bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis
Authors: Nerlekar Nitesh , Ha Francis J. , Verma Kunal P. , Bennett Martin R. , Cameron James D. , Meredith Ian T. , Brown Adam J. 
Published: November 2016

Background—
Current guidelines suggest that coronary artery bypass grafting (CABG) should be the preferred revascularization method for unprotected left main coronary artery stenosis. In light of evidence from recent randomized trials, we assessed whether percutaneous coronary intervention (PCI) using drug-eluting stents is as safe and effective as CABG for the treatment of unprotected left main coronary artery disease.

Methods and Results—

Digital databases and manual searches were performed for randomized trials comparing PCI and CABG for unprotected left main coronary artery stenosis. Among 3887 potentially relevant studies, 5 met inclusion criteria. The primary safety end point was defined as the composite of all-cause death, myocardial infarction, or stroke. Secondary end points included a clinical effectiveness composite, which was defined as all-cause death, myocardial infarction, stroke, or repeat revascularization. Summary estimates were obtained using random-effects modeling. In total, 4594 patients were included in the analysis. There was no significant difference in the primary safety end point between the revascularization strategies (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.79–1.17;
P
=0.73). However, when compared with CABG, PCI was less effective (OR, 1.36; 95% CI, 1.18–1.58;
P
<0.001) because of significantly higher rates of repeat revascularization (OR, 1.85; 95% CI, 1.53–2.23;
P
<0.001). The incidence of all-cause death (OR, 1.03; 95% CI, 0.78–1.35;
P
=0.61), myocardial infarction (OR, 1.46; 95% CI, 0.88–2.45;
P
=0.08), and stroke (OR, 0.88; 95% CI, 0.39–1.97;
P
=0.53) did not differ between PCI and CABG.

Conclusions—
PCI using drug-eluting stents and CABG are equally safe methods of revascularization for patients at low surgical risk with significant unprotected left main coronary artery stenosis. However, CABG is associated with significantly lower rates of repeat revascularization.
Prevalence and Clinical Significance of Discordant Changes in Fractional and Coronary Flow Reserve After Elective Percutaneous Coronary Intervention
Authors: Matsuda Junji , Murai Tadashi , Kanaji Yoshihisa , Usui Eisuke , Araki Makoto , Niida Takayuki , Ichijyo Sadamitsu , Hamaya Rikuta , Lee Tetsumin , Yonetsu Taishi , Isobe Mitsuaki , Kakuta Tsunekazu 
Published: November 2016

Background

Fractional flow reserve (
FFR
) and coronary flow reserve (
CFR
) are well‐validated physiological indices; however, changes in
FFR
and
CFR
after percutaneous coronary intervention (
PCI
) remain elusive. We sought to evaluate these changes and to investigate whether physiological indices predict cardiac event‐free survival after
PCI
.

Methods and Results

Physiological assessment of 220 stenoses from 220 patients was performed before and after
PCI
. The changes in
FFR
and
CFR
were studied, and factors associated with
CFR
change were investigated. Follow‐up data were collected to determine the predictor of cardiac events.
CFR
increase was found in 158 (71.8%) territories, and 62 (28.2%) presented a decrease, whereas
FFR
increased in all 220 (100%) territories. Pre‐ and post‐
PCI
percentage diameter stenoses were 57.7±11.2% and 7.48±4.79%, respectively. Post‐
PCI CFR
increase was associated with pre‐
PCI
indices including low
FFR
, low
CFR
and high microvascular resistance, and post‐
PCI
hyperemic coronary flow increase. Post‐
PCI CFR
decrease was not associated with significant post‐
PCI
hyperemic coronary flow increase. At a median follow‐up of 24.3 months, adverse event–free survival was significantly worse in patients with lower pre‐
PCI CFR
(log‐rank test λ
2
=7.26;
P
=0.007). Cox proportional hazards analysis showed that lower pre‐
PCI CFR
(hazard ratio 0.73; 95%
CI
0.55–0.97;
P
=0.028) was an independent predictor of adverse cardiovascular events after
PCI
.

Conclusions

CFR
decrease after
PCI
was not uncommon, and discordant change in
FFR
and
CFR
was associated with high pre‐
PCI CFR
, low pre‐
PCI
microvascular resistance, and no significant post‐
PCI
hyperemic coronary flow increase. Pre‐
PCI CFR
, not post‐
PCI
physiological indices, may help identify patients who require adjunctive management strategy after successful
PCI
.
Temporal Evolution of Poststroke Cognitive Impairment Using the Montreal Cognitive Assessment
Authors: Nijsse Britta , Visser-Meily Johanna M.A. , van Mierlo Maria L. , Post Marcel W.M. , de Kort Paul L.M. , van Heugten Caroline M. 
Published: November 2016

Background and Purpose—
The Montreal Cognitive Assessment (MoCA) is nowadays recommended for the screening of poststroke cognitive impairment. However, little is known about the temporal evolution of MoCA-assessed cognition after stroke. The objective of this study was to examine the temporal pattern of overall and domain-specific cognition at 2 and 6 months after stroke using the MoCA and to identify patient groups at risk for cognitive impairment at 6 months after stroke.

