bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic Associations With White Matter Hyperintensities Confer Risk of Lacunar Stroke
Authors: Traylor Matthew , Rutten-Jacobs Loes C.A. , Thijs Vincent , Holliday Elizabeth G. , Levi Chris , Bevan Steve , Malik Rainer , Boncoraglio Giorgio , Sudlow Cathie , Rothwell Peter M. , Dichgans Martin , Markus Hugh S. 
Published: April 2016

Background and Purpose—
White matter hyperintensities (WMH) are increased in patients with lacunar stroke. Whether this is because of shared pathogenesis remains unknown. Using genetic data, we evaluated whether WMH-associated genetic susceptibility factors confer risk of lacunar stroke, and therefore whether they share pathogenesis.

Methods—
We used a genetic risk score approach to test whether single nucleotide polymorphisms associated with WMH in community populations were associated with magnetic resonance imaging–confirmed lacunar stroke (n=1,373), as well as cardioembolic (n=1,331) and large vessel (n=1,472) Trial of Org 10172 in Acute Stroke Treatment subtypes, against 9,053 controls. Second, we separated lacunar strokes into those with WMH (n=568) and those without (n=787) and tested for association with the risk score in these 2 groups. In addition, we evaluated whether WMH-associated single nucleotide polymorphisms are associated with lacunar stroke, or in the 2 groups.

Results—

The WMH genetic risk score was associated with lacunar stroke (odds ratio [OR; 95% confidence interval [CI]]=1.14 [1.06–1.22];
P
=0.0003), in patients both with and without WMH (WMH: OR [95% CI]=1.15 [1.05–1.26];
P
=0.003 and no WMH: OR [95% CI]=1.11 [1.02–1.21];
P
=0.019). Conversely, the risk score was not associated with cardioembolic stroke (OR [95% CI]=1.03 [0.97–1.09];
P
=0.63) or large vessel stroke (OR [95% CI]=0.99 [0.93,1.04];
P
=0.39). However, none of the WMH-associated single nucleotide polymorphisms passed Bonferroni-corrected significance for association with lacunar stroke.

Conclusions—
Genetic variants that influence WMH are associated with an increased risk of lacunar stroke but not cardioembolic or large vessel stroke. Some genetic susceptibility factors seem to be shared across different radiological manifestations of small vessel disease.
Significance of Hematoma Shape and Density in Intracerebral Hemorrhage
Authors: Delcourt Candice , Zhang Shihong , Arima Hisatomi , Sato Shoichiro , Salman Rustam Al-Shahi , Wang Xia , Davies Leo , Stapf Christian , Robinson Thompson , Lavados Pablo M. , Chalmers John , Heeley Emma , Liu Ming , Lindley Richard I. , Anderson Craig S. ,   for the INTERACT2 investigators
Published: April 2016

Background and Purpose—
In patients with acute intracerebral hemorrhage (ICH), the shape and density of the hematoma are associated with its subsequent growth, but the impact of these parameters on clinical outcome is uncertain.

Methods—
Baseline computed tomographic scans and clinical data were obtained in the Intensive Blood Pressure Reduction in Acute Intracerebral Hemorrhage Trial (INTERACT2). Three independent neurologists blind to clinical data assessed ICH for shape and density using a previously described scale. Shape was defined as irregular when the ICH had ≥2 extra lesions added to the ellipsoid-shaped ICH. Density was heterogeneous when there were ≥3 low-density lesions within the ICH. Outcome measures were death and major disability (modified Rankin scale score of 3–5), combined and separate at 90-day postrandomization. Multivariable logistic regression models were used to determine the significance of hematoma characteristics on outcome.

Results—
There were 2066 patient computed tomographic scans included in the analysis, with 46% and 38% having irregular and heterogeneous ICH, respectively. Irregular shape was independently associated with death/major disability (adjusted odds ratio, 1.60; 95% confidence interval [CI], 1.29–1.98) and major disability alone (adjusted odds ratio, 1.60; 95% CI, 1.31–1.95), but not with death alone (adjusted odds ratio, 0.97; 95% CI, 0.68–1.39). Heterogeneous density was not associated with clinical outcomes (adjusted odds ratio, 1.06; 95% CI, 0.85–1.33), 1.04 (95% CI, 0.73–1.48), and 1.14 (95% CI, 0.93–1.39), respectively, for death/major disability, death alone, and disability alone).

