bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Evaluation of Defibrillation Threshold and Postshock Rhythm in Young ICD Recipients
Authors: RADBILL ANDREW E. , TRIEDMAN JOHN K. , BERUL CHARLES I. , WALSH EDWARD P. , ALEXANDER MARK E. , WEBSTER GREGORY , CECCHIN FRANK 
Published: September 2012

Background:

Adaptation of implantable cardioverter defibrillator (ICD) systems to the needs of pediatric and congenital heart patients is problematic due to constraints of vascular and thoracic anatomy. An improved understanding of the defibrillation energy and postshock pacing requirements in such patients may help direct more tailored ICD therapy. We describe the first prospective evaluation of defibrillation threshold (DFT) and postshock rhythm in this population.
Methods:

We prospectively studied patients ≤60 kg at time of ICD intervention. DFTs were obtained using a binary search protocol with three VF inductions. Postshock pacing was programmed using a stepwise protocol, lowering the rate prior to each VF induction.
Results:

Twenty patients were enrolled: 11 had channelopathy, five congenital heart disease, and four cardiomyopathy. The median age was 16 years, median weight 48 kg. Twelve patients had a transvenous high‐voltage coil; eight had pericardial +/− subcutaneous coil(s). Median DFT was 7 J (range 3–31 J); 19/20 patients had DFT ≤15 J and all patients <25 kg had DFT ≤9 J (n = 6). There was no difference in DFT between patients with transvenous versus pericardial +/− subcutaneous coils (median 7 J vs 6 J, P = 0.59). No patient with normal atrioventricular conduction prior to defibrillation required postshock pacing (n = 16). There were no adverse events.
Conclusions:

These data suggest that many pediatric ICD patients have low DFTs and adequate postshock escape rhythm. This may help determine appropriate parameters for future design of pediatric‐specific ICDs. (PACE 2012;35:1487–1493)
The Fabric of Thought: Priming Tactile Properties During Reading Influences Direct Tactile Perception
Authors: Brunyé Tad T. , Walters Eliza K. , Ditman Tali , Gagnon Stephanie A. , Mahoney Caroline R. , Taylor Holly A. 
Published: September 2012

