bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nationwide Analysis of Patients With ST-Segment–Elevation Myocardial Infarction Transferred for Primary Percutaneous Intervention
Authors: Dauerman Harold L. , Bates Eric R. , Kontos Michael C. , Li Shuang , Garvey J. Lee , Henry Timothy D. , Manoukian Steven V. , Roe Matthew T. 
Published: April 2015

Background—
Current American College of Cardiology/American Heart Association guidelines recommend transfer and primary percutaneous coronary intervention (PCI) for ST-segment–elevation myocardial infarction (STEMI) patients within the time limit of first contact to device ≤120 minutes. We determined the hospital-level, patient-level, and process characteristics of timely versus delayed primary PCI for a diverse national sample of transfer patients confined to a travel distance that facilitates the process.

Methods and Results—
We studied 14 518 patients transferred from non–PCI-capable hospitals for primary PCI to 398 National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines hospitals between July 2008 and December 2012. Patients with estimated transfer times >60 minutes (by Google Maps driving times) were excluded from the analysis. Patients achieving first door-to-device time ≤120 minutes were compared with patients with delayed treatment; independent predictors of timely treatment were determined using generalized estimating equations logistic regression models. The median estimated transfer distance was 26.5 miles. First door-to-device ≤120 minutes was achieved in 65% of patients (n=9380); only 37% of the hospitals were high-performing hospitals (defined as risk-adjusted rate, ≥75% of transfer STEMI patients with ≤120-minute first door-to-device time). In addition to known predictors of delay (cardiogenic shock, cardiac arrest, and prolonged door-in door-out time), STEMI referral hospitals’ rural location and longer estimated transfer time were identified as predictors of delay. In this diverse national sample, regional and racial variations in care were observed. Finally, lower PCI hospital annual STEMI volume was a potent predictor of delay.

Conclusions—
More than one third of US STEMI patients transferred for primary PCI fail to achieve first door-to-device time ≤120 minutes, despite estimated transfer times <60 minutes. Delays are related to process variables, comorbidities, and lower annual PCI hospital STEMI volumes.
Seasonal Variation of the Pacific South Equatorial Current Bifurcation
Authors: Chen Zhaohui , Wu Lixin 
Published: April 2015

AbstractThe seasonal variation of the South Equatorial Current (SEC) bifurcation off the Australian coast in the South Pacific (SP) is investigated with observations and a nonlinear, reduced-gravity, primitive equation model of the upper ocean. The mean SEC bifurcation latitude (SBL) integrated over the upper thermocline is around 17.5°S, almost 2° south of the position predicted by Sverdrup theory. For its seasonal variation, the SBL reaches its southernmost position in June/July and its northernmost position in November/December. The south–north migration of 2.7° is twice as large as its counterpart in the North Pacific. It is found that the large seasonal amplitude of the SBL results from the combined effect of Low-Lat-SP and Non-Low-Lat-SP processes. The Low-Lat-SP process (referred to as the Rossby wave dynamics forced by the wind stress curl over the low-latitude SP) accounts for almost ⅔ of the SBL seasonal variability, and the Non-Low-Lat-SP processes account for ⅓. Both of these processes are responsible for its south–north migration but in different ways. The Low-Lat-SP wind forcing determines the offshore upper-layer thickness (ULT) via Rossby wave propagation, while the Non-Low-Lat-SP wind forcing determines the alongshore ULT via coastal Kelvin wave propagation. A simple bifurcation model is proposed under the framework of linear Rossby wave dynamics. It is found that the seasonal bifurcation latitude is predominantly determined by the spatial pattern of the wind and baroclinic Rossby wave propagation. This model explains the roles of local/remote wind forcing and baroclinic adjustment in the south–north migration and peak seasons of the bifurcation latitude.
Conducting qualitative research in mental health: Thematic and content analyses
Authors: Crowe Marie , Inder Maree , Porter Richard 
Published: April 2015

Objective: The objective of this paper is to describe two methods of qualitative analysis – thematic analysis and content analysis – and to examine their use in a mental health context. Method: A description of the processes of thematic analysis and content analysis is provided. These processes are then illustrated by conducting two analyses of the same qualitative data. Transcripts of qualitative interviews are analysed using each method to illustrate these processes. Results: The illustration of the processes highlights the different outcomes from the same set of data. Conclusion: Thematic and content analyses are qualitative methods that serve different research purposes. Thematic analysis provides an interpretation of participants’ meanings, while content analysis is a direct representation of participants’ responses. These methods provide two ways of understanding meanings and experiences and provide important knowledge in a mental health context.
Prevalence of Musculoskeletal Disorders for Nurses in Hospitals, Long-Term Care Facilities, and Home Health Care
Authors: Davis Kermit G. , Kotowski Susan E. 
Published: April 2015

