bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Age on Thrombolysis Outcome in Wake-Up Stroke
Authors: Manawadu Dulka , Bodla Shankaranand , Keep Jeff , Kalra Lalit 
Published: August 2013

Background and Purpose—
Thrombolysis in patients >80 years remains controversial; we hypothesized that >80-year-old patients with wake-up ischemic stroke (WUIS) will benefit from thrombolysis despite risks because of poor outcomes with no treatment.

Methods—
The study included 68 thrombolysed patients with WUIS (33 [48%] >80 years), 54 nonthrombolysed patients with WUIS (21 [39%] >80 years), and 117 patients (>80 years old) thrombolysed within 4.5 hours of symptom onset (reference group). Mortality and modified Rankin Scale (mRS) were assessed at 90 days.

Results—

Baseline characteristics of thrombolysed and nonthrombolysed >80 and ≤80-year-old patients with WUIS were comparable. Thrombolysis outcomes in >80-year-old patients with WUIS were better than in nonthrombolysed >80-year-old patients with WUIS (90-day mortality: 24% versus 47%,
P
=0.034; mRS 0–2: 30% versus 5%,
P
=0.023; mRS 0–1: 15% versus 5%,
P
=0.24) and comparable with thrombolysed ≤80-year-old patients with WUIS. Thrombolysis was associated with odds ratio 0.27 (95% confidence interval, 0.05–0.97) for mortality and odds ratio 28.6 (95% confidence interval, 1.8–448) for mRS 0 to 2 at 90 days in >80-year-old patients with WUIS after adjusting for stroke severity and risk factors.

Conclusions—
Thrombolysis may be associated with greater benefit in >80-year-old patients with WUIS but a selection bias favoring thrombolysis in those most likely to benefit may significantly reduce interpretability of these findings.
MMP9 Variation After Thrombolysis Is Associated With Hemorrhagic Transformation of Lesion and Death
Authors: Inzitari Domenico , Giusti Betti , Nencini Patrizia , Gori Anna Maria , Nesi Mascia , Palumbo Vanessa , Piccardi Benedetta , Armillis Alessandra , Pracucci Giovanni , Bono Giorgio , Bovi Paolo , Consoli Domenico , Guidotti Mario , Nucera Antonia , Massaro Francesca , Micieli Giuseppe , Orlandi Giovanni , Perini Francesco , Tassi Rossana , Tola Maria Rosaria , Sessa Maria , Toni Danilo , Abbate Rosanna 
Published: August 2013

Background and Purpose—
Experimentally, matrix metalloproteinases (MMPs) play a detrimental role related to hemorrhagic transformation and severity of an ischemic brain lesion. Tissue-type plasminogen activator (tPA) enhances such effects. This study aimed to expand clinical evidence in this connection.

Methods—
We measured MMPs 1, 2, 3, 7, 8, 9, and tissue inhibitors of metalloproteinases 1, 2, 4 circulating level in blood taken before and 24 hours after tPA from 327 patients (mean age, 68.9±12.1 years; median National Institutes of Health Stroke Scale, 11) with acute ischemic stroke. Delta median values ([24 hours post tPA–pre tPA]/pre tPA) of each MMP or tissue inhibitors of metalloproteinase were analyzed across subgroups of patients undergoing symptomatic intracerebral hemorrhage, 3-month death, or 3-month modified Rankin Scale score 3 to 6.

Results—

Adjusting for major clinical determinants, only matrix metalloproteinase-9 variation proved independently associated with death (odds ratio [95% confidence interval], 1.58 [1.11–2.26];
P
=0.045) or symptomatic intracerebral hemorrhage (odds ratio [95% confidence interval], 1.40 [1.02–1.92];
P
=0.049). Both matrix metalloproteinase-9 and tissue inhibitors of metalloproteinase-4 changes were correlated with baseline, 24 hours, and 7 days National Institutes of Health Stroke Scale (Spearman
P
from <0.001 to 0.040).

