bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Long‐term Clinical Endpoints in Patients With Refractory Angina
Authors: Povsic Thomas J. , Broderick Samuel , Anstrom Kevin J. , Shaw Linda K. , Ohman E. Magnus , Eisenstein Eric L. , Smith Peter K. , Alexander John H. 
Published: January 2015

Background

Clinical outcomes in patients with refractory angina (
RA
) are poorly characterized and variably described. Using the Duke Database for Cardiovascular Disease (
DDCD
), we explored characteristics that drive clinical endpoints in patients with class
II
to
IV
angina stabilized on medical therapy.

Methods and Results

We explored clinical endpoints and associated costs of patients who underwent catheterization at Duke University Medical Center from 1997 to 2010 for evaluation of coronary artery disease (
CAD
) and were found to have advanced
CAD
ineligible for additional revascularization, and were clinically stable for a minimum of 60 days. Of 77 257 cardiac catheterizations performed, 1908 patients met entry criteria. The 3‐year incidence of death; cardiac rehospitalization; and a composite of death, myocardial infarction, stroke, cardiac rehospitalization, and revascularization were 13.0%, 43.5%, and 52.2%, respectively. Predictors of mortality included age, ejection fraction (
EF
), low body mass index, multivessel
CAD
, low heart rate, diabetes, diastolic blood pressure, history of coronary artery bypass graft surgery, cigarette smoking, history of congestive heart failure (
CHF
), and race. Multivessel
CAD
,
EF
<45%, and history of
CHF
increased risk of mortality; angina class and prior revascularization did not. Total rehospitalization costs over a 3‐year period per patient were $10 185 (95%
CI
8458, 11912) in 2012
US
dollars.

Conclusions

Clinically stable patients with
RA
who are medically managed have a modest mortality, but a high incidence of hospitalization and resource use over 3 years. These findings point to the need for novel therapies aimed at symptom mitigation in this population and their potential impact on health care utilization and costs.
Antithrombotic Therapy and Outcomes After ICD Implantation in Patients With Atrial Fibrillation and Coronary Artery Disease: An Analysis From the National Cardiovascular Data Registry (NCDR)
®
Authors: Ghanbari Hamid , Nallamothu Brahmajee K. , Wang Yongfei , Curtis Jeptha P. 
Published: January 2015

Background
Management of antithrombotic agents after implantable cardioverter defibrillator implantation is challenging, particularly among patients with atrial fibrillation and coronary artery disease.

Methods and Results

Using data from National Cardiovascular Data Registry
®
Implantable Cardioverter Defibrillator Registry
™
linked with Medicare claims data, we identified 25 180 patients with atrial fibrillation and coronary artery disease who underwent implantable cardioverter defibrillator implantation. Patients were categorized into 5 different groups according to antithrombotic agents prescribed at discharge (any 1 antiplatelet agent [A, n=6538], dual antiplatelet therapy [
DA
, n=3414], warfarin [n=5264], warfarin+A [n=7994], warfarin+
DA
[n=1970]). We assessed the primary outcomes occurring within 30 days of hospital discharge. Combinations of
DA
(adjusted hazard ratio [
HR
]: 1.39; 95%
CI
: 1.03 to 1.87), warfarin+A (adjusted
HR
: 1.32; 95%
CI
: 1.03 to 1.69), and warfarin+
DA
(adjusted
HR
: 2.03; 95%
CI
: 1.49 to 2.77) were associated with a higher bleeding risk. The risk of major adverse cardiovascular events was higher in patients discharged with A (adjusted
HR
: 1.69; 95%
CI
: 1.33 to 2.16),
DA
(adjusted
HR
: 2.17; 95%
CI
: 1.66 to 2.83), and
DA
+warfarin (adjusted
HR
: 1.61; 1.16 to 2.24). There was no association between postdischarge antithrombotic agents and thromboembolic events or device‐related complications.

