bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom Recognition and Healthcare Experiences of Young Women With Acute Myocardial Infarction
Authors: Lichtman Judith H. , Leifheit-Limson Erica C. , Watanabe Emi , Allen Norrina B. , Garavalia Brian , Garavalia Linda S. , Spertus John A. , Krumholz Harlan M. , Curry Leslie A. 
Published: February 2015

Background—
Prompt recognition of acute myocardial infarction symptoms and timely care-seeking behavior are critical to optimize acute medical therapies. Relatively little is known about the symptom presentation and care-seeking experiences of women aged ≤55 years with acute myocardial infarction, a group shown to have increased mortality risk as compared with similarly aged men. Understanding symptom recognition and experiences engaging the healthcare system may provide opportunities to reduce delays and improve acute care for this population.

Methods and Results—
We conducted a qualitative study using in-depth interviews with 30 women (aged 30–55 years) hospitalized with acute myocardial infarction to explore their experiences with prodromal symptoms and their decision-making process to seek medical care. Five themes characterized their experiences: (1) prodromal symptoms varied substantially in both nature and duration; (2) they inaccurately assessed personal risk of heart disease and commonly attributed symptoms to noncardiac causes; (3) competing and conflicting priorities influenced decisions about seeking acute care; (4) the healthcare system was not consistently responsive to them, resulting in delays in workup and diagnosis; and (5) they did not routinely access primary care, including preventive care for heart disease.

Conclusions—
Participants did not accurately assess their cardiovascular risk, reported poor preventive health behaviors, and delayed seeking care for symptoms, suggesting that differences in both prevention and acute care may be contributing to young women’s elevated acute myocardial infarction mortality relative to men. Identifying factors that promote better cardiovascular knowledge, improved preventive health care, and prompt care-seeking behaviors represent important target for this population.
Optimal Medical Therapy Improves Clinical Outcomes in Patients Undergoing Revascularization With Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting
Authors: Iqbal Javaid , Zhang Yao-Jun , Holmes David R. , Morice Marie-Claude , Mack Michael J. , Kappetein Arie Pieter , Feldman Ted , Stahle Elizabeth , Escaned Javier , Banning Adrian P. , Gunn Julian P. , Colombo Antonio , Steyerberg Ewout W. , Mohr Friedrich W. , Serruys Patrick W. 
Published: February 2015

Background—
There is a paucity of data on the use of optimal medical therapy (OMT) in patients with complex coronary artery disease undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting (CABG) and its long-term prognostic significance.

Methods and Results—

The Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial is a multicenter, randomized, clinical trial of patients (n=1800) with complex coronary disease randomized to revascularization with percutaneous coronary intervention or CABG. Detailed drug history was collected for all patients at discharge and at the 1-month, 6-month, 1-year, 3-year, and 5-year follow-ups. OMT was defined as the combination of at least 1 antiplatelet drug, statin, β-blocker, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. Five-year clinical outcomes were stratified by OMT and non-OMT. OMT was underused in patients treated with coronary revascularization, especially CABG. OMT was an independent predictor of survival. OMT was associated with a significant reduction in mortality (hazard ratio, 0.64; 95% confidence interval, 0.48–0.85;
P
=0.002) and composite end point of death/myocardial infarction/stroke (hazard ratio, 0.73; 95% confidence interval, 0.58–0.92;
P
=0.007) at the 5-year follow-up. The treatment effect with OMT (36% relative reduction in mortality over 5 years) was greater than the treatment effect of revascularization strategy (26% relative reduction in mortality with CABG versus percutaneous coronary intervention over 5 years). On stratified analysis, all the components of OMT were important for reducing adverse outcomes regardless of revascularization strategy.