Conclusions—
Irregular shape, but not heterogeneous density, is independently associated with poor outcome after ICH.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00716079.
Lymphocytopenia Is an Independent Predictor of Unfavorable Functional Outcome in Spontaneous Intracerebral Hemorrhage
Authors: Giede-Jeppe Antje , Bobinger Tobias , Gerner Stefan T. , Madžar Dominik , Sembill Jochen , Lücking Hannes , Kloska Stephan P. , Keil Toni , Kuramatsu Joji B. , Huttner Hagen B. 
Published: April 2016

Background and Purpose—
Stroke-associated immunosuppression is an increasingly recognized factor triggering infections and thus potentially influencing outcome after stroke. Specifically, lymphocytopenia after intracerebral hemorrhage (ICH) has only been addressed in small-sized retrospective studies of mixed intracranial bleedings. This cohort study investigated the natural course of lymphocytopenia, parameters associated with lymphocytopenia on admission (LOA) and during stay, and evaluated the clinical impact of lymphocytopenia in solely ICH patients.

Methods—

This observational study included 855 consecutive patients with ICH. Patient demographics, clinical and neuroradiological data as well as laboratory and in-hospital measures were retrieved from institutional prospective databases. Functional 3-month outcome was assessed by mailed questionnaires. Lymphocytopenia was defined as <1.0 (10
9
/L) and was correlated with patient’s characteristics and outcome.

Results—

Prevalence of LOA was 27.3%. Patients with LOA showed significant associations with poorer neurological status (18 [10–32] versus 13 [5–24];
P
<0.001), larger hematoma volume (18.5 [6.2–46.2] versus 12.8 [4.4–37.8];
P
=0.006), and unfavorable outcome (74.7% versus 63.3%;
P
=0.0018). Natural course of lymphocyte count during hospital stay revealed a lymphocyte nadir of 1.1 (0.80–1.53 [10
9
/L]) at day 5. Focusing on patients with day-5-lymphocytopenia, compared with patients with LOA, revealed increased rates of infections (63 [71.6] versus 113 [48.5];
P
<0.001) and poorer functional outcome at 3 months (76 [86.4] versus 175 [75.1);
P
=0.029). Adjusting for baseline confounders, multivariable logistic and receiver operating characteristics analyses documented independent associations of day-5-lymphocytopenia with unfavorable outcome (day-5-lymphocytopenia: odds ratio, 2.017 [95% confidence interval, 1.029–3.955],
P
=0.041; LOA: odds ratio, 1.391 [0.795–2.432],
P
=0.248; receiver operating characteristics: day-5-lymphocytopenia: area under the curve=0.673,
P
<0.0001, Youden’s index=0.290; LOA: area under the curve=0.513,
P
=0.676, Youden’s index=0.084), whereas receiver operating characteristics analyses revealed no association of age or hematoma volume with day-5-lymphocytopenia (age: area under the curve=0.540,
P
=0.198, Youden’s index=0.106; volume: area under the curve=0.550,
P
=0.0898, Youden’s index=0.1224).

Conclusions—
Lymphocytopenia is frequently present in patients with ICH and may represent an independent parameter associated with unfavorable functional outcome. Developing lymphocytopenia affected outcome even stronger than LOA, a finding that may open up new therapeutic avenues in specific subsets of patients with ICH.
Risk Reduction of Cerebral Stroke After Stereotactic Radiosurgery for Small Unruptured Brain Arteriovenous Malformations
Authors: Hanakita Shunya , Shin Masahiro , Koga Tomoyuki , Igaki Hiroshi , Saito Nobuhito 
Published: April 2016

Background and Purpose—
A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) indicated the superiority of medical management in reducing the risks for strokes and other neurological deficits over observation alone. The aim of our study was to verify the rationale for stereotactic radiosurgery (SRS) for small unruptured arteriovenous malformation.

Methods—
A retrospective review was performed for 292 patients with unruptured arteriovenous malformations referred for SRS. The risks for cerebral hemorrhages were statistically compared before and after SRS.

