bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extent to Which Network Hubs Are Affected by Ischemic Stroke Predicts Cognitive Recovery
Authors: Aben Hugo P. , Biessels Geert Jan , Weaver Nick A. , Spikman Jacoba M. , Visser-Meily Johanna M.A. , de Kort Paul L.M. , Reijmer Yael D. ,   on behalf of the PROCRAS Study Group*, Jansen Ben P.W. 
Published: August 2019

Background and Purpose—
It is uncertain what determines the potential for cognitive recovery after ischemic stroke. The extent to which strategic areas of the brain network, so-called hubs, are affected by the infarct could be a key factor. We developed a lesion impact score, which estimates the damage to network hubs by integrating information on infarct size with healthy brain network topology. We verified whether the lesion impact score indeed reflects global network disturbances in patients and assessed if it could predict cognitive recovery.

Methods—
Seventy-five ischemic stroke patients without signs of a prestroke cognitive disorder were included, all with evidence of a cognitive disorder during hospitalization. A brain magnetic resonance imaging and neuropsychological assessment were performed 5 weeks (±1 week) after stroke. Neuropsychological testing was repeated after 1 year to assess cognitive recovery. Brain networks were reconstructed from diffusion-weighted data and consisted of 90 gray matter regions (ie, network nodes). A standard brain network map, indicating the hub-score of each node, was obtained from network data of 44 cognitively healthy adults. For each patient, we calculated the lesion impact score by multiplying the percentage of node volume affected by the infarct with the node’s corresponding hub-score. The patients’ maximum lesion impact score was used as outcome predictor.

Results—

A higher lesion impact score in patients, indicating an increasing infarct size in nodes with a higher hub-score, was related to lower global brain network efficiency (β=−0.528 [−0.776 to −0.277];
P
<0.001), independent of age, brain volume, infarct volume, and white matter hyperintensity severity. A lower lesion impact score, however, was an independent predictor of cognitive recovery 1 year after stroke (odds ratio=0.434 [0.193–0.978];
P
=0.044).

Conclusions—
We introduced a lesion impact score that combines information on infarct size and network topology to predict long-term recovery after stroke. This score can potentially be used in a clinical setting, also without availability of high-resolution diffusion-weighted magnetic resonance imaging.
Cerebral Blood Flow Predicts the Infarct Core
Authors: Amukotuwa Shalini , Straka Matus , Aksoy Didem , Fischbein Nancy , Desmond Patricia , Albers Gregory , Bammer Roland 
Published: August 2019

Background and Purpose—
The aim of this study is to determine the spatial and volumetric accuracy of infarct core estimates from relative cerebral blood flow (rCBF) by comparison with near-contemporaneous diffusion-weighted imaging (DWI), and evaluate whether it is sufficient for patient triage to reperfusion therapies.

Methods—

One hundred ninety-three patients enrolled in the DEFUSE 2 (Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution) and SENSE 3 (Sensitivity Encoding) stroke studies were screened, and 119 who underwent acute magnetic resonance imaging with DWI and perfusion imaging within 24 hours of onset were included. Infarct core was estimated using reduced rCBF at 12 thresholds (<0.20–<0.44) and compared against DWI (apparent diffusion coefficient <620 10
−6
mm2/s). For each threshold, volumetric agreement between the rCBF and DWI core estimates was assessed using Bland-Altman, correlation, and linear regression analyses; spatial agreement was assessed using receiver operating characteristic analysis.

Results—

An rCBF threshold of 0.32 yielded the smallest mean absolute volume difference (14.7 mL), best linear regression fit (R
2
=0.84), and best spatial agreement (Youden index, 0.38; 95% CI, 0.34–0.41) between rCBF and DWI, with high correlation (
r
=0.91,
P
<0.05), a small mean volume difference (1.3 mL) and no fixed bias (
P
<0.05). At this threshold, 110 of 119 (92.4%) patients were correctly triaged when applying 70 mL as the volume limit for thrombectomy. Spatial agreement was better for prediction of large infarcts (>70 mL) than small infarcts (≤70 mL), with Youden indices of 0.53 (95% CI, 0.49–0.56) and 0.34 (95% CI, 0.30–0.37), respectively.

