bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organization of a United States County System for Comprehensive Acute Stroke Care
Authors: Cramer Steven C. , Stradling Dana , Brown David M. , Carrillo-Nunez Ignacio M. , Ciabarra Anthony , Cummings Michael , Dauben Richard , Lombardi David L. , Patel Nirav , Traynor Elizabeth N. , Waldman Stephen , Miller Ken , Stratton Samuel J. 
Published: January 2012

Background and Purpose—
Organized systems of care have the potential to improve acute stroke care delivery. The current report describes the experience of implementing a county-wide system of spoke-and-hub stroke neurology receiving centers (SNRC) that incorporated several comprehensive stroke center recommendations.

Methods—
Observational study of patients with suspected stroke of <5 hours duration transported by emergency medical system personnel to an SNRC during the first year of this system.

Results—

A total of 1360 patients with suspected stroke were evaluated at 9 hub SNRC, of which 553 (40.7%) had a discharge diagnosis of ischemic stroke. Of these 553, intravenous tissue-type plasminogen activator was administered to 110 patients (19.9% of ischemic strokes). Care at the 6 neurointerventional-ready SNRC was a major focus in which 25.1% (99/395) of the patients with ischemic stroke received acute intravenous or intra-arterial reperfusion therapy, and in which provision of such therapies was less common with milder stroke, older age, and Hispanic origin. The door-to-needle time for intravenous tissue-type plasminogen activator met the <60-minute target in only 25% of patients and was 37% longer (
P
=0.0001) when SNRC were neurointerventional-ready.

Conclusions—
A stroke system that incorporates features of comprehensive stroke centers can be effectively implemented with substantial rates of acute reperfusion therapy administration. Experiences potentially useful to broader implementation of comprehensive stroke centers are considered.
Dual or Mono Antiplatelet Therapy for Patients With Acute Ischemic Stroke or Transient Ischemic Attack
Authors: Geeganage Chamila M. , Diener Hans-Christoph , Algra Ale , Chen Christopher , Topol Eric J. , Dengler Reinhard , Markus Hugh S. , Bath Matthew W. , Bath Philip M.W. ,   for the Acute Antiplatelet Stroke Trialists Collaboration
Published: January 2012

Background and Purpose—
Antiplatelets are recommended for patients with acute noncardioembolic stroke or transient ischemic attack. We compared the safety and efficacy of dual versus mono antiplatelet therapy in patients with acute ischemic stroke or transient ischemic attack.

Methods—
Completed randomized controlled trials of dual versus mono antiplatelet therapy in patients with acute (≤3 days) ischemic stroke/transient ischemic attack were identified using electronic bibliographic searches. The primary outcome was recurrent stroke (ischemic, hemorrhagic, unknown; fatal, nonfatal). Comparison of binary outcomes between treatment groups was analyzed with random effect models and described using risk ratios (95% CI).

Results—
Twelve completed randomized trials involving 3766 patients were included. In comparison with mono antiplatelet therapy, dual therapy (aspirin+dipyridamole and aspirin+clopidogrel) significantly reduced stroke recurrence, dual 58 (3.3%) versus mono 91 (5.0%; risk ratio, 0.67; 95% CI, 0.49–0.93); composite vascular event (stroke, myocardial infarction, vascular death), dual 74 (4.4%) versus mono 106 (6%; risk ratio, 0.75; 95% CI, 0.56–0.99); and the combination of stroke, transient ischemic attack, acute coronary syndrome, and all death, dual 100 (1.7%) versus mono 136 (9.1%; risk ratio, 0.71; 95% CI, 0.56–0.91); dual therapy was also associated with a nonsignificant trend to increase major bleeding, dual 15 (0.9%) versus mono 6 (0.4%; risk ratio, 2.09; 95% CI, 0.86–5.06).

Conclusions—
Dual antiplatelet therapy appears to be safe and effective in reducing stroke recurrence and combined vascular events in patients with acute ischemic stroke or transient ischemic attack as compared with mono therapy. These results need to be tested in prospective studies.
Impact of Emergency Department Transitions of Care on Thrombolytic Use in Acute Ischemic Stroke
Authors: Madej-Fermo Olga P. , Staff Ilene , Fortunato Gil , Abbott Lincoln , McCullough Louise D. 
Published: January 2012

Background and Purpose—
In-hospital mortality is higher for certain medical conditions based on the time of presentation to the emergency department. The primary goal of this study was to determine whether patients with acute ischemic stroke who arrived to the emergency department during a nursing shift change had similar rates of thrombolytic use and functional outcomes compared with patients presenting during nonshift change hours.

