bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunosuppression in Patients with High-Grade Gliomas Treated with Radiation and Temozolomide
Authors: Grossman Stuart A. , Ye Xiaobu , Lesser Glenn , Sloan Andrew , Carraway Hetty , Desideri Serena , Piantadosi Steven 
Published: July 2011

Abstract
Purpose: Patients with high-grade gliomas (HGG) routinely receive radiation, temozolomide, and glucocorticoids. As each of these is immunosuppressive, we conducted a prospective, multicenter study to follow CD4 counts over time and determine whether low CD4 counts were associated with adverse outcomes.
Experimental Design: Patients with newly diagnosed HGG had CD4 counts drawn before initiating standard therapy and monthly thereafter for 1 year. Information on hospitalizations, infections, glucocorticoid use, survival, and cause of death were also collected.
Results: Ninety-six evaluable patients were accrued [85% glioblastoma, median age of 57, median Karnofsky performance status (KPS) = 90]. The median CD4 count before radiation and temozolomide treatment was 664 cells/mm3. The CD4 count nadir occurred 2 months after initiating therapy when 73% of patients had CD4 counts less than 300 cells/mm3 and 40% had less than 200 cells/mm3. CD4 counts remained low throughout the year of follow-up. Patients with CD4 counts less than 200 cells/mm3at 2 months had shorter survival than those with higher counts (median: 13.1 vs. 19.7 months, P = 0.002). Median survival was related to CD4 toxicity grades (I = 23.8 months, II = 19.7 months, III–IV = 13.1 months, P = 0.009). The adjusted HR for death attributable to 2-month CD4 count below 200 was 1.66 (P = 0.03). Eighty-eight percent of deaths resulted from disease progression, whereas only 2.5% were due to infection.
Conclusions: Severe reductions in CD4 counts in patients with newly diagnosed HGG treated with radiation and temozolomide treatment are common, treatment-related, long-lasting, and associated with early death from tumor progression. Clin Cancer Res; 17(16); 5473–80. ©2011 AACR.
Interleukin-33 Induces Expression of Adhesion Molecules and Inflammatory Activation in Human Endothelial Cells and in Human Atherosclerotic Plaques
Authors: Demyanets Svitlana , Konya Viktoria , Kastl Stefan P. , Kaun Christoph , Rauscher Sabine , Niessner Alexander , Pentz Richard , Pfaffenberger Stefan , Rychli Kathrin , Lemberger Christof E. , de Martin Rainer , Heinemann Akos , Huk Ihor , Gröger Marion , Maurer Gerald , Huber Kurt , Wojta Johann 
Published: July 2011

Objective—
Interleukin (IL)-33 is the most recently described member of the IL-1 family of cytokines and it is a ligand of the ST2 receptor. While the effects of IL-33 on the immune system have been extensively studied, the properties of this cytokine in the cardiovascular system are much less investigated.

Methods/Results—
We show here that IL-33 promoted the adhesion of human leukocytes to monolayers of human endothelial cells and robustly increased vascular cell adhesion molecule-1, intercellular adhesion molecule-1, endothelial selectin, and monocyte chemoattractant protein-1 protein production and mRNA expression in human coronary artery and human umbilical vein endothelial cells in vitro as well as in human explanted atherosclerotic plaques ex vivo. ST2-fusion protein, but not IL-1 receptor antagonist, abolished these effects. IL-33 induced translocation of nuclear factor-κB p50 and p65 subunits to the nucleus in human coronary artery endothelial cells and human umbilical vein endothelial cells and overexpression of dominant negative form of IκB kinase 2 or IκBα in human umbilical vein endothelial cells abolished IL-33-induced adhesion molecules and monocyte chemoattractant protein-1 mRNA expression. We detected IL-33 and ST2 on both protein and mRNA level in human carotid atherosclerotic plaques.

Conclusion—
We hypothesize that IL-33 may contribute to early events in endothelial activation characteristic for the development of atherosclerotic lesions in the vessel wall, by promoting adhesion molecules and proinflammatory cytokine expression in the endothelium.
Left Atrial Size Is a Potent Predictor of Mortality in Mitral Regurgitation Due to Flail Leaflets
Authors: Rusinaru Dan , Tribouilloy Christophe , Grigioni Francesco , Avierinos Jean François , Suri Rakesh M. , Barbieri Andrea , Szymanski Catherine , Ferlito Marinella , Michelena Hector , Tafanelli Laurence , Bursi Francesca , Mezghani Sonia , Branzi Angelo , Habib Gilbert , Modena Maria G. , Enriquez-Sarano Maurice 
Published: July 2011

Background—
Left atrium (LA) enlargement is common in organic mitral regurgitation (MR) and is an emerging prognostic indicator. However, outcome implications of LA enlargement have not been analyzed in the context of routine clinical practice and in a multicenter study.

