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Perceived Implicit Determination Mediates the result of Reason Incongruence about Career Burnout as well as Task Fulfillment.
AIMS To estimate the volume of past year televised alcohol advertising exposure by product category and demographic group among adults living in the United States (U.S.) and test associations between estimated alcohol advertising exposure and past 30-day drinking behavior. DESIGN Secondary analysis of data from two national-level U.S. datasets Kantar data on appearances of televised alcohol advertisements and data from the Simmons National Consumer Survey (NCS), a large national mail survey on television viewing patterns and product use. SETTING United States PARTICIPANTS 54,671 adults, ages 21 and older, who were randomly selected to participate in the Simmons NCS. MEASUREMENTS Estimated exposure to televised advertisements for beer, wine, and spirits, self-reported alcohol use in the past year, number of drinks consumed in the past 30 days. FINDINGS The average respondent was exposed to an estimated 576 [95% confidence interval (CI) = 570-582] televised alcohol ads in the year preceding their survey. Exposure was higher among males versus females and African Americans versus Whites. learn more A 1 percent increase in the estimated volume of ad exposure was associated with a 0.11 [95% CI 0.08-0.13] percentage point increase in the odds of having at least one drink in the last 30 days and, among past 30-day drinkers, a 0.05 [95% CI 0.04-0.07] percent increase in the number of alcoholic drinks consumed. Associations were consistent across product categories and demographics. CONCLUSIONS There appears to be a small but consistent positive association between alcohol advertising exposure and drinking behavior among American adults. This article is protected by copyright. All rights reserved.BACKGROUND Morphology algorithms are currently recommended as standalone discriminator in single chamber ICDs. However, these proprietary algorithms differ in both design and nominal programming. OBJECTIVE To compare three different algorithms with nominal versus advanced programming in their ability to discriminate between ventricular (VT) and supraventricular tachycardia (SVT). METHODS In nine European centers, VT and SVTs were collected from Abbott™, Boston Scientific™ and Medtronic™ dual and triple chamber ICDs via their respective remote-monitoring portals. Percentage morphology matches were recorded for selected episodes which were classified as VT or SVT by means of atrioventricular comparison. Sensitivity and related specificity of each manufacturer discriminator were determined at various values of template match percentage from ROC curve analysis. RESULTS A total of 534 episodes were retained for the analysis. In ROC analyses, Abbott Far Field MD (AUC 0.91; p less then 0.001) and Boston Scientific Rhythm ID (AUC 0.95; p less then 0.001) show higher AUC than Medtronic Wavelet (AUC 0.81; p less then 0.001) when tested for their ability to discriminate VT from SVT. At nominal % match threshold all devices provided high sensitivity in VT identification, (91%, 100% and 90% respectively for Abbott, Boston Scientific and Medtronic) but contrasted specificities in SVT discrimination (85%, 41% and 62% respectively). Abbott and Medtronic nominal thresholds were similar to the optimal thresholds. Optimization of the % match threshold improved the Boston Scientific specificity to 79% without compromising the sensitivity. CONCLUSION Proprietary morphology discriminators show important differences in their ability to discriminate SVT. How much this impact the overall discrimination process remains to be investigated. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND del Nido (DN) cardioplegia is commonly used during robotic mitral valve surgery. Poor venous drainage during surgery may result in venous backpressure and washout of this one-shot cardioplegia, limiting its cardioprotective effects. METHODS One hundred eighty-seven patients undergoing isolated robotic mitral valve surgery, from January 2015 to July 2017, were retrospectively reviewed. Intraoperative central venous pressure (CVP) tracings were reviewed and venous drainage was categorized as good or poor and the relationship of the quality of venous drainage to postoperative ventricular dysfunction (operationalized as the need for inotropic support during and after weaning from cardiopulmonary bypass [CPB]) was assessed. RESULTS Drainage was judged to be good in 107 patients and poor in 79 patients. On univariate analysis, 23 patients (41%) with good drainage required inotropic support whereas 33 patients (59%) with poor drainage required inotropic support (P = .0025). On multivariable analysis, poor venous drainage remained significantly associated with inotropic use even after adjusting for cross-clamp and CPB time. Inotrope use was associated with significantly longer intensive care unit length of stay (P = .027). CONCLUSION Maintenance of excellent venous drainage, as assessed by CVP monitoring, should be a high priority in isolated robotic mitral valve surgery undertaken with DN cardioplegia. © 2020 Wiley Periodicals, Inc.OBJECTIVE There is a paucity of clinical data on critically ill patients with COVID-19 requiring extracorporeal life support. METHODS A statewide multi-institutional collaborative for COVID-19 patients was utilized to obtain clinical data on the first 10 critically ill COVID-19 patients who required extracorporeal membrane oxygenation (ECMO). RESULTS Of the first 10 patients that required ECMO for COVID-19, the age ranged from 31 to 62 years with the majority (70%) being men. Seven (70%) had comorbidities. The majority (80%) of patients had known sick contact and exposure to COVID-19 positive patients or traveled to pandemic areas inside the United States within the 2 weeks before symptom onset. None of the patients were healthcare workers. The most common symptoms leading to the presentation were high fever ≥103°F (90%), cough (80%) and dyspnea (70%), followed by fatigue and gastrointestinal symptoms (both 30%), myalgia, loss of taste, pleuritic chest pain, and confusion (all 10%). All patients had bilateral infiltrates on chest X-rays suggestive of interstitial viral pneumonia.
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