bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethnic Differences in Prevalence of Post-stroke Depression
Authors: Dong Liming , Sánchez Brisa N. , Skolarus Lesli E. , Morgenstern Lewis B. , Lisabeth Lynda D. 
Published: January 2018

Background:
Little is known about ethnic differences in poststroke depression (PSD) in the United States. This study aims to estimate the prevalence of PSD at 90 days after first-ever stroke and to examine ethnic differences in the prevalence between Mexican Americans (MAs) and non-Hispanic whites (NHWs).

Methods and Results:
Stroke cases from 2011 to 2015 were identified from the BASIC project (Brain Attack Surveillance in Corpus Christi)—a population-based stroke surveillance study in south Texas. Participants were interviewed at the onset of stroke (baseline interview) and ≈90 days post-stroke (outcome interview). PSD was assessed by the Patient Health Questionnaire-8. Inverse probability weights were generated to account for differential attrition, and weighted logistic regression was used to investigate the association between ethnicity and PSD. The study sample consisted of 586 first-ever stroke patients who completed nonproxy baseline and outcome interviews and had depression assessment. Approximately, 60% of them were MAs, and 40% were NHWs. After accounting for attrition, the prevalence of depression at 90 days post-stroke was 30.4% for MAs (95% confidence interval, 25.0%–35.9%) and 20.7% for NHWs (95% confidence interval, 15.7%–25.7%). The crude odds of PSD in MAs was 1.69 times greater than that in NHWs (95% confidence interval, 1.13–2.51). The odds ratio decreased by 23.6% after adjustment for education (odds ratio, 1.29; 95% confidence interval, 0.82–2.02) and was further attenuated with additional adjustment for other covariates.

Conclusions:
MAs had a higher prevalence of PSD at 90 days than NHWs. The ethnic difference was explained by sociodemographic and health factors, especially low educational attainment.
Bmal1 in Perivascular Adipose Tissue Regulates Resting-Phase Blood Pressure Through Transcriptional Regulation of Angiotensinogen
Authors: Chang Lin , Xiong Wenhao , Zhao Xiangjie , Fan Yanbo , Guo Yanhong , Garcia-Barrio Minerva , Zhang Jifeng , Jiang Zhisheng , Lin Jiandie D. , Chen Y. Eugene 
Published: January 2018

Background:
The perivascular adipose tissue (PVAT) surrounding vessels constitutes a distinct functional integral layer of the vasculature required to preserve vascular tone under physiological conditions. However, there is little information on the relationship between PVAT and blood pressure regulation, including its potential contributions to circadian blood pressure variation.

Methods:
Using unique brown adipocyte–specific aryl hydrocarbon receptor nuclear translocator-like protein 1 (Bmal1) and angiotensinogen knockout mice, we determined the vasoactivity of homogenized PVAT in aortic rings and how brown adipocyte peripheral expression of Bmal1 and angiotensinogen in PVAT regulates the amplitude of diurnal change in blood pressure in mice.

Results:
We uncovered a peripheral clock in PVAT and demonstrated that loss of Bmal1 in PVAT reduces blood pressure in mice during the resting phase, leading to a superdipper phenotype. PVAT extracts from wild-type mice significantly induced contractility of isolated aortic rings in vitro in an endothelium-independent manner. This property was impaired in PVAT from brown adipocyte–selective Bmal1-deficient (BA-Bmal1-KO) mice. The PVAT contractile properties were mediated by local angiotensin II, operating through angiotensin II type 1 receptor–dependent signaling in the isolated vessels and linked to PVAT circadian regulation of angiotensinogen. Indeed, angiotensinogen mRNA and angiotensin II levels in PVAT of BA-Bmal1-KO mice were significantly reduced. Systemic infusion of angiotensin II, in turn, reduced Bmal1 expression in PVAT while eliminating the hypotensive phenotype during the resting phase in BA-Bmal1-KO mice. Angiotensinogen, highly expressed in PVAT, shows circadian expression in PVAT, and selective deletion of angiotensinogen in brown adipocytes recapitulates the phenotype of selective deletion of Bmal1 in brown adipocytes. Furthermore, angiotensinogen is a transcriptional target of Bmal1 in PVAT.

