bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corrie Health Digital Platform for Self-Management in Secondary Prevention After Acute Myocardial Infarction
Authors: Spaulding Erin M. , Marvel Francoise A. , Lee Matthias A. , Yang William E. , Demo Ryan , Wang Jane , Xun Helen , Shah Lochan , Weng Daniel , Fashanu Oluwaseun E. , Carter Jocelyn , Sheidy Julie , McLin Renee , Flowers Jennifer , Majmudar Maulik , Elgin Eric , Vilarino Valerie , Lumelsky David , Bhardwaj Vinayak , Padula William , Allen Jerilyn K. , Martin Seth S. 
Published: May 2019

Background:
Unplanned readmissions after hospitalization for acute myocardial infarction are among the leading causes of preventable morbidity, mortality, and healthcare costs. Digital health interventions could be an effective tool in promoting self-management, adherence to guideline-directed therapy, and cardiovascular risk reduction. A digital health intervention developed at Johns Hopkins—the Corrie Health Digital Platform (Corrie)—includes the first cardiology Apple CareKit smartphone application, which is paired with an Apple Watch and iHealth Bluetooth-enabled blood pressure cuff. Corrie targets: (1) self-management of cardiac medications, (2) self-tracking of vital signs, (3) education about cardiovascular disease through articles and animated videos, and (4) care coordination that includes outpatient follow-up appointments.

Methods and Results:
The 3 phases of the MiCORE study (Myocardial infarction, Combined-device, Recovery Enhancement) include (1) the development of Corrie, (2) a pilot study to assess the usability and feasibility of Corrie, and (3) a prospective research study to primarily compare time to first readmission within 30 days postdischarge among patients with Corrie to patients in the historical standard of care comparison group. In Phase 2, the feasibility of deploying Corrie in an acute care setting was established among a sample of 60 patients with acute myocardial infarction. Phase 3 is ongoing and patients from 4 hospitals are being enrolled as early as possible during their hospital stay if they are 18 years or older, admitted with acute myocardial infarction (ST-segment–elevation myocardial infarction or type I non–ST-segment–elevation myocardial infarction), and own a smartphone. Patients are either being enrolled with their own personal devices or they are provided an iPhone and/or Apple Watch for the duration of the study. Phase 3 started in October 2017 and we aim to recruit 140 participants.

Conclusions:
This article will provide an in-depth understanding of the feasibility associated with implementing a digital health intervention in an acute care setting and the potential of Corrie as a self-management tool for acute myocardial infarction recovery.
Obesity-Stroke Paradox Exists in Insulin-Resistant Patients But Not Insulin Sensitive Patients
Authors: Xu Jie , Wang Anxin , Meng Xia , Jing Jing , Wang Yilong , Wang Yongjun ,   on behalf of the investigators for ACROSS-China†, Dong Qiang , Cui Liying , Zhou Shengnian , Yu Fengchun , Zhao Xingquan , Wang Chunxue , Zheng Huaguang , Jia Qian , zhou Yong , Liu Liping , Liu Gaifen , Wang Zhijiang , Wu Haibo , Sun Yuheng , Yu Fengchun , Sun Huashan , Li Jinying , Li Guozhong , Guo Li , Cao Yibin , Yuan Xiaodong , Li Juntao , Wu Yiping , Zhang Jiewen , Xu Yuming , Zhou Shengnian , Li Guanglai , Guo Minxia , Li Shuguang , Sun Shenggang , Wang Wei , Xiao Bo , Huang Renbin , Chen Kangning , Wu Xiaoping , Bai Qingke , Sun Xiaojiang , Li Xin , Gu Dexiang , Luo Benyan , Zheng Rongyuan , Cai Yefeng , Mo Xuean , Gao Li , Gao Xiaoping , Qi Chunbo , Gao Lianbo , Niu Jianping , Wu Yi , Shan Yimin 
Published: May 2019

Background and Purpose—
The underlying mechanisms of stroke-obesity paradox are still not fully understood. This study aims to investigate the contribution of insulin resistance to the association between body mass index and stroke outcomes.

Methods—
Patients with ischemic stroke without history of diabetes mellitus in the Abnormal Glucose Regulation in Patients With Acute Stroke Across-China registry were included. Overweight or obese was defined as body mass index ≥23, and the median of homeostasis model assessment–insulin resistance index was chosen as cutoff to define insulin resistance. Cox or logistic regression model was used to assess the interaction between body mass index and homeostasis model assessment–insulin resistance on 1-year prognosis (all-cause mortality and poor functional outcome defined as modified Rankin Scale score 3–6).

