1,649,421 results match your criteria Objective Refractometers and Wavefront Imaging


The social impact of early psychological maturity in adolescents with cancer.

Psychooncology 2019 Jan 15. Epub 2019 Jan 15.

McMaster University, Hamilton, ON.

Objective: There is a growing need to assess the long-term quality of life (QOL) of pediatric oncology patients since many children now survive their disease. This paper highlights the subjective perspectives of pediatric cancer patients and specifically explores how experiencing cancer at a young age impacts adolescents in the areas of social functioning, peer relationships and QOL. The findings emerged from a qualitative research study that explored how pediatric oncology patients ascribe meaning to their illness. Read More

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http://dx.doi.org/10.1002/pon.4982DOI Listing
January 2019

Isthmocele: From Risk Factors to Management.

Rev Bras Ginecol Obstet 2019 Jan 15. Epub 2019 Jan 15.

Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, Azienda Ospedaliero-Universitaria S. Anna, Università di Ferrara, Cona, Ferrara, Italy.

Objective:  The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele-a hypoechoic area within the myometrium at the site of the uterine scar of a previous cesarean section-by exploring in depth every aspect of this condition.

Methods:  A comprehensive review of the literature was performed to identify the most relevant studies about this topic.

Results:  Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Read More

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http://dx.doi.org/10.1055/s-0038-1676109DOI Listing
January 2019

Adverse Maternal Outcomes Associated with Uterine Extensions at the Time of Cesarean Delivery.

Am J Perinatol 2019 Jan 15. Epub 2019 Jan 15.

Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Objective:  We sought to compare adverse maternal outcomes between women with and without a uterine extension at the time of cesarean.

Study Design:  We conducted a retrospective cohort study of women with and without a uterine extension during a primary low transverse cesarean of a full-term singleton gestation. The primary outcomes were (1) estimated blood loss (EBL) and (2) composite maternal morbidity (defined as ≥ 1 of the following: blood transfusion, endometritis, or readmission). Read More

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http://dx.doi.org/10.1055/s-0038-1676827DOI Listing
January 2019

Evaluation of the Effect of Low-Dose Aspirin on Biochemical and Biophysical Biomarkers for Placental Disease in Low-Risk Pregnancy: Secondary Analysis of a Multicenter RCT.

Am J Perinatol 2019 Jan 15. Epub 2019 Jan 15.

UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland.

Objective:  To assess the effect of aspirin use in low-risk pregnancy on: (1) pregnancy-associated plasma protein-A (PAPP-A) and placental-like growth factor (PLGF); (2) urinary albumin-to-creatinine ratio (ACR) and blood pressure; (3) fetal growth parameters; and (4) placental histopathology.

Study Design:  This secondary analysis from the rial of low-dose aspirin with an arly creening est for preeclampsia and growth restriction randomized controlled trial was based on low-risk nulliparous women randomized at 11 weeks to (1) aspirin 75 mg; (2) no aspirin; and (3) aspirin based on the preeclampsia Fetal Medicine Foundation screening test. At baseline, women underwent assessment of blood pressure, PAPP-A, PLGF, and ACR, repeated 9 to 10 weeks postaspirin, in addition to fetal growth assessment. Read More

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http://dx.doi.org/10.1055/s-0038-1677476DOI Listing
January 2019

Adverse Outcomes with Maternal Blood Pressure Less than 140/90 in Pregnancy Complicated by Hypertension.

Am J Perinatol 2019 Jan 15. Epub 2019 Jan 15.

Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.

Objective:  We assessed the risk of small for gestational age and other outcomes in pregnancies complicated by chronic hypertension with blood pressure <140/90 mm Hg.

Study Design:  Retrospective cohort of singletons with hypertension at a single institution from 2000 to 2014. Mean systolic blood pressure and mean diastolic blood pressure were analyzed as continuous and dichotomous variables (<120/80 and 120-139/80-89 mm Hg). Read More

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http://dx.doi.org/10.1055/s-0038-1677474DOI Listing
January 2019

Association of Fast Food and Supermarket Density with Neonatal Outcomes of Pregnancies Affected by Gestational Diabetes.

Am J Perinatol 2019 Jan 15. Epub 2019 Jan 15.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern Feinberg School of Medicine, Chicago, Illinois.