Methods—
Prospective cohort study in which 324 patients were administered the MoCA at 2 and 6 months post stroke. Cognitive impairment was defined as MoCA<26. Differences in cognitive impairment rates between 2 and 6 months post stroke were analyzed in different subgroups. Patients with MoCA score <26 at 2 months, who improved by ≥2 points by 6 months, were defined as reverters. Logistic regression analyses were used to identify determinants of (1) cognitive impairment at 6 months post stroke and (2) reverter status.

Results—

Between 2 and 6 months post stroke, mean MoCA score improved from 23.7 (3.9) to 24.7 (3.5),
P
<0.001. Prevalence of cognitive impairment at 2 months was 66.4%, compared with 51.9% at 6 months (
P
<0.001). More comorbidity and presence of cognitive impairment at 2 months were significant independent predictors of cognitive impairment 6 months post stroke. No significant determinants of reverter status were identified.

Conclusions—
Although cognitive improvement is seen ≤6 months post stroke, long-term cognitive deficits are prevalent. Identifying patients at risk of cognitive impairment is, therefore, important as well as targeting interventions to this group.
Perioperative Antihypertensive Treatment in Patients With Spontaneous Intracerebral Hemorrhage
Authors: Zheng Jun , Li Hao , Lin Sen , Ma Junpeng , Guo Rui , Ma Lu , Fang Yuan , Tian Meng , Liu Ming , You Chao 
Published: November 2016

Background—
Studies on antihypertensive treatment for surgical patients with spontaneous intracerebral hemorrhage are insufficient. This pilot study was conducted to investigate the safety of the perioperative intensive blood pressure lowering in surgical patients with spontaneous intracerebral hemorrhage.

Methods—
This study was a prospective, parallel, randomized, assessor-blinded trial. Patients allocated to the intensive group received perioperative intensive antihypertensive treatment aiming to achieve a target systolic blood pressure between 120 and 140 mm Hg, whereas the patients in the conservative group received conservative treatment aiming to achieve a target systolic blood pressure between 140 and 180 mm Hg for 7 days. The primary outcome was the rate of rehemorrhage at 7 days after surgery.

Results—

Rehemorrhage was noted in 11 patients (11%) in the intensive group and 14 (14%) in the conservative group (
P
=0.689). There was no significant difference in mortality at 7 days (4.0% versus 10.0%;
P
=0.164), 30 days (10.4% versus 17.2%;
P
=0.247), and 90 days (13.5% versus 18.2%;
P
=0.490) between the 2 groups.

Conclusions—
Perioperative intensive blood pressure lowering was not associated with a reduced incidence of rehemorrhage, death, or other serious adverse events.

Clinical Trial Registration—

URL:
http://www.chictr.org.cn/
. Unique identifier: ChiCTR-TRC-13004304.
Cannabinoid Type-2 Receptor Drives Neurogenesis and Improves Functional Outcome After Stroke
Authors: Bravo-Ferrer Isabel , Cuartero María I. , Zarruk Juan G. , Pradillo Jesús M. , Hurtado Olivia , Romera Víctor G. , Díaz-Alonso Javier , García-Segura Juan M. , Guzmán Manuel , Lizasoain Ignacio , Galve-Roperh Ismael , Moro María A. 
Published: November 2016

Background and Purpose—
Stroke is a leading cause of adult disability characterized by physical, cognitive, and emotional disturbances. Unfortunately, pharmacological options are scarce. The cannabinoid type-2 receptor (CB2R) is neuroprotective in acute experimental stroke by anti-inflammatory mechanisms. However, its role in chronic stroke is still unknown.

Methods—

Stroke was induced by permanent middle cerebral artery occlusion in mice; CB2R modulation was assessed by administering the CB2R agonist JWH133 ((6aR,10aR)-3-(1,1-dimethylbutyl)-6a,7,10,10a-tetrahydro-6,6,9-trimethyl-6H-dibenzo[b,d]pyran) or the CB2R antagonist SR144528 (
N
-[(1S)-
endo
-1,3,3-trimethylbicyclo-[2.2.1]-heptan-2-yl]-5-(4-chloro-3-methylphenyl)-1-(4-methylbenzyl)-pyrazole-3-carboxamide) once daily from day 3 to the end of the experiment or by CB2R genetic deletion. Analysis of immunofluorescence-labeled brain sections, 5-bromo-2´-deoxyuridine (BrdU) staining, fluorescence-activated cell sorter analysis of brain cell suspensions, and behavioral tests were performed.

