bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Department Shift Change Is Associated With Pneumonia in Patients With Acute Ischemic Stroke
Authors: Jones Erica M. , Albright Karen C. , Fossati-Bellani Marco , Siegler James E. , Martin-Schild Sheryl 
Published: September 2011

Background and Purpose—
Emergency department (ED) nurses play a pivotal role in early acute ischemic stroke patient management. We hypothesized that patients exposed to ED nursing shift changes (SC) may develop pneumonia (PNA) more frequently and have worse early outcomes than do patients who have continuity of care until stroke unit admission.

Methods—
Consecutive acute ischemic stroke patients presenting to our ED were studied using chart review and prospectively collected registry data. We evaluated the association of patient presence during an ED SC (ie, 07:00–08:00, 19:00–20:00) with length of stay in the ED, PNA rates, and early outcome measures (discharge disposition, modified Rankin Scale score, and death).

Results—

Three hundred sixty-six consecutive acute ischemic stroke patients met the criteria. Of those, 54.9% were present during an SC. After adjusting for baseline National Institutes of Health Stroke Scale, admission glucose, and intravenous tissue-type plasminogen activator, patients present during SC were half as likely to be discharged home or to inpatient rehab (OR, 0.50; 95% CI, 0.26–0.96;
P
=0.04) and were 2.5 times more likely to develop PNA (OR, 2.54; 95% CI, 1.02–6.30;
P
=0.045). After additional adjustment for time in the ED, the difference in favorable discharge disposition was no longer significant, but SC was associated with 5 times the odds of PNA (OR, 5.35; 95% CI, 1.34–21.39;
P
=0.018) compared with patients with continuity of care.

Conclusions—
In our center, acute ischemic stroke patients present during an ED nursing SC experienced higher rates of PNA and had decreased rates of favorable discharge disposition compared with patients with continuity of care. Strategies to prevent PNA and improve hand-off communication during SC may reduce this risk.
Lung Cancer and Incidence of Stroke
Authors: Chen Pei-Chun , Muo Chih-Hsin , Lee Yuan-Teh , Yu Yang-Hao , Sung Fung-Chang 
Published: September 2011

Background and Purpose—
Stroke is a known cerebrovascular complication in lung cancer patients; however, whether lung cancer patients are at elevated risk of developing stroke relative to the noncancer population remains unclear.

Methods—
The present study used population-based claims data from the Taiwan National Health Insurance, which identified 52 089 patients with an initial diagnosis of lung cancer between 1999 and 2007, and 104 178 matched noncancer subjects from all insured subjects age 20 years and older. Subsequent occurrence of stroke was measured until 2008, and the association between lung cancer and the hazard of developing stroke was estimated using Cox proportional hazard models.

Results—
The incidence of stroke was 1.5 times higher (25.9 versus 17.4 per 1000 person–years) in the lung cancer group compared with the comparison group. The multivariate-adjusted hazard ratio (HR) comparing lung cancer patients with the noncancer group was 1.47 (95% CI, 1.39–1.56) for stroke, 1.78 (95% CI, 1.54–2.05) for hemorrhagic stroke, and 1.43 (95% CI, 1.34–1.51) for ischemic stroke. The risk of stroke fell over time, decreasing after 1 year of follow-up for men and after 2 years of follow-up for women. Within the first year of follow-up, the risk of stroke peaked during the first 3 months for men and within 4 to 6 months for women.

Conclusions—
Lung cancer is associated with increased risk of subsequent stroke within 1 year after diagnosis for men and 2 years after diagnosis for women.
Neuroprotection by Freezing Ischemic Penumbra Evolution Without Cerebral Blood Flow Augmentation With a Postsynaptic Density-95 Protein Inhibitor
Authors: Bråtane Bernt T. , Cui Hong , Cook Douglas J. , Bouley James , Tymianski Michael , Fisher Marc 
Published: September 2011

Background and Purpose—
The purpose of this study was to determine whether neuroprotection is feasible without cerebral blood flow augmentation in experimental permanent middle cerebral artery occlusion.

