bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Thrombolysis on Stroke Outcome at 12 Months in a Population
Authors: Fischer Urs , Mono Marie-Luise , Zwahlen Marcel , Nedeltchev Krassen , Arnold Marcel , Galimanis Aekatarini , Bucher Sabine , Findling Oliver , Meier Niklaus , Brekenfeld Caspar , Gralla Jan , Heller Regula , Tschannen Beatrice , Schaad Heinz , Waldegg Gabriel , Zehnder Thomas , Ronsdorf Anke , Oswald Phillip , Brunner Georg , Schroth Gerhard , Mattle Heinrich P. ,   for the QABE investigators
Published: March 2012

Background and Purpose—
Thrombolysis improves outcome of patients with acute ischemic stroke, but it is unknown whether thrombolysis has a measurable effect on long-term outcome in a defined population.

Methods—
We prospectively assessed demographic data, management, and outcome of acute ischemic stroke patients admitted within 48 hours to 18 primary care hospitals of the canton of Bern (969 299 inhabitants) during 12 months. Blinded follow-up was obtained at 3 and 12 months. Predictors of mortality and favorable outcome (modified Rankin Scale score ≤2) at 3 and 12 months using logistic regression were analyzed.

Results—
From December 2007 to December 2008, 807 patients (mean age, 72 years) were included. Median National Institutes of Health Stroke Scale score on admission was 5; 107 patients (13%) received intravenous, intra-arterial, or mechanical thrombolysis. Estimated cumulative mortality at 3 months was 20.6% and at 12 months 27.4%. Age 75 years or older, higher National Institutes of Health Stroke Scale scores, and higher Charlson comorbidity index were independent predictors of mortality at 3 and 12 months. Estimated favorable outcome at 3 months was 48.2% and at 12 months was 44.6%. Thrombolysis was the only modifiable independent predictor of favorable outcome at 3 (relative risk, 1.49; 95% CI, 1.18–1.89) and 12 months (relative risk, 1.59; 95% CI, 1.24–2.04), whereas age younger than 75 years, male gender, National Institutes of Health Stroke Scale score <4, and lower Charlson comorbidity index were nonmodifiable predictors.

Conclusions—
Thirteen percent of acute ischemic stroke patients admitted within 48 hours to Bernese hospitals underwent thrombolysis, which exerted a measurable effect on 3-month outcome in this population. This effect was sustained at 12 months. Age, stroke severity, Charlson comorbidity index, and male gender were independent nonmodifiable predictors of outcome.
Noncompliance With Certain Quality Indicators Is Associated With Risk-Adjusted Mortality After Stroke
Authors: Abilleira Sònia , Ribera Aida , Permanyer-Miralda Gaietà , Tresserras Ricard , Gallofré Miquel 
Published: March 2012

Background and Purpose—
To investigate the 30-day and 12-month mortality risks among hospitalized stroke patients according to compliance with guideline-based process indicators.

Methods—
We used data from the Second Stroke Audit and the Mortality Register of Catalonia (Spain). The audit retrospectively explored quality of stroke care based on compliance with indicators among patients discharged from all public hospitals in Catalonia in 2007; they were identified and selected through a pre-established sampling method. The magnitude of the independent association of each indicator with 30-day and 12-month mortality was assessed using logistic regression with generalized estimating equations to account for clustering of patients within hospitals. Generalized estimating equations modeling was initially restricted to patients alive >72 hours poststroke to control for confounding by severity. Analyses were also run in 3 other samples (all patients, patients alive >7 days, and patients alive >14 days).

Results—
Of 1767 stroke admissions in the Second Stroke Audit, 1697 patients survived >72 hours poststroke. Within this sample, the adjusted 30-day mortality risk was negatively associated with nonadherence to different indicators, of which only antithrombotics at discharge (OR, 4.3; 95% CI, 1.72–10.78) remained significant in all data sets. At 12 months, the adjusted mortality risk was negatively associated with management of hypertension (OR, 1.87; 95% CI, 1.22–2.86) and antithrombotics at discharge (OR, 2.79; 95% CI, 1.41–5.54). Both remained unchanged across different samples.