Methods—
A retrospective review of patients with acute ischemic stroke presenting to the emergency department of a primary stroke center from 2005 through 2010. The time to notify the stroke team, perform a head CT scan, and to start intravenous or intra-arterial thrombolysis was assessed. Thrombolysis rates, mortality rate, discharge disposition, change in the National Institutes of Health Stroke Scale, and change in modified Barthel Index at 3 and 12 months were assessed.

Results—
Of 3133 patients with acute ischemic stroke, 917 met criteria for inclusion. Arrival during nursing shift change, weekends, and July through September had no impact on process times, thrombolysis rates, and functional outcomes. Arrival at night did result in longer time to intra-arterial but not to intravenous thrombolysis, higher mortality rate, and smaller gain in functional status as measured by the modified Barthel Index at 3 months. The degree of emergency department “busyness” also did not influence tissue-type plasminogen activator treatment times.

Conclusions—
Presentation during a nursing shift change, a time of transition of care, did not delay thrombolytic use in eligible patients with acute ischemic stroke. Presentation with acute ischemic stroke at night did result in delays of care for patients undergoing interventional therapies.
Intracerebral Hemorrhage in the Very Old
Authors: Stein Marco , Misselwitz Björn , Hamann Gerhard F. , Scharbrodt Wolfram , Schummer Dorothee I. , Oertel Matthias F. 
Published: January 2012

Background and Purpose—
In most European societies and in the United States, the percentage of patients ≥80 years has been rising over the past century. The present study was conducted to observe this demographic change and its impact on patients with intracerebral hemorrhage (ICH).

Methods—
We reviewed patients' data with the diagnosis of ICH from January 2007 to December 2009. All data were collected out of a prospective stroke registry covering the entire state of Hesse, Germany. Incidence rates and absolute numbers of patients with ICH for 2009 to 2050 were calculated.

Results—
Of 3448 patients, 34% had an age ≥80 years. Hospital mortality was 35.9% for patients ≥80 years and 20.0% for patients <80 years. Unfavorable outcome (modified Rankin Scale score >2) was more often found in patients ≥80 years compared with patients <80 years (84.9% versus 74.8%). By the year 2050, the proportion of all patients with ICH ≥80 years will be 2.5-fold higher than in 2009. The total number of ICH cases will increase approximately 35.2% assuming that ICH probability stays the same. The number of patients who die in the hospital will increase approximately 60.2%. The total number of patients with severe disability due to ICH will increase approximately 36.8%.

Conclusions—
If current treatment strategies according to age remain unchanged, an increase of in-hospital mortality and a higher proportion of patients who need lifelong care after ICH can be expected in the coming decades.
Reduced Ipsilesional Cortical Volumes in Fetal Periventricular Venous Infarction
Authors: Li Damon , Hodge Jacquie , Wei Xing-Chang , Kirton Adam 
Published: January 2012

Background and Purpose—
Perinatal stroke causes most term-born hemiplegic cerebral palsy. Many suffer additional sequelae. Periventricular venous infarction (PVI) is a common fetal stroke in which isolated subcortical injury may cause only motor deficits. However, cognitive, language, and behavioral deficits also occur. We hypothesized that ipsilesional cortical gray matter volumes are reduced in PVI.

Methods—
Children (12 months to 18 years) with MRI-confirmed PVI were identified through the Alberta Perinatal Stroke Project. We developed an MRI method to quantify sectional gray (GM) and white matter (WM) volumes from lesioned and unlesioned (control) hemispheres (OsiriX software). Differences in cortical GM and WM volumes were compared between hemispheres in preselected regions “above” the lesion (middle) and anterior and posterior to this. Outcomes dichotomized for “cortical dysfunction” (cognitive, behavioral, language) and motor deficit severity (Pediatric Stroke Outcome Measure) were compared with GM volumes.

Results—

Twenty-two children (81% boys; median age, 8 years) were included. Methods demonstrated high intrarater and inter-rater reliabilities (ρ=0.988, ρ=0.943) and minimal observer bias. Ipsilesional GM volume was significantly reduced in the middle (
P
=0.007) and posterior (
P
=0.03) regions. Middle ipsilesional WM volumes were reduced (
P
<0.001). The degree of GM reduction was not associated with cortical dysfunction or severity of motor deficit.

