bluuebunny/crossref_metadata_2025_split huggingface dataset:
HUBUNGAN IMT DENGAN KADAR KOLESTEROL PADA KARYAWAN WANITA DI RUMAH SAKIT ADVENT BANDAR LAMPUNG
Authors: Aldito Arjuna 
Published: November 2020

Kolesterol adalah salah satu golongan lemak yang bersifat atarogenik atau mudah menempel dan membentuk plak pada dinding pembuluh darah, mengakibatkan kelebihan kolesterol dalam darah (hiperkolesterolemia). Kondisi hiperkolesterolemia sangat beresiko terkena penyakit kardiovaskular. Penyakit kardiovaskular atau yang dikenal dengan The silent killer masih menjadi penyebab nomor satu kematian didunia. Adapun tujuan dari penelitian ini adalah untuk mengetahui hubungan IMT dengan kadar kolesterol. Penelitian ini menggunakan desain cross sectional. Pengambilan sampel dilakukan secara non probability sampling dengan menggunakan teknik purposive sampling Pengumpulan data dilakukan di Rumah Sakit Advent Bandar Lampung dengan jumlah responden sebanyak 40 orang karyawan wanita. Uji analisis bivariat menggunakan uji statistic Pearson Product-Moment Correlation. Hasil analisis statistik menunjukkan tidak ada hubungan yang signifikan antara IMT dan kadar kolesterol (p value 0,431) pada wanita dewasa di Rumah Sakit Advent Bandar Lampung. Saran yang dapat diberikan adalah dengan menambah jumlah responden untuk penelitian selanjutnya, atau melakukan penelitian tentang faktor- faktor lain yang dapat mempengaruhi peningkatan kadar kolesterol dalam darah.

Kata kunci: Indeks Massa Tubuh, Kolesterol total
High-frequency Ultrasound Assessment of Systemic Sclerosis Skin Involvement: Intraobserver Repeatability and Relationship With Clinician Assessment and Dermal Collagen Content
Authors: Flower Victoria A. , Barratt Shaney L. , Hart Darren J. , Mackenzie Amanda B. , Shipley Jacqueline A. , Ward Stephen G. , Pauling John D. 
Published: November 2020

Objective.The modified Rodnan skin score (mRSS) remains the preferred method for skin assessment in systemic sclerosis (SSc). There are concerns regarding high interobserver variability of mRSS and negative clinical trials utilizing mRSS as the primary endpoint. High-frequency ultrasound (HFUS) allows objective assessment of cutaneous fibrosis in SSc. We investigated the relationship between HFUS with both mRSS and dermal collagen.Methods.Skin thickness (ST), echogenicity, and novel shear wave elastography (SWE) were assessed in 53 patients with SSc and 15 healthy controls (HCs) at the finger, hand, forearm, and abdomen. The relationship between HFUS parameters with mRSS (n = 53) and dermal collagen (10 patients with SSc and 10 HCs) was investigated. Intraobserver repeatability of HFUS was calculated using intraclass correlation coefficients (ICCs).Results.HFUS assessment of ST (hand/forearm) and SWE (finger/hand) correlated with local mRSS at some sites. Subclinical abnormalities in ST, echogenicity, and SWE were present in clinically uninvolved SSc skin. Additionally, changes in echogenicity and SWE were sometimes apparent despite objectively normal ST on HFUS. ST, SWE, and local mRSS correlated strongly with collagen quantification (r = 0.697, 0.709, 0.649, respectively). Intraobserver repeatability was high for all HFUS parameters (ICCs for ST = 0.946–0.978; echogenicity = 0.648–0.865; and SWE = 0.953–0.973).Conclusion.Our data demonstrate excellent reproducibility and reassuring convergent validity with dermal collagen content. Detection of subclinical abnormalities is an additional benefit of HFUS. The observed correlations with collagen quantification support further investigation of HFUS as an alternative to mRSS in clinical trial settings.
Does Etanercept Biosimilar Prescription in a Rheumatology Center Bend the Medication Cost Curve?
Authors: Müskens Wieland D. , Rongen-van Dartel Sanne A.A. , van Riel Piet L.C.M. , Adang Eddy M.M. 
Published: November 2020