Conclusions—
Assessing the impact of quality of stroke care on mortality is complex and is hampered by residual confounding, particularly in the short-term. Nevertheless, this study suggests that at least a few indicators should be used to monitor quality of stroke services.
Initial Lesion Volume Is an Independent Predictor of Clinical Stroke Outcome at Day 90
Authors: Vogt Gerhard , Laage Rico , Shuaib Ashfaq , Schneider Armin 
Published: March 2012

Background and Purpose—
Age and National Institutes of Health Stroke Scale early after stroke onset have been identified as important determinants of final stroke outcome. We analyzed the Virtual International Stroke Trials Archive (VISTA) database to define the influence of infarct or hemorrhagic volume on clinical outcome after stroke.

Methods—
All patients were extracted from VISTA where infarct or hemorrhage volume information was available (n=2538; most images obtained by CT within 72 hours after stroke onset with a subset of MRI data included, volumes calculated by the ABC/2 approximation method). We used multivariate regression models to study the influence of age, National Institutes of Health Stroke Scale at baseline, and initial infarct/hemorrhage volume on clinical outcome (modified Rankin Scale, National Institutes of Health Stroke Scale, mortality) at day 90.

Results—

We find that in a large cohort of >1800 patients with ischemic stroke, initial lesion size is a strong and independent predictor of stroke outcome in a statistical regression model that also accounts for age and National Institutes of Health Stroke Scale at baseline (
P
<0.0001). The use of infarct/hemorrhage volume as an additional predictive factor further reduces the fraction of unexplained variance in outcome by approximately 15% (
R
2
of 0.41 versus 0.26 in a model without lesion volume). The predictive strength of initial lesion size is only marginally influenced by image modality or time point of image acquisition within the first 72 hours. The model was equally valid for both ischemic and hemorrhagic strokes.

Conclusions—
Infarct/hemorrhage volume at baseline together with age and National Institutes of Health Stroke Scale at baseline should be used in the effect analysis of future therapeutic stroke trials to improve power.
Randomized Trial of Clazosentan in Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Endovascular Coiling
Authors: Macdonald R. Loch , Higashida Randall T. , Keller Emanuela , Mayer Stephan A. , Molyneux Andy , Raabe Andreas , Vajkoczy Peter , Wanke Isabel , Bach Doris , Frey Aline , Nowbakht Pegah , Roux Sébastien , Kassell Neal 
Published: March 2012

Background and Purpose—
Clazosentan, an endothelin receptor antagonist, has been shown to reduce vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). CONSCIOUS-3 assessed whether clazosentan reduced vasospasm-related morbidity and all-cause mortality postaSAH secured by endovascular coiling.

Methods—
This double-blind, placebo-controlled, phase III trial randomized patients with aSAH secured by endovascular coiling to ≤14 days intravenous clazosentan (5 or 15 mg/h) or placebo. The primary composite end point (all-cause mortality; vasospasm-related new cerebral infarcts or delayed ischemic neurological deficits; rescue therapy for vasospasm) was evaluated 6 weeks postaSAH. The main secondary end point was dichotomized extended Glasgow Outcome Scale (week 12).

Results—

CONSCIOUS-3 was halted prematurely following completion of CONSCIOUS-2; 577/1500 of planned patients (38%) were enrolled and 571 were treated (placebo, n=189; clazosentan 5 mg/h, n=194; clazosentan 15 mg/h, n=188). The primary end point occurred in 50/189 of placebo-treated patients (27%), compared with 47/194 patients (24%) treated with clazosentan 5 mg/h (odds ratio [OR], 0.786; 95% CI, 0.479–1.289;
P=
0.340), and 28/188 patients (15%) treated with clazosentan 15 mg/h (OR, 0.474; 95% CI, 0.275–0.818;
P=
0.007). Poor outcome (extended Glasgow Outcome Scale score ≤4) occurred in 24% of patients with placebo, 25% of patients with clazosentan 5 mg/h (OR, 0.918; 95% CI, 0.546–1.544;
P=
0.748), and 28% of patients with clazosentan 15 mg/h (OR, 1.337; 95% CI, 0.802–2.227;
P=
0.266). Pulmonary complications, anemia, and hypotension were more common in patients who received clazosentan than in those who received placebo. At week 12, mortality was 6%, 4%, and 6% with placebo, clazosentan 5 mg/h, and clazosentan 15 mg/h, respectively.

