bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antithrombotic Treatment Following Intracerebral Hemorrhage in Patients With and Without Atrial Fibrillation
Authors: Pennlert Johanna , Asplund Kjell , Carlberg Bo , Wiklund Per-Gunnar , Wisten Aase , Åsberg Signild , Eriksson Marie 
Published: July 2015

Background and Purpose—
Patients who survive intracerebral hemorrhage (ICH) often have compelling indications for anticoagulant and antiplatelet medication. This nationwide observational study aimed to determine the extent and predictors of antithrombotic treatment after ICH in Sweden.

Methods—
Patients with a first-ever ICH in the Swedish Stroke Register (Riksstroke) 2005 to 2012 who survived hospital discharge were included. Riksstroke data were individually linked with other national registers to determine comorbid conditions and dispensed prescriptions of antithrombotic agents.

Results—

Among the 2777 patients with atrial fibrillation (AF), the proportion with a dispensed prescription of antithrombotic agents was 8.5% (anticoagulants) and 36.6% (antiplatelet agents) within 6 months and 11.1% (anticoagulants) and 43.6% (antiplatelet agents) within 1 year. Among the 11 268 patients without AF, the corresponding figures were 1.6% (anticoagulants) and 13.8% (antiplatelet agents) within 6 months and 2.0% (anticoagulants) and 17.5% (antiplatelet agents) within 1 year. In patients with AF, predictors of anticoagulant treatment were less severe ICH, younger age, previous anticoagulation, valvular disease, and previous ischemic stroke. High CHA
2
DS
2
-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke [doubled], vascular disease, age, and sex category [female]) scores did not correlate with anticoagulant treatment. There was a positive correlation between high CHA
2
DS
2
-VASc and HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol) scores (
r
s
=0.590,
P
<0.001).

Conclusions—

In majority of patients who receive antithrombotic agents, treatment is initiated within 6 months of ICH. Still, many patients with compelling indications for antithrombotic treatment are not prescribed antithrombotic agents. Factors other than high risk of embolic stroke by CHA
2
DS
2
-VASc in ICH survivors with concurrent AF are used to guide the anticoagulant treatment decision in Swedish clinical practice.
Predictors of Mortality in Acute Ischemic Stroke Intervention
Authors: Linfante Italo , Walker Gail R. , Castonguay Alicia C. , Dabus Guilherme , Starosciak Amy K. , Yoo Albert J. , Abou-Chebl Alex , Britz Gavin W. , Marden Franklin A. , Alvarez Alexandria , Gupta Rishi , Sun Chun-Huan J. , Martin Coleman , Holloway William E. , Mueller-Kronast Nils , English Joey D. , Malisch Tim W. , Bozorgchami Hormozd , Xavier Andrew , Rai Ansaar T. , Froehler Michael T. , Badruddin Aamir , Nguyen Thanh N. , Taqi M. Asif , Abraham Michael G. , Janardhan Vallabh , Shaltoni Hashem , Novakovic Roberta , Chen Peng R. , Kaushal Ritesh , Nanda Ashish , Issa Mohammad A. , Nogueira Raul G. , Zaidat Osama O. 
Published: July 2015

Background and Purpose—
Failure to recanalize predicts mortality in acute ischemic stroke. In the North American Solitaire Acute Stroke registry, we investigated parameters associated with mortality in successfully recanalized patients.

Methods—

Logistic regression was used to evaluate baseline characteristics and recanalization parameters for association with 90-day mortality. A multivariable model was developed based on backward selection with retention criteria of
P
<0.05 from factors with at least marginal significance (
P
≤0.10), then refit to minimize the number of excluded cases (missing data).

Results—

Successfully recanalized patients had lower mortality (25.2% [59/234] versus 46.9% [38/81]
P
<0.001). There was no difference in symptomatic intracranial hemorrhage between patients with successful versus failed recanalization (9% [21/234] versus 14% [11/79];
P
=0.205). However, mortality was significantly higher in patients with symptomatic intracranial hemorrhage (72% [23/32] versus 26% [73/281];
P
<0.001). Proximal occlusion (internal carotid artery or vertebrobasilar), initial National Institutes of Health Stroke Scale≥18, use of rescue therapy (
P
<0.05), and 3+ passes (
P
<0.10) were associated with mortality in recanalized patients. In the multivariate model with good predictive power (
c
index=0.72), proximal occlusion, initial National Institutes of Health Stroke Scale≥18, and use of rescue therapy remained significant independent predictors of 90-day mortality.

