Post-Stroke Mortality, Stroke Severity, and Preadmission Antipsychotic Medicine Use – A Population-Based Cohort Study
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{"title"=>"Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use - A population-based cohort study", "type"=>"journal", "authors"=>[{"first_name"=>"Anders", "last_name"=>"Prior", "scopus_author_id"=>"56094445800"}, {"first_name"=>"Thomas Munk", "last_name"=>"Laursen", "scopus_author_id"=>"7006633414"}, {"first_name"=>"Karen Kjær", "last_name"=>"Larsen", "scopus_author_id"=>"36913419500"}, {"first_name"=>"Søren Paaske", "last_name"=>"Johnsen", "scopus_author_id"=>"35229439300"}, {"first_name"=>"Jakob", "last_name"=>"Christensen", "scopus_author_id"=>"7402503077"}, {"first_name"=>"Grethe", "last_name"=>"Andersen", "scopus_author_id"=>"55568472700"}, {"first_name"=>"Mogens", "last_name"=>"Vestergaard", "scopus_author_id"=>"18937632500"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84897371837", "pui"=>"372732119", "doi"=>"10.1371/journal.pone.0084103", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "sgr"=>"84897371837", "pmid"=>"24416196"}, "id"=>"db040ba9-1660-3cab-865a-ee2589ab3a3f", "abstract"=>"BACKGROUND AND PURPOSE: It has been suggested that antipsychotic medication may be neuroprotective and may reduce post-stroke mortality, but studies are few and ambiguous. We aimed to investigate the post-stroke effects of preadmission antipsychotic use.\\n\\nMETHODS: We conducted a nationwide, population-based cohort study of 81,143 persons admitted with stroke in Denmark from 2003-2010. Using Danish health care databases, we extracted data on preadmission use of antipsychotics and confounding factors. We examined the association between current, former, and never use of antipsychotics and stroke severity, length of hospital stay, and 30-day post-stroke mortality using logistic regression analysis, survival analysis, and propensity score matching.\\n\\nRESULTS: Current users of antipsychotics had a higher risk of severe or very severe stroke on The Scandinavian Stroke Scale than never users of antipsychotics (adjusted odds ratios, 1.43; 95% CI, 1.29-1.58). Current users were less likely to be discharged from hospital within 30 days of admission than never users (probability of non-discharge, 27.0% vs. 21.9%). Antipsychotics was associated with an increased 30-day post-stroke mortality among current users (adjusted mortality rate ratios, 1.42; 95% CI, 1.29-1.55), but not among former users (adjusted mortality rate ratios, 1.05; 95% CI, 0.98-1.14).\\n\\nCONCLUSIONS: Preadmission use of antipsychotics was associated with a higher risk of severe stroke, a longer duration of hospital stay, and a higher post-stroke mortality, even after adjustment for known confounders. Antipsychotics play an important role in the treatment of many psychiatric conditions, but our findings do not support the hypothesis that they reduce stroke severity or post-stroke mortality.", "link"=>"http://www.mendeley.com/research/poststroke-mortality-stroke-severity-preadmission-antipsychotic-medicine-populationbased-cohort-stud", "reader_count"=>15, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>2, "Student > Master"=>2, "Other"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>2, "Student > Master"=>2, "Other"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>7, "Agricultural and Biological Sciences"=>1, "Neuroscience"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>7}, "Neuroscience"=>{"Neuroscience"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>2}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1340927"], "description"=>"<div><p>Background and Purpose</p><p>It has been suggested that antipsychotic medication may be neuroprotective and may reduce post-stroke mortality, but studies are few and ambiguous. We aimed to investigate the post-stroke effects of preadmission antipsychotic use.</p><p>Methods</p><p>We conducted a nationwide, population-based cohort study of 81,143 persons admitted with stroke in Denmark from 2003–2010. Using Danish health care databases, we extracted data on preadmission use of antipsychotics and confounding factors. We examined the association between current, former, and never use of antipsychotics and stroke severity, length of hospital stay, and 30-day post-stroke mortality using logistic regression analysis, survival analysis, and propensity score matching.</p><p>Results</p><p>Current users of antipsychotics had a higher risk of severe or very severe stroke on The Scandinavian Stroke Scale than never users of antipsychotics (adjusted odds ratios, 1.43; 95% CI, 1.29–1.58). Current users were less likely to be discharged from hospital within 30 days of admission than never users (probability of non-discharge, 27.0% vs. 21.9%). Antipsychotics was associated with an increased 30-day post-stroke mortality among current users (adjusted mortality rate ratios, 1.42; 95% CI, 1.29–1.55), but not among former users (adjusted mortality rate ratios, 1.05; 95% CI, 0.98–1.14).</p><p>Conclusions</p><p>Preadmission use of antipsychotics was associated with a higher risk of severe stroke, a longer duration of hospital stay, and a higher post-stroke mortality, even after adjustment for known confounders. Antipsychotics play an important role in the treatment of many psychiatric conditions, but our findings do not support the hypothesis that they reduce stroke severity or post-stroke mortality.