ObjectiveThe market entry of biosimilars is expected to bring budgetary relief. Our objective was to determine how the introduction of biosimilars influences medication costs in patients with rheumatoid arthritis (RA) and which patients gain access to biologics due to the availability of biosimilars.MethodsUsing hospital data of patients with RA between 2014 and 2018, an interrupted time series was performed. The interruption in the time series was placed at June 2016 (i.e., the introduction of the etanercept biosimilar). The changes in trends for rheumatic medication costs before and after the interruption were measured. Secondary analyses focused on explaining these trends.ResultsIn the first quarter after the interruption, there was a decrease in total costs for biologic users of –€63,020 (95% CI –€96,487 to –€29,553,P= 0.001). The postinterruption trend did not differ from the preinterruption trend (95% CI –€6695 to €6715,P= 0.998) and after 3 quarters, the medication costs were back at the interruption level. After the interruption, the average cost per biologic user decreased by –€370 (95% CI –€602 to –€138,P= 0.005), followed by a quarterly decrease (relative to the preinterruption trend; 95% CI –€86 to –€14,P= 0.010), bending the average cost curve. The percentage of patients being treated with biologics increased in postinterruption by 0.50 percentage points quarterly (95% CI 0.38–0.62,P< 0.001). Also, the average age at the start of the first biologic increased after the interruption (P= 0.057).ConclusionThe average cost per patient treated with biologics decreased after the introduction of biosimilars with a persistent trend. However, the budgetary relief due to market entry of biosimilars vanished quickly due to an increase in patients treated with biologics.
Circulating Fibroblast Growth Factor-21 Levels in Rheumatoid Arthritis: Associations With Disease Characteristics, Body Composition, and Physical Functioning
Authors: Gould Patrick W. , Zemel Babette S. , Taratuta Elena G. , Baker Joshua F. 
Published: November 2020

ObjectiveThis study evaluated associations between fibroblast growth factor (FGF)-21, an adipokine associated with metabolic stress, and adverse longitudinal changes in body composition and physical functioning in patients with rheumatoid arthritis (RA).MethodsAt baseline and follow-up, patients with RA aged 18–70 years completed whole-body dual-energy X-ray absorptiometry and peripheral quantitative computed tomography to quantify lean mass, fat mass, and muscle density. Dynamometry assessed muscle strength at the hand and knee, and physical functioning was measured with the Health Assessment Questionnaire (HAQ) and the Short Physical Performance Battery (SPPB). FGF-21 and inflammatory cytokines were measured at baseline. Linear and logistic regression analyses assessed associations between FGF-21 levels and both body composition and physical functioning over time.ResultsThere were 113 patients with RA enrolled, and 84 (74%) returned for follow-up at a median of 2.68 years. At baseline, FGF-21 was associated with age, smoking, methotrexate use, adiposity, and inflammatory cytokines: tumor necrosis factor receptor type I, YKL-40, vascular endothelial growth factor (VEGF), and resistin. The highest FGF-21 quartile was associated with worse SPPB and HAQ. Higher baseline FGF-21 levels (per 1 SD) were associated with worsening in muscle density and area Z-scores (β –0.06, 95% CI –0.12 to 0.008, P = 0.08; and β –0.05, 95% CI –0.10 to 0.006, P = 0.08, respectively) and a greater probability of a clinically meaningful worsening of HAQ (OR 2.37, 95% CI 1.21–4.64, P = 0.01). The fourth FGF-21 quartile was associated with worsening of SPPB (β –0.57, 95% CI –1.04 to –0.09, P = 0.02).ConclusionFGF-21 levels are associated with obesity and inflammatory cytokines, and with worsening in physical functioning in RA. These data support the hypothesis that FGF-21 can identify patients at risk of functional decline.
Residual Disease Burden in Patients With Axial Spondyloarthritis and Psoriatic Arthritis Despite Low Disease Activity States in a Multiethnic Asian Population
Authors: Liu Venice , Fong Warren , Kwan Yu Heng , Leung Ying Ying 
Published: November 2020