Conclusions—
Failure to recanalize and presence of symptomatic intracranial hemorrhage resulted in increased mortality. Despite successful recanalization, proximal occlusion, high National Institutes of Health Stroke Scale, and need for rescue therapy were predictors of mortality.
Uric Acid Therapy Improves Clinical Outcome in Women With Acute Ischemic Stroke
Authors: Llull Laura , Laredo Carlos , Renú Arturo , Pérez Belén , Vila Elisabet , Obach Víctor , Urra Xabier , Planas Anna , Amaro Sergio , Chamorro Ángel 
Published: July 2015

Background and Purpose—
It is unknown whether women and men with acute ischemic stroke respond similar to an antioxidant regimen administered in combination with thrombolysis. Here, we investigated the independent effect of sex on the response to uric acid (UA) therapy in patients with acute stroke treated with alteplase.

Methods—
In the Efficacy Study of Combined Treatment With Uric Acid and rtPA in Acute Ischemic Stroke (URICO-ICTUS) trial, 206 women and 205 men were randomized to UA 1000 mg or placebo. In this reanalysis of the trial, the primary outcome was the rate of excellent outcome at 90 days (modified Rankin Scale, 0–1, or 2, if premorbid score of 2) in women and men using regression models adjusted for confounders associated with sex. The interaction of UA levels by treatment on infarct growth was assessed in selected patients.

Results—

Excellent outcome occurred in 47 of 111 (42%) women treated with UA, and 28 of 95 (29%) treated with placebo, and in 36 of 100 (36%) men treated with UA and 38 of 105 (34%) treated with placebo. Treatment and sex interacted significantly with excellent outcome (
P
=0.045). Thus, UA therapy doubled the effect of placebo to attain an excellent outcome in women (odd ratio [95% confidence interval], 2.088 [1.050–4.150];
P
=0.036), but not in men (odd ratio [95% confidence interval], 0.999 [0.516–1.934];
P
=0.997). The interactions between treatment and serum UA levels (
P
<0.001) or allantoin/UA ratio (
P
<0.001) on infarct growth were significant only in women.

Conclusions—
In women with acute ischemic stroke treated with alteplase, the administration of UA reduced infarct growth in selected patients and was better than placebo to reach excellent outcome.

Clinical Trial Registration—

URL:
https://clinicaltrials.gov
. Unique identifier: NCT00860366.
Contributions of Surface Sensible Heat Fluxes to Tropical Cyclone. Part II: The Sea Spray Processes
Authors: Ma Zhanhong , Fei Jianfang , Cheng Xiaoping , Wang Yuqing , Huang Xiaogang 
Published: July 2015

Abstract
In Part II of this study, the roles of surface sensible heat fluxes (SHX) in tropical cyclones (TCs) are further investigated in the context of sea spray processes. Results show that the sea spray evaporation is favorable for the TC intensification through enhancing the surface latent heat fluxes (LHX).
Unlike the results in Part I, the removal of SHX has led to a somewhat weaker TC by inclusion of sea spray. This is because the spray-mediated latent heat fluxes are simultaneously diminished after cutting down the SHX. Without the warming of SHX from the ocean, the surface air becomes cooler and thereby closer to saturation, which substantially hinders the evaporation of sea spray droplets. Therefore, the SHX are instrumental for sustaining the release of latent heat fluxes by sea spray evaporation. In the experiments of Part I and this study, the reduced total surface enthalpy fluxes as a result of the removal of SHX do not necessarily result in weakened TCs, while the larger LHX basically correspond to stronger TCs. This suggests that the TC intensity is largely dependent on the LHX rather than the total surface enthalpy fluxes, although the latter is generally dominated by the former. Relative roles of thermal and moisture effects in radially elevating the surface equivalent potential temperature θe are also compared. The contributions of thermal effects account for 30%–35% of the total changes in θe for mature TCs, no matter whether SHX from the ocean are included. This further implies that the SHX contribute insignificantly to the spinup of a TC.
The Seasonal Nature of Extreme Hydrological Events in the Northeastern United States
Authors: Frei Allan , Kunkel Kenneth E. , Matonse Adao 
Published: July 2015

