bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mexican Americans Receive Less Intensive Stroke Rehabilitation Than Non-Hispanic Whites
Authors: Morgenstern Lewis B. , Sais Emma , Fuentes Michael , Ifejika Nneka L. , Jiang Xiaqing , Horn Susan D. , Case Erin , Lisabeth Lynda D. 
Published: April 2017

Background and Purpose—
Mexican Americans (MAs) have worse neurological, functional, and cognitive outcomes after stroke. Stroke rehabilitation is important for good outcome. In a population-based study, we sought to determine whether allocation of stroke rehabilitation services differed by ethnicity.

Methods—

Patients with stroke were identified as part of the Brain Attack Surveillance in Corpus Christi (BASIC) project, TX, USA. Cases were validated by physicians using source documentation. Patients were followed prospectively for 3 months after stroke to determine rehabilitation services and transitions. Descriptive statistics were used to depict the study population. Continuous baseline variables were compared using 2 sample
t
tests or Wilcoxon rank-sum tests by ethnicity. Categorical baseline variables were compared using χ
2
tests. Ethnic comparisons of rehabilitation services were compared using χ
2
tests, Fisher’s exact tests, and logistic regression.

Results—

Seventy-two subjects (50 MA and 22 non-Hispanic white [NHW]) were followed. Mean age, NHW-69 (SD 13), MA-66 (SD 11) years, sex (NHW 55% male, MA 50% male) and median presenting National Institutes of Health Stroke Scale did not differ significantly. There were no ethnic differences among the proportion of patients who were sent home without any rehabilitation services (
P
=0.9). Among those who received rehabilitation, NHWs were more likely to get inpatient rehabilitation (73%) compared with MAs (30%),
P
=0.016. MAs (51%) were much more likely to receive home rehabilitation services compared with NHWs (0%) (
P
=0.0017).

Conclusions—
In this population-based study, MAs were more likely to receive home-based rehabilitation, whereas NHWs were more likely to get inpatient rehabilitation. This disparity may, in part, explain the worse stroke outcome in MAs.
Inhibition of Pre–Supplementary Motor Area by Continuous Theta Burst Stimulation Leads to More Cautious Decision-making and More Efficient Sensory Evidence Integration
Authors: Tosun Tuğçe , Berkay Dilara , Sack Alexander T. , Çakmak Yusuf Ö. , Balcı Fuat 
Published: April 2017

AbstractDecisions are made based on the integration of available evidence. The noise in evidence accumulation leads to a particular speed–accuracy tradeoff in decision-making, which can be modulated and optimized by adaptive decision threshold setting. Given the effect of pre-SMA activity on striatal excitability, we hypothesized that the inhibition of pre-SMA would lead to higher decision thresholds and an increased accuracy bias. We used offline continuous theta burst stimulation to assess the effect of transient inhibition of the right pre-SMA on the decision processes in a free-response two-alternative forced-choice task within the drift diffusion model framework. Participants became more cautious and set higher decision thresholds following right pre-SMA inhibition compared with inhibition of the control site (vertex). Increased decision thresholds were accompanied by an accuracy bias with no effects on post-error choice behavior. Participants also exhibited higher drift rates as a result of pre-SMA inhibition compared with the vertex inhibition. These results, in line with the striatal theory of speed–accuracy tradeoff, provide evidence for the functional role of pre-SMA activity in decision threshold modulation. Our results also suggest that pre-SMA might be a part of the brain network associated with the sensory evidence integration.
Seasonal activity and basking of the southernmost population of the freshwater turtle Phrynops hilarii (Chelidae)
Authors: Semeñiuk María B. , Alcalde Leandro 
Published: April 2017

This study focuses on basking behaviour of Phrynops hilarii in the southernmost population of the species’ range. The objective was to determine how environmental features affect the basking behaviour of the species. We analyzed two years of data on the seasonal activity of the species for the same stream. We detected 389 P. hilarii basking, mostly alone (76.8%), and on logs and branches (79.3%), but large turtles used shorelines more frequently than did smaller turtles. Basking peaked during late winter and early spring. We found no correlation between the number of basking turtles and air, substrate or water temperatures. P. hilarii was active through all seasons, with activity peaking in summer, when temperature is highest but basking frequency is low. Type of substrate, time of day, and season are key factors that influence the basking behaviour of P. hilarii.
The Impact of El Niño–Southern Oscillation (ENSO) on Winter and Early Spring U.S. Tornado Outbreaks
Authors: Cook Ashton Robinson , Leslie Lance M. , Parsons David B. , Schaefer Joseph T. 
Published: April 2017