Conclusions—
Ipsilesional GM volume is diminished in PVI. Speculative mechanisms include retrograde neuronal degeneration and disrupted migration. Neuropsychological testing of larger samples is required to determine clinical significance.
The Climatology of Synoptic-Scale Ascent over Western North America: A Perspective on Storm Tracks
Authors: Lareau Neil P. , Horel John D. 
Published: January 2012

Abstract
The position and variability of storm tracks across western North America are examined during the October–April cool seasons spanning 1989–2010. The location and intensity of storms are represented by strong synoptic-scale ascent, which is diagnosed by the alternative balance omega equation applied to ECMWF Re-Analysis Interim data. This dynamically filtered method removes poorly resolved updrafts arising from subsynoptic-scale phenomena such as convection and mountain waves. The resulting vertical motions are illustrated for the case of a strong storm traversing the western United States.
Summary statistics of synoptic-scale ascent are compiled over months, seasons, and the entire 21-yr period. Locations exhibiting high mean values of ascent are deemed to represent storm tracks. The climatological-mean storm track exhibits a sinusoidal shape across the eastern Pacific and western North America. The composite evolution of strong storms moving along specific segments of the storm track show regional differences (e.g., storms poleward of 50°N tend to result from progressive low-amplitude troughs progressing through the mean planetary ridge, while storms over the western United States are initiated by digging troughs that temporarily suppress the mean ridge).
Seasonal shifts in the storm track are pronounced and exhibit coherent regional patterns. Interannual variations in synoptic-scale ascent indicate meridional shifts in position as well as changes in the degree of amplification within the dominant sinusoidal storm track. These changes in structure are related to the phase of ENSO: El Niño (La Niña) winters favor zonal (amplified) and southern (northern) storm tracks.
The HWRF Hurricane Ensemble Data Assimilation System (HEDAS) for High-Resolution Data: The Impact of Airborne Doppler Radar Observations in an OSSE
Authors: Aksoy Altuğ , Lorsolo Sylvie , Vukicevic Tomislava , Sellwood Kathryn J. , Aberson Sim D. , Zhang Fuqing 
Published: January 2012

Abstract
Within the National Oceanic and Atmospheric Administration, the Hurricane Research Division of the Atlantic Oceanographic and Meteorological Laboratory has developed the Hurricane Weather Research and Forecasting (HWRF) Ensemble Data Assimilation System (HEDAS) to assimilate hurricane inner-core observations for high-resolution vortex initialization. HEDAS is based on a serial implementation of the square root ensemble Kalman filter. HWRF is configured with a horizontal grid spacing of km on the outer/inner domains. In this preliminary study, airborne Doppler radar radial wind observations are simulated from a higher-resolution km version of the same model with other modifications that resulted in appreciable model error.
A 24-h nature run simulation of Hurricane Paloma was initialized at 1200 UTC 7 November 2008 and produced a realistic, category-2-strength hurricane vortex. The impact of assimilating Doppler wind observations is assessed in observation space as well as in model space. It is observed that while the assimilation of Doppler wind observations results in significant improvements in the overall vortex structure, a general bias in the average error statistics persists because of the underestimation of overall intensity. A general deficiency in ensemble spread is also evident. While covariance inflation/relaxation and observation thinning result in improved ensemble spread, these do not translate into improvements in overall error statistics. These results strongly suggest a need to include in the ensemble a representation of forecast error growth from other sources such as model error.
The use of UKCP09 to produce weather files for building simulation
Authors: Mylona Anastasia 
Published: January 2012

