bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect Size Estimates for the ESCAPE Trial
Authors: Sajobi Tolulope T. , Zhang Yukun , Menon Bijoy K. , Goyal Mayank , Demchuk Andrew M. , Broderick Joseph P. , Hill Michael D. 
Published: May 2015

Background and Purpose—
Ordinal outcomes, such as modified Rankin Scale (mRS), are the standard primary end points in acute stroke trials. Regression models for assessing treatment efficacy after adjusting for baseline covariates have been developed for continuous, binary, or ordinal end points. There has been no consensus on the best choice of method for analyzing these data.

Methods—
We compared several regression models for assessing treatment efficacy in acute stroke trials using existing data sets from the Interventional Management of Stroke-III and Prolyse in Acute Cerebral Thromboembolism II (PROACT-2) trials. Patients with baseline non–contrast computed tomographic Alberta Stroke Program Early CT Score (ASPECTS) > 5, baseline computed tomographic angiography, or conventional angiogram showing an intracranial internal carotid artery or middle cerebral artery trunk (M-1) occlusion, adequate collateral circulation shown on computed tomographic angiography, and treatment times of non–contrast computed tomographic to groin puncture of ≤90 minutes, were included. Monte Carlo techniques were used to compare the statistical power of these regression models under a variety of simulated data analytic scenarios.

Results—
Binary logistic regression showed greater power when the treatment is predicted to show evidence of benefit on one end of the mRS with no other gains across other levels of the scale. Proportional odds regression showed greater power when the treatment is predicted to show evidence of improvement on both ends of the mRS.

Conclusions—
The mRS distribution for both treatment and control groups influences the power of the investigated statistical models to assess treatment efficacy. A careful evaluation of the expected outcome distribution across the mRS scale is required to determine the best choice of primary analysis.
Effect of Blood Pressure Lowering in Early Ischemic Stroke
Authors: Lee Meng , Ovbiagele Bruce , Hong Keun-Sik , Wu Yi-Ling , Lee Jing-Er , Rao Neal M. , Feng Wayne , Saver Jeffrey L. 
Published: May 2015

Background and Purpose—
Elevated blood pressure is common in acute stage of ischemic stroke and the strategy to manage this situation is not well established. We therefore conducted a meta-analysis of randomized controlled trials comparing active blood pressure lowering and control groups in early ischemic stroke.

Methods—
Pubmed, EMBASE, and Clinicaltrials.gov from January 1966 to March 2015 were searched to identify relevant studies. We included randomized controlled trials with blood pressure lowering started versus control within 3 days of ischemic stroke onset. The primary outcome was unfavorable outcome at 3 months or at trial end point, defined as dependency or death, and the key secondary outcome was recurrent vascular events. Pooled relative risks and 95% confidence intervals were calculated using random-effects model.

Results—

The systematic search identified 13 randomized controlled trials with 12 703 participants comparing early blood pressure lowering and control. Pooling the results with the random-effects model showed that blood pressure lowering in early ischemic stroke did not affect the risk of death or dependency at 3 months or at trial end point (relative risk, 1.04; 95% confidence interval, 0.96–1.13;
P
=0.35). Also, blood pressure lowering also had neutral effect on recurrent vascular events, as well as on disability or death, all-cause mortality, recurrent stroke, and serious adverse events.

Conclusions—
This meta-analysis suggested blood pressure lowering in early ischemic stroke had a neutral effect on the prevention of death or dependency.
Finding the Prophetic in Failure
Authors: Ludwig Kathryn 
Published: May 2015

In recent decades, a body of literary writing has emerged in which religious questions are foregrounded. This body of writing and the criticism connected with it is increasingly referred to as postsecular. In E. L. Doctorow’s City of God, the characters and the text perform the struggle of reading prophetically, as it is defined in the writings of Jewish philosopher Martin Buber. In his time, Buber urged not a return to existing models of the religious, but a turn toward prophetic reading, which is founded in relation. Literary writing of this postsecular moment, including City of God, is likewise engaged in a reconceptualization of the religious. Doctorow’s novel conveys the idea that engaging the religious involves failure, but that it is through failure that we are pushed to a new modality of reading.
The Contribution of Striations to the Eddy Energy Budget and Mixing: Diagnostic Frameworks and Results in a Quasigeostrophic Barotropic System with Mean Flow
Authors: Chen Ru , Flierl Glenn R. 
Published: May 2015