ObjectivesTo evaluate the burden of residual disease in patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) who achieved low disease activity (LDA) status.MethodsWe used baseline data from a clinic registry of SpA in a tertiary hospital in Singapore. For axSpA, LDA was defined as Ankylosing Spondylitis (AS) Disease Activity Score based on erythrocyte sedimentation rate (ASDAS-ESR) < 2.1 or Bath AS Disease Activity Index (BASDAI) < 3/10. For PsA, LDA was defined by achieving 5/7 cutoffs in the minimal disease activity (MDA) or Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) ≤ 13.ResultsIn 262 cases of axSpA (21% women; mean ± standard deviation (SD) age 42 ± 14 yrs), 33% and 43% of patients achieved ASDAS-ESR and BASDAI LDA states, respectively, while in 142 cases of PsA (49% women, mean age 51 ± SD 14 yrs), 35% and 63% achieved MDA and cDAPSA LDA, respectively. Both axSpA and PsA patients with LDA had pain scores ranging from 14.0 to 21.4/100 and fatigue scores ranging from 3.1 to 3.6/10. Substantial burden in physical disability and mental well-being were observed, with low physical and mental component summary scores on the 36-item Short Form Health Survey. AxSpa patients in BASDAI LDA had higher ESR and lower disability than those in ASDAS-ESR LDA. cDAPSA classified nearly twice as many PsA patients into LDA than MDA. Compared to PsA patients in MDA LDA, those in cDAPSA LDA had higher active joint counts, dactylitis, enthesitis, pain scores, and patient global assessment.ConclusionDespite being in LDA, patients with axSpA and PsA experienced substantial residual burden in pain, poorer physical function, and mental well-being.
Risk of Adverse Outcomes in Hospitalized Patients With Autoimmune Disease and COVID-19: A Matched Cohort Study From New York City
Authors: Faye Adam S. , Lee Kate E. , Laszkowska Monika , Kim Judith , Blackett John William , McKenney Anna S. , Krigel Anna , Giles Jon T. , Wang Runsheng , Bernstein Elana J. , Green Peter H.R. , Krishnareddy Suneeta , Hur Chin , Lebwohl Benjamin 
Published: November 2020

Objective.To examine the effect of autoimmune (AI) disease on the composite outcome of intensive care unit (ICU) admission, intubation, or death from COVID-19 in hospitalized patients.Methods.Retrospective cohort study of 186 patients hospitalized with COVID-19 between March 1, 2020, and April 15, 2020 at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center. The cohort included 62 patients with AI disease and 124 age- and sex-matched controls. The primary outcome was a composite of ICU admission, intubation, and death, with secondary outcome as time to in-hospital death. Baseline demographics, comorbidities, medications, vital signs, and laboratory values were collected. Conditional logistic regression and Cox proportional hazards regression were used to assess the association between AI disease and clinical outcomes.Results.Patients with AI disease were more likely to have at least one comorbidity (87.1% vs 74.2%, P = 0.04), take chronic immunosuppressive medications (66.1% vs 4.0%, P < 0.01), and have had a solid organ transplant (16.1% vs 1.6%, P < 0.01). There were no significant differences in ICU admission (13.7% vs 19.4%, P = 0.32), intubation (13.7% vs 17.7%, P = 0.47), or death (16.1% vs 14.5%, P = 0.78). On multivariable analysis, patients with AI disease were not at an increased risk for a composite outcome of ICU admission, intubation, or death (ORadj 0.79, 95% CI 0.37–1.67). On Cox regression, AI disease was not associated with in-hospital mortality (HRadj 0.73, 95% CI 0.33–1.63).Conclusion.Among patients hospitalized with COVID-19, individuals with AI disease did not have an increased risk of a composite outcome of ICU admission, intubation, or death.
Executive Function, Dexterity, and Discharge Disposition in Older Intensive Care Unit Survivors
Authors: Elías Maya N. , Munro Cindy L. , Liang Zhan 
Published: November 2020

Background
Dexterity is a component of motor function. Executive function, a subdomain of cognition, may affect dexterity in older adults recovering from critical illness after discharge from an intensive care unit (ICU).

Objectives
To explore associations between executive function (attention and cognitive flexibility) and dexterity (fine motor coordination) in the early post-ICU period and examine dexterity by acuity of discharge disposition.

Methods
The study involved 30 older adults who were functionally independent before hospitalization, underwent mechanical ventilation in the ICU, and had been discharged from the ICU 24 to 48 hours previously. Dexterity was evaluated with the National Institutes of Health Toolbox (NIHTB) Motor Battery 9-Hole Pegboard Dexterity Test (PDT); attention, with the NIHTB Cognition Battery Flanker Inhibitory Control and Attention Test (FICAT); and cognitive flexibility, with the NIHTB Cognition Battery Dimensional Change Card Sort Test (DCCST). Exploratory regression was used to examine associations between executive function and dexterity (fully corrected T scores). Independent-samples t tests were used to compare dexterity between participants discharged home and those discharged to a facility.

