bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computed Tomographic Perfusion Selection and Clinical Outcomes After Endovascular Therapy in Large Vessel Occlusion Stroke
Authors: Bouslama Mehdi , Haussen Diogo C. , Grossberg Jonathan A. , Dehkharghani Seena , Bowen Meredith T. , Rebello Leticia C. , Bianchi Nicolas A. , Frankel Michael R. , Nogueira Raul G. 
Published: April 2017

Background and Purpose—
Different imaging paradigms have been used to select patients for endovascular therapy in stroke. We sought to determine whether computed tomographic perfusion (CTP) selection improves endovascular therapy outcomes compared with noncontrast computed tomography alone.

Methods—
Review of a prospectively collected registry of anterior circulation stroke patients undergoing stent-retriever thrombectomy at a tertiary care center between September 2010 and March 2016. Patients undergoing CTP were compared with those with noncontrast computed tomography alone. The primary outcome was the shift in the 90-day modified Rankin scale (mRS).

Results—

A total of 602 patients were included. CTP-selected patients (n=365, 61%) were younger (
P
=0.02) and had fewer comorbidities. CTP selection (n=365, 61%) was associated with a favorable 90-day mRS shift (adjusted odds ratio [aOR]=1.49; 95% confidence interval [CI], 1.06–2.09;
P
=0.02), higher rates of good outcomes (90-day mRS score 0–2: 52.9% versus 40.4%;
P
=0.005), modified Thrombolysis in Cerebral Infarction-3 reperfusion (54.8% versus 40.1%;
P
<0.001), smaller final infarct volumes (24.7 mL [9.8–63.1 mL] versus 34.6 mL [13.1–88 mL];
P
=0.017), and lower mortality (16.6% versus 26.8%;
P
=0.005). When matched on age, National Institutes of Health Stroke Scale (NIHSS) score, and glucose (n=424), CTP remained associated with a favorable 90-day mRS shift (
P
=0.016), lower mortality (
P
=0.02), and higher rates of reperfusion (
P
<0.001). CTP better predicted functional outcomes in patients presenting after 6 hours (as assessed by comparison of logistic regression models: Akaike information criterion: 199.35 versus 287.49 and Bayesian information criterion: 196.71 versus 283.27) and those with an Alberta Stroke Program Early Computed Tomography Score ≤7 (Akaike information criterion: 216.69 versus 334.96 and Bayesian information criterion: 213.6 versus 329.94).

Conclusions—
CTP selection is associated with a favorable mRS shift in patients undergoing stent-retriever thrombectomy. Future prospective studies are warranted.
Stroke in Indigenous Africans, African Americans, and European Americans
Authors: Owolabi Mayowa , Sarfo Fred , Howard Virginia J. , Irvin Marguerite R. , Gebregziabher Mulugeta , Akinyemi Rufus , Bennett Aleena , Armstrong Kevin , Tiwari Hemant K. , Akpalu Albert , Wahab Kolawole W. , Owolabi Lukman , Fawale Bimbo , Komolafe Morenikeji , Obiako Reginald , Adebayo Philip , Manly Jennifer M. , Ogbole Godwin , Melikam Ezinne , Laryea Ruth , Saulson Raelle , Jenkins Carolyn , Arnett Donna K. , Lackland Daniel T. , Ovbiagele Bruce , Howard George 
Published: April 2017

Background and Purpose—
The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European Americans (EA).

Methods—
SIREN (Stroke Investigative Research and Educational Network) is a large multinational case–control study in West Africa—the ancestral home of 71% AA—whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a cohort study including AA and EA in the United States. Using harmonized assessments and standard definitions, we compared data on stroke type and established risk factors for stroke in acute stroke cases aged ≥55 years in both studies.

Results—

There were 811 IA, 452 AA, and 665 EA stroke subjects, with mean age of 68.0±9.3, 73.0±8.3, and 76.0±8.3 years, respectively (
P
<0.0001). Hemorrhagic stroke was more frequent among IA (27%) compared with AA (8%) and EA (5.4%;
P
<0.001). Lacunar strokes were more prevalent in IA (47.1%), followed by AA (35.1%) and then EA (21.0%;
P
<0.0001). The frequency of hypertension in decreasing order was IA (92.8%), followed by AA (82.5%) and then EA (64.2%;
P
<0.0001) and similarly for diabetes mellitus IA (38.3%), AA (36.8%), and EA (21.0%;
P
<0.0001). Premorbid sedentary lifestyle was similar in AA (37.7%) and EA (34.0%) but lower frequency in IA (8.0%).