AbstractLow-frequency oceanic motions have banded structures termed “striations.” Since these striations embedded in large-scale gyre flows can have large amplitudes, the authors investigated the effect of mean flow on their directions as well as their contribution to energetics and mixing using a β-plane, barotropic, quasigeostrophic ocean model. In spite of the model simplicity, striations are always found to exist regardless of the imposed barotropic mean flow. However, their properties are sensitive to the mean flow. Rhines jets move with the mean flow and are not necessarily striations. If the meridional component of the mean flow is large, Rhines jets become high-frequency motions; low-frequency striations still exist, but they are nonzonal, have small magnitudes, and contribute little to energetics and mixing. Otherwise, striations are zonal, dominated by Rhines jets, and contribute significantly to energetics and mixing. This study extends the theory of β-plane, barotropic turbulence, driven by white noise forcing at small scales, to include the effect of a constant mean flow. Theories developed in this study, based upon the Galilean invariance property, illustrate that the barotropic mean flow has no effect on total mixing rates, but does affect the energy cascades in the frequency domain. Diagnostic frameworks developed here can be useful to quantify the striations’ contribution to energetics and mixing in the ocean and more realistic models. A novel diagnostic formula is applied to estimating eddy diffusivities.
Sensitivity of Limited-Area Hybrid Variational-Ensemble Analyses and Forecasts to Ensemble Perturbation Resolution
Authors: Schwartz Craig S. , Liu Zhiquan , Huang Xiang-Yu 
Published: May 2015

Abstract
Dual-resolution (DR) hybrid variational-ensemble analysis capability was implemented within the community Weather Research and Forecasting (WRF) Model data assimilation (DA) system, which is designed for limited-area applications. The DR hybrid system combines a high-resolution (HR) background, flow-dependent background error covariances (BECs) derived from a low-resolution ensemble, and observations to produce a deterministic HR analysis. As DR systems do not require HR ensembles, they are computationally cheaper than single-resolution (SR) hybrid configurations, where the background and ensemble have equal resolutions.
Single-observation tests were performed to document some characteristics of limited-area DR hybrid analyses. Additionally, the DR hybrid system was evaluated within a continuously cycling framework, where new DR hybrid analyses were produced every 6 h over ~3.5 weeks. In the DR configuration presented here, the deterministic backgrounds and analyses had 15-km horizontal grid spacing, but the 32-member WRF Model–based ensembles providing flow-dependent BECs for the hybrid had 45-km horizontal grid spacing. The DR hybrid analyses initialized 72-h WRF Model forecasts that were compared to forecasts initialized by an SR hybrid system where both the ensemble and background had 15-km horizontal grid spacing. The SR and DR hybrid systems were coupled to an ensemble adjustment Kalman filter that updated ensembles each DA cycle.
On average, forecasts initialized from 15-km DR and SR hybrid analyses were not statistically significantly different, although tropical cyclone track forecast errors favored the SR-initialized forecasts. Although additional studies over longer time periods and at finer grid spacing are needed to further understand sensitivity to ensemble perturbation resolution, these results suggest users should carefully consider whether SR hybrid systems are worth the extra cost.
The Feasibility, Acceptability, and Preliminary Effectiveness of a Promotora-Led Diabetes Prevention Program (PL-DPP) in Latinas
Authors: O’Brien Matthew J. , Perez Alberly , Alos Victor A. , Whitaker Robert C. , Ciolino Jody D. , Mohr David C. , Ackermann Ronald T. 
Published: May 2015

