bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences in Health Status and Adverse Outcomes Among Patients With Peripheral Arterial Disease
Authors: Dreyer Rachel P. , van Zitteren Moniek , Beltrame John F. , Fitridge Robert , Denollet Johan , Vriens Patrick W. , Spertus John A. , Smolderen Kim G. 
Published: December 2014

Background

Few studies have examined gender differences in health status and cardiovascular outcomes in patients with peripheral artery disease (
PAD
). This study assessed (1) self‐reported health status at
PAD
diagnosis and 12‐months later, and explored (2) whether outcomes in women with
PAD
differ with regard to long‐term major adverse events.

Methods and Results

A total of 816 patients (285 women) with
PAD
were enrolled from 2 vascular clinics in the Netherlands. Baseline clinical data and subsequent adverse events were recorded and patients completed the Short Form‐12 (
SF
‐12, Physical Component Score [
PCS
] and Mental Component Score [
MCS
]) upon
PAD
diagnosis and 12‐months later. Women had similar ages and clinical characteristics, but poorer socio‐economic status and more depressive symptoms at initial diagnosis, as compared with men. Women also had poorer physical (
PCS
: 37±10 versus 40±10,
P
=0.004) and mental (
MCS
: 47±12 versus 49±11,
P
=0.005) health status at the time of presentation. At 12‐months, women still reported a poorer overall
PCS
score (41±12 versus 46±11,
P
=0.006) and
MCS
score (42±14 versus 49±12,
P
=0.002). Female gender was an independent determinant of a poorer baseline and 12‐month
PCS
and
MCS
scores. However, there were no significant differences by gender on either mortality (unadjusted hazard ratio [
HR
]=0.93, 95%
CI
0.60;1.44,
P
=0.74) or major adverse events (unadjusted
HR
=0.90, 95%
CI
0.63;1.29,
P
=0.57), after a median follow‐up of 3.2 years.

Conclusions

Women's physical and mental health status is compromised both at initial
PAD
diagnosis and at 12‐month follow‐up, despite experiencing a similar magnitude of change in their health scores throughout the first 12‐months after diagnosis.
Alberta Stroke Program Early Computed Tomographic Scoring Performance in a Series of Patients Undergoing Computed Tomography and MRI
Authors: McTaggart Ryan A. , Jovin Tudor G. , Lansberg Maarten G. , Mlynash Michael , Jayaraman Mahesh V. , Choudhri Omar A. , Inoue Manabu , Marks Michael P. , Albers Gregory W. 
Published: December 2014

Background and Purpose—
In this study, we compare the performance of pretreatment Alberta Stroke Program Early Computed Tomographic scoring (ASPECTS) using noncontrast CT (NCCT) and MRI in a large endovascular therapy cohort.

Methods—
Prospectively enrolled patients underwent baseline NCCT and MRI and started endovascular therapy within 12 hours of stroke onset. Inclusion criteria for this analysis were evaluable pretreatment NCCT, diffusion-weighted MRI (DWI), and 90-day modified Rankin Scale scores. Two expert readers graded ischemic change on NCCT and DWI using the ASPECTS. ASPECTS scores were analyzed with the full scale or were trichotomized (0–4 versus 5–7 versus 8–10) or dichotomized (0–7 versus 8–10). Good functional outcome was defined as a 90-day modified Rankin Scale score of 0 to 2.

Results—

Seventy-four patients fulfilled our study criteria. The full-scale inter-rater agreement for CT-ASPECTS and DWI-ASPECTS was 0.579 and 0.867, respectively. DWI-ASPECTS correlated with functional outcome (
P
=0.004), whereas CT-ASPECTS did not (
P
=0.534). Both DWI-ASPECTS and CT-ASPECTS correlated with DWI volume. The receiver operating characteristic analysis revealed that DWI-ASPECTS outperformed both CT-ASPECTS and the time interval between symptom onset and start of the procedure for predicting good functional outcome (modified Rankin Scale score, ≤2) and DWI volume ≥70 mL.

