Examining the effect of a non-attendance fee on writing workshop attendance, grant submission, and success rates among K award applicants.

In 2009, the University of Michigan's Michigan Institute for Clinical and Health Research developed a three-session K Writing workshop. Beginning in 2016, we implemented a non-attendance fee to encourage attendance across the three sessions. We examined whether this fee improved attendance, increased submission of an NIH K or R grant proposal, and improved success rates.

Psychosocial Risk Assessment for Heart Transplantation: Evaluating for Bias and Impact on Post-transplant Outcomes.

Background: Pretransplant psychosocial risk (PSR) assessment is subjective, so we investigated potential biases and the relationship between assessed PSR and post-transplant outcomes at our heart transplant center.

Methods: Between 05/2004 and 01/2021, 479 heart transplant (HT) recipients had a pre-transplant psychosocial evaluation, at which a social worker collected information about 25 characteristics and categorized the candidate's PSR for post-transplant death. Relationships between PSR and post-transplant outcomes (death, hospitalization and rejection) were evaluated.

Lipodystrophy Severity Score to Assess Disease Burden in Lipodystrophy.

Context: Lipodystrophy syndromes are rare disorders characterized by deficient adipose tissue, leading to insulin resistance, dyslipidemia, and organ system abnormalities.

Objective: Our goal was to develop a lipodystrophy severity score (LDS) to holistically capture the diverse manifestations of lipodystrophy into a numerical score to aid in prediction of clinical outcomes and/or treatment impact.

Design: An 8-domain LDS was developed by eight disease experts in consultation with patient organizations.

High Interleukin (IL)-6 is Associated with Lower Lung Function and Increased Likelihood of Metabolic Dysfunction in Asthma.

Introduction: Asthma is a complex condition characterized by airway inflammation. Interleukin-6 (IL-6) plays a significant role in asthma pathogenesis through its effects on T cells and its association with pro-inflammatory responses. Both lung and circulating IL-6 levels are elevated in asthma.

Time to successful outcome vs. treatment duration in cranial remolding orthosis treatment.

Background: Cranial remolding orthoses are an effective treatment of deformational plagiocephaly. Typical treatment durations are well documented. However, treatment duration can be affected by multiple factors and may not be a true representation of the time necessary to achieve a successful clinical outcome.

Diabetic foot infection severity as a predictor of re-ulceration following partial forefoot amputation.

Diabetic foot ulcer re-ulceration is a common complication following partial forefoot amputation. Re-ulceration refers to the occurrence of a skin break that penetrates through the epidermis and a portion of the dermis, occurring at any site on either the same or opposite foot where amputation took place. Treatment for diabetic foot ulcers often includes an extended course of local wound care and may entail surgical procedures.

Longitudinal Change and Predictors of Myocardial Flow Reserve by Positron Emission Tomography for the Evaluation of Cardiac Allograft Vasculopathy Following Heart Transplantation.

Background: Positron emission tomography (PET) myocardial flow reserve (MFR) is a noninvasive method of detecting cardiac allograft vasculopathy in recipients of heart transplants (HTs). There are limited data on longitudinal change and predictors of MFR following HT.

Methods: We conducted a retrospective analysis of HT recipients undergoing PET myocardial perfusion imaging at an academic center.

Heart Failure With Recovered Ejection Fraction in Patients With Nonischemic Cardiomyopathy: Characteristics, Outcomes, and Long-term Follow-up.

Background: Duration of recovery and long-term outcomes have not been well-described in a large cohort of patients with heart failure with recovered ejection fraction (HFrecEF) owing to nonischemic cardiomyopathy. The aim of the study was to characterize the duration of recovery and long-term outcomes of patients with HFrecEF.

Methods And Results: We performed a retrospective analysis of our institution's databases.

Impact of diabetes on weight loss outcomes after bariatric surgery: Experience from 5-year follow-up of Michigan Bariatric Surgery Cohort.

Objective: For patients with obesity and diabetes, bariatric surgery can lead to the remission of both diseases. However, the possible impact of diabetes on the magnitude of weight loss outcomes after bariatric surgery has not been precisely quantified.

Research Design And Methods: Data from Michigan Bariatric Surgery Cohort (MI-BASiC) was extracted to examine the effect of baseline diabetes on weight loss outcomes.

Sociodemographic variables associated with risk for diabetic retinopathy.

Background: Several systemic and sociodemographic factors have been associated with the development and progression of diabetic retinopathy (DR). However, there is limited investigation of the potential role sociodemographic factors may play in augmenting systemic risk factors of DR. We hypothesize that age, sex, race, ethnicity, income, and insurance payor have an impact on hemoglobin A1c (HbA1c), body mass index, and systolic blood pressure, and therefore an upstream effect on the development of DR and vision-threatening forms of DR (VTDR).

