bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ischemia in Intracerebral Hemorrhage Is Associated With Leukoaraiosis and Hematoma Volume, Not Blood Pressure Reduction
Authors: Gioia Laura C. , Kate Mahesh , Choi Victor , Sivakumar Leka , Jeerakathil Thomas , Kosior Jayme , Emery Derek , Butcher Ken 
Published: April 2015

Background and Purpose—
Diffusion-weighted imaging (DWI) lesions have been identified both inside and outside the perihematoma region. We tested the hypotheses that larger hematoma volumes and blood pressure reduction are associated with DWI lesions.

Methods—

Hematoma and perihematoma edema volumes were measured using planimetric techniques in 117 intracerebral hemorrhage (ICH) patients who underwent DWI. Perihematoma and remote DWI lesion volumes were measured using apparent diffusion coefficient thresholds for moderate (<730×10
−6
mm/s) and severe (<550×10
−6
mm/s) ischemia. Acute blood pressure change over the first 24 hours was calculated.

Results—

The median (interquartile range) time to magnetic resonance imaging was 2 (1–5) days. Median hematoma volume was 9.8 (2.6–23.0) mL, and median perihematoma edema volume was 7.0 (2.9–18.6) mL. A small portion of the perihematoma region contained tissue below the thresholds for moderate (8.0 [2.9–14.5]%) and severe ischemia (1.1 [0.3–3.5]%). Ischemic perihematoma tissue volumes were correlated with hematoma volumes (
R
=0.52,
P
<0.001), but not maximal systolic blood pressure drop at 24 hours (
R
=−0.09,
P
=0.38). Remote DWI lesions were found in 17 (14.5%) patients (mean volume=0.44±0.3 mL). Patients with remote DWI lesions had higher rates of antiplatelet use (
P
=0.01), prior ICH (
P
=0.03), lobar ICH (0.04), and larger leukoaraiosis volumes (
P
=0.02). Maximal systolic blood pressure drop at 24 hours was similar in patients with (−20.5 [−55, −10] mm Hg) and without remote DWI lesions (−27 [−46, −13] mm Hg,
P
=0.96).

Conclusions—
Small DWI lesions within and outside the perihematoma region are common in primary ICH. Perihematoma DWI lesions were independently associated with larger hematoma volumes. Remote DWI lesions may be an epiphenomenon associated with the underlying microvascular pathogenesis. These data do not support a hemodynamic mechanism of ischemic injury after primary ICH.
Clinical Predictors of Accurate Prehospital Stroke Recognition
Authors: Oostema J. Adam , Konen John , Chassee Todd , Nasiri Mojdeh , Reeves Mathew J. 
Published: April 2015

Background and Purpose—
Prehospital activation of in-hospital stroke response hastens treatment but depends on accurate emergency medical services (EMS) stroke recognition. We sought to measure EMS stroke recognition accuracy and identify clinical factors associated with correct stroke identification.

Methods—
Using EMS and hospital records, we assembled a cohort of EMS-transported suspect, confirmed, or missed ischemic stroke or transient ischemic attack cases. The sensitivity and positive predictive value (PPV) for EMS stroke recognition were calculated using the hospital discharge diagnosis as the gold standard. We used multivariable logistic regression analysis to determine the association between Cincinnati Prehospital Stroke Scale use and EMS stroke recognition.

Results—

During a 12-month period, 441 EMS-transported patients were enrolled; of which, 371 (84.1%) were EMS-suspected strokes and 70 (15.9%) were EMS-missed strokes. Overall, 264 cases (59.9%) were confirmed as either ischemic stroke (n=186) or transient ischemic attack (n=78). The sensitivity of EMS stroke recognition was 73.5% (95% confidence interval, 67.7–78.7), and PPV was 52.3% (95% confidence interval, 47.1–57.5). Sensitivity (84.7% versus 30.9%;
P
<0.0001) and PPV (56.2% versus 30.4%;
P
=0.0004) were higher among cases with Cincinnati Prehospital Stroke Scale documentation. In multivariate analysis, Cincinnati Prehospital Stroke Scale documentation was independently associated with EMS sensitivity (odds ratio, 12.0; 95% confidence interval, 5.7–25.5) and PPV (odds ratio, 2.5; 95% confidence interval, 1.3–4.7).