Objective:  To measure the association of fast food density (FFD) and supermarket density (SD) with adverse neonatal outcomes in pregnancies with gestational diabetes mellitus (GDM).

Study Design:  This was a retrospective cohort study of women with GDM who delivered at a tertiary care center in a large metropolitan area (1/2010-2/2016). ZIP codes were used to link women with surrounding food environment. Read More

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http://dx.doi.org/10.1055/s-0038-1677478DOI Listing
January 2019

Complications and Long-Term Outcome in 16 Canine Cementless Hybrid Hip Arthroplasties.

Vet Comp Orthop Traumatol 2019 Jan 15;32(1):73-78. Epub 2019 Jan 15.

Small Animal Clinic, Free University of Berlin, Berlin, Germany.

Objective:  The purpose of this study was to retrospectively evaluate the complications and long-term outcomes of total hip arthroplasty (THA) using a hybrid cementless system.

Materials And Methods:  Medical records of dogs that underwent THA using a combined implant system consisting of Innoplant Screw Cup, Kyon taper head and Zurich cementless (Z-THA) stem between March 2010 and March 2015 were reviewed. Dogs with a minimum follow-up of 2 years were included. Read More

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http://dx.doi.org/10.1055/s-0038-1676072DOI Listing
January 2019
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Technical Repeatability and Reproducibility of the Stress Radiographs Performed with the Vezzoni-Modified Badertscher Hip Distension Device.

Vet Comp Orthop Traumatol 2019 Jan 15;32(1):67-72. Epub 2019 Jan 15.

Department of Genetics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Objective:  The aim of this study was to evaluate the repeatability and reproducibility of the radiographical stress technique using the Vezzoni-modified Badertscher distension device (VMBDD).

Materials And Methods:  Stress radiographs of 10 dogs obtained with the VMBDD were performed consecutively by two different operators and then measured twice by a third veterinarian. The technical repeatability was first assessed individually for the two operators who took the stress radiographs, followed by the technical reproducibility. Read More

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http://dx.doi.org/10.1055/s-0038-1676306DOI Listing
January 2019

Effects of Hole Diameter on Torsional Mechanical Properties of the Rabbit Femur.

Vet Comp Orthop Traumatol 2019 Jan 15;32(1):51-58. Epub 2019 Jan 15.

Department of Anatomy, Physiology and Cell Biology, University of California, Davis, One Garrod Drive, Davis, California, United States.

Objective:  The aim of this study was to evaluate and compare the effect of three clinically applicable screw hole diameters on rabbit femoral torsional structural properties.

Sample:  Eighteen pairs of skeletally mature New Zealand White rabbit femora (36 bones).

Materials And Methods:  Femora with a bicortical hole at mid-diaphysis from one of the 3-drill bit sizes, 1. Read More

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http://dx.doi.org/10.1055/s-0038-1676331DOI Listing
January 2019

Copper Bead Therapy in Severe Bone Infection: A Rabbit Tibial Model.

Vet Comp Orthop Traumatol 2019 Jan 15;32(1):41-50. Epub 2019 Jan 15.

Unit of Animal Experimentation "Cantacuzino" National Institute for Medico-Military Research and Development, Bucharest, Romania.

Objective:  We investigated the benefits of a local preventive therapy based on copper beads against severe bone infection using a rabbit open tibial fracture model.

Materials And Methods:  Cotton mesh balls soaked in a very high concentration of ATCC 6538 culture were inoculated in drilled holes of the tibiae of treated and control groups. The treated group was also implanted with small copper beads simultaneously, as prevention therapy. Read More

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http://dx.doi.org/10.1055/s-0038-1676292DOI Listing
January 2019

Prospective Evaluation of Surgical Wound Dressings and the Incidence of Surgical Site Infections in Dogs Undergoing a Tibial Plateau Levelling Osteotomy.

Vet Comp Orthop Traumatol 2019 Jan 15;32(1):18-25. Epub 2019 Jan 15.

Virginia Veterinary Surgical Associates, a BluePearl Partner, Richmond, Virginia, United States.

Objective:  The main aim of this study was to evaluate the efficacy of a topical 2-octyl cyanoacrylate (2OC) tissue adhesive and an adhesive barrier dressing (BD) in minimizing the incidence of surgical site infections (SSI) in dogs undergoing a tibial plateau levelling osteotomy (TPLO).

