State University of New York System

About: State University of New York System is a education organization based out in Albany, New York, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 54077 authors who have published 78070 publications receiving 2985160 citations.

High WSS or Low WSS? Complex Interactions of Hemodynamics with Intracranial Aneurysm Initiation, Growth, and Rupture: Toward a Unifying Hypothesis

Abstract: Summary: Increasing detection of unruptured intracranial aneurysms, catastrophic outcomes from subarachnoid hemorrhage, and risks and cost of treatment necessitate defining objective predictive parameters of aneurysm rupture risk. Image-based computational fluid dynamics models have suggested associations between hemodynamics and intracranial aneurysm rupture, albeit with conflicting findings regarding wall shear stress. We propose that the “high-versus-low wall shear stress” controversy is a manifestation of the complexity of aneurysm pathophysiology, and both high and low wall shear stress can drive intracranial aneurysm growth and rupture. Low wall shear stress and high oscillatory shear index trigger an inflammatory-cell-mediated pathway, which could be associated with the growth and rupture of large, atherosclerotic aneurysm phenotypes, while high wall shear stress combined with a positive wall shear stress gradient trigger a mural-cell-mediated pathway, which could be associated with the growth and rupture of small or secondary bleb aneurysm phenotypes. This hypothesis correlates disparate intracranial aneurysm pathophysiology with the results of computational fluid dynamics in search of more reliable risk predictors.

Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension.

Abstract: Clinical practice guidelines for the management of hypertension in the community a statement by the American society of hypertension and the International society of hypertension

Interrater reliability of the 7-level functional independence measure (FIM)

Abstract: The Functional Independence Measure (FIM) is an 18-item, 7-level scale developed to uniformly assess severity of patient disability and medical rehabilitation functional outcome. FIM interrater reliability in the clinical setting is reported here. Clinicians from 89 US inpatient comprehensive medical rehabilitation facilities newly subscribing to the uniform Data System for Medical Rehabilitation from January 1988-June 1990 evaluated 1018 patients with the FIM. FIM total, domain and subscale score intraclass correlation coefficients (ICC) were calculated using ANOVA; FIM item score agreement was assessed with unweighted Kappa coefficient. Total FIM ICC was 0.96; motor domain 0.96 and cognitive domain 0.91; subscale score range: 0.89 (social cognition) to 0.94 (self-care). FIM item Kappa range: 0.53 (memory) to 0.66 (stair climbing). A subset of 24 facilities meeting UDSMR data aggregation reliability criteria had Intraclass and Kappa coefficients exceeding those for all facilities. It is concluded that the 7-level FIM is reliable when used by trained/tested inpatient medical rehabilitation clinicians.