Conclusion—
Inter-rater agreement for DWI-ASPECTS was superior to that for CT-ASPECTS. DWI-ASPECTS outperformed NCCT ASPECTS for predicting functional outcome at 90 days.
Effect of a Broad-Specificity Chemokine-Binding Protein on Brain Leukocyte Infiltration and Infarct Development
Authors: Lee Seyoung , Chu Hannah X. , Kim Hyun Ah , Real Nicola C. , Sharif Saeed , Fleming Stephen B. , Mercer Andrew A. , Wise Lyn M. , Drummond Grant R. , Sobey Christopher G. 
Published: December 2014

Background and Purpose—
Expression of numerous chemokine-related genes is increased in the brain after ischemic stroke. Here, we tested whether post-stroke administration of a chemokine-binding protein (CBP), derived from the parapoxvirus bovine papular stomatitis virus, might reduce infiltration of leukocytes into the brain and consequently limit infarct development.

Methods—
The binding spectrum of the CBP was evaluated in chemokine ELISAs, and binding affinity was determined using surface plasmon resonance. Focal stroke was induced in C57Bl/6 mice by middle cerebral artery occlusion for 1 hour followed by reperfusion for 23 or 47 hours. Mice were treated intravenously with either bovine serum albumin (10 μg) or CBP (10 μg) at the commencement of reperfusion. At 24 or 48 hours, we assessed plasma levels of the chemokines CCL2/MCP-1 and CXCL2/MIP-2, as well as neurological deficit, brain leukocyte infiltration, and infarct volume.

Results—
The CBP interacted with a broad spectrum of CC, CXC, and XC chemokines and bound CCL2/MCP-1 and CXCL2/MIP-2 with high affinity (pM range). Stroke markedly increased plasma levels of CCL2/MCP-1 and CXCL2/MIP-2, as well as numbers of microglia and infiltrating leukocytes in the brain. Increases in plasma chemokines were blocked in mice treated with CBP, in which there was reduced neurological deficit, fewer brain-infiltrating leukocytes, and ≈50% smaller infarcts at 24 hours compared with bovine serum albumin–treated mice. However, CBP treatment was no longer protective at 48 hours.

Conclusions—
Post-stroke administration of CBP can reduce plasma chemokine levels in association with temporary atten uation of brain inflammation and infarct volume development.
Chronic Ischemia Alters Brain Microstructural Integrity and Cognitive Performance in Adult Moyamoya Disease
Authors: Kazumata Ken , Tha Khin Khin , Narita Hisashi , Kusumi Ichiro , Shichinohe Hideo , Ito Masaki , Nakayama Naoki , Houkin Kiyohiro 
Published: December 2014

Background and Purpose—
The mechanisms underlying frontal lobe dysfunction in moyamoya disease (MMD) are unknown. We aimed to determine whether chronic ischemia induces subtle microstructural brain changes in adult MMD and evaluated the association of changes with neuropsychological performance.

Methods—
MRI, including 3-dimensional T1-weighted imaging and diffusion tensor imaging, was performed in 23 adult patients with MMD and 23 age-matched controls and gray matter density and major diffusion tensor imaging indices were compared between them; any alterations in the patients were tested for associations with age, ischemic symptoms, hemodynamic compromise, and neuropsychological performance.

Results—

Decrease in gray matter density, associated with hemodynamic compromise (
P
<0.05), was observed in the posterior cingulate cortex of patients with MMD. Widespread reduction in fractional anisotropy and increases in radial diffusivity and mean diffusivity in some areas were also observed in bilateral cerebral white matter. The fractional anisotropy (
r
=0.54;
P
<0.0001) and radial diffusivity (
r
=−0.41;
P
<0.01) of white matter significantly associated with gray matter density of the cingulate cortex. The mean fractional anisotropy of the white matter tracts of the lateral prefrontal, cingulate, and inferior parietal regions were significantly associated with processing speed, executive function/attention, and working memory.

Conclusions—
In adult MMD, there were more white matter abnormalities than gray matter changes. Disruption of white matter may play a pivotal role in the development of cognitive dysfunction.
Reliability and Limitations of Automated Arrhythmia Detection in Telemetric Monitoring After Stroke
Authors: Kurka Natalia , Bobinger Tobias , Kallmünzer Bernd , Koehn Julia , Schellinger Peter D. , Schwab Stefan , Köhrmann Martin 
Published: December 2014

Background and Purpose—
Guidelines recommend continuous ECG monitoring in patients with cerebrovascular events. Studies on intensive care units (ICU) demonstrated high sensitivity but high rates of false alarms of monitoring systems resulting in desensitization of medical personnel potentially endangering patient safety. Data on patients with acute stroke are lacking.

