bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Dose Recombinant Tissue-Type Plasminogen Activator Enhances Clot Resolution in Brain Hemorrhage
Authors: Naff Neal , Williams Michael A. , Keyl Penelope M. , Tuhrim Stanley , Bullock M. Ross , Mayer Stephan A. , Coplin William , Narayan Raj , Haines Stephen , Cruz-Flores Salvador , Zuccarello Mario , Brock David , Awad Issam , Ziai Wendy C. , Marmarou Anthony , Rhoney Denise , McBee Nichol , Lane Karen , Hanley Daniel F. 
Published: August 2011

Background and Purpose—
Patients with intracerebral hemorrhage and intraventricular hemorrhage have a reported mortality of 50% to 80%. We evaluated a clot lytic treatment strategy for these patients in terms of mortality, ventricular infection, and bleeding safety events, and for its effect on the rate of intraventricular clot lysis.

Methods—
Forty-eight patients were enrolled at 14 centers and randomized to treatment with 3 mg recombinant tissue-type plasminogen activator (rtPA) or placebo. Demographic characteristics, severity factors, safety outcomes (mortality, infection, bleeding), and clot resolution rates were compared in the 2 groups.

Results—

Severity factors, including admission Glasgow Coma Scale, intracerebral hemorrhage volume, intraventricular hemorrhage volume, and blood pressure were evenly distributed, as were adverse events, except for an increased frequency of respiratory system events in the placebo-treated group. Neither intracranial pressure nor cerebral perfusion pressure differed substantially between treatment groups on presentation, with external ventricular device closure, or during the active treatment phase. Frequency of death and ventriculitis was substantially lower than expected and bleeding events remained below the prespecified threshold for mortality (18% rtPA; 23% placebo), ventriculitis (8% rtPA; 9% placebo), symptomatic bleeding (23% rtPA; 5% placebo, which approached statistical significance;
P
=0.1). The median duration of dosing was 7.5 days for rtPA and 12 days for placebo. There was a significant beneficial effect of rtPA on rate of clot resolution.

Conclusions—
Low-dose rtPA for the treatment of intracerebral hemorrhage with intraventricular hemorrhage has an acceptable safety profile compared to placebo and historical controls. Data from a well-designed phase III clinical trial, such as CLEAR III, will be needed to fully evaluate this treatment.

Clinical Trial Registration—
Participant enrollment began before July 1, 2005.
Comprehensive Stroke Centers Overcome the Weekend Versus Weekday Gap in Stroke Treatment and Mortality
Authors: McKinney James S. , Deng Yingzi , Kasner Scott E. , Kostis John B. ,   for the Myocardial Infarction Data Acquisition System (MIDAS 15) Study Group
Published: August 2011

Background and Purpose—
Hospital staffing may be reduced on weekends. Prior studies of weekend disparities in stroke care have focused on in-hospital mortality with variable results. We hypothesized that 90-day mortality was higher in patients with stroke hospitalized on weekends versus weekdays, and this difference has been minimized over time by improvements in organization and delivery of stroke care.

Methods—
We used the Myocardial Infarction Data Acquisition System administrative database, which includes data on patients discharged with a primary diagnosis of cerebral infarction from all nonfederal acute care hospitals in New Jersey between 1996 and 2007. Out-of-hospital deaths were assessed by matching MIDAS records with New Jersey death registration files. New Jersey hospitals are designated by the state as comprehensive stroke centers, primary stroke centers, or nonstroke centers. The primary outcome measure was 90-day all-cause mortality after hospital admission.

Results—

A total of 134 441 patients were admitted with a primary diagnosis of cerebral infarction during the study period. A total of 23.4% were admitted to a comprehensive stroke center, 51.5% to a primary stroke center, and 25.1% to a nonstroke center. Ninety-day mortality was greater in patients with stroke admitted on weekends compared with weekdays (17.2% versus 16.5%;
P
=0.002). The adjusted risk of death at 90 days was significantly greater for weekend admission (hazard ratio, 1.05; 95% CI, 1.02 to 1.09). No difference in 90-day mortality was observed for patients admitted to comprehensive stroke centers on weekends versus weekdays (hazard ratio, 1.01; 95% CI, 0.95 to 1.08).