Methods—
Rats were subjected to permanent middle cerebral artery occlusion by the suture occlusion method and were treated 1 hour thereafter with a single 5-minute intravenous infusion of the postsynaptic density-95 protein inhibitor Tat-NR2B9c (7.5 mg/kg) or saline (n=8/group). Arterial spin-labeled perfusion-weighted MRI and diffusion weighted MRI were obtained with a 4.7-T Bruker system at 30, 45, 70, 90, 120, 150, and 180 minutes postmiddle cerebral artery occlusion to determine cerebral blood flow and apparent diffusion coefficient maps, respectively. At 24 hours, animals were neurologically scored (0 to 5), euthanized, and the brains stained with 2–3-5-triphenyl tetrazolium chloride to ascertain infarct volumes corrected for edema. Additionally, the effects of Tat-NR2B9c on adenosine 5′-triphosphate levels were measured in vitro in neurons subjected to oxygen–glucose deprivation.

Results—

Final infarct volume was decreased by 30.3% in the Tat-NR2B9c-treated animals compared with controls (
P
=0.028). There was a significant improvement in 24 hours neurological scores in the Tat-NR2B9c group compared with controls, 1.8±0.5 and 2.8±1.0, respectively (
P
=0.021). Relative to controls, Tat-NR2B9c significantly attenuated diffusion-weighted imaging lesion growth and preserved the diffusion-weighted imaging/perfusion-weighted imaging mismatch (ischemic penumbra) without affecting cerebral blood flow in the ischemic core or penumbra. Tat-NR2B9c treatment of primary neuronal cultures resulted in 26% increase in cell viability and 34% greater adenosine 5′-triphosphate levels after oxygen–glucose deprivation.

Conclusions—
Preservation of adenosine 5′-triphosphate levels in vitro and neuroprotection in permanent middle cerebral artery occlusion in rats is achievable without cerebral blood flow augmentation using a postsynaptic density-95 protein inhibitor.
Assessment of the Genetic Effects of Polymorphisms in the Osteoprotegerin Gene, TNFRSF11B, on Serum Osteoprotegerin Levels and Carotid Plaque Vulnerability
Authors: Straface Giuseppe , Biscetti Federico , Pitocco Dario , Bertoletti Giovanni , Misuraca Maria , Vincenzoni Claudio , Snider Francesco , Arena Vincenzo , Stigliano Egidio , Angelini Flavia , Iuliano Luigi , Boccia Stefania , de Waure Chiara , Giacchi Francesco , Ghirlanda Giovanni , Flex Andrea 
Published: September 2011

Background and Purpose—
Osteoprotegerin (OPG) is a secretory glycoprotein which belongs to the tumor necrosis factor receptor family. Various mechanisms have been suggested by which calcification might alter atherosclerotic plaque stability, but the significance of this intimal calcification is controversial. High concentrations of OPG have been associated with the presence of vascular and cardiovascular diseases. This study was designed to assess the association between gene polymorphisms of the OPG gene (TNFRSF11B), the serum OPG level, and plaque stability in patients with carotid atherosclerosis.

Methods—
We studied 177 patients with internal carotid artery stenosis who underwent carotid endarterectomy and also 303 controls. Carotid endarterectomy samples removed from patients were assessed by immunohistochemistry. Concentrations of OPG were measured and gene polymorphisms were examined by polymerase chain reaction and restriction enzyme analysis and were compared, initially between patients with carotid atherosclerosis and controls, and subsequently between stable and unstable carotid plaques.

Results—

We found that the GG genotype of the
T245G
polymorphism, the
CC
genotype of the
T950C
polymorphism, and the
CC
genotype of the
G1181C
polymorphism were significantly higher in patients with carotid plaque than in controls (21.5% versus 10.9% ,
P
<0.01; 15.8% versus 7.6%,
P
<0.01; and 20.3% versus 10.9%,
P
<0.01, respectively) and that these polymorphisms were associated with high serum OPG levels (4.02 [3.07] versus 2.94 [1.81] pmol/L;
P
<0.01), which were significantly higher in patients with unstable atherosclerotic plaques (5.86 [4.02] versus 3.53 [1.87] pmol/L;
P
<0.01).

