bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stroke Epidemiology and Risk Factor Management
Authors: Guzik Amy , Bushnell Cheryl 
Published: February 2017

ABSTRACT

Purpose of Review: Death from stroke has decreased over the past decade, with stroke now the fifth leading cause of death in the United States. In addition, the incidence of new and recurrent stroke is declining, likely because of the increased use of specific prevention medications, such as statins and antihypertensives. Despite these positive trends in incidence and mortality, many strokes remain preventable. The major modifiable risk factors are hypertension, diabetes mellitus, tobacco smoking, and hyperlipidemia, as well as lifestyle factors, such as obesity, poor diet/nutrition, and physical inactivity. This article reviews the current recommendations for the management of each of these modifiable risk factors.

Recent Findings: It has been documented that some blood pressure medications may increase variability of blood pressure and ultimately increase the risk for stroke. Stroke prevention typically includes antiplatelet therapy (unless an indication for anticoagulation exists), so the most recent evidence supporting use of these drugs is reviewed. In addition, emerging risk factors, such as obstructive sleep apnea, electronic cigarettes, and elevated lipoprotein (a), are discussed.

Summary: Overall, secondary stroke prevention includes a multifactorial approach. This article incorporates evidence from guidelines and published studies and uses an illustrative case study throughout the article to provide examples of secondary prevention management of stroke risk factors.
Treatment of Acute Ischemic Stroke
Authors: Rabinstein Alejandro A. 
Published: February 2017

ABSTRACT

Purpose of Review: This article provides an update on the state of the art of the emergency treatment of acute ischemic stroke with particular emphasis on the alternatives for reperfusion therapy.

Recent Findings: The results of several randomized controlled trials consistently and conclusively demonstrating that previously functional patients with disabling strokes from a proximal intracranial artery occlusion benefit from prompt recanalization with mechanical thrombectomy using a retrievable stent have changed the landscape of acute stroke therapy. Mechanical thrombectomy within 6 hours of symptom onset should now be considered the preferred treatment for these patients along with IV thrombolysis with recombinant tissue plasminogen activator (rtPA) within the first 4.5 hours for all patients who do not have contraindications for systemic thrombolysis. Patients who are ineligible for IV rtPA can also benefit from mechanical thrombectomy. Collateral status and time to reperfusion are the main determinants of outcome.

Summary: Timely successful reperfusion is the most effective treatment for patients with acute ischemic stroke. Systems of care should be optimized to maximize the number of patients with acute ischemic stroke able to receive reperfusion therapy.
Prevention and Management of Poststroke Complications
Authors: Huang Josephine F. 
Published: February 2017

ABSTRACT

Purpose of Review: This article provides a synopsis of the immediate and delayed medical complications of stroke, with an emphasis on prevention and management of these complications.

Recent Findings: Meta-analysis of the trials for endovascular treatment of acute stroke shows no significant increase in hemorrhagic events. Rehabilitation guidelines published by the American Heart Association and American Stroke Association in 2016 aid in providing the best clinical practice for patients with stroke, from the time of their initial hospitalization to their return to the community.

Summary: Medical complications from stroke are common and are associated with poor clinical outcomes, increased length of hospital stays and higher rates of readmission, increased cost of care, delayed time to rehabilitation, and increased mortality. Being cognizant of the common complications encountered, taking appropriate measures to prevent them, and knowing how to manage them when they do occur are essential to the continued care of patients with stroke.
Stroke Rehabilitation
Authors: Belagaje Samir R. 
Published: February 2017

ABSTRACT

Purpose of Review: Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery.

Recent Findings: Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation.

Summary: A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a multidisciplinary approach with judicious use of resources to identify and treat common poststroke sequelae.
Arterial Ischemic Stroke in Children and Young Adults
Authors: Lo Warren D. , Kumar Riten 
Published: February 2017

ABSTRACT

Purpose of Review: This article reviews risk factors, recurrence risk, evaluation, management, and outcomes of arterial ischemic stroke in children and young adults.

Recent Findings: The risk for recurrence and mortality appear to be low for neonatal and childhood stroke. Most children have relatively mild deficits, but those who have greater neurologic deficits, poststroke epilepsy, or strokes early in life are at risk for lower overall cognitive function. Stroke recurrence and long-term mortality after stroke in young adults are greater than originally thought. Cognitive impairments, depression, and anxiety are associated with higher levels of poststroke unemployment and represent targets for improved poststroke care. Poststroke care in young adults involves more than medical management. Self-reported memory and executive function impairments may be more severe than what is detected by objective measures. Assessment of possible cognitive impairments and appropriate management of psychological comorbidities are key to maximizing the long-term functional outcome of stroke survivors.