Conclusions—
Strong correlation and agreement with near-contemporaneous DWI indicate that infarct core estimates obtained using rCBF are sufficiently accurate for patient triage to reperfusion therapies. The identified optimal rCBF threshold of 0.32 closely approximates the threshold currently used in clinical practice.
Concentration or dispersal of research funding?
Authors: Aagaard Kaare , Kladakis Alexander , Nielsen Mathias W. 
Published: August 2019

Abstract
The relationship between the distribution of research funding and scientific performance is a major discussion point in many science policy contexts. Do high shares of funding handed out to a limited number of elite scientists yield the most value for money, or is scientific progress better supported by allocating resources in smaller portions to more teams and individuals? In this review article, we seek to qualify discussions on the benefits and drawbacks of concentrating research funds on fewer individuals and groups. Based on an initial screening of 3,567 articles and a thorough examination of 92 papers, we present a condensation of central arguments. Further, we juxtapose key findings from 20 years of empirical research on the relation between the size of research grants and scientific performance. Overall, the review demonstrates a strong inclination toward arguments in favor of increased dispersal. A substantial body of empirical research also exhibits stagnant or diminishing returns to scale for the relationship between grant size and research performance. The findings question the rationale behind current funding trends and point toward more efficient ways to allocate resources. In addition, they highlight the need for more research on the interplay between science-internal mechanisms and policy priorities in accelerating concentration of funding.
Molecular identity of Nemoura lacustris (Plecoptera: Nemouridae) throughout its distributional range
Authors: FOCHETTI ROMOLO , OLIVERIO MARCO , RUSSINI VALERIA , TAPIA GLORIA , DE FIGUEROA JOSÈ MANUEL TIERNO 
Published: August 2019

The recent report of Nemoura lacustris Pictet, 1865 in Great Britain has raised doubts on its identity, given the isolation with respect to the Mediterranean and continental populations of this species. Using molecular analyses, we tested if populations from the United Kingdom and the Iberian Peninsula were conspecific and tested the hypotheses of a recent colonization event versus a more ancient origin for the British populations. Phylogenetic analysis of the mitochondrial marker COI allowed us to conclude that the United Kingdom specimens morphologically ascribed to N. lacustris were conspecific with populations from France and the Iberian Peninsula. Based on the genetic divergence of the two reciprocally monophyletic clades from the Iberian Peninsula and Great Britain/France, respectively, the present distribution of N. lacustris can be postulated as a relatively recent dispersal or introduction into Great Britain from France. Finally, we note the isolated position displayed by N. lacustris in the phylogenetic tree of Nemoura species based on COI sequences, as the sister to all included species of the genus. This isolated position corresponds with the specific morphology of N. lacustris genitalia and requires additional studies to ascertain clearer generic boundaries within the Nemouridae.-
A Bayesian Processor of Uncertainty for Precipitation Forecasting Using Multiple Predictors and Censoring
Authors: Reggiani Paolo , Boyko Oleksiy 
Published: August 2019

Abstract
A Bayesian processor of uncertainty for numerical precipitation forecasts is presented. The predictive density is estimated on the basis of normalized variates, the use of censored distributions, and the implementation of a parameter-parsimonious and computationally efficient processor that is applicable in operational settings. The structure of the processor is sufficiently generic to handle mixed binary-continuous random processes such as intermittent rainfall (and similarly ephemeral river flows), and an arbitrary number of predictors. First, predictors and observations, the parent data sample, are mapped into standard Gaussian variates, obtaining a nonparametric approximately multivariate normal distribution (MVND) that is considered censored for days with no precipitation. To convert the Gaussian binary-continuous multivariate precipitation process into a continuous one, the parent sample is augmented into the negative range through Bayesian imputation by Gibbs sampling, recovering the true, a priori unknown variance–covariance structure of the full uncensored sample. The dependency among marginal distributions of observations and predictions is hereby assumed multivariate normal, for which closed-form expressions of conditional densities exist. These are then mapped back into the variable space of provenience to yield the predictive density. The processor is applied to a well-monitored study area in Switzerland. Standard forecast performance evaluation and verification metrics are employed to set the approach into perspective against Bayesian model averaging (BMA).
Role of Postoperative Patient-Reported Outcomes to Predict Ankle Arthroplasty and Arthrodesis Revision
Authors: Desai Sameer , Sutherland Jason M. , Younger Alastair , Penner Murray , Veljkovic Andrea , Yusuf Fardowsa , Wing Kevin 
Published: August 2019