Results—

Of 1227 study participants, the median homeostasis model assessment–insulin resistance was 1.9 (interquartile range, 1.1–3.1) and 863 (70.3%) patients were classified as overweight or obese. Among insulin-resistant patients, overweight/obese patients experienced one-half of the risk of death after stroke than their low/normal weight counterparts (9.42% versus 17.69%, unadjusted hazard ratio, 0.50; 95% CI, 0.31–0.82), while among insulin-sensitive ones, no significant difference of mortality risk was found (7.58% versus 6.91%, 1.07; 0.57–1.99). Similar trends were observed for poor functional outcome. Results were similar after adjustments for confounders. There were significant interactions between body mass index and homeostasis model assessment–insulin resistance on the risks of mortality (
P
=0.045) and poor functional outcome (
P
=0.049).

Conclusions—
We observed the obesity paradox for mortality and functional outcome in insulin-resistant patients but did not find the obesity paradox in insulin-sensitive patients. Insulin resistance may be one of the mechanisms underlying the obesity paradox of the outcome in patients with ischemic stroke.
Ischemic Diffusion Lesion Reversal After Endovascular Treatment
Authors: Yoo Joonsang , Choi Jin Wook , Lee Seong-Joon , Hong Ji Man , Hong Jeong-Ho , Kim Chang-Hyun , Kim Yong-Won , Kang Dong-Hun , Kim Yong-Sun , Hwang Yang-Ha , Ovbiagele Bruce , Demchuk Andrew M. , Lee Jin Soo , Sohn Sung-Il 
Published: May 2019

Background and Purpose—
Several studies have reported partial reversal of diffusion-weighted imaging (DWI) lesions after acute stroke reperfusion treatment. However, factors associated with DWI reversal have not yet been systematically investigated. We evaluated the factors associated with DWI reversal after endovascular treatment (EVT).

Methods—
We retrospectively analyzed consecutively encountered patients with acute ischemic stroke who underwent EVT at 3 comprehensive stroke centers in Korea from January 2011 to February 2016. Patients who received EVT within 24 hours of anterior circulation infarction and had both baseline and follow-up DWIs were included. DWI reversal was defined as a decrease in DWI volume from baseline to follow-up. We compared the characteristics and outcomes between patients with and without DWI reversal and assessed independent factors associated with DWI reversal.

Results—

Of 720 patients encountered during the time period, 404 patients (56.1%) met the study criteria, with 63 patients (15.5%) showing DWI reversal after EVT. The mean time interval between baseline and follow-up DWI was 4.7±2.4 days. Mean baseline DWI volumes of patients with and without DWI reversal were 30.1±36.7 versus 22.0±30.7 mL (
P
=0.106), and follow-up DWI volumes were 17.8±24.9 versus 68.7±77.5 mL (
P
<0.001). Patients with DWI reversal showed better functional outcomes at 3 months than those without DWI reversal (modified Rankin Scale [interquartile range], 1 [0–3] versus 2 [1–4];
P
=0.001). In a multivariate analysis, complete reperfusion (odds ratio, 1.954; 95% CI, 1.063–3.582) and shorter time from baseline DWI to final reperfusion (odds ratio, 0.991; 95% CI, 0.983–0.998) were independently associated with DWI reversal.

Conclusions—
Complete reperfusion and shorter imaging time to recanalization were independently associated with DWI reversal among patients with acute ischemic stroke who received EVT.
Impacts of Small-Scale Urban Encroachment on Air Temperature Observations
Authors: Leeper Ronald D. , Kochendorfer John , Henderson Timothy A. , Palecki Michael A. 
Published: May 2019

