bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promoting Influenza Vaccination Among an ACA Health Plan Subscriber Population: A Randomized Trial
Authors: Nehme Eileen K. , Delphia Michelle , Cha Eun Me , Thomas Milton , Lakey David 
Published: January 2019

Purpose: To assess the effectiveness of an intervention to promote influenza vaccination among members of an Affordable Care Act (ACA) insurance plan. Design: Randomized controlled trial. Setting: Messages were delivered by a community-based, nonprofit health insurance provider to its members in Central Texas. Participants: Adult subscribers for whom either a phone number or an e-mail address was available (n = 25 649). Intervention: Participants were randomly assigned to be sent (1) no messages, (2) messages encouraging influenza vaccination via e-mails and texts, and (3) messages encouraging influenza vaccination through e-mails, texts, and postal mail. Messages were sent between September 12, 2017 and November 17, 2017. Measures: Influenza vaccination was determined using medical and pharmacy claims. Analysis: Rate differences and 95% confidence intervals between each exposure condition were calculated for the overall population and by subgroups. Results: The vaccination rate by December 31, 2017 was 16.9%. Those sent both electronic messages and postal mail were significantly more likely to be vaccinated than those who were not sent messages (rate difference: 2.5%; 95% confidence interval [CI]: 1.4-3.6) and those who were sent electronic messages only (rate difference: 1.6%; 95% CI: 0.5-2.8). Conclusion: A combination of messages delivered via text, e-mail, and postal mail generated a modest but significant positive effect on influenza vaccine rates in an ACA plan population. The postal mail component was essential for achieving this effect.
Suicidal Thoughts and Contexts in Black African Stroke Survivors
Authors: Ojagbemi Akin , Bello Toyin , Elugbadebo Fisayo 
Published: January 2019

Objectives: Poststroke suicide has not been studied in Black Africans. We assessed the characteristics and contexts of serious suicidal thoughts after first-ever stroke in Nigerians. Methods: Using a comparative cross-sectional design, we consecutively recruited 130 stroke survivors attending rehabilitation in a large university hospital. Also included were 130 age-, sex-, and education-matched caregivers who were unrelated to stroke survivors. Along with clinical and historical details, cognitive functions, experience of serious suicidal thoughts, and major depressive disorder (MDD) were independently assessed using validated semi-structured interviews. Results: Serious suicidal thoughts were present in 20 (15.4%) stroke survivors and 19 (14.6%) controls. Poststroke suicidal thoughts occurred in the contexts of MDD ( P < .001), marital separation ( P = .019), and cognitive dysfunction ( P = .037). In a multivariate logistic regression model including age, gender, MDD, marital separation, and cognitive dysfunction as covariates, poststroke MDD and marital separation led to 5.6-fold (95% confidence interval [CI]: 3.5-21.0) and 4-fold (95% CI: 1.2-14.0) increases, respectively, in the odds of serious suicidal thoughts. Conclusions: Serious suicidal thoughts after stroke in this African sample were more common than the reported average prevalence in the global literature. Poststroke major depression was the key reversible risk factor for suicidal thoughts. Depression is treatable and prompt treatment may prevent suicidal deaths and reduce the burden of stroke in black Africans.
Risk Factors for Polypharmacy in Elderly Patients With Cancer Pain
Authors: Morio Kayoko , Maeda Isseki , Yokota Isao , Niki Kazuyuki , Murata Taizo , Matsumura Yasushi , Uejima Etsuko 
Published: January 2019

Objective: Polypharmacy (PP) is a burden in elderly patients with cancer pain; however, risk factors for PP remain unclear. The purpose of this study was to investigate the risk factors for PP in this patient population. Methods: We retrospectively reviewed the medical charts of patients aged ≥65 years with cancer pain who were treated at Osaka University Hospital between February 2014 and June 2016 according to the World Health Organization 3-step ladder for cancer pain relief. We defined PP as ≥5 medications and conducted exploratory research to examine the association between PP and patient characteristics. Performance status (PS) was estimated according to the Eastern Cooperative Oncology Group system and is categorized as good PS (0-1) and poor PS (2-4). Results: We reviewed 206 patients (122 men and 84 women) with a median age of 71 years (range, 65-89 years) and found that 174 patients (84.5%) had PP. In multivariate logistic analysis, PP was significantly associated with an increased number of comorbidities (odds ratio [OR]: 4.93, 95% confidence interval [CI], 2.57-11.42, P < .001), poor PS (OR: 4.50, 95% CI, 1.06-31.68, P = .039), and administration of an anticancer or molecular targeted drug (OR: 2.78, 95% CI, 1.13-7.16, P = .025). Conclusions: An increased number of comorbidities, poor PS, and administration of an anticancer or molecular targeted drug were considered risk factors for PP in elderly patients with cancer pain. Sharing these risk factors with medical staff will help reduce the occurrence of problems associated with PP.
Self-measurement with Icare HOME tonometer, patients’ feasibility and acceptability
Authors: Cvenkel Barbara , Velkovska Makedonka Atanasovska , Jordanova Vesna Dimovska 
Published: January 2019