Conclusions:
These data indicate that local Bmal1 in PVAT regulates angiotensinogen expression and the ensuing increase in angiotensin II, which acts on smooth muscle cells in the vessel walls to regulate vasoactivity and blood pressure in a circadian fashion during the resting phase. These findings will contribute to a better understanding of the cardiovascular complications of circadian disorders, alterations in the circadian dipping phenotype, and cross-talk between systemic and peripheral regulation of blood pressure.
Reduced Long‐Term Risk of Aortic Aneurysm and Aortic Dissection Among Individuals With Type 2 Diabetes Mellitus: A Nationwide Observational Study
Authors: Avdic Tarik , Franzén Stefan , Zarrouk Moncef , Acosta Stefan , Nilsson Peter , Gottsäter Anders , Svensson Ann‐Marie , Gudbjörnsdottir Soffia , Eliasson Björn 
Published: January 2018

Background

No studies have examined long‐term risks for aortic aneurysm (
AA
) and aortic dissection (
AD
) or mortality after
AA
or
AD
hospitalization among patients with type 2 diabetes mellitus (T2
DM
).

Methods and Results

In this observational cohort study, we linked data for patients with T2
DM
in the Swedish National Diabetes Register, and 5 individually matched population‐based control subjects (
CSs
) without diabetes mellitus (on the basis of sex, age, and county), to other national databases to capture hospitalizations and death. We examined the risk of hospitalization for
AA
and
AD
, as well as mortality risk after
AA
and
AD
using Kaplan‐Meier curves and Cox regression hazards models. Data on 448 319 patients with T2DM and 2 251 015
CSs
were obtained between 1998 and 2015. Mean follow‐up time was 7.0 years for the T2
DM
group and 7.2 years for the CS group. Patients with T2
DM
had a relative risk reduction of 28% (hazard ratio, 0.72; 95% confidence interval, 0.68–0.76;
P
<0.0001) for
AA
and a 47% relative risk reduction (hazard ratio, 0.53; 95% confidence interval, 0.42–0.65;
P
<0.0001) for
AD
compared with
CSs
. Patients with T2DM had a relative risk reduction of 12% (hazard ratio, 0.88; 95% confidence interval, 0.82–0.94;
P
<0.0001) for mortality after hospitalization for
AA
, and unaltered risk (hazard ratio, 1.07; 95% confidence interval, 0.85–1.34;
P
=0.5859) for mortality after
AD
, up to 2 years compared with
CSs
.

Conclusions

Patients with T2DM had significantly reduced risks of
AA
and
AD
as well as reduced risk of mortality after hospitalization for
AA, compared to CS
. Data suggest that glycated cross‐links in aortic tissue may play a protective role in the progression of aortic diseases among patients with T2DM.
Oxidative Stress Biomarkers of Brain Damage
Authors: Lorenzano Svetlana , Rost Natalia S. , Khan Muhib , Li Hua , Lima Fabricio O. , Maas Matthew B. , Green Rebecca E. , Thankachan Tijy K. , Dipietro Allison J. , Arai Ken , Som Angel T. , Pham Loc-Duyen D. , Wu Ona , Harris Gordon J. , Lo Eng H. , Blumberg Jeffrey B. , Milbury Paul E. , Feske Steven K. , Furie Karen L. 
Published: January 2018

Background and Purpose—
Oxidative stress is an early response to cerebral ischemia and is likely to play an important role in the pathogenesis of cerebral ischemic injury. We sought to evaluate whether hyperacute plasma concentrations of biomarkers of oxidative stress, inflammation, and tissue damage predict infarct growth (IG).

Methods—
We prospectively measured plasma F2-isoprostane (F2-isoP), urinary 8-oxo-7,8-dihydro-2′-deoxyguoanosine, plasma oxygen radical absorbance capacity assay, high sensitivity C reactive protein, and matrix metalloproteinase 2 and 9 in consecutive patients with acute ischemic stroke presenting within 9 hours of symptom onset. Patients with baseline diffusion-weighted magnetic resonance imaging and follow-up diffusion-weighted imaging or computed tomographic scan were included to evaluate the final infarct volume. Baseline diffusion-weighted imaging volume and final infarct volume were analyzed using semiautomated volumetric method. IG volume was defined as the difference between final infarct volume and baseline diffusion-weighted imaging volume.