Materials And Methods:  In a prospective clinical study, 437 client-owned dogs undergoing a TPLO as treatment for cranial cruciate ligament disease with or without concurrent patellar luxations from July 2015 to September 2016 were included. In each dog, the type of postoperative wound dressing was randomly selected as either no dressing (ND), a 2OC tissue adhesive or an adhesive BD. Read More

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http://dx.doi.org/10.1055/s-0038-1676352DOI Listing
January 2019

Prevalence of Elective and Ruptured Abdominal Aortic Aneurysm Repairs by Age and Sex From 2003 to 2016 in Ontario, Canada.

JAMA Netw Open 2018 Nov 2;1(7):e185418. Epub 2018 Nov 2.

Department of Surgery, Division of Vascular Surgery, University of Toronto, Toronto, Ontario, Canada.

Importance: Age and sex are important considerations in assessing and individualizing therapy for abdominal aortic aneurysm (AAA) repair.

Objective: To determine the prevalence of open and endovascular elective AAA (EAAA) and ruptured AAA (RAAA) repair by age and sex.

Design, Setting, And Participants: In this retrospective, population-based, cross-sectional, time-series analysis in Ontario, Canada, from April 1, 2003, to March 31, 2016, all patients undergoing AAA repair who were older than 39 years were included. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5418DOI Listing
November 2018

Association of Childhood Adversity With Differential Susceptibility of Transdiagnostic Psychopathology to Environmental Stress in Adulthood.

JAMA Netw Open 2018 Nov 2;1(7):e185354. Epub 2018 Nov 2.

Department of Psychiatry, University of Minnesota Medical School, Minneapolis.

Importance: Multivariable comorbidity research indicates that childhood adversity increases the risk for the development of common mental disorders. This risk is explained by underlying internalizing and externalizing transdiagnostic constructs that are amplified by environmental stressors. The differential susceptibility model suggests that this interaction of risk and environment is bidirectional: at-risk individuals will have worse outcomes in high-stress environments but better outcomes in in low-stress environments. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5354DOI Listing
November 2018

Prevalence of and Factors Associated With Patient Nondisclosure of Medically Relevant Information to Clinicians.

JAMA Netw Open 2018 Nov 2;1(7):e185293. Epub 2018 Nov 2.

Department of Population Health Sciences, University of Utah, Salt Lake City.

Importance: Patient failure to disclose medically relevant information to clinicians can undermine patient care or even lead to patient harm.

Objective: To examine the frequency of patients failing to disclose to their clinicians information that is relevant to their care and their reasons for doing so.

Design, Setting, And Participants: Two national nonprobability samples were recruited to participate in an online survey, one using Amazon's Mechanical Turk (MTurk) from March 16 to 30, 2015 (2096 respondents), followed by one using Survey Sampling International (SSI) from November 6 to 17, 2015 (3011 respondents). Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5293DOI Listing
November 2018

Assessment of Safety and Outcome of Lateral Hypothalamic Deep Brain Stimulation for Obesity in a Small Series of Patients With Prader-Willi Syndrome.

JAMA Netw Open 2018 Nov 2;1(7):e185275. Epub 2018 Nov 2.

Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.

Importance: Deep brain stimulation (DBS) has been investigated for treatment of morbid obesity with variable results. Patients with Prader-Willi syndrome (PWS) present with obesity that is often difficult to treat.

Objective: To test the safety and study the outcome of DBS in patients with PWS. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5275DOI Listing
November 2018

Polyvascular Disease and Risk of Major Adverse Cardiovascular Events in Peripheral Artery Disease: A Secondary Analysis of the EUCLID Trial.

JAMA Netw Open 2018 Nov 2;1(7):e185239. Epub 2018 Nov 2.

Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

Importance: The effect of polyvascular disease on cardiovascular outcomes in the background of peripheral artery disease (PAD) is unclear.

Objective: To determine the risk of ischemic events (both cardiac and limb) among patients with PAD and polyvascular disease.

Design, Setting, And Participants: In this post hoc secondary analysis of the international Examining Use of Ticagrelor in Peripheral Artery Disease (EUCLID) trial, outcomes were compared among 13 885 enrolled patients with PAD alone, PAD + coronary artery disease (CAD), PAD + cerebrovascular disease (CVD), and PAD + CAD + CVD. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5239DOI Listing
November 2018
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Association of Primary Care Consultation Patterns With Early Signs and Symptoms of Psychosis.