AbstractThe present studies examined whether implied tactile properties during language comprehension influence subsequent direct tactile perception, and the specificity of any such effects. Participants read sentences that implicitly conveyed information regarding tactile properties (e.g., Grace tried on a pair of thick corduroy pants while shopping) that were either related or unrelated to fabrics and varied in implied texture (smooth, medium, rough). After reading each sentence, participants then performed an unrelated rating task during which they felt and rated the texture of a presented fabric. Results demonstrated that the texture properties implied in sentences influence direct tactile perception. Specifically, after reading about a smooth or rough texture, subsequent fabric ratings became notably smoother or rougher, respectively. However, we also show that there was some specificity to these effects: Fabric‐related sentences elicited more specific and interactive effects on subsequent ratings. Together, we demonstrate that under certain circumstances, language comprehension can prime tactile representations and affect direct tactile perception. Results are discussed with regard to the nature and scope of multimodal mental simulation during reading.
High Fidelity Case‐based Simulation Debriefing: Everything You Need to Know
Authors: Hart Danielle , McNeil Mary Ann , Griswold‐Theodorson Sharon , Bhatia Kriti , Joing Scott 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 1084–1085 © 2012 by the Society for Academic Emergency MedicineAbstractIn this 30‐minute talk, the authors take an in‐depth look at how to debrief high‐fidelity case‐based simulation sessions, including discussion on debriefing theory, goals, approaches, and structure, as well as ways to create a supportive and safe learning environment, resulting in successful small group learning and self‐reflection. Emphasis is placed on the “debriefing with good judgment” approach. Video clips of sample debriefing attempts, highlighting the “dos and don’ts” of simulation debriefing, are included. The goal of this talk is to provide you with the necessary tools and information to develop a successful and effective debriefing approach. There is a bibliography and a quick reference guide in Data Supplements S1 and S2 (available as supporting information in the online version of this paper).The video is located here: https://vimeo.com/33991081password is perls
Validation of a Clinical Prediction Model for Early Admission to the Intensive Care Unit of Patients With Pneumonia
Authors: Labarère José , Schuetz Philipp , Renaud Bertrand , Claessens Yann‐Erick , Albrich Werner , Mueller Beat 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:993–1003 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The Risk of Early Admission to the Intensive Care Unit (REA‐ICU) index is a clinical prediction model that was derived based on 4,593 patients with community‐acquired pneumonia (CAP) for predicting early admission to the intensive care unit (ICU; i.e., within 3 days following emergency department [ED] presentation). This study aimed to validate the REA‐ICU index in an independent sample.Methods:  The authors retrospectively stratified 850 CAP patients enrolled in a multicenter prospective randomized trial conducted in Switzerland, using the REA‐ICU index, alternate clinical prediction models of severe pneumonia (SMART‐COP, CURXO‐80, and the 2007 IDSA/ATS minor severity criteria), and pneumonia severity assessment tools (the Pneumonia Severity Index [PSI] and CURB‐65).Results:  The rate of early ICU admission did not differ between the validation and derivation samples within each risk class of the REA‐ICU index, ranging from 1.1% to 1.8% in risk class I to 27.1% to 27.6% in risk class IV. The areas under the receiver operating characteristic (ROC) curve were 0.76 (95% confidence interval [CI] = 0.70 to 0.83) and 0.80 (95% CI = 0.77 to 0.83) in the validation and derivation samples, respectively. In the validation sample, the REA‐ICU index performed better than the pneumonia severity assessment tools, but failed to demonstrate an accuracy advantage over alternate prediction models in predicting ICU admission.Conclusions:  The REA‐ICU index reliably stratifies CAP patients into four categories of increased risk for early ICU admission within 3 days following ED presentation. Further research is warranted to determine whether inflammatory biomarkers may improve the performance of this clinical prediction model.
A Model for Emergency Department End‐of‐life Communications After Acute Devastating Events—Part I: Decision‐making Capacity, Surrogates, and Advance Directives*
Authors: Limehouse Walter E. , Ramana Feeser V. , Bookman Kelly J. , Derse Arthur 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 1068–1072; © 2012 by the Society for Academic Emergency MedicineAbstractMaking decisions for a patient affected by sudden devastating illness or injury traumatizes a patient’s family and loved ones. Even in the absence of an emergency, surrogates making end‐of‐life treatment decisions may experience negative emotional effects. Helping surrogates with these end‐of‐life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end‐of‐life communications after acute devastating events comprises the following steps: 1) determine the patient’s decision‐making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life‐limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed.Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long‐term benefit of continued life‐sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision‐making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end‐of‐life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end‐of‐life discussions and to implement shared decisions.
Emergency Cricothyroidotomy: A Randomized Crossover Trial Comparing Percutaneous Techniques: Classic Needle First Versus “Incision First”
Authors: Kanji Hussein , Thirsk Warren , Dong Sandy , Szava‐Kovats Michael , Villa‐Roel Cristina , Singh Mira , Rowe Brian H. 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1061–1067 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  Emergency cricothyroidotomy is potentially lifesaving in patients with airway compromise who cannot be intubated or ventilated by conventional means. The literature remains divided on the best insertion technique, namely, the open/surgical and percutaneous methods. The two are not mutually exclusive, and the study hypothesis was that an “incision‐first” modification (IF) may improve the traditional needle‐first (NF) percutaneous approach. This study assessed the IF technique compared to the NF method.Methods:  A randomized controlled crossover design with concealed allocation was completed for 180 simulated tracheal models. Attending and resident emergency physicians were enrolled. The primary outcome was time to successful cannulation; secondary outcomes included needle insertion(s), incision, and dilatation attempts. Finally, proportions of intratracheal insertion on the first attempt and subjective ease of insertion were compared.Results:  The IF technique was significantly faster than the standard NF technique (median = 53 seconds, interquartile range [IQR] = 45.0 to 86.4 seconds vs. median = 90 seconds, IQR = 55.2 to 108.6 seconds; p < 0.001). The median number of needle insertions was significantly higher for the NF technique (p = 0.018); there was no significant difference in dilation or incision attempts. Intratracheal insertion on the first attempt was documented in 90 and 93% of the NF and IF techniques, respectively (p = 0.317). All the study participants found the IF hybrid approach easier.Conclusions:  The IF modification allows faster access, fewer complications, and more favorable clinician endorsement than the classic NF percutaneous technique in a validated model of cricothyroidotomy. We suggest therefore that the IF technique be considered as an improved method for insertion of an emergency cricothyroidotomy.
The Evacuation of Cairns Hospitals Due to Severe Tropical Cyclone Yasi
Authors: Little Mark , Stone Theona , Stone Richard , Burns Jan , Reeves Jim , Cullen Paul , Humble Ian , Finn Emmeline , Aitken Peter , Elcock Mark , Gillard Noel 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1088–1098 © 2012 by the Society for Academic Emergency MedicineAbstractOn February 2, 2011, Tropical Cyclone Yasi, the largest cyclone to cross the Australian coast and a system the size of Hurricane Katrina, threatened the city of Cairns. As a result, the Cairns Base Hospital (CBH) and Cairns Private Hospital (CPH) were both evacuated, the hospitals were closed, and an alternate emergency medical center was established in a sports stadium 15 km from the Cairns central business district.This article describes the events around the evacuation of 356 patients, staff, and relatives to Brisbane (approximately 1,700 km away by road), closure of the hospitals, and the provision of a temporary emergency medical center for 28 hours during the height of the cyclone.Our experience highlights the need for adequate and exercised hospital evacuation plans; the need for clear command and control with identified decision‐makers; early decision‐making on when to evacuate; having good communication systems with redundancy; ensuring that patients are adequately identified and tracked and have their medications and notes; ensuring adequate staff, medications, and oxygen for holding patients; and planning in detail the alternate medical facility safety and its role, function, and equipment.
FKBP5 and emotional neglect interact to predict individual differences in amygdala reactivity
Authors: White M. G. , Bogdan R. , Fisher P. M. , Muñoz K. E. , Williamson D. E. , Hariri A. R. 
Published: September 2012