Results—

A total of 220 acute ischemic stroke subjects were included in the final analysis. One hundred seventy of these had IG. Baseline F2-isoP significantly correlated with IG volume (Spearman ρ=0.20;
P
=0.005) and final infarct volume (Spearman ρ=0.19;
P
=0.009). In a multivariate binary logistic regression model, baseline F2-isoP emerged as an independent predictor of the occurrence of IG (odds ratio, 2.57; 95% confidence interval, 1.37–4.83;
P
=0.007). In a multivariate linear regression model, baseline F2-isoP was independently associated with IG volume (B, 0.38; 95% confidence interval, 0.04–0.72;
P
=0.03).

Conclusions—
Elevated hyperacute plasma F2-isoP concentrations independently predict the occurrence of IG and IG volume in patients with acute ischemic stroke. If validated in future studies, measuring plasma F2-isoP might be helpful in the acute setting to stratify patients with acute ischemic stroke for relative severity of ischemic injury and expected progression.
Validating the TeleStroke Mimic Score
Authors: Ali Syed F. , Hubert Gordian J. , Switzer Jeffrey A. , Majersik Jennifer J. , Backhaus Roland , Shepard L. Wylie , Vedala Kishore , Schwamm Lee H. 
Published: January 2018

Background and Purpose—
Up to 30% of acute stroke evaluations are deemed stroke mimics, and these are common in telestroke as well. We recently published a risk prediction score for use during telestroke encounters to differentiate stroke mimics from ischemic cerebrovascular disease derived and validated in the Partners TeleStroke Network. Using data from 3 distinct US and European telestroke networks, we sought to externally validate the TeleStroke Mimic (TM) score in a broader population.

Methods—
We evaluated the TM score in 1930 telestroke consults from the University of Utah, Georgia Regents University, and the German TeleMedical Project for Integrative Stroke Care Network. We report the area under the curve in receiver-operating characteristic curve analysis with 95% confidence interval for our previously derived TM score in which lower TM scores correspond with a higher likelihood of being a stroke mimic.

Results—

Based on final diagnosis at the end of the telestroke consultation, there were 630 of 1930 (32.6%) stroke mimics in the external validation cohort. All 6 variables included in the score were significantly different between patients with ischemic cerebrovascular disease versus stroke mimics. The TM score performed well (area under curve, 0.72; 95% confidence interval, 0.70–0.73;
P
<0.001), similar to our prior external validation in the Partners National Telestroke Network.

Conclusions—
The TM score’s ability to predict the presence of a stroke mimic during telestroke consultation in these diverse cohorts was similar to its performance in our original cohort. Predictive decision-support tools like the TM score may help highlight key clinical differences between mimics and patients with stroke during complex, time-critical telestroke evaluations.
Functional Trajectories, Cognition, and Subclinical Cerebrovascular Disease
Authors: Dhamoon Mandip S. , Cheung Ying-Kuen , Gutierrez Jose , Moon Yeseon P. , Sacco Ralph L. , Elkind Mitchell S.V. , Wright Clinton B. 
Published: January 2018

Background and Purpose—
Cognition and education influence functional trajectories, but whether associations differ with subclinical brain infarcts (SBI) or white matter hyperintensity volume (WMHV) is unknown. We hypothesized that SBI and WMHV moderated relationships between cognitive performance and education and functional trajectories.

Methods—
A total of 1290 stroke-free individuals underwent brain magnetic resonance imaging and were followed for 7.3 years (mean) with annual functional assessments with the Barthel index (range, 0–100). Magnetic resonance imaging measurements included pathology-informed SBI (PI-SBI) and WMHV (% total cranial volume). Generalized estimating equation models tested associations between magnetic resonance imaging variables and baseline Barthel index and change in Barthel index, adjusting for demographic, vascular, cognitive, and social risk factors, and stroke and myocardial infarction during follow-up. We tested interactions among education level, baseline cognitive performance (Mini-Mental State score), and functional trajectories and ran models stratified by levels of magnetic resonance imaging variables.