Results—

Of the 292 patients in whom arteriovenous malformation was found unruptured at initial diagnosis, 17 sustained hemorrhages in the period between the diagnosis and the initial therapeutic intervention (annual bleeding rate, 2.1%; 95% confidence interval [CI], 1.2%–3.4%). Of the remaining 275 patients, 240 were initially treated with SRS, and 16 sustained a hemorrhage after SRS (annual bleeding rate, 1.1%; 95% CI, 0.6%–1.8%), but only 2 sustained a hemorrhage after angiographic obliteration (annual bleeding rate, 0.3%; 95% CI, 0.04%–1.2%). Comparing the risk of hemorrhage between the periods before and after SRS, a 53% risk reduction was achieved after SRS (hazard ratio, 0.47; 95% CI, 0.24–0.94;
P
=0.03), and 85% reduction was achieved after angiographic obliteration (hazard ratio, 0.15; 95% CI, 0.02–0.53;
P
=0.002).

Conclusions—
SRS can significantly reduce the risk of stroke in the patients with small unruptured arteriovenous malformations. To definitively determine the clinical benefits of SRS, a longer follow-up will be necessary. However, based on our results, we can recommend SRS for patients who face a latent risk for stroke from this intractable vascular disease.
The Plumbing of Land Surface Models: Is Poor Performance a Result of Methodology or Data Quality?
Authors: Haughton Ned , Abramowitz Gab , Pitman Andy J. , Or Dani , Best Martin J. , Johnson Helen R. , Balsamo Gianpaolo , Boone Aaron , Cuntz Matthias , Decharme Bertrand , Dirmeyer Paul A. , Dong Jairui , Ek Michael , Guo Zichang , Haverd Vanessa , van den Hurk Bart J. J. , Nearing Grey S. , Pak Bernard , Santanello Joe A. , Stevens Lauren E. , Vuichard Nicolas 
Published: April 2016

Abstract
The Protocol for the Analysis of Land Surface Models (PALS) Land Surface Model Benchmarking Evaluation Project (PLUMBER) illustrated the value of prescribing a priori performance targets in model intercomparisons. It showed that the performance of turbulent energy flux predictions from different land surface models, at a broad range of flux tower sites using common evaluation metrics, was on average worse than relatively simple empirical models. For sensible heat fluxes, all land surface models were outperformed by a linear regression against downward shortwave radiation. For latent heat flux, all land surface models were outperformed by a regression against downward shortwave radiation, surface air temperature, and relative humidity. These results are explored here in greater detail and possible causes are investigated. It is examined whether particular metrics or sites unduly influence the collated results, whether results change according to time-scale aggregation, and whether a lack of energy conservation in flux tower data gives the empirical models an unfair advantage in the intercomparison. It is demonstrated that energy conservation in the observational data is not responsible for these results. It is also shown that the partitioning between sensible and latent heat fluxes in LSMs, rather than the calculation of available energy, is the cause of the original findings. Finally, evidence is presented that suggests that the nature of this partitioning problem is likely shared among all contributing LSMs. While a single candidate explanation for why land surface models perform poorly relative to empirical benchmarks in PLUMBER could not be found, multiple possible explanations are excluded and guidance is provided on where future research should focus.
Tumor Volume Predicts Survival Rate of Advanced Nasopharyngeal Carcinoma Treated with Concurrent Chemoradiotherapy
Authors: Qin Li , Wu Fang , Lu Heming , Wei Bo , Li Guisheng , Wang Rensheng 
Published: April 2016

