bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Asymptomatic Coronary Artery Diseasein Patients With Ischemic Stroke and Transient Ischemic Attack
Authors: Calvet David , Song Dongbeom , Yoo Joonsang , Turc Guillaume , Sablayrolles Jean-Louis , Choi Byoung Wook , Heo Ji Hoe , Mas Jean-Louis 
Published: November 2013

Background and Purpose—
Identifying occult coronary artery stenosis may improve secondary prevention of stroke patients. The aim of this study was to derive and validate a simple score to predict severe occult coronary artery stenosis in stroke patients.

Methods—
We derived a score from a French hospital–based cohort of consecutive patients (n=300) who had an ischemic stroke or a transient ischemic attack and no previous history of coronary heart disease (Predicting Asymptomatic Coronary Artery Disease in Patients With Ischemic Stroke and Transient Ischemic Attack [PRECORIS] score) and validated the score in a similar Korean cohort (n=1602). In both cohorts, severe coronary artery stenosis was defined by the presence of at least 1 ≥50% coronary artery stenosis as detected by 64-section CT coronary angiography.

Results—
A 5-point score (Framingham Risk Score–predicted 10-year coronary heart disease risk [≥20%=3; 10–19%=1; <10%=0] and cervicocephalic artery stenosis [≥50%=2; <50%=1; none=0]) was predictive of occult ≥50% coronary artery stenosis risk in the derivation cohort (C-statistic=0.77 [0.70–0.84]) and in the validation cohort (C-statistic=0.66 [0.63–0.68]). The predictive ability of the score was even stronger when only ≥50% left main trunk disease or 3-vessel disease were considered (C-statistic=0.83 [0.74–0.92] and 0.70 [0.66–0.74] in derivation and validation cohorts, respectively). The prevalence of occult ≥50% coronary artery stenosis and ≥50% left main trunk or 3-vessel disease increased gradually with the PRECORIS score, reaching 44.2% and 13.5% in derivation cohort and 49.8% and 12.8% in validation cohort in patients with a PRECORIS score ≥4.

Conclusions—
The PRECORIS score can identify a population of stroke or transient ischemic attack patients with a high prevalence of occult severe coronary artery stenosis.
MicroRNA-18a Improves Human Cerebral Arteriovenous Malformation Endothelial Cell Function
Authors: Ferreira Raquel , Santos Tiago , Amar Arun , Tahara Stanley M. , Chen Thomas C. , Giannotta Steven L. , Hofman Florence M. 
Published: November 2013

Background and Purpose—
Cerebral arteriovenous malformation (AVM) is a vascular disease that disrupts normal blood flow and leads to serious neurological impairment or death. Aberrant functions of AVM-derived brain endothelial cells (AVM-BECs) are a disease hallmark. Our aim was to use microRNA-18a (miR-18a) as a therapeutic agent to improve AVM-BEC function.

Methods—
Human AVM-BECs were tested for growth factor production and proliferation under different shear flow conditions and evaluated for tubule formation. Thrombospondin-1, inhibitor of DNA-binding protein 1, and vascular endothelial growth factor (VEGF) isotype mRNA levels were quantified by quantitative real-time polymerase chain reaction. Thrombospondin-1, VEGF-A, and VEGF-D protein expression was measured using enzyme-linked immunosorbent assay. Proliferation and tubule formation were evaluated using bromodeoxyuridine incorporation and growth factor–reduced Matrigel assays, respectively.

Results—
miR-18a increased thrombospondin-1 production but decreased inhibitor of DNA-binding protein 1, a transcriptional repressor of thrombospondin-1. miR-18a reduced VEGF-A and VEGF-D levels, both overexpressed in untreated AVM-BECs. This is the first study reporting VEGF-D overexpression in AVM. These effects were most prominent under arterial shear flow conditions. miR-18a also reduced AVM-BEC proliferation, improved tubule formation, and was effectively internalized by AVM-BECs in the absence of extraneous transfection reagents.

