From the University of Pittsburgh Schools of Nursing (M.H., E.A.C.) and the Medicine Division of Cardiology (J.M.F., J.G.) and Division of Neurosurgery (Y.C., M.B.H.), University of Pittsburgh, Pittsburgh, PA; and Mie University Graduate School of Medicine (M.T.), Tsu City, Mie Prefecture, Japan. (At 2009-11)