JAMA Netw Open 2018 Nov 2;1(7):e185174. Epub 2018 Nov 2.

Division of Psychiatry, University College London, London, United Kingdom.

Importance: Primary care is an important part of the care pathway for patients with psychosis; therefore, primary care physicians need to be able to accurately identify those at clinical high risk of psychosis. The difficulty of this task is increased because clinical high-risk symptoms are frequently nonspecific to psychosis.

Objective: To determine whether the consultation patterns for a prespecified set of symptoms can be used to identify primary care patients who later developed a psychotic illness. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5174DOI Listing
November 2018

Comparison of the Complexity of Patients Seen by Different Medical Subspecialists in a Universal Health Care System.

JAMA Netw Open 2018 Nov 2;1(7):e184852. Epub 2018 Nov 2.

Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

Importance: Clinical experience suggests that there are substantial differences in patient complexity across medical specialties, but empirical data are lacking.

Objective: To compare the complexity of patients seen by different types of physician in a universal health care system.

Design, Setting, And Participants: Population-based retrospective cohort study of 2 597 127 residents of the Canadian province of Alberta aged 18 years and older with at least 1 physician visit between April 1, 2014 and March 31, 2015. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4852DOI Listing
November 2018

Acute Effects of Smoked and Vaporized Cannabis in Healthy Adults Who Infrequently Use Cannabis: A Crossover Trial.

JAMA Netw Open 2018 Nov 2;1(7):e184841. Epub 2018 Nov 2.

Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Importance: Vaporization is an increasingly popular method for cannabis administration, and policy changes have increased adult access to cannabis drastically. Controlled examinations of cannabis vaporization among adults with infrequent current cannabis use patterns (>30 days since last use) are needed.

Objective: To evaluate the acute dose effects of smoked and vaporized cannabis using controlled administration methods. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4841DOI Listing
November 2018

Changes in the US Burden of Chronic Kidney Disease From 2002 to 2016: An Analysis of the Global Burden of Disease Study.

JAMA Netw Open 2018 Nov 2;1(7):e184412. Epub 2018 Nov 2.

Clinical Epidemiology Center, Research and Education Service, Veterans Affairs St Louis Health Care System, St Louis, Missouri.

Introduction: Over the past 15 years, changes in demographic, social, and epidemiologic trends occurred in the United States. These changes likely contributed to changes in chronic kidney disease (CKD) epidemiology.

Objective: To describe the change in burden of CKD at the US state level from 2002 to 2016. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4412DOI Listing
November 2018

Exploring the Role of Family Functioning in the Association Between Frequency of Family Dinners and Dietary Intake Among Adolescents and Young Adults.

JAMA Netw Open 2018 Nov 2;1(7):e185217. Epub 2018 Nov 2.

Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.

Importance: Eating meals, particularly dinner, with family members has been associated with improved dietary intake among youths. However, existing studies have not examined how family functioning may moderate or confound this association.

Objective: To examine whether level of family functioning is associated cross-sectionally with frequency of family dinners and dietary intake among a US national sample of adolescents and young adults. Read More

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http://jamanetworkopen.jamanetwork.com/article.aspx?doi=10.1
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http://dx.doi.org/10.1001/jamanetworkopen.2018.5217DOI Listing
November 2018
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Development of a Group Judgment Process for Forecasts of Health Care Innovations.

JAMA Netw Open 2018 Nov 2;1(7):e185108. Epub 2018 Nov 2.

Public Policy, Pharmacy, and Economics, University of Southern California, Los Angeles.

Importance: Health care costs have increased substantially over the past few decades, in part owing to the development and diffusion of new medical treatments. Forecasting potential future technologic innovations can allow for more informed planning.

Objective: To assess the predictive validity of a structured formal method for forecasting future technologic innovations in health care. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5108DOI Listing
November 2018

Association of Diagnosis of Leukodystrophy With Race and Ethnicity Among Pediatric and Adolescent Patients.

JAMA Netw Open 2018 Nov 2;1(7):e185031. Epub 2018 Nov 2.

Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City.