AbstractA field experiment was performed in Oak Ridge, Tennessee, with four instrumented towers placed over grass at increasing distances (4, 30, 50, 124, and 300 m) from a built-up area. Stations were aligned in such a way to simulate the impact of small-scale encroachment on temperature observations. As expected, temperature observations were warmest for the site closest to the built environment with an average temperature difference of 0.31° and 0.24°C for aspirated and unaspirated sensors, respectively. Mean aspirated temperature differences were greater during the evening (0.47°C) than during the day (0.16°C). This was particularly true for evenings following greater daytime solar insolation (20+ MJ day−1) with surface winds from the direction of the built environment where mean differences exceeded 0.80°C. The impact of the built environment on air temperature diminished with distance with a warm bias only detectable out to tower B′ located 50 m away. The experimental findings were comparable to a known case of urban encroachment at a U.S. Climate Reference Network station in Kingston, Rhode Island. The experimental and operational results both lead to reductions in the diurnal temperature range of ~0.39°C for fan-aspirated sensors. Interestingly, the unaspirated sensor had a larger reduction in diurnal temperature range (DTR) of 0.48°C. These results suggest that small-scale urban encroachment within 50 m of a station can have important impacts on daily temperature extrema (maximum and minimum) with the magnitude of these differences dependent upon prevailing environmental conditions and sensing technology.
Relating the Diffusive Salt Flux just below the Ocean Surface to Boundary Freshwater and Salt Fluxes
Authors: Nurser A. J. George , Griffies Stephen M. 
Published: May 2019

AbstractWe detail the physical means whereby boundary transfers of freshwater and salt induce diffusive fluxes of salinity. Our considerations focus on the kinematic balance between the diffusive fluxes of salt and freshwater, with this balance imposed by mass conservation for an element of seawater. The flux balance leads to a specific balanced form for the diffusive salt flux immediately below the ocean surface and, in the Boussinesq approximation, to a specific form for the salinity flux. This balanced form should be used in specifying the surface boundary condition for the salinity equation and the contribution of freshwater to the buoyancy budget.
Detection of Ground Clutter for Dual-Polarization Weather Radar Using a Novel 3D Discriminant Function
Authors: Golbon-Haghighi Mohammad-Hossein , Zhang Guifu 
Published: May 2019

AbstractA novel 3D discriminant function is introduced as part of a ground clutter detection algorithm for improving weather radar observations. The 3D discriminant function utilizes the phase fluctuations of the received signals for horizontal and vertical polarizations and the dual-scan cross-correlation coefficient. An optimal decision based on the 3D discriminant function is made using a simple Bayesian classifier to distinguish clutter from weather signals. For convenience of use, a multivariate Gaussian mixture model is used to represent the probability density functions of discriminant functions. The model parameters are estimated based on the maximum likelihood using the expectation–maximization (ML-EM) method. The performance improvements are demonstrated by applying the proposed detection algorithm to radar data collected by the polarimetric Norman, Oklahoma (KOUN), weather radar. This algorithm is compared to other clutter detection algorithms and the results indicate that, using the proposed detection algorithm, a better probability of detection can be achieved.
Association between 25-OH-vitamin D and C-reactive protein as a marker of inflammation and cardiovascular risk in clinical practice
Authors: Hernández-Álvarez Elena , Pérez-Barrios Clara , Blanco-Navarro Inmaculada , Pérez-Sacristán Belén , Donoso-Navarro Encarnación , Silvestre Ramona A , Granado-Lorencio Fernando 
Published: May 2019

Background C-reactive protein is an acute phase response marker and, in an epidemiological context, a predictor of cardiovascular risk. 25-Hydroxy-vitamin D is the best indicator for vitamin D status, but it can be altered by the presence of acute phase response. Our aim was to evaluate the association between serum concentrations of 25-hydroxy-vitamin D and C-reactive protein to assist the interpretation of vitamin D status in a clinical context. Methods We evaluated retrospectively 5076 patients ( n = 4087 women) assessed for 25-hydroxy-vitamin D and C-reactive protein simultaneously. Subjects were classified according to the origin as hospitalized patients ( n = 410) and outpatients ( n = 4666). Outpatients included patients from specialized ( n = 3943) and primary ( n = 723) care. Serum 25-hydroxy-vitamin D was determined by using liquid chromatography and serum C-reactive protein by using immunoturbidimetry. Results Concentrations of 25-hydroxy-vitamin D and C-reactive protein were significantly different between hospitalized subjects and outpatients but not for specialized and primary care settings. Serum concentrations of 25-hydroxy-vitamin D decreased as C-reactive protein increased. Hospitalized patients with C-reactive protein concentrations >30 mg/L showed a significant reduction of 25-hydroxy-vitamin D. In outpatients with C-reactive protein within the reference range (≤10 mg/L), C-reactive protein concentrations were not significantly different for serum 25-hydroxy-vitamin D concentrations >37.5 nmol/L. Conclusions Our data question the reliability and usefulness of assessing 25-hydroxy-vitamin D status as a biomarker of nutritional status in patients displaying acute phase response, especially at concentrations of C-reactive protein >30 mg/L. In addition, the present study shows that in subjects displaying C-reactive protein values within the reference range, serum concentrations of 25-hydroxy-vitamin D >37.5 nmol/L were not associated with lower concentrations of cardiovascular risk (as assessed by C-reactive protein concentrations).
Labour migration of doctors and nurses and the impact on the quality of health care in Eastern European countries: The case of Poland
Authors: Żuk Piotr , Żuk Paweł , Lisiewicz-Jakubaszko Justyna 
Published: May 2019