Conclusions—
The use of OMT remains low in patients with complex coronary disease requiring coronary intervention with percutaneous coronary intervention and even lower in patients treated with CABG. Lack of OMT is associated with adverse clinical outcomes. Targeted strategies to improve OMT use in postrevascularization patients are warranted.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00114972.
Patterns of Use of Angiotensin‐Converting Enzyme Inhibitors/Angiotensin Receptor Blockers Among Patients With Acute Myocardial Infarction in China From 2001 to 2011: China PEACE‐Retrospective AMI Study
Authors: Liu Jiamin , Masoudi Frederick A. , Spertus John A. , Wang Qing , Murugiah Karthik , Spatz Erica S. , Li Jing , Li Xi , Ross Joseph S. , Krumholz Harlan M. , Jiang Lixin ,   China PEACE Collaborative Group
Published: February 2015

Background

Chinese and
U.S.
guidelines recommend angiotensin‐converting enzyme inhibitors (
ACEIs
)/angiotensin receptor blockers (
ARBs
) for all patients with acute myocardial infarction (
AMI
) in the absence of contraindications as either a Class I or Class
II
a recommendation. Little is known about the use and trends of
ACEI
/
ARB
therapy in China over the past decade.

Methods and Results

Using nationally representative data from the China Patient‐centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction (China
PEACE
‐Retrospective
AMI
Study), we assessed use of
ACEI
/
ARB
therapy in 2001, 2006, and 2011, overall and across geographic regions and strata of estimated mortality risk, and predictors of
ACEI
/
ARB
therapy, among patients with Class I indication by Chinese guidelines. The weighted rate of
ACEI
/
ARB
therapy increased from 62.0% in 2001 to 71.4% in 2006, decreasing to 67.6% in 2011. Use was low across all 5 geographic regions. By strata of estimated mortality risk, in 2001, rates of therapy increased with increasing risk; however, by 2011, this reversed and those at higher risk were less likely to be treated (70.7% in lowest‐risk quintile vs. 63.5% in the highest‐risk quintile;
P
<0.001).

Conclusion

One third of Chinese
AMI
patients with Class I indications do not receive
ACEI
/
ARB
therapy during hospitalization, with little improvement in rates over time. Patients at higher mortality risk in 2011 were less likely to be treated, highlighting important opportunities to optimize the use of this cost‐effective therapy.

Clinical Trial Registration
URL: ClinicalTrials.gov. Unique identifier: NCT01624883.
Prognostic Significance of Perihematomal Edema in Acute Intracerebral Hemorrhage
Authors: Yang Jie , Arima Hisatomi , Wu Guojun , Heeley Emma , Delcourt Candice , Zhou Junshan , Chen Guofang , Wang Xia , Zhang Shihong , Yu Sungwook , Chalmers John , Anderson Craig S. 
Published: February 2015

Background and Purpose—
Controversy exists over the prognostic significance of perihematomal edema (PHE) in intracerebral hemorrhage. We aimed to determine the association of early PHE and clinical outcome among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT) studies.

Methods—

Pooled analyses of computed tomographic substudies in the pilot phase (INTERACT1) and main phase (INTERACT2), both international, prospective, open, blinded end point, randomized controlled trials, of patients with spontaneous intracerebral hemorrhage (<6 hours) and elevated systolic blood pressure, randomly assigned to intensive (target systolic blood pressure, <140 mm Hg) or guideline-based (systolic blood pressure, <180 mm Hg) blood-pressure management. Substudy participants (n=1310; 346 INTERACT1, 964 INTERACT2) had blinded central analyses of digital images from standardized baseline and 24-hour computed tomography. Predictors of death or dependency (modified Rankin scale scores, ≥3) at 90 days were assessed in logistic regression models and reported with odds ratios and 95% confidence intervals. INTERACT studies are registered at
ClinicalTrials.gov
(NCT00226096 and NCT00716079).

Results—

Of 1138 (87%) patients with 2 CTs available for edema analysis and outcome information, time from intracerebral hemorrhage onset to baseline computed tomography, baseline hematoma volume, 24-hour hematoma growth, and intraventricular extension were independent predictors of 24-hour PHE growth. Absolute growth in PHE volume was significantly associated with death or dependency (adjusted odds ratio, 1.17; 95% confidence interval, 1.02–1.33 per 5 mL increase from baseline;
P
=0.025) at 90 days after adjustment for demographic, clinical, and hematoma parameter prognostic factors. Associations were consistent across various sensitivity analyses.