</p></div>", "links"=>[], "tags"=>["cardiovascular", "stroke", "Drugs and devices", "Neuropharmacology", "Pharmacoepidemiology", "epidemiology", "Cardiovascular disease epidemiology", "Mental health", "psychiatry", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Hemorrhagic stroke", "preadmission", "antipsychotic", "population-based", "cohort"], "article_id"=>896006, "categories"=>["Medicine"], "users"=>["Anders Prior", "Thomas Munk Laursen", "Karen Kjær Larsen", "Søren Paaske Johnsen", "Jakob Christensen", "Grethe Andersen", "Mogens Vestergaard"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084103", "stats"=>{"downloads"=>27, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Post_Stroke_Mortality_Stroke_Severity_and_Preadmission_Antipsychotic_Medicine_Use_8211_A_Population_Based_Cohort_Study_/896006", "title"=>"Post-Stroke Mortality, Stroke Severity, and Preadmission Antipsychotic Medicine Use – A Population-Based Cohort Study", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 02:45:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/1340924"], "description"=>"<p>Stroke severity on the Scandinavian Stroke Scale dichotomized into two groups (mild and moderate versus severe and very severe). Adjusted for former stroke, pre-stroke drug use (lipid-lowering drugs, antihypertensive drugs, antidiabetic drugs, platelet inhibitors), education level, age group, year of admission, and modified Charlson’s index (cerebrovascular disorders excluded). Overall estimates adjusted for gender. Interaction between genders (<i>p</i><0.01).</p>", "links"=>[], "tags"=>["cardiovascular", "stroke", "Drugs and devices", "Neuropharmacology", "Pharmacoepidemiology", "epidemiology", "Cardiovascular disease epidemiology", "Mental health", "psychiatry", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Hemorrhagic stroke", "preadmission", "antipsychotic", "scandinavian", "acute"], "article_id"=>896003, "categories"=>["Medicine"], "users"=>["Anders Prior", "Thomas Munk Laursen", "Karen Kjær Larsen", "Søren Paaske Johnsen", "Jakob Christensen", "Grethe Andersen", "Mogens Vestergaard"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084103.t002", "stats"=>{"downloads"=>6, "page_views"=>17, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_preadmission_antipsychotic_medication_use_and_risk_of_severe_and_very_severe_stroke_on_the_Scandinavian_Stroke_Scale_on_admission_for_acute_stroke_/896003", "title"=>"Association between preadmission antipsychotic medication use and risk of severe and very severe stroke on the Scandinavian Stroke Scale on admission for acute stroke.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 02:45:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/1340923"], "description"=>"<p>Adjusted for gender, former stroke, pre-stroke drug use (lipid-lowering drugs, antihypertensive drugs, antidiabetic drugs, platelet inhibitors), education level, age group, year of admission, and modified Charlson’s index (cerebrovascular disorders excluded).</p>", "links"=>[], "tags"=>["cardiovascular", "stroke", "Drugs and devices", "Neuropharmacology", "Pharmacoepidemiology", "epidemiology", "Cardiovascular disease epidemiology", "Mental health", "psychiatry", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Hemorrhagic stroke", "preadmission", "antipsychotic", "30-day", "acute", "patients"], "article_id"=>896002, "categories"=>["Medicine"], "users"=>["Anders Prior", "Thomas Munk Laursen", "Karen Kjær Larsen", "Søren Paaske Johnsen", "Jakob Christensen", "Grethe Andersen", "Mogens Vestergaard"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084103.t004", "stats"=>{"downloads"=>3, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_preadmission_antipsychotic_medication_use_and_30_day_mortality_in_acute_stroke_patients_according_to_prescription_period_/896002", "title"=>"Association between preadmission antipsychotic medication use and 30-day mortality in acute stroke patients according to prescription period.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 02:45:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/1340926"], "description"=>"<p>Modified Charlson’s index (cerebrovascular disorders excluded).</p><p>Sums of proportions can exceed total number of users; some patients will appear in both categories, e.g. current use of atypical and former use of typical antipsychotics.</p>", "links"=>[], "tags"=>["cardiovascular", "stroke", "Drugs and devices", "Neuropharmacology", "Pharmacoepidemiology", "epidemiology", "Cardiovascular disease epidemiology", "Mental health", "psychiatry", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Hemorrhagic stroke", "acute", "patients", "preadmission", "antipsychotic"], "article_id"=>896005, "categories"=>["Medicine"], "users"=>["Anders Prior", "Thomas Munk Laursen", "Karen Kjær Larsen", "Søren Paaske Johnsen", "Jakob Christensen", "Grethe Andersen", "Mogens Vestergaard"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084103.t001", "stats"=>{"downloads"=>7, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_acute_stroke_patients_n_8202_8202_81_143_according_to_preadmission_antipsychotic_medication_use_/896005", "title"=>"Characteristics of acute stroke patients (n = 81,143) according to preadmission antipsychotic medication use.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 02:45:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/1340925"], "description"=>"<p>Model 1: adjusted for age group and calendar period. Overall estimates adjusted for gender in all models.</p><p>†Model 2: further adjusted for type of stroke, former stroke, pre-stroke drug use (lipid-lowering drugs, antihypertensive drugs, antidiabetic drugs, platelet inhibitors) and education level.</p><p>‡Model 3: further adjusted for year of admission, severity of stroke, and modified Charlson’s index (cerebrovascular disorders excluded). No interaction between genders in model 3 (<i>p</i> = 0.79).</p>", "links"=>[], "tags"=>["cardiovascular", "stroke", "Drugs and devices", "Neuropharmacology", "Pharmacoepidemiology", "epidemiology", "Cardiovascular disease epidemiology", "Mental health", "psychiatry", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Hemorrhagic stroke", "preadmission", "antipsychotic", "30-day", "acute", "patients", "adjusted"], "article_id"=>896004, "categories"=>["Medicine"], "users"=>["Anders Prior", "Thomas Munk Laursen", "Karen Kjær Larsen", "Søren Paaske Johnsen", "Jakob Christensen", "Grethe Andersen", "Mogens Vestergaard"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084103.t003", "stats"=>{"downloads"=>5, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_preadmission_antipsychotic_medication_use_and_30_day_mortality_in_acute_stroke_patients_in_various_adjusted_models_/896004", "title"=>"Association between preadmission antipsychotic medication use and 30-day mortality in acute stroke patients in various adjusted models.