Conclusions—
Clazosentan 15 mg/h significantly reduced postaSAH vasospasm-related morbidity/all-cause mortality; however, neither dose improved outcome (extended Glasgow Outcome Scale).

Clinical Trial Registration—

URL:
http://clinicaltrials.gov
. Unique identifier: NCT00940095.
The Push for Precedent in Russia's Judicial System
Authors: Gutbrod Max , Pomeranz William 
Published: March 2012

AbstractRussia is currently undergoing a spirited public debate over the role of precedent in a civil-law system. This article examines this debate from a theoretical and practical standpoint, exploring the nature of Russian court decisions and the extent to which they correspond to the Anglo-American theory of precedent. The article further analyzes how the Russian Higher Arbitrazh Court has carved out a narrow right to issue binding precedent and how this authority could impact Russia's civil-law understanding of such concepts as separation of powers and judicial independence.
Law as a Programming Language
Authors: Lisachenko Alexey V. 
Published: March 2012

AbstractThe author draws a parallel between the world of law and the world of the computer. Law accordingly can be seen as a collection of programs, as a programming language—as a programming environment of human society. In this article, the social roles are highlighted in this tripartite system, and the author points to the dangers of turning law from something humanistic into something mechanistic.
Mother of the Gods: Goddess of Power and Protector of Cities
Authors: Bøgh Birgitte 
Published: March 2012

AbstractThe article presents a survey of the roles and status of Meter’s cult in the western Black Sea area, her reception in the archaic period, and the subsequent development of the goddess’s characteristics. Based on new scholarship on the goddess’s roles and status in Phrygia, and taking as a starting point an analysis of a selected number of archaeological Meter objects from the Black Sea region, it will be argued that Meter in this area throughout the centuries functioned as, primarily, a goddess of power, a protector of cities, and a goddess of the elite — the very traits that also characterised her cult in Phrygia. Furthermore, it is suggested that Meter, because of these traits, was eagerly embraced by official authorities outside the Black Sea area also, and that hence they were the primary reason for her early presence in Athens and later in Rome.
Institutional Design for Collective Action: Tweaking the Rules of the Game for the Common Good
Authors: Meyer Heinz-Dieter 
Published: March 2012

Abstract
At present, institutional design is an under-theorized and underdeveloped part of the social sciences. In this paper I focus on designs for situations of collective action where the outcome is controlled by the choices of several self-interested actors. In those situations the goal of institutional design is to alter the rules of the game so that self-interested actors find it rational to cooperate. I explore the viability of that definition by considering two examples of institutional design: urban safety and academic peer review. I discuss the implications of my findings for our conception of rational self-interest and propose that three design principles – publicity, boundaries, and contiguity – can be inferred from the analysis.
Is World Bank “Good Governance” Good for the Poor? Central American Experiences
Authors: Horton Lynn 
Published: March 2012

AbstractThis paper explores the World Bank’s concept of “good governance” as applied in rural Central America. It argues that World Bank good governance seeks to constrain unequal accumulation and privilege in the public sector, but leaves largely unaddressed structural inequalities in the private sector and the conflation of economic and political power in the public sector. This paper suggests that the World Bank analysis does not adequately consider more embedded state/civil society relations linked to national and sub-national political cultures. In contexts in which nation-building projects have promoted forms citizenship linked to more activist “leveling” and paternalistic states, good governance is likely to be ideologically contested. World Bank good governance under these circumstances is unlikely to quell discontent or naturalize the neoliberal state.
Theology as an Intellectual Vocation: Some Thoughts on the Theo-logical Vision of Simone Weil*
Authors: Bingemer Maria Clara Lucchetti 
Published: March 2012