Results
FICAT (β = 0.375, P = .03) and DCCST (β = 0.698, P = .001) scores were independently and positively associated with PDT scores. Further, PDT scores were worse among participants discharged to a facility than among those discharged home (mean [SD], 26.71 [6.14] vs 36.33 [10.30]; t24 = 3.003; P = .006).

Conclusions
Poor executive function is associated with worse dexterity; thus, dexterity may be a correlate of both post-ICU cognitive impairment and functional decline. Performance on dexterity tests could identify frail older ICU survivors at risk for worse discharge outcomes.
Physician and Nurse Research in Multidisciplinary Intensive Care Units
Authors: Laupland Kevin B. , Coyer Fiona 
Published: November 2020

Background
Although clinical care is multidisciplinary, intensive care unit research commonly focuses on single-discipline themes. We sought to characterize intensive care unit research conducted by physicians and nurses.

Methods
One hundred randomly selected reports of clinical studies published in critical care medical and nursing journals were reviewed.

Results
Of the 100 articles reviewed, 50 were published in medical journals and 50 were published in nursing journals. Only 1 medical study (2%) used qualitative methods, compared with 9 nursing studies (18%) (P = .02). The distribution of quantitative study designs differed between medical and nursing journals (P &lt; .001), with medical journals having a predominance of cohort studies (29 articles [58%]). Compared with medical journal articles, nursing journal articles had significantly fewer authors (median [interquartile range], 5 [3-6] vs 8 [6-10]; P &lt; .001) and study participants (94 [51-237] vs 375 [86-4183]; P &lt; .001) and a significantly lower proportion of male study participants (55% [26%-65%] vs 60% [51%-65%]; P = .02). Studies published in medical journals were much more likely than those published in nursing journals to exclusively involve patients as participants (47 [94%] vs 25 [50%]; P &lt; .001). Coauthorship between physicians and nurses was evident in 14 articles (14%), with infrequent inclusion of authors from other health care disciplines.

Conclusions
Physician research and nurse research differ in several important aspects and tend to occur within silos. Increased interprofessional collaboration is possible and worthwhile.
Family and Clinician Experiences of Sympathy Cards in the 3 Wishes Project
Authors: Takaoka Alyson , Vanstone Meredith , Neville Thanh H. , Goksoyr Sophia , Swinton Marilyn , Clarke France J. , Smith Orla M. , LeBlanc Allana , Foster Denise , Kao Yuhan , Xu Xueqing , Hoad Neala , Toledo Feli , Cook Deborah J. 
Published: November 2020

Background
A recent randomized trial of bereaved family members of patients who died in an intensive care unit identified symptoms of depression and posttraumatic stress in recipients of semistructured condolence letters.

Objectives
To explore family member and clinician experiences with receiving or sending handwritten sympathy cards upon the death of patients involved in a personalized end-of-life intervention, the 3 Wishes Project.

Methods
Interviews and focus groups were held with 171 family members and 222 clinicians at 4 centers to discuss their experiences with the 3 Wishes Project. Interview transcripts were searched to identify participants who discussed sympathy cards. Data related to sympathy cards were independently coded by 2 investigators through conventional content analysis.

Results
Sympathy cards were discussed during 32 interviews (by 25 family members of 21 patients and by 11 clinicians) and 2 focus groups (8 other clinicians). Family members reported that personalized sympathy cards were a welcome surprise; they experienced them as a heartfelt act of compassion. Clinicians viewed cards as an opportunity to express shared humanity with families, reminding them that they and their loved one were not forgotten. Signing cards allowed clinicians to reminisce individually and collectively with colleagues. Family members and clinicians experienced sympathy cards as a meaningful continuation of care after a patient’s death.

Conclusions
Inviting clinicians who cared for deceased patients to offer personalized, handwritten condolences to bereaved family members may cultivate sincere and individualized expressions of sympathy that bereaved families appreciate after the death of patients involved in the 3 Wishes Project.
Accuracy of Measuring Bladder Volumes With Ultrasound and Bladder Scanning
Authors: Schallom Marilyn , Prentice Donna , Sona Carrie , Vyers Kara , Arroyo Cassandra , Wessman Brian , Ablordeppey Enyo 
Published: November 2020

Background
Removal of urinary catheters depends on accurate noninvasive measurements of bladder volume. Patients with acute kidney injury often have low bladder volumes/ascites, possibly causing measurement inaccuracy.

Objective
To evaluate the accuracy of bladder volumes measured with bladder scanning and 2-dimensional ultrasound (US) compared with urinary catheterization among different types of clinicians.