Conclusions
Short‐term bleeding risk and major adverse cardiovascular events differ with usage patterns of antithrombotic agents, while the risk of thromboembolic events and device‐related complications is relatively constant. These data may help clinicians balance risks and benefits when choosing antithrombotic therapy following implantable cardioverter defibrillator implantation.
The Association Between Reduction in Inflammation and Changes in Lipoprotein Levels and HDL Cholesterol Efflux Capacity in Rheumatoid Arthritis
Authors: Liao Katherine P. , Playford Martin P. , Frits Michelle , Coblyn Jonathan S. , Iannaccone Christine , Weinblatt Michael E. , Shadick Nancy S. , Mehta Nehal N. 
Published: January 2015

Background

Potent anti‐inflammatory rheumatoid arthritis (RA) treatments are associated with reduced cardiovascular risk as well as increases in low‐density lipoprotein (
LDL
) cholesterol. This apparent paradox may be explained by favorable changes in other lipid measurements. The objective of this study was to determine the longitudinal association between changes in inflammation with advanced lipoprotein measurements and high‐density lipoprotein (
HDL
) cholesterol efflux capacity.

Methods and Results

We conducted this study in a longitudinal
RA
cohort from a large academic center, including subjects with high‐sensitivity C‐reactive protein (hs‐
CRP
) reduction ≥10 mg/L at 2 time points 1 year apart. Subjects receiving statins during the study period or preceding 6 months were excluded. We compared total cholesterol,
LDL
cholesterol, HDL cholesterol, apolipoprotein B, and apolipoprotein A1 levels and
HDL
cholesterol efflux capacity at baseline and 1‐year follow‐up by using the paired
t
test. We also assessed the correlations between reductions in hs‐
CRP
with percentage change in lipid parameters. We studied 90
RA
subjects (mean age 57 years, 89% female), all of whom were receiving disease‐modifying antirheumatic drugs. We observed a 7.2% increase in
LDL
cholesterol levels (
P
=0.02) and improvement in efflux capacity by 5.7% (
P
=0.002) between baseline and follow‐up, with a median hs‐
CRP
reduction of 23.5 mg/L. We observed significant correlations between reductions in hs‐
CRP
with increases in apolipoprotein A1 (
r
=0.27,
P
=0.01) and
HDL
cholesterol efflux capacity (
r
=0.24,
P
=0.02).

Conclusion

Among
RA
subjects experiencing reductions in hs‐
CRP
, we observed increased
LDL
cholesterol levels and concomitant improvements in
HDL
cholesterol efflux capacity. These findings provide further insight into lipid modulation and the beneficial effect of reduction in inflammation on lipids in vivo.
Seasonal-to-Interannual Variability of Ethiopia/Horn of Africa Monsoon. Part II: Statistical Multimodel Ensemble Rainfall Predictions
Authors: Segele Zewdu T. , Richman Michael B. , Leslie Lance M. , Lamb Peter J. 
Published: January 2015

AbstractAn ensemble-based multiple linear regression technique is developed to assess the predictability of regional and national June–September (JJAS) anomalies and local monthly rainfall totals for Ethiopia. The ensemble prediction approach captures potential predictive signals in regional circulations and global sea surface temperatures (SSTs) two to three months in advance of the monsoon season. Sets of 20 potential predictors are selected from visual assessments of correlation maps that relate rainfall with regional and global predictors. Individual predictors in each set are utilized to initialize specific forward stepwise regression models to develop ensembles of equal number of statistical model estimates, which allow quantifying prediction uncertainties related to individual predictors and models. Prediction skill improvement is achieved through error minimization afforded by the ensemble.For retroactive validation (RV), the ensemble predictions reproduce well the observed all-Ethiopian JJAS rainfall variability two months in advance. The ensemble mean prediction outperforms climatology, with mean square error reduction (SSClim) of 62%. The skill of the prediction remains high for leave-one-out cross validation (LOOCV), with the observed–predicted correlation r (SSClim) being +0.81 (65%) for 1970–2002. For tercile predictions (below, near, and above normal), the ranked probability skill score is 0.45, indicating improvement compared to climatological forecasts. Similarly high prediction skill is found for local prediction of monthly rainfall total at Addis Ababa (r = +0.72) and Combolcha (r = +0.68), and for regional prediction of JJAS standardized rainfall anomalies for northeastern Ethiopia (r = +0.80). Compared to the previous generation of rainfall forecasts, the ensemble predictions developed in this paper show substantial value to benefit society.
The Role of Cloud-Top Generating Cells and Boundary Layer Circulations in the Finescale Radar Structure of a Winter Cyclone over the Great Lakes
Authors: Rauber Robert M. , Plummer David M. , Macomber Matthew K. , Rosenow Andrew A. , McFarquhar Greg M. , Jewett Brian F. , Leon David , Owens Nathan , Keeler Jason M. 
Published: January 2015

