bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Intracerebral Hemorrhage Growth With the Spot Sign
Authors: Dowlatshahi Dar , Brouwers H. Bart , Demchuk Andrew M. , Hill Michael D. , Aviv Richard I. , Ufholz Lee-Anne , Reaume Michael , Wintermark Max , Hemphill J. Claude , Murai Yasuo , Wang Yongjun , Zhao Xingquan , Wang Yilong , Li Na , Sorimachi Takatoshi , Matsumae Mitsunori , Steiner Thorsten , Rizos Timolaos , Greenberg Steven M. , Romero Javier M. , Rosand Jonathan , Goldstein Joshua N. , Sharma Mukul 
Published: February 2016

Background and Purpose—
Hematoma expansion after acute intracerebral hemorrhage is common and is associated with early deterioration and poor clinical outcome. The computed tomographic angiography (CTA) spot sign is a promising predictor of expansion; however, frequency and predictive values are variable across studies, possibly because of differences in onset-to-CTA time. We performed a patient-level meta-analysis to define the relationship between onset-to-CTA time and frequency and predictive ability of the spot sign.

Methods—
We completed a systematic review for studies of CTA spot sign and hematoma expansion. We subsequently pooled patient-level data on the frequency and predictive values for significant hematoma expansion according to 5 predefined categorized onset-to-CTA times. We calculated spot-sign frequency both as raw and frequency-adjusted rates.

Results—

Among 2051 studies identified, 12 met our inclusion criteria. Baseline hematoma volume, spot-sign status, and time-to-CTA were available for 1176 patients, and 1039 patients had follow-up computed tomographies for hematoma expansion analysis. The overall spot sign frequency was 26%, decreasing from 39% within 2 hours of onset to 13% beyond 8 hours (
P
<0.001). There was a significant decrease in hematoma expansion in spot-positive patients as onset-to-CTA time increased (
P
=0.004), with positive predictive values decreasing from 53% to 33%.

Conclusions—
The frequency of the CTA spot sign is inversely related to intracerebral hemorrhage onset-to-CTA time. Furthermore, the positive predictive value of the spot sign for significant hematoma expansion decreases as time-to-CTA increases. Our results offer more precise risk stratification for patients with acute intracerebral hemorrhage and will help refine clinical prediction rules for intracerebral hemorrhage expansion.
Significance of Cerebral Small-Vessel Disease in Acute Intracerebral Hemorrhage
Authors: Sato Shoichiro , Delcourt Candice , Heeley Emma , Arima Hisatomi , Zhang Shihong , Al-Shahi Salman Rustam , Stapf Christian , Woo Daniel , Flaherty Matthew L. , Vagal Achala , Levi Christopher , Davies Leo , Wang Jiguang , Robinson Thompson , Lavados Pablo M. , Lindley Richard I. , Chalmers John , Anderson Craig S. ,   on behalf of the INTERACT2 Investigators
Published: February 2016

Background and Purpose—
The significance of structural changes associated with cerebral small-vessel disease (SVD), including white matter lesions (WML), lacunes, and brain atrophy, to outcome from acute intracerebral hemorrhage is uncertain. We determined associations of computed tomographic radiological manifestations of cerebral SVD and outcomes, and in terms of any differential effect of early intensive blood pressure–lowering treatment, in the large-scale Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).

Methods—
We graded WML (van Swieten scale), the presence of lacunes, and brain atrophy (2 linear measurements and visual rating) for 2069 of 2839 patients with available baseline brain computed tomography (<6 hours of intracerebral hemorrhage onset) by 3 independent neurologists blind to clinical data.

Results—

WML grade and 2 linear measurements of brain atrophy were associated with death or major disability at 90 days: multivariable-adjusted odds ratios for WML (grade 3 and 4 versus 0), frontal ratio, and third ventricle Sylvian fissure distance (most versus least severe atrophy quartile) were 1.42 (95% confidence interval, 1.02–1.98), 1.47 (1.08–1.99), and 1.64 (1.21–2.22), respectively (all
P
for trend <0.05). There was no association between lacunes and outcomes. There were no significant differences in the effects of intensive blood pressure–lowering across subgroups of cerebral SVD.