Results—

SR144528 decreased neuroblast migration toward the boundary of the infarct area when compared with vehicle-treated mice 14 days after middle cerebral artery occlusion. Consistently, mice on this pharmacological treatment, like mice with CB2R genetic deletion, displayed a lower number of new neurons (NeuN
+
/BrdU
+
cells) in peri-infarct cortex 28 days after stroke when compared with vehicle-treated group, an effect accompanied by a worse sensorimotor performance in behavioral tests. The CB2R agonist did not affect neurogenesis or outcome in vivo, but increased the migration of neural progenitor cells in vitro; the CB2R antagonist alone did not affect in vitro migration.

Conclusions—
Our data support that CB2R is fundamental for driving neuroblast migration and suggest that an endocannabinoid tone is required for poststroke neurogenesis by promoting neuroblast migration toward the injured brain tissue, increasing the number of new cortical neurons and, conceivably, enhancing motor functional recovery after stroke.
Transcranial Direct Current Stimulation Potentiates Improvements in Functional Ability in Patients With Chronic Stroke Receiving Constraint-Induced Movement Therapy
Authors: Figlewski Krystian , Blicher Jakob Udby , Mortensen Jesper , Severinsen Kåre Eg , Nielsen Jørgen Feldbæk , Andersen Henning 
Published: November 2016

Background and Purpose—
Transcranial direct current stimulation may enhance effect of rehabilitation in patients with chronic stroke. The objective was to evaluate the efficacy of anodal transcranial direct current stimulation combined with constraint-induced movement therapy of the paretic upper limb.

Methods—
A total of 44 patients with stroke were randomly allocated to receive 2 weeks of constraint-induced movement therapy with either anodal or sham transcranial direct current stimulation. The primary outcome measure, Wolf Motor Function Test, was assessed at baseline and after the intervention by blinded investigators.

Results—
Both groups improved significantly on all Wolf Motor Function Test scores. Group comparison showed improvement on Wolf Motor Function Test in the anodal group compared with the sham group.

Conclusions—
Anodal transcranial direct current stimulation combined with constraint-induced movement therapy resulted in improvement of functional ability of the paretic upper limb compared with constraint-induced movement therapy alone.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01983319.
Long-Term Risk of Dementia Among Survivors of Ischemic or Hemorrhagic Stroke
Authors: Corraini Priscila , Henderson Victor W. , Ording Anne G. , Pedersen Lars , Horváth-Puhó Erzsébet , Sørensen Henrik T. 
Published: November 2016

Background and Purpose—
Stroke is a risk factor for dementia, but the risk of dementia after different stroke types is poorly understood. We examined the long-term risk of dementia among survivors of any first-time stroke and of first-time ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage.

Methods—
We conducted a 30-year nationwide population-based cohort study using data from Danish medical databases (1982–2013) covering all Danish hospitals. We identified 84 220 ischemic stroke survivors, 16 723 intracerebral hemorrhage survivors, 9872 subarachnoid hemorrhage survivors, and 104 303 survivors of unspecified stroke types. Patients were aged ≥18 years and survived for at least 3 months after diagnosis. We formed a comparison cohort from the general population (1 075 588 patients without stroke, matched to stroke patients by age and sex). We computed absolute risks and hazard ratios of dementia up to 30 years after stroke.

Results—
The 30-year absolute risk of dementia among stroke survivors was 11.5% (95% confidence interval, 11.2%–11.7%). Compared with the general population, the hazard ratio (95% confidence interval) for dementia among stroke survivors was 1.80 (1.77–1.84) after any stroke, 1.72 (1.66–1.77) after ischemic stroke, 2.70 (2.53–2.89) after intracerebral hemorrhage, and 2.74 (2.45–3.06) after subarachnoid hemorrhage. Younger patients regardless of stroke type faced higher risks of poststroke dementia than older patients. The pattern of hazard ratios by stroke type did not change during follow-up and was not altered appreciably by age, sex, or preexisting diagnoses of vascular conditions.