Conclusions—
Our clinical evidence corroborates the detrimental role of matrix metalloproteinase-9 during ischemic stroke treated with thrombolysis, and prompts clinical trials testing agents antagonizing its effects.
Internal Variability in Projections of Twenty-First-Century Arctic Sea Ice Loss: Role of the Large-Scale Atmospheric Circulation
Authors: Wettstein Justin J. , Deser Clara 
Published: August 2013

Abstract
Internal variability in twenty-first-century summer Arctic sea ice loss and its relationship to the large-scale atmospheric circulation is investigated in a 39-member Community Climate System Model, version 3 (CCSM3) ensemble for the period 2000–61. Each member is subject to an identical greenhouse gas emissions scenario and differs only in the atmospheric model component's initial condition.
September Arctic sea ice extent trends during 2020–59 range from −2.0 × 106 to −5.7 × 106 km2 across the 39 ensemble members, indicating a substantial role for internal variability in future Arctic sea ice loss projections. A similar nearly threefold range (from −7.0 × 103 to −19 × 103 km3) is found for summer sea ice volume trends.
Higher rates of summer Arctic sea ice loss in CCSM3 are associated with enhanced transpolar drift and Fram Strait ice export driven by surface wind and sea level pressure patterns. Over the Arctic, the covarying atmospheric circulation patterns resemble the so-called Arctic dipole, with maximum amplitude between April and July. Outside the Arctic, an atmospheric Rossby wave train over the Pacific sector is associated with internal ice loss variability. Interannual covariability patterns between sea ice and atmospheric circulation are similar to those based on trends, suggesting that similar processes govern internal variability over a broad range of time scales. Interannual patterns of CCSM3 ice–atmosphere covariability compare well with those in nature and in the newer CCSM4 version of the model, lending confidence to the results. Atmospheric teleconnection patterns in CCSM3 suggest that the tropical Pacific modulates Arctic sea ice variability via the aforementioned Rossby wave train. Large ensembles with other coupled models are needed to corroborate these CCSM3-based findings.
Error Covariance Estimation for Coupled Data Assimilation Using a Lorenz Atmosphere and a Simple Pycnocline Ocean Model
Authors: Han Guijun , Wu Xinrong , Zhang Shaoqing , Liu Zhengyu , Li Wei 
Published: August 2013

Abstract
Coupled data assimilation uses a coupled model consisting of multiple time-scale media to extract information from observations that are available in one or more media. Because of the instantaneous exchanges of information among the coupled media, coupled data assimilation is expected to produce self-consistent and physically balanced coupled state estimates and optimal initialization for coupled model predictions. It is also expected that applying coupling error covariance between two media into observational adjustments in these media can provide direct observational impacts crossing the media and thereby improve the assimilation quality. However, because of the different time scales of variability in different media, accurately evaluating the error covariance between two variables residing in different media is usually very difficult. Using an ensemble filter together with a simple coupled model consisting of a Lorenz atmosphere and a pycnocline ocean model, which characterizes the interaction of multiple time-scale media in the climate system, the impact of the accuracy of coupling error covariance on the quality of coupled data assimilation is studied. Results show that it requires a large ensemble size to improve the assimilation quality by applying coupling error covariance in an ensemble coupled data assimilation system, and the poorly estimated coupling error covariance may otherwise degrade the assimilation quality. It is also found that a fast-varying medium has more difficulty being improved using observations in slow-varying media by applying coupling error covariance because the linear regression from the observational increment in slow-varying media has difficulty representing the high-frequency information of the fast-varying medium.
Simulation of a Flash Flooding Storm at the Steep Edge of the Himalayas*
Authors: Kumar Anil , Houze Robert A. , Rasmussen Kristen L. , Peters-Lidard Christa 
Published: August 2013

AbstractA flash flood and landslide in the Leh region of the Indus Valley in the Indian state of Jammu and Kashmir on 5–6 August 2010 resulted in hundreds of deaths and great property damage. Observations have led to the hypothesis that the storm, which formed over the Tibetan Plateau, was steered over the steep edge of the plateau by 500-hPa winds and then energized by the ingestion of lower-level moist air, which was approaching from the Arabian Sea and Bay of Bengal and rose up the Himalayan barrier. A coupled land surface and atmospheric model simulation validates this hypothesized storm scenario, with the model storm taking the form of a traveling mesoscale squall line with a leading convective line, trailing stratiform region, and midlevel inflow jet. In this region, the development of a mesoscale storm over high terrain is highly unusual, especially one in the form of a propagating squall line system. This unusual storm occurrence and behavior could serve as a warning sign in flash flood prediction. The coupled atmosphere and land surface model showed that the excessive runoff leading to the flood and landslide were favored by the occurrence of this unusual meteorological event coinciding temporally and spatially with favorable hydrologic conditions. Additionally, the model simulations showed that previous rainstorms had moistened the soil during the entire season and especially over the few days leading up to the Leh flood, so the normally arid mountainsides were likely not able to rapidly absorb the additional rainfall of the sudden 5 August squall line.
On Well-Posedness of the Viscous–Plastic Sea Ice Model
Authors: Guba Oksana , Lorenz Jens , Sulsky Deborah 
Published: August 2013

