bluuebunny/crossref_metadata_2025_split huggingface dataset:
Independent Prognostic Value of Stroke Volume Index in Patients With Immunoglobulin Light Chain Amyloidosis
Authors: Milani Paolo , Dispenzieri Angela , Scott Christopher G. , Gertz Morie A. , Perlini Stefano , Mussinelli Roberta , Lacy Martha Q. , Buadi Francis K. , Kumar Shaji , Maurer Mathew S. , Merlini Giampaolo , Hayman Suzanne R. , Leung Nelson , Dingli David , Klarich Kyle W. , Lust John A. , Lin Yi , Kapoor Prashant , Go Ronald S. , Pellikka Patricia A. , Hwa Yi L. , Zeldenrust Stephen R. , Kyle Robert A. , Rajkumar S. Vincent , Grogan Martha 
Published: May 2018

Background:
Heart involvement is the most important prognostic determinant in AL amyloidosis patients. Echocardiography is a cornerstone for the diagnosis and provides important prognostic information.

Methods and Results:

We studied 754 patients with AL amyloidosis who underwent echocardiographic assessment at the Mayo Clinic, including a Doppler-derived measurement of stroke volume (SV) within 30 days of their diagnosis to explore the prognostic role of echocardiographic variables in the context of a well-established soluble cardiac biomarker staging system. Reproducibility of SV, myocardial contraction fraction, and left ventricular strain was assessed in a separate, yet comparable, study cohort of 150 patients from the Pavia Amyloidosis Center. The echocardiographic measures most predictive for overall survival were SV index <33 mL/min, myocardial contraction fraction <34%, and cardiac index <2.4 L/min/m
2
with respective hazard ratios (95% confidence intervals) of 2.95 (2.37–3.66), 2.36 (1.96–2.85), and 2.32 (1.91–2.80). For the subset that had left ventricular strain performed, the prognostic cut point was −14% (hazard ratios, 2.70; 95% confidence intervals, 1.84–3.96). Each parameter was independent of systolic blood pressure, Mayo staging system (NT-proBNP [N-terminal pro-B-type natriuretic peptide] and troponin), and ejection fraction on multivariable analysis. Simple predictive models for survival, including biomarker staging along with SV index or left ventricular strain, were generated.

Conclusions:
SV index prognostic performance was similar to left ventricular strain in predicting survival in AL amyloidosis, independently of biomarker staging. Because SV index is routinely calculated and widely available, it could serve as the preferred echocardiographic measure to predict outcomes in AL amyloidosis patients.
Cardiac Structural Remodeling, Longitudinal Systolic Strain, and Torsional Mechanics in Lean and Nonlean Dysglycemic Chinese Adults
Authors: Lin Jiun-Lu , Sung Kuo-Tzu , Su Cheng-Huang , Chou Tzu-Hsun , Lo Chi-In , Tsai Jui-Peng , Chang Shun-Chuan , Lai Yau-Huei , Hu Kuang-Chun , Liu Chia-Yuan , Yun Chun-Ho , Hung Chung-Lieh , Yeh Hung-I , Lam Carolyn S.P. 
Published: May 2018

Background:
Diabetes mellitus and pre–diabetes mellitus are associated with lower body mass indices and increased risk of cardiovascular events (including heart failure) at lower glucose thresholds in Chinese compared with Western cohorts. However, the extent of cardiac remodeling and regulation on cardiac mechanics in lean and nonlean dysglycemic Chinese adults is understudied.

Methods and Results:

We studied 3950 asymptomatic Chinese (aged 49.7±10.7 years; 65% male; body mass index: 24.3±3.5 kg/m
2
) with comprehensive echocardiography including speckle tracking for left ventricular global longitudinal strain/torsion, with plasma sugar, glycosylated hemoglobin (HbA1c), and insulin resistance (homeostasis model assessment of insulin resistance) obtained. Participants were classified as (1) nondiabetic (fasting glucose <100 mg/mL; HbA1c <5.7%; n=1416), prediabetic (fasting glucose 100–126 mg/dL; HbA1c 5.7%–6.4%; n=2029), or diabetic (n=505) and (2) lean (body mass index <23 kg/m
2
; n=1445) or nonlean (n=2505). Higher sugar, HbA1c, and homeostasis model assessment of insulin resistance were independently associated with higher left ventricular mass, greater mass-to-volume ratio, more impaired diastolic indices, and worse global longitudinal strain even after adjusting for clinical covariates (adjusted coefficient value: 0.28/0.12 for global longitudinal strain per 1 U HbA1c/homeostasis model assessment of insulin resistance increment; both
P
<0.001), with a consistent trend toward greater torsion (all trend
P
<0.001). The optimal cutoffs in identifying subclinical systolic dysfunction (global longitudinal strain more impaired than −18%) for lean versus nonlean individuals were 97 versus 106 mg/dL for fasting sugar, 130 versus 135 mg/mL for postprandial sugar, 5.62% versus 6.28% for HbA1c, and 1.81 versus 2.40 for homeostasis model assessment of insulin resistance, respectively.