Conclusions—
Preexisting cerebral SVD manifestations of WML and brain atrophy predict poor outcome in acute intracerebral hemorrhage. There is no apparent hazard of early intensive lowering of blood pressure according to the INTERACT2 protocol, in patients with underlying cerebral SVD.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00716079.
Advanced Problems in Mathematics
Authors: Siklos Stephen 
Published: February 2016

This book is intended to help candidates prepare for entrance examinations in mathematics and scientific subjects, including STEP (Sixth Term Examination Paper). STEP is an examination used by Cambridge colleges as the basis for conditional offers. They are also used by Warwick University, and many other mathematics departments recommend that their applicants practice on the past papers even if they do not take the examination.
Advanced Problems in Mathematics is recommended as preparation for any undergraduate mathematics course, even for students who do not plan to take the Sixth Term Examination Paper. The questions analysed in this book are all based on recent STEP questions selected to address the syllabus for Papers I and II, which is the A-level core (i.e. C1 to C4) with a few additions. Each question is followed by a comment and a full solution. The comments direct the reader’s attention to key points and put the question in its true mathematical context. The solutions point students to the methodology required to address advanced mathematical problems critically and independently.
This book is a must read for any student wishing to apply to scientific subjects at university level and for anybody interested in advanced mathematics.
Seismic Imaging of Rapid Onset of Stratified Turbulence in the South Atlantic Ocean
Authors: Falder Matthew , White N. J. , Caulfield C. P. 
Published: February 2016

AbstractBroadband measurements of the internal wavefield will help to unlock an understanding of the energy cascade within the oceanic realm. However, there are challenges in acquiring observations with sufficient spatial resolution, especially in horizontal dimensions. Seismic reflection profiling can achieve a horizontal and vertical resolution of order meters. It is suitable for imaging thermohaline fine structure on scales that range from tens of meters to hundreds of kilometers. This range straddles the transition from internal wave to turbulent regimes. Here, the authors analyze an 80-km-long seismic image from the Falkland Plateau and calculate vertical displacement spectra of tracked reflections. First, they show that these spectra are consistent with the Garrett–Munk model at small horizontal wavenumbers (i.e., kx ≲ 3 × 10−3 cpm). There is a transition to stratified turbulence at larger wavenumbers (i.e., kx ≳ 2 × 10−1 cpm). This transition occurs at length scales that are significantly larger than the Ozmidov length scale above which stratification is expected to modify isotropic Kolmogorov turbulence. Second, the authors observe a rapid onset of this stratified turbulence over a narrow range of length scales. This onset is consistent with a characteristic energy injection scale of stratified turbulence with a forward cascade toward smaller scales through isotropic turbulence below the Ozmidov length scale culminating in microscale dissipation. Finally, they estimate the spatial pattern of diapycnal diffusivity and show that the existence of an injection scale can increase these estimates by a factor of 2.
Drought Risk and Adaptation in the Interior United States: Understanding the Importance of Local Context for Resource Management in Times of Drought*
Authors: McNeeley Shannon M. , Beeton Tyler A. , Ojima Dennis S. 
Published: February 2016

Abstract
Drought is a natural part of the historical climate variability in the northern Rocky Mountains and high plains region of the United States. However, recent drought impacts and climate change projections have increased the need for a systematized way to document and understand drought in a manner that is meaningful to public land and resource managers. The purpose of this exploratory study was to characterize the ways in which some federal and tribal natural resource managers experienced and dealt with drought on lands managed by the U.S. Department of the Interior (DOI) and tribes in two case site examples (northwest Colorado and southwest South Dakota) that have experienced high drought exposure in the last two decades. The authors employed a social–ecological system framework, whereby key informant interviews and local and regional drought indicator data were used characterize the social and ecological factors that contribute to drought vulnerability and the ways in which drought onset, persistence, severity, and recovery impact management. Results indicated that local differences in the timing, decisions, and specific management targets defined within the local social–ecological natural resource contexts are critical to understanding drought impacts, vulnerabilities, and responses. These findings suggest that manager-defined social–ecological contexts are critically important to understand how drought is experienced across the landscape and the indices that are needed to inform adaptation and response strategies.
Improved Gustatory Sensitivity in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy
Authors: Altun Huseyin , Hanci Deniz , Altun Hasan , Batman Burcin , Serin Rahmi Kursat , Karip Aziz Bora , Akyuz Umit 
Published: February 2016