Traditionally, hourly weather years such as the test reference years (TRYs) and design summer years (DSYs) have been used for building energy and thermal performance analysis. Until recently, these weather datasets were based on observed measurements, but the need to adapt buildings to the impacts of likely future climate change has introduced a requirement to incorporate climate projections, such as the UK Climate Projections (UKCP09), into building performance analysis. Four research projects, funded by the EPSRC, examined the use of UKCP09 data, and the associated Weather Generator tool, in producing weather files appropriate for building simulation. A methodology called ‘morphing’, previously used to create the currently available to practitioners, UK Climate Impacts Programme (UKCIP02) based, CIBSE Future Weather Years, will also be discussed here as a potential alternative for the production of UKCP09-based weather files. This article reviews all above methodologies developed to produce weather files for building simulation, using the UKCP09 projections, and discusses their benefits and limitations as well as their ease of use by designers. Practical application: This article aims to provide a comprehensive review of the various methodologies currently available for the production of future weather files for building thermal and energy performance simulation using the UKCP09 projections. This analysis aims to provide users with the benefits and limitations associated with each methodology and end product based on their accessibility, consistency with other currently used datasets, computational resources required and spatial availability.
Composite Mandibulectomy
Authors: Sidell Douglas R. , Aghaloo Tara , Tetradis Sotirios , Lee Min , Bezouglaia Olga , DeConde Adam , St. John Maie A. 
Published: January 2012

ObjectivesSegmental mandibular defects can result after the treatment of various pathologic processes, including osteoradionecrosis, tumor resection, or fracture nonunion with sequestration. The variety of etiologies and the frequency of occurrence make the reconstruction of segmental mandibular defects a topic of significant interest. Despite these incentives, a well‐established small‐animal model of the segmental mandibulectomy, including composite resection, does not exist. The objective of this study is the creation of a reliable animal model that can be used to study the reconstruction of en bloc mandibular defects. Surgical techniques and an array of reconstructive options are described.Study designDescription of an animal model.SettingAnimal laboratory at a quaternary care university medical center.MethodsWe present an Animal Research Oversight Committee–approved prospective analysis of survival operations in the rat model. A detailed, stepwise description of surgical technique and relevant intraoperative anatomy is presented. Postoperative management, early pitfalls, surgical complications, and future applications are discussed.ResultsA total of 72 operations were performed by a single individual between July and October 2010. Two intraoperative and 9 postoperative complications were recognized. There were 6 orocutaneous fistulas, 2 abscesses, and 1 seroma. There were 4 fatalities, which were attributed to anesthetic complications (2, intraoperative), hematoma formation (1, postoperative), and foreign‐body aspiration (1, postoperative).ConclusionThis novel animal model reliably replicates the en bloc segmental mandibular defects seen in our patient population and can be manipulated to achieve a wide variety of research objectives.
Individual working lives and collective action. An introduction to capability for work and capability for voice
Authors: Bonvin Jean-Michel 
Published: January 2012

This article presents the capability approach as an alternative conceptual and normative framework to assess the impact and relevance of existing labour market regulations. In this perspective, what matters is not GDP growth or the overall employment rate, but the development of people’s real freedom to choose a job or an activity they have reason to value. The two key notions of ‘capability for work’ and ‘capability for voice’ are presented in detail, as well as the way to use them as a framework for scientific analysis and empirical research. The article strongly emphasizes the significant difference that the use of such tools makes when it comes to assessing the impact and relevance of collective regulations in the field of work. Cet article présente l’approche par les capacités comme un cadre conceptuel et normatif alternatif pour évaluer l’impact et la pertinence des réglementations existantes du marché du travail. Dans cette perspective, ce qui importe, ce n’est pas la croissance du PIB ou le taux global d’emploi, mais le développement de la liberté effective des individus de choisir un emploi ou une activité qu’ils ont des raisons d’apprécier. Les deux notions essentielles de « capacité à exercer un travail » et de « capacité à faire entendre sa voix » sont présentées en détail, de même que la manière d’utiliser ces notions comme cadre d’analyse scientifique et de recherche empirique. L’article souligne fortement la différence considérable qu’entraîne l’utilisation de tels outils quand il s’agit d’évaluer l’impact et la pertinence des réglementations collectives dans le domaine du travail. In diesem Beitrag wird der Ansatz der Verwirklichungschancen als alternativer konzeptueller und normativer Rahmen vorgeschlagen, um die Auswirkungen und die Relevanz der bestehenden Arbeitsmarktvorschriften zu bewerten. Unter diesem Gesichtspunkt ist nicht das BIP-Wachstum oder die Gesamtbeschäftigungsrate von Bedeutung, sondern die Entwicklung der realen Freiheit der Menschen, eine Arbeit oder Tätigkeit zu wählen, die sie wertschätzen. Die beiden zentralen Konzepte der “capability for work” (Verwirklichungschance im Arbeitsleben) und der “capability for voice” (Chance, für Arbeitnehmerbelange einzutreten) werden ausführlich beschrieben, und es wird erklärt, wie diese als Rahmen für die wissenschaftliche Analyse und empirische Forschungsarbeiten dienen. Der Beitrag unterstreicht den bedeutenden Vorteil, der sich aus der Verwendung derartiger Konzepte bei der Bewertung der Auswirkungen und der Relevanz kollektiver Regelungen im Arbeitsbereich ergibt.
Collective responsibility in the workplace from a capability perspective
Authors: Zimmermann Bénédicte 
Published: January 2012