AbstractIn recent years, the potential of seasonal outlooks for tornadoes has attracted the attention of researchers. Previous studies on this topic have focused mainly on the influence of global circulation patterns [e.g., El Niño–Southern Oscillation (ENSO), North Atlantic Oscillation, or Pacific decadal oscillation] on spring tornadoes. However, these studies have yielded conflicting results of the roles of these climate drivers on tornado intensity and frequency. The present study seeks to establish linkages between ENSO and tornado outbreaks over the United States during winter and early spring. These linkages are established in two ways: 1) statistically, by relating raw counts of tornadoes in outbreaks (defined as six or more tornadoes in a 24-h period in the United States east of the Rocky Mountains), and their destructive potential, to sea surface temperature anomalies observed in the Niño-3.4 region, and 2) qualitatively, by relating ENSO to shifts in synoptic-scale atmospheric phenomena that contribute to tornado outbreaks. The latter approach is critical for interpreting the statistical relationships, thereby avoiding the deficiencies in a few of the previous studies that did not provide physical explanations relating ENSO to shifts in tornado activity. The results suggest that shifts in tornado occurrence are clearly related to ENSO. In particular, La Niña conditions consistently foster more frequent and intense tornado activity in comparison with El Niño, particularly at higher latitudes. Furthermore, it is found that tornado activity changes are tied not only to the location and intensity of the subtropical jet during individual outbreaks but also to the positions of surface cyclones, low-level jet streams, and instability axes.
A Coupled Circulation–Wave Model for Numerical Simulation of Storm Tides and Waves
Authors: Marsooli Reza , Orton Philip M. , Mellor George , Georgas Nickitas , Blumberg Alan F. 
Published: April 2017

AbstractThe Stevens Institute of Technology Estuarine and Coastal Ocean Model (sECOM) is coupled here with the Mellor–Donelan–Oey (MDO) wave model to simulate coastal flooding due to storm tides and waves. sECOM is the three-dimensional (3D) circulation model used in the New York Harbor Observing and Prediction System (NYHOPS). The MDO wave model is a computationally cost-effective spectral wave model suitable for coupling with 3D circulation models. The coupled sECOM–MDO model takes into account wave–current interactions through wave-enhanced water surface roughness and wind stress, wave–current bottom stress, and depth-dependent wave radiation stress. The model results are compared with existing laboratory measurements and the field data collected in New York–New Jersey (NY–NJ) harbor during Hurricane Sandy. Comparisons between the model results and laboratory measurements demonstrate the capabilities of the model to accurately simulate wave characteristics, wave-induced water elevation, and undertow current. The model results for Hurricane Sandy reveal the successful performance of sECOM–MDO in situations where high waves and storm tides coexist. The results indicate that the temporal maximum wave setup in NY–NJ harbor was 0.26 m. On the other hand, the contribution of wave setup to the peak storm tide was 0.13 m, a contribution of only 3.8%. It is found that the inclusion of wave radiation stress and wave-enhanced bottom friction in the circulation model can reduce the errors in the calculated storm tides. At the Battery (New York), for example, the root-mean-square error reduced from 0.17 to 0.12 m.
The Influence of PBL Parameterization on the Practical Predictability of Convection Initiation during the Mesoscale Predictability Experiment (MPEX)
Authors: Burlingame Bryan M. , Evans Clark , Roebber Paul J. 
Published: April 2017