Methods and Results—

The Mitral Regurgitation International DAtabase (MIDA) registry enrolls patients with organic MR due to flail leaflets, diagnosed in routine clinical practice, in 5 US and European centers. We investigated the relation between LA diameter and mortality under medical treatment and after mitral surgery in 788 patients in sinus rhythm (64±12 years; median LA, 48 [43 to 52] mm). LA diameter was independently associated with survival after diagnosis (hazard ratio, 1.08 [1.04 to 1.12] per 1 mm increment). Compared with patients with LA <55 mm, those with LA ≥55 mm had lower 8-year overall survival (
P
<0.001). LA ≥55 mm independently predicted overall mortality (hazard ratio, 3.67 [1.95 to 6.88]) and cardiac mortality (hazard ratio, 3.74 [1.72 to 8.13]) under medical treatment. The association of LA ≥55 mm and mortality was consistent in subgroups. Similar excess mortality associated with LA ≥55 mm was observed in asymptomatic and symptomatic patients (
P
for interaction, 0.77). In patients who underwent mitral surgery, LA ≥55 mm had no impact on postoperative outcome (
P
>0.20). Mitral surgery was associated with greater survival benefit in patients with LA ≥55 mm compared with LA <55 mm (
P
for interaction, 0.008).

Conclusions—
In MR caused by flail leaflets, LA diameter ≥55 mm is associated with increased mortality under medical treatment, independent of the presence of symptoms or left ventricular dysfunction.
Integration of 3D Imaging Data in the Assessment of Aortic Stenosis
Authors: O'Brien Bridget , Schoenhagen Paul , Kapadia Samir R. , Svensson Lars G. , Rodriguez Leonardo , Griffin Brian P. , Tuzcu E. Murat , Desai Milind Y. 
Published: July 2011

Background—
In patients with aortic stenosis (AS), precise assessment of severity is critical for treatment decisions. Estimation of aortic valve area (AVA) with transthoracic echocardiographic (TTE)-continuity equation (CE) assumes a circular left ventricular outflow tract (LVOT). We evaluated incremental utility of 3D multidetector computed tomography (MDCT) over TTE assessment of AS severity.

Methods and Results—

We included 51 patients (age, 81±8 years; 61% men; mean gradient, 42±12 mm Hg) with calcific AS who underwent evaluation for treatment options. TTE parameters included systolic LVOT diameter (D) and continuous and pulsed wave (CW and PW) velocity-time integrals (VTI) through the LVOT and mean transaortic gradient. MDCT parameters included systolic LVOT area, ratio of maximal to minimal LVOT diameter (eccentricity index), and aortic planimetry (AVA
p
). TTE-CE AVA [(D
2
×0.786×VTIpw)/VTIcw] and dimensionless index (DI) [VTIpw/VTIcw] were calculated. Corrected AVA was calculated by substituting MDCT LVOT area into CE. The majority (96%) of patients had eccentric LVOT. LVOT area, measured on MDCT, was higher than on TTE (3.84±0.8 cm
2
versus 3.03±0.5 cm
2
,
P
<0.01). TTE-AVA was smaller than AVA
p
and corrected AVA (0.67±0.1cm
2
, 0.82±0.3 cm
2
, and 0.86±0.3 cm
2
,
P
<0.01). Using TTE measurements alone, 73% of patients had congruence for severe AS (DI ≤0.25 and CE AVA <0.8 cm
2
), which increased to 92% using corrected CE.

Conclusions—
In patients with suspected severe AS, incorporation of MDCT-LVOT area into CE improves congruence for AS severity.
Collateral Flow Averts Hemorrhagic Transformation After Endovascular Therapy for Acute Ischemic Stroke
Authors: Bang Oh Young , Saver Jeffrey L. , Kim Suk Jae , Kim Gyeong-Moon , Chung Chin-Sang , Ovbiagele Bruce , Lee Kwang Ho , Liebeskind David S. ,   for the UCLA-Samsung Stroke Collaborators
Published: July 2011

Background and Purpose—
Collaterals sustain the ischemic penumbra to limit growth of the infarct core before revascularization, yet the impact of baseline collateral flow on hemorrhagic transformation (HT) after endovascular therapy remains unknown.