ObjectiveTo delineate the prognostic value of primary gross tumor volume (GTVp) for patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy.Study DesignAnalysis of prognostic variables in a prospective cohort.SettingDepartment of Radiotherapy, First Affiliated Hospital of Guangxi Medical University, China.Subjects and MethodsBetween January 2006 and August 2008, 249 patients with stage III‐IVb NPC, all treated by intensity‐modulated radiotherapy plus concurrent chemotherapy, were included in this multicenter prospective study. GTVp was measured with treatment‐planning computed tomography or magnetic resonance imaging scans.ResultsGTVp was significantly associated with locoregional control, distant metastasis, and overall survival for patients with advanced NPC. Furthermore, T classification was not an independent prognostic factor. In receiver operator receiver operating characteristic curve analysis, 33 mL was determined as the cutoff points of GTVp for OS and locoregional control. Patients with a GTVp ≥33 mL had poorer OS, worse locoregional control, and more distant metastasis than patients with a GTVp <33 mL (P =. 006,. 009,. 002, and. 007, respectively).ConclusionsGTVp had significant prognostic value for patients with advanced NPC. The incorporation of GTVp could improve the current TNM classification system.
Starting the polypill: the use of a single age cut-off in males and females
Authors: Wald Nicholas J , Luteijn Johannes M , Morris Joan K 
Published: April 2016

Objective Age screening and preventive medication for future myocardial infarction and stroke has been previously described. We aimed to ascertain whether different age cut-offs are needed for males and females. Methods We determined five parameters for each sex according to age cut-off: detection rate (sensitivity), false-positive rate, proportion of the population eligible for treatment with a polypill, proportion who benefit from taking a polypill (simvastatin 20 mg, losartan 25 mg, hydrochlorothiazide 12.5 mg, amlodipine 2.5 mg), and among these, years of life gained without a first myocardial infarction or stroke. Results Approximately one-third benefit, regardless of the age cut-off. For males and females combined, using ages 40 and 80, the detection rates are 98% and 52%, false-positive rates are 51% and 7%, population percentages eligible for treatment are 52% and 7%, and years of life gained without a first myocardial infarction or stroke are 8.4 and 3.6. Using age 50, detection rates are 93% (males) 98% (females), false-positive rates 37% (males) 40% (females), percentage of the population eligible for treatment 38% (males) 41% (females), percentage who benefit 35% (males) 33% (females), and years of life gained without an event 8.5 (males) 7.0 (females). At a given age cut-off, the sex differences are relatively small. Conclusion A single age cut-off can be used for both sexes.
Ethical issues of prison nursing: A qualitative study in Northern Italy
Authors: Sasso Loredana , Delogu Barbara , Carrozzino Roberto , Aleo Giuseppe , Bagnasco Annamaria 
Published: April 2016

Background: Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues. Research questions: ‘How do correctional nurses describe their working experience in prisons? What issues emerged?’ Methodology: This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data. Participants and research context: Our sample included 31 correctional nurses in seven prisons in Northern Italy. Ethical considerations: The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses’ employer. Formal consent was obtained from all the nurses who volunteered to participate in this study. Findings: Five themes emerged from the focus groups: (1) prisoners’ healthcare needs, (2) negotiation between custody and care, (3) satisfaction of working in prisons, (4) obstacles to quality care and (5) safety. ‘Manipulation’ was a transversal theme that emerged from all the focus groups. Discussion: The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care. Conclusion: In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress.
Closing gaps between open software and public data in a hackathon setting: User-centered software prototyping
Authors: Busby Ben , Lesko Matthew ,   August 2015 and January 2016 Hackathon participants, Federer Lisa 
Published: April 2016

In genomics, bioinformatics and other areas of data science, gaps exist between extant public datasets and the open-source software tools built by the community to analyze similar data types. The purpose of biological data science hackathons is to assemble groups of genomics or bioinformatics professionals and software developers to rapidly prototype software to address these gaps. The only two rules for the NCBI-assisted hackathons run so far are that 1) data either must be housed in public data repositories or be deposited to such repositories shortly after the hackathon’s conclusion, and 2) all software comprising the final pipeline must be open-source or open-use. Proposed topics, as well as suggested tools and approaches, are distributed to participants at the beginning of each hackathon and refined during the event. Software, scripts, and pipelines are developed and published on GitHub, a web service providing publicly available, free-usage tiers for collaborative software development. The code resulting from each hackathon is published at https://github.com/NCBI-Hackathons/ with separate directories or repositories for each team.
Preparing for the ICD-10-CM Transition: Automated Methods for Translating ICD Codes
in Clinical Phenotype Definitions
Authors: Fung Kin Wah , Richesson Rachel , Smerek Michelle , Pereira Katherine C. , Green Beverly B. , Patkar Ashwin , Clowse Megan , Bauck Alan , Bodenreider Olivier 
Published: April 2016