The purpose of this commentary article is to explain the causes and effects of the economic migration of health care workers from Poland to Western countries, and to analyse the impact of the migration of doctors and nurses on the functioning of the public health system. We use data from the National Central Statistical Office, our own preliminary research, social surveys and the Watch Health Care database. Domestic data are analysed and compared with trends in Western Europe as described in Eurostat and Organisation for Economic Co-operation and Development reports. The decreasing number of active physicians remaining in the health care system results in long waits for specialist appointments. The demand for doctors from Central and Eastern Europe will continue to grow. Consequently, there will be a further outflow of medical staff from Poland and other countries in the region and the current problems with access to health care will continue. JEL Codes: I00, I11, J61
Predictive model for quality of life in patients with recurrent coronary artery disease
Authors: Jo Eunhee , Kim Sung Reul , Kim Hye Young 
Published: May 2019

Background: The aims of this study were to construct and verify a model that explains the quality of life in patients with recurrent coronary artery disease. Methods: Participants were 212 patients with recurrent coronary artery disease undergoing percutaneous coronary intervention. Data were collected through structured questionnaires from 21 December 2016–30 April 2017, and were analyzed using SPSS 23.0 and AMOS 23.0. Results: The model’s fit indices were adequate. Type D personality, symptom experience, and resilience had a direct effect on quality of life, while type D personality, cardiac function status, social support, and resilience had an indirect effect on quality of life. Type D personality, cardiac function status, social support, symptom experience, and resilience explained 55% of the total variance in quality of life. Thus, type D personality, cardiac function status, social support, symptom experience, and resilience affected the quality of life in patients with recurrent coronary artery disease. Conclusions: Systematic and integrated intervention programs considering factors related to quality of life may be useful for improving quality of life for patients with recurrent coronary artery disease.
Peripheral Arterial Endovascular Procedures Performed in a Non-Hospital-Based Facility by First-Year Vascular Surgery Fellows
Authors: Pineda Danielle M. , Calligaro Keith D. , Tyagi Sam , Troutman Douglas A. , Domenico Lou , Dougherty Matthew J. 
Published: May 2019

Objective: Traditionally, vascular surgery fellows (VSFs) have learned to perform peripheral arterial endovascular procedures in a hospital setting. Many vascular surgeons currently perform these procedures in an “outpatient” non-hospital-based setting. Loss of these cases from the hospital setting may impact vascular surgery fellowship endovascular volume. We assessed the safety of first-year VSFs performing peripheral endovascular procedures under the supervision of vascular surgery attending surgeons in a non-hospital-based facility. Methods: Between January 1, 2012, and December 31, 2016, 166 patients underwent 193 endovascular procedures in a non-hospital-based ambulatory facility: 136 interventions (65 femoral, 40 iliac, 13 popliteal, and 9 infrapopliteal arteries) and 31 diagnostic arteriograms for claudication (57.8%; 85), rest pain (11.6%; 17), tissue loss (12.9%; 19), and failing grafts (17.7%; 26). Interventions included balloon angioplasty alone in 8.8% (12/136) of cases, stents in 16.9% (23/136), covered stents in 14% (19/136), atherectomy in 60.3% (82/136), and mechanical thrombolysis in 0.7% (1/136). Results: First-year VSFs performed an increasing percentage of these procedures during this interval: academic year 2012 to 2013 = 0% (0/49), 2013 to 2014 = 31% (17/54), 2014 to 2015 = 93% (56/60), and 2015 to 2016 = 82% (57/70). All but 5 (3%) patients having 167 procedures were discharged home after 2 to 6 hours of bed rest without any 30-day adverse outcomes. Four patients were immediately transferred to our hospital after the intervention: 2 for respiratory issues (hypoxia), 1 for groin hematoma (observation only), and 1 for arterial occlusion (required tibial stent not available at outpatient center). One patient returned to our hospital with rest pain due to treatment site occlusion the following day. Conclusion: Our results demonstrate that complex peripheral arterial endovascular procedures can be performed safely by first-year VSFs under vascular attending supervision in an outpatient, non-hospital-based setting.
Root cause analysis of epidural spinal cord stimulator implant infections with resolution after implementation of an improved protocol for surgical placement
Authors: Arnold Forest W , Bishop Sarah , Johnson David , Scott LaShawn , Heishman Crystal , Oppy Leah , Ball Tyler , Sharma Mayur , Angeli Claudia , Ferreira Christie , Chen Yangsheng , Harkema Susan , Boakye Maxwell 
Published: May 2019