Results—

Mean age was 70.6 (SD, 9.0) years; 19% had PI-SBI, and mean WMHV was 0.68%. Education did not modify associations between cognition and functional trajectories. PI-SBI modified associations between cognition and functional trajectories (
P
=0.04) with a significant protective effect of better cognition on functional decline seen only in those without PI-SBI. There was no significant interaction for WMHV (
P
=0.8). PI-SBI, and greater WMHV, were associated with 2- to 3-fold steeper functional decline, holding cognition constant.

Conclusions—
PI-SBI moderated the association between cognition and functional trajectories, with 3-fold greater decline among those with PI-SBI (compared with no PI-SBI) and normal baseline cognition. This highlights the strong and independent association between subclinical markers and patient-centered trajectories over time.
Sappho F 44 Voigt and Euripides’ Troades
Authors: Mariscal Lucía P. Romero 
Published: January 2018

Abstract
In this paper a new interpretation of the first stasimon of Euripides’ Troades is proposed, based on a plausible relationship with Sappho’s F 44 Voigt. Sappho’s version of the wedding of Hektor and Andromache seems to be poetically evoked by the women of the chorus right before Andromache’s arrival on stage in the second episode of the play. The lyric, recalling the welcoming of the Trojan Horse to the town and the ensuing communal revelry, conjures up the civic celebrations at the nuptial procession and reception of the happy couple. The striking contrast between the lyric past and the tragic present casts an even more somber light not only on the widow of Hektor but also on the Trojan women themselves who form the chorus of the play.
Precautionary Management and the Development of Future Fishing Opportunities: The International Regulation of New and Exploratory Fisheries
Authors: Caddell Richard 
Published: January 2018

Abstract
The extensive pressures upon current commercial fisheries, compounded by the projected impacts of climate change and associated processes on marine ecosystems, will increasingly displace elements of future fishing effort towards new locations, target species and techniques. For transboundary stocks, where a new or exploratory fishery is contemplated, Article 6(6) of the un Fish Stocks Agreement 1995 mandates cautious conservation measures to acquire sufficient catch data to assess the impacts of fishing on the stock and surrounding ecosystem. Thereafter, if appropriate, measures may be adopted to facilitate the gradual development of the fishery and its eventual transition to commercial management. However, there has been minimal analysis of the regulatory requirements for emergent fisheries during this interim stage. This article accordingly collates and evaluates the current international law and practice towards new and exploratory fisheries, with particular reference to Antarctic developments and the protection of vulnerable marine ecosystems from proliferating deep-sea fisheries.
Statistical–Dynamical Typhoon Intensity Predictions in the Western North Pacific Using Track Pattern Clustering and Ocean Coupling Predictors
Authors: Kim Sung-Hun , Moon Il-Ju , Chu Pao-Shin 
Published: January 2018

Abstract
A statistical–dynamical model for predicting tropical cyclone (TC) intensity has been developed using a track-pattern clustering (TPC) method and ocean-coupled potential predictors. Based on the fuzzy c-means clustering method, TC tracks during 2004–12 in the western North Pacific were categorized into five clusters, and their unique characteristics were investigated. The predictive model uses multiple linear regressions, where the predictand or the dependent variable is the change in maximum wind speed relative to the initial time. To consider TC-ocean coupling effects due to TC-induced vertical mixing and resultant surface cooling, new potential predictors were also developed for maximum potential intensity (MPI) and intensification potential (POT) using depth-averaged temperature (DAT) instead of sea surface temperature (SST). Altogether, 6 static, 11 synoptic, and 3 DAT-based potential predictors were used. Results from a series of experiments for the training period of 2004–12 using TPC and DAT-based predictors showed remarkably improved TC intensity predictions. The model was tested on predictions of TC intensity for 2013 and 2014, which are not used in the training samples. Relative to the nonclustering approach, the TPC and DAT-based predictors reduced prediction errors about 12%–25% between 24- and 96-h lead time. The present model is also compared with four operational dynamical forecast models. At short leads (up to 24 h) the present model has the smallest mean absolute errors. After a 24-h lead time, the present model still shows skill that is comparable with the best operational models.
LY3045697: Results from two randomized clinical trials of a novel inhibitor of aldosterone synthase
Authors: Sloan-Lancaster Joanne , Raddad Eyas , Flynt Amy , Jin Yan , Voelker James , Miller Jeffrey W 
Published: January 2018

