bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the Extended Thrombolysis Time Window on the Proportion of Recombinant Tissue-Type Plasminogen Activator-Treated Stroke Patients and on Door-to-Needle Time
Authors: Minnerup Jens , Wersching Heike , Ringelstein E. Bernd , Schilling Matthias , Schäbitz Wolf-Rüdiger , Wellmann Jürgen , Berger Klaus 
Published: August 2011

Background and Purpose—
The European Cooperative Acute Stroke Study (ECASS) III extended the thrombolysis time window for patients with stroke from 3 to 4.5 hours after symptom onset. We investigated the effect of the extended thrombolysis time window on the proportion of recombinant tissue-type plasminogen activator-treated stroke patients and on the time of treatment initiation after hospital arrival.

Methods—
The present study was based on a prospective database of 93 hospitals of the Stroke Register of Northwestern Germany, which included 91 805 patients with ischemic stroke admitted between January 2007 and December 2009. Main outcome measures were the use of recombinant tissue-type plasminogen activator among patients with stroke and the door-to-needle time before and after the publication of ECASS III in September 2008 and subsequent changes of the German guidelines in May 2009.

Results—
Overall, 9262 patients (10.1%) were treated with recombinant tissue-type plasminogen activator. The proportion of thrombolyzed patients increased from 8.6% in 2007 to 11.7% in 2009. This increase was pronounced for patients admitted between 3 and 6 hours after symptom onset after the third quarter of 2008 (OR, 1.88; 95% CI, 1.24 to 2.85) and after the second and third quarters of 2009 (OR, 2.50; 95% CI, 1.69 to 3.69 and OR, 3.02; 95% CI, 2.07 to 4.41) compared with the first half year 2007. The proportion of patients with stroke with a door-to-needle time <60 minutes increased after publication of ECASS III (OR, 1.49; 95% CI, 1.37 to 1.63).

Conclusions—
Results of ECASS III were rapidly implemented in routine stroke care. Concerns of a delay in recombinant tissue-type plasminogen activator treatment initiation after the extension of the thrombolysis time window were not confirmed.
The Inclusion of Stroke in Risk Stratification for Primary Prevention of Vascular Events
Authors: Dhamoon Mandip S. , Moon Yeseon Park , Paik Myunghee C. , Sacco Ralph L. , Elkind Mitchell S.V. 
Published: August 2011

Background and Purpose—
The Framingham coronary heart disease (CHD) risk score estimates 10-year risk of myocardial infarction (MI) and CHD death. Because preventive approaches to CHD and stroke are similar, a composite outcome may be more appropriate. We compared 10-year risk of (1) MI or CHD death; and (2) stroke, MI, or CHD death among individuals free of vascular disease.

Methods—
The Northern Manhattan Study contains a prospective, population-based study of stroke- and CHD-free individuals ≥40 years of age followed for a median of 10 years for vascular events. Framingham coronary heart disease risk score was calculated for each individual and for each category of predicted risk, Kaplan–Meier observed 10-year cumulative probabilities were calculated for (1) MI or CHD death; and (2) stroke, MI, or CHD death. The cumulative probability of (1) was subtracted from (2), and 95% CIs for the difference were obtained with 1000 bootstrap samples. Using stratified analyses by race–ethnicity, we compared risk differences among race–ethnic groups.

Results—

Among 2613 participants (53% Hispanic, 25% non-Hispanic black, and 20% non-Hispanic white), observed 10-year risk of MI or CHD death was 14.20%. With stroke in the outcome, observed risk was 21.98% (absolute risk difference, 7.78%; 95% CI, 5.86% to 9.75%). The absolute risk difference among blacks was significantly larger than among whites (
P
=0.01).

Conclusions—
In this multiethnic urban population, adding stroke to the risk stratification outcome cluster resulted in a 55% relative increase in estimated risk and crossing of the absolute risk threshold (>20% over 10 years) considered for preventive treatments such as statins.
Stroke Treatment Academic Industry Roundtable (STAIR) Recommendations for Maximizing the Use of Intravenous Thrombolytics and Expanding Treatment Options With Intra-arterial and Neuroprotective Therapies
Authors: Albers Gregory W. , Goldstein Larry B. , Hess David C. , Wechsler Lawrence R. , Furie Karen L. , Gorelick Philip B. , Hurn Patty , Liebeskind David S. , Nogueira Raul G. , Saver Jeffrey L. ,   for the STAIR VII Consortium
Published: August 2011

Background and Purpose—
The goal of the Stroke Treatment Academic Industry Roundtable (STAIR) meetings is to advance the development of acute and restorative stroke therapies.