Conclusions—
Patients with stroke admitted on weekends to New Jersey hospitals had a significantly higher risk of death by 90 days. No such difference in mortality was observed at comprehensive stroke centers.
Acute Pediatric Stroke
Authors: Turney Colin M. , Wang Wei , Seiber Eric , Lo Warren 
Published: August 2011

Background and Purpose—
Recent studies examined the overall cost of pediatric stroke, but there are little data regarding the sources of these costs. We examined an administrative database that collected charges from 24 US children's hospitals to determine the sources of costs for acute hospital care of stroke.

Methods—
We used International Classification of Diseases, 9th Revision codes to search the Pediatric Health Information System. From 2003 to 2009 there were 1667 patients who had a primary diagnosis of stroke, 703 of which were hemorrhagic and 964 were ischemic. Individual costs, excluding physician charges, were gathered under 7 categories that were ranked to determine which contributed the most to total cost. Individual costs were ranked within their categories. We analyzed costs based on stroke type. Total costs were adjusted using the US Consumer Price Index to compare increases with the rate of inflation.

Results—
Median total cost for any stroke was $19 548 (interquartile range, $10 764–$40 721). The category “other/nursing” contributed the most to hospital costs followed by imaging, laboratory, and pharmacy. Brain MRI and CT contributed the most to imaging costs. Hemorrhagic strokes (median $24 843) were more expensive than ischemic strokes (median $16 954). Total cost increased from 2003 to 2009, but no overall annual trend emerged after controlling for gender, age, race, and hospital.

Conclusions—
This is the first in-depth analysis of cost for pediatric stroke care. The highest cost categories are potential targets for cost containment but are also crucial for effective diagnosis and treatment. Necessary yet prudent use of imaging technologies and inpatient stays may be strategies for cost containment.
High-Intensity Signal on Time-of-Flight Magnetic Resonance Angiography Indicates Carotid Plaques at High Risk for Cerebral Embolism During Stenting
Authors: Yoshimura Shinichi , Yamada Kiyofumi , Kawasaki Masanori , Asano Takahiko , Kanematsu Masayuki , Takamatsu Manabu , Hara Akira , Iwama Toru 
Published: August 2011

Background and Purpose—
A major disadvantage of carotid artery stenting (CAS) compared to carotid endarterectomy is the increased risk of cerebral embolism. Thus, establishing a simple method to discriminate fragile plaques on preoperative routine examination is important. The present study examined whether high-intensity signal (HIS) in the plaque on time-of-flight (TOF) MRA, performed for screening, can discriminate plaque at high risk for cerebral embolism during CAS.

Methods—
In the 30 patients treated using carotid endarterectomy, relationships between pathological findings of the plaques and TOF-MRA findings were analyzed. In the 112 patients treated using CAS, postoperative ipsilateral ischemic lesions on diffusion-weighted imaging and periprocedural ischemic symptoms were analyzed.

Results—

The percentage area of intraplaque hemorrhage stained by glycophorin A was significantly larger in HIS-positive plaques (51.8%±9.8%) than in HIS-negative plaques (8.6%±9.4%;
P
<0.001). Postoperative ischemic lesions on diffusion-weighted imaging were more frequent in the HIS-positive plaques (25/38; 65.8%) than in the HIS-negative plaques (26/74; 35.1%;
P
=0.002). Periprocedural ischemic symptoms were more frequently observed in HIS-positive plaques (7/38; 18.4%) than in HIS-negative plaques (1/74; 1.4%;
P
=0.003). Multivariate logistic regression analysis identified HIS on TOF-MRA as an independent predictor of periprocedural ischemic symptoms (odds ratio, 15.08; 95% confidence interval, 1.76–129.0).

Conclusions—
HIS in the plaque on TOF-MRA performed for screening could discriminate plaques at high risk for cerebral embolism during CAS.
Relations of Blood Inflammatory Marker Levels With Cerebral Microbleeds
Authors: Miwa Kaori , Tanaka Makiko , Okazaki Shuhei , Furukado Shigetaka , Sakaguchi Manabu , Kitagawa Kazuo 
Published: August 2011

Background and Purpose—
Cerebral microbleeds (CMB) are observed in the elderly and have been regarded as one of the manifestations of small vessel disease. Although inflammatory processes have attracted much attention not only in large-artery disease, but also in small vessel disease, their involvement in CMB remains to be determined. The purpose of this study is to clarify relations between inflammatory marker levels and CMB.