Introduction: LY3045697 is a potent and selective aldosterone synthase (CYP11B2) inhibitor that was developed as a safer alternative to mineralocorticoid receptor antagonists. Effects of LY3045697 on aldosterone and cortisol synthesis, as well as potassium ion homeostasis, were evaluated in two clinical studies in healthy subjects. Materials and methods: Two incomplete, placebo-controlled crossover-design clinical studies examined safety, pharmacodynamics, and pharmacokinetics under single and repeated dose conditions in healthy subjects. Pharmacodynamics was assessed following oral potassium challenge and intravenous adrenocorticotropic hormone procedures with spironolactone 25 mg/d as an active comparator. Results: A total of 51 subjects participated in the two studies, which included 38 males and 13 females (of non-childbearing potential), from 18–65 years old. LY3045697 caused rapid dose and concentration-dependent unstimulated plasma aldosterone concentration reduction seen as early as 4 h after the first dose at dose levels as low as 1 mg, and reaching near complete suppression at high doses. The potency (IC50) decreased significantly upon multiple dosing. After eight days of dosing, post-adrenocorticotropic hormone challenge plasma aldosterone concentration increase was dose-dependently blunted by LY3045697 with high potency with a dose as low as 0.1 mg resulting in substantial effect, and with an overall IC50 of 0.38 ng/ml. Minor reductions in cortisol were observed only at the top dose of 300 mg. LY3045697 is generally safe and tolerated, and exhibits linear pharmacokinetics. Conclusions: LY3045697 is a potent and highly selective aldosterone synthase inhibitor with selectivity for CYP11B2, offering a substantial potential advantage over previous aldosterone synthase inhibitors evaluated in the clinic.
Aldosterone breakthrough does not alter central hemodynamics
Authors: Beenken Andrew , Bomback Andrew S. 
Published: January 2018

Introduction: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are widely used in congestive heart failure and chronic kidney disease, but up to 40% of patients will experience aldosterone breakthrough, with aldosterone levels rising above pre-treatment levels after 6–12 months of renin-angiotensin-aldosterone system blockade. Aldosterone breakthrough has been associated with worsening congestive heart failure and chronic kidney disease, yet the pathophysiology remains unclear. Breakthrough has not been associated with elevated peripheral blood pressure, but no studies have assessed its effect on central blood pressure. Methods: Nineteen subjects with well-controlled peripheral blood pressure on stable doses of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker had aldosterone levels checked and central blood pressure parameters measured using the SphygmoCor system. The central blood pressure parameters of subjects with or without breakthrough, defined as serum aldosterone >15 ng/dl, were compared. Results: Of the 19 subjects, six had breakthrough with a mean aldosterone level of 33.8 ng/dl, and 13 were without breakthrough with a mean level of 7.1 ng/dl. There was no significant difference between the two groups in any central blood pressure parameter. Conclusions: We found no correlation between aldosterone breakthrough and central blood pressure. The clinical impact of aldosterone breakthrough likely depends on its non-genomic, pro-fibrotic, pro-inflammatory effects rather than its regulation of extracellular volume.
Building clinical academic leadership capacity: sustainability through partnership
Authors: Westwood Greta , Richardson Alison , Latter Sue , Macleod Clark Jill , Fader Mandy 
Published: January 2018

Background A national clinical academic training programme has been developed in England for nurses, midwives and allied health professionals but is insufficient to build a critical mass to have a significant impact on improved patient care. Aim We describe a partnership model led by the University of Southampton and its neighbouring National Health Service partners that has the potential to address this capacity gap. In combination with the Health Education England/National Institute of Health Research Integrated Clinical Academic programme, we are currently supporting nurses, midwives and allied health professionals at Master’s ( n = 28), Doctoral ( n = 36), Clinical Lecturer ( n = 5) and Senior Clinical Lecturer ( n = 2) levels working across seven National Health Service organisations, and three nurses hold jointly funded Clinical Professor posts. Results Key to the success of our partnership model is the strength of the strategic relationship developed at all levels across and within the clinical organisations involved, from board to ward. We are supporting nurses, midwives and allied health professionals to climb, in parallel, both clinical and academic career ladders. We are creating clinical academic leaders who are driving their disciplines forward, impacting on improved health outcomes and patient benefit. Conclusions We have demonstrated that our partnership model is sustainable and could enable doctoral capacity to be built at scale.