Purpose: To evaluate and compare the accuracy of self-measurement of intraocular pressure using Icare Home rebound tonometer with Goldmann applanation tonometer and assess acceptability of self-tonometry in patients with glaucoma and ocular hypertension. Methods: In the study, 117 subjects were trained to use Icare Home for self-measurement. Icare Home tonometer readings were compared with Goldmann applanation tonometer, including one eye per patient. Agreement between the two methods of measurement was evaluated by Bland and Altmann analysis. Questionnaire was used to evaluate patients’ perception of self-tonometry. Results: One hundred and three out of 117 patients (88%) were able to measure their own intraocular pressure and 96 (82%) fulfilled the requirements for certification. The mean (SD) difference Goldmann applanation tonometer minus Icare Home was 1.2 (2.4) mmHg (95% limits of agreement, –3.4 to 5.9 mmHg). The magnitude of bias between the two methods depended on central corneal thickness, with greater bias at central corneal thickness <500 µm. In 65 out of 96 subjects (67.7%), Icare Home results were within 2 mmHg of the Goldmann applanation tonometer. Seventy-three out of 93 (78.5%) felt that self-tonometry was easy to use and 75 patients (80.6%) responded that they would use the device at home. Conclusion: Icare Home tonometry tends to slightly underestimate intraocular pressure compared to Goldmann applanation tonometer. Most patients were able to perform self-tonometry and found it acceptable for home use. Measurements using rebound self-tonometry could improve the quality of intraocular pressure data and optimize treatment regimen.
Early to mid-term outcome of Oxinium on Verilast highly cross-linked polyethylene bearing surface in uncemented total hip arthroplasty
Authors: Sobti Anshul S , Busch Constant A , Afolayan John O , Michael Dean , Chana Rishi 
Published: January 2019

Introduction: We report 5- to 10-year clinical and radiological outcomes of a series of uncemented Oxinium on Verilast (highly cross-linked polyethylene liners) total hip replacements (THAs) using the Anthology stem and R3/Reflection cup system. Methods: 116 THAs were performed by 2 senior authors in 104 patients from 2005 to 2009. The mean age at time of operation was 63.8 (45–80) years. The average length of follow-up was 8.8 years. At final data collection 12 patients had died (13 THAs) and 3 patients (3 THAs) were lost to follow-up. Results: In the remaining 100 THAs, the preoperative Harris Hip Score of 39 improved to 91 and Oxford Hip Score improved from 16 to 44 (mean at 5 to 10 years). 100 THAs were available for radiographic analysis: all had stable bony ingrowth of both the stem and cup. Dorr’s methods for wear in the 100 THAs showed an average wear <0.01 mm/year and no osteolysis; only 1 case showed 0.22 mm/year with some proximal femoral osteolysis but no cup lesions. There were no dislocations or revisions, survivorship in this series for both components for any cause as an endpoint was 100%. 1 intraoperative calcar fracture was sustained and treated with a cerclage wires, 2 peri-prosthetic fractures occurred and were treated with open reduction and fixation, both healed well with excellent outcomes. Discussion: The study has shown good clinical and radiological outcomes at 5–10 years and supports existing data on the potential benefits of this bearing performance in literature.
Evaluation of culture-specific popular music as a mental metronome for cardiopulmonary resuscitation: a randomised crossover trial
Authors: Ho Andrew Fu Wah , Liu Zhenghong , Wah Win , Fook-Chong Stephanie , Pek Pin Pin , Lo Hong Yee , Teo Rui Ming , Poon Beng Hoong , Ng Yih Yng , Ong Marcus Eng Hock 
Published: January 2019

