bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract WP567: The Association Between Decreased Cerebral Blood Flow in Transient Ischemic Attack Patients and Cognition
Authors: Reid Meaghan , McDougall Connor , Forkert Nils , Frayne Richard , Coutts Shelagh , Gupta Sah Rani , d'Esterre Christopher D , Barber Philip 
Published: January 2019

Patients with transient ischemic attack (TIA) have a 4-fold increase in developing late-life dementia. Cerebral blood flow has shown to be reduced approximately 30% in patients with Alzheimer’s disease (AD). Vascular abnormalities may initiate and aggravate AD pathology prior to the development of clinical symptoms. We hypothesize that middle-aged patients with a history of TIA will have lower cerebral blood flow (CBF) in the hippocampus, thalamus, white matter and grey matter compared to healthy controls. Additionally, we hypothesize that individuals with lower cerebral blood flow in our regions of interest will have lower cognitive scores.
Participants between the ages of 45-85 years old without dementia were subject to a clinical brain MRI arterial-spin-labelling CBF sequence accompanied by a cognitive battery. The cognitive battery included the Montreal Cognitive Assessment (MOCA) and a composite memory score created with the Addenbrooke’s Cognitive Examination, the Brief Visuospatial Memory Test Revised, and the Rey Auditory Verbal Learning Test. TIA patients had their assessments within 14-days of ictus. Atlas-based imaging analysis was performed using FSL.

Sixty-three (63) healthy controls (63
+
10 years of age) and 51 TIA (69
+
9 years of age) participants were analyzed. In an independent one-tailed t-test, TIA patients had significantly (p<0.05) lower CBF than healthy controls in the left/right hippocampus and thalamus, and right white matter. A multiple regression was performed to predict MOCA and composite memory scores from CBF, while correcting for age, gender and premorbid intelligence. Lower hemispheric CBF in the hippocampus, thalamus, white matter and grey matter each significantly predicted lower MOCA scores (F(4,101), R
2
=[0.1701-0.2013], p<0.05) and lower composite memory scores (F(4,101), R
2
=[0.2429-0.2864], p<0.05) in all participants. In conclusion
,
TIA patients have significantly lower CBF values in regions of interest compared to healthy control subjects and decreased CBF values in all participants are associated with poorer cognitive scores. By investigating neuroimaging biomarkers associated with cognition in mid-life, we may begin to understand why TIA patients have a higher risk of developing AD in late-life.
An Evaluation of Clouds and Precipitation in Convection-Permitting Forecasts for South Africa
Authors: Stein T. H. M. , Keat W. , Maidment R. I. , Landman S. , Becker E. , Boyd D. F. A. , Bodas-Salcedo A. , Pankiewicz G. , Webster S. 
Published: January 2019

Abstract
Since 2016, the South African Weather Service (SAWS) has been running convective-scale simulations to assist with forecast operations across southern Africa. These simulations are run with a tropical configuration of the Met Office Unified Model (UM), nested in the Met Office global model, but without data assimilation. For November 2016, convection-permitting simulations at 4.4- and 1.5-km grid lengths are compared against a simulation at 10-km grid length with convection parameterization (the current UM global atmosphere configuration) to identify the benefits of increasing model resolution for forecasting convection across southern Africa. The simulations are evaluated against satellite rainfall estimates, CloudSat vertical cloud profiles, and SAWS radar data. In line with previous studies using the UM, on a monthly time scale, the diurnal cycle of convection and the distribution of rainfall rates compare better against observations when convection-permitting model configurations are used. The SAWS radar network provides a three-dimensional composite of radar reflectivity for northeast South Africa at 6-min intervals, allowing the evaluation of the vertical development of precipitating clouds and of the timing of the onset of deep convection. Analysis of four case study days indicates that the 4.4-km simulations have a later onset of convection than the 1.5-km simulations, but there is no consistent bias of the simulations against the radar observations across the case studies.
Lithium treatment for unipolar major depressive disorder: Systematic review
Authors: Undurraga Juan , Sim Kang , Tondo Leonardo , Gorodischer Ariel , Azua Emilio , Tay Kai Hong , Tan David , Baldessarini Ross J 
Published: January 2019