The article shows how a shift in perspective results from use of the capability approach in evaluating corporate activity: instead of a narrow focus on economic development, attention is paid also to the human development dimension. The author puts forward a conception of professional development resulting from the combined exercise of different capabilities, of which she discusses three essential dimensions, namely, freedom of choice, empowerment and collective responsibility. On the basis of a case study, she analyses the forms and founding principles of collective responsibility as related to individual capabilities. She describes how these factors impact on workplace participation procedures, and outlines the principles of justice that they entail. More broadly, she shows the tensions and new challenges to trade unionism and collective action thrown up by the need to combine individual and collective voice. L’article montre le déplacement de perspective qu’induit le recours à l’approche par les capacités pour évaluer l’activité des entreprises: du strict développement économique à la prise en compte du développement humain. L’auteure avance une conception du développement professionnel comme résultant de l’exercice conjoint de différentes capacités dont elle discute trois dimensions essentielles: la liberté de choisir, le pouvoir d’agir et la responsabilité collective. A partir d’une étude de cas, elle analyse les formes et les fondements de la responsabilité collective mise en jeu par les capacités individuelles. Elle en relève les conséquences sur les procédures de participation dans l’entreprise et les principes de justice mis en œuvre. Plus largement, elle montre les tensions et les nouveaux défis qui en résultent pour le syndicalisme et l’action collective en vue de combiner « voice » individuelle et collective. Der Beitrag beschreibt den Perspektivenwechsel, der sich aus der Verwendung des Ansatzes der Verwirklichungschancen für die Bewertung der Unternehmenstätigkeiten ergibt: Die Tätigkeit eines Unternehmens wird demnach nicht nur unter dem Gesichtspunkt der wirtschaftlichen Entwicklung, sondern auch der menschlichen Entwicklung bewertet. Die Autorin schlägt ein Konzept der beruflichen Entwicklung vor, das sich aus der gleichzeitigen Wahrnehmung verschiedener Verwirklichungschancen ergibt, und erörtert die drei wichtigsten Dimensionen dieser Chancen: Wahlfreiheit, Handlungsmöglichkeit und kollektive Verantwortung. Anhand einer Fallstudie werden die Formen und Grundlagen der kollektiven Verantwortung, die sich aus den individuellen Verwirklichungschancen ergibt, untersucht. Die Autorin erläutert die daraus resultierenden Folgen für die Partizipationsverfahren im Unternehmen sowie die Gerechtigkeitsprinzipien, die dabei angewandt werden. In einem weiteren Kontext ergeben sich daraus Spannungen und neue Herausforderungen für die Gewerkschaftsbewegung und kollektives Handeln, um individuelle und kollektive “Voice” miteinander zu verknüpfen.
Stigma Is Associated with Delays in Seeking Care among HIV-Infected People in India
Authors: Steward Wayne T. , Bharat Shalini , Ramakrishna Jayashree , Heylen Elsa , Ekstrand Maria L. 
Published: January 2012

Background: Stigma shapes the lives of people living with HIV and may affect their willingness to seek medical care. But treatment delays can compromise health and increase the risk of transmission to others. Purpose: To examine whether the 4 stigma manifestations— enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma’s prevalence), and internalized (personal endorsement of stigma beliefs)—were linked with delays in seeking care among HIV-infected people in India. Methods: A cross-sectional survey was conducted with 961 HIV-positive men and women in Mumbai and Bengaluru. Results: Enacted and internalized stigmas were correlated with delays in seeking care after testing HIV positive. Depression symptoms mediated the associations of enacted and internalized stigmas with care-seeking delays, whereas efforts to avoiding disclosing HIV status mediated only the association between internalized stigma and care-seeking delays. Conclusion: It is vital to develop stigma reduction interventions to ensure timely receipt of care.