Methods—
One-hundred fifty-one consecutive patients with acute cerebrovascular events were prospectively included. Automatically identified arrhythmia events were analyzed by manual ECG analysis. Muting of alarms was registered. Sensitivity was evaluated by beat-to-beat analysis of the entire recorded ECG data in a subset of patients. Ethics approval was obtained by University of Erlangen-Nuremberg.

Results—
A total of 4809.5 hours of ECG registration and 22 509 alarms were analyzed. The automated detection algorithm missed no events but the overall rate of false alarms was 27.4%. Only 0.6% of all alarms indicated acute life-threatening events and 91.4% of these alarms were incorrect. Transient muting of acoustic alarms was observed in 20.5% patients.

Conclusions—
Continuous ECG monitoring using automated arrhythmia detection is highly sensitive in acute stroke. However, high rates of false alarms and alarms without direct therapeutic consequence cause desensitization of personnel. Therefore, acoustic alarms may be limited to life-threatening events but standardized manual evaluation of all alarms should complement automated systems to identify clinically relevant arrhythmias.
Common and Unique Representations in pFC for Face and Place Attractiveness
Authors: Pegors Teresa K. , Kable Joseph W. , Chatterjee Anjan , Epstein Russell A. 
Published: December 2014

AbstractAlthough previous neuroimaging research has identified overlapping correlates of subjective value across different reward types in the ventromedial pFC (vmPFC), it is not clear whether this “common currency” evaluative signal extends to the aesthetic domain. To examine this issue, we scanned human participants with fMRI while they made attractiveness judgments of faces and places—two stimulus categories that are associated with different underlying rewards, have very different visual properties, and are rarely compared with each other. We found overlapping signals for face and place attractiveness in the vmPFC, consistent with the idea that this region codes a signal for value that applies across disparate reward types and across both economic and aesthetic judgments. However, we also identified a subregion of vmPFC within which activity patterns for face and place attractiveness were distinguishable, suggesting that some category-specific attractiveness information is retained in this region. Finally, we observed two separate functional regions in lateral OFC: one region that exhibited a category-unique response to face attractiveness and another region that responded strongly to faces but was insensitive to their value. Our results suggest that vmPFC supports a common mechanism for reward evaluation while also retaining a degree of category-specific information, whereas lateral OFC may be involved in basic reward processing that is specific to only some stimulus categories.
Diurnally Modulated Cumulus Moistening in the Preonset Stage of the Madden–Julian Oscillation during DYNAMO*
Authors: Ruppert James H. , Johnson Richard H. 
Published: December 2014

Abstract
Atmospheric soundings, radar, and air–sea flux measurements collected during Dynamics of the Madden–Julian Oscillation (DYNAMO) are employed to study MJO convective onset (i.e., the transition from shallow to deep convection) in the tropical Indian Ocean. The findings indicate that moistening of the low–midtroposphere during the preonset stage of the MJO is achieved by simultaneous changes in the convective cloud population and large-scale circulation. Namely, cumuliform clouds deepen and grow in areal coverage as the drying by large-scale subsidence and horizontal (westerly) advection wane. The reduction of large-scale subsidence is tied to the reduction of column radiative cooling during the preonset stage, which ultimately links back to the evolving cloud population. While net column moistening in the preonset stage is tied to large-scale circulation changes, a new finding of this study is the high degree to which the locally driven diurnal cycle invigorates convective clouds and cumulus moistening each day. This diurnal cycle is manifest in a daytime growth of cumulus clouds (in both depth and areal coverage) in response to oceanic diurnal warm layers, which drive a daytime increase of the air–sea fluxes of heat and moisture. This diurnally modulated convective cloud field exhibits prominent mesoscale organization in the form of open cells and horizontal convective rolls. It is hypothesized that the diurnal cycle and mesoscale cloud organization characteristic of the preonset stage of the MJO represent two manners in which local processes promote more vigorous daily-mean column moistening than would otherwise occur.
Precipitable Water from GPS over the Continental United States: Diurnal Cycle, Intercomparisons with NARR, and Link with Convective Initiation
Authors: Radhakrishna Basivi , Fabry Frédéric , Braun John J. , Van Hove Teresa 
Published: December 2014

