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  • 1
    Online Resource
    Online Resource
    Investigation of the Thermal Performance of Salt Hydrate Phase Change of Nanoparticle Slurry Flow in a Microchannel
    Hindawi Limited ; 2019
    In:  Journal of Chemistry Vol. 2019 ( 2019-01-03), p. 1-10
    Details
    In: Journal of Chemistry, Hindawi Limited, Vol. 2019 ( 2019-01-03), p. 1-10
    Abstract: Computational study was conducted to investigate the thermal performance of water-based salt hydrate S44 nanoparticles as the phase change material (PCM) in a microchannel heat sink. Constant heat dissipation was applied on the top wall of the heat sink. Forced internal convection of the PCM slurry flow was performed through a homogeneous approach. Three thermal performance parameters, including effectiveness ratio, performance index, and Merit number, were used to quantify the cooling performance of S44 for various concentrations of the PCM nanoparticles. The thermal performance of the salt hydrate S44 slurry was also compared with a similar study conducted for lauric acid nanoparticle slurry found in the literature. Specific operating conditions were identified. The salt hydrate S44 would provide better thermal performance than lauric acid, and vice versa. Finally, Nusselt number correlations have been developed for the microchannel PCM heat sink for Reynolds numbers in the range 12.23 to 47.14 and Prandtl numbers in the range 3.74 to 5.30. A design guideline for manufacturing PCM particles and microchannel heat sinks is provided. With this guideline, the heat absorption ability of the heat sink is maximized, and the pumping power and the losses related to the addition of the particles are minimized.
    Type of Medium: Online Resource
    ISSN: 2090-9063 , 2090-9071
    URL: Article
    DOI: 10.1155/2019/5271923
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2019
    detail.hit.zdb_id: 2393625-3
    detail.hit.zdb_id: 2703077-5
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  • 2
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    Outcomes of In–Hospital Cardiopulmonary Resuscitation in Patients with CKD
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Clinical Journal of the American Society of Nephrology Vol. 11, No. 10 ( 2016-10), p. 1744-1751
    Details
    In: Clinical Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 10 ( 2016-10), p. 1744-1751
    Abstract: Advance care planning, including code/resuscitation status discussion, is an essential part of the medical care of patients with CKD. There is little information on the outcomes of cardiopulmonary resuscitation in these patients. We aimed to measure cardiopulmonary resuscitation outcomes in these patients. Design, setting, participants, & measurements Our study is observational in nature. We compared the following cardiopulmonary resuscitation–related outcomes in patients with CKD with those in the general population by using the Nationwide Inpatient Sample (2005–2011): ( 1 ) survival to hospital discharge, ( 2 ) discharge destination, and ( 3 ) length of hospital stay. All of the patients were 18 years old or older. Results During the study period, 71,961 patients with CKD underwent in–hospital cardiopulmonary resuscitation compared with 323,620 patients from the general population. Unadjusted in–hospital mortality rates were higher in patients with CKD (75% versus 72%; P 〈 0.001) on univariate analysis. After adjusting for age, sex, and potential confounders, patients with CKD had higher odds of mortality (odds ratio, 1.24; 95% confidence interval, 1.11 to 1.34; P ≤0.001) and length of stay (odds ratio, 1.11; 95% confidence interval, 1.07 to 1.15; P =0.001). Hospitalization charges were also greater in patients with CKD. There was no overall difference in postcardiopulmonary resuscitation nursing home placement between the two groups. In a separate subanalysis of patients ≥75 years old with CKD, higher odds of in-hospital mortality were also seen in the patients with CKD (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.17; P =0.01). Conclusions In conclusion, we observed slightly higher in-hospital mortality in patients with CKD undergoing in–hospital cardiopulmonary resuscitation.