Conclusions—
The TNFRSF11B gene polymorphisms studied are associated with high serum OPG levels and might be potential markers for plaque instability.
Prediction of Malignant Middle Cerebral Artery Infarction Using Computed Tomography-Based Intracranial Volume Reserve Measurements
Authors: Minnerup Jens , Wersching Heike , Ringelstein E. Bernd , Heindel Walter , Niederstadt Thomas , Schilling Matthias , Schäbitz Wolf-Rüdiger , Kemmling André 
Published: September 2011

Background and Purpose—
Early decompressive surgery in patients with malignant middle cerebral artery (MCA) infarction improves outcome. Elevation of intracranial pressure depends on both the space occupying brain edema and the intracranial volume reserve (cerebrospinal fluid [CSF]). However, CSF volume was not investigated as a predictor of malignant infarction so far. We hypothesize that assessment of CSF volume in addition to admission infarct size improves early prediction of malignant MCA infarction.

Methods—
Stroke patients with carotid-T or MCA main stem occlusion and ischemic lesion (reduced cerebral blood volume [CBV]) on perfusion CT were considered for the analysis. The end point malignant MCA infarction was defined by clinical signs of herniation. Volumes of CSF and CBV lesion were determined on admission. Receiver-operator characteristics analysis was used to calculate predictive values for radiological and clinical measurements.

Results—
Of 52 patients included, 26 (50%) developed malignant MCA infarction. Age, a decreased level of consciousness on admission, CBV lesion volume, CSF volume, and the ratio of CBV lesion volume to CSF volume were significantly different between malignant and nonmalignant groups. The best predictor of a malignant course was the ratio of CBV lesion volume to CSF volume with a cut-off value of 0.92 (96.2% sensitivity, 96.2% specificity, 96.2% positive predictive value, and 96.2% negative predictive value).

Conclusions—
Based on admission native CT and perfusion CT measurements, the ratio of ischemic lesion volume to CSF volume predicts the development of malignant MCA infarction with higher accuracy than other known predictors, including ischemic lesion volume or clinical characteristics.
Christian Conscience, Catholic Teaching and Lay Participation in Public Life
Authors: Clague Julie 
Published: September 2011

AbstractVatican II left Catholicism with some unresolved tensions: on the one hand between the authority of conscience and the teaching authority of the church and, on the other hand, concerning the proper relationship between the hierarchy and the laity. Such unfinished business continues to play itself out in public and political life. This article traces developments in the Catholic understanding of conscientious participation in public life, stretching from John F. Kennedy’s presidential candidature in 1960 up to the present writings of Pope Benedict XVI. In the post-Vatican II era, Popes John Paul II and Benedict XVI have emphasized the strong correspondence that should exist between church teaching and the Christian conscience.
Catholicism, Human Rights and the Public Sphere
Authors: McCrudden Christopher 
Published: September 2011

AbstractThis article suggests that the scope and meaning of human rights, and its relationship to religion, is anything but settled, and that this gives an opportunity to those who support a role for religion in public life to intervene. Such intervention should address four main issues. First, it should ensure that judges engage in attempting to understand religious issues from a cognitively internal viewpoint. Secondly, it should articulate a justification for freedom of religion that fully captures the core of the significance of religious belief, and the importance of the religious principles in the public sphere. Thirdly, it should ensure engagement and dialogue between the churches and others on the meaning of human dignity, given its centrality to religious and secular perspectives on rights. Lastly, the churches should consider more carefully what it means to give ‘public reasons’ in the political and cultural context, and how it can engage in the process of ‘public reasoning’ regarding human rights.
The Relevance of the Responsibility to Protect for Latin America and the Caribbean Region: Prevention and The Role of Civil Society
Authors: Rodrigues Gilberto M. A. , Serbin Andrés 
Published: September 2011

