bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Socioeconomic Status Measures on Hospital Profiling in New York City
Authors: Blum Alexander B. , Egorova Natalia N. , Sosunov Eugene A. , Gelijns Annetine C. , DuPree Erin , Moskowitz Alan J. , Federman Alex D. , Ascheim Deborah D. , Keyhani Salomeh 
Published: May 2014

Background—
Current 30-day readmission models used by the Center for Medicare and Medicaid Services for the purpose of hospital-level comparisons lack measures of socioeconomic status (SES). We examined whether the inclusion of an SES measure in 30-day congestive heart failure readmission models changed hospital risk-standardized readmission rates in New York City (NYC) hospitals.

Methods and Results—

Using a Centers for Medicare & Medicaid Services (CMS)-like model, we estimated 30-day hospital-level risk-standardized readmission rates by adjusting for age, sex, and comorbid conditions. Next, we examined how hospital risk-standardized readmission rates changed relative to the NYC mean with inclusion of the Agency for Healthcare Research and Quality (AHRQ)−validated SES index score. In a secondary analysis, we examined whether inclusion of the AHRQ SES index score in 30-day readmission models disproportionately impacted the risk-standardized readmission rates of minority-serving hospitals. Higher AHRQ SES scores, indicators of higher SES, were associated with lower odds (0.99) of 30-day readmission (
P
<0.019). The addition of the AHRQ SES index did not change the model’s C statistic (0.63). After adjustment for the AHRQ SES index, 1 hospital changed status from worse than the NYC average to no different than the NYC average. After adjustment for the AHRQ SES index, 1 NYC minority-serving hospital was reclassified from worse to no different than average.

Conclusions—
Although patients with higher SES were less likely to be admitted, the impact of SES on readmission was small. In NYC, inclusion of the AHRQ SES score in a CMS-based model did not impact hospital-level profiling based on 30-day readmission.
Choices for Patients “Without a Choice”
Authors: Ottenberg Abigale L. , Cook Katlyn E. , Topazian Rachel J. , Mueller Luke A. , Mueller Paul S. , Swetz Keith M. 
Published: May 2014

Background—
Patients undergo major physical and psychological changes after implantation of a left ventricular assist device as destination therapy (DT). We sought to qualitatively study outcomes and attitudes of patients after DT.

Methods and Results—
Ambulatory outpatients with DT at our institution were invited to be interviewed between June and August 2011. In-person interviews were audio-recorded, transcribed, and analyzed qualitatively using thematic analysis. The study included 12 patients (11 men) from the Midwestern United States with a median age of 71.5 years (range, 33–78 years). Interviews were conducted at a median (range) time of 1.37 (0.43–5.04) years after DT implantation. Most patients were white (n=11), married (n=10), and Christian (n=10). We identified 6 themes commonly discussed by the interviewees: preparedness planning, new lease on life, optimizing support networks, systemic limitations, reflections on time, and communication matters. Analysis revealed that most patients saw DT as their only choice, despite other alternatives.

Conclusions—
Ambulatory patients reported varied experiences after DT but commonly reported gratitude for improved functional status and a perception of improved symptom burden. Recommendations for improving post-DT care include developing patient support systems, systematizing education for community providers, and expanding respite services.
Resuscitation Preferences in Community Patients With Heart Failure
Authors: Dunlay Shannon M. , Swetz Keith M. , Redfield Margaret M. , Mueller Paul S. , Roger Véronique L. 
Published: May 2014

Background—
Little is known about the resuscitation preferences of patients with heart failure, how they may change over the course of the disease, and their association with mortality.