Summary: Childhood and young adult stroke survivors survive for many more years than older patients with stroke. To ensure that these survivors maximize the productivity of their lives, neurologists must not only optimize medical management but also recognize that impairments in cognition and mood may be remediable barriers to long-term functional independence.
Failure Is an Option: Institutional Change, Entrepreneurial Risk, and New Firm Growth
Authors: Eberhart Robert N. , Eesley Charles E. , Eisenhardt Kathleen M. 
Published: February 2017

Does an institutional change that lowers failure barriers improve new firm growth? We take advantage of a quasi-natural experiment in Japan that drastically reduced the stringency of bankruptcy regulations to examine this question. Using longitudinal data over a 10-year period, we find that bankruptcy reform increases the rates of bankruptcy and founding—and, more importantly, the likelihood of high-growth ventures—by disproportionately encouraging elite individuals (i.e., those with superior human and social capital) to start firms. In turn, these firms are more likely than others to achieve high growth. Broadly put, we contribute to research at the nexus of institutional theory and entrepreneurship by emphasizing the connectedness of barriers to failure, venture growth, and elite entrepreneurs. We also highlight how institutional change that eases bankruptcy change can foster a regenerative cycle of failure, founding, and growth by attracting more capable entrepreneurs. Overall, we conclude that lowering barriers to failure via lenient bankruptcy laws encourages more capable—and not just more—entrepreneurs to start firms. The online appendix is available at https://doi.org/10.1287/orsc.2017.1110 .
Effects of work environment on patient and nurse outcomes
Authors: Copanitsanou Panagiota , Fotos Nikolaos , Brokalaki Hero 
Published: February 2017

Background: Several parameters of the nurse's work environment lead to fewer patient complications and lower nurse burnout. The aim of this systematic review was the analysis of research data related to the effect of nurses' work environments on outcomes for both patients and nurses. Methods: Medline was searched by using keywords: ‘working conditions’, ‘work environment’, ‘nurses’, ‘nursing staff’, ‘patients’, ‘outcomes’. Results: In total, 10 studies were included, of which 4 were cross-sectional and the remaining were descriptive correlational studies. Patients who were hospitalised in units with good work environments for the nurses were more satisfied with the nursing care than the patients in units with poor work environments. Nurses who perceived their work environment to be good experienced higher job satisfaction and lower rates of burnout syndrome. Conclusions: A good work environment constitutes a determinant factor for high care quality and, at the same time, relates to improved outcomes for the nurses.
Crisis resource management in relation to empowering people to speak up in emergency medical service clinical practice settings
Authors: Gangaram Padarath , Menacho Aldo Mendoza , Alinier Guillaume 
Published: February 2017

Teamwork and effective communication have been identified as key principles in Crisis Resource Management (CRM) in the context of emergency care medicine. The aim of CRM is to ultimately improve patient safety and prevent at-risk situations or events. These principles optimise patient safety and benefits. Pre-hospital emergency care in Qatar is provided by the national Ambulance Service (HMCAS). Their operations are labour intensive, and depend on the professional readiness and communication of their culturally diverse practitioners. Structures within HMCAS are hierarchical, which may be a deterrent to effective communication in Qatar. Emergency medical care (EMC) practitioners may not be forthcoming with their concerns to the detriment of patient safety. These factors can create an environment which is not conducive to effective communication, and may inherently suppress free expression of speech in emergency situations and day-to-day working practices. Managers should therefore be encouraged to create an environment whereby practitioners can speak up, irrespective of culture, nationality, or the presence of more senior or experienced colleagues. CRM principles are well incorporated as part of the EMC's orientation programme and specialised professional development courses. Regular training involving all role players (including supervisors) in different settings, and appropriately simulated scenarios that call for application of CRM principles is required to further improve the quality of EMC service in Qatar.
Paramedics and their role in end-of-life care: perceptions and confidence
Authors: Kirk Andrew , Crompton Philip W , Knighting Katherine , Kirton Jennifer , Jack Barbara 
Published: February 2017