Introduction: The reduction in the preferences for sweet and fat containing tastes in obese patients who underwent bariatric surgery was relatively well shown; however, there are only limited data on the changes in the sensitivity of other tastes like sour, salty, and bitter. Methods: We investigated the changes in gustatory sensitivity of 52 morbidly obese patients (M/F, 22/30; age range, 19-60 years; BMI range, 32.5-63.0 kg/m2) after laparoscopic sleeve gastrectomy. The surgery was performed by the same surgeon using 5 ports technique. Gustatory sensitivity was tested preoperatively and 1 and 3 months after the surgery using standardized Taste Strips test. Results: There was a statistically significant improvement in the taste acuity to sweet, sour, salty, and bitter tastants in morbidly obese patients after the laparoscopic sleeve gastrectomy during the follow-up period of 3 months. Median whole test scores of the patients were increased from 11.5 preoperatively to 14 in the first and third months. Conclusion: In this study, we were able to show the significant improvement in gustatory sensitivity of morbidly obese patients after laparoscopic sleeve gastrectomy for the first time in literature.
Improvements of deep vein reflux following radiofrequency ablation for saphenous vein incompetence
Authors: Kim Suh Min , Jung In Mok , Chung Jung Kee 
Published: February 2016

Objectives The aim of this study was to describe the changes of deep vein reflux after radiofrequency ablation for great saphenous vein incompetence. Method The data on 139 limbs which were treated with radiofrequency ablation for great saphenous vein incompetence were prospectively collected and reviewed. Results Deep vein reflux was present in 43 of 139 limbs (30.9%). There were no significant differences in the rate of successful closure, the incidence of procedure-related complications, and the improvements of symptoms and quality of life between the limbs with or without deep vein reflux. With a mean follow-up of 5.9 months, the peak reflux velocity and duration of reflux were improved in all limbs with deep vein reflux and it was completely corrected in 13 limbs (30.2%) after radiofrequency ablation. Conclusions The presence of deep vein reflux does not affect the treatment outcomes of radiofrequency ablation for great saphenous vein incompetence and is improved in all patients. Deep vein reflux is not a barrier to performing radiofrequency ablation.
Medical indication regarding life-sustaining treatment for children: Focus groups with clinicians
Authors: Lotz Julia Desiree , Jox Ralf J , Meurer Christine , Borasio Gian Domenico , Führer Monika 
Published: February 2016

Background: Decisions about medical indication are a relevant problem in pediatrics. Difficulties arise from the high prognostic uncertainty, the decisional incapacity of many children, the importance of the family, and conflicts with parents. The objectivity of judgments about medical indication has been questioned. Yet, little is known about the factors pediatricians actually include in their decisions. Aim: Our aims were to investigate which factors pediatricians apply in deciding about medical indication, and how they manage conflicts with parents. Design: We performed a qualitative focus group study with experienced pediatricians. The transcripts were subjected to qualitative content analysis. Setting/participants: We conducted three focus groups with pediatricians from different specialties caring for severely ill children/adolescents. They discussed life-sustaining treatment in two case scenarios that varied according to diagnosis, age, and gender. Results: The decisions about medical indication were based on considerations relating to the individual patient, to the family, and to other patients. Individual patient factors included clinical aspects and benefit–burden considerations. Physicians’ individual views and feelings influenced their decision-making. Different factors were applied or weighed differently in the two cases. In case of conflict with parents, physicians preferred solutions aimed at establishing consensus. Conclusion: The pediatricians defined medical indication on a case-by-case basis and were influenced by emotional reasoning. In contrast to prevailing ethico-legal principles, they included the interests of other persons in their decisions. Decision-making strategies should incorporate explicit discussions of social aspects and physicians’ feelings to improve the transparency of the decision-making process and reduce bias.
Twenty years of triptans in the United States Medicaid programs: Utilization and reimbursement trends from 1993 to 2013
Authors: Xia Ying , Kelton Christina ML , Wigle Patricia R , Heaton Pamela C , Guo Jeff J 
Published: February 2016