Conclusions:
These data demonstrate the presence of preclinical cardiac remodeling and systolic dysfunction in prediabetic and diabetic Chinese adults, occurring at lower thresholds of glycemic indices than defined by international standards, particularly in lean individuals.
Safety Issues with Patient-Controlled Analgesia; Wake-Up Call: Unlabeled Containers Lead to Patient's Death
Authors: Cohen Michael R. 
Published: May 2018

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR). Any reports published by ISMP will be anonymous. Comments are also invited; the writers’ names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) Web sites or communicated directly to ISMP by calling 1-800-FAIL SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications.
Atorvastatin: Rheumatoid Arthritis
Authors: Generali Joyce , Cada Dennis J. 
Published: May 2018

Off-Label Drug Uses This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data—including background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Disparities in Initiation of Direct-Acting Antiviral Agents for Hepatitis C Virus Infection in an Insured Population
Authors: Marcus Julia L. , Hurley Leo B. , Chamberland Scott , Champsi Jamila H. , Gittleman Laura C. , Korn Daniel G. , Lai Jennifer B. , Lam Jennifer O. , Pauly Mary Pat , Quesenberry Charles P. , Ready Joanna , Saxena Varun , Seo Suk I. , Witt David J. , Silverberg Michael J. 
Published: May 2018

Objectives: The cost of direct-acting antiviral agents (DAAs) for hepatitis C virus (HCV) infection may contribute to treatment disparities. However, few data exist on factors associated with DAA initiation. Methods: We conducted a retrospective cohort study of HCV-infected Kaiser Permanente Northern California members aged ≥18 during October 2014 to December 2016, using Poisson regression models to evaluate demographic, behavioral, and clinical factors associated with DAA initiation. Results: Of 14 790 HCV-infected patients aged ≥18 (median age, 60; interquartile range, 53-64), 6148 (42%) initiated DAAs. DAA initiation was less likely among patients who were non-Hispanic black (adjusted rate ratio [aRR] = 0.7; 95% confidence interval [CI], 0.7-0.8), Hispanic (aRR = 0.8; 95% CI, 0.7-0.9), and of other minority races/ethnicities (aRR = 0.9; 95% CI, 0.8-1.0) than among non-Hispanic white people and among those with lowest compared with highest neighborhood deprivation index (ie, a marker of socioeconomic status) (aRR = 0.8; 95% CI, 0.7-0.8). Having maximum annual out-of-pocket health care costs >$3000 compared with ≤$3000 (aRR = 0.9; 95% CI, 0.8-0.9) and having Medicare (aRR = 0.8; 95% CI, 0.8-0.9) or Medicaid (aRR = 0.7; 95% CI, 0.6-0.8) compared with private health insurance were associated with a lower likelihood of DAA initiation. Behavioral factors (eg, drug abuse diagnoses, alcohol use, and smoking) were also significantly associated with a lower likelihood of DAA initiation (all P < .001). Clinical factors associated with a higher likelihood of DAA initiation were advanced liver fibrosis, HCV genotype 1, previous HCV treatment (all P < .001), and HIV infection ( P = .007). Conclusions: Racial/ethnic and socioeconomic disparities exist in DAA initiation. Substance use may also influence patient or provider decision making about DAA initiation. Strategies are needed to ensure equitable access to DAAs, even in insured populations.
Laycarers can confidently prepare and administer subcutaneous injections for palliative care patients at home: A randomized controlled trial
Authors: Healy Sue , Israel Fiona , Charles Margaret , Reymond Liz 
Published: May 2018