Abstract
Data from airborne W-band radar are used in conjunction with thermodynamic fields from the Weather Research and Forecasting Model and air-parcel back trajectories from the HYSPLIT model to investigate the finescale reflectivity, vertical motion, and airmass structure of the comma head of a winter cyclone in the vicinity of the Great Lakes. Cloud-top generating cells formed along an upper-level frontal boundary vertically separating dry air, which 48 h earlier was located in the upper troposphere over south-central Canada, from moist air, which was located in the lower troposphere over the southeast United States. The stronger updrafts within the generating cells had vertical velocities ranging from 1 to 3 m s−1. The generating cells were important to precipitation production within the comma head. Precipitation trails formed within the generating cells could sometimes be followed to the boundary layer before merging.
Boundary layer air beneath the cyclone’s comma head exhibited convective circulations and was turbulent. Gravity waves were sometimes observed at the base of the stable layer atop the convective boundary layer. Trajectory analyses showed that boundary layer air sampled by radar beneath the aircraft path had a history of crossing the Great Lakes. The magnitude of updrafts and downdrafts in the boundary layer were 1–2 m s−1, while wave circulations exhibited maximum updrafts and downdrafts of ~3 m s−1. The tops of some boundary layer convective circulations and gravity waves exhibited enhancements in radar reflectivity. The data presented illustrate the impact of the Great Lakes on cyclone mesostructure during the passage of a cyclone through the region.
Traffic analysis of a simplified two-dimensional elevator system
Authors: So Albert , Al-Sharif Lutfi , Hammoudeh Ahmad 
Published: January 2015

The idea of multicar operation within one hoistway is not new. Two-car systems are currently available on the market, whereby the two cars travel with restricted independence because one car must always remain above the other. With recent advances in linear machines, systems with more than two cars in one hoistway will soon become possible. In this paper, the authors go one step forward by assuming that multiple cars can move in a two-dimensional plane either attached to the facade of the building or across a vertical slice within the building. The analysis has been restricted at this stage to incoming traffic only. It is assumed that elevator cars can move upwards, downwards as well as sideways. In this way, passengers can exit at a stop very close to their destinations. The foreseeable technology is discussed, and two configurations (denoted as setups A and B) are proposed. The traffic analysis equations for such a system are also derived. A simulation is then carried out for the two setups based on one-car operation. The simulation shows that the proposed two-dimensional elevator system can reduce the total traveling time of a passenger as compared with the conventional one-dimensional setup. The system is described as special because the number of hoistways is restricted (up to a maximum of 2). Practical application: This paper provides a practical way of evaluating the round trip time for two different two-dimensional elevator applications. It also then compares three different sizes of buildings and shows that the use of two-dimensional elevator arrangements is only feasible for building with more than 30 floors high by 30 rooms wide.
Outcomes of gait trainer use in home and school settings for children with motor impairments: a systematic review
Authors: Paleg Ginny , Livingstone Roslyn 
Published: January 2015

Objective: To summarize and critically appraise evidence regarding use of gait trainers (walkers providing trunk and pelvic support) at home or school with children who are unable to walk independently or with hand-held walkers. Data sources: Searches were performed in seven electronic databases including EBM Reviews, CINAHL, Medline and EMBASE for publications in English from database inception to November 2014. Review methods: Included studies involved at least one child with a mobility limitation and measured an outcome related to gait trainer use. Articles were appraised using American Academy of Cerebral Palsy and Developmental Medicine criteria for group and single-subject designs and quality ratings completed for studies rated levels I-III. The PRISMA statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, abstracts and full-text articles. Results: Seventeen studies involving 182 children were included. Evidence from one small randomized controlled trial suggests a non-significant trend toward increased walking distance while the other evidence level II study (concurrent multiple baseline design) reports increased number of steps. Two level III studies (non-randomized two-group studies) report statistically significant impact on mobility level with one finding significant impact on bowel function and an association between increased intervention time and bone mineral density. Remaining descriptive level evidence provides support for positive impact on a range of activity outcomes, with some studies reporting impact on affect, motivation and participation with others. Conclusions: Evidence supporting outcomes for children using gait trainers is primarily descriptive and, while mainly positive, is insufficient to draw firm conclusions.
Over ground walking and body weight supported walking improve mobility equally in cerebral palsy: a randomised controlled trial
Authors: Swe Ni Ni , Sendhilnnathan Sunitha , van Den Berg Maayken , Barr Christopher 
Published: January 2015