Objective After sumatriptan was approved by the Food and Drug Administration in 1992, triptans became first-line anti-migraine therapies. Rapidly rising triptan expenditures, however, led payers, including Medicaid, to implement cost-containment policies. We describe triptan utilization and reimbursement trends in Medicaid. Methods Using national summary files for outpatient drug utilization, utilization and expenditure data from 1993 to 2013 were extracted and summed for all triptan national drug codes reimbursed by Medicaid. Data were collected separately for tablets, injections and sprays. Results The number of triptan prescriptions increased from 87,348 in 1993 to 0.9 million in 2004; fell to 0.4 million in 2009; rose to 1 million in 2011; and rose 1.2 million in 2013. In 2013, Medicaid spent $96.8 million on triptans: 74.4%, 18.4% and 7.2% for tablets, injections and sprays, respectively. Average reimbursement per prescription was $54 for tablets, $351 for injections and $235 for sprays in 2013. From 1993 to 2013, sumatriptan was the most widely prescribed among the triptans. Conclusions The substantial increase in triptan prescriptions from 2009 to 2011, without being convincingly explained by either rising migraine prevalence or rising Medicaid enrollment, is suggestive of reduced access to these medications prior to 2009. Cost-containment policies may have inadvertently prevented Medicaid migraineurs from obtaining appropriate pharmacotherapy. Prior presentations An earlier version of this paper was presented as a poster at the Annual Meeting of the International Society for Pharmacoeconomics and Outcomes Research, Philadelphia, PA, May 2015, where it received a finalist award.
Impact of pulmonary disease on patient-reported outcomes and patient-performed functional testing in systemic lupus erythematosus
Authors: Fidler L , Keen K J , Touma Z , Mittoo S 
Published: February 2016

Objectives This study examines the effect of pulmonary disease on patient-reported outcomes (PROs) and patient-performed outcome (PPO) in systemic lupus erythematosus (SLE) patients at a single tertiary referral center. Methods Pulmonary function tests (PFTs), chest imaging, SLE-related damage, and disease activity were examined in 110 SLE patients. Presence was noted of abnormal PFTs, pleural disease, pulmonary hypertension (PH), pulmonary infarction, interstitial lung disease (ILD), and shrinking lung syndrome (SLS). PROs included the Medical Outcome Short Form-36 Health Survey, Pittsburgh Sleep Quality Index, Fatigue Severity Scale, Borg Dyspnea Scale, patient dyspnea and cough. The PPO of interest was the six-minute walk test (6MWT). Relationships amongst PROs, 6MWT, and pulmonary disease were studied. Results Pulmonary disease was present in 62 (56%) of 110 subjects: 54 (49%) abnormal PFT, 13 (12%) pleural disease, 12 (11%) ILD, 11 (10%) SLS and five (5%) PH. Dyspnea was the only PRO found to be significantly associated with pulmonary disease ( P = 0.0004). Participants with pulmonary disease compared to those without had significantly reduced distance ( P = 0.00015, 95% CI for mean 39–125 m) and predicted distance ( P = 0.00001, 10%–26%) on 6MWT. Conclusions Pulmonary disease is common in SLE and adversely impacts 6MWT distance and dyspnea without apparent influence on other PROs. The 6MWT may be a promising tool in the assessment of pulmonary disease in SLE.
‘Enabling dissent’: Contesting austerity and right populism in Toronto, Canada
Authors: Thomas Mark , Tufts Steven 
Published: February 2016

AbstractFollowing the 2008 financial crisis, austerity measures have been introduced in many national contexts to reorganise public sector work and redesign labour laws and labour policies. At the same time, right-populist discourses and movements have arisen in ways that give both legitimacy and voice to the politics of austerity. Toronto, Canada, provides a world-renowned case of populist experimentation at the metropolitan scale, as the actions of Mayor Rob Ford typified this nexus of austerity and populism. Set in the context of Ford’s term as Mayor of Toronto (2010–2014), this article asks how the combined rise of austerity and right populism creates both new challenges and new opportunities for public sector labour in urban spaces. We argue that public sector unions are central in both the making and unmaking of populist austerity and identify potential trajectories for organised labour in the face of the continuation of austerity-driven politics.
The PTEN/Akt Signaling Pathway Mediates Myocardial Apoptosis in Swine After Coronary Microembolization
Authors: Wang Jiangyou , Chen Han , Su Qiang , Zhou You , Liu Tao , Li Lang 
Published: February 2016