Conclusions—
Environmental risk factors such as sedentary lifestyle may contribute to the higher proportion of ischemic stroke in AA compared with IA, whereas racial factors may contribute to the higher proportion of hypertension and diabetes mellitus among stroke subjects of African ancestry.
Mortality Reduction for Fever, Hyperglycemia, and Swallowing Nurse-Initiated Stroke Intervention
Authors: Middleton Sandy , Coughlan Kelly , Mnatzaganian George , Low Choy Nancy , Dale Simeon , Jammali-Blasi Asmara , Levi Chris , Grimshaw Jeremy M. , Ward Jeanette , Cadilhac Dominique A. , McElduff Patrick , Hiller Janet E. , D’Este Catherine 
Published: April 2017

Background and Purpose—
Implementation of nurse-initiated protocols to manage fever, hyperglycemia, and swallowing dysfunction decreased death and disability 90 days poststroke in the QASC trial (Quality in Acute Stroke Care) conducted in 19 Australian acute stroke units (2005–2010). We now examine long-term all-cause mortality.

Methods—
Mortality was ascertained using Australia’s National Death Index. Cox proportional hazards regression compared time to death adjusting for correlation within stroke units using the cluster sandwich (Huber–White estimator) method. Primary analyses included treatment group only unadjusted for covariates. Secondary analysis adjusted for age, sex, marital status, education, and stroke severity using multiple imputation for missing covariates.

Results—

One thousand and seventy-six participants (intervention n=600; control n=476) were followed for a median of 4.1 years (minimum 0.3 to maximum 70 months), of whom 264 (24.5%) had died. Baseline demographic and clinical characteristics were generally well balanced by group. The QASC intervention group had improved long-term survival (>20%), but this was only statistically significant in adjusted analyses (unadjusted hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.58–1.07;
P
=0.13; adjusted HR, 0.77; 95% CI, 0.59–0.99;
P
=0.045). Older age (75–84 years; HR, 4.9; 95% CI, 2.8–8.7;
P
<0.001) and increasing stroke severity (HR, 1.5; 95% CI, 1.3–1.9;
P
<0.001) were associated with increased mortality, while being married (HR, 0.70; 95% CI, 0.49–0.99;
P
=0.042) was associated with increased likelihood of survival. Cardiovascular disease (including stroke) was listed either as the primary or secondary cause of death in 80% (211/264) of all deaths.

Conclusions—
Our results demonstrate the potential long-term and sustained benefit of nurse-initiated multidisciplinary protocols for management of fever, hyperglycemia, and swallowing dysfunction. These protocols should be a routine part of acute stroke care.

Clinical Trial Registration—

URL:
http://www.anzctr.org.au
. Unique identifier: ACTRN12608000563369.
A Dedicated Spanish Language Line Increases Enrollment of Hispanics Into Prehospital Clinical Research
Authors: Sanossian Nerses , Rosenberg Lauren , Liebeskind David S. , Starkman Sidney , Eckstein Marc , Stratton Samuel , Pratt Franklin D. , Hamilton Scott , Kim-Tenser May , Sharma Latisha K. , Restrepo Lucas , Valdes-Suieras Miguel , Conwit Robin , Saver Jeffrey L. 
Published: April 2017

Background and Purpose—
Novel methods are needed to reduce the disparity of Hispanic enrollment in stroke clinical trials. Prehospital enrollment using a dedicated Spanish language line may help overcome this bias.

Methods—
Subjects or legally authorized representatives provided information on race and ethnicity for all cases enrolled in the FAST-MAG clinical trial (Field Administration of Stroke Therapy-Magnesium), a prehospital phase 3 randomized study of intravenous magnesium for neuroprotection. One of 2 in-ambulance cell phones (in English or Spanish) was used to obtain informed content in the field. We describe the yield and characteristics of subjects enrolled via Spanish line.