Summary of Review—
At the STAIR VII recommendations for strategies to maximize the use of intravenous thrombolytics through targeting public education, and the refinement of current treatment exclusion criteria were proposed. Increased utilization of mechanical devices for intra-arterial recanalization can be achieved by obtaining more definitive evidence of efficacy in randomized clinical trials, identification of patient characteristics associated with treatment efficacy, optimization of technical approaches, clarification of effective time windows, and development of approaches to limit complications. Neuroprotective strategies remain viable; recommendations for further study of these agents include an emphasis on rapid administration, consideration of the systemic effects of ischemic stroke, prevention of complications associated with early reperfusion, a focus on agents with multiple mechanisms of action, and consideration of possible interactions between neuroprotective and thrombolytic therapies.

Conclusions—
Extending intravenous thrombolysis to a broader patient population, clarifying the risk and benefits of intra-arterial reperfusion therapies, and further development of neuroprotective therapies were the key recommendations from STAIR VII.
Punishment for Genocide – Exploratory Analysis of ICTR Sentencing
Authors: Hola Barbora , Bijleveld Catrien , Smeulers Alette 
Published: August 2011

AbstractThe sentencing practice of the International Criminal Tribunal for Rwanda (ICTR) is a relatively neglected topic in academic discussions. The few empirical studies on sentencing of international crimes have focused primarily on the sentencing practice of its 'sister court', the International Criminal Tribunal for the Former Yugoslavia (ICTY). Unlike ICTY defendants, almost all ICTR defendants have been convicted of and sentenced for genocide – arguably the most serious international crime. This empirical study examines the sentencing practice of the ICTR and analyses the relationship between sentence severity and the primary consideration in sentencing – crime gravity. The relevant principles stemming from ICTR case law are reviewed, followed by an examination of the interrelationship between sentence severity and factors relating to crime gravity, such as category of crime, scale of crime and the form and degree of a defendant's involvement in the crime. The ICTR judges appear in most cases to follow the main principles emphasized in their case law, with sentences gradated in line with the increasing seriousness of defendants' crimes and their culpability.
Modelling and economic optimisation of under-floor heating system
Authors: Sanaye Sepehr , Mahmoudimehr Javad , Aynechi Mohsen 
Published: August 2011

Modelling and optimisation of the under-floor heating system (UFHS) with Pex pipes are studied in this paper. For modelling the system, two regions were considered. The first one was the over-floor region which included room air and walls. This region was considered as one control volume and the system of non-linear energy equations for room air and walls were solved using Newton–Raphson method. The second or under-floor region included heating pipes, concrete and floor finish. This region was modelled using finite volume method. For optimising the UFHS, an objective function (sum of investment and operating costs of UFHS) was proposed and type and thickness of the floor finish, velocity of hot water passing through the pipe, concrete thickness and pipe diameter, were considered as the decision variables (design parameters). The sensitivity analysis showed 19.8%, 10.5%, 2.8% and 0.3% increase in the objective function with the deviation of the four above-mentioned design parameters from their optimum values (floor finish from tile to marble, water velocity from 1.5 to 2.5 m/s, concrete thickness from 6 to 8 cm and pipe diameter from ½ to ¾ in.). Finally, with the decrease in external temperature from −10°C to −20°C, the objective function increased by 21.7% and the required floor heat flux increased by 33.1%. Increasing the insulation thickness from 2.5 to 7 cm also decreased the objective function by 20.5% and decreased the required floor heat flux by 38.5%. Practical application: A new and fast combined numerical and analytical procedure for thermal modelling of UFHS was proposed in this paper. By applying the proposed modelling procedure, the optimum values of UHFS design parameters for reaching the system lowest cost were obtained. The variation of total cost with deviation of design parameters from their optimum values was investigated. The effects of change in atmospheric temperature and wall insulation thickness on building thermal load and the total cost were studied.
The effect of sound on office productivity
Authors: Mak CM , Lui YP 
Published: August 2011

This article reports the results of a questionnaire survey examining the effects of sound on office productivity and assessing the relationship between changes in office productivity and noise sources as well as five environmental and office design factors, namely temperature, air quality, office layout, sound and lighting. The convenience sample for the survey comprised 259 office workers in 38 air-conditioned offices in Hong Kong. The subjects were requested to complete the questionnaires themselves. The results show that among the five environmental and office design factors examined, sound and temperature were the principal factors affecting office productivity. A strong and significant correlation was also found between changes in office productivity and sound, temperature and office layout. Participants were separated into low- and high-productivity groups using the mean productivity score of all participants as the cut-point. The three most annoying noise sources, including conversation, ringing phones and machines, differed little in mean annoyance scores for the low- and high-productivity participants, indicating that they had a significant negative impact on all participants. The results also indicate that low-productivity participants were easily influenced by noises such as background noise, closing doors, and human activity, as well as those coming from both inside and outside the office. Practical applications: This study evaluates the effects of sound and other environmental and office design factors on office productivity. It suggests that sound is a principal factor affecting office productivity in modern air-conditioned offices.
Reliability analysis of elevator car frame using analytical and finite element methods
Authors: Onur Yusuf Aytaç , İmrak C Erdem 
Published: August 2011