Abstract
Recent analyses of extreme hydrological events across the United States, including those summarized in the recent U.S. Third National Climate Assessment (May 2014), show that extremely large (extreme) precipitation and streamflow events are increasing over much of the country, with particularly steep trends over the northeastern United States. The authors demonstrate that the increase in extreme hydrological events over the northeastern United States is primarily a warm season phenomenon and is caused more by an increase in frequency than magnitude. The frequency of extreme warm season events peaked during the 2000s; a secondary peak occurred during the 1970s; and the calmest decade was the 1960s. Cold season trends during the last 30–50 yr are weaker. Since extreme precipitation events in this region tend to be larger during the warm season than during the cold season, trend analyses based on annual precipitation values are influenced more by warm season than by cold season trends. In contrast, the magnitude of extreme streamflow events at stations used for climatological analyses tends to be larger during the cold season: therefore, extreme event analyses based on annual streamflow values are overwhelmingly influenced by cold season, and therefore weaker, trends. These results help to explain an apparent discrepancy in the literature, whereby increasing trends in extreme precipitation events appear to be significant and ubiquitous across the region, while trends in streamflow appear less dramatic and less spatially coherent.
A self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy: a randomised controlled trial (the SELF study)
Authors: Littlewood Chris , Bateman Marcus , Brown Kim , Bury Julie , Mawson Sue , May Stephen , Walters Stephen J 
Published: July 2015

Objectives: To evaluate the clinical effectiveness of a self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy. Design: Multi-centre pragmatic unblinded parallel group randomised controlled trial. Setting: UK National Health Service. Participants: Patients with a clinical diagnosis of rotator cuff tendinopathy. Interventions: The intervention was a programme of self-managed exercise prescribed by a physiotherapist in relation to the most symptomatic shoulder movement. The control group received usual physiotherapy treatment. Main outcome measures: The primary outcome measure was the Shoulder Pain & Disability Index (SPADI) at three months. Secondary outcomes included the SPADI at six and twelve months. Results: A total of 86 patients (self-managed loaded exercise n=42; usual physiotherapy n=44) were randomised. Twenty-six patients were excluded from the analysis because of lack of primary outcome data at the 3 months follow-up, leaving 60 ( n=27; n=33) patients for intention to treat analysis. For the primary outcome, the mean SPADI score at three months was 32.4 (SD 20.2) for the self-managed group, and 30.7 (SD 19.7) for the usual physiotherapy treatment group; mean difference adjusted for baseline score: 3.2 (95% Confidence interval -6.0 to +12.4 P = 0.49). By six and twelve months there remained no significant difference between the groups. Conclusions: This study does not provide sufficient evidence of superiority of one intervention over the other in the short-, mid- or long-term and hence a self-management programme based around a single exercise appears comparable to usual physiotherapy treatment.
Difficult healthcare transitions
Authors: Abdool Rosalind , Szego Michael , Buchman Daniel , Justason Leah , Bean Sally , Heesters Ann , Kaufman Hannah , Parke Bob , Wagner Frank , Gibson Jennifer 
Published: July 2015

Background: In Ontario, Canada, patients who lack decision-making capacity and have no family or friends to act as substitute decision-makers currently rely on the Office of the Public Guardian and Trustee to consent to long-term care (nursing home) placement, but they have no legal representative for other placement decisions. Objectives: We highlight the current gap in legislation for difficult transition cases involving unrepresented patients and provide a novel framework for who ought to assist with making these decisions and how these decisions ought to be made. Research design: This paper considers models advanced by Volpe and Steinman with regard to who ought to make placement decisions for unrepresented patients, as well as current ethical models for analyzing how these decisions should be made. Participants and research context: We describe an anonymized healthcare transition case to illustrate the fact that there is no legally recognized decision-maker for placement destinations other than long-term care facilities and to show how this impacts all stakeholders. Ethical considerations: The case provided is an anonymized vignette representing a typical transition case involving an unrepresented patient. Findings: As a result of a gap in provincial legislation, healthcare providers usually determine the appropriate placement destination without a clear framework to guide the process and this can cause significant moral distress. Discussion: We argue for a team decision-making approach in the short term, and a legislative change in the long-term, to respect the patient voice, evaluate benefit and risk, enhance collaboration between healthcare providers and patients, and promote social justice. We believe that our approach, which draws upon the strengths of interprofessional teams, will be of interest to all who are concerned with the welfare and ethical treatment of the patients for whom they care. Conclusions: One of the main strengths of our recommendation is that it provides all members of the healthcare team (including nurses, social workers, therapists, and others) an increased opportunity to advocate on behalf of unrepresented patients.
Algorithm for Severe Hallux Valgus Associated With Metatarsus Adductus
Authors: Sharma Jyoti , Aydogan Umur 
Published: July 2015