Conclusion—
PHE growth is an independent prognostic factor in intracerebral hemorrhage.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00226096 and NCT00716079.
Measure of Functional Independence Dominates Discharge Outcome Prediction After Inpatient Rehabilitation for Stroke
Authors: Brown Allen W. , Therneau Terry M. , Schultz Billie A. , Niewczyk Paulette M. , Granger Carl V. 
Published: February 2015

Background and Purpose—
Identifying clinical data acquired at inpatient rehabilitation admission for stroke that accurately predict key outcomes at discharge could inform the development of customized plans of care to achieve favorable outcomes. The purpose of this analysis was to use a large comprehensive national data set to consider a wide range of clinical elements known at admission to identify those that predict key outcomes at rehabilitation discharge.

Methods—
Sample data were obtained from the Uniform Data System for Medical Rehabilitation data set with the diagnosis of stroke for the years 2005 through 2007. This data set includes demographic, administrative, and medical variables collected at admission and discharge and uses the FIM (functional independence measure) instrument to assess functional independence. Primary outcomes of interest were functional independence measure gain, length of stay, and discharge to home.

Results—

The sample included 148 367 people (75% white; mean age, 70.6±13.1 years; 97% with ischemic stroke) admitted to inpatient rehabilitation a mean of 8.2±12 days after symptom onset. The total functional independence measure score, the functional independence measure motor subscore, and the case-mix group were equally the strongest predictors for any of the primary outcomes. The most clinically relevant 3-variable model used the functional independence measure motor subscore, age, and walking distance at admission (
r
2
=0.107). No important additional effect for any other variable was detected when added to this model.

Conclusions—
This analysis shows that a measure of functional independence in motor performance and age at rehabilitation hospital admission for stroke are predominant predictors of outcome at discharge in a uniquely large US national data set.
Regional Variability in New Zealand’s Wind Resource Linked to Synoptic-Scale Circulation: Implications for Generation Reliability
Authors: Gibson Peter B. , Cullen Nicolas J. 
Published: February 2015

AbstractEven in locations endowed with excellent wind resources, the intermittent nature of wind is perceived as a barrier to reliable generation. However, recent studies have demonstrated that electrically interconnecting wind farms in a meteorologically oriented network can reduce supply variability and the observed frequency of zero-generation conditions. In this study a 5-yr synthetic dataset of 15 wind farms is utilized to investigate the benefits to supply reliability from wind farm interconnection in New Zealand. An examination is carried out primarily through a synoptic climatology framework, hypothesizing that benefits to reliability are primarily related to the degree to which wind farms are influenced differently by the synoptic-scale circulation. Using a weather-typing approach and composite analysis, regionality is observed in the linkages between synoptic-scale circulation and wind resources, particularly between wind farms located in the far northern and far southern regions of the country. Subsequently, and as compared with all other possible combinations, supply reliability is observed to be optimized in a network that includes wind farms connected between far northern and far southern regions, under which the frequency of hours with zero generation is almost eliminated. It is likely that the frequency of hours with zero generation could be further reduced on the basis of a more extensive meteorologically based selection of wind data from a greater number of locations. It is suggested that these findings should be taken into consideration in future planning and site selection of wind farm projects in New Zealand.
Evaluation of Long-Term Calibrations of the AVHRR Visible Radiances
Authors: Rossow William B. , Ferrier Joseph 
Published: February 2015