Conclusions—
EMS providers recognized 3 quarters of the patients with ischemic stroke and transient ischemic attack; however, half of EMS-suspected strokes were false positives. Documentation of a Cincinnati Prehospital Stroke Scale was associated with higher EMS stroke recognition sensitivity and PPV.
Recovery to Preinterventional Functioning, Return-to-Work, and Life Satisfaction After Treatment of Unruptured Aneurysms
Authors: Backes Daan , Rinkel Gabriel J.E. , van der Schaaf Irene C. , Nij Bijvank Jenny A. , Verweij Bon H. , Visser-Meily Johanna M.A. , Post Marcel W. , Algra Ale , Vergouwen Mervyn D.I. 
Published: April 2015

Background and Purpose—
The eventual goal of preventive treatment of unruptured intracranial aneurysms is to increase the number of life years with high life satisfaction. Insight in the time with reduced functioning, working capacity, and life satisfaction after aneurysm treatment is pivotal to balance the pros and cons of preventive aneurysm occlusion.

Methods—
We sent a questionnaire on time-to-recovery to preintervention functioning and return-to-work and life satisfaction to patients treated for an unruptured aneurysm between 2000 and 2013. Changes in life satisfaction before treatment, during recovery, and at follow-up were assessed with Wilcoxon signed-rank tests.

Results—

The questionnaire was sent to 159 patients of whom 110 (69%) responded. The mean follow-up time after aneurysm treatment was 6 years (SD 4). Fifty-four patients had endovascular and 56 had microsurgical occlusion. Complete recovery to preintervention functioning was reported by 81% (95% confidence interval [CI], 74–88) of patients, with a median time-to-recovery of 3 months (range 0–48). Complete work recovery was reported by 78% (95% CI, 66–87) of patients. The proportion of patients with high life satisfaction reduced from 76% (95% CI, 67–84) before treatment to 52% (95% CI, 43–61) during the period of recovery (
P
<0.01) and restored largely at long-term follow-up (67% [95% CI, 59–76],
P
=0.08).

Conclusion—
Life satisfaction is significantly reduced during the period of recovery after treatment of unruptured aneurysms. In the long-term, ≈1 out of 5 patients reports incomplete recovery. These treatment effects should be kept in mind when considering preventive aneurysm treatment. Prospective studies are needed to better compare these losses in patients treated for unruptured aneurysms with those who had subarachnoid hemorrhage.
Dynamics and Predictability of Hurricane Nadine (2012) Evaluated through Convection-Permitting Ensemble Analysis and Forecasts
Authors: Munsell Erin B. , Sippel Jason A. , Braun Scott A. , Weng Yonghui , Zhang Fuqing 
Published: April 2015

Abstract
The governing dynamics and uncertainties of an ensemble simulation of Hurricane Nadine (2012) are assessed through the use of a regional-scale convection-permitting analysis and forecast system based on the Weather Research and Forecasting (WRF) Model and an ensemble Kalman filter (EnKF). For this case, the data that are utilized were collected during the 2012 phase of the National Aeronautics and Space Administration’s (NASA) Hurricane and Severe Storm Sentinel (HS3) experiment. The majority of the tracks of this ensemble were successful, correctly predicting Nadine’s turn toward the southwest ahead of an approaching midlatitude trough, though 10 members forecasted Nadine to be carried eastward by the trough. Ensemble composite and sensitivity analyses reveal the track divergence to be caused by differences in the environmental steering flow that resulted from uncertainties associated with the position and subsequent strength of a midlatitude trough.
Despite the general success of the ensemble track forecasts, the intensity forecasts indicated that Nadine would strengthen, which did not happen. A sensitivity experiment performed with the inclusion of sea surface temperature (SST) updates significantly reduced the intensity errors associated with the simulation. This weakening occurred as a result of cooling of the SST field in the vicinity of Nadine, which led to weaker surface sensible and latent heat fluxes at the air–sea interface. A comparison of environmental variables, including relative humidity, temperature, and shear yielded no obvious differences between the WRF-EnKF simulations and the HS3 observations. However, an initial intensity bias in which the WRF-EnKF vortices are stronger than the observed vortex appears to be the most likely cause of the final intensity errors.
Trusting a Virtual Driver That Looks, Acts, and Thinks Like You
Authors: Verberne Frank M. F. , Ham Jaap , Midden Cees J. H. 
Published: April 2015