The aim of this study is to determine the values of stress and deformation occurring on elevator car frame components with finite element and analytical methods. Two analytical approaches have been used to obtain the mechanical behaviours of elevator car frame components. Different design parameters have been used to show fluctuation of safety factors, stress and deformation values occurring on elevator car frame components. Optimisations of vertical and crosshead beams have been performed by the finite element method in order to attain optimum weight and stress reduction. It is found that the most critical component of elevator car frame is the crosshead beam when elevator is overloaded. Practical applications: This article presents the stress and deformation values on car frame components depending on the number of passengers for elevator designed for five passengers. Safety factors have been presented for car frame components separately when the elevator is overloaded. The allowable maximum load capacities of car frame components designed for five passengers have been presented.
The Effects of Betahistine in Addition to Epley Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo
Authors: Guneri Enis Alpin , Kustutan Ozge 
Published: August 2011

ObjectiveThe purpose of this study is to evaluate the effects of betahistine in addition to Epley maneuver on the quality of life of patients with posterior semicircular canal benign paroxysmal positional vertigo (BPPV) of the canalithiasis type.Study DesignDouble‐blind, randomized, controlled clinical trial.SettingAcademic university hospital.Subjects and MethodsSeventy‐two patients were enrolled in the study. The first group was treated with Epley maneuver only. The second group received placebo drug 2 times daily for 1 week in addition to Epley maneuver, and the third group received 24 mg betahistine 2 times daily for 1 week in addition to Epley maneuver. The effectiveness of the treatments was assessed in each group as well as between them by analyzing and comparing data of 4 different vertigo symptom scales.ResultsEpley maneuver, alone or combined with betahistine or placebo, was found to be very effective with a primary success rate of 86.2%. The symptoms were significantly reduced in group 3 patients overall, and those patients younger or older than 50 years of age who had hypertension, with symptom onset <1 month, and with attack duration of less than a minute did significantly better with the combination of betahistine 48 mg daily.ConclusionBetahistine in addition to Epley maneuver is more effective than Epley maneuver alone or combined with placebo with regard to improvement of symptoms in certain patients. However, future clinical studies covering more patients to investigate the benefit of medical treatments in addition to Epley maneuver are needed.
Seeking professional help for mental health problems, among New Zealand secondary school students
Authors: Mariu Kimberley R. , Merry Sally N. , Robinson Elizabeth M. , Watson Peter D. 
Published: August 2011

Objective: Our aim was to investigate whether secondary school students with mental health problems sought help from general practitioners and to investigate whether mental illness type, socio-demographic variables, family, school and community factors were associated with seeking help. Method: A randomly selected sample of 9699 secondary school students from across New Zealand participated in the Youth2000 Health and Wellbeing Survey. Data analysis included uni-variate and regression analyses. Results: Having symptoms of anxiety (p<0.0001), depression (p<0.0001), and suicidal thoughts (p<0.0001) were associated with help seeking. However, 82%of students who had significant mental health problems had not sought help from a general practitioner. Rates of help seeking increased with age for girls and decreased with age for boys. Seeking help for mental health problems was also associated with living in a single parent family (p<0.0001), living in an over-crowded house (p=0.0006), and being well known by a teacher (p=0.0004). Conclusions: The majority of New Zealand secondary school students with mental health problems do not obtain the help they need from general practitioners. Given the prevalence of mental health problems, it is important to find ways of identifying adolescents with difficulties and encouraging them to seek help.
Nigerian secondary school children’s knowledge of and attitudes to mental health and illness
Authors: Dogra Nisha , Omigbodun Olayinka , Adedokun Tunde , Bella Tolulope , Ronzoni Pablo , Adesokan Adekunle 
Published: August 2011

Background: Children tend to lack knowledge of, and hold negative attitudes towards mental illness. However, most of the work undertaken in Nigeria has been done with adults. Aims: To establish the views and knowledge about mental health and illness in pupils at four secondary schools in rural and urban Southwest Nigeria. Methods: A cross-sectional survey based on a questionnaire previously used in the UK and adapted to Nigeria. Results: Data from 145 Nigerian schoolchildren showed little knowledge of, negative attitudes and social distance towards persons with mental health problems. Urban participants and boys appeared less knowledgeable than rural children and girls. Conclusions: Nigerian schoolchildren, as with Nigerian adults and young people in Western countries, show stigma towards mental illness. This may be underpinned by a lack of knowledge regarding mental health problems. Educational interventions need to be appropriate to area, age and gender to effectively improve mental health literacy, which in turn will influence attitudes and social distance. However, the fact that the schoolchildren were optimistic about recovery is a strength that could be built upon.
Leadership development: Applying the same leadership theories and development practices to different contexts?
Authors: Pinnington Ashly H. 
Published: August 2011