Background: The potential value of lithium treatment in particular aspects of unipolar major depressive disorder remains uncertain. Methods: With reports of controlled trials identified by systematic searching of Medline, Cochrane Library, and PsycINFO literature databases, we summarized responses with lithium and controls followed by selective random-effects meta-analyses. Results: We identified 36 reports with 39 randomized controlled trials: six for monotherapy and 12 for adding lithium to antidepressants for acute major depression, and 21 for long-term treatment. Data for monotherapy of acute depression were few and inconclusive. As an adjunct to antidepressants, lithium was much more effective than placebo ( p<0.0001). For long-term maintenance treatment, lithium was more effective than placebo in monotherapy ( p=0.011) and to supplement antidepressants ( p=0.038), and indistinguishable from antidepressant monotherapy. Conclusions: The findings indicate efficacy of lithium as a treatment for some aspects of major depressive disorder, especially as an add-on to antidepressants and for long-term prophylaxis. It remains uncertain whether some benefits of lithium treatment occur with many major depressive disorder patients, or if efficacy is particular to a subgroup with bipolar disorder-like characteristics or mixed-features.
Clozapine augmentation strategies – a systematic meta-review of available evidence. Treatment options for clozapine resistance
Authors: Wagner Elias , Löhrs Lisa , Siskind Dan , Honer William G , Falkai Peter , Hasan Alkomiet 
Published: January 2019

Background: Treatment options for clozapine resistance are diverse whereas, in contrast, the evidence for augmentation or combination strategies is sparse. Aims: We aimed to extract levels of evidence from available data and extrapolate recommendations for clinical practice. Methods: We conducted a systematic literature search in the PubMed/MEDLINE database and in the Cochrane database. Included meta-analyses were assessed using Scottish Intercollegiate Guidelines Network criteria, with symptom improvement as the endpoint, in order to develop a recommendation grade for each clinical strategy identified. Results: Our search identified 21 meta-analyses of clozapine combination or augmentation strategies. No strategies met Grade A criteria. Strategies meeting Grade B included combinations with first- or second-generation antipsychotics, augmentation with electroconvulsive therapy for persistent positive symptoms, and combination with certain antidepressants (fluoxetine, duloxetine, citalopram) for persistent negative symptoms. Augmentation strategies with mood-stabilisers, anticonvulsants, glutamatergics, repetitive transcranial magnetic stimulation, transcranial direct current stimulation or cognitive behavioural therapy met Grades C–D criteria only. Conclusion: More high-quality clinical trials are needed to evaluate the efficacy of add-on treatments for symptom improvement in patients with clozapine resistance. Applying definitions of clozapine resistance would improve the reporting of future clinical trials. Augmentation with second-generation antipsychotics and first-generation antipsychotics can be beneficial, but the supporting evidence is from low-quality studies. Electroconvulsive therapy may be effective for clozapine-resistant positive symptoms.
A Novel Treatment Strategy for Severe Guillain-Barré Syndrome: Zipper Method
Authors: Kesici Selman , Tanyıldız Murat , Yetimakman Filiz , Bayrakci Benan 
Published: January 2019