Abstract
This study evaluates the influence of planetary boundary layer parameterization on short-range (0–15 h) convection initiation (CI) forecasts within convection-allowing ensembles that utilize subsynoptic-scale observations collected during the Mesoscale Predictability Experiment. Three cases, 19–20 May, 31 May–1 June, and 8–9 June 2013, are considered, each characterized by a different large-scale flow pattern. An object-based method is used to verify and analyze CI forecasts. Local mixing parameterizations have, relative to nonlocal mixing parameterizations, higher probabilities of detection but also higher false alarm ratios, such that the ensemble mean forecast skill only subtly varied between parameterizations considered. Temporal error distributions associated with matched events are approximately normal around a zero mean, suggesting little systematic timing bias. Spatial error distributions are skewed, with average mean (median) distance errors of approximately 44 km (28 km). Matched event cumulative distribution functions suggest limited forecast skill increases beyond temporal and spatial thresholds of 1 h and 100 km, respectively. Forecast skill variation is greatest between cases with smaller variation between PBL parameterizations or between individual ensemble members for a given case, implying greatest control on CI forecast skill by larger-scale features than PBL parameterization. In agreement with previous studies, local mixing parameterizations tend to produce simulated boundary layers that are too shallow, cool, and moist, while nonlocal mixing parameterizations tend to be deeper, warmer, and drier. Forecasts poorly resolve strong capping inversions across all parameterizations, which is hypothesized to result primarily from implicit numerical diffusion associated with the default finite-differencing formulation for vertical advection used herein.
Altered pupillary light response scales with disease severity in migrainous photophobia
Authors: Cortez Melissa M , Rea Natalie A , Hunter Lindsay A , Digre Kathleen B , Brennan KC 
Published: April 2017

Background Autonomic dysfunction and light sensitivity are core features of the migraine attack. Growing evidence also suggests changes in these parameters between attacks. Though sensory and autonomic responses likely interact, they have not been studied together across the spectrum of disease in migraine. Methods We performed digital infrared pupillometry while collecting interictal photophobia thresholds (PPT) in 36 migraineurs (14 episodic; 12 chronic; 10 probable) and 24 age and sex-matched non-headache controls. Quantitative pupillary light reflexes (PLR) were assessed in a subset of subjects, allowing distinction of sympathetic vs parasympathetic pupillary function. A structured questionnaire was used to ascertain migraine diagnosis, headache severity, and affective symptoms. Results Photophobia thresholds were significantly lower in migraineurs than controls, and were lowest in chronic migraine, consistent with a disease-related gradient. Lower PPT correlated with smaller dark-adapted pupil size and larger end pupil size at PPT, which corresponded to a reduced diameter change. On PLR testing, measures of both parasympathetic constriction and sympathetic re-dilation were reduced in migraineurs with clinically severe migraine. Conclusions In summary, we show that severity of photophobia in migraine scales with disease severity, in association with shifts in pupillary light responses. These alterations suggest centrally mediated autonomic adaptations to chronic light sensitivity.
Characteristic symptoms and associated features of exploding head syndrome in undergraduates
Authors: Sharpless Brian A 
Published: April 2017

Background Exploding head syndrome (EHS) is characterized by loud noises or a sense of explosion in the head during sleep transitions. Though relatively common, little is known about its characteristic symptoms or associated features. Methods A cross-sectional study of 49 undergraduates with EHS was performed. A clinical interview established diagnosis. Results The most common accompanying symptoms were tachycardia, fear, and muscle jerks/twitches with the most severe associated with respiration difficulties. Visual phenomena were more common than expected (27%). EHS episodes were perceived as having a random course, but were most likely to occur during wake-sleep transitions and when sleeping in a supine position. Only 11% reported EHS to a professional, and 8% of those with recurrent EHS attempted to prevent episodes. Conclusions EHS episodes are complex (Mean (M) = 4.5 additional symptoms), often multisensorial, and usually associated with clinically-significant fear. They are rarely reported to professionals and treatment approaches are limited.
Association Between Hemogram Parameters and Survival of Critically Ill Patients
Authors: Karagoz Ibrahim , Aktas Gulali , Yoldas Hamit , Yildiz Isa , Ogun Muhammet Nur , Bilgi Murat , Demirhan Abdullah 
Published: April 2017