Introduction: Bystander cardiopulmonary resuscitation (CPR) improves survival in out-of-hospital cardiac arrest. The use of certain songs as mental metronomes for CPR have been validated and recognised by contemporary guidelines. We hypothesise that the National Day song, Count on me Singapore (COMS CPR), is not inferior to standard ‘one-and-two-and-three-and-four’ counting (standard CPR) for timing CPR, in terms of the proportion of participants achieving the guideline compression rate of 100–120/minute. Methods: This was a prospective randomised crossover trial powered to demonstrate non-inferiority in the CPR rate. After a familiarisation session, volunteers were randomly assigned to two groups. Group A performed one cycle of standard CPR while group B performed one cycle of COMS CPR. Participants then crossed over to perform the other method. The Laerdal SkillReporter measured CPR quality. Four weeks later, participants attended a test scenario, using standard CPR or COMS CPR (randomly allocated). Results: Ninety subjects were recruited; 46 were randomly assigned to group A and 44 to group B. Baseline characteristics were similar; 41.1% of COMS CPR achieved 100–120/minute, versus 28.9% of standard CPR ( P=0.028). In mixed effects logistical regression, significantly more COMS CPR was performed at 100–120/minute compared to standard CPR (odds ratio 2.44, 95% confidence interval 1.01–5.9, P=0.047). The proportion of insufficient depth was higher in COMS CPR (80.59% vs. 68.01%, P<0.001). There were no differences in other aspects of CPR quality. There were no differences in CPR quality between standard CPR and COMS CPR during the follow-up. Conclusion: COMS CPR was not inferior in terms of the proportion of participants delivering a guideline-compliant rate of chest compression. COMS CPR may have applications to layman CPR education, such as in mass education events.
Serum potassium levels and mortality of patients with acute myocardial infarction: A systematic review and meta-analysis of cohort studies
Authors: Xi Hui , Yu Rong-Hui , Wang Ning , Chen Xue-Zhi , Zhang Wen-Chao , Hong Tao 
Published: January 2019

BackgroundThe evidence of current epidemiological studies investigating the association between serum potassium levels and mortality of acute myocardial infarction (AMI) patients is controversial and inadequate.DesignSystematic review and meta-analysis.MethodsTwo researchers independently searched the PubMed, EMBASE and Web of Science databases to identify observational studies published prior to 31 October 2017. Similarly, two researchers separately extracted data and any differences were resolved by discussion. Pooled relative risks and 95% confidence intervals (CIs) were computed with an inverse variance-weighted random-effects model. Heterogeneity among studies was assessed with the I2statistic.ResultsSeven cohort studies were included for analysis. Compared with the reference group (3.5 to <4.0 mEq/L), the pooled relative risks of mortality were 1.15 (95% CI = 1.00–1.32), 1.09 (95% CI = 0.97–1.24), 1.42 (95% CI = 1.19–1.70) and 1.85 (95% CI = 1.39–2.47) for AMI patients with a potassium level of<3.5, 4.0 to <4.5, 4.5 to <5.0, and ≥5.0 mEq/L, respectively. For admission and post-admission potassium, although J-shaped associations were also indicated, non-significant results were observed for AMI patients with potassium levels of <3.5 mEq/L when compared with the reference group. Notably, in subgroup analyses of study characteristics, stratified by study quality, geographic location, type of outcome, number of cases, type of AMI, and adjustment for potential confounders, the findings were broadly consistent across strata.ConclusionsThese findings indicate that both lower (<3.5 mEq/L) and higher (≥4.5 mEq/L) serum potassium levels are associated with an increased risk of mortality of patients with AMI.
Release of mitochondrial DNA is associated with mortality in severe acute heart failure
Authors: Krychtiuk Konstantin A , Wurm Raphael , Ruhittel Sarah , Lenz Max , Huber Kurt , Wojta Johann , Heinz Gottfried , Hülsmann Martin , Speidl Walter S 
Published: January 2019

Background:
Inflammation is regarded as an important trigger for disease progression in heart failure. Particularly in severe acute heart failure, tissue hypoxia may lead to cellular damage and the release of intracellular mitochondrial DNA, which acts as an activator of the immune system due to its resemblance to bacterial DNA. It may therefore serve as a mediator of disease progression. The aim of this study was to determine circulating levels of mitochondrial DNA and its association with mortality in patients with heart failure in different presentations.

Methods:
Plasma levels of circulating mitochondrial DNA were measured in 90 consecutive patients with severe acute heart failure admitted to our medical intensive care unit as well as 109 consecutive chronic heart failure patients.