Methods and Results—

We enrolled consecutive Southeastern Minnesota residents with heart failure from October 2007 through September 2011 into a longitudinal study. Information on resuscitation preferences (Full Code or do-not-resuscitate [DNR]) was obtained from medical records through April 1, 2013. Of 608 patients enrolled, 237 died during follow-up. At enrollment, most patients (73.4%) were Full Code, whereas at death, most (78.5%) were DNR. The independent predictors of DNR status at enrollment were advanced age, chronic obstructive pulmonary disease, previous malignancy, and decreased mobility. Patients who were DNR were at increased risk of death (unadjusted hazard ratio, 2.03; 95% confidence interval, 1.48–2.73;
P
<0.001), but this risk did not persist after adjusting for age, comorbidity, and self-perceived general health (hazard ratio, 0.97; 95% confidence interval, 0.74–1.30;
P
=0.83). Of 481 patients who were Full Code during follow-up, 22 (4.6%) received cardiopulmonary resuscitation for an in-hospital cardiac arrest. Eight patients survived to hospital discharge; only 2 (9.1% of those receiving cardiopulmonary resuscitation) made a complete recovery and returned home. The median time from a final decision to be DNR until death was only 37 (7,70) days.

Conclusions—
The resuscitation preferences of patients with heart failure seem to be driven by the decline in clinical status that often accompanies advanced age and multimorbidity. Furthermore, these data suggest that electing DNR status does not independently affect a patient’s risk of death.
Stratifying the Risks of Oral Anticoagulation in Patients With Liver Disease
Authors: Efird Lydia M. , Mishkin Daniel S. , Berlowitz Dan R. , Ash Arlene S. , Hylek Elaine M. , Ozonoff Al , Reisman Joel I. , Zhao Shibei , Jasuja Guneet K. , Rose Adam J. 
Published: May 2014

Background—
Chronic liver disease presents a relative contraindication to warfarin therapy, but some patients with liver disease nevertheless require long-term anticoagulation. The goal is to identify which patients with liver disease might safely receive warfarin.

Methods and Results—

Among 102 134 patients who received warfarin from the Veterans Affairs from 2007 to 2008,
International Classification of Diseases
-Ninth Revision codes identified 1763 patients with chronic liver disease. Specific diagnoses and laboratory values (albumin, aspartate aminotransferase, alanine aminotransferase, creatinine, and cholesterol) were examined to identify risk of adverse outcomes, while controlling for available bleeding risk factors. Outcomes included percent time in therapeutic range, a measure of anticoagulation control, and major hemorrhagic events, by
International Classification of Diseases
-Ninth Revision codes. Patients with liver disease had lower mean time in therapeutic range (53.5%) when compared with patients without (61.7%;
P
<0.001) and more hemorrhages (hazard ratio, 2.02;
P
<0.001). Among patients with liver disease, serum albumin and creatinine levels were the strongest predictors of both outcomes. We created a 4-point score system: patients received 1 point each for albumin (2.5–3.49 g/dL) or creatinine (1.01–1.99 mg/dL), and 2 points each for albumin (<2.5 g/dL) or creatinine (≥2 mg/dL). This score predicted both anticoagulation control and hemorrhage. When compared with patients without liver disease, those with a score of zero had modestly lower time in therapeutic range (56.7%) and no increase in hemorrhages (hazard ratio, 1.16;
P
=0.59), whereas those with the worst score (4) had poor control (29.4%) and high hazard of hemorrhage (hazard ratio, 8.53;
P
<0.001).

Conclusions—
Patients with liver disease receiving warfarin have poorer anticoagulation control and more hemorrhages. A simple 4-point scoring system using albumin and creatinine identifies those at risk for poor outcomes.
Impact of Sociodemographic Patient Characteristics on the Efficacy of Decision Aids
Authors: Coylewright Megan , Branda Megan , Inselman Jonathan W. , Shah Nilay , Hess Erik , LeBlanc Annie , Montori Victor M. , Ting Henry H. 
Published: May 2014

Background—
Decision aids (DAs) increase patient knowledge, reduce decisional conflict, and promote shared decision making (SDM). The extent to which they do so across diverse sociodemographic patient groups is unknown.