Objective: We examined whether participants would trust an agent that was similar to them more than an agent that was dissimilar to them. Background: Trust is an important psychological factor determining the acceptance of smart systems. Because smart systems tend to be treated like humans, and similarity has been shown to increase trust in humans, we expected that similarity would increase trust in a virtual agent. Methods: In a driving simulator experiment, participants ( N = 111) were presented with a virtual agent that was either similar to them or not. This agent functioned as their virtual driver in a driving simulator, and trust in this agent was measured. Furthermore, we measured how trust changed with experience. Results: Prior to experiencing the agent, the similar agent was trusted more than the dissimilar agent. This effect was mediated by perceived similarity. After experiencing the agent, the similar agent was still trusted more than the dissimilar agent. Conclusion: Just as similarity between humans increases trust in another human, similarity also increases trust in a virtual agent. When such an agent is presented as a virtual driver in a self-driving car, it could possibly enhance the trust people have in such a car. Application: Displaying a virtual driver that is similar to the human driver might increase trust in a self-driving car.
rs2043211 polymorphism in CARD8 is not associated with Tourette syndrome in a family-based association study in the Chinese Han population
Authors: Yi Mingji , Shao Xiaohui , Ma Jianhua , Tian Bo , Zhang Ying , Liu Shiguo 
Published: April 2015

Background Previous studies showed that postinfectious autoimmunity and immune deficiency played an important role in the pathogenesis of Tourette syndrome. CARD8 can suppress activity of NF-ΚB activated by inflammatory mediators. Objective To study the association between the rs2043211 polymorphism in CARD8 and susceptibility to Tourette syndrome in Chinese Han population. Methods We recruited 279 patients diagnosed with Tourette syndrome and their parents for the study. Genotyping for CARD8 rs2043211 single-nucleotide polymorphism was performed using predesigned TaqMan single-nucleotide polymorphism genotyping assay. The genetic contribution of this single-nucleotide polymorphism was evaluated using transmission disequilibrium test and haplotype relative risk and the haplotype-based haplotype relative risk. Results The results of the allelic and genotypic distribution of rs2043211 polymorphism in CARD8 showed that both the Tourette syndrome patients group and the parents group are in Hardy–Weinberg equilibrium. No significant differences were observed in the mutant allele transmission (transmission disequilibrium test = 1.107, df = 1, p = 0.322). Results of haplotype relative risk analysis showed that no statistical significant difference was found in the genotypic frequency (AA/AT/TT) of Tourette syndrome patients passed from parents (haplotype relative risk = 1.152, χ2 = 0.494, p = 0.482, 95% CI = 0.777–1.708). Similarly, the analysis of haplotype-based haplotype relative risk was also not to support a statistically significant association in allelic frequency (A/T) of Tourette syndrome patients passed from parents (haplotype-based haplotype relative risk = 1.130, χ2 = 1.037, p = 0.308, 95% CI = 0.893–1.429). Conclusion Our results suggest CARD8 might not play a role in the pathogenesis of Tourette syndrome in Chinese Han population. However, the results still need to be tested in a larger sample and different populations.
A validation study of the Facial-Oral Tract Therapy Swallowing Assessment of Saliva
Authors: Mortensen Jesper , Jensen Ditte , Kjaersgaard Annette 
Published: April 2015

Objective: To investigate the validity and reliability of the Swallowing Assessment of Saliva in detection of aspiration risk. Design: Validation study. Setting: Inpatient neurorehabilitation centre. Subjects: Adult patients with acquired brain injury. A total of 43 patients for concurrent validity and 33 other patients for inter-rater reliability. Interventions: Concurrent validity was established with blinded Swallowing Assessment of Saliva and endoscopic evaluation within a 24-hour time interval. Inter-rater reliability was established with two blinded Swallowing Assessments of Saliva within a one-hour time interval. Main measures: The Swallowing Assessment of Saliva is a seven-item scale with a combination of swallowing and non-swallowing items. It is based on the Facial-Oral Tract Therapy approach. Results: The Swallowing Assessment of Saliva had a sensitivity of 91%, 95% confidence interval (CI) (59; 100), a specificity of 88% %, 95% CI (71; 97) and a kappa coefficient of 0.87 ±0.17 in detection of aspiration risk. Furthermore, analyses showed that experienced and inexperienced occupational therapists performed equally in detection of aspiration risk. Conclusion: The Swallowing Assessment of Saliva is a simple, sensitive and reliable assessment for detecting aspiration risk in patients with acquired brain injury.
Intimate insight: MDMA changes how people talk about significant others
Authors: Baggott Matthew J , Kirkpatrick Matthew G , Bedi Gillinder , de Wit Harriet 
Published: April 2015