Results—

There were 1700 subjects enrolled from 2005 to 2012, of which 402 (24%) identified as Hispanic ethnicity. Study racial makeup was 1325 (78%) white, 219 (13%) black, and 139 (8%) Asian. The dedicated Spanish line was used for 195 (12%) enrollments. Spanish-line enrollments were younger (65 versus 70 years old;
P
<0.001), more likely to identify as Hispanic (98% versus 14%;
P
<0.001), and more likely to present with intracerebral hemorrhage (36% versus 21%;
P
<0.001).

Conclusions—
The use of a dedicated Spanish language enrollment line allowed for greater enrollment of Hispanics, a population with significantly different baseline characteristics.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00059332.
Prognostic implications of myocardial perfusion imaging and coronary calcium score in a Macedonian cohort of asymptomatic patients with type 2 diabetes
Authors: Mitevska Irena Peovska , Baneva Natalija , Srbinovska Elizabeta , Stojanovska Lily , Apostolopoulos Vasso , Bosevski Marijan 
Published: April 2017

Aim: Type 2 diabetes is a risk factor for coronary artery disease; however, a number of studies have shown that patients are asymptomatic for coronary artery disease. The presence of coronary artery disease in asymptomatic patients with type 2 diabetes was evaluated to determine its impact on management decision and prognosis. Methods: A total of 75 patients underwent single-photon emission computed tomography myocardial perfusion imaging for detection of suspected coronary artery disease. We used 17-segment model for perfusion and function analysis. Multislice computed tomography was performed in 45 patients to assess coronary artery calcium. Complete laboratory analyses with lipid values and standard risk factors were analysed. Forward logistic regression analysis was used to assess predictive parameters for myocardial ischaemia during the follow-up period of 20 ± 4 months. Results and Conclusion: Silent myocardial ischaemia and subclinical coronary artery disease can be detected in a significant proportion of asymptomatic patients with type 2 diabetes. Diabetic patients with normal myocardial perfusion imaging had an excellent 2-year prognosis with optimal medical therapy and intensive risk factor control. In comparison, an abnormal myocardial perfusion imaging led to an increased risk of cardiovascular events. Myocardial perfusion imaging and coronary artery calcium are valuable tools for risk stratification and optimal treatment decision in this asymptomatic diabetic cohort of Macedonian patients.
Inadequacy of ethical conduct and reporting of stepped wedge cluster randomized trials: Results from a systematic review
Authors: Taljaard Monica , Hemming Karla , Shah Lena , Giraudeau Bruno , Grimshaw Jeremy M , Weijer Charles 
Published: April 2017

Background/aims The use of the stepped wedge cluster randomized design is rapidly increasing. This design is commonly used to evaluate health policy and service delivery interventions. Stepped wedge cluster randomized trials have unique characteristics that complicate their ethical interpretation. The 2012 Ottawa Statement provides comprehensive guidance on the ethical design and conduct of cluster randomized trials, and the 2010 CONSORT extension for cluster randomized trials provides guidelines for reporting. Our aims were to assess the adequacy of the ethical conduct and reporting of stepped wedge trials to date, focusing on research ethics review and informed consent. Methods We conducted a systematic review of stepped wedge cluster randomized trials in health research published up to 2014 in English language journals. We extracted details of study intervention and data collection procedures, as well as reporting of research ethics review and informed consent. Two reviewers independently extracted data from each trial; discrepancies were resolved through discussion. We identified the presence of any research participants at the cluster level and the individual level. We assessed ethical conduct by tabulating reporting of research ethics review and informed consent against the presence of research participants. Results Of 32 identified stepped wedge trials, only 24 (75%) reported review by a research ethics committee, and only 16 (50%) reported informed consent from any research participants—yet, all trials included research participants at some level. In the subgroup of 20 trials with research participants at cluster level, only 4 (20%) reported informed consent from such participants; in 26 trials with individual-level research participants, only 15 (58%) reported their informed consent. Interventions (regardless of whether targeting cluster- or individual-level participants) were delivered at the group level in more than two-thirds of trials; nine trials (28%) had no identifiable data collected from any research participants. Overall, only three trials (9%) indicated that a waiver of consent had been granted by a research ethics committee. When considering the combined requirement of research ethics review and informed consent (or a waiver), only one in three studies were compliant. Conclusion The ethical conduct and reporting of key ethical protections in stepped wedge trials, namely, research ethics review and informed consent, are inadequate. We recommend that stepped wedge trials be classified as research and reviewed and approved by a research ethics committee. We also recommend that researchers appropriately identify research participants (which may include health professionals), seek informed consent or appeal to an ethics committee for a waiver of consent, and include explicit details of research ethics approval and informed consent in the trial report.
Increasing response rates to follow-up questionnaires in health intervention research: Randomized controlled trial of a gift card prize incentive
Authors: Morgan Amy J , Rapee Ronald M , Bayer Jordana K 
Published: April 2017