Methods and Results—

We conducted a patient-level meta-analysis of 7 randomized trials of DA versus usual care comprising 771 encounters between patients and clinicians discussing treatment options for chest pain, myocardial infarction, diabetes mellitus, and osteoporosis. Using a random effects model, we examined the impact of sociodemographic patient characteristics (age, sex, education, income, and insurance status) on the outcomes of knowledge transfer, decisional conflict, and patient involvement in SDM. Because of small numbers of people of color in the study population, we were not powered to investigate the role of race. Most patients were aged ≥65 years (61%), white (94%), and women (59%); two thirds had greater than a high school education. Compared with usual care, DA patients gained knowledge, were more likely to know their risk, and had less decisional conflict along with greater involvement in SDM. These gains were largely consistent across sociodemographic patient groups, with DAs demonstrating similar efficacy when used with vulnerable patients such as the elderly and those with less income and less formal education. Differences in efficacy were found only in knowledge of risk in 1 subgroup, with greater efficacy among those with higher education (35% versus 18%;
P
=0.02).

Conclusions—
In this patient-level meta-analysis of 7 randomized trials, DAs were efficacious across diverse sociodemographic groups as measured by knowledge transfer, decisional conflict, and patient involvement in SDM. To the extent that DAs increase patient knowledge and participation in SDM, they have potential to impact health disparities related to these factors.
A 40-Year Climatology of Extratropical Transition in the Eastern North Pacific
Authors: Wood Kimberly M. , Ritchie Elizabeth A. 
Published: May 2014

Abstract
A 42-yr study of eastern North Pacific tropical cyclones (TCs) undergoing extratropical transition (ET) is presented using the Japanese 55-yr Reanalysis dataset. By using cyclone phase space (CPS) to differentiate those TCs that undergo ET from those that do not, it is found that only 9% of eastern North Pacific TCs that developed from 1971 to 2012 complete ET, compared with 40% in the North Atlantic.
Using a combination of CPS, empirical orthogonal function (EOF) analysis, and composite analysis, it is found that the evolution of ET in this basin differs from that observed in the North Atlantic and western North Pacific, possibly as a result of the rapidly decreasing sea surface temperatures north of the main genesis region. The presence of a strong, deep subtropical ridge extending westward from North America into the eastern North Pacific is a major factor inhibiting ET in this basin. Similar to other basins, eastern North Pacific ET generally occurs in conjunction with an approaching midlatitude trough, which helps to weaken the ridge and allow northward passage of the TC. The frequency of ET appears to increase during developing El Niño events but is not significantly affected by the Pacific decadal oscillation.
Applying Scaled Vegetation Greenness Metrics to Constrain Simulated Transpiration Anomalies: A Study over Australia*
Authors: Decker Mark , Pitman Andy J. , Evans Jason 
Published: May 2014

Abstract
The feasibility of using vegetation greenness metrics as a proxy for transpiration variability over Australia is demonstrated. Several global evapotranspiration datasets, one of which provides transpiration data and is constructed independently of the vegetation greenness measurements, are compared to four satellite-based observations representative of the state of the vegetation over several regions in Australia. Further estimates of the transpiration are obtained by decomposing the evapotranspiration datasets using an ensemble of land surface model simulations. On monthly time scales, the greenness anomaly metrics show a near one-to-one relationship with the transpiration estimates when the time series are appropriately scaled by the mean. The authors demonstrate that anomalous vegetation greenness metrics, when properly scaled, provide a tool for evaluating transpiration variability simulated by land surface models and observation-based evapotranspiration datasets that include transpiration. These methods provide a new test to help constrain the dynamic behavior of the land surface in climate model simulations.
Resection of the Innominate Artery to Prevent an Impending Tracheoinnominate Fistula and to Permit Tracheotomy in a Patient With Subglottic Stenosis and High-riding Innominate
Authors: Tokita Joshua , Kung Raymond , Parekh Kalpaj , Hoffman Henry 
Published: May 2014