Purpose The purpose of this pilot study is to test the feasibility, acceptability, and preliminary effectiveness of a Promotora-Led Diabetes Prevention Program (PL-DPP) in Hispanic women (Latinas). Methods Twenty Latina adults with prediabetes were enrolled in this single-arm pilot trial of PL-DPP. Participants underwent a year-long lifestyle intervention consisting of 24 sessions divided into 14 weekly core sessions and 10 post-core sessions offered either biweekly or monthly. Each session was led by a promotora in Spanish. The primary outcome was weight change over the 12-month study period. Results The study participants were socioeconomically challenged, middle-aged Latinas with limited access to health care. Eighteen participants (90%) completed at least 12 sessions, and 1 was lost to follow-up. Overall, participants reported high levels of satisfaction with PL-DPP. At 12 months, the participants achieved a mean weight loss of 10.8 pounds, which corresponded to 5.6% of initial body weight. Significant pre-post reductions in waist circumference, diastolic blood pressure, LDL cholesterol, and insulin levels were also observed. Modest reductions in A1C and fasting plasma glucose were not significant. Conclusions The PL-DPP demonstrated feasibility, acceptability, and preliminary effectiveness in a high-risk population of Latinas. Future research examining this intervention in a randomized clinical trial should explore factors impacting its effects using both qualitative and quantitative methods.
Validation of the Immunization Data Reported under Health Management Information System by the Primary Health Centres of Rural Vadodara
Authors: Patel S.V. , Bakshi H.N. , Mazumdar V.S. , Kotecha P.V. 
Published: May 2015

To study the immunization data reported by the primary health centre/sub-centre (PHC/SC) and validate them at the village level, and to also assess the quality of care during immunization. A sample of 20 PHCs, 13 rural and 7 tribal, was selected using a stratified random sampling. For every PHC, two SCs and for every SC, one village were selected. Data on immunization were collected from the PHC/SC records and were validated by interviewing five beneficiaries from the village. The process evaluation of immunization session was done wherever possible to assess the quality of care. The district availability of vaccines was 77.0 per cent while the overall accessibility was 90 per cent. Following validation, the gap between reported and validated data was 15 per cent and 25 per cent of reported utilization and coverage, respectively. Process evaluation revealed that the process was followed correctly at 62 per cent as per the assessment score. Only a part of the gap could be accounted for by the reasons justified by the service providers. However, a substantial part of the gap may be chiefly due to over-reporting mainly to meet the dictated targets. Process evaluation revealed lacunae in safe injection practices.
Accumulating too much stuff: what is hoarding and what is not?
Authors: Snowdon John 
Published: May 2015

Objective: This paper considers the meaning of the terms hoarding, collecting and accumulation, with a focus on what is abnormal and what is not. Conclusions: Hoarding is an adaptive behaviour. When hoarding is excessive and interferes with people’s lives, it is a disorder. A central feature of hoarding disorder is accumulation of items due to unwillingness to discard them. This must be distinguished from abnormal accumulation of material caused by poor motivation or unawareness concerning the need to discard.
Anti-N-methyl-D-aspartate encephalitis – a case study of symptomatic progression
Authors: Bowes Emma , Levy Florence , Lawson John , Mandalis Anna , Mohan Adith , Shannon Weickert Cynthia 
Published: May 2015

Objective: To present the diagnosis course and sequelae of a case of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, drawing attention to early psychiatric symptoms. Method: The literature on anti-NMDA encephalitis is reviewed and possible psychopathological mechanisms discussed. Result: New onset psychoses, presenting with the combination of hallucinations, dyskinesias and seizures and progressing to catatonia should be referred to neurology for consideration of anti-NMDA receptor encephalitis. Conclusion: Early diagnosis is important for a favourable prognosis.
From Experiential Learning to Aesthetic Knowing
Authors: Sutherland Ian , Jelinek Jasna 
Published: May 2015

The Problem Following executive students in a series of choral conducting workshops, this article explores the growing practice of arts-based leadership development. Based in experiential learning, arts-based learning claims to have great potential in connecting intellect and emotions, to meaningfully challenge norms and assumptions, and to value the relational and subjective aspects of human experience. However, to date, there is a lack of empirical, participant-focused work exploring the “what” and “how” of arts-based leadership development as well as its impact on professional practice. The Solution Through observational and interview data gathered at a European business school, this research takes a grounded, participant-centered approach to exploring the experiences of participants in three choral conducting masterclasses. The findings support the effectiveness of arts-based methods for leadership development; potent learning emerges. Moreover, nuance is added to understandings of how and what learning takes place, describing a process of learning as sensemaking to aesthetic knowing. The development outcomes centered on relational dynamics of leadership and the aesthetics of power and responsibility, with longer-term data showing positive impact on the professional practice of participants. The Stakeholders This article speaks to HRD researchers, professionals, and development practitioners. Of interest for all three groups, the study overviews the growing trend of arts-based methods in leadership development while providing insights into how learning gets done,what is learned, and sheds light on longer-term impacts of this form of experiential learning.
Outcomes Following Limb Crossing in Endovascular Aneurysm Repairs
Authors: Dattani Nikesh , Wild John , Sidloff David , Fishwick Guy , Bown Matthew , Choke Edward , Sayers Robert 
Published: May 2015

