Obesity Paradox and the Effect of NT-proBNP on All-Cause and Cause-Specific Mortality.

Background: In heart failure patients, obesity is associated with better outcomes as compared to normal weight, a phenomenon called the obesity paradox.

Objective: To examine if obesity modifies the relationship between NT-proBNP and all-cause and cause-specific mortality in adults without coronary artery disease or heart failure history.

Methods: We used the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and linked it with mortality through December 31, 2019.

Systolic blood pressure, a predictor of mortality and life expectancy following heart failure hospitalization, 2010-2023.

Background: Optimal systolic blood pressure (SBP) targets for the treatment of hospitalized acute decompensated heart failure (ADHF) patients are not known.

Objectives: To investigate the association between SBP <130 mmHg at discharge or within 30 days and all-cause mortality or years of life lost (YLL) after ADHF hospitalization.

Methods: We analyzed medical records of 14,611 adults who survived ADHF hospitalization at 17 hospitals (2010-2022) with follow-up until May 2023.

The relationship between serum α-Klotho with all-cause and cause-specific mortality.

Aims: The relationship between α-Klotho (αK) and mortality is controversial and has not been examined in a large, diverse cohort. We investigated the association between serum αK protein levels with all-cause and cause-specific mortality in a cohort representative of the US population.

Methods: We used National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2016.

Medicaid expansion and 30-day hospital readmissions: A nationwide study.

In 2010, Congress enacted the Patient Protection and Affordable Care Act (ACA) to enhance health insurance affordability via subsidies and Medicaid expansion (ME). However, not all states adopted ME. We examined national hospital readmissions from 2005 to 2019 to investigate readmission reduction trends based on state ME status.

Sunscreen compound benzophenone-3 and its relationship with white blood cell counts.

Background: Evidence from animal models suggests a role for the organic ultraviolet filter benzophenone-3's (BP-3) on white blood cells (WBCs). However, BP-3's effect on WBCs in humans is unknown.

Materials And Methods: We used National Health and Nutrition Examination Survey data from 2003 to 2016.

Association of platelet distribution width with all-cause and cause-specific mortality in US adults.

Background: Platelet distribution width (PDW) indicates heterogeneity in circulating platelet sizes. Studies reporting PDW association with mortality were limited by small sample sizes. Therefore, we examined the relationship between PDW and all-cause and cause-specific mortality in a large representative cohort.

Increased donor inhibitory KIR are associated with reduced GVHD and improved survival following HLA-matched unrelated donor HCT in paediatric acute leukaemia.

Killer immunoglobulin-like receptor (KIR) and KIR-ligand (KIRL) interactions play an important role in natural killer cell-mediated effects after haematopoietic stem cell transplantation (HCT). Previous work has shown that accounting for known KIR-KIRL interactions may identify donors with optimal NK cell-mediated alloreactivity in the adult transplant setting. Paediatric acute leukaemia patients were retrospectively analysed, and KIR-KIRL combinations and maximal inhibitory KIR ligand (IM-KIR) scores were determined.

Improving Interdisciplinary Communication on an Academic Hospitalist Service: A Quality Improvement Project.

Effective communication is essential for quality patient care, and paging remains among the most common forms of communication despite the introduction of secure texting platforms. The goal of this project was to use quantitative and qualitative analyses of paging to guide improvements in paging best practices. A retrospective analysis of pages sent over a 7-day period was completed, characterizing the volume, content, and effectiveness of pages both preintervention and 3-month postintervention.

Competency-based assessment of procedural skills in resident training.

Background: No standardized summative tools exist to assess competency in bedside procedures or provide residents and programs with summative feedback.

Objective: To provide competency-based procedure training and feedback to residents, we created a procedure competency committee (PCC). Here, we describe the PCC process, its impact on procedure training, and examine residents' attainment of competency in bedside procedures.

The Long-Term Effect of Financial Penalties on 30-Day Hospital Readmission Rates.

Background: Although the immediate effect of financial penalties imposed by the Hospital Readmissions Reduction Program (HRRP) was a decrease in 30-day hospital readmission rates, the long-term effects are unclear. The authors studied 30-day readmissions before and immediately after HRRP penalties and during the most recent period before the COVID-19 pandemic and examined whether readmission trends differed between penalized and non-penalized hospitals.