Background: The national mandate for health systems to transition from ICD-9-CM to
ICD-10-CM in October 2015 has an impact on research activities. Clinical phenotypes
defined by ICD-9-CM codes need to be converted to ICD-10-CM, which has nearly four times
more codes and a very different structure than ICD-9-CM.Methods: We used the Centers for
Medicare & Medicaid Services (CMS) General Equivalent Maps (GEMs) to translate,
using four different methods, condition-specific ICD-9-CM code sets used for pragmatic
trials (n=32) into ICD-10-CM. We calculated the recall, precision, and F‑score of each
method. We also used the ICD-9-CM and ICD-10-CM value sets defined for electronic
quality measure as an additional evaluation of the mapping methods.Results: The
forward-backward mapping (FBM) method had higher precision, recall and F‑score metrics
than simple forward mapping (SFM). The more aggressive secondary (SM) and tertiary
mapping (TM) methods resulted in higher recall but lower precision. For clinical
phenotype definition, FBM was the best (F=0.67), but was close to SM (F=0.62) and TM
(F=0.60), judging on the F‑scores alone. The overall difference between the four methods
was statistically significant (one-way ANOVA, F=5.749, p=0.001). However, pairwise
comparisons between FBM, SM, and TM did not reach statistical significance. A similar
trend was found for the quality measure value sets.Discussion: The optimal method for
using the GEMs depends on the relative importance of recall versus precision for a given
use case. It appears that for clinically distinct and homogenous conditions, the recall
of FBM is sufficient. The performance of all mapping methods was lower for heterogeneous
conditions. Since code sets used for phenotype definition and quality measurement can be
very similar, there is a possibility of cross-fertilization between the two
activities.Conclusion: Different mapping approaches yield different collections of
ICD-10-CM codes. All methods require some level of human validation.
Decentralized Charging of Plug-In Electric Vehicles Using Lagrange Relaxation Method at the Residential Transformer Level
Authors: Xu Shaolun , Yan Zheng , Zhao Xiaobo , Zhang Liang , Feng Donghan , Xu Xiaoyuan 
Published: April 2016

Abstract
The expected rise of plug-in electric vehicles (PEVs) will lead to a significant additional demand on low voltage distribution systems, and PEVs can challenge power quality and reliability of power systems if their charging is not coordinated. The PEV aggregator, acting as an intermedium between customers and the grid operator, can solve the charging management problem effectively. In this study, a decentralized scheduling scheme of aggregators for PEV charging based on Lagrange Relaxation method is proposed. At the same time, a centralized model of aggregators is also formulated in the same situation in order to make comparisons with the proposed scheme. The two charging models are both aimed at maximizing the charging profit of PEV aggregators considering constraints including users’ electricity demand, charging time, available capacity of distribution transformers, etc. A number of charging scenarios are simulated to evaluate the proposed method. The economic benefits, computational complexity and efficiency are compared and analyzed between the centralized charging and the decentralized charging. Simulation results verify that the decentralized charging strategy based on Lagrange Relaxation method gains charging profit close to the centralized charging yet is more efficient and realizable than the centralized charging.
Zircaloy Plate Rolling Simulation with an Effective Strain-Rate-Dependent Stress-Updating Algorithm
Authors: Kong Xiangzhe , Yang Hongyan , Ding Shurong 
Published: April 2016

Abstract
Zircaloy is a kind of cladding material for monolithic nuclear fuel plates, which has a strong strain-rate-dependent mechanical constitutive relation at the rolling temperature. In order to model the rolling process of monolithic nuclear fuel plates, it is critical to effectively define the mechanical properties of Zircaloy in the commercial finite element software. Different three-dimensional stress-updating algorithms are built, respectively, including a fully implicit algorithm, a simplified implicit one and an explicit one. The corresponding VUMAT subroutines suitable for explicit dynamic rolling simulation for a Zircaloy plate are developed, and the computation precision and efficiency are compared in ABAQUS. The simplified implicit stress-updating algorithm is determined to be the best choice. The effects of temperature, rolling velocity and reduction on the strain rate distribution, the deformation and rolling force are investigated.