Methods—
Four hundred thirty-one patients without histories of cerebrovascular diseases were prospectively enrolled. The presence and number of CMB were assessed on gradient-echo magnetic resonance imaging. As common inflammatory markers, serum levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and interleukin-18 (IL-18) were evaluated.

Results—
CMB were found in 65 patients (15%). In 35 patients, at least one CMB was found in deep locations, but 30 patients had strictly lobar CMB. Levels of hsCRP, IL-6, and IL-18 were higher in patients with CMB than in those without. Logistic regression analyses showed that each 1SD increase in each inflammatory marker level was significantly associated with the presence of CMB after adjustment for age and sex, and after additional adjustment for cardiovascular risk factors, silent lacunar infarction, and white matter hyperintensity. The OR (95% CI) of hsCRP, IL-6, and IL-18 was 1.81 (1.35–2.46), 1.73 (1.18–2.61), and 2.41 (1.44–4.52), respectively. Furthermore, the inflammatory marker levels were associated with both deep and lobar CMB.

Conclusions—
Higher levels of hsCRP, IL-6, and IL-18 are associated with CMB, in both deep and lobar locations, suggesting the involvement of inflammation in CMB.
Replication Study of Chr17q25 With Cerebral White Matter Lesion Volume
Authors: Verhaaren Benjamin F.J. , de Boer Renske , Vernooij Meike W. , Rivadeneira Fernando , Uitterlinden André G. , Hofman Albert , Krestin Gabriel P. , van der Lugt Aad , Niessen Wiro J. , Breteler Monique M.B. , Ikram M. Arfan 
Published: August 2011

Background and Purpose—
Recently, the first genomewide association study on cerebral white matter lesion burden identified chr17q25 to be significantly associated with white matter lesions. We report on the first independent replication study of this genetic association.

Methods—
In a population-based cohort study, we investigated the association between the 6 genomewide significant single nucleotide polymorphisms at that locus and cerebral white matter lesion volume on MRI, measured quantitatively, adjusted for age, sex, and intracranial volume. Adjustments for ApoE4 carriership and cardiovascular risk factors were evaluated separately. Finally, we performed a meta-analysis of all published data for the single most significant single nucleotide polymorphism, rs3744028.

Results—

The risk alleles of all the 6 single nucleotide polymorphisms were significantly associated with white matter lesion volume with
P
=1.1*10
−3
for rs3744028, adjusted for age, sex, and intracranial volume. Additional adjustments only had minor influence on these associations. A meta-analysis with all published data for rs3744028 resulted in a probability value of 5.3*10
−17
.

Conclusions—
This study further establishes chr17q25 as a novel genetic locus for WML volume.
Increased Frequency of First-Episode Poststroke Depression After Discontinuation of Escitalopram
Authors: Mikami Katsunaka , Jorge Ricardo E. , Moser David J. , Arndt Stephan , Jang Mijin , Solodkin Ana , Small Steven L. , Fonzetti Pasquale , Hegel Mark T. , Robinson Robert G. 
Published: August 2011

Background and Purpose—
The purpose of this study was to compare escitalopram, problem-solving therapy, and placebo to prevent poststroke depression during 6 months after discontinuation of treatment.

Methods—
We examined for depression 33 patients assigned to placebo, 34 to escitalopram, and 41 to problem-solving therapy.

Results—
After controlling for age, gender, prior mood disorder, and severity of stroke, new-onset major depression and Hamilton Depression scores were significantly higher 6 months after escitalopram was discontinued compared with the problem-solving therapy or placebo groups.