Objective The aim of this study was to determine the prevalence of musculoskeletal pain and reported injuries for nurses and nursing aides. Background Nurses and nursing aides suffer from work-related pain and musculoskeletal disorders (MSDs). Although there have been a plethora of studies on MSDs, an overall understanding of the prevalence of MSDs and pain can lead to better prioritization of research needs with respect to the health care industry. Method A total of 132 articles on prevalence of MSD pain and injuries were included in the review. All articles were published in peer-reviewed English-speaking journals and subjected to a quality review. Results Reported prevalence of MSD pain for nurses and nursing aides was highest in the low back, followed by shoulders and neck. However, the majority of the studies have been concentrated on 12-month pain in the low back and predominantly in hospitals. Few researchers have investigated pain in the upper and lower extremities (less than 27% of the studies). Even fewer researchers have evaluated reported injuries or even subjective lost-time injuries (less than 15% of the studies). Conclusion MSD pain in the nursing profession has been widely investigated worldwide, with a major focus on low-back pain. Given new directions in health care, such as patients who live longer with more chronic diseases, bariatric patients, early mobility requirements, and those who want to be at home during sickness, higher prevalence levels may shift to different populations—home health care workers, long-term care workers, and physical therapists—as well as shift to different body regions, such as shoulders and upper extremities.
Comparison of human mesenchymal stem cells proliferation and differentiation on poly(methyl methacrylate) bone cements with and without mineralized collagen incorporation
Authors: Wu Jingjing , Xu Suju , Qiu Zhiye , Liu Peng , Liu Huiying , Yu Xiang , Cui Fu-Zhai , Chunhua Zhao Robert 
Published: April 2015

Poly(methyl methacrylate) bone cement is widely used in vertebroplasty, joint replacement surgery, and other orthopaedic surgeries, while it also exposed many problems on mechanical property and biocompatibility. Better performance in mechanical match and bone integration is highly desirable. Recently, there reported that incorporation of mineralized collagen into poly(methyl methacrylate) showed positive results in mechanical property and osteointegration ability in vivo. In the present study, we focused on the comparison of osteogenic behavior between mineralized collagen incorporated in poly(methyl methacrylate) and poly(methyl methacrylate). Human marrow mesenchymal stem cells are used in this experiment. Adhesion and proliferation were used to characterize biocompatibility. Activity of alkaline phosphatase was used to assess the differentiation of human marrow mesenchymal stem cells into osteoblasts. Real-time PCR was performed to detect the expression of osteoblast-related markers at messenger RNA level. The results show that osteogenic differentiation on mineralized collagen incorporated in poly(methyl methacrylate) bone cement is more than two times higher than that of poly(methyl methacrylate) after culturing for 21 days. Thus, important mechanism on mineralized collagen incorporation increasing the osteogenetic ability of poly(methyl methacrylate) bone cement may be understood in this concern.
Ethical aspects of a predictive test for Huntington’s Disease
Authors: Andersson Petra Lilja , Petersén Åsa , Graff Caroline , Edberg Anna-Karin 
Published: April 2015

Background: A predictive genetic test for Huntington’s disease can be used before any symptoms are apparent, but there is only sparse knowledge about the long-term consequences of a positive test result. Such knowledge is important in order to gain a deeper understanding of families’ experiences. Objectives: The aim of the study was to describe a young couple’s long-term experiences and the consequences of a predictive test for Huntington’s disease. Research design: A descriptive case study design was used with a longitudinal narrative life history approach. Participants and research context: The study was based on 18 interviews with a young couple, covering a period of 2.5 years; starting 6 months after the disclosure of the test results showing the woman to be a carrier of the gene causing Huntington’s disease. Ethical considerations: Even though the study was extremely sensitive, where potential harm constantly had to be balanced against the benefits, the couple had a strong wish to contribute to increased knowledge about people in their situation. The study was approved by the ethics committee. Findings: The results show that the long-term consequences were devastating for the family. This 3-year period was characterized by anxiety, repeated suicide attempts, financial difficulties and eventually divorce. Discussion: By offering a predictive test, the healthcare system has an ethical and moral responsibility. Once the test result is disclosed, the individual and the family cannot live without the knowledge it brings. Support is needed in a long-term perspective and should involve counselling concerning the families’ everyday life involving important decision-making, reorientation towards a new outlook of the future and the meaning of life. Conclusion: As health professionals, our ethical and moral responsibility thus embraces not only the phase in direct connection to the actual genetic test but also a commitment to provide support to help the family deal with the long-term consequences of the test.
Core professional nursing values of baccalaureate nursing students who are men
Authors: Schmidt Bonnie J 
Published: April 2015