Methods
Prospective correlational descriptive study of 73 adult critical care patients with low urine output receiving hemodialysis or unable to void. Bladder volumes were independently measured by (1) a physician and an advanced practice registered nurse using US, (2) an advanced practice registered nurse and a bedside nurse using bladder scanning, and (3) urinary catheterization (cath). Bland-Altman and χ2 analyses were conducted.

Results
Mean (SD) cath volume was 171.7 (269.7) mL (range, 0-1100 mL). Abdominal fluid was observed in 28% of patients. Bias was −1.3 mL for US vs cath and 3.3 mL for bladder scanning vs cath. For patients with abdominal fluid and cath volume less than 150 mL, decisions to not catheterize patients were accurate more often when based on US measurements (97%-100%) than when based on bladder scanning measurements (86%-89%; P = .02). In patients with cath volume of 300 mL or more, decisions to catheterize patients were accurate more often when based on bladder scanning measurements (94%-100%) than when based on horizontal US measurements (50%-56%; P = .001).

Conclusions
Bladder volume can be measured accurately with bladder scanning or US, but abdominal fluid remains a confounding factor limiting accuracy of bladder scanning.
Risk Factors for Hospital-Acquired Pressure Injury in Surgical Critical Care Patients
Authors: Alderden Jenny , Cowan Linda J. , Dimas Jonathan B. , Chen Danli , Zhang Yue , Cummins Mollie , Yap Tracey L. 
Published: November 2020

BackgroundHospital-acquired pressure injuries disproportionately affect critical care patients. Although risk factors such as moisture, illness severity, and inadequate perfusion have been recognized, nursing skin assessment data remain unexamined in relation to the risk for hospital-acquired pressure injuries.ObjectiveTo identify factors associated with hospital-acquired pressure injuries among surgical critical care patients. The specific aim was to analyze data obtained from routine nursing skin assessments alongside other potential risk factors identified in the literature.MethodsThis retrospective cohort study included 5101 surgical critical care patients at a level I trauma center and academic medical center. Multivariate logistic regression using the least absolute shrinkage and selection operator method identified important predictors with parsimonious representation. Use of specialty pressure redistribution beds was included in the model as a known predictive factor because specialty beds are a common preventive intervention.ResultsIndependent risk factors identified by logistic regression were skin irritation (rash or diffuse, nonlocalized redness) (odds ratio, 1.788; 95% CI, 1.404-2.274; P &lt; .001), minimum Braden Scale score (odds ratio, 0.858; 95% CI, 0.818-0.899; P &lt; .001), and duration of intensive care unit stay before the hospital-acquired pressure injury developed (odds ratio, 1.003; 95% CI, 1.003-1.004; P &lt; .001).ConclusionsThe strongest predictor was irritated skin, a potentially modifiable risk factor. Irritated skin should be treated and closely monitored, and the cause should be eliminated to allow the skin to heal.
Admission Rate of Patients With Major Psychiatric Disorders to the Intensive Care Unit
Authors: King Daniel A. , Hussein Essam , Shochet Gali Epstein , Bar-Lavie Yaron P. 
Published: November 2020

Background
Major psychiatric disorders such as major depression and schizophrenia interfere with patients’ life activities and ability to function. These disorders correlate with a higher prevalence of medical and psychiatric comorbidities.

Objective
To compare the admission rate of patients with major psychiatric disorders between the intensive care unit and other departments in a tertiary care center.

Methods
In a retrospective study of records of 238 721 patients, data were collected from admission files and the intensive care unit computer system. The study group was 245 patients with psychiatric disorders admitted to the intensive care unit. Control groups were 9226 psychiatric patients in other hospital departments and 3032 nonpsychiatric patients in the intensive care unit.

Results
A major psychiatric disorder was diagnosed twice as often in the 3277 patients admitted to the intensive care unit as in patients admitted to other departments (7.5% vs 3.8%, P &lt; .001). The study group had fewer male patients than did the nonpsychiatric intensive care unit group (52% vs 66%, P &lt; .001); the age distribution was similar. Patients with a psychiatric disorder required longer stays than other intensive care unit patients. However, their mortality rate was significantly lower (8.57% vs 17.1%, P = .001). A direct correlation between the admission and a psychiatric condition was found in one-third of admissions in the study group.

Conclusions
Psychiatric patients’ admission rate to the intensive care unit was significantly higher than their admission rate to other departments. Their intensive care unit stays were also longer, which may increase resource use.