Conclusions—
Discontinuation of escitalopram may increase poststroke depressive symptoms.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00071643.
Time Scales of Terrestrial Carbon Response Related to Land-Use Application: Implications for Initializing an Earth System Model
Authors: Sentman Lori T. , Shevliakova Elena , Stouffer Ronald J. , Malyshev Sergey 
Published: August 2011

Abstract
The dynamic vegetation and carbon cycling component, LM3V, of the Geophysical Fluid Dynamics Laboratory (GFDL) prototype Earth system model (ESM2.1), has been designed to simulate the effects of land use on terrestrial carbon pools, including secondary vegetation regrowth. Because of the long time scales associated with the carbon adjustment, special consideration is required when initializing the ESM when historical simulations are conducted. Starting from an equilibrated, preindustrial climate and potential vegetation state in an offline land-only model (LM3V), estimates of historical land use are instantaneously applied in five experiments beginning in the following calendar years: 1500, 1600, 1700, 1750, and 1800. This application results in the land carbon pools experiencing an abrupt change—a carbon shock—and the secondary vegetation needs time to regrow into consistency with the harvesting history. The authors find that it takes approximately 100 years for the vegetation to recover from the carbon shock, whereas soils take at least 150 years to recover. The vegetation carbon response is driven primarily by land-use history, whereas the soil carbon response is affected by both land-use history and the geographic pattern of soil respiration rates. Based on these results, the authors recommend the application of historical land-use scenarios in 1700 to provide sufficient time for the land carbon in ESMs with secondary vegetation to equilibrate to adequately simulate carbon stores at the start of the historical integrations (i.e., 1860) in a computationally efficient manner.
Determining Vertical Water Velocities from Seaglider
Authors: Frajka-Williams Eleanor , Eriksen Charles C. , Rhines Peter B. , Harcourt Ramsey R. 
Published: August 2011

Abstract
Vertical velocities in the world’s oceans are typically small, less than 1 cm s−1, posing a significant challenge for observational techniques. Seaglider, an autonomous profiling instrument, can be used to estimate vertical water velocity in the ocean. Using a Seaglider’s flight model and pressure observations, vertical water velocities are estimated along glider trajectories in the Labrador Sea before, during, and after deep convection. Results indicate that vertical velocities in the stratified ocean agree with the theoretical Wentzel–Kramers–Brillouin (WKB) scaling of w; and in the turbulent mixed layer, scale with buoyancy, and wind forcing. It is estimated that accuracy is to within 0.5 cm s−1. Because of uncertainties in the flight model, velocities are poor near the surface and deep apogees, and during extended roll maneuvers. Some of this may be improved by using a dynamic flight model permitting acceleration and by better constraining flight parameters through pilot choices during the mission.
Exploring Variations in People’s Sources, Uses, and Perceptions of Weather Forecasts
Authors: Demuth Julie L. , Lazo Jeffrey K. , Morss Rebecca E. 
Published: August 2011

Abstract
Past research has shown that individuals vary in their attitudes and behaviors regarding weather forecast information. To deepen knowledge about these variations, this article explores 1) patterns in people’s sources, uses, and perceptions of everyday weather forecasts; and 2) relationships among people’s sources, uses, and perceptions of forecasts, their personal characteristics, and their experiences with weather and weather forecasts. It does so by performing factor and regression analysis on data from a nationwide survey of the U.S. public, combined with other data. Forecast uses factored into planning for leisure activities and for work/school-related activities, while knowing what the weather will be like and planning how to dress remained separate. Forecast parameters factored into importance of precipitation parameters and of temperature-related parameters, suggesting that these represent conceptually different constructs. Regression analysis showed that the primary drivers for how often people obtain forecasts are what they use forecasts for and their perceived importance of and confidence in forecast information. People’s forecast uses are explained in large part by their frequency of obtaining forecasts and their perceived importance of temperature-related and precipitation forecast information. This suggests that that individuals’ frequency of obtaining forecasts, forecast use, and importance of forecast parameters are closely interrelated. Sociodemographic characteristics and, to a lesser extent, weather-related experience also influence some aspects of people’s forecast sources, uses, and perceptions. These findings continue to build understanding of variations among weather forecast users, which can help weather information providers improve communication of forecasts to better meet users’ needs.
An Increase in the Number of Tornado Reports in Brazil
Authors: Silva Dias Maria A. F. 
Published: August 2011