Background: Crossing the limbs of the stent during endovascular aneurysm repair (EVAR) is often used to aid cannulation of the contralateral limb. This study assessed outcomes following the use of this technique. Methods: Retrospective review of crossed (n = 43) and uncrossed (n = 269) EVARs was performed at a tertiary vascular center over 5 years. Primary end points were graft limb occlusion (GLO), endoleak, and sac expansion rates. Indications for limb crossing were also assessed. Results: Two-year GLO ( P = .34) and type 1 endoleak ( P = .413) rates were similar between groups. Patients undergoing crossed EVAR experienced more type 2 endoleaks ( P = .002) at 24 months but no increase in sac expansion rates was observed ( P = .275). Thirty-day ( P = .57) and late ( P = .268) mortalities were similar between groups. The main indication for limb crossing was distal aortic angulation (48.8%). Conclusions: Crossed EVAR does not increase the risk of GLOs or clinically significant endoleaks. Further studies are needed to determine the effect on type 2 endoleak rates.
HeterozygousRTEL1mutations are associated with familial pulmonary fibrosis
Authors: Kannengiesser Caroline , Borie Raphael , Ménard Christelle , Réocreux Marion , Nitschké Patrick , Gazal Steven , Mal Hervé , Taillé Camille , Cadranel Jacques , Nunes Hilario , Valeyre Dominique , Cordier Jean François , Callebaut Isabelle , Boileau Catherine , Cottin Vincent , Grandchamp Bernard , Revy Patrick , Crestani Bruno 
Published: May 2015

Pulmonary fibrosis is a fatal disease with progressive loss of respiratory function. Defective telomere maintenance leading to telomere shortening is a cause of pulmonary fibrosis, as mutations in the telomerase component genesTERT(reverse transcriptase) andTERC(RNA component) are found in 15% of familial pulmonary fibrosis (FPF) cases. However, so far, about 85% of FPF remain genetically uncharacterised.Here, in order to identify new genetic causes of FPF, we performed whole-exome sequencing, with a candidate-gene approach, of 47 affected subjects from 35 families with FPF withoutTERTandTERCmutations.We identified heterozygous mutations in regulator of telomere elongation helicase 1 (RTEL1) in four families. RTEL1 is a DNA helicase with roles in DNA replication, genome stability, DNA repair and telomere maintenance. The heterozygousRTEL1mutations segregated as an autosomal dominant trait in FPF, and were predicted by structural analyses to severely affect the function and/or stability of RTEL1. In agreement with this,RTEL1-mutated patients exhibited short telomeres in comparison with age-matched controls.Our results provide evidence that heterozygousRTEL1mutations are responsible for FPF and, thereby, extend the clinical spectrum of RTEL1 deficiency. Thus,RTEL1enlarges the number of telomere-associated genes implicated in FPF.
Short-chain fatty acids affect cystic fibrosis airway inflammation and bacterial growth
Authors: Ghorbani Peyman , Santhakumar Prisila , Hu Qingda , Djiadeu Pascal , Wolever Thomas M.S. , Palaniyar Nades , Grasemann Hartmut 
Published: May 2015

