Longer Cumulative Time Research Articles

Association of Hypotension During Thrombectomy and Outcomes Differs With the Posterior Communicating Artery Patency.

Hypotension during endovascular therapy for acute ischemic stroke is associated with worse functional outcomes (FO). Given its important role in intracranial hemodynamics, we investigated whether hypotension during endovascular therapy had the same effect on FO according to the posterior communicating artery (PComA) patency. We performed a post hoc analysis of the ASTER trial (Contact Aspiration Versus Stent Retriever for Successful Revascularization). Patients were included if they had middle cerebral artery occlusions. Primary outcome was favorable FO, defined by a modified Rankin Scale scores between 0 and 2 at 3 months. One hundred forty-eight patients with middle cerebral artery occlusion were included. In patients with no PComA, an increase in minimum mean arterial pressure was positively associated with favorable FO (odds ratio per 10 mm Hg increase, 1.59 [95%CI, 1.11-2.25]; P=0.010), whereas no association was found in patients with a PComA (odds ratio, 0.77 [95% CI, 0.54-1.08]; P=0.12). Patients with no PComA and longer cumulative time with mean arterial pressure <90 mm Hg or systolic blood pressure <140 mm Hg had significantly lower rates of favorable FO, with an odds ratio per 10-minute increase of 0.75 (95% CI, 0.59-0.94; P=0.010) and 0.74 (95% CI, 0.60-0.91; P=0.003), but not in patients with a PComA. Hypotension during endovascular therapy for middle cerebral artery occlusion is consistently associated with worse FO in patients with no PComA but not in those with a PComA. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02523261.

Care Transitions Program for High-Risk Frail Older Adults is Most Beneficial for Patients with Cognitive Impairment.

Although posthospitalization care transitions programs (CTP) are highly diverse, their overall program thoroughness is most predictive of their success. To identify components of a successful homebased CTP and patient characteristics that are most predictive of reduced 30-day readmissions. Retrospective cohort. A total of 315 community-dwelling, hospitalized, older adults (≥60 years) at high risk for readmission (Elder Risk Assessment score ≥16), discharged home over the period of January 1, 2011 to June 30, 2013. Midwest primary care practice in an integrated health system. Enrollment in a CTP during acute hospitalization. The primary outcome was all-cause readmission within 30 days of the first CTP evaluation. Logistic regression was used to examine independent variables, including patient demographics, comorbidities, number of medications, completion, and timing of program fidelity measures, and prior utilization of healthcare. The overall 30-day readmission rate was 17.1%. The intensity of follow-up varied among patients, with 17.1% and 50.8% of the patients requiring one and ≥3 home visits, respectively, within 30 days. More than half (54.6%) required visits beyond 30 days. Compared with patients who were not readmitted, readmitted patients were less likely to exhibit cognitive impairment (29.6% vs 46.0%; P = .03) and were more likely to have high medication use (59.3% vs 44.4%; P = .047), more emergency department (ED; 0.8 vs 0.4; P = .03) and primary care visits (4.0 vs 3.0; P = .018), and longer cumulative time in the hospital (4.6 vs 2.5 days; P = .03) within 180 days of the index hospitalization. Multivariable analysis indicated that only cognitive impairment and previous ED visits were important predictors of readmission. No single CTP component reliably predicted reduced readmission risk. Patients with cognitive impairment and polypharmacy derived the most benefit from the program.

Characteristic Study on the "Weekend Effect" of Atmospheric O3 in Northern Suburb of Nanjing

The data of ozone (O3) and its precursors (NOx, CO, VOCs) observed at northern suburb of Nanjing from December 01, 2013 to November 30, 2014 were used to analyze the difference of pollutant concentrations on weekends and weekdays, and its causes. The results showed that there was an obvious "Weekend Effect" in northern suburb of Nanjing. The mass concentrations of O3 on weekdays were higher than those on weekends, whereas mass concentrations of its precursors were higher on the weekends; The average mass concentrations of O3 were 19.84 μg·m-3, 53.45 μg·m-3, 57.17 μg·m-3, and 40.43 μg·m-3 in winter, spring, summer, and autumn respectively. Compared with other seasons, "Weekend Effect " was more distinct in spring. The value of NO2/NO was 4.81% higher on weekdays (3.63) than on weekends (3.46). The longer cumulative time and higher accumulation rate of O3, and the stronger atmospheric oxidation capacity on weekdays were responsible for the higher O3 mass concentrations on weekdays. The correlation coefficients of the mass concentrations of O3 with VOCs, NOx, NO, and NO2 were higher on weekdays than on weekends.

Effect of bedtime on recurrent aphthous stomatitis in college students

In this study, we conducted a questionnaire-based survey at Sichuan University to investigate the potential effects of bedtime on recurrent aphthous stomatitis (RAS). An anonymous self-designed questionnaire was adopted to investigate the association between bedtime and RAS in college students at Sichuan University. Statistical analyses were used to identify risk factors for RAS and to explore the relationship between bedtime and RAS. One thousand six students were investigated. High frequency of colds (odds ratio [OR] 2.17; 95% confidence interval [CI] 1.52-3.10; P < .001) and bedtime after 11 p.m. (OR 16.55; 95% CI 6.49-42.16; P < .001) were independent risk factors for RAS recurrence, but family history, stress, bad relationships with roommates, and gastrointestinal disease were not. Moreover, increased frequency of bedtime after 11 p.m. (τ > 0; P < .05), as well as longer cumulative time from 11 p.m. to bedtime (R > 0; P < .05), was correlated with increased severity of ulcers. Bedtime after 11 p.m. not only served as an independent risk factor but both its frequency and cumulative time were also associated with severity of RAS in college students.

Investigation of the risk factors for fractures among hemodialysis patients

Objective To study the risk factors for fractures among hemedialysis patients. Methods 160 patients who received maintenance hemodialysis in our center had been followed from January of 2003 to December of 2007. Fractures were identified and the schedule of dialysis, laboratory values and medications were recorded. Results A total of 32 bone fratures occurred in 160 patients. Associated risk factors included age, sex, yeats on hemodialysis, cumulative time on hemofihration per week, prior renal transplant, history of medications, needs assistance to walk, serum calcium, phosphorus, Hb, PTH and B2-microglobulin. Conclusions Two main mechanisms may account for the increased fracture risk in HD patients: either a lower resistance of bone after relatively minor traumas or an increased propensity to falls. We should pay much attention to the patients with older age, female gender, longer cumulative time on HD, needs assistance to walk, a history of falls and higher PTH level. Key words: Hemodialysis; Fractures; Risk Factors

Hypervelocity impact tests on Space Shuttle Orbiter RCC thermal protection material

It is noted that the Shuttle Orbiter will be more subject to meteoroid impact than previous spacecraft, due to its greater surface area and longer cumulative time in space. The Orbiter structural material, RCC, a reinforced carbon-carbon laminate with a diffused silicon carbide coating, is evaluated in terms of its resistance to hypervelocity impact. It was found that the specimens (disks with a mass of 34 g and a thickness of 5.0 mm) were cratered only on the front surface when the impact energy was 3 J or less. At 3 J, a trace of the black carbon interior was exposed. The specimens were completely penetrated when the energy was 34 J or greater.