AbstractTwo systematic calibrations have been compiled for the visible radiances measured by the series of AVHRR instruments flown on the NOAA operational polar weather satellites: one by the International Satellite Cloud Climatology Project (ISCCP), anchored on NASA ER-2 underflights in the 1980s and early 1990s and covering the period 1981–2009, and one by the PATMOS-x project, anchored on comparisons to the MODIS instruments on the Aqua and Terra satellites in the 2000s and covering the period 1979–2010 (this result also includes calibration for the near-IR channels). Both methods have had to extend their anchor calibrations over a long series of instruments using different vicarious approaches, so a comparison provides an opportunity to evaluate how well this extension works by cross-checking the results at the anchor points. The basic result of this comparison is that for the “afternoon” series of AVHRRs, the calibrations agree to within their mutual uncertainties. However, this retrospective evaluation also shows that the representation of the time variations can be simplified. The ISCCP procedure had much more difficulty extending the calibration to the “morning” series of AVHRRs with the calibrations for NOAA-15 and NOAA-17 exceeding the estimated uncertainties. Given the general agreement, a new calibration for all AVHRR visible radiances (except TIROS-N, NOAA-6, NOAA-19, and MetOp-A) is proposed that is based on the average of the best linear fits to the two time records. The estimated uncertainty of these calibrations is ±3% absolute (scaled radiance units).
A Comparison of Near-Surface Buoyancy and Baroclinity across Three VORTEX2 Supercell Intercepts
Authors: Weiss Christopher C. , Dowell David C. , Schroeder John L. , Skinner Patrick S. , Reinhart Anthony E. , Markowski Paul M. , Richardson Yvette P. 
Published: February 2015

Abstract
Observations obtained during the second Verification of the Origin of Rotation in Tornadoes Experiment (VORTEX2) are analyzed for three supercell intercepts. These intercepts used a fleet of deployable “StickNet” probes, complemented by mobile radars and a mobile mesonet, to map state quantities over the expanse of target storms.
Two of the deployments occurred for different stages of a supercell storm near and east of Dumas, Texas, on 18 May 2010. A comparison of the thermodynamic and kinematic characteristics of the storm provides a possible explanation for why one phase was weakly tornadic and the other nontornadic. The weakly tornadic phase features a stronger horizontal virtual temperature gradient antiparallel to the forward-flank reflectivity gradient and perpendicular to the near-surface flow direction, suggesting that air parcels could acquire more significant baroclinic vorticity as they approach the low-level mesocyclone.
The strongly tornadic 10 May 2010 case near Seminole, Oklahoma, features comparatively small virtual and equivalent potential temperature deficits, suggesting the strength of baroclinic zones may be less useful than the buoyancy near the mesocyclone for assessing tornado potential. The distribution of positive pressure perturbations and backed ground-relative winds within the forward flank are consistent with the notion of a “starburst” pattern of diverging winds associated with the forward-flank downdraft.
Narrow (~1 km wide) zones of intense baroclinic vorticity generation of O(~10−4) s−2 are shown to exist within precipitation on the forward and left sides of the mesocyclone in the Dumas intercepts, not dissimilar from such zones identified in recent high-resolution numerical studies.
Academic Benchmarks for Otolaryngology Leaders
Authors: Eloy Jean Anderson , Blake Danielle M. , D’Aguillo Christine , Svider Peter F. , Folbe Adam J. , Baredes Soly 
Published: February 2015

Objective: This study aimed to characterize current benchmarks for academic otolaryngologists serving in positions of leadership and identify factors potentially associated with promotion to these positions. Methods: Information regarding chairs (or division chiefs), vice chairs, and residency program directors was obtained from faculty listings and organized by degree(s) obtained, academic rank, fellowship training status, sex, and experience. Research productivity was characterized by (a) successful procurement of active grants from the National Institutes of Health and prior grants from the American Academy of Otolaryngology–Head and Neck Surgery Foundation Centralized Otolaryngology Research Efforts program and (b) scholarly impact, as measured by the h-index. Results: Chairs had the greatest amount of experience (32.4 years) and were the least likely to have multiple degrees, with 75.8% having an MD degree only. Program directors were the most likely to be fellowship trained (84.8%). Women represented 16% of program directors, 3% of chairs, and no vice chairs. Chairs had the highest scholarly impact (as measured by the h-index) and the greatest external grant funding. Conclusion: This analysis characterizes the current picture of leadership in academic otolaryngology. Chairs, when compared to their vice chair and program director counterparts, had more experience and greater research impact. Women were poorly represented among all academic leadership positions.
Obstetric knowledge of nurse-educators in Nigeria: Levels, regional differentials and their implications for maternal health delivery
Authors: Ishaku Mohammed Salisu , Ahonsi Babatunde , Oginni Ayodeji Babatunde , Tukur Jamilu , Adoyi Gloria 
Published: February 2015