Abstract
The variation of precipitable water vapor (PW) over the continental United States is examined at various time scales using spatial maps of a column-averaged mixing ratio (CAMR) that is derived from integrated column PW from both observations and reanalysis data. CAMR spatial maps are generated utilizing PW measurements obtained from a network of ground-based global positioning system (GPS) receivers and the North American Regional Reanalysis (NARR) over a time span of 4 yr (February 2009–January 2013). The effect of topography on PW is mitigated by vertically averaging the mixing ratio instead of integrating the absolute humidity. An ordinary kriging interpolation technique is used to generate spatial maps of CAMR. The observed and predicted PW derived by GPS and NARR correlate well with each other at annual and monthly scales. When focusing on its diurnal cycle, moisture peaks in the late afternoon over the Great Plains and late night over the Rockies. It is also found that atmospheric moisture within NARR generally increases in the second half of the UTC day and is adjusted significantly lower when external observations, such as radiosondes, are assimilated into the analysis system. These adjustments in the analysis introduce nonphysical offsets that are not present within the GPS-derived moisture fields. At meso-β and meso-α scales, GPS PW fields can be used as a precursor to forecast convection up to 3 h prior to initiation. As stated previously, the correlation between GPS and NARR is high (&gt;0.98) at monthly and seasonal time scales, but there is poor correlation at time scales less than a day. This indicates that the water budget within NARR is not in proper balance over these short-term time scales. Over the continental United States, daily cycles of PW and precipitation are coupled differently in different areas.
Knowledge about prevention and management of acute diarrhoea among caregivers of children aged under 5 years treated at an emergency department in Pernambuco, Brazil
Authors: dos Santos Yuri FC , de B Correia Jailson , Falbo Ana R 
Published: December 2014

Background The World Health Organization stresses the need for training families in the adequate management of acute diarrhoea to reduce child mortality and morbidity. This study analysed caregiver knowledge about diarrhoea prevention and management in north-east Brazil. Methods Cross-sectional study of 213 children aged under 5 years treated at a public emergency department in Pernambuco, Brazil. Caregiver knowledge was assessed with a questionnaire. Results Caregivers believed that breastfeeding until age 6 months, not using tap water for food preparation, vaccination against rotavirus and other diseases help prevent diarrhoea. Regarding treatment, caregivers reported taking children to the hospital at the first sign of diarrhoea (57.3%), administering medication (68.1%) and withholding solids (63.7%). Only 40.8% knew how to prepare oral rehydration solution; 78.4% believed it could cure diarrhoea. Only 43.9% of caregivers mentioned one or more signs of dehydration. Conclusions Caregivers in this region had limited knowledge of appropriate diarrhoea management.
Transport of sick neonates to a tertiary care hospital, south India: condition at arrival and outcome
Authors: Rathod Deepak , Adhisivam B , Bhat B Vishnu 
Published: December 2014

Objective To describe the transport of sick neonates to a tertiary care hospital and evaluate their condition at arrival and outcome. Methods This descriptive study included 303 extramural neonates who were transported to a tertiary care hospital in south India. Demographic parameters, transport details and clinical features at arrival were recorded. All neonates were followed up till discharge or death. Transport and clinical variables were correlated with outcome. Results Sepsis and birth asphyxia were the major indications for transport. Only 11% were transported by 108 ambulances (free government service). One-fifth of all neonates died and among them 76% were hypothermic and 10% hypoglycemic on admission. Prematurity, pregnancy induced hypertension (PIH), prolonged rupture of membranes (PROM), respiratory distress, grunting, bleeding, abdominal distension and a positive blood culture correlated with a poor outcome. Conclusion Stabilisation prior to transport is essential and the principles of neonatal transportation are independent of distance. Hypothermia and hypoglycaemia should be prevented in neonates during transport as they adversely affect the outcome.
Alteration patterns of brain glucose metabolism: comparisons of healthy controls, subjective memory impairment and mild cognitive impairment
Authors: Song In-Uk , Choi Eun Kyoung , Oh Jin Kyoung , Chung Yong-An , Chung Sung-Woo 
Published: December 2014