Objective: To assess partial body weight supported treadmill training versus over ground training for walking ability in children with mild to moderate cerebral palsy. Design: Randomised controlled trial. Setting: A Special Needs school in Singapore. Subjects: Thirty children with cerebral palsy, aged 6-18, with a Gross Motor Function Classification System score of II-III. Interventions: Two times 30 minute sessions of walking training per week for 8 weeks, progressed as tolerated, either over ground (control) or using partial body weight supported treadmill training (intervention). Main measures: The 10 metre walk test, and the 6 minute walk test. Secondary measures were sub-sections D and E on the Gross Motor Function Measure. Outcomes were assessed at baseline, and after 4 and 8 weeks of training. Results: There was no effect of group allocation on any outcome measure, while time was a significant factor for all outcomes. Walking speed improved significantly more in the intervention group by week 4 (0.109 (0.067)m/s vs 0.048 (0.071)m/s, P=0.024) however by week 8 the change from baseline was similar (intervention 0.0160 (0.069)m/s vs control 0.173 (0.109)m/s, P=0.697). All gains made by week 4 were significantly improved on by week 8 for the 10 metre walk test, 6 minute walk test, and the gross motor function measure. Conclusions: Partial body weight supported treadmill training is no more effective than over ground walking at improving aspects of walking and function in children with mild to moderate cerebral palsy. Gains seen in 4 weeks can be furthered by 8 weeks.
Postanaesthetic emergence agitation in adult patients after general anaesthesia for urological surgery
Authors: Kim Hyun-Chang , Kim Eugene , Jeon Young-Tae , Hwang Jung-Won , Lim Young-Jin , Seo Jeong-Hwa , Park Hee-Pyoung 
Published: January 2015

Objective To investigate the incidence and risk factors for emergence agitation in the postanaesthetic care unit (PACU), in adult patients undergoing urological surgery. Methods Medical records were retrospectively reviewed. Preoperative, intraoperative and postoperative variables were evaluated. Emergence agitation was defined as a Riker sedation–agitation score ≥5. Logistic regression analysis was used to determine independent risk factors for emergence agitation. Results Emergence agitation was observed in 48/488 (9.8%) patients. Chronic lung disease (odds ratio [OR] 2.72, 95% confidence interval [CI] 1.03, 7.17), duration of surgery (OR 1.01, 95% CI 1.00, 1.01), history of social drinking (OR 2.48, 95% CI 1.25, 4.93), postoperative pain score (OR 1.32, 95% CI 1.14, 1.53), voiding urgency (OR 2.20, 95% CI 1.01, 4.77) and presence of gastric tube (OR 2.85, 95% CI 1.07, 7.54) were independent risk factors for emergence agitation. Conclusions Adequate postoperative pain management and prevention of catheter-related bladder discomfort may be helpful in reducing the incidence of emergence agitation in urology patients.
A 24-Hour Postintensive Care Unit Transition-of-Care Model Shortens Hospital Stay
Authors: Kheir Fayez , Shawwa Khaled , Nguyen Du , Alraiyes Abdul Hamid , Simeone Francesco , Nielsen Nathan D. 
Published: January 2015