Background: The perceptions of core professional nursing values of men in baccalaureate nursing programs are poorly understood. Objective: The study purpose was to understand and interpret the meaning of core professional nursing values to male baccalaureate nursing students. Research design and context: One-to-one interviews were conducted with male nursing students from a public university in the Midwest, following interpretive phenomenology. Ethical considerations: Measures to protect participants included obtaining Institutional Review Board approval, obtaining signed informed consent, and maintaining confidentiality. Findings: The study revealed five themes and several subthemes under an overarching finding of caring. Acquisition of professional nursing values began prior to the nursing program and continued to varying degrees throughout the program. Discussion: Several implications are offered for nursing education, nursing practice, research, and public policy. These include identification of common values, teaching-learning strategies, inclusive environments, teamwork, and conflict resolution. Conclusion: Caring was revealed using a metaphor of a puzzle.
Physician–pharmacist collaboration for oral chemotherapy monitoring: Insights from an academic genitourinary oncology practice
Authors: Holle Lisa M , Puri Sonam , Clement Jessica M 
Published: April 2015

Background Oral chemotherapy is being routinely used in metastatic castrate-resistant prostate and renal cell cancer. Although convenient, these drugs require monitoring for adherence, toxicity, and drug interactions to maximize outcomes. Oncology pharmacists have the training and expertise that place them in an optimal position to collaboratively provide medication therapy management. Methods A board-certified oncology pharmacist, working in collaboration with a medical oncologist, initiated an oral chemotherapy–monitoring program. The pharmacist provided education, completed medication therapy management; monitored for adherence and toxicity; and recommended treatment of toxicity and supportive care issues. Patient encounters included one of the following: collaboration with medical oncologist visit, pharmacist visit, or telephone or email follow-up between visits. Results From December 2012 to May 2014, the pharmacist had 123 encounters with 20 patients with either metastatic prostate ( n = 17) or renal cell cancer ( n = 3). All patients were males (median age 80 years). Most encounters were clinic visits, in collaboration with physician visit or alone (52%); 36% were telephone encounters, and 11.3% were email follow-ups. Medication-related problems were identified in 25% of the 315 assessments made. Problems included: adverse drug reactions, 40%; inappropriate therapy, 20%; and noncompliance, 18%. Recommendations included: modification of laboratory monitoring, 25%; cancer or non-cancer therapy modification, 12%; drug discontinuation, 6.9%. Non-cancer therapy-related drug information and coordination of care accounted for 30% of recommendations. Conclusion Our program led to identification of a number of potentially clinically significant issues for patients on oral chemotherapy and demonstrated the benefit of the pharmacist in the multidisciplinary team to assist in addressing them.
‘Know before you go’: information-seeking behaviour of German patients receiving health services abroad in light of the provisions of Directive 2011/24/EU
Authors: Panteli Dimitra , Wagner Caroline , Verheyen Frank , Busse Reinhard 
Published: April 2015

Objective While Directive 2011/24/EU on cross-border patient mobility makes specific provisions in relation to information availability and accessibility, little empirical evidence exists to guide best practice. This paper explores the information-seeking behaviour of German patients who received planned care abroad. Methods A postal survey among German patients treated in other European countries was carried out by Techniker Krankenkasse, a major German sickness fund. The influence of certain predictors on whether patients informed themselves before travelling for care was investigated using multiple logistic regression. Types and sources of information were analysed using descriptive statistics. Results Information activity was contingent on patients' level of education, type of service, regularity of treatment abroad and awareness of entitlement to cross-border services. Respondents most frequently enquired about elements of reimbursement, entitlement to services and cost-saving, and consulted their sickness fund for information. Differences in both content and medium of choice were observed between patient groups. Conclusion A structured and inclusive approach to information provision should be adopted. National Contact Points should collaborate with a range of stakeholders, who will vary depending on the health care system; however, patient organizations, health professionals and third-party payers should always be represented. Dynamically monitoring cross-border movements can help determine the range, medium and language of relevant information.
Quantificazione automatica di spettri 1H ed estrazione di mappe metaboliche da acquisizioni CSI mediante Wavelet Packets
Authors: Origgi D. , Mainardi L.T. , Falini A. , Calabrese G. , Scotti G. , Cerutti S. , Tosi G. 
Published: April 2015