Background: Radiographic angles, such as the intermetatarsal angle, hallux valgus angle, and distal metatarsal articular angle, are commonly used to help guide operative planning for soft tissue and osseous treatment options for hallux valgus. Hallux valgus treatment in the setting of associated metatarsus adductus is less common and not well described. The presence of metatarsus adductus reduces the gap between the first and second metatarsals. Consequently, it complicates the measurement of the first-second intermetatarsal angle and can limit the area available for transposition of the first metatarsal head. A compensatory pronation is also created, which must be compensated for. We present 4 cases of patients that had hallux valgus with severe metatarsus adductus treated operatively, as well as a treatment algorithm. Methods: For concomitant correction of both the metatarsus adductus and the hallux valgus, a thorough surgical treatment algorithm was implemented to address the hallux, lesser toe deformities, and pes planus deformity. Postoperatively, the patients were kept non–weight bearing for 6 weeks, followed by gradual weight bearing in a protective boot. Physical therapy was instituted at the start of weight bearing to encourage a return to activities of daily living. Results: At follow-up, patients reported significant relief of their pain symptoms with a narrower and improved appearance of the foot. No recurrence was noted. One patient used a medial arch support but was otherwise symptom free. Radiographic measurements improved on postoperative radiographs. Conclusions: For the treatment of hallux valgus with metatarsus adductus, the second and third metatarsals may need to be addressed for the first metatarsal to be laterally transposed adequately. Overall, this comprehensive approach addresses the hindfoot, midfoot, and forefoot for patients with hallux valgus associated with metatarsus adductus, with successful results. Level of Evidence: Level V, case series.
A fiscal job? An analysis of fiscal policy and the labor market
Authors: Bova Elva , Kolerus Christina , Tapsoba Sampawende J.A. 
Published: July 2015

Abstract
This paper examines the role of fiscal policies in the dynamics of the labor market. Through the lenses of Okun’s Law, we assess how fiscal policy instruments as well as fiscal consolidation and expansion episodes affect labor market outcomes. Using a panel of 34 OECD countries over the period 1985-2013, we find that fiscal consolidation has a sizeable, positive and robust impact on the Okun’s coefficient. This effect is particularly strong for expenditure based consolidations, suggesting that a reduction in the size of the government increases the responsiveness of employment to output and is not altered by an expansionary or recessionary position in the business cycle. Interestingly, we find no impact of fiscal expansion on the Okun’s coefficient nor for specific fiscal instruments.
TNF Receptors Predict Hip Fracture Risk in the WHI Study and Fatty Acid Intake Does Not Modify This Association
Authors: Ing Steven W. , Orchard Tonya S. , Lu Bo , LaMonte Michael J. , Barbour Kamil E. , Cauley Jane A. , Jackson Rebecca D. 
Published: July 2015