AbstractThe authors argue in this article that the main dimensions to be considered regarding the implementation of the Responsibility to Protect in Latin America and the Caribbean are the preventive dimension and, eventually the rebuilding dimension. The preventive dimension of the Responsibility to Protect cannot be dissociated from a general strategy of armed or violent conflict prevention, and should not be focused only in the prevention of mass atrocities. In the framework of the juridical and cultural legacy of the region, special attention should be directed to avoid considering the reactive dimension of RtoP, as well-embedded principles of national sovereignty, non-intervention and regional peaceful resolution of disputes obstruct any attempt of external intervention, even if they are related to international community initiatives. In this regard, the authors argue that the traditional role of regional organisations and mechanisms in peaceful resolution of inter-state conflicts, should be deepened, combined and coordinated with civil society initiatives, in the implementation of RtoP. The role of civil society organisations and networks should be strengthened through an increasing capacity building process, which includes developing skills and capacities to address both prevention and early warning, and which ought to be based on research, education and networking.
Making Europe's Responsibility to Protect More Credible
Authors: Petersson Jens 
Published: September 2011

AbstractEuropean nations should strengthen the United Nations military capability to manage conflicts on the African continent. The EU should also learn from the AU and incorporate a paragraph similar to §4h in the AU charter into the EU's own security political framework. Combined, these actions should make Europe's contribution to the military aspects of R2P more credible.
Can Surface-Cover Tiles Be Summed to Give Neighborhood Fluxes in Cities?
Authors: Salmond J. A. , Roth M. , Oke T. R. , Christen A. , Voogt J. A. 
Published: September 2011

AbstractThe paper addresses the question of whether the modeling practice of summing separate land-cover tiles to give urban fluxes at the neighborhood scale has merit. A central-city site in Basel, Switzerland, was instrumented to measure turbulent sensible heat fluxes QH from the two main land-cover types (roofs and canyons) separately and from the whole neighborhood. Path-averaged QH values were measured in the roughness sublayer (RSL) using scintillometry, and the spatially averaged QH neighborhood-scale flux was measured in the inertial sublayer (ISL) by an eddy-covariance system. The roof and canyon flux results are combined and weighted according to the respective plan-area abundance of each to give an estimated value of the neighborhood flux. The results show that this “bottom up” approach underestimates the measured ISL values by about 25% when averaged across all periods and wind directions. This finding led to consideration of possible errors from instrumentation, inappropriate turbulent source areas, failure to sample representative surfaces, and inability to fully capture RSL heat exchange. Sorting data by the two main wind directions revealed significant differences. The measured fluxes in the ISL and across the canyon top depend little upon wind direction, but daytime roof values show a marked sensitivity to wind direction. Qualitative analysis suggests this might be caused by systematic controls such as solar angle, site morphometry, and observational setup. The comparison of bottom up versus ISL is inconclusive; in some conditions agreement appears promising, and in others it does not. The question has not been proven or disproven. It may be too ambitious to test the concept at a real-world site.
How Physical Parameterizations Can Modulate Internal Variability in a Regional Climate Model
Authors: Crétat Julien , Pohl Benjamin 
Published: September 2011

Abstract
The authors analyze to what extent the internal variability simulated by a regional climate model is sensitive to its physical parameterizations. The influence of two convection schemes is quantified over southern Africa, where convective rainfall predominates. Internal variability is much larger with the Kain–Fritsch scheme than for the Grell–Dévényi scheme at the seasonal, intraseasonal, and daily time scales, and from the regional to the local (grid point) spatial scales. Phenomenological analyses reveal that the core (periphery) of the rain-bearing systems tends to be highly (weakly) reproducible, showing that it is their morphological features that induce the largest internal variability in the model. In addition to the domain settings and the lateral forcing conditions extensively analyzed in the literature, the physical package appears thus as a key factor that modulates the reproducible and irreproducible components of regional climate variability.
Supersaturation Fluctuations in Cirrus Clouds Driven by Colored Noise
Authors: Kärcher B. 
Published: September 2011