Conclusions—
Stroke increases dementia risk. Survivors of intracerebral hemorrhage and subarachnoid hemorrhage are at particularly high long-term risk of poststroke dementia.
Rehabilitation Augments Hematoma Clearance and Attenuates Oxidative Injury and Ion Dyshomeostasis After Brain Hemorrhage
Authors: Williamson Michael R. , Dietrich Kristen , Hackett Mark J. , Caine Sally , Nadeau Colby A. , Aziz Jasmine R. , Nichol Helen , Paterson Phyllis G. , Colbourne Frederick 
Published: November 2016

Background and Purpose—
We assessed the elemental and biochemical effects of rehabilitation after intracerebral hemorrhage, with emphasis on iron-mediated oxidative stress, using a novel multimodal biospectroscopic imaging approach.

Methods—
Collagenase-induced striatal hemorrhage was produced in rats that were randomized to enriched rehabilitation or control intervention starting on day 7. Animals were euthanized on day 14 or 21, a period of ongoing cell death. We used biospectroscopic imaging techniques to precisely determine elemental and molecular changes on day 14. Hemoglobin content was assessed with resonance Raman spectroscopy. X-ray fluorescence imaging mapped iron, chlorine, potassium, calcium, and zinc. Protein aggregation, a marker of oxidative stress, and the distribution of other macromolecules were assessed with Fourier transform infrared imaging. A second study estimated hematoma volume with a spectrophotometric assay at 21 days.

Results—

In the first experiment, rehabilitation reduced hematoma hemoglobin content (
P
=0.004) and the amount of peri-hematoma iron (
P
<0.001). Oxidative damage was highly localized at the hematoma/peri-hematoma border and was decreased by rehabilitation (
P
=0.004). Lipid content in the peri-hematoma zone was increased by rehabilitation (
P
=0.016). Rehabilitation reduced the size of calcium deposits (
P
=0.040) and attenuated persistent dyshomeostasis of Cl
−
(
P
<0.001) but not K
+
(
P
=0.060). The second study confirmed that rehabilitation decreased hematoma volume (
P
=0.024).

Conclusions—
Rehabilitation accelerated clearance of toxic blood components and decreased chronic oxidative stress. As well, rehabilitation attenuated persistent ion dyshomeostasis. These novel effects may underlie rehabilitation-induced neuroprotection and improved recovery of function. Pharmacotherapies targeting these mechanisms may further improve outcome.
Over 5,000 Years of Ensemble Future Climate Simulations by 60-km Global and 20-km Regional Atmospheric Models
Authors: Mizuta Ryo , Murata Akihiko , Ishii Masayoshi , Shiogama Hideo , Hibino Kenshi , Mori Nobuhito , Arakawa Osamu , Imada Yukiko , Yoshida Kohei , Aoyagi Toshinori , Kawase Hiroaki , Mori Masato , Okada Yasuko , Shimura Tomoya , Nagatomo Toshiharu , Ikeda Mikiko , Endo Hirokazu , Nosaka Masaya , Arai Miki , Takahashi Chiharu , Tanaka Kenji , Takemi Tetsuya , Tachikawa Yasuto , Temur Khujanazarov , Kamae Youichi , Watanabe Masahiro , Sasaki Hidetaka , Kitoh Akio , Takayabu Izuru , Nakakita Eiichi , Kimoto Masahide 
Published: November 2016

Abstract
An unprecedentedly large ensemble of climate simulations with a 60-km atmospheric general circulation model and dynamical downscaling with a 20-km regional climate model has been performed to obtain probabilistic future projections of low-frequency local-scale events. The climate of the latter half of the twentieth century, the climate 4 K warmer than the preindustrial climate, and the climate of the latter half of the twentieth century without historical trends associated with the anthropogenic effect are each simulated for more than 5,000 years. From large ensemble simulations, probabilistic future changes in extreme events are available directly without using any statistical models. The atmospheric models are highly skillful in representing localized extreme events, such as heavy precipitation and tropical cyclones. Moreover, mean climate changes in the models are consistent with those in phase 5 of the Coupled Model Intercomparison Project (CMIP5) ensembles. Therefore, the results enable the assessment of probabilistic change in localized severe events that have large uncertainty from internal variability. The simulation outputs are open to the public as a database called “Database for Policy Decision Making for Future Climate Change” (d4PDF), which is intended to be utilized for impact assessment studies and adaptation planning for global warming.
Multidecadal Indian Ocean Variability Linked to the Pacific and Implications for Preconditioning Indian Ocean Dipole Events
Authors: Ummenhofer Caroline C. , Biastoch Arne , Böning Claus W. 
Published: November 2016