Objective: This study aimed to determine the long-term viability of innominate artery resection and tracheotomy for a patient at high risk of developing a tracheoinnominate fistula (TIF) in the setting of subglottic stenosis and a high-riding innominate artery. Methods: Chart review with 2-year follow-up. Results: A 45-year-old diabetic man with obstructive sleep apnea and multiple admissions for coma and delirium tremens associated with alcohol abuse developed subglottic stenosis. He was found to have a palpable supraclavicular pulse during preoperative examination for a tracheotomy. Computed tomography examination revealed a high-riding innominate artery at the level of stenosis along with granulation tissue and disruption of the cartilaginous trachea, suggesting a high risk of impending TIF. The patient underwent a sternotomy-approach resection of the innominate artery with closure of the distal stump with a sternohyoid muscle flap. Intraoperatively, a plane of adhesions between the posterior innominate artery and trachea was dissected. The anterior tracheal wall appeared calcified but without evidence of erosion of either the trachea or the artery. Six weeks later, a tracheotomy was performed. Follow-up at 27 months did not identify complications from the innominate artery resection. Conclusion: Resection of the innominate artery is an option for some patients either to address the warning signs of TIF or to permit a tracheotomy to be performed in the presence of a high innominate artery.
Increasing health research literacy through outreach and networking: Why translational research should matter to communities
Authors: Dwyer-White Molly , Choate Celeste , Markel Dorene S 
Published: May 2014

Background: Increasingly clinical and health research awareness is a priority for health and medical research communities. Translational research, including the prevention and treatment of conditions, relies upon proper funding as well as public participation in research studies. This requires executing more effective communication strategies to care for recipients and the community at large – providing the downstream benefit to improved public health and patient care. Without new and improved approaches, recruiting research volunteers will remain a significant challenge for clinical research teams, particularly as limited funding necessitates smaller budgets and shorter timelines to engage participants. Objective: This community-based project partnered the complementary strengths of a public library (the Library) located in the same city as an academic research centre (the University): The University’s research infrastructure and the Library’s community and information delivery expertise combined to impact awareness of clinical research in the local population. Methods: This project utilised a multi-method approach to assess interest in health research, to deliver relevant information on community-relevant health topics and to increase awareness of health research in general. It was designed with the community to identify a sustainable, affordable model to deliver health information and illuminate the role of research in the process. Results: The project demonstrated a successful community-based model, utilising Health Research Forums and online resources to increase the connection between health research information and health research participation opportunities. Conclusion: By linking researchers with community members, providing related resources to augment linkage between health information and research, the project demonstrated an increased awareness regarding opportunities that exist for community participation in research through a sustainable model.
Investigation of defrosting control function based on model and sequence diagram
Authors: Tu Qiu , Feng Yuhai , Liu Qingming , Li Chao Zheng , Du Peng 
Published: May 2014

Defrosting is an important controlled event of variable refrigerant flow air conditioning system (VRF AC). The whole course includes defrosting preparation phase, defrosting execution phase, defrosting end preparation phase and pump-down residual running phase. The defrosting control function can make a great influence on the performance of variable refrigerant flow air conditioning system, whose elements are composed of a certain controlled event, controlled components, executed conditions, controlled time, controlled courses and control logic. A sequence diagram is adopted to express the defrosting dynamic process and the control models of execution conditions on defrosting arrival, defrosting end and pump-down residual running end have been built. Thus, the defrosting control function has been formed based on the model and sequence diagram. The defrosting experiments demonstrate that the built model and sequence diagram can scientifically and accurately express the defrosting control function. Practical application: Defrosting is an important controlled event of variable refrigerant flow air conditioning system. It is difficult to describe the complex controlled course, which is composed of defrosting preparation phase, defrosting execution phase, defrosting end preparation phase and pump-down residual running phase. A sequence diagram can be adopted to express the defrosting dynamic process and the control models of executed conditions on defrosting arrival, defrosting end and pump-down residual running end have been built. Thus, the defrosting control function has been formed based on model and sequence diagram.
Ossicular Reconstruction for Incus Long‐Process Defects: Bone Cement or Partial Ossicular Replacement Prosthesis
Authors: Baylancicek Serdar , Iseri Mete , Topdağ Deniz Özlem , Ustundag Emre , Ozturk Murat , Polat Senol , Uneri Cuneyd 
Published: May 2014