    Type of Medium: Online Resource
    ISSN: 1555-9041 , 1555-905X
    URL: Article
    DOI: 10.2215/CJN.07530715
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2216582-4
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  • 3
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    Abstract 50: Oral Contraceptive Use and Incident Stroke in Women With Sickle Cell Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: Oral contraceptives increase the risk of ischemic stroke among women. However, the effect is not studied in the stroke prone sickle cell disease population. Objective: To determine the rate of incident stroke among women with sickle cell disease enrolled a large cohort with longitudinal follow-up. Methods: A total of 1263 women aged ≥15 and 〈 45 years, were enrolled in Phase 1 of Cooperative Study of Sickle Cell Disease from 23 centers across the US. Participants underwent a baseline examination for assessment of demographics, prior medical history, lab assessments, and clinical data. Post baseline data included routine follow-up examinations, measures of organ damage, and collection of acute and chronic complications. The effect of oral contraceptive use on incident stroke were assessed after adjusting for age, cigarette smoking, and history of exchange transfusion by Cox Proportional Hazards analysis. Results: A total of 281 (22.2%) of 1263 women with sickle cell disease reported use of oral contraceptives. There was no difference in the mean age (±SD) of the women who reported use compared with those without of oral contraceptives (27 ±6 versus 27±8, p=0.9). History of exchange transfusions (24.2 % versus 15.0 %, p=0.003) and cigarette smoking (24.7 % versus 18.5 %, p=0.03) were more common among women who report use of oral contraceptives. The age adjusted annual incidence of incident stroke among women who used oral contraceptives was four folds higher than those who did not report use (1.4% versus 0.3%, p= 0.04). After adjusting for exchange transfusion and cigarette smoking, oral contraceptive use was not associated with rate of ischemic stroke (HR, 0.3 95% CI 0.06-1.3, p= 0.2) or stroke free survival (HR, 0.98 95% CI 0.6-1.6, p= 0.9). Conclusions: The four fold higher risk of incident stroke associated with use of oral contraceptives in women with sickle cell disease can be mitigated by avoiding cigarette smoking.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.50
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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  • 4
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    Abstract W P138: Pregnancy Associated Cerebral Ischemia in Women with Sickle Cell Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: Cerebral ischemia is commonly seen in patients with sickle cell disease but little information is available regarding such occurrence during pregnancy. Objective: To determine the rates of pregnancy associated cerebral ischemia in women with sickle cell disease and affect on outcome of pregnancy. Methods: We analyzed data collected as part of the Cooperative Study of Sickle Cell Disease, which was a multicenter, prospective study on the natural history of sickle cell disease. A total of 1043 adolescent and 1183 adults were enrolled in phase 1 of the study period 1978-1988. Data regarding pregnancy and outcome was ascertained throughout the follow-up period. We tested the effect of pregnancy associated cerebral ischemia as an interaction in the multivariate analysis assessing the effect of predictors on abortion or miscarriage. Results: Of the 1024 women enrolled, 297 (29%) women experienced one or more pregnancy. Thirteen of the 297 women experienced an episode of cerebral ischemia during pregnancy. Patients with pregnancy associated cerebral ischemia had a higher rate of previous history of stroke (9 of 13 versus 107 of 284, p=0.01). There was a trend towards higher rate of pre-eclampsia among patients with cerebral ischemia (3 of 13 versus 28 of 284, p=0.1). A total of 102 of 297 first pregnancies resulted in abortion or miscarriage. After adjusting for age, history of previous stroke, and alcohol use, the interaction between pregnancy associated cerebral ischemia and abortion or miscarriage was not significant (p=0.2). Conclusions: There appears to be high rates of cerebral ischemia and abortion or miscarriage among pregnant women with sickle cell disease but occurrence of cerebral ischemia does not influence subsequent abortion or miscarriage.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.wp138
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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  • 5
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    Online Resource
    The endogenous opioid system in human alcoholics: molecular adaptations in brain areas involved in cognitive control of addiction : Opioids in human alcoholics
    Wiley ; 2013
    In:  Addiction Biology Vol. 18, No. 1 ( 2013-01), p. 161-169
    Details
    In: Addiction Biology, Wiley, Vol. 18, No. 1 ( 2013-01), p. 161-169
    Type of Medium: Online Resource
    ISSN: 1355-6215
    URL: Issue
    URL: Article
    DOI: 10.1111/adb.2013.18.issue-1
    DOI: 10.1111/j.1369-1600.2011.00366.x
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 1495537-4
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  • 6
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    Abstract 58: Rates of In-Hospital Adverse Events and Discharge Outcomes Among Ischemic Stroke Patients Admitted to Joint Commission Primary Stroke Centers in United States