Context:Chronic inflammation may increase the risk of fracture, and omega-3 polyunsaturated fatty acids (PUFAs) may reduce fracture risk via down-regulation of inflammatory cytokine gene expression and other mechanisms.Objective:We investigated associations between baseline samples of inflammatory markers, TNFα soluble receptors 1 and 2 (TNFα-sR1 and -sR2), and incident hip fracture. These associations were then tested for effect modification by dietary PUFA intake estimated by a baseline food frequency questionnaire.Design and Setting:A nested case-control study was conducted among participants of the Women's Health Initiative Observational Study (ages, 50–79 y). Multivariable conditional logistic regression models were constructed to account for the paired design.Participants:This study sampled 400 pairs of hip fracture cases and controls without incident hip fracture, matched on age, year of enrollment, and menopausal hormone use.Main Outcome Measures:Odds ratio of hip fracture by quartile of TNF soluble receptors.Results:The odds ratio of hip fracture comparing the highest to lowest quartiles was 2.24 (95% confidence interval, 1.05–4.79; P for linear trend, .048) for TNFα-sR1 and 2.83 (95% confidence interval, 1.34–5.99; P for linear trend, .011) for TNFα-sR2, adjusted for FRAX hip fracture score, nutritional variables, and selected factors impacting inflammation; there was a gradient of risk by increasing quartile in TNFα-sR1. PUFA intake did not modify these associations.Conclusions:Women with the highest levels of TNFα-sR1 and TNFα-sR2 had a greater than 2-fold increased hip fracture risk, independent of other fracture risk factors. These associations did not differ by high vs low PUFA intake.
Temporal order of RNase IIIb and loss-of-function mutations during development determines phenotype in DICER1 syndrome: a unique variant of the two-hit tumor suppression model
Authors: Brenneman Mark , Field Amanda , Yang Jiandong , Williams Gretchen , Doros Leslie , Rossi Christopher , Schultz Kris Ann , Rosenberg Avi , Ivanovich Jennifer , Turner Joyce , Gordish-Dressman Heather , Stewart Douglas , Yu Weiying , Harris Anne , Schoettler Peter , Goodfellow Paul , Dehner Louis , Messinger Yoav , Hill D. Ashley 
Published: July 2015

Pleuropulmonary blastoma (PPB) is the most frequent pediatric lung tumor and often the first indication of a pleiotropic cancer predisposition, DICER1 syndrome, comprising a range of other individually rare, benign and malignant tumors of childhood and early adulthood. The genetics of DICER1-associated tumorigenesis are unusual in that tumors typically bear neomorphic missense mutations at one of five specific “hotspot” codons within the RNase IIIb domain of DICER 1, combined with complete loss of function (LOF) in the other allele. We analyzed a cohort of 124 PPB children for predisposing DICER1 mutations and sought correlations with clinical phenotypes. Over 70% have inherited or de novo germline LOF mutations, most of which truncate the DICER1 open reading frame. We identified a minority of patients who have no germline mutation, but are instead mosaic for predisposing DICER1 mutations. Mosaicism for RNase IIIb domain hotspot mutations defines a special category of DICER1 syndrome patients, clinically distinguished from those with germline or mosaic LOF mutations by earlier onsets and numerous discrete foci of neoplastic disease involving multiple syndromic organ sites. A final category of patients lack predisposing germline or mosaic mutations and have disease limited to a single PPB tumor bearing tumor-specific RNase IIIb and LOF mutations. We propose that acquisition of a neomorphic RNase IIIb domain mutation is the rate limiting event in DICER1-associated tumorigenesis, and that distinct clinical phenotypes associated with mutational categories reflect the temporal order in which LOF and RNase IIIb domain mutations are acquired during development.
Analysis of the Emergencies in Russia, 2000–2014
Authors: Евдокимов  , Evdokimov V. , Кислова  , Kislova G. 
Published: July 2015

Statistical data for 15 years on emergency situations (ES), fires and accidents on water is provided, and normalized indicators
are calculated. During 2000–2014, 8588 disasters were registered in Russia, which killed 14,826 and injured 5 million 841
thousand people. There were 5097 (59,4%) man-made disasters, 2786 (32,4%) natural ESs, 587 (6,8%) biological and social
ESs, and 118 (1,4%) major terrorist attacks. Local ESs count up to 4313 (50,2%), municipal — 2977 (34,7%), intermunicipal –
1069 (12,5%), regional — 191 (2,2%), inter-regional — 23 (0,3%), Federal — 12 (0,1%). Every day (1,58 ± 0,15) emergency
situations happened which caused death of (2,76 ± 0,25) people. The risk of being in ES (R1) in Russia amounted to (0,40
± 0,04) · 10–5, the risk of death in an ES was (1,82 ± 0,10) fatalities per year, individual risk of death in ES was (0,70 ± 0,06)
0183 10–5 per year. There is a significant downward trend in these indicators. The lack of continuity of representing even
basic ES indicators in State reports &#34;On the state of protection of population and territory of the Russian Federation from
emergencies of natural and man-made origin&#34; prevents their comparison.