Background: Studies have highlighted paramedics are inadequately prepared to care for patients who are at the end of their life, due to the historical focus of their training on acute medical management. This appears to cause conflict with paramedic perceptions of their role. Objective: To gain an understanding of paramedics' perceptions, confidence and concerns towards dealing with end of life care patients and their families. Design: An online survey comprising open and closed questions was distributed to all paramedics in a regional ambulance service in the north of England. Demographic data included: National Health Service (NHS) grade, personal experience, education and training to contextualise the data. A total population sample across differing organisational roles was used for paramedics in a regional ambulance service in the north of England. Responses were obtained from 182 staff. Results: NHS grade and length of service as a paramedic influenced the participant's confidence and concerns when dealing with end of life patients. A large number of participants (n=126, 70%) identified validity of documentation as a concern with 83 (46%) highlighting fear of litigation and 90 (50%) identifying that conflict with families was a concern. Support from other services was viewed as a contributing factor to increased paramedic involvement in end of life care. Conclusion: Most paramedics viewed end of life care as central to their role, but there was a need for further specific education to help enable paramedics to feel more confident, competent and supported in ensuring patients receive optimal care.
Traprock Transformation into Clayey Materials in Soil Environments of the Central Siberian Plateau, Russia
Authors: Lessovaia Sofia N. , Plötze Michael , Inozemzev Svyatoslav , Goryachkin Sergey 
Published: February 2017

AbstractThe study of hard rock conversion into fine earths and clayey materials in the pedosphere is important in understanding the relative proportions of recent soil features to features that were inherited from ancient epochs. Cold environments are widely thought to be areas of physical weathering, but the coexistence of physical and chemical processes have also been shown. To further examine mafic rock (dolerite) weathering in soil environments and the conversion into clayey materials, Entic Podzols formed in the cold continental climate were studied. The key study was located in the central part of the flood basalt complex, or traps (traprocks), of the Central Siberian Plateau (Russia). The qualitative mineralogy was studied using X-ray diffraction and the quantitative mineral composition was determined using X-ray diffraction and subsequent Rietveld analysis. The micromorphological characteristics of the soils were studied in thin sections. Dolerite fragments and fine earths were sampled from soil profiles underlain by dolerite. XRD analyses indicated that pyroxene and especially plagioclase contents in the dolerite fragments and fine earths decreased from the bottom to the top soil horizons mostly in the mature soil profiles that were affected by chemical weathering of dolerite. The dioctahedral and trioctahedral smectites in the soils were inherited from a dolerite previously subjected to chemical weathering. The smectite was conserved in the inherited aggregates and protected against dissolution even in acidic soil horizons. Recent pedogenesis processes fractured individual fragments, converted it into soil micromass, and slightly decreased the total smectite content of the <1 µm soil fraction. However, in soil samples collected from the bottom to the top horizons of a mature soil profile, trioctahedral smectite contents decreased as dioctahedral smectite contents increased. This suggests that dioctahedral smectites formed by pedogenic alteration of inherited trioctahedral smectites.
Characteristics of Early Earth’s Critical Zone Based on Middle—Late Devonian Paleosol Properties (Voronezh High, Russia)
Authors: Alekseeva Tatiana , Kabanov Pavel , Alekseev Andrey , Kalinin Pavel , Alekseeva Veronika 
Published: February 2017

AbstractLand colonization with vascular plants during the late Silurian—early Devonian and then arborescence during the Pragian—Givetian caused the development of new soil types. These true-rooted soils increased the rate of pedogenesis on a global scale. Since that time, soil has become a key component of the biosphere and has given rise to profound development of the Earth’s Critical Zone (CZ). Case studies of Devonian CZs have helped to record the transformation from Precambrian—Lower Paleozoic ‘proto-CZs,’ which had insufficient proto-soil cover, to modern soils with true-rooted pedosphere. Devonian (Givetian—Frasnian) paleosols from the Voronezh region of Russia are combined into pedocomplexes which occupied the top, slope, and bottom positions of a pronounced paleo-relief. Paleosols were developed from terrigenous argillites and volcanigenic-sedimentary deposits. Each pedocomplex consisted of four or more paleosols with different degrees of development and profile preservation. Paleosols exhibited several common characteristics including production and translocation of clay, ferruginization and the presence of siderite nodules, enhanced MnO/Al2O3 and (Fe2O{3}+MnO)/Al2O3 values, and in situ roots and root-system traces. The latter are siderite/goethite substituted. Stable isotope analysis of siderite shows δ13C values of between -6.1 and -13.7% indicating that CO2 had originated from C3 plants. The main mineral component of clay fractions in automorphic paleosols (top and slope of the paleorelief) is kaolinite. The important feature of these paleosols is the red-stained hematite-rich layer in their bases. These horizons developed at different depths and with different thicknesses, and marked the paleo-groundwater tables of each sub-CZ. Evidence of the imprints of vegetation is seen in the abundant in situ roots, plant fragments, and spores of rhyniophytes, lycopsids, progymnosperms, cladoxylalean ferns, and phytoleims of algae-like vascular plants. The near-equatorial location and the overall characteristics of paleosols studied suggest that the aforementioned horizons were formed in a tropically warm and humid climate. The paleo-ecological environments which accompanied pedogenesis were probably controlled by tectonic activity and volcanism.
Diurnal and Long-term Variation in Plasma Concentrations and Renal Clearances of Circulating Markers of Kidney Proximal Tubular Secretion
Authors: Rivara Matthew B , Zelnick Leila R , Hoofnagle Andrew N , Newitt Rick , Tracy Russell P , Kratz Mario , Weigle David S , Kestenbaum Bryan R 
Published: February 2017

Abstract

BACKGROUND
The renal proximal tubule is essential for removing organic solutes and exogenous medications from the circulation. We evaluated diurnal, prandial, and long-term biological variation of 4 candidate endogenous markers of proximal tubular secretion.