AbstractThis paper presents the development of tornado reports in Brazil since the middle of the twentieth century, both for the country as a whole and for the five regions of Brazil: the south, southeast, central-west, northeast, and north. No official tornado registry exists in Brazil so the reports come from various sources. Most of the tornadoes reported are from the south and southeast regions. The low number of reports for the central-west regions suggests, in view of the literature on intense storms and mesoscale convective complexes, that most tornadoes cases go unreported. The increase in tornado reports is compared to the evolution of population density and communications, with the latter represented by the evolution of local television stations and the popularization of the Internet. One particular event is a new Web site for volunteer tornado reports, which has completely changed the trends of tornado reports. Another possible cause for an increase in the number of tornado reports in the south and southern regions could be a shift in climate variability in this region in the 1970s, which has been reported by several authors. However, the increase in rainfall and extreme events reported by these studies point to an increase of as much as 40%, which is not compatible with the observed tenfold increase in tornado reports.
Modeling the Spatial Distribution of Snow Cover in the Dudhkoshi Region of the Nepal Himalayas
Authors: Shrestha Maheswor , Wang Lei , Koike Toshio , Xue Yongkang , Hirabayashi Yukiko 
Published: August 2011

Abstract
In this study, a distributed biosphere hydrological model with three-layer energy-balance snow physics [an improved version of the Water and Energy Budget–based Distributed Hydrological Model (WEB-DHM-S)] is applied to the Dudhkoshi region of the eastern Nepal Himalayas to estimate the spatial distribution of snow cover. Simulations are performed at hourly time steps and 1-km spatial resolution for the 2002/03 snow season during the Coordinated Enhanced Observing Period (CEOP) third Enhanced Observing Period (EOP-3). Point evaluations (snow depth and upward short- and longwave radiation) at Pyramid (a station of the CEOP Himalayan reference site) confirm the vertical-process representations of WEB-DHM-S in this region. The simulated spatial distribution of snow cover is evaluated with the Moderate Resolution Imaging Spectroradiometer (MODIS) 8-day maximum snow-cover extent (MOD10A2), demonstrating the model’s capability to accurately capture the spatiotemporal variations in snow cover across the study area. The qualitative pixel-to-pixel comparisons for the snow-free and snow-covered grids reveal that the simulations agree well with the MODIS data to an accuracy of 90%. Simulated nighttime land surface temperatures (LST) are comparable to the MODIS LST (MOD11A2) with mean absolute error of 2.42°C and mean relative error of 0.77°C during the study period. The effects of uncertainty in air temperature lapse rate, initial snow depth, and snow albedo on the snow-cover area (SCA) and LST simulations are determined through sensitivity runs. In addition, it is found that ignoring the spatial variability of remotely sensed cloud coverage greatly increases bias in the LST and SCA simulations. To the authors’ knowledge, this work is the first to adopt a distributed hydrological model with a physically based multilayer snow module to estimate the spatial distribution of snow cover in the Himalayan region.
Goals with limited vision: a qualitative study of coping with vision-related goal interference in midlife
Authors: Boerner Kathrin , Wang Shu-wen 
Published: August 2011

Objective: To investigate how middle-aged adults manage their goal pursuits in the face of visual disability. Design: Cross-sectional qualitative study. Setting: Vision rehabilitation agency. Subjects: 216 middle-aged adults with visual impairment. Methods: Telephone interviews composed of structured and open-ended assessments of life goals and the strategies used to cope with vision-related goal interference. Results: Individuals reported strategies that reflected the broader domains found in prior research with older adults: internal resource use, new approach use, technology use, help use, and psychological self-regulation. The most frequently reported strategy was help use ( n = 192), followed by new approach use ( n = 166), internal resource use ( n = 162), technology use ( n = 159) and psychological self-regulation ( n = 130). Across domains, the most frequently reported strategies were instrumental informal help, instrumental formal help, optical aids, and invest effort. Specific strategy domains emerged as more typical in response to interference with particular types of goals; for example, help use was reported by a majority for interference with functional and psychological goals, but only by half for interference with social goals. Conclusions: Study findings revealed a rich array of strategies used by middle-aged adults with vision impairment in their daily lives to deal with vision-related goal interference. Results suggest that rehabilitation services should consider multiple methods of coping and their goal-related function when working with middle-aged adults with disabilities.