La quantificazione dei picchi spettrali del segnale di spettroscopia 1H in risonanza magnetica, utile per un'analisi metabolica dei tessuti in-vivo, richiede un tempo di elaborazione elevato, soprattutto quando si tratta di acquisizioni CSI dove ad essere elaborata è un'intera matrice di dati. Inoltre, la sovrapposizione dei picchi, maggiormente marcata negli spettri con tempo di eco breve (20 ms), rende spesso difficoltosa la separazione dei singoli contributi metabolici. Si propone pertanto un metodo automatico per la quantificazione dei metaboliti, che utilizza l'algoritmo delle Wavelet Packets per scomporre il segnale nel dominio del tempo (FID) in sottobande. La stima dei parametri di ampiezza, fase, frequenza e smorzamento viene quindi eseguita nelle sottobande, dove cadono i picchi di interesse, mediante metodi di predizione lineare basati sulla scomposizione a valori singolari (LPSDV). L'ampiezza stimata dei picchi viene infine utilizzata sia per il calcolo dei rapporti metabolici sia per l'estrazione di mappe metaboliche. Il metodo di quantificazione proposto è stato messo a punto su fantocci e poi applicato alle acquisizioni di volontari sani e infine su alcuni pazienti. L'elaborazione automatica dei dati spettroscopici con il metodo proposto offre la possibilità di studiare in modo efficace ed affidabile i metaboliti cerebrali nonché di rappresentare la loro distribuzione spaziale mediante mappe metaboliche.
Contributo della risonanza magnetica spettroscopica del protone (1H-RMS) nella infezione da HIV
Authors: Simone I.L. , Tortorella C. , Federico F. , Lucivero V. , Carrara D. , Giannini P. , Bellacosa A. , Andreula C.F. 
Published: April 2015

È stato condotto uno studio combinato di RMI e 1H-RMS (Magnetom Siemens 1,5 Tesla) in 60 pazienti sieropositivi per HIV (n. 25 encefalopatie-HIV correlate, n. 20 toxoplasmosi, n. 8 PML, n. 7 linfomi) e 22 controlli neurologici sieronegativi per HIV. Gli spettri sono stati acquisiti su volumi singoli localizzati su lesioni focali in toxoplasmosi, PML, linfomi o su lesioni diffuse nelle encefalopatie da HIV (sequenza Spin Echo, TE 135 ms). In tutti i sottogruppi HIV si è evidenziato un significativo decremento del rapporto NAA/Cr rispetto ai controlli neurologici, suggerendo un danno neuronale e/o assonale indipendentemente dall'eziologia. Tuttavia il rapporto NAA/Cr era più basso nelle PML e nei linfomi. Un significativo incremento del rapporto Cho/Cr era rilevato nelle encefalopatie da HIV, nelle PML e in particolare nei linfomi ove tale incremento era associato alla presenza del segnale dei lipidi, marker entrambi di un aumentato turnover e sintesi di membrane cellulari. Nelle PML si rilevava infine con elevata frequenza il segnale del lattato. I dati confermano una elevata sensibilità della 1H-RMS nel rilevare una compromissione metabolica cerebrale in corso di infezione da HIV. Nonostante una globale scarsa specificità nel discriminare lesioni di differente eziologia, determinati pattern metabolici possono risultare di supporto alla RMI per la diagnosi eziologica di alcune lesioni, per esempio di PML.
Valore prognostico della risonanza magnetica spettroscopica protonica nell'ictus ischemico
Authors: Mezzapesa D.M. , Lucivero V. , Simone I.L. , Laddomada G. , Petruzzellis M. , Tortorella G , Federico F. 
Published: April 2015