Background: Patient-reported outcomes are becoming common for measuring patient-centric outcomes in surgery. However, there is little known about the relationship between postoperatively collected patient-reported outcomes and objective clinical outcomes. The objective of this study was to measure whether postoperative Ankle Osteoarthritis Scale (AOS) values were associated with risk of revision among patients having ankle arthrodesis or total ankle arthroplasty for treatment of symptomatic end-stage ankle arthritis. Methods: This is a retrospective analysis of a longitudinal cohort of ankle arthrodesis and total ankle arthroplasty patients. A single center recruited patients between 2003 and 2013 and follow-up was at least 4 years. Patients completed the AOS preoperatively and annually following surgery. An extended Cox regression model incorporating time-varying AOS values was used to model risk of failure. A total of 336 patients and 348 ankles were included, representing 139 ankle arthrodesis procedures and 209 total ankle arthroplasties. Results: The median follow-up time for revisions was 8.2 years and 46 patients had a revision. Higher values of patients’ AOS scores in the postoperative period were associated with a higher likelihood of revision (hazard ratio, 1.04 per 1-point increase; 95% confidence interval, 1.03-1.05). Ankle arthrodesis was associated with a reduced risk of revision compared with ankle fusion (hazard ratio, 0.12; 95% confidence interval, 0.03-0.49). Conclusion: This study showed that persistent pain and poor function after fusion or replacement surgery, as measured by elevated values of the AOS, were associated with higher risk of further surgery. Level of Evidence: Level III, retrospective cohort study.
Pull-through technique combined with percutaneous angioplasty for treating high-grade arteriovenous fistula stenosis
Authors: He Qing , Yu Bo , Shi Weihao , Tan Jinyun , Zhu Lei , Liang Kun 
Published: August 2019

Purpose: The aim of this study was to investigate the effectiveness of a new pull-through technique through a brachial artery approach combined with angioplasty for the treatment of arteriovenous fistula. Methods: In this retrospective study, a total of 56 arteriovenous fistula patients with high-grade stenosis induced by arteriovenous fistula, which was divided into pull-through technique through a brachial artery approach (pull-through group, n = 28) and solely through a venous approach (control group, n = 28), were analyzed. Both groups underwent percutaneous transluminal angioplasty treatments simultaneously. Results: The success rate of the pull-through group (89.3%, 25 out of 28) was similar to that of the control group (75.0%, 21 out of 28, p = 0.296). Fistula restenosis occurred with time in both groups but no significant differences in the post-operative fistula patency were found between the pull-through and control groups in follow-ups at 3, 6, and 12 months (71.4% vs 67.9%, 57.1% vs 60.7%, and 20.0% vs 30.0%, respectively, p > 0.05). No significant difference in the post-operative patency rate in patients with diabetes, hypertension, or coronary disease was found between the pull-through and control groups in the follow-ups at 3 and 12 months, respectively. The pull-through group had significantly shorter operation times compared with the control group (45 ± 9 min vs 65 ± 15 min, p < 0.001). No surgical complications were reported in the pull-through group in contrast to three cases (11%, 3 out of 28) with puncture hematoma and acute occlusion in the control group. Conclusion: The pull-through technique combined with percutaneous transluminal angioplasty is an effective, safe and lasting option to treat high-grade arteriovenous fistula stenosis in the upper limb.
Inhaled Amphotericin B as Aspergillosis Prophylaxis in Hematologic Disease: An Update
Authors: Duckwall Madison J , Gales Mark A , Gales Barry J 
Published: August 2019