Objective: Intravenous immunoglobulin and plasma exchange are proven treatments for Guillain-Barré syndrome. Despite these treatments, the prognosis for severe Guillain-Barré syndrome is still not satisfactory. This article seeks for a logical timing for plasma exchange–intravenous immunoglobulin synergy, which may improve outcome in severe Guillain-Barré syndrome requiring mechanical ventilation. Study Design: This study is an open-label study. Nine pediatric severe Guillain-Barré syndrome patients requiring mechanical ventilation were treated with novel treatment strategy named as “zipper method.” In this method, following diagnosis of Guillain-Barré syndrome, plasma exchange was started immediately. In the first session of plasma exchange, one and a half volume of patients’ plasma was removed by using 5% albumin as replacement solution. At the end of the plasma exchange session, 0.4 g/kg intravenous immunoglobulin infusion was started immediately. Second plasma exchange session was applied with one volume change after 24 hours from the end of the intravenous immunoglobulin infusion. Each plasma exchange session was followed by intravenous immunoglobulin infusions. This plasma exchange–intravenous immunoglobulin cycle was repeated for 5 times. Results: Among the 9 patients, the mean mechanical ventilation duration was 7 (5-14) days and the mean hospital stay was 18 (10-30) days. Medical Research Council sum score was increased in all patients, especially after the third session. All patients survived and all patients were able to walk unaided on the 28th day of admission. Conclusion: The zipper method as a novel treatment modality seems to reduce mortality, speed up weaning from mechanical ventilation, and shorten hospital stay, with excellent outcome in severe Guillain-Barré syndrome patients, who require intensive care. This technique stands as a promising immunomodulation strategy for various scenarios.
Pharmacist Statin Prescribing Initiative in Diabetic Patients at an Internal Medicine Resident Clinic
Authors: Vincent Robert , Kim Jennifer , Ahmed Tasrif , Patel Vishal 
Published: January 2019

Background: Despite general increases in statin use in the United States, statin therapy may be underutilized in diabetic patients and vulnerable populations. Objective: To determine the impact of a collaborative pharmacist initiative on statin prescribing for diabetic patients in an internal medicine residency clinic. The primary outcome was the change in prevalence of patients on statin therapy before and after intervention implementation. Secondary outcomes included recommendation acceptance rates and reported adverse effects. Methods: This was a single-center, quasi-experimental pre–post intervention study. The study site was a hospital-based primary care residency clinic serving patients regardless of financial or insurance status. Diabetic patients 40 to 75 years old who were not on a statin and had an upcoming primary care physician appointment were included. Over 3 months, a clinical pharmacist and pharmacy resident evaluated clinical appropriateness and cost of statin therapy, provided recommendations to physicians, facilitated statin prescribing, and provided patient education. Results: Of 454 patients, 343 were on statin therapy (75.6%) prior to the initiative. The mean age was 58 years, 59.7% were female, 76.4% were black, and 90% had hypertension. After implementation, 375 (82.6%) patients were on statins ( P < .0001). Recommendations were well received (90.2% accepted) and no significant adverse effects were reported. Conclusion: Pharmacist implementation of a collaborative, patient-centered initiative increased statin prescribing in diabetic patients, most of which were black and had hypertension, in an internal medicine resident clinic.
Patients’ Perspectives on Approaches to Facilitate Completion of Advance Directives
Authors: Rolnick Joshua A. , Shea Judy A. , Hart Joanna L. , Halpern Scott D. 
Published: January 2019

Background: Little is understood about the different ways patients complete advance directives (ADs), which is most commonly through lawyers and increasingly using websites. Objective: To understand patients’ perspectives on different approaches to facilitating AD completion, the value of legal regulation of ADs, and the use of a web-based platform to create an AD. Design: Semi-structured interviews with patients. Setting/Participants: We purposively sampled 25 patients at least 70 years of age or with a chronic disease from 2 internal medicine clinics. Measurements: Interviews focused on experiences and perspectives creating ADs, including facilitation by lawyers, health-care professionals, and websites. Feedback on a website prototype was also obtained. Responses were analyzed with modified grounded theory until thematic saturation was achieved. Results: Although a majority of participants with ADs had used lawyers, participants were ambivalent about the benefits of lawyer facilitation. Most valued both the medical perspective of a health-care professional and a lawyer’s attention to legal requirements for AD validity. Participants had positive impressions of the web platform, but some were concerned about privacy with online storage. Trust emerged as an overarching theme, and participants valued legal regulation of ADs to ensure document authenticity and delivery of preference-concordant care. Conclusion: Efforts to improve documentation of care planning need to address the disparate methods by which participants complete ADs. Creating options that combine the perceived benefits of a legal approach with greater health professional involvement could appeal to participants. Privacy concerns may limit web use by some patients.
Theoretical analysis of a rolling-sliding elastohydrodynamic lubrication line contact with a subsurface inclusion
Authors: Félix Quiñonez Armando , Morales Espejel Guillermo E 
Published: January 2019