Conclusions—
We report VEGF-D overexpression in AVM and the capacity of miR-18a to induce AVM-BECs to function more normally. This highlights the clinical potential of microRNA as a treatment for AVM and other vascular diseases.
Morphological and anatomical characterization of a new natural hybrid between Cohniella ascendens and C. brachyphylla (Oncidiinae: Orchidaceae)
Authors: CETZAL-IX WILLIAM , CARNEVALI GERMAN , NOGUERA-SAVELLI ELIANA , JAUREGUI DAMELIS 
Published: November 2013

A putative natural hybrid between Cohniella ascendens and C. brachyphylla (Orchidaceae, Oncidiinae) from western Costa Rica, C. ×francoi, is herein newly described, illustrated and characterized based upon both morphological and anatomical characters. This taxon hybrid is most similar to C. ascendens but the flowers show intermediate characters between the putative parents. Cohniella ×francoi is similar to C. ascendens in its semipendulous inflorescences, callus shape, cylindrical column base with linear oblong wings, and obovate stigmatic cavity plus several anatomical characters. On the other hand, it is similar to C. brachyphylla in the oblong to subquadrate lateral lobes of the labellum that are in the same plane as the central lobe, and the rectangular disc of the labellum with a lateral extension of the callus in the margins. A table of diagnostic characters for the new hybrid and its putative parents, a comparative figure, and a map showing their geographical distributions are also provided. Cohniella ×francoi, un híbrido natural entre Cohniella ascendens y C. brachyphylla (Orchidaceae, Oncidiinae) del oeste de Costa Rica es aquí descrito, ilustrado y caracterizado por caracteres morfológicos y anatómicos. El nuevo híbrido es más similar a C. ascendens pero las flores presentan caracteres intermedios entre sus padres putativos. Cohniella ×francoi se parece a C. ascendens en la inflorescencia semipéndula, la forma del callo, la columna cilíndrica con las alas linear oblongas y la cavidad estigmática obovada, además de varios caracteres anatómicos. Por otro lado, es similar a C. brachyphylla por los lóbulos laterales del labelo oblongos a subcuadrados y extendidos en el mismo plano que el lóbulo central y el disco rectangular con extensiones laterales del callo en los márgenes. Adicionalmente, proporcionamos una tabla de caracteres diagnósticos para el nuevo híbrido y sus padres putativos, una figura comparativa y un mapa detallando las distribuciones geográficas de los tres taxones.
Pseudo-Orbit Data Assimilation. Part II: Assimilation with Imperfect Models
Authors: Du Hailiang , Smith Leonard A. 
Published: November 2013

AbstractData assimilation and state estimation for nonlinear models is a challenging task mathematically. Performing this task in real time, as in operational weather forecasting, is even more challenging as the models are imperfect: the mathematical system that generated the observations (if such a thing exists) is not a member of the available model class (i.e., the set of mathematical structures admitted as potential models). To the extent that traditional approaches address structural model error at all, most fail to produce consistent treatments. This results in questionable estimates both of the model state and of its uncertainty. A promising alternative approach is proposed to produce more consistent estimates of the model state and to estimate the (state dependent) model error simultaneously. This alternative consists of pseudo-orbit data assimilation with a stopping criterion. It is argued to be more efficient and more coherent than one alternative variational approach [a version of weak-constraint four-dimensional variational data assimilation (4DVAR)]. Results that demonstrate the pseudo-orbit data assimilation approach can also outperform an ensemble Kalman filter approach are presented. Both comparisons are made in the context of the 18-dimensional Lorenz96 flow and the two-dimensional Ikeda map. Many challenges remain outside the perfect model scenario, both in defining the goals of data assimilation and in achieving high-quality state estimation. The pseudo-orbit data assimilation approach provides a new tool for approaching this open problem.
Equatorial Dry Air Intrusion and Related Synoptic Variability in MJO Initiation during DYNAMO
Authors: Kerns Brandon W. , Chen Shuyi S. 
Published: November 2013