Background/Aims: Phosphatase and the tensin homolog deleted on chromosome ten (PTEN) has been recognized as a promoter of apoptosis in various tissues and has been shown to be upregulated in circumstances of coronary microembolization (CME). We hypothesized that the upregulation of PTEN correlates with CME-induced myocardial apoptosis. Methods: Swine CME was induced by an intracoronary injection of inert plastic microspheres (diameter of 42 μm) into the left anterior descending coronary, with or without pretreatment of the PTEN small-interfering RNA (siRNA). Echocardiological measurements, a pathological examination, Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) staining, and Western blotting, were performed to assess their functional, morphological, and molecular effects in CME. Results: PTEN was aberrantly upregulated in cardiomyocytes following CME. Downregulation of PTEN in vivo via siRNA was associated with improved cardiac function and attenuated myocardial apoptosis; concomitantly inhibited the expression of key proapoptotic proteins, such as phosphorylated Bad (p-Bad); cleaved caspase-3; and enhanced the expression of key antiapoptotic proteins, such as phosphorylated protein kinase B (p-Akt). However, there was no difference in the Akt-regulated downstream protein IκB kinases (IKKα, IKKβ, and IKKγ) among the sham, CME, and control siRNA groups. Conclusion: This study demonstrates, for the first time, that the PTEN/Akt signaling pathway contributes to cardiomyocyte apoptosis. The data generated from this study provide a rationale for the development of PTEN-based therapeutic strategies for CME-induced myocardial injury.
Perfusion reduction in the absence of structural differences in cognitively impaired versus unimpaired RRMS patients
Authors: Hojjat Seyed-Parsa , Cantrell Charles Grady , Carroll Timothy J , Vitorino Rita , Feinstein Anthony , Zhang Lying , Symons Sean P , Morrow Sarah A , Lee Liesly , O’Connor Paul , Aviv Richard I 
Published: February 2016

Background: Cognitive impairment affects 40%–68% of relapsing-remitting multiple sclerosis (RRMS) patients. Gray matter (GM) demyelination is complicit in cognitive impairment, yet cortical lesions are challenging to image clinically. We wanted to determine whether cortical cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) differences exist between cognitively impaired (CI) and unimpaired (NI) RRMS. Methods: Prospective study of healthy controls ( n = 19), CI ( n = 20), and NI ( n = 19) undergoing magnetic resonance imaging (MRI) and cognitive testing <1 week apart. White matter (WM) T2 hyperintense lesions and T1 black holes were traced. General linear regression assessed the relationship between lobar WM volume and cortical and WM CBF, CBV, and MTT. Relationship between global and lobar cortical CBF, CBV, and MTT and cognitive impairment was tested using a generalized linear model. Adjusted Bonferroni p < 0.005 was considered significant. Results: No significant differences for age, gender, disease duration, and any fractional brain or lesion volume were demonstrated for RRMS subgroups. Expanded Disability Status Scale (EDSS) and Hospital Anxiety and Depression Scale–Depression (HADS-D) were higher in CI. Lobar cortical CBF and CBV were associated with cognitive impairment ( p < 0.0001) after controlling for confounders. Cortical CBV accounted for 7.2% of cognitive impairment increasing to 8.7% with cortical CBF ( p = 0.06), while WM and cortical CBF accounted for 8.2% of variance ( p = 0.04). Conclusion: Significant cortical CBF and CBV reduction was present in CI compared to NI in the absence of structural differences.
A Closed Lateral Subtalar Dislocation With Checkrein Deformity of Great Toe due to Entrapment of Flexor Hallucis Longus
Authors: Tanwar Yashwant Singh , Singh Satyaprakash , Arya Rajender Kumar , Aujla Navneet , Mathur Ashish , Kharbanda Yatinder 
Published: February 2016

Closed lateral subtalar dislocation is a very rare injury. We report a case of closed lateral subtalar dislocation with entrapment of flexor hallucis longus tendon producing a checkrein deformity. The patient was managed immediately with closed reduction under regional anesthesia and fixated with percutaneous Kirschner wires. Early mobilization and weightbearing was started and there were no complications till the last follow-up visit. Levels of Evidence: Therapeutic, Level IV: Case study