Background Some groups have focused on the detection and management of subjective memory impairment (SMI) as the stage that precedes mild cognitive impairment (MCI). However, there have been few clinical studies that have examined biomarkers of SMI to date. Purpose To investigate the differences in glucose metabolism as a prodromal marker of dementia in patients with SMI, MCI, and healthy controls using brain F-18 fluoro-2-deoxyglucose positron emission tomography (FDG-PET). Material and Methods Sixty-eight consecutive patients with SMI, 47 patients with MCI, and 42 age-matched healthy subjects were recruited. All subjects underwent FDG-PET and detailed neuropsychological testing. FDG-PET images were analyzed using the statistical parametric mapping (SPM) program. Results FDG-PET analysis showed glucose hypometabolism in the periventricular regions of patients with SMI and in the parietal, precentral frontal, and periventricular regions of patients with MCI compared with healthy controls. Interestingly, hypometabolism on FDG-PET was noted in the parietal and precentral frontal regions in MCI patients compared to SMI patients. Conclusion The results suggest that hypometabolism in the periventricular regions as seen on FDG-PET may play a role as a predictive biomarker of pre-dementia, and the extension of reduced glucose metabolism into parietal regions likely reflects progression of cognitive deterioration.
Factors Predictive of Concomitant Injuries Among Children and Adolescents Undergoing Anterior Cruciate Ligament Surgery
Authors: Newman Justin T. , Carry Patrick M. , Terhune E. Bailey , Spruiell Murray D. , Heare Austin , Mayo Meredith , Vidal Armando F. 
Published: December 2014

Background: The timing of treatment for pediatric anterior cruciate ligament (ACL) injuries remains controversial. The risks of delaying reconstruction and the differences between age groups are poorly defined. Purpose: To investigate factors that contribute to the prevalence and severity of concomitant chondral and meniscal injuries among patients aged 14 to 19 years versus those aged ≤14 years at the time of ACL reconstruction. The hypothesis was that concomitant injuries would be more prevalent in older versus younger subjects. Also, a delay in surgery would be predictive of the presence and severity of concomitant knee injuries requiring additional operative procedures. Study Methods: Cohort study; Level of evidence, 3. Methods: All subjects who underwent primary ACL reconstruction at a single tertiary pediatric hospital between 2005 and 2012 were retrospectively reviewed. The location, severity, and treatment of all concomitant knee injuries were recorded. Chi-square tests were used to compare the prevalence of chondral and meniscal injuries in the older (age, 14-19 years; n = 165) versus younger (age, ≤14 years; n = 66) cohorts. A multivariable logistic regression analysis was used to identify factors related to the presence of a concomitant injury that required additional treatment. Kaplan-Meier analyses were used to explore the relation between time to surgery and meniscal injury severity. Results: There was a significant relationship between time to surgery and the development of an irreparable meniscal injury ( P < .05 for all) in both the younger and older groups. Time to surgery correlated with severity of chondral injury in the younger cohort ( P = .0343) but not in the older cohort ( P = .8877). In the younger cohort, only a delay in surgery >3 months (odds ratio [OR] = 4.8; 95% CI, 1.7-14.4; P = .0027) was significantly predictive of the presence of an injury that required additional operative procedures. In the older patients, a return to activity before surgery (OR = 3.8; 95% CI, 1.52-11.9; P = .0034) and obesity (OR = 2.5; 95% CI, 1.1-7.4; P = .0381) were significantly predictive of an injury that required additional operative procedures. Conclusion: Compared with younger subjects, the prevalence of concomitant knee injuries as well as the need for additional operative procedures was greater among older subjects. A delay to surgery correlated with increased severity of injury among both older and younger populations. A delay in surgery >3 months was the strongest predictor of the development of a concomitant injury in the younger cohort. A return to activity and obesity were significantly related to the presence of a concomitant knee injury in the older cohort.
To create a cleanroom controlled environment using a mobile air decontamination unit for the preparation of antineoplastic drugs
Authors: Lecordier Julien , Plivard Claire , Gardeux Michel , Daouadi Karim , Lahet Jean-Jacques 
Published: December 2014

Objectives To use a mobile air decontamination unit (MADU) for a microbial destruction and decreased particle burden making a cleanroom controlled environment in a Centralized Chemotherapy Preparation Unit (CCPU). Good manufacturing practices (GMP) in France specify that the ambient air in the vicinity of a class III biosafety cabinet (isolator) complies with air cleanliness ISO 8 level in CCPU. This guideline has a significant impact because implementing a dedicated air handling unit (AHU) brings some engineering constraints and generates substantial additional costs. Methods Authors have previously studied some technical and economical aspects to evaluate the feasibility of the MADU option. Results Using a MADU was the chosen option. Qualification of the CCPU showed that results were in compliance with the French GMP. After one year of use, the efficiency of the MADU was confirmed. According to these results, using a MADU constitutes a beneficial option for CCPU previously equipped with an isolator when compared to renovation work involving a standard built-in AHU.