Methods—
A collaborative study from 2 stroke centers in distinct geographic regions included 222 consecutive patients who received endovascular therapy for acute cerebral ischemia. The influence of collaterals on HT was analyzed in distinct case scenarios relative to baseline collateral grade at angiography (0 to 1 versus 2 to 4) and recanalization (Thrombolysis in Myocardial Ischemia scale, 0 to 1 versus 2 to 3): good collaterals and successful recanalization (n=98), poor collaterals with successful recanalization (n=43), good collaterals and no recanalization(n=46), and poor collaterals and no recanalization (n=35).

Results—

HT after endovascular therapy occurred in 103 (46.4%) patients; 42 (18.9%) were symptomatic. HT was more frequently observed in patients with poor collaterals and recanalization than in other groups (
P
=0.048). When revascularization was achieved, patients with poorer collaterals were more likely to have symptomatic worsening with HT (
r
=−0.181,
P
=0.032). Multiple logistic regression analysis identified aggressive treatment (OR, 2.558 for Merci clot retrieval; 95% CI, 1.153 to 5.678; OR, 3.618 for combined fibrinolytics and mechanical therapy; 95% CI, 1.551 to 8.437; and OR, 2.085 for intravenous thrombolysis before endovascular therapy; 95% CI, 1.096 to 3.969), poor collaterals and recanalization (OR, 2.666; 95% CI, 1.163 to 6.113), and serum glucose levels (OR, 1.007; 95% CI, 1.000 to 1.014) as independent predictors of HT.

Conclusions—
Angiographic grade of collateral flow strongly influences the rate of HT after therapeutic recanalization for acute ischemic stroke. Collateral status readily available from baseline angiography may therefore refine therapeutic decision-making in acute cerebral ischemia.
Factors Associated With Impaired Kidney Function and Its Impact on Long-Term Outcome in Young Ischemic Stroke
Authors: Putaala Jukka , Haapaniemi Elena , Gordin Daniel , Liebkind Ron , Groop Per-Henrik , Kaste Markku , Tatlisumak Turgut 
Published: July 2011

Background and Purpose—
After ischemic stroke, kidney dysfunction is linked to poor outcomes in the elderly, but regarding young patients, data are lacking.

Methods—

We investigated estimated glomerular filtration rate (eGFR) on admission according to the Modification of Diet in Renal Disease equation in 958 consecutive patients aged 15 to 49 years with their first-ever ischemic stroke. Logistic regression adjusted for demographics and stroke risk factors served to identify factors related to low (<60) and high (>120 mL/min/1.73 m
2
) eGFR. In the long-term follow-up (mean, 8.9±3.8 years) study, Cox proportional hazards analysis described the association between eGFR and the following end points: nonfatal/fatal ischemic stroke; composite vascular event of any stroke, myocardial infarction, revascularization/other arterial occlusive event, or vascular death; and death of any cause.

Results—
Estimated GFR was normal in 809 (84.4%), low in 43 (4.5%), and high in 106 (11.1%) patients. Type 1 diabetes (OR, 18.84; 95% CI, 8.65 to 41.03), hypertension (4.29; 1.94 to 9.48), and cardiovascular disease (2.66; 1.19 to 5.96) were independently associated with low eGFR. Type 2 diabetes (3.82; 1.93 to 7.55), lower age (0.95 per year; 0.93 to 0.98), and male gender (1.74; 1.08 to 2.82) were associated with high eGFR. Both low (hazard ratio, 5.73; 95% CI, 3.54 to 9.25) and high eGFR (1.78; 1.01 to 3.14) were associated with long-term mortality when adjusted for age, gender, risk factors, stroke severity, and subtype. No independent association appeared between eGFR and vascular events.

Conclusions—
Despite their different associated risk factors in our young patient cohort, both low and high eGFR predicted long-term mortality after ischemic stroke.
Restoring Neuronal Function After Stroke by Cell Replacement
Authors: Dihné Marcel , Hartung Hans-Peter , Seitz Rüdiger J. 
Published: July 2011

Background and Purpose—
A major challenge to effective treatment after stroke is the restoration of neuronal function. In recent years, cell-based therapies for stroke have been explored in experimental animal models, and the results have suggested behavioral improvements. However, the anatomic targets of a cell-based stroke therapy and the relationship of cell grafts to post stroke reorganization are poorly understood, which results in difficulties defining strategies for neuronal substitution. Given that stroke causes a variety of secondary changes at locations beyond the infarct lesion, overcoming these difficulties is even more important.