The hypoxic environment of cystic fibrosis airways allows the persistence of facultative anaerobic bacteria, which can produce short-chain fatty acids (SCFAs) through fermentation. However, the relevance of SCFAs in cystic fibrosis lung disease is unknown. We show that SCFAs are present in sputum samples from cystic fibrosis patients in millimolar concentrations (mean±sem1.99±0.36 mM).SCFAs positively correlated with sputum neutrophil count and higher SCFAs were predictive for impaired nitric oxide production. We studied the effects of the SCFAs acetate, propionate and butyrate on airway inflammatory responses using epithelial cell lines and primary cell cultures. SCFAs in concentrations present in cystic fibrosis airways (0.5–2.5 mM) affected the release of granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor and interleukin (IL)-6. SCFAs also resulted in higher IL-8 release from stimulated cystic fibrosis transmembrane conductance regulator (CFTR) F508del-mutant compared to wild-type CFTR-corrected bronchial epithelial cells. At 25 mM propionate reduced IL-8 release in control but not primary cystic fibrosis epithelial cells. Low (0.5–2.5 mM) SCFA concentrations increased, while high (25–50 mM) concentrations decreased inducible nitric oxide synthase expression. In addition, SCFAs affected the growth ofPseudomonas aeruginosain a concentration- and pH-dependent manner.Thus, our data suggest that SCFAs contribute to cystic fibrosis-specific alterations of responses to airway infection and inflammation.
Combining bosentan and sildenafil in pulmonary arterial hypertension patients failing monotherapy: real-world insights
Authors: Dardi Fabio , Manes Alessandra , Palazzini Massimiliano , Bachetti Cristina , Mazzanti Gaia , Rinaldi Andrea , Albini Alessandra , Gotti Enrico , Monti Enrico , Bacchi Reggiani Maria Letizia , Galiè Nazzareno 
Published: May 2015

Pulmonary arterial hypertension is a severe disease with a complex pathogenesis, for which combination therapy is an attractive option.This study aimed to assess the impact of sequential combination therapy on both short-term responses and long-term outcomes in a real-world setting.Patients with idiopathic/heritable pulmonary arterial hypertension, or pulmonary arterial hypertension associated with congenital heart disease or connective tissue disease and who were not meeting treatment goals on either first-line bosentan or sildenafil monotherapy, were given additional sildenafil or bosentan and assessed after 3–4 months. Double combination therapy significantly improved clinical and haemodynamic parameters, independent of aetiology or the order of drug administration. Significant improvements in functional class were observed in patients with idiopathic/heritable pulmonary arterial hypertension. The 1-, 3- and 5-year overall survival estimates were 91%, 69% and 59%, respectively. Patients with pulmonary arterial hypertension associated with connective tissue disease had significantly poorer survival rates compared to other aetiologies (p<0.003).The favourable short-term haemodynamic results and good survival rates, observed in patients receiving both bosentan and sildenafil, supports the use of sequential combination therapy in patients failing on monotherapy in a real-world setting.
Outcomes of β-blocker use in pulmonary arterial hypertension: a propensity-matched analysis
Authors: Bandyopadhyay Debabrata , Bajaj Navkaranbir S. , Zein Joe , Minai Omar A. , Dweik Raed A. 
Published: May 2015

The utility and safety of β-blockers in pulmonary hypertension is controversial. Anecdotal reports suggest that β-blockers may be harmful in these patients. The aim of our study was to evaluate outcomes of β-blocker use in pulmonary hypertension.We reviewed patients from our pulmonary hypertension registry between 2000 and 2011. Patients who continued to use β-blockers were compared to those who never used β-blockers for all-cause mortality, time to clinical worsening events, defined as death, lung transplantation and hospitalisation due to pulmonary hypertension. We also evaluated the effect of β-blockers on 6-min walking distance and New York Heart Association (NYHA) functional class.133 patients used β-blockers and 375 patients never used β-blockers. Mean±sdage was 57±16 years and the median follow-up period was 78 months. Propensity-matched analysis showed that the adjusted odds ratio (95% CI) for mortality with β-blocker use was 1.13 (0.69–1.82) and for clinical worsening events was 0.96 (0.55–1.68). No significant difference was noted in probability of survival and time to clinical worsening events. Patients on β-blockers walked a shorter distance on follow-up 6 min walk test; follow-up NYHA class was similar between groups.Pulmonary hypertension patients receiving β-blockers had a similar survival and time to clinical worsening events compared to patients not receiving them. Functional outcomes were similar, although β-blocker use was associated with a tendency towards shorter walking distance.