Results:
In patients admitted to our medical intensive care unit (median age 64 (49–74) years, median NT-pro-brain natriuretic peptide 4986 (1525–23,842) pg/mL, 30-day survival 64.4%), mitochondrial DNA levels were significantly higher in patients who died within 30 days after intensive care unit admission, and patients with plasma levels of mitochondrial DNA in the highest quartile had a 3.4-fold increased risk (P=0.002) of dying independent of renal function, vasopressor use and NT-pro-brain natriuretic peptide, troponin T, lactate levels or CardShock and acute physiology and chronic health evaluation II score. However, mitochondrial DNA did not provide incremental prognostic accuracy on top of the current gold standard acute physiology and chronic health evaluation II. Patients with severe acute heart failure showed significantly higher mitochondrial DNA levels (P&lt;0.005) as compared to patients with chronic heart failure. In these patients, mitochondrial DNA levels were associated with the New York Heart Association functional class but were not associated with outcome.

Conclusions:
The release of mitochondrial DNA into the circulation is associated with mortality in patients with severe acute heart failure but not in patients with chronic heart failure. The release of mitochondrial DNA may therefore play a role within the pathophysiology of acute heart failure, which warrants further research. However, the use of mitochondrial DNA as a biomarker for risk stratification in these patients is of limited utility.
Electrocardiography changes and their significance during treatment of patients with intermediate-high and high-risk pulmonary embolism
Authors: Novicic Natasha , Dzudovic Boris , Subotic Bojana , Shalinger-Martinovic Sonja , Obradovic Slobodan 
Published: January 2019

Background: Electrocardiography (ECG) signs, typical or acute pulmonary embolism, and their changes can be used for the prediction of clinical and haemodynamic outcomes. Purpose: To study the predictive value of the resolution of admission ECG signs in higher risk pulmonary embolism patients for 30-day survival and for the decrease in right ventricular systolic pressure. Methods: We analysed the 12-lead ECGs at admission and daily for the first 5 days after hospitalisation in 110 intermediate-high and high-risk pulmonary embolism patients admitted to the intensive care unit of a single tertiary centre. The predictive value of the resolution of four ECG signs were analysed for 30-day survival and for the changes in right ventricular systolic pressure during hospitalisation: S-wave in the first standard lead, right bundle branch block pattern, S-wave in the aVL lead and negative T-waves in precordial leads. Results: ECG recordings showed the existence of S-wave in the I lead in 71 (64.5%), S-wave in the aVL in 77 (70%), right bundle branch block pattern in 30 (27.3%) and negative T-waves in 66 (60%) patients. All-cause 30-day in-hospital mortality was 13.6%. Among the ECG signs, only the presence of right bundle branch block at admission was significantly associated with 30-day all-cause mortality (hazard ratio (HR) adjusted for age, gender and right ventricular systolic pressure at admission was 7.7, 95% confidence interval (CI) 2.1–27.9; P=0.002). The resolution of three ECG signs during the first 5 days of hospitalisation, S-wave in the I lead (HR 26.4, 95% CI 3.1–226.6; P=0.003), S-wave in the aVL (HR 21.5, 95% CI 2.6–175.3; P=0.004) and right bundle branch block configuration (HR 5.2, 95% CI 1.3–20.8; P=0.020) were associated with 30-day survival. The intermediate-high and high-risk pulmonary embolism patients with S-wave resolution in lead aVL had 0.0% and 7.1% 30-day all-cause mortality, respectively. The patients with resolution of the S-wave in the first lead and in aVL as well as right bundle branch block had more pronounced changes in right ventricular systolic pressure at discharge (27±13 vs. 13±15 mmHg; P=0.011 for S-wave in I lead resolution, 27±12 vs. 15±17 mmHg; P=0.004 for S-wave in aVL resolution and 23±14 vs. 9±14 mmHg; P=0.040 for right bundle branch block resolution) than patients without resolution. Conclusion: Resolution of S-waves and right bundle branch block in ECG correlates with lower all-cause 30-day mortality in intermediate-high and high-risk pulmonary embolism patients. Resolution of S-waves in the first lead and in aVL and right bundle branch block correlates with a decrease of right ventricular systolic pressure.
Feasibility of population screening tests to establish a healthy ageing trajectory
Authors: Gordon Susan J , Grimmer Karen A , Baker Nicky , Bell Elaine , Coveney John , Jordaan Johanna H , Lind Christopher , Marin Tania , Murray Joanne , Norton Lynda H , Perimal-Lewis Lua , Sparrow Karen , Steffens Margie A , Thomas Jolene , Kidd Michael 
Published: January 2019