Abstract
This study examines the well-posedness of the initial-value problems that arise in common models of sea ice. The model equations describe the balance of linear momentum combined with simplified thermodynamics represented by two continuity equations for effective ice thickness and ice concentration. The constitutive model for sea ice is given by two possible variants of the viscous–plastic model: the viscous–plastic model with pressure replacement and the viscous–plastic model with pressure replacement plus a tensile cutoff. The authors identify regimes of well- and ill-posedness for both models in one and two space dimensions. In one space dimension, the study finds that the viscous–plastic model and viscous–plastic model with pressure replacement behave similarly: there is ill-posedness when the divergent flow rate is larger than a minimum value. On the other hand, the viscous–plastic model with pressure replacement plus a tensile cutoff is ill-posed for all divergent flows. In two space dimensions the analysis is inconclusive for the viscous–plastic model with pressure replacement, but with the tensile cutoff the problem is ill-posed for certain divergent flows. The authors also discuss energy bounds and the difference between ill-posedness and stability of a solution. The study shows by examples that boundedness of solutions does not imply well-posedness and that it is possible for well-posed problems to have unstable solutions. The analysis shows that previous arguments in the literature, which state that a bound on the energy in sea ice models provides control over ill-posedness, are flawed.
The Decay Rate of Ocean Swell Observed by Altimeter
Authors: Young I. R. , Babanin A. V. , Zieger S. 
Published: August 2013

Abstract
Altimeter data from transects across the Southern Ocean are analyzed to determine the decay of oceanic swell. The resulting decay rate is shown to be proportional to wavenumber squared and swell amplitude cubed. Such a decay relationship is consistent with turbulent interaction with the background, either in the air or water. The present data cannot distinguish between these two cases. The results are consistent with the limited previous studies and present a source term suitable for use in wave prediction models.
Immune dysregulation and autoimmunity in bipolar disorder: Synthesis of the evidence and its clinical application
Authors: Rege Sanil , Hodgkinson Suzanne J 
Published: August 2013

Objective: Increasing evidence suggests that inflammation and immune dysregulation play an important role in the pathogenesis of bipolar disorder. Because the brain can be affected by various autoimmune processes, it is possible that some psychiatric disorders may have an autoimmune basis. Method: This article reviews the literature on peripheral and central immune dysregulation and autoimmunity in bipolar disorder. The mechanisms of the innate and adaptive immune systems in the pathophysiology of bipolar disorder are explored. The clinical features and pathogenesis of neuropsychiatric systemic lupus erythematosus, anti-NMDA encephalitis, and Hashimoto’s encephalopathy are summarized. Results: Neuroinflammation and peripheral immune dysregulation may play a role in the pathophysiology of bipolar disorder. This involves a complex interaction between immune cells of the central nervous system and periphery resulting in cellular damage through mechanisms involving excitotoxicity, oxidative stress, and mitochondrial dysfunction. Neuropsychiatric systemic lupus erythematosus, anti-NMDA encephalitis, and Hashimoto’s encephalopathy are important differentials for a psychiatrist to consider when suspecting autoimmune encephalopathy. Conclusions: The link between immune dysregulation, autoimmunity, and bipolar disorder may be closer than previously thought. Psychiatrists should be vigilant for autoimmunity in presentations of bipolar disorder due to its high morbidity and therapeutic implications. Advances in neuroimaging and biomarker identification related to immune dysregulation and neuroinflammation will contribute to our knowledge of the pathophysiology of bipolar disorder.
Intracochlear Electrical Stimulation Suppresses Apoptotic Signaling in Rat Spiral Ganglion Neurons after Deafening in Vivo
Authors: Kopelovich Jonathan C. , Cagaanan Alain P. , Miller Charles A. , Abbas Paul J. , Green Steven H. 
Published: August 2013