Importance: Inherited leukodystrophies are a group of neurological diseases affecting myelin that cause significant morbidities and death. Timely and correct diagnosis is important for initiating treatment, designing disease screening, and offering care and guidance to patients and families.

Objective: To determine whether there are disparities in leukodystrophy diagnosis in different racial backgrounds. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5031DOI Listing
November 2018

Association of Elective and Emergency Cesarean Delivery With Early Childhood Overweight at 12 Months of Age.

JAMA Netw Open 2018 Nov 2;1(7):e185025. Epub 2018 Nov 2.

Duke-NUS Medical School, Singapore, Singapore.

Importance: Global cesarean delivery (CD) rates have more than doubled over the past 2 decades, with an increasing contribution from elective CDs. Cesarean delivery has been linked to early childhood overweight and obesity, but limited studies have examined elective and emergency CDs separately.

Objective: To investigate whether elective or emergency CD was associated with risk of early childhood overweight. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5025DOI Listing
November 2018
1 Read

Association of Exposure to Police Violence With Prevalence of Mental Health Symptoms Among Urban Residents in the United States.

JAMA Netw Open 2018 Nov 2;1(7):e184945. Epub 2018 Nov 2.

School of Social Work, University of Maryland, Baltimore.

Importance: Police violence is reportedly widespread in the United States and may pose a significant risk to public mental health.

Objective: To examine the association between 12-month exposure to police violence and concurrent mental health symptoms independent of trauma history, crime involvement, and other forms of interpersonal violence exposure.

Design, Setting, And Participants: This cross-sectional, general population survey study of 1221 eligible adults was conducted in Baltimore, Maryland, and New York City, New York, from October through December 2017. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4945DOI Listing
November 2018

Evaluation of Hospital-Based Hematuria Diagnosis and Subsequent Cancer Risk Among Adults in Denmark.

JAMA Netw Open 2018 Nov 2;1(7):e184909. Epub 2018 Nov 2.

Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.

Importance: Data on the long-term risk of urologic and nonurologic cancer after hematuria diagnosis are sparse. Such data can improve understanding of hematuria and cancer and can provide insight into the clinical course of patients with hematuria.

Objective: To assess the risk of urologic or nonurologic cancer after a hospital-based diagnosis of hematuria. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4909DOI Listing
November 2018

Association Between Health Insurance Literacy and Avoidance of Health Care Services Owing to Cost.

JAMA Netw Open 2018 Nov 2;1(7):e184796. Epub 2018 Nov 2.

Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City.

Importance: Navigating health insurance and health care choices requires considerable health insurance literacy. Although recommended preventive services are exempt from out-of-pocket costs under the Affordable Care Act, many people may remain unaware of this provision and its effect on their required payment. Little is known about the association between individuals' health insurance literacy and their use of preventive or nonpreventive health care services. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4796DOI Listing
November 2018

Evaluation of Differences in Temporal Synchrony Between Brain Regions in Individuals With Autism and Typical Development.

JAMA Netw Open 2018 Nov 2;1(7):e184777. Epub 2018 Nov 2.

Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City.

Importance: Despite reports of widespread but heterogeneous atypicality of functional connectivity in individuals with autism, little is known regarding the temporal dynamics of functional brain connections and how they relate to autistic traits.

Objective: To investigate differences in temporal synchrony between brain regions in individuals with autism and those with typical development.

Design, Setting, And Participants: This cohort study, conducted at the University of Utah, included 90 adolescent and adult male participants. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4777DOI Listing
November 2018

Effect of Real-time Patient-Centered Education Bundle on Administration of Venous Thromboembolism Prevention in Hospitalized Patients.

JAMA Netw Open 2018 Nov 2;1(7):e184741. Epub 2018 Nov 2.

Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland.

Importance: Numerous interventions have improved prescription of venous thromboembolism (VTE) prophylaxis; however, many prescribed doses are not administered to hospitalized patients, primarily owing to patient refusal.

Objective: To evaluate a real-time, targeted, patient-centered education bundle intervention to reduce nonadministration of VTE prophylaxis.