Aim: Recently, hemogram parameters, such as mean platelet volume (MPV), had been proposed as novel inflammatory and prognostic factors. In present retrospective analysis, we aimed to determine and compare MPV of survived and dead patients whom admitted to intensive care unit (ICU) of our institution. Methods: We recorded hemogram parameters and other laboratory data and demographic characteristics of patients treated in ICU. Patients are divided into 2 groups—dead patients and survived patients. Laboratory data of survived patients compared to those of dead patients. Results: Age, gender, and other laboratory variables were not significantly different between dead and survived patients. On the other hand, MPV of survived patients was significantly higher than that of the dead patients ( P = .001). Conclusion: We think that elevated MPV levels in an ICU patient should alert clinicians for worse outcome. Physicians should be more careful in the management of these patients.
Multicenter study to assess presenteeism in systemic lupus erythematosus and its relationship with clinical and sociodemographic features
Authors: Cosatti M A , Muñoz S , Alba P , Helling C A , Roverano S , Sarano J , Malm-Green S , Danielsen M , Medina Bornachera D , Alvarez A , Eimon A , Pendón G , Mayer M , Marin J , Catoggio C , Pisoni C N 
Published: April 2017

Objective The aim of this study was to measure presenteeism (productivity impairment while the patient is at work) and the related risk factors in patients with systemic lupus erythematosus (SLE) from Argentina. Methods A total of 130 consecutive (1997 American College of Rheumatology (ACR) criteria) working patients with SLE were assessed using a standardized data collection form. Sociodemographic, disease and work-related variables were collected. The Work Productivity and Activity Impairment (WPAI) questionnaire was performed. Results Overall, 130 patients were included in the analysis; 91% were women, and the mean age was 39 years (range 19–77). A total of 43% were White, 43% Mestizo and 13% Amerindian. Overall, 38% were single and 38% were married. A total of 75% had more than 12 years of formal education. The median disease duration was 7 years (interquartile range 25–75 (IQR) 4–13). Median Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score was 0 (IQR 0–2), and median Systemic Lupus International Collaborating Clinics/ACR Damage Index (SLICC-SDI) score was 0 (IQR 0–1). Lupus quality of life (LupusQoL) domains scores were: physical health 87 (IQR 70–96), emotional health 78 (IQR 54–91), burden to others 75 (IQR 50–92), intimate relationships 87 (IQR 50–100), and body image 85 (IQR 70–100). Absenteeism was 8%, presenteeism was 19%, and overall work impairment (absenteeism + presenteeism) was 26%. In the multiple regression analysis, considering presenteeism as dependent variable, (adjusting by age, disease duration, >12 years of education, Non-white race, Visual Analogue Scale (VAS) pain, VAS fatigue, SLICC-SDI, LupusQoL, physical and emotional domains), we found that SLICC-SDI (odds ratio (OR) 1.68, confidence interval (CI) 1–2.7) and Non-white race (OR 3.27, CI 1.04–10) were related to presenteeism and >12 years of education (OR 0.30, CI 0.09–0.98) and higher scores of LupusQoL emotional health domain (OR 0.95, CI 0.92–0.98) were protective. Conclusions organ damage and Non-white race were significantly associated with presenteeism while >12 years of education and higher scores of LupusQoL emotional health domain were protective.
The role of TIPS in the management of liver transplant candidates
Authors: Unger Lukas W , Stork Theresa , Bucsics Theresa , Rasoul‐Rockenschaub Susanne , Staufer Katharina , Trauner Michael , Maschke Svenja , Pawloff Max , Soliman Thomas , Reiberger Thomas , Berlakovich Gabriela A 
Published: April 2017

BackgroundTransjugular intrahepatic portosystemic shunt (TIPS) implantation is used for treatment of several complications in patients with liver cirrhosis. Recent studies have identified a survival benefit for patients on the waiting list after TIPS implantation, but the optimal time point for TIPS implantation prior to orthotopic liver transplantation (OLT) has not been established.StudyThis study retrospectively assessed patients undergoing TIPS implantation before or after listing for OLT at the Medical University of Vienna. n  = 98 patients with TIPS on the waiting list between January 1993 and December 2013 were identified (n  = 73 (74.5%) pre‐listing TIPS, n  = 25 (25.5%) post‐listing TIPS). A matched control group at the time of OLT without TIPS (n  = 60) was included.ResultsMore patients with post‐listing TIPS (28.0%, 7/25) showed clinical improvement and went off‐list than patients with pre‐listing TIPS (8.2%, 6/73, p  = .0119). A similar proportion of patients with pre‐listing TIPS (19.2%, 14/73) and post‐listing TIPS (20.0%, 5/25) died on the OLT waiting list. Transplant surgery time was similar in patients with and without TIPS: 348(±13) vs. 337(±10) minutes (p  = .5139). Estimated 1‐year post‐transplant survival was similar across all groups (pre‐listing TIPS: 76.2%, post‐listing TIPS: 86.0%, no TIPS: 91.2%, log‐rank p  = .1506).ConclusionTIPS should be considered in all liver transplant candidates, since it can obviate the need for OLT and optimize bridging to OLT.
Biomechanical Evaluation of Unilateral Versus Bilateral C1 Lateral Mass-C2 Intralaminar Fixation
Authors: Bhatia Nitin , Rama Asheen , Sievers Brandon , Quigley Ryan , McGarry Michelle H. , Lee Yu-Po , Lee Thay Q 
Published: April 2017

