pattern cards containing swatches of worsted and worsted mixed with other yarns to facilitate sales and trade. Studying such well-preserved and dated materials provides valuable information that can translate into informed decisions for the care of Norwich textile collections. Using a Norwich pattern book from Winterthur Museum’s Special Collections dated c. 1790–1793, we report the first stage of a substantial study that combines spectroscopic and chromatographic techniques with archival research. A combination of X-ray fluorescence (XRF), high performance liquid chromatography-photodiode array (HPLC–PDA) and scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM–EDX) allowed for identification of characteristic mordants like iron and tin salts; and dyes, like quercitron, native to North America. In addition, a combination of Fourier transform infrared spectroscopy (FTIR) and gas chromatography-mass spectrometry (GC–MS) allowed for partial identification of the glazed finish in some textiles as a natural gum. Setting the foundations for future conservation and conservation science work, our research contributes to the care of these important and beautiful textiles, by providing scientific evidence for humidity and/or light sensitive constituent materials.