Summary of Review
We describe which brain structures and cell types are candidates for substitution and how new neuronal functionality could be implemented in a damaged brain by capitalizing on current concepts of post stroke plasticity.
Matrix Metalloproteinase-9 in an Exploratory Trial of Intravenous Minocycline for Acute Ischemic Stroke
Authors: Switzer Jeffrey A. , Hess David C. , Ergul Adviye , Waller Jennifer L. , Machado Livia S. , Portik-Dobos Vera , Pettigrew L. Creed , Clark Wayne M. , Fagan Susan C. 
Published: July 2011

Background and Purpose—
Plasma matrix metalloproteinase-9 levels predict posttissue plasminogen activator (tPA) hemorrhage.

Methods—
The authors investigated the effect of minocycline on plasma matrix metalloproteinase-9 in acute ischemic stroke in the Minocycline to Improve Neurological Outcome in Stroke (MINOS) trial and a comparison group.

Results—

Matrix metalloproteinase-9 level decreased at 72 hours compared with baseline in MINOS (tPA,
P
=0.0022; non-tPA,
P
=0.0066) and was lower than in the non-MINOS comparison group at 24 hours (tPA,
P
<0.0001; non-tPA,
P
=0.0019).

Conclusions—
Lower plasma matrix metalloproteinase-9 was seen among tPA-treated subjects in the MINOS trial. Combining minocycline with tPA may prevent the adverse consequences of thrombolytic therapy through suppression of matrix metalloproteinase-9 activity.
Iodinated Contrast Media and Cerebral Hemorrhage After Intravenous Thrombolysis
Authors: MacDougall Niall J.J. , McVerry Ferghal , Baird Sally , Baird Tracey , Teasdale Evelyn , Muir Keith W. 
Published: July 2011

Background and Purpose—
Iodinated contrast is increasingly used in CT perfusion or angiographic examinations in acute stroke. Increased risk of intracranial hemorrhage (ICH) complicating microcatheter contrast injections has recently been reported in the second Interventional Management of Stroke (IMS 2) trial with contrast toxicity potentially contributory.

Methods—
We reviewed clinical and radiological data on all patients treated with intravenous alteplase at a single center between May 2003 and November 2008.

Results—

Of 312 patients treated with intravenous alteplase, 69 (22.1%) received intravenous iodinated contrast in volumes between 50 and 150 mL. Incidence of symptomatic ICH defined as per European Cooperative Acute Stroke Study 2 was 16 of 312 (5.1%; 95% CI, 2.7% to 7.6%); among patients not given contrast, it was 12 of 243 (4.9%; 2.2% to 7.7%) compared with 4 of 69 (5.8%; 0.3% to 11.3%) in those given contrast. Incidence of symptomatic ICH defined as per Safe Implementation of Thrombolysis in Stroke-MOnitoring Study (SITS-MOST) criteria was 12 of 312 (3.9%; 1.7% to 6%), 9 of 243 (3.7%; 1.3% to 6%) among those not given contrast, and 3 of 69 (4.4%; 95% CI, −0.5% to 9.2%) among those given contrast. Patients with symptomatic ICH were older, had higher pretreatment National Institutes of Health Stroke Scale, and blood glucose than those without symptomatic ICH. In logistic regression analysis, pretreatment blood glucose was the only significant predictor of symptomatic ICH by either definition (OR, 1.23; 95% CI, 1.03 to 1.48 per mmol/L increment;
P
=0.024). Contrast administration or dose was not associated with symptomatic ICH.

Conclusions—
Intravenous iodinated contrast in doses typically required for CT angiography and perfusion imaging was not associated with symptomatic intracranial hemorrhage in patients treated with alteplase.
The Impact of Climate Change on Air Quality–Related Meteorological Conditions in California. Part II: Present versus Future Time Simulation Analysis
Authors: Zhao Zhan , Chen Shu-Hua , Kleeman Michael J. , Mahmud Abdullah 
Published: July 2011