Abstract
Dynamics of the Madden–Julian oscillation (DYNAMO) was conducted over the equatorial Indian Ocean (IO) from October 2011 to March 2012. During mid- to late November, a strong Madden–Julian oscillation (MJO) event, denoted MJO-2, initiated in the western IO and passed through the DYNAMO observation array. Dry air intrusions associated with synoptic variability in the equatorial region played a key role in the evolution of MJO-2. First, a sharp dry air intrusion surging from the subtropics into the equatorial region suppresses convection in the ITCZ south of the equator. This diminishes subsidence on the equator associated with the ITCZ convection, which leads to an equatorward shift of convection. It is viewed as a contributing factor for the onset of equatorial convection in MJO-2. Once the MJO convection is established, a second type of dry air intrusion is related to synoptic gyres within the MJO convective envelope. The westward-propagating gyres draw drier air from the subtropics into the equatorial region on the west side of the MJO-2. This dry air intrusion contributes to a 1–2-day break in the rainfall during the active phase of MJO-2. Furthermore, the dry air intrusion suppresses convection in the westerlies of the MJO in the IO. This favors the abrupt shutdown of MJO convection during transition to the suppressed phase in DYNAMO. The two types of dry air intrusions can redistribute convection from the ITCZ to the equator and favor the eastward propagation of the MJO convection. Further study of multiple MJO events is necessary to determine the generality of these findings.
Antidepressants for mothers: what are psychiatrists prescribing?
Authors: Kean LJ , Pasupuleti P , Shah P 
Published: November 2013

Background and aims Depressive illness in the perinatal period is common and can be associated with detrimental effects to both mother and child. The evolving evidence base on the safety of antidepressants in pregnancy and breastfeeding can make prescribing decisions challenging. This study aimed to investigate current prescribing practices and attitudes of hospital psychiatrists towards depression in pregnant and breastfeeding mothers. Methods and results This qualitative survey was conducted by way of e-mail survey to 95 psychiatrists, of all grades and specialities, based within The Royal Edinburgh Hospital. A majority of psychiatrists are choosing and avoiding antidepressants in accordance with the National Institute for Health and Clinical Excellence guidelines. A minority of respondents are selecting classes of antidepressants, which raises concern about the safety of such prescribing decisions. The majority of psychiatrists expressed a lack of confidence when prescribing and expressed a wish for further training in this area. Conclusion This study indicates a degree of uncertainty amongst psychiatrists of all grades when prescribing to these special groups. We would recommend increased training in this area to all psychiatrists and an increased emphasis placed upon incorporating perinatal psychiatry within the postgraduate psychiatric curriculum.
Gentamicin use in neonates: should we have a change of practice?
Authors: Krishnamoorthy SS , Nair A , Furness J , Sanderson J 
Published: November 2013

Background Gentamicin, one of the most commonly used antibiotics in neonates, has potential toxicity. This study was performed to determine the incidence of potential toxicity of gentamicin in term and preterm neonates. Methods A one-year retrospective study in neonates admitted to Special Baby Care Units at University Hospital of North Durham and Darlington Memorial Hospitals. We reviewed each admission and looked through the case notes in detail to document information about gentamicin administration, dosage and elevated gentamicin levels in the blood. Pre-third dose gentamicin levels >2 mg/L were classified as elevated. Results Overall, 192 babies (83 term and 109 preterm) had documented gentamicin levels. Of these, 43% (84/192) manifested elevated gentamicin levels. Of the babies with elevated gentamicin levels, 67% (56/84) weighed less than 2.5 kg. When a combination of gestation period and weight was considered, 61% (51/84) of preterm infants weighing <2.5 kg had elevated levels whereas only one term infant <2.5 kg exhibited elevated levels. Conclusion Preterm neonates and specifically low birth weight neonates tolerate gentamicin poorly. Dosage and/or interval of administration of the medication may need modification in this group to minimise toxicity.
Utility of Head and Neck Cutaneous Squamous Cell Carcinoma Sentinel Node Biopsy: A Systematic Review
Authors: Ahmed Mostafa M. , Moore Brian A. , Schmalbach Cecelia E. 
Published: November 2013