This work investigates the transient effects of a single subsurface inclusion over the pressure, film thickness, and von Mises stress in a line elastohydrodynamic lubrication contact. Results are obtained with a fully-coupled finite element model for either a stiff or a soft inclusion moving at the speed of the surface. Two cases analyzed consider the inclusion moving either at the same speed as the mean velocity of the lubricant or moving slower. Two additional cases investigate reducing either the size of the inclusion or its stiffness differential with respect to the matrix. It is shown that the well-known two-wave elastohydrodynamic lubrication mechanism induced by surface features is also applicable to the inclusions. Also, that the effects of the inclusion become weaker both when its size is reduced and when its stiffness approaches that of the matrix. A direct comparison with predictions by the semi-analytical model of Morales-Espejel et al. ( Proc IMechE, Part J: J Engineering Tribology 2017; 231) shows reasonable qualitative agreement. Quantitatively some differences are observed which, after accounting for the semi-analytical model's simplicity, physical agreement, and computational efficiency, may then be considered as reasonable for engineering applications.
Application of machine learning to predict obstructive sleep apnea syndrome severity
Authors: Mencar Corrado , Gallo Crescenzio , Mantero Marco , Tarsia Paolo , Carpagnano Giovanna E , Foschino Barbaro Maria P , Lacedonia Donato 
Published: January 2019

Introduction: Obstructive sleep apnea syndrome has become an important public health concern. Polysomnography is traditionally considered an established and effective diagnostic tool providing information on the severity of obstructive sleep apnea syndrome and the degree of sleep fragmentation. However, the numerous steps in the polysomnography test to diagnose obstructive sleep apnea syndrome are costly and time consuming. This study aimed to test the efficacy and clinical applicability of different machine learning methods based on demographic information and questionnaire data to predict obstructive sleep apnea syndrome severity. Materials and methods: We collected data about demographic characteristics, spirometry values, gas exchange (PaO2, PaCO2) and symptoms (Epworth Sleepiness Scale, snoring, etc.) of 313 patients with previous diagnosis of obstructive sleep apnea syndrome. After principal component analysis, we selected 19 variables which were used for further preprocessing and to eventually train seven types of classification models and five types of regression models to evaluate the prediction ability of obstructive sleep apnea syndrome severity, represented either by class or by apnea–hypopnea index. All models are trained with an increasing number of features and the results are validated through stratified 10-fold cross validation. Results: Comparative results show the superiority of support vector machine and random forest models for classification, while support vector machine and linear regression are better suited to predict apnea–hypopnea index. Also, a limited number of features are enough to achieve the maximum predictive accuracy. The best average classification accuracy on test sets is 44.7 percent, with the same average sensitivity (recall). In only 5.7 percent of cases, a severe obstructive sleep apnea syndrome (class 4) is misclassified as mild (class 2). Regression results show a minimum achieved root mean squared error of 22.17. Conclusion: The problem of predicting apnea–hypopnea index or severity classes for obstructive sleep apnea syndrome is very difficult when using only data collected prior to polysomnography test. The results achieved with the available data suggest the use of machine learning methods as tools for providing patients with a priority level for polysomnography test, but they still cannot be used for automated diagnosis.
Synthetic glycopolymers and natural fucoidans cause human platelet aggregation via PEAR1 and GPIbα
Authors: Kardeby Caroline , Fälker Knut , Haining Elizabeth J. , Criel Maarten , Lindkvist Madelene , Barroso Ruben , Påhlsson Peter , Ljungberg Liza U. , Tengdelius Mattias , Rainger G. Ed , Watson Stephanie , Eble Johannes A. , Hoylaerts Marc F. , Emsley Jonas , Konradsson Peter , Watson Steve P. , Sun Yi , Grenegård Magnus 
Published: January 2019