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: The beneficial impact of certification by Joint Commission (JC) for primary stroke centers (PSCs), on in hospital adverse events and outcomes remains unproven. Objective: To compare the rates of in-hospital adverse events and discharge outcomes among ischemic stroke patients between PSC and no PSC hospitals in United States. Methods and Results: We obtained the data from Nationwide Inpatient Sample from 2010 and 2011. The analysis was limited to states that publicly reported hospital identity. PSCs were identified by matching the NIS hospital files with the list provided by JC. The analysis was limited to patients (age ≥18 years) discharged with a principal diagnosis of ischemic stroke (ICD9 codes 433.x1, 434.x1, 436). Results: We identified a total of 123,131 ischemic stroke patients from 28 states. A total of 72,982 (59.3%) patients were admitted at PSCs. Patients admitted at PSCs were more likely to be men (48.3 vs. 46.7, p 〈 0.0001), white (75.2 vs. 73.3, p 〈 0.0001) and younger in age (71.1±14.7 vs. 72.3±14.3 p 〈 0.0001. Total length of stay was similar among PSCs and non-PSCs (5.09±6. vs. 5.14±6.15 p 〈 0.0001), while total charges were higher at PSCs ($48828 vs. $35946±14.3 p 〈 0.0001). After adjusting for age, sex, race co-morbidities, DRG-based disease severity, and hospital characteristics, patients admitted at PSCs were at lower risk of in hospital adverse events complications; pneumonia (OR, 0.8; 95% CI, 0.7 to 0.9)-, urinary tract infection (OR, 0.97; 95% CI, 0.0.92 to 1.02), sepsis (OR, 0.65; 95% CI, 0..56 to 0..76), deep venous thrombosis (OR, 1.0; 95% CI, 0.76 to 1.33) and pulmonary embolism (OR, 0.58; 95% CI, 0.43 to 0.72). Patients evaluated at PSCs were more likely to receive rt-PA (OR, 1.32; 95% CI, 1.19 to 1.45) with less impatient mortality (OR, 0.88; 95% CI, 0.81 to 0.96) and more likely to get discharge to home (OR, 1.11; 95% CI, 1.07 to 1.15). Conclusions: Patients admitted to PSCs are less likely to have in hospital adverse events and better discharge outcomes.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.58
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 7
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    Abstract T MP24: Are There Disparities in Thrombolytic Treatment and Mortality in Acute Ischemic Stroke in the Hispanic Population Living in Border States versus Non-Border States?
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: Recent studies have found an underutilization of hospital in-patient care for coronary artery disease in Hispanics living in Border States. Objective: To identify acute treatment disparities in acute ischemic stroke Hispanic patients and determine the effect of such disparity on patient outcomes. Methods: We identified Hispanic and non-Hispanic acute ischemic stroke patients from the Nationwide Inpatient Sample-2011 data files. We determined the rate of utilization of thrombolytics and outcomes according to patient’s demographic and clinical characteristics and whether or not they lived in a Border state (defined as California, Arizona, New Mexico and Texas). Results: A total of 34,904 Hispanic patients were admitted with ischemic stroke; of those 21,130 were admitted in Border states and 13,774 in non-Border states. Patient demographics, risk factors, complications and discharge disposition are included in the Tables below. There was a significantly lower rate of thrombolytic use in Hispanic patients (1013 (4.8%) and non-Hispanics (5326 (5.7%, p=0.05). After adjusting for age, gender, and other confounding risk factors, Hispanics were 30% more likely to suffer in-hospital mortality versus there non-Hispanic counter-parts in Border states [OR 1.3 (1.1-1.6) p=0.009], which was not apparent in the non-Border states [OR 1.0 (0.8-1.2) p=0.9] . Conclusions: There was an underutilization of thrombolytics and higher mortality in the Hispanic population admitted in Border States but not in non-Border States. Further studies are warranted to better understand the associated factors.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.tmp24
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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  • 8
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    Abstract T P323: National Trends in Utilization and Outcomes of Intravenous Thrombolytic Treatment Among Pediatric Patients With Acute Ischemic Stroke in United States
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: Thrombolytic treatment has been used with varying frequency among pediatric ischemic stroke patients. Objective: To evaluate trends in utilization of IV recombinant tissue plasminogen activator (rt-PA) and associated rates of death and disability among acute ischemic stroke patients over a six year period. Methods: We obtained data for pediatric patients (aged ≤18 years) admitted to United States in 2003, 2006 and 2009 with a primary diagnosis of ischemic stroke using the Nationwide Inpatient Sample (NIS-KID). We determined the rate and pattern of utilization, and associated in-hospital outcomes of IV-rt-PA including post-thrombolytic intracerebral hemorrhage (ICH) and rates death among pediatric ischemic stroke patients. Results: Of the 5,137 pediatric patients admitted with ischemic stroke, 48 (0.93%) received IV rt-PA during the study period. There was a 2.5 fold increase in rates of patients who received the thrombolytic treatment (0.53% in 2003, 0.87% in 2006 and 1.35% in 2009). The rate of post-thrombolytic ICH was 9.6% with no change in frequency over the three periods. The overall rate of post-thrombolytic intracerebral hemorrhage (ICH) was 9.6% with a trend towards decrease in rates (41%, 9.8%, and 0%) in 2003, 2006, and 2009. The overall rate of in hospital mortality was 9.6% with some decrease in rates (17.2%, 13.0%, and 5.9%, p value for trend=0.7). Conclusion: There has been a significant increase in the proportion of pediatric acute ischemic stroke patients receiving IV rt-PA treatment with some evidence of decrease in adverse outcomes at discharge.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.tp323