AbstractIndividual variation in physiological responsiveness to stress mediates risk for mental illness and is influenced by both experiential and genetic factors. Common polymorphisms in the human gene for FK506 binding protein 5 (FKBP5), which is involved in transcriptional regulation of the hypothalamic–pituitary–adrenal (HPA) axis, have been shown to interact with childhood abuse and trauma to predict stress‐related psychopathology. In the current study, we examined if such gene–environment interaction effects may be related to variability in the threat‐related reactivity of the amygdala, which plays a critical role in mediating physiological and behavioral adaptations to stress including modulation of the HPA axis. To this end, 139 healthy Caucasian youth completed a blood oxygen level‐dependent functional magnetic resonance imaging probe of amygdala reactivity and self‐report assessments of emotional neglect (EN) and other forms of maltreatment. These individuals were genotyped for 6 FKBP5 polymorphisms (rs7748266, rs1360780, rs9296158, rs3800373, rs9470080 and rs9394309) previously associated with psychopathology and/or HPA axis function. Interactions between each SNP and EN emerged such that risk alleles predicted relatively increased dorsal amygdala reactivity in the context of higher EN, even after correcting for multiple testing. Two different haplotype analyses confirmed this relationship as haplotypes with risk alleles also exhibited increased amygdala reactivity in the context of higher EN. Our results suggest that increased threat‐related amygdala reactivity may represent a mechanism linking psychopathology to interactions between common genetic variants affecting HPA axis function and childhood trauma.
Influence of comorbidity in cancer surgery on treatment decisions, postoperative course and oncological outcome
Authors: Chaudhary Rahul K , Bhaduri Debanshu , Bhatia Manish , Hatti Sharanabasappa , Ba Roshan , Meva Jignesh 
Published: September 2012

AbstractAimComorbidity in cancer patients may influence treatment decisions, postoperative morbidity and ultimately, survival. The TNM staging system does not take comorbidity into account. This study investigates the burden of comorbidity in cancer patients, its effect on resection rate, postoperative morbidity, adjuvant therapy, recurrence and survival.Methods This prospective cohort study included 358 patients with potentially operable cancer. Pretreatment comorbidity was assessed using a modified Kaplan–Feinstein index (adult comorbidity evaluation‐27) and its influence on resection rate and postoperative adjuvant therapy was assessed. The comorbidity grade was consolidated with TNM stage into four distinct groups that were compared for differences in the incidence of postoperative complications, duration of hospital stay, 30‐day mortality, recurrence and survival.ResultsCardiovascular diseases including hypertension (27%) and diabetes mellitus (12%) were the most common comorbidities. Comorbidity did not influence the resection rate, but affected adjuvant treatment (P < 0.01). There was a greater incidence of postoperative local and systemic complications and duration of hospital stay in patients with comorbidity. Recurrence rates were unaffected. Mortality in patients with comorbidity was greater, especially postoperative 30‐day mortality, but this was statistically insignificant.ConclusionComorbidity increases postoperative morbidity and affects adjuvant therapy, although the resection rate is not influenced. The greater percentage of deaths in patients with comorbidity warrants further studies. Recurrence rates remain unaffected. However, a longer period of follow up is needed for a clearer picture.
Inpatient Stroke Care Quality for Veterans: Are There Differences between Veterans Affairs Medical Centers in the Stroke Belt and other Areas?
Authors: Jia Huanguang , Phipps Michael , Bravata Dawn , Castro Jaime , Li Xinli , Ordin Diana , Myers Jennifer , Vogel W. Bruce , Williams Linda , Chumbler Neale 
Published: September 2012