Background/aims Achieving a high response rate to follow-up questionnaires in randomized controlled trials of interventions is important for study validity. Few studies have tested the value of incentives in increasing response rates to online questionnaires in clinical trials of health interventions. This study evaluated the effect of a gift card prize-draw incentive on response rates to follow-up questionnaires within a trial of an online health intervention. Method The study was embedded in a host randomized controlled trial of an online parenting program for child anxiety. A total of 433 participants were randomly allocated to one of two groups: (1) being informed that they would enter a gift card prize-draw if they completed the final study questionnaire (24-week follow-up) and (2) not informed about the prize-draw. All participants had a 1 in 20 chance of winning an AUD50 gift card after they completed the online questionnaire. Results The odds of the informed group completing the follow-up questionnaire were significantly higher than the uninformed group, (79.6% vs 68.5%, odds ratio = 1.79, 95% confidence interval = 1.15–2.79). This response rate increase of 11.1% (95% confidence interval = 2.8–19.1) occurred in both intervention and control groups in the host randomized controlled trial. The incentive was also effective in increasing questionnaire commencement (84.6% vs 75.9%, odds ratio = 1.74, 95% confidence interval = 1.07–2.84) and reducing the delay in completing the questionnaire (19.9 vs 22.6 days, hazard ratio = 1.34, 95% confidence interval = 1.07–1.67). Conclusion This study adds to evidence for the effectiveness of incentives to increase response rates to follow-up questionnaires in health intervention trials.
The use of social media by arthritis health professionals to disseminate a self-management program to patients: A feasibility study
Authors: De Angelis Gino , Davies Barbara , King Judy , Wells George A , Brosseau Lucie 
Published: April 2017

Objective The objective of this study was to determine the feasibility of Facebook as a dissemination strategy for the People Getting a Grip on Arthritis self-management program by arthritis health professionals to their patients. Methods The feasibility study comprised a single arm, pre-post design that included a convenience sample of 78 arthritis health professionals across Canada. Assessments were performed at baseline, two-weeks post-intervention, and at three-months follow-up using online questionnaires. The primary outcome measure was change in perceived usability of Facebook as a dissemination strategy for the People Getting a Grip on Arthritis program with patients at two-weeks post-intervention using an instrument based on an extended version of the Technology Acceptance Model 2. Comparisons with baseline were assessed using t-test analyses. Results Statistically significant improvements from baseline were seen for all items of the Technology Acceptance Model 2 domains: perceived ease of use (four items), intention to use (two items) and output quality (two items) domains. Variable results were seen for the job relevance, perceived usefulness, voluntariness, and result demonstrability domains of the Technology Acceptance Model 2. There were no statistically significant improvements for the subjective norm and image domains. Conclusions Facebook may provide arthritis health professionals with an additional option of how to best share evidence-based information to allow their patients to successfully self-manage their arthritis.
Direct evidence for a polygenic etiology in familial multiple myeloma
Authors: Halvarsson Britt-Marie , Wihlborg Anna-Karin , Ali Mina , Lemonakis Konstantinos , Johnsson Ellinor , Niroula Abhishek , Cibulskis Carrie , Weinhold Niels , Försti Asta , Alici Evren , Langer Christian , Pfreundschuh Michael , Goldschmidt Hartmut , Mellqvist Ulf-Henrik , Turesson Ingemar , Waage Anders , Hemminki Kari , Golub Todd , Nahi Hareth , Gullberg Urban , Hansson Markus , Nilsson Björn 
Published: April 2017

Key Points
Although common risk alleles for multiple myeloma have been identified, their contribution to familial MM is unknown. We demonstrate an enrichment of common MM risk alleles in familial cases, providing the first direct evidence for a polygenic contribution.
4-D light field reconstruction by irradiance decomposition
Authors: Aoto Takahito , Sato Tomokazu , Mukaigawa Yasuhiro , Yokoya Naokazu 
Published: April 2017