Abstract
The French philosopher Simone Weil always understood her privileged access to the intellectual world as a ‘terrible’ responsibility, and at the same time as a way opened for the service she was called to provide to society, particularly to the oppressed and the unfortunate in its midst. Her life, experience and reflection are the content of this article. The experience and reflection of Weil can be understood as theo-logy, as it is and wants to be a permanent search and encounter with truth, which at a certain point of her life she will identify with the God of Jesus Christ. The consequences of this ‘theo-logy’ for the public space generate a true ‘fundamental public theology’, especially in the domain of intelligence and culture. Weil’s thought can be considered an important contribution for what we understand today, dynamically, as ‘public theology’; that is, a presence of faith in the world of science and thinking.
The Church and Society Movement and the Roots of Public Theology in Brazilian Protestantism*
Authors: Barreto Raimundo 
Published: March 2012

Abstract
Brazilian Protestantism in its origins tended to develop a kind of pietistic and individualistic spirituality without much concern with the social structures of Brazilian society. Nevertheless, in its historical relation with a reality marked by poverty, social injustice and oppression, some Brazilian Protestants began to develop a sense of social responsibility and social justice, which has been manifest in different ways. This article is an overview of the first attempt from a Protestant viewpoint to develop a public theological discourse in Brazil, during the 1950s and early 1960s. It focuses on the Religion and Society movement, which not only preceded liberation theology in Latin America, but also dialogued with liberationist thought and influenced it, as well as other later public discourses among Catholics and Protestants in Latin America. Richard Shaull was the first significant organic intellectual who mediated the dialogue between European/North American theologies and the Latin American public theology, which was in the making.
Forecast Skill and Predictability of Observed Atlantic Sea Surface Temperatures
Authors: Zanna Laure 
Published: March 2012

Abstract
An empirical statistical model is constructed to assess the forecast skill and the linear predictability of Atlantic Ocean sea surface temperature (SST) variability. Linear inverse modeling (LIM) is used to build a dynamically based statistical model using observed Atlantic SST anomalies between latitudes 20°S and 66°N from 1870 to 2009. LIM allows one to fit a multivariate red-noise model to the observed annually averaged SST anomalies and to test it. Forecast skill is assessed and is shown to be O(3–5 yr). After a few years, the skill is greatly reduced, especially in the subpolar region. In the stable dynamical system determined by LIM, skill of annual average SST anomalies arises from four damped eigenmodes. The four eigenmodes are shown to be relevant in particular for the optimal growth events of SST variance, with a pattern reminiscent of the low-frequency mode of variability, and in general for the predictability and variability of Atlantic SSTs on interannual time scales. LIM might serve as a useful benchmark for interannual and decadal forecasts of SST anomalies that are based on numerical models.
Carbon Monoxide Urban Emission Monitoring: A Ground-Based FTIR Case Study
Authors: Té Y. , Dieudonné E. , Jeseck P. , Hase F. , Hadji-Lazaro J. , Clerbaux C. , Ravetta F. , Payan S. , Pépin I. , Hurtmans D. , Pelon J. , Camy-Peyret C. 
Published: March 2012

Abstract
The characterization and the precise measurements of atmospheric pollutant’s concentration are essential to improve the understanding and modeling of urban air pollution processes. The QualAir platform at the Université Pierre et Marie Curie (UPMC) is an experimental research platform dedicated to urban air quality and pollution studies. As one of the major instruments, the ground-based QualAir Fourier transform spectrometer (FTS) provides information on the air composition of a megacity like Paris, France. Operating in solar infrared absorption, it enables the monitoring of several important pollutants involved in tropospheric chemistry and atmospheric transport around the Ile de France region. Results on nitrous oxide (N2O), methane (CH4), and carbon monoxide (CO) will be presented in this paper, as well as the CO measurements comparison with satellite and in situ measurements showing the capabilities and strengths of this ground-based FTS with the other instruments of the QualAir platform.
Localization and Sampling Error Correction in Ensemble Kalman Filter Data Assimilation
Authors: Anderson Jeffrey L. 
Published: March 2012