This paper examines leadership development in the public, private and not-for-profit sectors and assesses the extent that they constitute distinctive contexts for leadership approaches and practices. The results of an empirical survey issued in one country provides some evidence for sector differences whereby leadership is conceptualized and practised with a greater emphasis placed on normative, ethical considerations in the public and not-for-profit sectors. Leadership development in the private sector is more strongly motivated by instrumental economic concerns. Whilst this sector difference is not new or surprising, the potential for greater sectoral distinctiveness in leadership approaches and their development warrants more discussion by academics and practitioners in leadership development. This study of leadership development examines five leadership approaches (charismatic, transformational, authentic, servant and spiritual) and six common leadership development practices (360 degree feedback, mentoring, coaching, networks, job assignment and action learning). Leadership development practices are similar across the private, public and not-for-profit sectors. Furthermore, charismatic and transformational approaches do not appear to discriminate effectively between private and public sector leadership. However, interpretation of the data strongly suggests that leadership theories and practices should be more flexible to the sectoral contexts. Private sector models of leadership development superficially appear to be adequate in so far as they share substantial commonality with the public and not-for-profit sectors in their development practices. However, respondents from the public and not-for-profit sectors are less convinced by the importance of some of the private sector 's approaches and its dominant values such as preparedness to facilitate the leaders’ confidence and power to create effective leadership. This distinction requires further investigation in future research on theories, practices and contexts for leadership development.
Customers’ perspectives on the impact of the Pathways to Work Condition Management Programme on their health, well-being and vocational activity
Authors: Secker Jenny , Pittam Gail , Ford Fiona 
Published: August 2011

Aims: Pathways to Work is a UK initiative aimed at supporting customers on incapacity benefits to return to work. This qualitative study complements previous evaluations of Pathways to Work by exploring customers’ perceptions of the impact of the Condition Management Programme (CMP) offered to claimants with long-term health conditions. Methods: 39 customers took part in focus groups held at the seven sites where Pathways was originally piloted. The main focus of the discussions was on perceptions of the ways in which participation had impacted on health, well-being and return to work. The discussions were audio-recorded and fully transcribed for analysis using a text analysis framework to enable the development and refinement of categories and overarching patterns in the data. Results: Perceived impacts on health and well-being included a more positive outlook, social contact, changed perceptions of conditions and improvements in health. Some customers also reported an increase in their vocational activity and others felt ready to embark on new activities. Factors associated with positive outcomes included the extent and quality of contact with CMP staff and practical advice about condition management. Factors impeding positive employment outcomes related mainly to obstacles to returning to work. Conclusions: The results indicated that CMP can assist customers to learn about and manage their health conditions and increase their vocational activity, and that CMP therefore provides a promising means of enabling people with long-term health conditions to regain a fulfilling, productive life.
Breastfeeding is associated with increased lung function at 18 years of age: a cohort study
Authors: Soto-Ramírez N. , Alexander M. , Karmaus W. , Yousefi M. , Zhang H. , Kurukulaaratchy R.J. , Raza A. , Mitchell F. , Ewart S. , Arshad S.H. 
Published: August 2011

Breastfeeding has been linked with increased forced vital capacity (FVC) in children but not in older adolescents. Our aim was to investigate the effects of breastfeeding duration and infant weight gain on FVC in both developmental periods.In a birth cohort, information on breastfeeding duration was collected at 1 and 2 yrs; spirometric tests were conducted at 10 and 18 yrs. To estimate the effect of breastfeeding duration on FVC at 18 yrs of age, we used linear models; to analyse repeated FVC measurements at 10 and 18 yrs of age, we used linear mixed models. Links between breastfeeding, infant weight gain and FVC at 10 and 18 yrs of age were analysed through path analyses.Among 808 breastfed children, 49% were breastfed for ≥4 months. At 18 yrs of age the augmenting effect of breastfeeding on FVC was reduced with increased height. Linear mixed models identified that breastfeeding duration was associated with increased FVC. Path analysis suggested a direct effect of breastfeeding on FVC at 10 yrs of age, but an indirect effect at 18 yrs of ageviaFVC at 10 yrs of age. Although inversely related to breastfeeding, a higher weight gain in infants led to taller adolescents and, in turn, resulted in increased FVC.In conclusion, a longer duration of breastfeeding contributes to lung health in childhood and adolescence.