AbstractFundamental properties of ice supersaturation variability in cirrus clouds are studied by means of an idealized probabilistic model. Damped supersaturation fluctuations are assumed to be exponentially correlated in time, statistically stationary, and normally distributed. The damping process is tied to the ability of the ice crystals to scavenge water vapor. The temporal evolution of supersaturation separates into an early ballistic and a late asymptotic regime. The latter allows for a stationary solution for the probability distribution of supersaturation in the presence of cloud ice and corresponds to a diffusive solution in cloud-free conditions. Low ice crystal number densities, small ice crystal sizes, short supersaturation correlation times, and large fluctuation intensities favor the spreading of cirrus ice crystal sizes, especially in conditions conducive to sublimation. Otherwise, size spreading of ice crystals is hampered by ice-induced damping of supersaturation fluctuations. The spreading of the probability distributions of ice supersaturation for very weak damping may lead to an increase of cirrus fractional coverage, as parameterized in large-scale atmospheric models, even for small mean supersaturations.
Interdecadal Variations in ENSO Teleconnection to the Indo–Western Pacific for 1870–2007
Authors: Chowdary J. S. , Xie Shang-Ping , Tokinaga Hiroki , Okumura Yuko M. , Kubota Hisayuki , Johnson Nat , Zheng Xiao-Tong 
Published: September 2011

Slow modulation of interannual variability and its relationship to El Niño–Southern Oscillation (ENSO) is investigated for the period of 1870–2007 using shipboard surface meteorological observations along a frequently traveled track across the north Indian Ocean (NIO; from the Gulf of Aden through Malacca Strait) and the South China Sea (to Luzon Strait). During the decades in the late nineteenth–early twentieth century and in the late twentieth century, the El Niño–induced NIO warming persists longer than during the 1910s–mid-1970s, well into the summer following the peak of El Niño. During the epochs of the prolonged NIO warming, rainfall drops and sea level pressure rises over the tropical northwest Pacific in summer following El Niño. Conversely, during the period when the NIO warming dissipates earlier, these atmospheric anomalies are not well developed. This supports the Indian Ocean capacitor concept as a mechanism prolonging El Niño influence into summer through the persistent Indian Ocean warming after El Niño itself has dissipated. The above centennial modulation of ENSO teleconnection to the Indo–northwest Pacific region is reproduced in an atmospheric general circulation model forced by observed SST. The modulation is correlated not with the Pacific decadal oscillation but rather with the ENSO variance itself. When ENSO is strong, its effect in the Indo–northwest Pacific strengthens and vice versa. The fact that enhanced ENSO teleconnections occurred 100 years ago during the late nineteenth–early twentieth century indicates that the recent strengthening of the ENSO correlation over the Indo–western Pacific may not entirely be due to global warming but reflect natural variability.
Terminating the Last Interglacial: The Role of Ice Sheet–Climate Feedbacks in a GCM Asynchronously Coupled to an Ice Sheet Model
Authors: Herrington Adam R. , Poulsen Christopher J. 
Published: September 2011

Abstract
Climatic deterioration in northeastern Canada following the last interglacial resulted in the formation and abrupt expansion of the Laurentide Ice Sheet. However, the physical mechanisms leading to rapid ice sheet expansion are not well understood. Here, the authors report on experiments using an ice sheet model asynchronously coupled to a GCM to investigate the role of ice sheet–climate feedbacks in terminating the last interglacial period. In agreement with simpler models, the experiments indicate that a specific type of ice–albedo feedback, the small ice cap instability, is the dominant process controlling rapid expansion of the Laurentide Ice Sheet. As ice elevations increase in northeastern Canada, a stationary wave forms and strengthens over the Laurentide Ice Sheet, which acts to hinder further expansion of the ice margin and reduce the effect of the small ice cap instability. The sensitivity of these feedbacks to ice topography results in a reduction in simulated ice volume when the communication interval between the GCM and ice sheet model is lengthened since this permits larger gains in ice elevation between GCM updates and biases the simulation toward a stronger stationary wave feedback. The shortest communication interval (500 yr) leads to a Laurentide ice volume of 6 × 106 km3 in 10 kyr, which is less than ice volume estimates based on the geological record but is a substantial improvement over previous GCM studies. The authors discuss potential improvements to the asynchronous coupling scheme that would more accurately resolve ice sheet–climate feedbacks, potentially leading to greater simulated ice volume.