Background: Palliative care patients consistently nominate home as their preferred care environment. This is challenging without support from laycarers, especially if patients require subcutaneously administered symptom relief. Laycarers typically lack confidence with this task and request professional guidance. Aim: To explore differences in laycarers’ confidence in administering subcutaneous injections depending upon whether a laycarer, registered nurse or pharmacist prepared injections for subsequent administration by laycarers. Design: Prospective randomized controlled trial with three intervention arms: laycarer prepares, labels and stores injections; registered nurse prepares injections; and pharmacist prepares injections for later administration by laycarer. Setting/participants: In all, 93 laycarers, from 24 urban and rural community services, completed the study. Results: The primary outcome of interest was laycarer confidence with injection administration; analysis of variance revealed no significant differences between the three intervention arms; mean values ranged from 5.9 to 6.1 out of 7 ( F(2, 90) = 0.50, p = 0.61). Comparison of confidence after laycarer preparation versus other (nurse or pharmacist) was not statistically significant ( t = 0.7, df = 90, p = 0.49). Averaged over intervention arms, confidence levels increase significantly with injecting experience, from 5.3 to 6.1 ( F(1, 75) = 47.6, p < 0.001). Conclusion: Upskilled laycarers can confidently administer subcutaneous injections for loved ones, regardless of who prepares injections. This finding can improve patient outcomes and potentially decrease unwanted admissions to inpatient facilities.
Development and validation of the Measure of Supporting Co-occupation for family caregivers
Authors: Ono Kenichi , Kanayama Yuri , Tsuchiya Keiko , Iwata Miyuki , Yabuwaki Kenji 
Published: May 2018

Introduction It is important to understand the experiences of elderly people with dementia and their family caregivers. Moreover, the maintenance of family caregivers’ satisfaction with co-occupation is important to ensure that they intend to continue providing care. This study developed and validated the Measure of Supporting Co-occupation, which assesses co-occupation involving elderly people with dementia and their family caregivers. Method This study used a cross-sectional design and questionnaire survey. Participants were recruited from 21 institutions. Descriptive statistics were calculated for the following domains: ‘evocation of the story of co-occupation’, ‘intention to continue co-occupation’ and ‘preferred co-occupation’. The construct validity and reliability of the ‘intention to continue co-occupation’ domain were examined using exploratory factor analysis, confirmatory factor analysis and Cronbach’s alpha. The criterion-related validity of the ‘intention to continue co-occupation’ was examined by means of correlations with other scales. Results There were 115 pairs of participants. Good criterion-related validity and internal consistency were confirmed for the ‘intention to continue co-occupation’ domain. However, confirmatory factor analysis showed insufficient model fitness. Conclusion The ‘intention to continue co-occupation’ domain is not ready for clinical application due to insufficient model fitness, it is necessary to revise the Measure of Supporting Co-occupation.
Employee Adherence to a Tobacco-Free Executive Order in Kentucky
Authors: Ickes Melinda J. , Wiggins Amanda , Rayens Mary Kay , Edwards Jean , Hahn Ellen J. 
Published: May 2018

Purpose: Examine predictors of short- and long-term adherence to a tobacco-free policy prohibiting all tobacco use inside and outdoors on Executive Branch property in Kentucky. Design: Cross-sectional online surveys administered at 2 time points. Setting: Commonwealth of Kentucky. Participants: 27 000 employees of the Kentucky Executive Branch were invited to participate in 2 online surveys: March 2015, 4 months postpolicy (N = 4854) and August 2015, 9 months postpolicy (N = 3522). Intervention: Executive order prohibiting tobacco use on Executive property implemented November 2014. Measures: Tobacco use, tobacco users’ adherence to the tobacco-free policy, and personal characteristics were assessed. Analysis: Two separate logistic regression models used to determine predictors of short- and long-term adherence to the policy. Results: In the short term, employees who had seen others violate the policy ( P < .001) and had more tobacco-using friends ( P = .020) were less likely to adhere to the policy. At 9 months after the policy, employees who were older ( P = .038) and those who had seen others violate the policy ( P < .001) were less likely to report adherence to the policy. Tobacco-using employees who worked in a county with a comprehensive smoke-free ordinance ( P = .047) were more likely to adhere to the policy. Conclusion: This study indicates the need for strong policy compliance procedures, employer-based tobacco treatment programs accompanying tobacco-free policy change, and smoke-free workplace laws to promote prohealth norms.
An Algorithm for the Assessment of Facial Asymmetry in Children With Focus on Etiology and Treatment
Authors: Wenger Tara L. , Gallagher Emily R. , Bhoj Elizabeth J. 
Published: May 2018