Objectives: There are no agreed comprehensive tests for age-related changes to physical, emotional, mental and social functioning. Research into declining function focuses on those 75 years and older and little is known about age-related changes in younger people. The aims of this project were (1) to ascertain a comprehensive test battery that could underpin community-based health screening programmes for people aged 40–75 years and pilot both (2) community-based recruitment and (3) the utility, acceptability, response burden and logistics. Methods: A total of 11 databases were searched using a broad range of relevant terms. An identified comprehensive, recent, high-quality systematic review of screening instruments for detection of early functional decline for community-dwelling older people identified many relevant tools; however, not all body systems were addressed. Therefore, lower hierarchy papers identified in the rapid review were included and expert panel consultation was conducted before the final test battery was agreed. Broad networks were developed in one Australian city to aid pilot recruitment of community-dwellers 40–75 years. Recruitment and testing processes were validated using feasibility testing with 12 volunteers. Results: The test battery captured (1) online self-reports of demographics, health status, sleep quality, distress, diet, physical activity, oral health, frailty and continence; and (2) objective tests of anthropometry; mobility; lung function; dexterity; flexibility, strength and stability; hearing; balance; cognition and memory; foot sensation; and reaction time. Recruitment and testing processes were found to be feasible. Conclusion: This screening approach may provide new knowledge on healthy ageing in younger people.
CDK6 coordinates JAK2V617F mutant MPN via NF-κB and apoptotic networks
Authors: Uras Iris Z. , Maurer Barbara , Nivarthi Harini , Jodl Philipp , Kollmann Karoline , Prchal-Murphy Michaela , Milosevic Feenstra Jelena D. , Zojer Markus , Lagger Sabine , Grausenburger Reinhard , Grabner Beatrice , Holly Raimund , Kavirayani Anoop , Bock Christoph , Gisslinger Heinz , Valent Peter , Kralovics Robert , Sexl Veronika 
Published: January 2019

Abstract
Over 80% of patients with myeloproliferative neoplasms (MPNs) harbor the acquired somatic JAK2V617F mutation. JAK inhibition is not curative and fails to induce a persistent response in most patients, illustrating the need for the development of novel therapeutic approaches. We describe a critical role for CDK6 in MPN evolution. The absence of Cdk6 ameliorates clinical symptoms and prolongs survival. The CDK6 protein interferes with 3 hallmarks of disease: besides regulating malignant stem cell quiescence, it promotes nuclear factor κB (NF-κB) signaling and contributes to cytokine production while inhibiting apoptosis. The effects are not mirrored by palbociclib, showing that the functions of CDK6 in MPN pathogenesis are largely kinase independent. Our findings thus provide a rationale for targeting CDK6 in MPN.
Successful donor engraftment and repair of the blood-brain barrier in cerebral adrenoleukodystrophy
Authors: Orchard Paul J. , Nascene David R. , Miller Weston P. , Gupta Ashish , Kenney-Jung Dan , Lund Troy C. 
Published: January 2019

Abstract
Adrenoleukodystrophy (ALD) is caused by mutations within the X-linked ABCD1 gene, resulting in the inability to transport acylated very long chain fatty acids (VLCFAs) into the peroxisome for degradation. VLCFAs subsequently accumulate in tissues, including the central nervous system. Up to 40% of boys develop a severe progressive demyelinating form of ALD, cerebral ALD, resulting in regions of demyelination observed on brain magnetic resonance imaging that are associated with a “garland ring” of gadolinium contrast enhancement. Gadolinium enhancement indicates blood-brain barrier (BBB) disruption and an active inflammatory disease process. Only hematopoietic cell transplant (HCT) has been shown to halt neurologic progression, although the mechanism of disease arrest is unknown. We evaluated imaging- and transplant-related biomarkers in 66 males who underwent HCT. In 77% of patients, gadolinium contrast resolved by 60 days post-HCT. We determined that time to neutrophil recovery and extent of donor chimerism correlated significantly with time to contrast resolution post-HCT. Graft failure was associated with a significantly slower rate of contrast resolution (P &lt; .0001). Time to neutrophil recovery remained significant in multivariate analysis with other biomarkers (P = .03). Our data suggest that robust donor myeloid recovery is necessary for timely repair of the BBB.