Methods: Centers for Medicare & Medicaid Services hospital archive data and US Census Bureau data were used to analyze hospital characteristics, including readmission penalty status, and hospital service area (HSA) demographic information, respectively.

Anemia prevalence time trends and disparities in the US population: examination of NHANES 1999-2020.

While a rising prevalence of anemia in the United States was reported in older studies, recent data are lacking. To estimate the prevalence and time trends of anemia in the United States and to examine how these estimates differ by gender, age, race, and household income to poverty threshold ratio (HIPR), we used the National Health and Nutrition Examination Surveys from 1999 to 2020. The presence of anemia was determined using the World Health Organization criteria.

Factors Affecting Adherence With Follow-up Appointments in HIV Patients.

Currently, the majority of new human immunodeficiency virus (HIV) infections are transmitted by individuals with untreated HIV. In this retrospective study, we examined associations between demographic factors, viral suppression, acquired immunodeficiency syndrome (AIDS) status (CD4 count <200), and adherence to clinical follow-up in individuals living with HIV. Of the 489 patients, 135 (27.

Sex-specific relationship between blood selenium levels and platelet count in a large cohort representative of the United States population.

While several small studies have found that selenium deficiency is associated with low platelet counts, they lack generalizability. We used data from the National Health and Nutrition Examination Surveys collected over a 12-year period. We examined the relationship between selenium quartiles and platelet count using survey-weighted linear regression models adjusting for age, sex, race, household income to poverty threshold income, highest education attainment, smoking status, red blood cell folate, and body mass index.

Serum Klotho and pulse pressure; insight from NHANES.

Background: Low levels of the Klotho protein are associated with accelerated tissue aging, including arterial stiffness, in patients with cardiovascular and renal diseases. However, this association has not been examined in a diverse cohort. We aimed to investigate the association between serum Klotho protein levels and pulse pressure, as an indicator of arterial stiffness, in a cohort representative of the US population.

Impact of a Hospitalist-Run Procedure Service on Time to Paracentesis and Length of Stay.

Hospitals are establishing procedure services to address resident training and patient safety. We examined whether a hospitalist procedure service affects a patient's hospital length of stay (LOS) and the time from admission to paracentesis (A2P). We queried our electronic medical records for all inpatient peritoneal fluid samples from July 1, 2016, to May 31, 2019.

The association between serum liver enzymes and cancer mortality.

Interpreting levels of liver enzymes is often challenging because they may be influenced by metabolic processes beyond the liver. Given their pathophysiologic roles in inflammation and oxidative stress, higher levels of these enzymes may be associated with increased risk of mortality. However, studies have found inconsistent results.

Increased donor inhibitory KIR with known HLA interactions provide protection from relapse following HLA matched unrelated donor HCT for AML.

Killer immunoglobulin-like receptor (KIR) and KIR-ligand (KIRL) interactions play an important role in natural killer cell-mediated graft versus leukemia effect (GVL) after hematopoietic cell transplant (HCT) for AML. Accounting for known KIR-KIRL interactions may identify donors with optimal NK cell-mediated alloreactivity and GVL. A retrospective study of 2359 donor-recipient pairs (DRP) who underwent unrelated donor (URD) HCT for AML was performed.

The relationship between chronic arsenic exposure and body measures among US adults: National Health and Nutrition Examination Survey 2009-2016.

Background: Current research on the relationship between arsenic and body measures is inconclusive. We explored the relationship between arsenic and body measures in a large cohort representative of the United States population.

Methods: Data were analyzed from the 2009-2016 National Health and Nutrition Examination Survey (NHANES).

Relationship Between Physician Burnout and Patient's Perception of Bedside Time Spent by Physicians.

Although the adverse effect of burnout on physicians has been widely documented, studies have shown an inconsistent relationship between burnout and the quality of patient care. We hypothesized that physician burnout will have an inverse relationship with the time spent at the bedside by physicians. In a cross-sectional study, we surveyed patients on their perception of the time spent by their physician on the day of the survey (4 categories: 0-5, 6-10, 11-15, >15 minutes).