Background Stroke mortality has been found to be much higher among residents in the stroke belt region than in the rest of United States, but it is not known whether differences exist in the quality of stroke care provided in Department of Veterans Affairs medical centers in states inside and outside this region. Objective We compared mortality and inpatient stroke care quality between Veterans Affairs medical centers inside and outside the stroke belt region. Methods Study patients were veterans hospitalized for ischemic stroke at 129 Veterans Affairs medical centers. Inpatient stroke care quality was assessed by 14 quality indicators. Multivariable logistic regression models were fit to examine differences in quality between facilities inside and outside the stroke belt, adjusting for patient characteristics and Veterans Affairs medical centers clustering effect. Results Among the 3909 patients, 28·1% received inpatient ischemic stroke care in 28 stroke belt Veterans Affairs medical centers, and 71·9% obtained care in 101 non-stroke belt Veterans Affairs medical centers. Patients cared for in stroke belt Veterans Affairs medical centers were more likely to be younger, Black, married, have a higher stroke severity, and less likely to be ambulatory pre-stroke. We found no statistically significant differences in short- and long-term post-admission mortality and inpatient care quality indicators between the patients cared for in stroke belt and non-stroke belt Veterans Affairs medical centers after risk adjustment. Conclusions These data suggest that a stroke belt does not exist within the Veterans Affairs health care system in terms of either post-admission mortality or inpatient care quality.
A Systematic Review of Perceived Barriers and Motivators to Physical Activity after Stroke
Authors: Nicholson Sarah , Sniehotta Falko F. , van Wijck Frederike , Greig Carolyn A. , Johnston Marie , McMurdo Marion E. T. , Dennis Martin , Mead Gillian E 
Published: September 2012

Background and purpose Physical fitness is impaired after stroke, may contribute to disability, yet is amenable to improvement through regular physical activity. To facilitate uptake and maintenance of physical activity, it is essential to understand stroke survivors' perceived barriers and motivators. Therefore, we undertook a systematic review of perceived barriers and motivators to physical activity after stroke. Methods Electronic searches of EMBASE, Medline, CINAHL, and PsychInfo were performed. We included peer-reviewed journal articles, in English, between 1 January 1966 and 30 August 2010 reporting stroke survivors' perceived barriers and motivators to physical activity. Results Searches identified 73 807 citations of which 57 full articles were retrieved. Six articles were included, providing data on 174 stroke survivors (range 10 to 83 per article). Two reported barriers and motivators, two reported only motivators, and two reported only barriers. Five were qualitative articles and one was quantitative. The most commonly reported barriers were lack of motivation, environmental factors (e.g. transport), health concerns, and stroke impairments. The most commonly reported motivators were social support and the need to be able to perform daily tasks. Conclusion This review has furthered our understanding of the perceived barriers and motivators to physical activity after a stroke. This review will enable the development of tailored interventions to target barriers, while building upon perceived motivators to increase and maintain stroke survivors' physical activity.
A Longitudinal Cohort Study on Quality of Life in Stroke Patients and Their Partners: Restore4Stroke Cohort
Authors: van Mierlo Maria L. , van Heugten Caroline M. , Post Marcel W. M. , Lindeman Eline , de Kort Paul L. M. , Visser-Meily Johanna M.A. 
Published: September 2012

Background Stroke is a major cause of disability in the Western world. Its long-term consequences have a negative impact on the quality of life of both the patients and their partners. Aim The aim of the Restore4Stroke Cohort study is to investigate the changes in quality of life of stroke patients and their partners over time, and to determine factors predicting quality of life in several domains, especially personal and environmental factors. Method Multicentre prospective longitudinal cohort study. Inclusion and the first assessment take place during hospital stay in the first week post-stroke. Follow-up assessments take place at two months, six months, one year, and two years post-stroke. Recruitment of 500 patients from stroke units in six participation hospitals is foreseen. If the patient has a partner, he or she is also asked to participate in the study. Outcomes The main outcome is quality of life, considered from a health-related quality of life and domain-specific quality of life perspective. Factors predicting long-term quality of life will be determined by taking into account the health condition (pre-stroke health condition and stroke-related health condition), personal factors (e.g. coping and illness cognitions), and environmental factors (e.g. caregiver burden and social support). Discussion This study is expected to provide information about the changes in quality of life of stroke patients and their partners over time. Furthermore, the identification of factors predicting quality of life can be used to improve rehabilitation care and develop new interventions for stroke patients and their partners.