Study Design: Biomechanical, cadaveric study. Objectives: To compare the relative stiffness of unilateral C1 lateral mass-C2 intralaminar fixation to intact specimens and bilateral C1 lateral mass-C2 intralaminar constructs. Methods: The biomechanical integrity of a unilateral C1 lateral mass-C2 intralaminar screw construct was compared to intact specimens and bilateral C1 lateral mass-C2 intralaminar screw constructs. Five human cadaveric specimens were used. Range of motion and stiffness were tested to determine the stiffness of the constructs. Results: Unilateral fixation significantly decreased flexion/extension range of motion compared to intact ( P < .001) but did not significantly affect axial rotation ( P = .3) or bending range of motion ( P = .3). There was a significant decrease in stiffness in extension for both unilateral and bilateral fixation techniques compared to intact ( P = .04 and P = .03, respectively). There was also a significant decrease in stiffness for ipsilateral rotation for the unilateral construct compared to intact ( P = .007) whereas the bilateral construct significantly increased ipsilateral rotation stiffness compared to both intact and unilateral fixation ( P < .001). Conclusion: Bilateral constructs did show improved biomechanical properties compared to the unilateral constructs. However, unilateral C1-C2 fixation using a C1 lateral mass and C2 intralaminar screw-rod construct decreased range of motion and improved stiffness compared to the intact state with the exception of extension and ipsilateral rotation. Hence, a unilateral construct may be acceptable in clinical situations in which bilateral fixation is not possible, but an external orthosis may be necessary to achieve a fusion.
Factors Associated With Clinical Outcomes After Lumbar Interbody Fusion With a Porous Nitinol Implant
Authors: Abduljabbar Fahad H. , Makhdom Asim M. , Rajeh Mona , Tales Alisson R. , Mathew Jacob , Ouellet Jean , Weber Michael , Jarzem Peter 
Published: April 2017

Study Design: A retrospective cohort study. Objective: The aim of this study is to assess the association of demographic and perioperative factors with clinical outcomes of lumbar interbody fusion with a porous nitinol (TiNi) implant for degenerative disc disease. Methods: Forty-one patients with degenerative lumbar disease were prospectively followed for a mean of 4.8 years. All patients were instrumented with porous TiNi interbody fusion devices. The Oswestry Disability Index (ODI) and return to work were used to assess clinical outcomes. Factors including age, body mass index, smoking status, insurance status, number of comorbidities, duration of surgery, estimated blood loss, number of levels fused, time since surgery, and preoperative ODI score were assessed. A multiple linear regression analysis was performed to look for demographic and perioperative factors associated with clinical outcome. Results: All patients except one (98%) showed complete fusion on radiography at 1 year. Estimated blood loss and duration of surgery were significantly associated with higher postoperative ODI scores ( P = .002 and P = .019, respectively). Smoking status, salary insurance status, age, body mass index, number of comorbidities, number of levels fused, time since surgery, and preoperative ODI score were not significantly associated with outcome. Conclusions: Porous nitinol permitted fusion rates similar to those reported in the literature for alternative fusion cages. Poor functional outcome of patients was strongly associated with intraoperative blood loss and duration of surgery. We believe that estimated blood loss should be carefully evaluated in studies of postoperative outcome, as it may affect midterm outcomes. Level of Evidence: Level 3