Design, Setting, And Participants: This nonrandomized controlled, preintervention-postintervention comparison trial included 19 652 patient visits on 16 units at The Johns Hopkins Hospital, Baltimore, Maryland, from April 1 through December 31, 2015. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4741DOI Listing
November 2018

Association of Fatality Risk With Value-Based Drug Pricing of Epinephrine Autoinjectors for Children With Peanut Allergy: A Cost-effectiveness Analysis.

JAMA Netw Open 2018 Nov 2;1(7):e184728. Epub 2018 Nov 2.

Children's Hospital Colorado, Section of Allergy and Immunology, University of Colorado School of Medicine, Aurora.

Importance: The high cost of self-injectable epinephrine autoinjectors may represent a barrier to community anaphylaxis management. Value-based pricing can provide a benchmark for rational epinephrine autoinjector costs.

Objective: To define value-based pricing of community epinephrine autoinjectors. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4728DOI Listing
November 2018

Motivators, Barriers, and Facilitators to Traveling to the Safest Hospitals in the United States for Complex Cancer Surgery.

JAMA Netw Open 2018 Nov 2;1(7):e184595. Epub 2018 Nov 2.

Section of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.

Importance: Directing patients to safer hospitals for complex cancer surgery (regionalization) may prevent thousands of mortalities in the United States.

Objective: To understand the potential for individuals to move to safer hospitals: what would inspire them to travel (motivators), what challenges would they face (barriers), and what would enable them to travel (facilitators).

Design, Setting, And Participants: This nationally representative online survey study asked respondents to consider complex cancer surgery at their local hospital or a hospital specializing in cancer an hour farther away. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4595DOI Listing
November 2018

Association of Obesity With Mortality Over 24 Years of Weight History: Findings From the Framingham Heart Study.

JAMA Netw Open 2018 Nov 2;1(7):e184587. Epub 2018 Nov 2.

Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.

Importance: Many studies of the association between obesity and mortality rely on weight status at a single point in time, making it difficult to adequately address bias associated with reverse causality.

Objective: To investigate the association between maximum body mass index (BMI) and all-cause mortality without the consequences of reverse causality.

Design, Setting, And Participants: Prospective cohort studies for the original and offspring cohorts of the Framingham Heart Study. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4587DOI Listing
November 2018

Association Between Obesity and Cardiovascular Outcomes: A Systematic Review and Meta-analysis of Mendelian Randomization Studies.

JAMA Netw Open 2018 Nov 2;1(7):e183788. Epub 2018 Nov 2.

Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.

Importance: Although dyslipidemia has been consistently shown to be associated with atherogenesis, an association between obesity and cardiovascular disease outcomes remains controversial. Mendelian randomization can minimize confounding if variables are randomly and equally distributed in the population of interest.

Objective: To assess evidence from mendelian randomization studies to provide a less biased estimate of any association between obesity and cardiovascular outcomes. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.3788DOI Listing
November 2018

Association of a Competency-Based Assessment System With Identification of and Support for Medical Residents in Difficulty.

JAMA Netw Open 2018 Nov 2;1(7):e184581. Epub 2018 Nov 2.

Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.

Importance: Competency-based medical education is now established in health professions training. However, critics stress that there is a lack of published outcomes for competency-based medical education or competency-based assessment tools.

Objective: To determine whether competency-based assessment is associated with better identification of and support for residents in difficulty. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4581DOI Listing
November 2018

Prevalence of Severe Maternal Morbidity and Factors Associated With Maternal Mortality in Ontario, Canada.

JAMA Netw Open 2018 Nov 2;1(7):e184571. Epub 2018 Nov 2.

Department of Obstetrics and Gynaecology, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.

Importance: Severe maternal morbidity is defined by potentially life-threatening conditions. The association between the number of severe maternal morbidity (SMM) indicators and maternal death is not known.

Objective: To quantify the association between the number of SMM indicators and maternal mortality. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4571DOI Listing
November 2018

Temporal Trends in the Use of Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest.

JAMA Netw Open 2018 Nov 2;1(7):e184511. Epub 2018 Nov 2.

University of Iowa Carver College of Medicine, Iowa City.

Importance: Despite evidence that therapeutic hypothermia improves patient outcomes for out-of-hospital cardiac arrest, use of this therapy remains low.

Objective: To determine whether the use of therapeutic hypothermia and patient outcomes have changed after publication of the Targeted Temperature Management trial on December 5, 2013, which supported more lenient temperature management for out-of-hospital cardiac arrest.