AbstractEnsemble Kalman filters use the sample covariance of an observation and a model state variable to update a prior estimate of the state variable. The sample covariance can be suboptimal as a result of small ensemble size, model error, model nonlinearity, and other factors. The most common algorithms for dealing with these deficiencies are inflation and covariance localization. A statistical model of errors in ensemble Kalman filter sample covariances is described and leads to an algorithm that reduces ensemble filter root-mean-square error for some applications. This sampling error correction algorithm uses prior information about the distribution of the correlation between an observation and a state variable. Offline Monte Carlo simulation is used to build a lookup table that contains a correction factor between 0 and 1 depending on the ensemble size and the ensemble sample correlation. Correction factors are applied like a traditional localization for each pair of observations and state variables during an ensemble assimilation. The algorithm is applied to two low-order models and reduces the sensitivity of the ensemble assimilation error to the strength of traditional localization. When tested in perfect model experiments in a larger model, the dynamical core of a general circulation model, the sampling error correction algorithm produces analyses that are closer to the truth and also reduces sensitivity to traditional localization strength.
Initiation of Boreal Summer Intraseasonal Oscillation: Dynamic Contribution by Potential Vorticity
Authors: Seo Kyong-Hwan , Song Eun-Ji 
Published: March 2012

Abstract
Potential vorticity (PV) thinking conceptually connects the upper-level (upper troposphere in the extratropics and middle troposphere for the tropics) dynamical process to the lower-level process. Here, the initiation mechanism of the boreal summer intraseasonal oscillation (BSISO) in the tropics is investigated using PV thinking. The authors demonstrate that the midtropospheric PV anomaly produces a dynamical environment favorable for the BSISO initiation. Under seasonal easterly vertical wind shear, the PV anomaly enhances low-level convergence and upward motion at its western edge. Tropical PV forcing in the middle troposphere produces balanced mass and circulation fields that spread horizontally and vertically so that its effect can reach even the lowest troposphere. The downward influence of the midtropospheric PV forcing is one of the key aspects of the PV thinking. Direct piecewise PV inversions confirm that the anomalous lower-level zonal wind and its convergence necessary for the initiation of BSISO convection do not arise solely from the response to the lower-level PV forcing but from the summed contribution by PV forcing at all levels. About 50% of the low-level circulation variations result from PV forcing from 700 to 450 hPa, with the largest contribution from the 600–650-hPa PV anomalies for the convection initiation region over the western Indian Ocean. The current study is compared with and incorporated into the thermodynamic recharge process and the frictional moisture flux convergence mechanism for the BSISO initiation. This study is the first qualitative application of the PV thinking approach that reveals the BSISO dynamics.
Mobile, X-band, Polarimetric Doppler Radar Observations of the 4 May 2007 Greensburg, Kansas, Tornadic Supercell
Authors: Tanamachi Robin L. , Bluestein Howard B. , Houser Jana B. , Frasier Stephen J. , Hardwick Kery M. 
Published: March 2012

AbstractOn 4 May 2007, a supercell produced an EF-5 tornado that severely damaged the town of Greensburg, Kansas. Volumetric data were collected in the “Greensburg storm” by the University of Massachusetts X-band, mobile, polarimetric Doppler radar (UMass X-Pol) for 70 min; 10 tornadoes were detected. This mobile Doppler radar dataset is one of only a few documenting an EF-5 tornado and the supercell’s transition from short-track, cyclic tornado production (mode 1) to long-track tornado production (mode 2). Using bootstrap confidence intervals, it is determined that the mode-2 tornadoes moved in the same direction as the supercell vault. In contrast, the mode-1 tornadoes moved to the left with respect to the vault.From polarimetric data collected in this storm, the authors infer the presence of large, oblate drops (high ZDR, high ρhv) in the forward flank and surrounding some of the tornadoes. The authors speculate that the weak-echo column (WEC) in the Greensburg tornado, which extended above 10 km AGL, was caused primarily by the centrifuging of hydrometeors at low levels and rapid upward transport of relatively scatterer-free air at upper levels. This WEC was collocated at low levels with a low-ZDR, low-ρhv column, indicating lofted debris.Dual-Doppler analyses, generated at ~10-min intervals using data from UMass X-Pol and the Dodge City, Kansas, Weather Surveillance Radar-1988 Doppler (WSR-88D), were used to locate updrafts and downdrafts near the hook echo. In the immediate vicinity of tornadoes, diminished ZDR values downstream of analyzed downdrafts may indicate the ingestion by tornadoes of relatively small drops, fallout of larger drops, or a combination of both.