ObjectiveSentinel lymph node biopsy (SLNB) is standard of care for melanoma, but its role in cutaneous squamous cell carcinoma (cSCC) has not been established. Study objectives include: (1) analyze the feasibility and reliability SLNB for head and neck (H&N) cSCC and (2) identify risk factors associated with a positive SLN.Data SourcesMEDLINE, PubMed, Cochrane, and ASCO databases searches conducted (1946‐2013).Review MethodsUsing the PRISM model, a comprehensive systematic review of H&N cSCC SLNB studies with associated recurrence rates was conducted. Dual‐blinded data extraction identify primary outcomes (successful SLN harvest and false omission rate) and secondary outcomes (risk factors associated with a +SLN).ResultsTwo hundred twenty‐one articles were screened; 73 patients from 11 publications met inclusion criteria (3 case series; 8 prospective cohorts). Studies ranged from 1 to 15 patients (median 5). Median age was 74 years. Median follow‐up was 21.5 months. Average tumor size was 3.09 cm. At least 1 SLN was identified in 100% of patients (median 2). Ten (13.5%) had a positive SLN; no additional metastatic nodes were identified in 9 patients receiving completion lymphadenectomy. Tumor diameter was not associated with SLN status (P =. 09; 95% CI, –.27 to 3.02). Risk factors (tumor depth, perineural invasion, location, differentiation) were not consistently recorded. Three of 63 (4.76%) failed regionally following a negative SLNB.ConclusionH&N cSCC SLNB is feasible and reliable for staging, with a false omission rate of 4.7% mirroring melanoma. Prospective studies documenting high risk features are required to further define its role.
Complications of Surgery for Sporadic Vestibular Schwannoma
Authors: Mahboubi Hossein , Ahmed Omar H. , Yau Amy Y. , Ahmed Yasmina C. , Djalilian Hamid R. 
Published: November 2013

ObjectivesWe sought to investigate the postoperative complications of vestibular schwannoma excision and determine their significant clinical predictors.Study DesignCross‐sectional.SettingCalifornia Hospital Inpatient Discharge Datasets 1997‐2011.Subjects and MethodsData for vestibular schwannoma excisions performed in California were extracted using the ICD‐9‐CM code “04.01 excision of acoustic neuroma.” Demographics, principal payer, state of residence, comorbidities, as well as hospital case volume were examined as possible predictors. Postoperative complications and patient disposition were examined as outcome variables. Comorbidities and complications were identified using ICD‐9‐CM diagnoses and procedures codes.ResultsOverall, 6553 cases were examined. Comorbidities were present in 2539 (38.7%) patients. Postoperative complications occurred in 1846 (28.2%) patients; 1714 (26.2%) neurological and 337 (5.1%) medical complications. Patients’ admission ended with death or further care (ie, skilled nursing facilities) in 260 (4.0%) cases. Mortality rate was 0.2%. No significant changes were observed over time. Multivariate analysis revealed that the odds of neurological complications were greater in the 2007‐2011 period (OR = 1.51; 95% CI, 1.12‐2.04), in patients with comorbidities (OR = 1.48; 95% CI, 1.16‐1.88), and in hospitals with low case volume (OR = 1.69; 95% CI. 1.31‐2.18). The odds of medical complications were also greater in the 2007‐2011 period (OR = 1.69; 95%, CI 1.02‐2.80). Female gender, non‐Caucasian ethnicity, presence of comorbidities, and low hospital case volume were associated with greater odds of patients requiring further care.ConclusionComorbidities and low hospital case volume were major risk factors for complications. No significant changes in rates of complications from vestibular schwannoma surgery were observed over the 15‐year period.
Exploring the financial impact of caring for family members receiving palliative and end-of-life care: A systematic review of the literature
Authors: Gardiner Clare , Brereton Louise , Frey Rosemary , Wilkinson-Meyers Laura , Gott Merryn 
Published: November 2013