Rationale: ±3,4-methylenedioxymethamphetamine (MDMA) is widely believed to increase sociability. The drug alters speech production and fluency, and may influence speech content. Here, we investigated the effect of MDMA on speech content, which may reveal how this drug affects social interactions. Method: Thirty-five healthy volunteers with prior MDMA experience completed this two-session, within-subjects, double-blind study during which they received 1.5 mg/kg oral MDMA and placebo. Participants completed a five-minute standardized talking task during which they discussed a close personal relationship (e.g. a friend or family member) with a research assistant. The conversations were analyzed for selected content categories (e.g. words pertaining to affect, social interaction, and cognition), using both a standard dictionary method (Pennebaker’s Linguistic Inquiry and Word Count: LIWC) and a machine learning method using random forest classifiers. Results: Both analytic methods revealed that MDMA altered speech content relative to placebo. Using LIWC scores, the drug increased use of social and sexual words, consistent with reports that MDMA increases willingness to disclose. Using the machine learning algorithm, we found that MDMA increased use of social words and words relating to both positive and negative emotions. Conclusions: These findings are consistent with reports that MDMA acutely alters speech content, specifically increasing emotional and social content during a brief semistructured dyadic interaction. Studying effects of psychoactive drugs on speech content may offer new insights into drug effects on mental states, and on emotional and psychosocial interaction.
Modafinil in the treatment of crack-cocaine dependence in the Netherlands: Results of an open-label randomised controlled feasibility trial
Authors: Nuijten Mascha , Blanken Peter , van den Brink Wim , Hendriks Vincent 
Published: April 2015

Background Crack-cocaine dependence is a serious disorder with no approved pharmacological treatment. Modafinil is a promising medication with increased cocaine abstinence and reduced craving in some previous studies. In the present study, we examined the acceptance, safety and potential benefits of modafinil as an add-on treatment to cognitive behavioural therapy (CBT) in crack-cocaine dependent patients. Methods Sixty-five crack-cocaine dependent outpatients participated in an open-label, randomised feasibility trial. Patients were randomised to receive either 12-week individual CBT plus 400 mg/day modafinil or 12-week individual CBT only. The primary outcome measure was CBT treatment retention. Secondary outcomes included modafinil adherence, tolerability and safety, use of cocaine and other substances, cocaine craving, health, social functioning and patient satisfaction. Results Modafinil adherence was low, with only 10% treatment completers. Intent-to-treat analyses showed that modafinil did not improve CBT treatment retention or any of the secondary cocaine-related outcomes. Both groups showed similar, large reductions in cocaine use during the study treatment. Post hoc exploratory analyses within the CBT plus modafinil group showed significantly larger baseline to week 12 reductions in cocaine use days in high (⩾ 8 weeks) modafinil adherent patients. Conclusions Acceptance and benefits of modafinil were not demonstrated in the present study. Since reduction in cocaine use was observed in high modafinil adherent patients, further research in the treatment of cocaine dependence, in which modafinil adherence is optimised, is warranted.
Simulated patients in a mental health occupational therapy course: A pilot study
Authors: Haracz Kirsti , Arrighi Gillian , Joyce Brian 
Published: April 2015

Introduction The use of simulated patients is well established in medicine and nursing. There is little research evaluating the use of simulated patients in occupational therapy education and none which focuses on mental health. This study sought to determine the acceptability and effectiveness of using simulated patients in a mental health occupational therapy course. The pilot also sought to address the challenge of providing simulation experience to a large number of students in a cost and time effective manner. Method Occupational therapy students participated in a simulation which involved an initial interview assessment with an actor portraying a person with a mental health diagnosis. The students worked in small groups for the simulation, rotating into the therapist role using a carousel model. Students completed a survey about their experience of the simulation. Results The students rated the simulation experience highly in terms of authenticity and learning outcomes. Qualitative analysis of open-ended responses produced five themes: authentic experience, developing skills, feedback and reflection, we should do more of this, and developing the experience further. Conclusion The pilot was effective in allowing a large number of students to engage directly with the simulated patient without negatively impacting on the experience.
Incidence, Risk Factors, and Prognosis of Intra-Abdominal Hypertension in Critically Ill Children
Authors: Thabet Farah Chedly , Bougmiza Iheb Mohamed , Chehab May Said , Bafaqih Hind Ali , AlMohaimeed Sulaiman Abdulkareem , Malbrain Manu L.N.G. 
Published: April 2015