ObjectiveTo establish the intracellular consequences of electrical stimulation to spiral ganglion neurons after deafferentation. Here we use a rat model to determine the effect of both low and high pulse rate acute electrical stimulation on activation of the proapoptotic transcription factor Jun in deafferented spiral ganglion neurons in vivo.Study DesignExperimental animal study.SettingHearing research laboratories of the University of Iowa Departments of Biology and Otolaryngology.MethodsA single electrode was implanted through the round window of kanamycin‐deafened rats at either postnatal day 32 (P32, n = 24) or P60 (n = 22) for 4 hours of stimulation (monopolar, biphasic pulses, amplitude twice electrically evoked auditory brainstem response [eABR] threshold) at either 100 or 5000 Hz. Jun phosphorylation was assayed by immunofluorescence to quantitatively assess the effect of electrical stimulation on proapoptotic signaling.ResultsJun phosphorylation was reliably suppressed by 100 Hz stimuli in deafened cochleae of P32 but not P60 rats. This effect was not significant in the basal cochlear turns. Stimulation frequency may be consequential: 100 Hz was significantly more effective than was 5 kHz stimulation in suppressing phospho‐Jun.ConclusionsSuppression of Jun phosphorylation occurs in deafferented spiral ganglion neurons after only 4 hours of electrical stimulation. This finding is consistent with the hypothesis that electrical stimulation can decrease spiral ganglion neuron death after deafferentation.
Computed tomography angiography of coronary artery bypass grafts: robustness in emergency and clinical routine settings
Authors: Heye Tobias , Kauczor Hans-Ulrich , Szabo Gabor , Hosch Waldemar 
Published: August 2013

Background There is a high probability for presence of irregular heart rates and artifacts in patients with previous coronary artery bypass graft (CABG) surgery. Previously reported diagnostic performance of ECG-gated 64-slice dual-source computer tomography angiography (CTA) in this patient group is based on pre-selection for normal heart rate and routine clinical setting. Purpose To investigate image quality and diagnostic performance of CTA in patients with previous CABG surgery in various clinical settings. Material and Methods Fifty-six non-selected, consecutive patients (110 grafts, 44 arterial, 66 venous) with previous CABG surgery were prospectively examined using a dual-source 64-slice CT (Siemens Definition, Forchheim, Germany) without utilization of CT-related pharmaceutical heart rate control. Patients were stratified according to the clinical setting: planned redo-cardiac surgery; emergency CTA within 30 days after CABG surgery; routine follow-up after CABG surgery. A reference standard was available for 30 patients (53.6%; 67/110 grafts). Image quality, artifacts, and graft patency were independently assessed by two observers. Results All CTAs were diagnostic despite the presence of irregular heart rhythm (25% of cases) and artifacts (72.7% of grafts). CTA was accurate in all patient groups in assessing graft patency (97.9% sensitivity; 100% specificity; 98.5% accuracy) but artifacts decreased diagnostic performance for stenosis detection (60% sensitivity; 88.6% specificity; 84.1% accuracy). Arterial grafts exhibited more surgical clip artifacts compared to venous grafts, which predominantly showed motion artifacts. Overall diagnostic quality was rated excellent in 70.9%/56.4%, good in 23.4%/39.1%, and sufficient in 5.5%/4.5% by each observer, respectively. CTA detected acute findings in 10 cases (graft bleeding, graft occlusion, pericardial hematoma, sternal instability with retrosternal abscess formation, pericardial effusion, left ventricle thrombus) in the emergency group; seven cases required surgical revision. Conclusion Dual-source CTA is a robust and accurate method for assessment of graft patency and detection of relevant extra-cardiac pathologies in a non-selected patient population after CABG surgery in routine as well as emergency clinical settings. Artifacts caused by irregular heart rhythm or surgical clips do not impair graft patency evaluation but limit stenosis assessment.
US-guided transthoracic biopsy of peripheral lung lesions: pleural contact length influences diagnostic yield
Authors: Jeon Kyung Nyeo , Bae Kyungsoo , Park Mi Jung , Choi Ho Cheol , Shin Hwa Seon , Shin Suyoung , Kim Ho Cheol , Ha Chang Yoon 
Published: August 2013