Objective: To assess the knowledge of nurse-midwife educators on the major causes of maternal mortality in Nigeria. Setting: Schools of nursing and midwifery in Nigeria. Method: A total of 292 educators from 171 schools of nursing and midwifery in Nigeria were surveyed for their knowledge of the major causes of maternal mortality as a prelude to the design and implementation of a train-the-trainer intervention geared towards improved maternal health-care delivery. Results: There was paucity of knowledge across all major causes. Only 57.2% and 62.7% of educators could diagnose pre-eclampsia and severe pre-eclampsia, respectively. While 86% knew about magnesium sulphate (MgSO4) as the ‘gold standard’ for treating eclampsia, only 16.8% knew of calcium gluconate as an antidote to MgSO4 toxicity. Of the educators, 63.7% could not describe the components of active management of third stage of labour, while 29.5% were not aware of uterine atony as a cause of postpartum haemorrhage. Furthermore, 65.4% believed that misoprostol is the preferred oxytocic for hospital delivery. Other potentially harmful knowledge gaps were also found, such as 47.3% of the participants reporting that they would perform episiotomies on all primigravidae. Conclusion: Nurse/midwife educators in Nigeria are not as knowledgeable as previously thought, especially concerning the causes of maternal mortality. In order to scale up the quality of obstetric care, updated pre-service curricula should be implemented fully while in-service appraisal and continuing education should be introduced.
How and why young adults do and do not search for health information: Cognitive and affective factors
Authors: Myrick Jessica Gall , Willoughby Jessica Fitts , Verghese Roshni Susana 
Published: February 2015

Objective: The goal of this study was to take an in-depth look at why college students do (or do not) seek health information, and how they seek information when they do. Design: Qualitative content analysis of responses to an open-ended prompt embedded in a survey about health information seeking behaviours. Setting: Nearly 700 ( N = 697) college students at a public university in the Southeastern USA responded to an open-ended prompt to discuss health information seeking. Method: Two coders used constant-comparative method to identify themes within the data set. Results: Students in the sample were motivated to seek health information by personal relevance, emotions, identity and media coverage. When they did seek such information, they relied heavily on the Internet. Many respondents reported not seeking health information due to perceptions of low personal risk, third person perceptions that they knew more than others and/or a fatalistic view of their future health. Conclusion: College students seek health information largely based on perceptions of relevance. Health professionals wanting to motivate this population to educate themselves about health issues may wish to focus on making relevance salient as well as understanding both cognitive and affective motivations to seek or avoid seeking.
The Impact of Sleep Disruption on Complex Cognitive Tasks
Authors: Wickens Christopher D. , Hutchins Shaun D. , Laux Lila , Sebok Angelia 
Published: February 2015

Objective: We aimed to build upon the state of knowledge about the impacts of sleep disruption into the domain of complex cognitive task performance for three types of sleep disruption: total sleep deprivation, sleep restriction, and circadian cycle. Background: Sleep disruption affects human performance by increasing the likelihood of errors or the time it takes to complete tasks, such as the Psychomotor Vigilance Task. It is not clear whether complex tasks are affected in the same way. Understanding the impact of sleep disruption on complex cognitive tasks is important for, and in some instances more relevant to, professional workers confronted with unexpected, catastrophic failures following a period of disrupted sleep. Method: Meta-analytic review methods were applied to each of the three different areas of sleep disruption research. Results: Complex cognitive task performance declines over consecutive hours of continuous wakefulness as well as consecutive days of restricted sleep, is worse for severely restricted sleep (4 or fewer hours in bed), is worse during the circadian nadir than apex, and appears less degraded than simple task performance. Conclusion: The reviews suggest that complex cognitive task performance may not be impacted by disrupted sleep as severely as simple cognitive task performance. Application: Findings apply to predicting effects of sleep disruption on workers in safety-critical environments, such as health care, aviation, the military, process control, and in particular, safety-critical environments involving shiftwork or long-duration missions.