AbstractFucoidans are sulfated fucose-based polysaccharides that activate platelets and have pro- and anticoagulant effects; thus, they may have therapeutic value. In the present study, we show that 2 synthetic sulfated α-l-fucoside-pendant glycopolymers (with average monomeric units of 13 and 329) and natural fucoidans activate human platelets through a Src- and phosphatidylinositol 3-kinase (PI3K)–dependent and Syk-independent signaling cascade downstream of the platelet endothelial aggregation receptor 1 (PEAR1). Synthetic glycopolymers and natural fucoidan stimulate marked phosphorylation of PEAR1 and Akt, but not Syk. Platelet aggregation and Akt phosphorylation induced by natural fucoidan and synthetic glycopolymers are blocked by a monoclonal antibody to PEAR1. Direct binding of sulfated glycopolymers to epidermal like growth factor (EGF)–like repeat 13 of PEAR1 was shown by avidity-based extracellular protein interaction screen technology. In contrast, synthetic glycopolymers and natural fucoidans activate mouse platelets through a Src- and Syk-dependent pathway regulated by C-type lectin-like receptor 2 (CLEC-2) with only a minor role for PEAR1. Mouse platelets lacking the extracellular domain of GPIbα and human platelets treated with GPIbα-blocking antibodies display a reduced aggregation response to synthetic glycopolymers. We found that synthetic sulfated glycopolymers bind directly to GPIbα, substantiating that GPIbα facilitates the interaction of synthetic glycopolymers with CLEC-2 or PEAR1. Our results establish PEAR1 as the major signaling receptor for natural fucose-based polysaccharides and synthetic glycopolymers in human, but not in mouse, platelets. Sulfated α-l-fucoside-pendant glycopolymers are unique tools for further investigation of the physiological role of PEAR1 in platelets and beyond.
Cerebral Blood Flow during Exercise in Heart Failure: Effect of Ventricular Assist Devices
Authors: SMITH KURT J. , SUAREZ IGNACIO M. , SCHEER ANNA , CHASLAND LAUREN C. , THOMAS HANNAH J. , CORREIA MARILIA A. , DEMBO LAWRENCE G. , NAYLOR LOUISE H. , MAIORANA ANDREW J. , GREEN DANIEL J. 
Published: January 2019

ABSTRACT

Introduction
In healthy individuals, cerebral blood flow (CBF) increases during exercise, but few studies have compared changes in CBF during exercise in patients with heart failure (HF) to healthy controls (CTRL) or assessed the effects of left ventricular assist devices (LVAD). We hypothesized that subjects implanted with LVAD would exhibit impaired cerebrovascular responses to cycle exercise when compared with age- and sex-matched healthy CTRL subjects but would have enhanced responses relative to subjects with HF.

Methods
Internal carotid artery (ICA) blood flow and intracranial middle (MCAv) and posterior cerebral (PCAv) artery velocities were measured continuously using Doppler ultrasound, alongside cardiorespiratory measures at rest and in response to an incremental submaximal cycle ergometer exercise protocol in nine LVAD participants (58 ± 15 yr, 87 ± 16 kg, 172 ± 8 cm, six females), nine age- and sex-matched subjects with HF (58 ± 8 yr, 84 ± 11 kg, 177 ± 6 cm), and nine CTRL (55 ± 14 yr, 74 ± 16 kg, 168 ± 10 cm).

Results
At rest, ICA hemodynamics (velocity, shear rate, and flow) were greater in CTRL and LVAD than that in HF (P < 0.05). Higher MCAv (+5.52 ± 1.59 cm·s−1, P = 0.003) and PCAv (+5.82 ± 1.41 cm·s−1, P = 0.001) were also observed in LVAD subjects than healthy CTRL. During exercise, ICA flow increased at all workloads in CTRL, but not in HF or LVAD groups. MCAv increased from baseline in both HF and CTRL participants (P = 0.0001), but not in LVAD subjects. Nonetheless, CTRL and LVAD showed higher MCAv (P = 0.006) and PCAv (P < 0.0001) values throughout exercise than HF.

Conclusion
Our findings indicate that LVAD subjects exhibit higher CBF at rest and during exercise than matched HF participants but attenuated brain blood flows during exercise when compared with healthy subjects. CBF should be considered when designing exercise training interventions in patients with HF and LVAD.