Abstract
The Indian Ocean has sustained robust surface warming in recent decades, but the role of multidecadal variability remains unclear. Using ocean model hindcasts, characteristics of low-frequency Indian Ocean temperature variations are explored. Simulated upper-ocean temperature changes across the Indian Ocean in the hindcast are consistent with those recorded in observational products and ocean reanalyses. Indian Ocean temperatures exhibit strong warming trends since the 1950s limited to the surface and south of 30°S, while extensive subsurface cooling occurs over much of the tropical Indian Ocean. Previous work focused on diagnosing causes of these long-term trends in the Indian Ocean over the second half of the twentieth century. Instead, the temporal evolution of Indian Ocean subsurface heat content is shown here to reveal distinct multidecadal variations associated with the Pacific decadal oscillation, and the long-term trends are thus interpreted to result from aliasing of the low-frequency variability. Transmission of the multidecadal signal occurs via an oceanic pathway through the Indonesian Throughflow and is manifest across the Indian Ocean centered along 12°S as westward-propagating Rossby waves modulating thermocline and subsurface heat content variations. Resulting low-frequency changes in the eastern Indian Ocean thermocline depth are associated with decadal variations in the frequency of Indian Ocean dipole (IOD) events, with positive IOD events unusually common in the 1960s and 1990s with a relatively shallow thermocline. In contrast, the deeper thermocline depth in the 1970s and 1980s is associated with frequent negative IOD and rare positive IOD events. Changes in Pacific wind forcing in recent decades and associated rapid increases in Indian Ocean subsurface heat content can thus affect the basin’s leading mode of variability, with implications for regional climate and vulnerable societies in surrounding countries.
Evaluation of Quantitative Precipitation Estimations through Hydrological Modeling in IFloodS River Basins
Authors: Wu Huan , Adler Robert F. , Tian Yudong , Gu Guojun , Huffman George J. 
Published: November 2016

Abstract
A multiple-product-driven hydrologic modeling framework (MMF) is utilized for evaluation of quantitative precipitation estimation (QPE) products, motivated by improving the utility of satellite QPE in global flood modeling. This work addresses the challenge of objectively determining the relative value of various QPEs at river basin/subbasin scales. A reference precipitation dataset is created using a long-term water-balance approach with independent data sources. The intercomparison of nine QPEs and corresponding hydrologic simulations indicates that all products with long-term (2002–13) records have similar merits as over the short-term (April–June 2013) Iowa Flood Studies period. The model performance in calculated streamflow varies approximately linearly with precipitation bias, demonstrating that the model successfully translated the level of precipitation quality to streamflow quality with better streamflow simulations from QPEs with less bias. Phase 2 of the North American Land Data Assimilation System (NLDAS-2) has the best streamflow results for the Iowa–Cedar River basin, with daily and monthly Nash–Sutcliffe coefficients and mean annual bias of 0.81, 0.88, and −2.1%, respectively, for the long-term period. The evaluation also indicates that a further adjustment of NLDAS-2 to form the best precipitation estimation should consider spatial–temporal distribution of bias. The satellite-only products have lower performance (peak and timing) than other products, while simple bias adjustment can intermediately improve the quality of simulated streamflow. The TMPA research product (TMPA-RP; research-quality data) can generate results approaching those of the ground-based products with only monthly gauge-based adjustment to the TMPA real-time product (TMPA-RT; near-real-time data). It is further noted that the streamflow bias is strongly correlated to precipitation bias at various time scales, though other factors may play a role as well, especially on the daily time scale.
Estimation of Needleleaf Canopy and Trunk Temperatures and Longwave Contribution to Melting Snow
Authors: Musselman K. N. , Pomeroy J. W. 
Published: November 2016

AbstractA measurement and modeling campaign evaluated variations in tree temperatures with solar exposure at the edge of a forest clearing and how the resulting longwave radiation contributed to spatial patterns of snowmelt energy surrounding an individual tree. Compared to measurements, both a one-dimensional (1D) energy-balance model and a two-dimensional (2D) radial trunk heat transfer model that simulated trunk surface temperatures and thermal inertia performed well (RMSE and biases better than 1.7° and ±0.4°C). The 2D model that resolved a thin bark layer better simulated daytime temperature spikes. Measurements and models agreed that trunk surfaces returned to ambient air temperature values near sunset. Canopy needle temperatures modeled with a 1D energy-balance approach were within the range of measurements. The radiative transfer model simulated substantial tree-contributed snow surface longwave irradiance to a distance of approximately one-half the tree height, with higher values on the sun-exposed sides of the tree. Trunks had very localized and substantially lower longwave energy influence on snowmelt compared to that of the canopy. The temperature and radiative transfer models provide the spatially detailed information needed to develop scaling relationships for estimating net radiation for snowmelt in sparse and discontinuous forest canopies.