METHODS
We used LC-MS to measure plasma and urine concentrations of hippurate (HA), cinnamoylglycine (CMG), indoxyl sulfate (IS), and p-cresol sulfate (PCS) in 25 healthy adults. We measured plasma concentrations of secreted solutes at 13 time points over a 24-h period, and again after 2 weeks and 14 weeks of follow-up. We further measured 24-h renal clearances of secreted solutes at baseline, 2 weeks, and 14 weeks.

RESULTS
Plasma concentrations of secreted solutes varied over the 24-h baseline period. Diurnal variation was greatest for HA, followed by CMG, IS, and PCS. Plasma concentrations of HA (P = 0.002) and IS (P = 0.02), but not CMG and PCS, increased significantly following meals. Long-term intraindividual biological variation (CVI) in plasma concentrations of secreted solutes over 14 weeks varied from 21.8% for IS to 67.3% for PCS, and exceeded that for plasma creatinine (CVI, 7.1%). Variation in 24-h renal clearances was similar among the secreted solutes [intraindividual variation (CVA+I), 33.6%–47.3%] and was lower using pooled plasma samples from each study visit.

CONCLUSIONS
Plasma concentrations of HA, CMG, IS, and PCS fluctuate within individuals throughout the day and over weeks. Renal clearances of these secreted solutes, which serve as estimates of renal proximal tubule secretion, are also subject to intraindividual biological variation that can be improved by additional plasma measurements.
Evaluation of Effective Manure Disposal Systems and its Influence on Soil Fertility
Authors: Gridnev Pawel I. , Gridneva Tamayana T. , Spotaru Julia.Y. , Romaniuk Wacław 
Published: February 2017

Abstract
The paper presents main provisions of methodology of manure utilization systems evaluation. All costs, starting with the costs related to manure cleaning in premises to the costs of increasing the biological yield obtained from its use, including the soil fertility value changes, were considered. The target function is offered a minimum of complex costs of entering the required amount of nutrients and organic matter per unit area for the planned yield. The effective technical solutions of calculations based on the proposed method include: construction of a boom conveyor with a hydraulic drive and described performance, scraper and screw types of conveyors, automatic scraper loading installation of manure from livestock buildings. The proposed solutions will reduce losses of nutrients by 50-70%, and will allow production of 20 million tons of grain annually.
Comparison of Applications Supporting Selection and Design of Household Solar Collector Systems
Authors: Kobel Przemysław , Romański Leszek , Bieniek Jerzy , Bukowski Przemysław , Martynowicz Agnieszka 
Published: February 2017

Abstract
In order to support the designing process and selection of subassemblies of an installation, specialist application programs are created. Selected applications were compared in the paper through their use for designing hypothetical solar collector systems for a single family house with a varied number of household members. With the use of particular applications, calculations for the same input assumptions were made. Results obtained with the use of a traditional calculation method were a reference point. Applications were compared on account of the type and amount of input parameters which may be introduced, type and number of determined values and their value. Based on the obtained results usefulness and scope of use of an application were assessed.
Pro-Ecological Energy Solutions which Minimize The Use of Fossil Fuels in The Roofed Facilities
Authors: Kurpaska Sławomir 
Published: February 2017

AbstractThe paper, based on the materials of the Main Statistical Office, presents a present state of use of renewable energy sources in the Polish power industry. Moreover, based on the available data, the amount of energy used for roofed production was estimated (heat, electric energy). Additionally, the amount of emission to atmosphere of hazardous substances (sulphur oxides, lead oxides, carbon dioxide and carbon oxide, dust and benzo(a) piren) was determined. Based on the available literature, technical solutions, which are analysed in various scientific centres, which aim at decrease of fuel consumption, were presented. A detailed analysis focused on the possibility of substituting fossil fuel with another heat source, effectiveness of energy use, increase of insulation ability of the facility roof and modification of greenhouses structures. From among the available energy sources, problems and its possible use in horticultural production were presented. The following energy sources were analysed: geothermal energy, sun and wind energy, biomass, heat pump; co-generative system (triple co-generative). Also barriers and possibilities of use of own boiler house and heat from central heating grid as energy source were analysed.