Background Transthoracic biopsy of peripheral lung lesions under ultrasonography (US) guidance is a useful diagnostic technique. However, factors affecting diagnostic yield of US-guided transthoracic biopsy of peripheral lung lesions are not well established. Purpose To determine the factors that influence diagnostic yield of US-guided transthoracic biopsy in peripheral lung lesions. Material and Methods A total of 100 consecutive patients underwent US-guided percutaneous cutting biopsy of peripheral lung lesions from October 2007 to March 2009. After seven unconfirmed cases were excluded, 97 procedures in 93 consecutive patients were included in this study. The accuracy of the lung biopsies was assessed by comparing the biopsy results with the final diagnoses. We divided the cases into a correct group (true-positive and true-negative) and an incorrect group (false-positive, false-negative, and non-diagnostic results) and analyzed the differences in the lesions, procedures, and patient variables between the two groups. Results According to the final diagnoses, 56 cases (57.7%) were malignant and 41 cases (42.3%) were benign. An overall diagnostic accuracy of 91.8% was obtained. The median size of the lesions was 46.0 mm (interquartile range [IQR], 30.0–69.5 mm), and the median lesion-pleura contact arc length (LPCAL) was 31.0 mm (IQR, 18.0–51.0 mm). Multivariate logistic regression analysis showed that only LPCAL (odds ratio, 1.16; 95% CI, 1.04–1.30) was a significant predictor of a correct diagnosis. When we divided the lesions into those with LPCAL values >30 mm and LPCAL values ≤30 mm, the sensitivity (96.6% vs. 74.1%; P = 0.02) and the accuracy (98% vs. 85.4%; P = 0.03) were significantly higher in the group with larger LPCAL. Conclusion In US-guided transthoracic biopsy of peripheral lung lesions, the LPCAL of the lesions is an important factor for a correct diagnosis.
Hepatitis B surface antigen seroclearance in patients with chronic hepatitis B infection: A clinical study
Authors: Ruan Peng , Xu Shao-Yong , Zhou Bo-Ping , Huang Jian , Gong Zuo-Jiong 
Published: August 2013

Objective To investigate the clinical characteristics of hepatitis B surface antigen (HBsAg) seroclearance in patients with chronic hepatitis B virus (HBV) infection. Methods Patients with chronic HBV infection who achieved sustained virological response (SVR) within 6 years of ceasing formal antiviral treatment were assessed for HBsAg seroclearance (defined as loss of serum HBsAg on repeated testing for a period of >6 months), using enzyme immunoassays. Phase of HBV infection and liver function (serum alanine aminotransferase [ALT] and aspartate aminotransferase [AST] levels) and HBV DNA levels were also assessed. Results In total, 272 patients with chronic HBV and SVR were included; HBsAg seroclearance was achieved in 42 patients and not achieved in 230 patients. Serum HBsAg and ALT levels, ratios of HBsAg to HBV DNA and ratios of AST to ALT were significantly different between patients achieving, and not achieving, HBsAg seroclearance. The area under the receiver operating characteristic (ROC) curve of HBsAg levels for predicting the likelihood of HBsAg seroclearance was 0.85; the cut-off value was 203.86 IU/ml. Conclusions These data demonstrate that HBsAg seroclearance was independently associated with host immunity, serum HBsAg level, serum ALT level, serum HBsAg to HBV DNA ratio and timing of drug therapy within the course of chronic HBV infection.
Meta-analysis of probiotics and/or prebiotics for the prevention of eczema
Authors: Dang Dan , Zhou Wenli , Lun Zhi Jun , Mu Xin , Wang Dong Xuan , Wu Hui 
Published: August 2013

Objective The efficacy of probiotics and/or prebiotics for preventing eczema in infants remains unclear. This meta-analysis evaluated published studies on pro/prebiotics for eczema prevention, investigating bacterial strain efficacy and changes to the allergy status of the children involved. Methods Randomized, double-blind, placebo-controlled trials were analysed, irrespective of bacterial strains used in the pro/prebiotics. Studies of pregnant women, nursing mothers and infants receiving pro/prebiotics were included. All infant participants were assessed within 2 years of birth. Incidences of eczema and systemic sensitization were measured by weighted relative risk ratios (RRR). Results The 14 studies on probiotics had a pooled RRR of 0.69 (95% confidence interval [CI]: 0.62, 0.78). Three studies on prebiotic consumption showed a RRR of 0.80 (95% CI: 0.54, 1.18). One study of mixed pro/prebiotic (synbiotic) strains found a RRR ratio of 0.81 (95% CI: 0.66, 0.99). No consistent sensitization changes were found. Only the combination of nonspore lactobacilli and bifidobacteria reduced the incidence of eczema. Conclusion This meta-analysis found that probiotics or synbiotics may reduce the incidence of eczema in infants aged <2 years. Systemic sensitization did not change following probiotic administration.