Purpose: To assess the incidence, risk factors, and outcomes of intra-abdominal hypertension (IAH) in a pediatric intensive care unit (PICU). Methods: Prospective cohort study from January 2011 to January 2013. All children consecutively admitted to the PICU, staying more than 24 hours and requiring bladder catheterization, were included in the study. On admission, demographic data and risk factors for IAH were studied. The intra-abdominal pressure was measured every 6 hours through a bladder catheter until discharge, death, or removal of the catheter. Results: Of the 175 patients, 22 (12.6%) had IAH and 7 (4%) had abdominal compartment syndrome during the intensive care unit (ICU) stay. The independent risk factors associated with IAH were the presence of abdominal distension (odds ratio [OR] 7.1; 95% confidence interval [CI], 2.6-19.9; P < .0001) and a plateau pressure of more than 30 cm H2O (OR 6.42; 95% CI, 2.13-19.36; P = .01). The presence of IAH was associated with higher mortality (40.9% vs 15.6%; P = .01) and prolonged ICU stay (19.5 [3-97] vs 8 [1-104] days, OR 1.02; 95% CI, 1.00-1.04; P = .02). Thirty-three (18.8%) patients died in the ICU, and IAH was an independent risk factor for mortality (OR 6.98; 95% CI, 1.75-27.86; P = .006). Conclusion: Intra-abdominal hypertension does occur in about 13% of the critically ill children, albeit less frequently than adult patients, probably related to a better compliance of the abdominal wall. The presence of abdominal distension and a plateau pressure of more than 30 cm H2O was found to be independent predictors of IAH. Children with IAH had higher mortality rate and more prolonged ICU stay.
Isolated Subtalar Distraction Arthrodesis Using Porous Tantalum
Authors: Papadelis Eustratios A. , Karampinas Panagiotis K. , Kavroudakis Eustratios , Vlamis John , Polizois Vasilios D. , Pneumaticos Spiros G. 
Published: April 2015

Background: During reconstructive procedures of the hindfoot, a structural graft is often needed to fill gaps. To eliminate donor site morbidity and limited availability of autografts, porous tantalum was used. Methods: Eighteen patients who underwent subtalar joint distraction arthrodesis by means of trabecular metal augment were reviewed retrospectively. The results were evaluated clinically, with the American Orthopaedic Foot & Ankle Society (AOFAS) score and the visual analog scale (VAS) for pain, and were assessed radiologically. The mean follow-up period was 18 months. Results: Computed tomography showed sound fusion. There was a marked increase in AOFAS scores and a decrease in VAS scores. Arthrodesis was achieved in all cases with no major postoperative complications. Radiographically, there was a marked increase in all measured parameters (talocalcaneal angle, talocalcaneal height, talar declination angle), and the intraoperatively achieved correction was maintained at the last follow-up visit. Conclusion: Our data suggest that porous tantalum may be used as a structural graft option for subtalar arthrodesis. Level of Evidence: Level IV, retrospective case series.
Evidence for early, non-lesional cerebellar damage in patients with multiple sclerosis: DTI measures correlate with disability, atrophy, and disease duration
Authors: Deppe Michael , Tabelow Karsten , Krämer Julia , Tenberge Jan-Gerd , Schiffler Patrick , Bittner Stefan , Schwindt Wolfram , Zipp Frauke , Wiendl Heinz , Meuth Sven G. 
Published: April 2015

Background: Common symptoms of multiple sclerosis (MS) such as gait ataxia, poor coordination of the hands, and intention tremor are usually the result of dysfunctionality in the cerebellum. Magnetic resonance imaging (MRI) has frequently failed to detect cerebellar damage in the form of inflammatory lesions in patients presenting with symptoms of cerebellar dysfunction. Objective: To detect microstructural cerebellar tissue alterations in early MS patients with a “normal appearing” cerebellum using diffusion tensor imaging (DTI). Methods: A total of 68 patients with relapsing–remitting MS (RRMS) and without cerebellar lesions and 26 age-matched healthy controls were admitted to high-resolution MRI and DTI to assess microstructure and volume of the cerebellar white matter (CBWM). Results: We found cerebellar fractional anisotropy (FA) and CBWM volume reductions in the group of 68 patients. Interestingly, a subgroup of these patients that was derived by including only patients with early and mild MS ( N=23, median age 30 years, median Expanded Disability Status Scale =1.5, median duration 28 months) showed already cerebellar FA but no CBWM volume reductions. FA reductions were correlated with disability, atrophy, and disease duration. Conclusion: “Normal appearing” cerebellar white matter can be damaged in a very early stage of RRMS. DTI seems to be a sensitive tool for detecting this hidden cerebellar damage.