Design, Setting, And Participants: A retrospective cohort was conducted between January 1, 2013, and December 31, 2016, of 45 935 US patients in the Cardiac Arrest Registry to Enhance Survival who experienced out-of-hospital cardiac arrest and survived to hospital admission. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4511DOI Listing
November 2018

Association of Childhood Trauma Exposure With Adult Psychiatric Disorders and Functional Outcomes.

JAMA Netw Open 2018 Nov 2;1(7):e184493. Epub 2018 Nov 2.

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.

Importance: Being exposed to trauma is a common childhood experience associated with symptoms and impairments in childhood.

Objective: To assess the association between cumulative childhood trauma exposure and adult psychiatric and functional outcomes.

Design, Setting, And Participants: Prospective, population-based cohort study of 1420 participants. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4493DOI Listing
November 2018

Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United States.

JAMA Netw Open 2018 Nov 2;1(7):e184468. Epub 2018 Nov 2.

Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis.

Importance: The veracity, nomenclature, and conceptualizations of sex addiction, out-of-control sexual behavior, hypersexual behavior, and impulsive or compulsive sexual behavior are widely debated. Despite such variation in conceptualization, all models concur on the prominent feature: failing to control one's sexual feelings and behaviors in a way that causes substantial distress and/or impairment in functioning. However, the prevalence of the issue in the United States is unknown. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4468DOI Listing
November 2018

Association of the Haptoglobin Gene Polymorphism With Cognitive Function and Decline in Elderly African American Adults With Type 2 Diabetes: Findings From the Action to Control Cardiovascular Risk in Diabetes-Memory in Diabetes (ACCORD-MIND) Study.

JAMA Netw Open 2018 Nov 2;1(7):e184458. Epub 2018 Nov 2.

Department of Medicine, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Importance: African American individuals have higher dementia risk than individuals of white race/ethnicity. They also have higher rates of type 2 diabetes, which may contribute to this elevated risk. This study examined the association of the following 2 classes of alleles at the haptoglobin (Hp) locus that are associated with poor cognition, cardiovascular disease, and mortality: Hp 1-1 (associated with poor cognition and cerebrovascular disease) and Hp 2-1 and Hp 2-2 (associated with greater risk of myocardial infarction and mortality). Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4458DOI Listing
November 2018

Association of Retinal Nerve Fiber Layer Thickness With Brain Alterations in the Visual and Limbic Networks in Elderly Adults Without Dementia.

JAMA Netw Open 2018 Nov 2;1(7):e184406. Epub 2018 Nov 2.

University Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherche (UMR) 1219, Bordeaux, France.

Importance: The eye is a sensory organ that is easily accessible for imaging techniques, allowing the measurement of the retinal nerve fiber layer (RNFL) thickness. The eye is part of the central nervous system, and its neurons may be susceptible to degeneration; therefore, changes in the RNFL thickness may reflect microstructural and volume alterations in the brain.

Objective: To explore the association between the peripapillary RNFL thickness and brain alterations in the visual and limbic networks in elderly people without dementia. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4406DOI Listing
November 2018

Facility and Geographic Variation in Rates of Successful Community Discharge After Inpatient Rehabilitation Among Medicare Fee-for-Service Beneficiaries.

JAMA Netw Open 2018 Nov 2;1(7):e184332. Epub 2018 Nov 2.

Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston.

Importance: The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 mandated a quality measure of successful community discharge for postacute care services. Examining variation in performance nationally can help identify opportunities for improving patient-centered quality of care.

Objective: To examine US facility-level and geographic variation in rates of successful community discharges after inpatient rehabilitation. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4332DOI Listing
November 2018

Comparison of Anesthesia Times and Billing Patterns by Anesthesia Practitioners.

JAMA Netw Open 2018 Nov 2;1(7):e184288. Epub 2018 Nov 2.

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.

Importance: Most physicians must exercise discretion in choosing billing details that determine payment for their services. Understanding the degree to which physicians inappropriately use this discretion has important implications for payment policies. However, separating higher case complexity from inappropriate billing has made this a challenging issue to study. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4288DOI Listing
November 2018

Association of a Care Coordination Model With Health Care Costs and Utilization: The Johns Hopkins Community Health Partnership (J-CHiP).