This review summarizes the literature on inhaled amphotericin B for invasive aspergillosis prophylaxis in patients with neutropenia secondary to hematologic malignancy treatment or stem cell transplant. Six trials, 2 randomized controlled and 4 with historical controls, were identified. Three inhaled amphotericin B deoxycholate trials found a reduced invasive aspergillosis incidence, 1 reaching statistical significance. Three inhaled liposomal amphotericin B trials demonstrated similar reductions with 2 finding statistical significance. Relative risk reductions for invasive aspergillosis were routinely 40-60%. Both formulations were without reported systemic or severe adverse effects. The most common adverse events were cough, bad taste, and nausea. Discontinuation rates ranged from 0-45%. The only randomized, placebo-controlled trial utilized inhaled liposomal amphotericin B reported a nearly 60% relative risk reduction. Inhaled liposomal amphotericin B 12.5 mg twice weekly is an alternative for invasive aspergillosis prophylaxis in high risk neutropenic patients with hematologic malignancies and stem cell transplant recipients when recommended azole agents are contraindicated or should not be used.
Home-based tele-rehabilitation presents comparable positive impact on self-reported functional outcomes as usual care: The Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) randomised controlled trial
Authors: Asano Miho , Tai Bee C , Yeo Felicity YT , Yen Shi C , Tay Arthur , Ng Yee S , De Silva Deidre A , Caves Kevin , Chew Eiffie , Hoenig Helen , Koh Gerald C 
Published: August 2019

Introduction The aim of this research was to evaluate the impact of a novel tele-rehabilitation system on self-reported functional outcomes compared to usual care during the first three months after stroke. Methods A parallel, two-arm, evaluator-blinded, randomised controlled trial was conducted. Adults aged ≥40 years who had suffered a stroke within four weeks of the start of the study were recruited from the general community. The intervention group received access to a novel tele-rehabilitation system and programme for three months. The primary outcome measures utilised were the frequency and limitation total scores of the Late-Life Function and Disability Instrument (LLFDI) at three months. Results A total of 124 individuals were recruited. The mean differences in the LLDFI frequency and limitation total scores at three months comparing the intervention and control groups were –3.30 (95% confidence interval (CI) –7.81 to 1.21) and –6.90 (95% CI –15.02 to 1.22), respectively. Adjusting for the respective baseline covariates and baseline Barthel Index also showed no significant difference between interventions in the LLFDI outcomes. Discussion The intervention and control groups self-reported similar improvements in functional outcomes. Tele-rehabilitation may be a viable option to provide post-stroke rehabilitation services in Singapore while reducing barriers to continue rehabilitation conventionally after discharge from hospital and encouraging more participation.
Development of Performance Indicators for Clinical Research Coordinators Using the Balanced Scorecard in South Korea
Authors: Hwang Youn Sun , Lee Tae Wha 
Published: August 2019

Background:This is a methodological study that aims to develop performance indicators based on a balanced scorecard for the clinical research coordinator (CRC) position.Methods:The CRC performance indicators were developed through a literature review, a data review, expert consultations, focus group interviews, and content validity verification. We also used these data to confirm whether the performance indicators were appropriately indexed.Results:We developed 10 strategies and 31 performance management indicators based on the 4 perspectives of the balanced scorecard (financial, customer, internal business process, and learning and growth).Conclusions:This research developed CRC performance indicators using a balanced scorecard in order to improve the quality of CRC work performance. These indicators establish the direction that tasks should take; they motivate CRCs by being associated with the compensation system, competence development programs, and a balanced performance evaluation system.
Influenza Vaccine Effectiveness Among Patients With Cancer: A Population-Based Study Using Health Administrative and Laboratory Testing Data From Ontario, Canada
Authors: Blanchette Phillip S. , Chung Hannah , Pritchard Kathleen I. , Earle Craig C. , Campitelli Michael A. , Buchan Sarah A. , Schwartz Kevin L. , Crowcroft Natasha S. , Gubbay Jonathan B. , Karnauchow Timothy , Katz Kevin , McGeer Allison J. , McNally James D. , Richardson David C. , Richardson Susan E. , Rosella Laura C. , Simor Andrew , Smieja Marek , Zahariadis George , Campigotto Aaron , Kwong Jeffrey C. 
Published: August 2019