ObjectiveThe objective of this study was to compare hearing results in patients undergoing ossiculoplasty with bone cement (BC) vs partial ossicular replacement prosthesis (PORP) in cases of incudostapedial discontinuity during tympanoplasty surgeries.Study DesignCase series with chart review.SettingTertiary referral center.SubjectsA total of 44 patients with incudostapedial discontinuity, 21 operated on with BC and 23 operated on with PORP, were enrolled in this study.MethodsPreoperative and postoperative audiograms at 12 months were evaluated. Pure‐tone averages and air‐bone gaps (ABGs) were calculated according to the guidelines.ResultsThe ABG was 26.61 dB preoperatively and 9.76 dB postoperatively in the BC group. The hearing gain in ABG was statistically significant (P =. 0001). The preoperative and postoperative ABGs in the PORP group were 29.48 and 8.89 dB, respectively. The hearing gain in ABG was statistically significant (P =. 0001). When the groups were compared for mean gains in the ABG, the difference was not statistically significant (P =. 192). The postoperative ABG of less than 20 dB was achieved by 90.4% in the BC group and 86.9% in the PORP group. This difference was not statistically significant (P =. 745). No adverse reactions or complications were observed.ConclusionsBoth BC and PORP are reliable and efficient methods for the repair of incudostapedial joint defects. There is no difference between these 2 methods, based on the hearing results. Additional research is necessary to determine the maximum incudostapedial defect length suitable for bone cement repair.
A novel SLC2A1 mutation linking hemiplegic migraine with alternating hemiplegia of childhood
Authors: Weller Claudia M , Leen Wilhelmina G , Neville Brian GR , Duncan John S , Vries Boukje de , Geilenkirchen Marije A , Haan Joost , Kamsteeg Erik-Jan , Ferrari Michel D , Maagdenberg Arn MJM van den , Willemsen Michèl AAP , Scheffer Hans , Terwindt Gisela M 
Published: May 2014

Background Hemiplegic migraine (HM) and alternating hemiplegia of childhood (AHC) are rare episodic neurological brain disorders with partial clinical and genetic overlap. Recently, ATP1A3 mutations were shown to account for the majority of AHC patients. In addition, a mutation in the SLC2A1 gene was reported in a patient with atypical AHC. We therefore investigated whether mutations in these genes may also be involved in HM. Furthermore, we studied the role of SLC2A1 mutations in a small set of AHC patients without ATP1A3 mutations. Methods We screened 42 HM patients (21 familial and 21 sporadic patients) for ATP1A3 and SLC2A1 mutations. In addition, four typical AHC patients and one atypical patient with overlapping symptoms of both disorders were screened for SLC2A1 mutations. Results A pathogenic de novo SLC2A1 mutation (p.Gly18Arg) was found in the atypical patient with overlapping symptoms of AHC and hemiplegic migraine. No mutations were found in the HM and the other AHC patients. Conclusion Screening for a mutation in the SLC2A1 gene should be considered in patients with a complex phenotype with overlapping symptoms of hemiplegic migraine and AHC.
Reliability and Validity of the Japanese Version of the Iowa Infant Feeding Attitude Scale
Authors: Nanishi Keiko , Jimba Masamine 
Published: May 2014

Background: The 17-item Iowa Infant Feeding Attitude Scale (IIFAS) has shown good reliability and validity to measure attitudes toward infant feeding in various countries. It is also known to be associated with breastfeeding intention and exclusivity. However, the IIFAS has not been psychometrically tested among Japanese women. Objective: This study aimed to develop the Japanese version of the IIFAS (IIFAS-J) and assess its reliability and validity. Methods: This longitudinal study was conducted with 781 women at 4 hospitals in Japan. The translated IIFAS was administered to participants during their third trimester. Infant feeding status was self-reported at 4 and 12 weeks postpartum using follow-up questionnaires. The predictive validity was determined by examining the association between the IIFAS-J score during pregnancy and infant feeding status at 4 and 12 weeks postpartum. Results: One item was removed after a principal components analysis. Therefore, the IIFAS-J consisted of 16 items. Cronbach’s alpha of the IIFAS-J was 0.66. A higher IIFAS-J score during the third trimester was associated with a higher postdischarge exclusive breastfeeding rate at 4 weeks postpartum (B = 0.05; adjusted odds ratio = 1.05; 95% confidence interval, 1.01-1.10). Conclusion: The 16-item Japanese version of the IIFAS is a reliable and valid scale for measuring maternal infant-feeding attitudes during pregnancy.