AbstractCommon light sources such as an ordinary flashlight with lenses and/or reflectors make complex 4-D light field that cannot be represented by conventional isotropic distribution model nor point light source model. This paper describes a new approach to estimate 4-D light field using an illuminated diffuser. Unlike conventional works that capture a 4-D light field directly, our method decomposes observed intensities on the diffuser into intensities of 4-D light rays based on inverse rendering technique with prior knowledge. We formulate 4-D light field reconstruction problem as a non-smooth convex optimization problem for mathematically finding the global minimum.
Fluid shear-induced cathepsin B release in the control of Mac1-dependent neutrophil adhesion
Authors: Akenhead Michael L , Fukuda Shunichi , Schmid-Schoünbein Geert W , Shin Hainsworth Y 
Published: April 2017

Abstract
There is compelling evidence that circulatory hemodynamics prevent neutrophil activation, including adhesion to microvessels, in the microcirculation. However, the underlying mechanism or mechanisms by which that mechanoregulation occurs remain unresolved. Here, we report evidence that exposure to fluid shear stress (FSS) promotes neutrophils to release cathepsin B (ctsB) and that this autocrine regulatory event is antiadhesive for neutrophils on endothelial surfaces through Mac1-selective regulation. We used a combined cell-engineering and immunocytochemistry approach to find that ctsB was capable of cleaving Mac1 integrins on neutrophils and demonstrated that this proteolysis alters their adhesive functions. Under no-flow conditions, ctsB enhanced neutrophil migration though a putative effect on pseudopod retraction rates. We also established a flow-based cell detachment assay to verify the role of ctsB in the control of neutrophil adhesion by fluid flow stimulation. Fluid flow promoted neutrophil detachment from platelet and endothelial layers that required ctsB, consistent with its fluid shear stress–induced release. Notably, compared with leukocytes from wild-type mice, those from ctsB-deficient (ctsB−/−) mice exhibited an impaired CD18 cleavage response to FSS, significantly elevated baseline levels of CD18 surface expression, and an enhanced adhesive capacity to mildly inflamed postcapillary venules. Taken together, the results of the present study support a role for ctsB in a hemodynamic control mechanism that is antiadhesive for leukocytes on endothelium. These results have implications in the pathogenesis of chronic inflammation, microvascular dysfunction, and cardiovascular diseases involving sustained neutrophil activation in the blood and microcirculation.
IL-4Rα on dendritic cells in neonates and Th2 immunopathology in respiratory syncytial virus infection
Authors: Shrestha Bishwas , You Dahui , Saravia Jordy , Siefker David T , Jaligama Sridhar , Lee Greg I , Sallam Asmaa A , Harding Jeffrey N , Cormier Stephania A 
Published: April 2017

Abstract
Respiratory syncytial virus (RSV) is one of the leading causes of bronchiolitis in children, and severe RSV infection early in life has been associated with asthma development. Using a neonatal mouse model, we have shown that down-regulation of IL-4 receptor α (IL-4Rα) with antisense oligonucleotides in the lung during neonatal infection protected from RSV immunopathophysiology. Significant down-regulation of IL-4Rα was observed on pulmonary CD11b+ myeloid dendritic cells (mDCs) suggesting a role for IL-4Rα on mDCs in the immunopathogenesis of neonatal RSV infection. Here, we demonstrated that neonatal CD11b+ mDCs expressed higher levels of IL-4Rα than their adult counterparts. Because CD11b+ mDCs mainly present antigens to CD4+ T cells, we hypothesized that increased expression of IL-4Rα on neonatal CD11b+ mDCs was responsible for Th2 - biased RSV immunopathophysiology. Indeed, when IL-4Rα was selectively deleted from CD11b+ mDCs, the immunopathophysiology typically observed following RSV reinfection was ablated, including Th2 inflammation, airway-mucus hyperproduction, and pulmonary dysfunction. Further, overexpression of IL-4Rα on adult CD11b+ DCs and their adoptive transfer into adult mice was able to recapitulate the Th2-biased RSV immunopathology typically observed only in neonates infected with RSV. IL-4Rα levels on CD11c+ cells were inversely correlated with maturation status of CD11b+ mDCs upon RSV infection. Our data demonstrate that developmentally regulated IL-4Rα expression is critical for the maturity of pulmonary CD11b+ mDCs and the Th2-biased immunopathogenesis of neonatal RSV infection.