JAMA Netw Open 2018 Nov 2;1(7):e184273. Epub 2018 Nov 2.

Johns Hopkins HealthCare, Glen Burnie, Maryland.

Importance: The Johns Hopkins Community Health Partnership was created to improve care coordination across the continuum in East Baltimore, Maryland.

Objective: To determine whether the Johns Hopkins Community Health Partnership (J-CHiP) was associated with improved outcomes and lower spending.

Design, Setting, And Participants: Nonrandomized acute care intervention (ACI) and community intervention (CI) Medicare and Medicaid participants were analyzed in a quality improvement study using difference-in-differences designs with propensity score-weighted and matched comparison groups. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4273DOI Listing
November 2018

Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction.

JAMA Netw Open 2018 Nov 2;1(7):e184240. Epub 2018 Nov 2.

Department of Cardiovascular Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri.

Importance: Black patients experience worse outcomes than white patients following acute myocardial infarction (AMI).

Objective: To examine the degree to which nonrace characteristics explain observed survival differences between white patients and black patients following AMI.

Design, Setting, And Participants: This cohort study used the extensive socioeconomic and clinical characteristics from patients recovering from an AMI that were prospectively collected at 31 hospitals across the contiguous United States between 2003 and 2008 for the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery registry and the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status registry. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4240DOI Listing
November 2018

Assessment of Patient Medication Adherence, Medical Record Accuracy, and Medication Blood Concentrations for Prescription and Over-the-Counter Medications.

JAMA Netw Open 2018 Nov 2;1(7):e184196. Epub 2018 Nov 2.

Precera Bioscience, Franklin, Tennessee.

Importance: Inaccurate medication records and poor medication adherence result in incomplete knowledge of therapy for patients.

Objective: To study accuracy of medical records and patient adherence by measuring blood concentrations of medications.

Design, Setting, And Participants: This cross-sectional study validated a serum-based liquid chromatography-tandem mass spectrometry assay to simultaneously quantify 263 medications used for acute and chronic conditions. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4196DOI Listing
November 2018

Association of Immunoglobulin Levels, Infectious Risk, and Mortality With Rituximab and Hypogammaglobulinemia.

JAMA Netw Open 2018 Nov 2;1(7):e184169. Epub 2018 Nov 2.

Division of Allergy & Immunology, Department of Pediatrics, Massachusetts General Hospital, Boston.

Importance: Rituximab is an anti-CD20 chimeric antibody used in a wide variety of clinical indications. There has not been widespread adoption of consistent immune monitoring before and after rituximab therapy. However, there is a subset of patients who develop prolonged, symptomatic hypogammaglobulinemia following rituximab, and monitoring before and after rituximab therapy could help to identify these patients and initiate measures to prevent excess morbidity and mortality. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4169DOI Listing
November 2018

Changes to Racial Disparities in Readmission Rates After Medicare's Hospital Readmissions Reduction Program Within Safety-Net and Non-Safety-Net Hospitals.

JAMA Netw Open 2018 Nov 2;1(7):e184154. Epub 2018 Nov 2.

Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia.

Importance: Although readmission rates are declining under Medicare's Hospital Readmissions Reduction Program (HRRP), concerns remain that the HRRP will harm quality at safety-net hospitals because they are penalized more often. Disparities between white and black patients might widen because more black patients receive care at safety-net hospitals. Disparities may be particularly worse for clinical conditions not targeted by the HRRP because hospitals might reallocate resources toward targeted conditions (acute myocardial infarction, pneumonia, and heart failure) at the expense of nontargeted conditions. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4154DOI Listing
November 2018

Incidence Trends of Atopic Dermatitis in Infancy and Early Childhood in a Nationwide Prescription Registry Study in Norway.

JAMA Netw Open 2018 Nov 2;1(7):e184145. Epub 2018 Nov 2.

Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.

Importance: With increasing prevalence of atopic dermatitis (AD) and its manifestation in most countries, together with the supporting evidence of the progression to other atopic phenotypes, AD has developed into a worldwide public health concern. The presence of the disease of has increased since the 1950s, but some recent studies suggest a stationary or decreasing trend.

Objective: To analyze a nationwide health register based on prescription data to determine the incidence rate (IR) of AD in an entire pediatric population. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.4145DOI Listing
November 2018
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