La risonanza magnetica spettroscopica protonica (1H-MRS) è stata applicata allo studio di pazienti con ictus ischemico in fase acuta-subacuta per valutare l'eventuale correlazione tra concentrazione dei metaboliti ed esito funzionale. L'esame è stato condotto su 26 pazienti entro la prima settimana dall'ictus. Il VOI è stato posto sull'area ischemica e su un'area cerebrale apparentemente sana controlaterale simmetrica. A sei mesi dall'ictus è stato valutato l'esito funzionale del paziente applicando la Scandivanian Stroke Scale (SSS) ed il Barthel Index (BI). I segnali provenienti da N-acetilaspartato (NAA), colina (Cho) e creatina-fosfocreatina (Cr) erano significativamente ridotti in confronto con le aree sane controlaterali (p<0,001; p<0,001 e p<0,003 rispettivamente al test di Wilcoxon). In 19 pazienti era presente acido lattico (Lac). Il coefficiente di correlazione per ranghi di Spearman ha mostrato una significativa correlazione positiva tra punteggio SSS a sei mesi e NAA (p = 0,01). I pazienti in cui il Lac era presente avevano un punteggio SSS significativamente più basso (p = 0,049 al test U di Mann-Whitney). L'1H-MRS eseguita in fase acuta-subacuta dell'ictus ischemico fornisce utili informazioni prognostiche.
Riorganizzazione plastica cerebrale post-ictus
Authors: Pelliccioli G.P. , Chiarini P. , Floridi P. , Leone F. , Franceschini M. , Todeschini E. , Zampolini M. 
Published: April 2015

Lo sviluppo delle moderne tecniche di immagini non invasive ha determinato un notevole progresso nelle conoscenze del recupero funzionale dopo ictus, potenzialmente di grande utilità per la messa a punto di programmi terapeutici e riabilitativi. Diversi meccanismi sono stati proposti, quali l'attivazione di vie derivanti dalle aree corticali motorie omolaterali al lato paretico, il reclutamento di aree corticali adiacenti alla lesione, il rinforzo di circuiti neuronali preesistenti, lo stabilirsi di nuove connessioni a livello sinaptico. Considerati i dati contraddittori della letteratura, abbiamo effettuato un studio mediante Risonanza Magnetica funzionale (fMRI) con lo scopo di definire meglio il ruolo delle proiezioni omolaterali e i fenomeni di riorganizzazione plastica post-ictale delle aree corticali motoria primaria (M1), premotoria laterale (PML) e supplementare motoria (SMA). Sono stati studiati 14 pazienti con pregresso ictus ischemico sottocorticale in buon recupero funzionale, 7 con emiparesi destra e 7 con emiparesi sinistra, ad una distanza mediana di 61 giorni dall'evento ischemico. I risultati hanno evidenziato durante il movimento della mano paretica un'attivazione bilaterale della M1 ed in misura minore delle PML e SMA, mentre si è registrata un'attivazione controlaterale più selettiva durante il movimento della mano sana. I dati sembrerebbero dimostrare che una maggiore attivazione delle aree motorie corticali omolaterali alla lesione sia un importante meccanismo di compenso al danno funzionale conseguente ad ictus non solo nella fase postacuta ma anche nella fase di stabilizzazione.
Il massiccio facciale superiore: Patologia non traumatica
Authors: Arcuri T. , Calabrò F. , Delucchi S. , Capellini C. 
Published: April 2015

Da sempre la componente ossea ha rappresentato una barriera per l'esplorazione radiologica del massiccio facciale superiore, barriera che è stata superata soltanto con l'avvento della tomografia computerizzata, che ha consentito di ottenere, oltre all'evidenziazione delle strutture ossee, anche importanti informazioni sui tessuti molli sia superficiali che profondi. La TC costituisce attualmente la modalità di scelta per la valutazione delle cavità nasali e paranasali, ove è in grado di delineare in particolare l'anatomia del complesso ostiomeatale: valutazione quest'ultima ormai indispensabile nello studio della patologia infiammatoria, specie ai fini della preparazione alla chirurgia funzionale endoscopica. La risonanza magnetica, pur con i limiti della non ottimale visualizzazione della componente ossea, permette, grazie alla sua sensibilità ed alla sua alta specificità, una differenziazione tissutale superiore rispetto alla TC come nel caso della patologia neoplastica ove consente spesso la distinzione tra tessuto neoplastico e materiale infiammatorio e/o da ritenzione specie endosinusale.