Background: Patients discharged early from the medical intensive care unit (MICU) are at risk of deterioration, MICU readmission, and increased mortality. An earlier discharge to a medical ward is desirable to reduce costs but it may adversely affect outcomes. To address this problem, a new model for the MICU transition of care was implemented at our academic center: The MICU team continued to manage all patients transferred from the MICU to the medical ward for at least 24 hours. Methods: Data were collected for all MICU patients admitted 1 year before and 1 year after the intervention. Hospital length of stay (LOS) after transfer from the MICU, readmission rate, and mortality rate were compared before and after the intervention. A nonparsimonious propensity model based on 30 factors was used to identify matched preintervention and postintervention cohorts. Results: A total of 618 of the 848 patients admitted to the MICU were transferred to medical ward during the year prior to the implementation of the new model, and 600 of the 883 patients were transferred during the following year. Pre- and postintervention cohorts were well matched (n = 483 patients in each group). Poisson regression analysis showed a decrease in the hospital LOS after MICU transfer by 1.17 days ( P < .001) without a significant change in adjusted mortality (lower by 1.9%, P = .181) and MICU readmission rates (lower by 2%, P = .264). Conclusion: A new model for the post-MICU transition of care, with the MICU team continuing to manage all patients transferred to the medical ward for at least 24 hours, significantly decreased duration of hospital stay after MICU transfer without affecting MICU readmission and mortality rate. The implementation of this model may lower medical costs and make transition of care safer without adverse outcomes.
Impact of Pharmacy Residency Research Training on Residents’ Actual Versus Perceived Ability and Interest to Identify and Solve Practice-Related Problems
Authors: Pinelli Nicole R. , Sikora Andrea N. , Witherspoon Leigh A. , Rao Kamakshi V. , Rhoney Denise H. 
Published: January 2015

Purpose: The American Society of Health-System Pharmacists (ASHP) requires that accredited residency programs provide pharmacy residents the opportunity to perform a practice-based project. The objective of this study was to evaluate the impact of pharmacy residency research training on residents’ actual versus perceived ability to solve practice-related problems in their professional careers. Methods: This cross-sectional study surveyed postgraduate year 1 (PGY1) pharmacy practice residents who completed training at a large academic medical center between 2007 and 2013. The survey consisted of 3 areas of assessment, that is, (1) general demographics, (2) perceived research abilities, and (3) self-reported research productivity. Results: A total of 39 residents were eligible; of those, 27 completed the survey (69.2% response rate). Participants reported low perceived ability for conductance of some research activities including study design development, implementation, and publication. No association between perceived research ability and self-reported research productivity was found. Research experience prior to residency training strongly predicted for subsequent publication after completion of PGY1 residency training ( P < .0001). Conclusions: New training mechanisms may be needed to optimize research training that will provide residents with greater emphasis on areas of perceived deficiency.
Availability and Accuracy of Information Regarding Nonprescription Emergency Contraception
Authors: Orr Katherine Kelly , Lemay Virginia A. , Wojtusik Amanda P. , Opydo-Rossoni Margaret , Cohen Lisa B. 
Published: January 2015

Background: Although access to emergency contraception (EC) has increased with nonprescription status and approval of Plan B One-Step without age restrictions, barriers may still remain in patient education. This study assesses product availability and accuracy of information for EC among community pharmacies in Rhode Island, comparing changes from 2009 to 2012. Methods: Two female investigators posing as patients seeking EC followed a standardized script over telephone conversations. Investigators assessed EC availability, product use information, and cost at all community (retail) pharmacies in Rhode Island. Data were reported as group results with no identifiers. Chi-square and Fisher exact tests were used to analyze results. Results: During spring of 2009 and 2012, 165 and 171 pharmacies were telephoned, respectively. Approximately 90% of pharmacies stocked EC both years. In all, 62% versus 28% ( P < .001) indicated EC should be taken as soon as possible; 82.5% versus 87.7% ( P = .220) provided correct administration information; 67% versus 84% ( P < .001) warned about adverse effects; and 67% versus 53% ( P = .123) provided the correct minimum age for purchase. Conclusions: Access to nonprescription EC in Rhode Island is very good. Sites not stocking EC should reassess plans for patients to obtain medication. There is need for reeducation on EC labeling to improve counseling provided over the telephone.
MERIT40 deficiency expands hematopoietic stem cell pools by regulating thrombopoietin receptor signaling
Authors: Rozenova Krasimira , Jiang Jing , Donaghy Ryan , Aressy Bernadette , Greenberg Roger A. , Tong Wei 
Published: January 2015

Key Points
MERIT40-deficient mice harbor an expanded HSC pool with increased quiescence, enhanced self-renewal, and reconstitution potential. MERIT40 negatively controls HSC homeostasis through regulating the Tpo/Mpl pathway.