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-08 02:45:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/1340922"], "description"=>"<p>Association between preadmission antipsychotic medication and cumulative 1-year post-stroke mortality stratified by gender and age.</p>", "links"=>[], "tags"=>["cardiovascular", "stroke", "Drugs and devices", "Neuropharmacology", "Pharmacoepidemiology", "epidemiology", "Cardiovascular disease epidemiology", "Mental health", "psychiatry", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Hemorrhagic stroke", "preadmission", "antipsychotic", "cumulative", "1-year", "post-stroke", "stratified"], "article_id"=>896001, "categories"=>["Medicine"], "users"=>["Anders Prior", "Thomas Munk Laursen", "Karen Kjær Larsen", "Søren Paaske Johnsen", "Jakob Christensen", "Grethe Andersen", "Mogens Vestergaard"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084103.g001", "stats"=>{"downloads"=>4, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_preadmission_antipsychotic_medication_and_cumulative_1_year_post_stroke_mortality_stratified_by_gender_and_age_/896001", "title"=>"Association between preadmission antipsychotic medication and cumulative 1-year post-stroke mortality stratified by gender and age.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-08 02:45:02"}

PMC Usage Stats | Further Information

  • {"unique-ip"=>"15", "full-text"=>"19", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2014", "month"=>"1"}
  • {"unique-ip"=>"14", "full-text"=>"11", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"2"}
  • {"unique-ip"=>"21", "full-text"=>"19", "pdf"=>"10", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"3"}
  • {"unique-ip"=>"8", "full-text"=>"9", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"5"}
  • {"unique-ip"=>"13", "full-text"=>"22", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"6"}
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  • {"unique-ip"=>"21", "full-text"=>"19", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"16", "full-text"=>"20", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"13", "full-text"=>"13", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"9", "full-text"=>"7", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"12", "full-text"=>"11", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"8", "full-text"=>"9", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"11", "full-text"=>"8", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"7", "full-text"=>"6", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"22", "full-text"=>"20", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"13", "full-text"=>"16", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"7"}
  • {"unique-ip"=>"16", "full-text"=>"19", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"8"}
  • {"unique-ip"=>"16", "full-text"=>"24", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"9"}
  • {"unique-ip"=>"6", "full-text"=>"7", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"13", "full-text"=>"12", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
  • {"unique-ip"=>"20", "full-text"=>"18", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"13", "full-text"=>"9", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"15", "full-text"=>"13", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"8", "full-text"=>"10", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"6", "full-text"=>"4", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"9", "full-text"=>"7", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"10", "full-text"=>"29", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"3", "full-text"=>"10", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"14", "full-text"=>"23", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"9", "full-text"=>"17", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"4", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"3", "full-text"=>"25", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"15", "full-text"=>"17", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"9", "full-text"=>"9", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"2", "full-text"=>"1", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"4", "full-text"=>"4", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"4", "full-text"=>"4", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"3", "full-text"=>"2", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"2", "full-text"=>"3", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"5", "full-text"=>"6", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"9", "full-text"=>"8", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"9", "full-text"=>"8", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"14", "full-text"=>"13", "pdf"=>"10", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"10", "full-text"=>"10", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"9", "full-text"=>"10", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}

Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Population biology", "average_usage"=>[312, 475]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[285]}, {"subject_area"=>"/Medicine and health sciences/Mental health and psychiatry", "average_usage"=>[299, 481]}, {"subject_area"=>"/Medicine and health sciences/Vascular medicine", "average_usage"=>[248]}, {"subject_area"=>"/Social sciences/Psychology", "average_usage"=>[314, 476]}]}
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