Abstract
In this study, the Weather Research and Forecasting (WRF) model was applied to dynamically downscale the Parallel Climate Model (PCM) projection for the climate change impact on regional meteorological conditions in California. Comparisons were made for meteorological fields that strongly influence regional air quality between the current (2000–06) and future (2047–53) downscaling results to infer potential air pollution changes in California. Changes in both the meteorological fields and the implied future air quality vary by region and season. Analyses showed that the normalized number of stagnation days (NNSD) integrating all stagnation events, during which most of the air pollution episodes occur, in California's San Joaquin Valley (SJV) will increase and the intensity of stagnation will be stronger in the future for the two main air pollution seasons (i.e., summer and winter). Increases in surface wind and planetary boundary layer height (PBLH) were observed for the coastal part of Los Angeles County (LAC) during summer, suggesting stronger ventilation in this region. Contrary situations were seen in other parts of the South Coast Air Basin (SoCAB) and SJV. Although a surface wind change was not evident in SJV during winter, there was a significant PBLH decrease. Climatechangeinduced variations in surface wind and PBLH were only statistically significant in coastal SoCAB and the southern portion of SJV relative to the corresponding interannual variability; changes in temperature are significant throughout the regions studied. The sea breeze along the coast of California plays an important role in the state's climate and air quality, especially during summertime owing to the stronger intensity compared to wintertime. Analysis of the land–sea temperature contrast and the southwesterly wind along the California coastline indicated that the summertime sea breeze will be stronger in the Central Valley (CV) but weaker for the SoCAB region in the future.
Meteorological Events Affecting Cold-Air Pools in a Small Basin
Authors: Dorninger Manfred , Whiteman C. David , Bica Benedikt , Eisenbach Stefan , Pospichal Bernhard , Steinacker Reinhold 
Published: July 2011

AbstractMeteorological events affecting the evolution of temperature inversions or cold-air pools in the 1-km-diameter, high-altitude (~1300 m MSL) Grünloch basin in the eastern Alps are investigated using data from lines of temperature dataloggers running up the basin sidewalls, nearby weather stations, and weather charts. Nighttime cold-air-pool events observed from October 2001 to June 2002 are categorized into undisturbed inversion evolution, late buildups, early breakups, mixing events, layered erosion at the inversion top, temperature disturbances occurring in the lower or upper elevations of the pool, and inversion buildup caused by the temporary clearing of clouds. In addition, persistent multiday cold-air pools are sometimes seen. Analyses show that strong winds and cloud cover are the governing meteorological parameters that cause the inversion behavior to deviate from its undisturbed state, but wind direction can also play an important role in the life cycle of the cold-air pools, because it governs the interaction with steep or gentle slopes of the underlying topography. Undisturbed cold-air pools are unusual in the Grünloch basin. A schematic diagram illustrates the different types of cold-air-pool events.
Lagrangian Coherent Structure Analysis of Terminal Winds Detected by Lidar. Part II: Structure Evolution and Comparison with Flight Data
Authors: Tang Wenbo , Chan Pak Wai , Haller George 
Published: July 2011

AbstractUsing observational data from coherent Doppler light detection and ranging (lidar) systems situated at the Hong Kong International Airport (HKIA), the authors extract Lagrangian coherent structures (LCS) intersecting the flight path of landing aircraft. They study the time evolution of LCS and compare them with onboard wind shear and altitude data collected during airplane approaches. Their results show good correlation between LCS extracted from the lidar data and updrafts and downdrafts experienced by landing aircraft. Overall, LCS analysis shows promise as a robust real-time tool to detect unsteady flow structures that impact airplane traffic.
Sensitivity of the Overturning Circulation in the Southern Ocean to Decadal Changes in Wind Forcing
Authors: Meredith Michael P. , Naveira Garabato Alberto C. , Hogg Andrew McC. , Farneti Riccardo 
Published: July 2011

AbstractThe sensitivity of the overturning circulation in the Southern Ocean to the recent decadal strengthening of the overlying winds is being discussed intensely, with some works attributing an inferred saturation of the Southern Ocean CO2 sink to an intensification of the overturning circulation, while others have argued that this circulation is insensitive to changes in winds. Fundamental to reconciling these diverse views is to understand properly the role of eddies in counteracting the directly wind-forced changes in overturning. Here, the authors use novel theoretical considerations and fine-resolution ocean models to develop a new scaling for the sensitivity of eddy-induced mixing to changes in winds, and they demonstrate that changes in Southern Ocean overturning in response to recent and future changes in wind stress forcing are likely to be substantial, even in the presence of a decadally varying eddy field. This result has significant implications for the ocean’s role in the carbon cycle, and hence global climate.