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 9
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    Abstract W P26: Meta-analysis Of Studies Using Solitaire And Trevo Pro Stent Retriever Devices For Mechanical Thromboembolectomy In Acute Cerebral Ischemia
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Objective: To report rates of recanalization and symptomatic intracerebral hemorrhage (SICH) after mechanical thromboembolectomy using Solitaire and Trevo Pro devices in acute cerebral ischemia using meta-analysis of published studies. Methods: We identified all studies that used Solitaire or Trevo devices for mechanical thromboembolectomy in treatment of acute cerebral ischemia using a search on PubMed and Cochrane libraries, stroke trials database, proceedings of neurology and neurosurgery related conferences, and supplemented by a review of bibliographies of selected publications. Recanalization was assessed using TICI 〉 2a and rates of SICH were recorded. For the meta-analysis, forest plots and statistical analysis including event rates [ER] with 95% confidence intervals [CI] based on both fixed and random models were performed using Comprehensive Meta-Analysis Software. The presence of publication bias was interrogated by funnel plot of Standard Error by log odds ratio. Results: Eighteen studies with Solitaire device and five with Trevo device were identified and included in the meta-analysis. There were a total of 433/505 (85%, ER 0.85 [CI] 0.80-0.88, P 〈 0.001) successful recanalizations with Solitaire device whereas 196/243 (80%, ER 0.80 [CI] 0.74-0.85, P 〈 0.001) successful recanalizations were noted with Trevo device. The incidence of SICH was 45/505 (9%, ER 0.09 [CI] 0.06-0.14, P 〈 0.001) with Solitaire device and 17/243 (6%, ER 0.06 [CI] 0.049-0129, P 〈 0.001) with Trevo device after mechanical thrombectomy. There was no publication bias. Conclusions: Meta-analysis of studies reveals similar rates for recanalization and SICH after mechanical thromboembolectomy using Solitaire or Trevo Pro devices.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.wp26
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 10
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    Abstract W P22: Is Hemoglobin A1c (HbA1C) Level an Independent Predictor of Adverse Outcomes in Patients With Acute Ischemic Stroke Undergoing Endovascular Treatment?
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: There is controversy whether acute or chronic hyperglycemia increases the rate of adverse outcomes in patients undergoing endovascular procedures. Objective: To evaluate the relationship between hemoglobin A1c (HbA1c), a marker of chronic hyperglycemia, and post-thrombolytic intracerebral hemorrhage (ICH), mortality and independence at discharge. Methods: Consecutive patients with acute ischemic stroke who underwent emergent endovascular treatment over seven years at three comprehensive stroke centers were included. HbA1c levels were collected within seven days of the procedure and strata was defined as (≤6.0%, 6.1 to 7.0% and 〉 7.1%). Patient characteristics and outcomes were analyzed including age, use of intravenous rt-PA, and use of additional mechanical thrombolysis. The rates of post-thrombolytic ICH and independence at discharge (modified Rankin score (mRS) = 0-2) and inpatient mortality were analyzed after adjusting for potential confounders. Results: There were 185 patients who received endovascular treatment for acute ischemic stroke; mean ±standard deviation (SD) age was 66.7 ± 15.6, and 82 (44.3%) were women. Rates of post-thrombolytic ICH was higher in patients with higher levels of HbA1c [11.6% in ≤6.0 strata, 15.7% in 6.1-7.0 strata, and 22.6% in ≥7.1 strata] . Rate of independence at discharge was lower in patients with higher levels of HbA1c [36.8% in ≤6.0 strata, 25.5% in 6.1-7.0 strata, and 23.3% in ≥7.1 strata] while inpatient mortality was higher [13.6% in ≤6.0 strata, 15.7% in 6.1-7.0 strata, and 26.7% in ≥7.1 strata] . Adjusting for age, admission NIHSS score, gender, medical comorbidities, recanalization and type of endovascular treatments, the HbA1C strata correlated with an increase in post-thrombolytic ICH (odds ratio [OR], 1.96, 95% confidence interval [CI] , 0.94-4.13, p= 0.074). We did not find any relation between increasing HbA1C and independence at discharge or inpatient mortality: (p= 0.6320) and (p= 0.6112), respectively. Conclusion: Chronic hyperglycemia increases the risk of post-thrombolytic ICH following endovascular treatment in acute ischemic stroke patients through mechanisms not yet clearly understood.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.wp22
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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