Background: Placing a spinal stimulator for the purpose of restoring paralysed function is a novel procedure; however, paralysis predisposes people to infection. Preventing surgical site infections is critical to benefit this population. Objective: The objective of this study was to review the root cause analysis of postoperative wound infections by a hospital epidemiology team following implantation of epidural spinal cord neurostimulators in patients with chronic spinal cord injury. Methods: A team was assembled to review the case of every individual who had been enrolled to receive a neurostimulator at the facility. A root cause analysis was performed evaluating five categories: the patient; equipment; facility/environment; procedure; and personnel. Findings: The root cause analysis included 11 patients. Two patients became infected. Three others dehisced their wound without becoming infected. All patients were given preoperative antibiotics on time. A mean of 17 personnel were in the operating room during surgery. Vancomycin powder was used in the patients who either dehisced their wound or became infected. Conclusions: The root cause analysis provides guidance for other institutions performing the same novel procedure. This analysis did not reveal a direct association, but did generate several areas for improvement including increasing pre-surgical screening, cleaning transient equipment (e.g., computer screens), limiting traffic in the operating room, using new sterile instruments for each stage of the procedure, not reopening the back incision, not applying vancomycin powder, and using an antimicrobial envelope for the stimulator.
Health-Related Quality of Life After Hip Arthroscopy for Femoroacetabular Impingement: A Systematic Review and Meta-analysis
Authors: Gohal Chetan , Shamshoon Saif , Memon Muzammil , Kay Jeffrey , Simunovic Nicole , Randelli Filippo , Ayeni Olufemi R. 
Published: May 2019

Context: Hip pain from femoroacetabular impingement (FAI) can impair health-related quality of life (HRQL) but can be treated via hip arthroscopy techniques. Objective: To systematically assess the HRQL outcomes after arthroscopic management of FAI. Date Sources: Three online databases (EMBASE, PubMed, and Ovid [MEDLINE]) were searched for relevant literature from database inception until June 2018 and screened by 2 reviewers independently and in duplicate. Study Selection: Level I to IV English studies that investigated HRQL outcomes after hip arthroscopy were included. Data for generic and hip-specific HRQL outcomes were collected. Mean differences were plotted in a forest plot when possible. Study Design: Systematic review. Level of Evidence: Level 4. Results: A total of 29 studies were included for assessment. Of the 6476 patients (6959 hips), the mean age was 32 years (range 9-79 years) and 50.7% were female. Significant improvements were reported in all studies assessing generic HRQL outcomes, including the 12-Item Short Form Health Survey (range of mean postoperative scores, 82.2-89.8), and EuroQOL-5D scores (range of mean postoperative scores, 0.74-0.87) between 12 and 24 months postoperatively. Significant improvements were similarly identified in the hip-specific HRQL outcomes scores, with the majority of studies also reporting improvement between 12 and 24 months postoperatively. Mean improvement in International Hip Outcome Tool–33 scores from preoperative values to postoperative values ranged from 22.7 to 43.2 ( I2 = 44%), for studies with follow-up between 12 and 24 months. Conclusion: Hip arthroscopy can lead to significant improvement in generic and hip-specific HRQL outcomes at 12 to 24 months postoperatively in patients with FAI who do not have advanced hip osteoarthritis. Confirmatory, high-quality, prospective studies are warranted to compare this observed improvement with other treatment modalities for FAI and to determine long-term outcomes.