Background: Research regarding the economic dimensions of palliative care is relatively limited. The economic implications of providing informal care are well recognised; however, within the context of palliative care, little is known about the costs and implications of providing care for a loved one at the end of life. Aim: To explore the financial costs and the financial impact of caring for family members receiving palliative/end-of-life care. Design: A systematic literature review of empirical research following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data Sources: Seven electronic databases were searched from inception to April 2012. Inclusion criteria were as follows: articles relating to the financial costs or implications of family caregiving at the end-of-life care, English language articles, empirical research or systematic reviews and articles relating to adults. Results: The review identified 21 relevant articles; however, evidence relating to the costs and implications of caregiving was relatively limited. The results indicate that the financial costs of caring for someone at the end of life are substantial. Financial costs can result in significant and multidimensional caregiver burden. Various factors were found to mediate the extent of financial burden. Conclusions: This review identified a significant gap in the evidence base regarding the economic implications of providing care to a family member within a palliative care context. Economic costs and implications are likely to be significant, and research to address this gap is urgently needed, particularly given policy initiatives in a number of developed countries to move the provision of palliative and end-of-life care from hospital to community settings.
Assessment of Instrumental Activities of Daily Living in Dementia
Authors: Sikkes Sietske A. M. , Pijnenburg Yolande A. L. , Knol Dirk L. , de Lange-de Klerk Elly S. M. , Scheltens Philip , Uitdehaag Bernard M. J. 
Published: November 2013

Background: Measuring impairments in “instrumental activities of daily living” (IADL) is important in dementia, but challenging due to the lack of reliable and valid instruments. We recently developed the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q; note 1). We aim to investigate the diagnostic accuracy of the A-IADL-Q for dementia in a memory clinic setting. Methods: Patients visiting the Alzheimer Center of the VU University Medical Center with their informants between 2009 and 2011 were included (N = 278). Diagnoses were established in a multidisciplinary consensus meeting, independent of the A-IADL-Q scores. An optimal A-IADL-Q cutoff point was determined, and sensitivity and specificity were calculated. Area under the curves (AUCs) were compared between A-IADL-Q and “disability assessment of dementia” (DAD). The additional diagnostic value of the A-IADL-Q to Mini-Mental State Examination (MMSE) was examined using logistic regression analyses. Results: Dementia prevalence was 50.5%. Overall diagnostic accuracy based on the AUC was 0.75 (95% confidence interval [CI]: 0.70-0.81) for the A-IADL-Q and 0.70 (95% CI: 0.63-0.77) for the DAD, which did not differ significantly. The optimal cutoff score for the A-IADL-Q was 51.4, resulting in sensitivity of 0.74 and specificity of 0.64. Combining the A-IADL-Q with the MMSE improved specificity (0.94), with a decline in sensitivity (0.55). Logistic regression models showed that adding A-IADL-Q improved the diagnostic accuracy (Z = 2.55, P = .011), whereas the DAD did not. Conclusions: In this study, we showed a fair diagnostic accuracy for A-IADL-Q and an additional value in the diagnosis of dementia. These results support the role of A-IADL-Q as a valuable diagnostic tool.
Propensity score estimators for the average treatment effect and the average treatment effect on the treated may yield very different estimates
Authors: Pirracchio R , Carone M , Rigon M Resche , Caruana E , Mebazaa A , Chevret S 
Published: November 2013

Objective Propensity score matching is typically used to estimate the average treatment effect for the treated while inverse probability of treatment weighting aims at estimating the population average treatment effect. We illustrate how different estimands can result in very different conclusions. Study design We applied the two propensity score methods to assess the effect of continuous positive airway pressure on mortality in patients hospitalized for acute heart failure. We used Monte Carlo simulations to investigate the important differences in the two estimates. Results Continuous positive airway pressure application increased hospital mortality overall, but no continuous positive airway pressure effect was found on the treated. Potential reasons were (1) violation of the positivity assumption; (2) treatment effect was not uniform across the distribution of the propensity score. From simulations, we concluded that positivity bias was of limited magnitude and did not explain the large differences in the point estimates. However, when treatment effect varies according to the propensity score (E[Y(1)–Y(0)|g(X)] is not constant, Y being the outcome and g(X) the propensity score), propensity score matching ATT estimate could strongly differ from the inverse probability of treatment weighting-average treatment effect estimate. We show that this empirical result is supported by theory. Conclusion Although both approaches are recommended as valid methods for causal inference, propensity score-matching for ATT and inverse probability of treatment weighting for average treatment effect yield substantially different estimates of treatment effect. The choice of the estimand should drive the choice of the method.