PURPOSE Seasonal influenza vaccination is recommended for patients with cancer despite concerns of disease or treatment-associated immunosuppression. The objective of this study was to evaluate vaccine effectiveness (VE) against laboratory-confirmed influenza for patients with cancer. PATIENTS AND METHODS We conducted an observational test-negative design study of previously diagnosed patients with cancer 18 years of age and older who underwent influenza testing during the 2010-2011 to 2015-2016 influenza seasons in Ontario, Canada. We linked individual-level cancer registry, respiratory virus testing, and health administrative data to identify the study population and outcomes. Vaccination status was determined from physician and pharmacist billing claims. We used multivariable logistic regression to estimate VE, adjusting for age, sex, rurality, income quintile, cancer characteristics, chemotherapy exposure, comorbidities, previous health care use, influenza season, and calendar time. RESULTS We identified 26,463 patients with cancer who underwent influenza testing, with 4,320 test-positive cases (16%) and 11,783 (45%) vaccinated. Mean age was 70 years, 52% were male, mean time since diagnosis was 6 years, 69% had solid tumor malignancies, and 23% received active chemotherapy. VE against laboratory-confirmed influenza was 21% (95% CI, 15% to 26%), and VE against laboratory-confirmed influenza hospitalization was 20% (95% CI, 13% to 26%). For patients with solid tumor malignancies, VE was 25% (95% CI, 18% to 31%), compared with 8% (95% CI, –5% to 19%) for patients with hematologic malignancies ( P = .015). Active chemotherapy usage did not significantly affect VE, especially among patients with solid tumor cancer. CONCLUSION Our results support recommendations for influenza vaccination for patients with cancer. VE was decreased for patients with hematologic malignancies, and there was no significant difference in VE among patients with solid tumor cancer receiving active chemotherapy. Strategies to optimize influenza prevention among patients with cancer are warranted.
Endometrial Cancers in BRCA1 or BRCA2 Germline Mutation Carriers: Assessment of Homologous Recombination DNA Repair Defects
Authors: Smith Evan S. , Da Cruz Paula Arnaud , Cadoo Karen A. , Abu-Rustum Nadeem R. , Pei Xin , Brown David N. , Ferrando Lorenzo , Sebastiao Ana Paula Martins , Riaz Nadeem , Robson Mark E. , Soslow Robert A. , Reis-Filho Jorge S. , Mandelker Diana , Weigelt Britta 
Published: August 2019

PURPOSE Endometrial cancer (EC) is not considered a component of the hereditary breast and ovarian cancer syndrome but can arise in patients with germline BRCA1/2 (g BRCA1/2) mutations. Biallelic BRCA1/2 alterations are associated with genomic features of homologous recombination DNA repair deficiency (HRD) in cancer. We sought to determine if ECs in g BRCA1/2 mutation carriers harbor biallelic alterations and/or features of HRD. METHODS Of 769 patients with EC who underwent germline panel testing, 10 pathogenic g BRCA1/2 mutation carriers were identified, and their tumor- and normal-derived DNA was subjected to massively parallel sequencing targeting at least 410 cancer-related genes. Three g BRCA1/2-associated ECs were identified in 232 ECs subjected to whole-exome sequencing by The Cancer Genome Atlas. Somatic mutations, copy number alterations, loss of heterozygosity, microsatellite instability (MSI), and genomic HRD features were assessed. RESULTS Of the 13 patients included who had EC, eight harbored pathogenic g BRCA1 mutations and five harbored g BRCA2 mutations. Eight (100%) and two (40%) ECs harbored biallelic BRCA1 and BRCA2 alterations through loss of heterozygosity of the wild-type allele. All ECs harbored somatic TP53 mutations. One monoallelic/sporadic g BRCA2-associated EC had MLH1 promoter methylation and was MSI high. High large-scale state transition scores, a genomic feature of HRD, were found only in ECs with bi- but not monoallelic BRCA1/2 alterations. The Signature Multivariate Analysis HRD signature Sig3 was enriched in biallelic g BRCA1/2 ECs, and the three ECs from The Cancer Genome Atlas with BRCA1 biallelic alterations subjected to whole-exome sequencing displayed a dominant HRD-related mutational signature 3. CONCLUSION A subset of g BRCA1/2-associated ECs harbor biallelic BRCA1/2 alterations and genomic features of HRD, which may benefit from homologous recombination–directed treatment regimens. ECs in BRCA2 mutation carriers might be sporadic and even MSI high, and may potentially benefit from immune-checkpoint inhibition.