Background: Facial asymmetry is a common referral indication for craniofacial teams but has a wide range of causes. Prompt identification of etiology is critical to treatment, as medical and surgical interventions vary depending on the cause of asymmetry in each patient. Solution: A standardized diagnostic algorithm. What We Did That Is New: We developed an algorithm to assist in the diagnostic evaluation of facial asymmetry with a focus on next steps for medically actionable causes.
The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?
Authors: Strömbäck Ulrica , Engström Åsa , Lundqvist Robert , Lundblad Dan , Vikman Irene 
Published: May 2018

Background: Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient. Aim: This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays ≥2 h at second myocardial infarction. Methods: A retrospective cohort study with 820 patients aged 31–74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry. Results: The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay ≥2 h at the first myocardial infarction were more likely to have a prehospital delay ≥2 h at the second myocardial infarction. Conclusions: Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient’s behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.
The role of miR-92b in cholangiocarcinoma patients
Authors: Zhou Min-hang , Zhou Hong-wei , Liu Mo , Sun Jun-zhong 
Published: May 2018

Purpose: The role of microRNA (miRNA) in cholangiocarcinoma was not clear. The aim of this study was to find the potential diagnostic and prognostic miRNA in cholangiocarcinoma patients. Methods: The miRNA expression profiles in cholangiocarcinoma patients from The Cancer Genome Atlas and Gene Expression Omnibus (GSE53870) were analyzed. The comparison of overall survival was performed using the Kaplan–Meier method. The targeted genes of prognostic miRNA were identified in miRanda, PicTar, or TargetScan, and their cell signaling pathways were analyzed by the Database for Annotation, Visualization and Integrated Discovery. Results: In The Cancer Genome Atlas and the Gene Expression Omnibus miRNA dataset, miR-92b and miR-99a were found with concordant directionality, up-regulated and down-regulated, respectively. In The Cancer Genome Atlas survival data, patients with the high level of miR-99b had obviously shorter overall survival time ( P=0.038). However, the level of miR-99a was not found to be significant. The 17 shared target genes of miR-92b were identified, such as DAB21IP, BCL21L11, SPHK2, PER2, and TSC1. The related pathways included positive regulation of transcription, positive regulation of cellular biosynthetic process, regulation of programmed cell death, etc. Conclusion: miR-92b was up-regulated in cholangiocarcinoma compared with normal controls. The high level of miR-92b was associated with adverse outcomes in cholangiocarcinoma patients, which might be partly explained by the targeted genes of miR-92b and their signaling pathways.
Outcomes of scapholunate intercarpal ligamentoplasty for chronic scapholunate dissociation: a prospective study in 26 patients
Authors: Athlani Lionel , Pauchard Nicolas , Dautel Gilles 
Published: May 2018

We report the outcomes of scapholunate intercarpal ligamentoplasty in 26 wrists. For 15 wrists with static instability and 11 with dynamic instability, we used a free palmaris longus graft to reconstruct the dorsal part of the scapholunate interosseous ligament and the dorsal intercarpal ligament. These patients were evaluated for pain and active wrist range of motion, grip strength and radiological appearance after a mean follow-up of 36 months (range 12–54) after surgery. Pain score was improved from 4.5 to 1.4 at rest and 6.7 to 1.9 during hand use. The average wrist flexion was 57°, extension 56°. Grip strength was 89% of the contralateral side. The mean scapholunate angle decreased from 76° to 62°, and static scapholunate gap reduced from 3.2 mm to 2.3 mm and the dynamic gap from 4.6 mm to 3.0 mm. Scaphoid subluxation was corrected. We conclude that this procedure led to satisfactory clinical and radiological results in a short- to mid-term follow-up. Level of evidence: II
The prognostic value of concurrent Horner syndrome in surgical decision making at 3 months in total-type neonatal brachial plexus palsy
Authors: Yoshida Kiyoshi , Kawabata Hidehiko 
Published: May 2018

We investigated the prognostic value of concurrent Horner syndrome for predicting spontaneous motor recovery in surgical decision making at 3 months with neonatal brachial plexus palsy. Medical records of 129 neonates with total-type brachial plexus palsy were reviewed, and clinical and follow-up data of patients with or without Horner syndrome were compared. Twenty-seven of 129 newborn babies with total-type palsy (21%) had concurrent Horner syndrome. Poor spontaneous motor recovery was observed in 21 (78%) neonates with concurrent Horner syndrome and in 84 (82%) without concurrent Horner syndrome. Concurrent Horner syndrome in neonates with brachial plexus palsy has no prognostic value in predicting poor spontaneous motor recovery of the brachial plexus in patients with total-type palsy. Level of evidence: III