Frailty Measures of Patient-reported Activity and Fatigue May Predict 1-year Outcomes in Ambulatory Advanced Heart Failure: A Report From the REVIVAL Registry.

Background: The Fried Frailty Phenotype predicts adverse outcomes in geriatric populations, but has not been well-studied in advanced heart failure (HF). The Registry Evaluation of Vital Information for Ventricular Assist Devices (VADs) in Ambulatory Life (REVIVAL) study prospectively collected frailty measures in patients with advanced HF to determine relevant assessments and their impact on clinical outcomes.

Methods And Results: HF-Fried Frailty was defined by 5 baseline components (1 point each): (1) weakness: hand grip strength less than 25% of body weight; (2) slowness based on time to walk 15 feet; (3) weight loss of more than 10 lbs in the past year; (4) inactivity; and (5) exhaustion, both assessed by the Kansas City Cardiomyopathy Questionnaire.

An early relook identifies high-risk trajectories in ambulatory advanced heart failure.

Introduction: Patients with ambulatory advanced heart failure (HF) are increasingly considered for durable mechanical circulatory support (MCS) and heart transplantation and their effective triage requires careful assessment of the clinical trajectory.

Methods: REVIVAL, a prospective, observational study, enrolled 400 ambulatory advanced HF patients from 21 MCS/transplant centers in 2015-2016. Study design included a clinical re-assessment of Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile within 120 days after enrollment.

Caregiver Health-Related Quality of Life, Burden, and Patient Outcomes in Ambulatory Advanced Heart Failure: A Report From REVIVAL.

Background Heart failure (HF) imposes significant burden on patients and caregivers. Longitudinal data on caregiver health-related quality of life (HRQOL) and burden in ambulatory advanced HF are limited. Methods and Results Ambulatory patients with advanced HF (n=400) and their participating caregivers (n=95) enrolled in REVIVAL (Registry Evaluation of Vital Information for VADs [Ventricular Assist Devices] in Ambulatory Life) were followed up for 24 months, or until patient death, left ventricular assist device implantation, heart transplantation, or loss to follow-up.

Statin intensity and risk for cardiovascular events after heart transplantation.

Aims: Statins improve survival and reduce rejection and cardiac allograft vasculopathy after heart transplantation (HT). The impact of different statin intensities on clinical outcomes has never been assessed. We set out to determine the impact of statin exposure on cardiovascular outcomes after HT.

Cartilage icing and chondrocalcinosis on knee radiographs in the differentiation between gout and calcium pyrophosphate deposition.

Objective: To determine if findings of "cartilage icing" and chondrocalcinosis on knee radiography can differentiate between gout and calcium pyrophosphate deposition (CPPD).

Methods: IRB-approval was obtained and informed consent was waived for this retrospective study. Electronic medical records from over 2.

Nurse staffing and healthcare-associated infections in a national healthcare system that implemented a nurse staffing directive: Multi-level interrupted time series analyses.

Background: In 2010, the Veterans Health Administration Office of Nursing Services (VHA ONS) issued a Staffing Methodology (SM) Directive, standardizing the method of determining appropriate nurse staffing for VHA facilities.

Objectives: To assess associations between the Directive, nurse staffing trends, and healthcare-associated infections.

Research Design: We conducted multi-level interrupted time series analyses of nurse staffing trends and the rates of two healthcare-associated infections before and after implementation of the Directive, October 1, 2008 - June 30, 2014.

Impact of Socioeconomic Factors on Patient Desire for Early LVAD Therapy Prior to Inotrope Dependence.

Background: Worsening heart failure (HF) and health-related quality of life (HRQOL) have been shown to impact the decision to proceed with left ventricular assist device (LVAD) implantation, but little is known about how socioeconomic factors influence expressed patient preference for LVAD.

Methods And Results: Ambulatory patients with advanced systolic HF (n=353) reviewed written information about LVAD therapy and completed a brief survey to indicate whether they would want an LVAD to treat their current level of HF. Ordinal logistic regression analyses identified clinical and demographic predictors of LVAD preference.

Influence of Clinical Factors on Risk of Contrast-Induced Nephrotoxicity From IV Iodinated Low-Osmolality Contrast Material in Patients With a Low Estimated Glomerular Filtration Rate.

The objective of our study was to explore whether clinical factors historically associated with contrast material-causative kidney injury (contrast-induced nephrotoxicity [CIN]) increase risk after use of IV iodinated low-osmolality contrast material (LOCM) in patients with stage IIIb-V chronic kidney disease. In this retrospective hypothesis-generating study, 1:1 propensity score matching was used to assess post-CT acute kidney injury (AKI) after unenhanced or contrast-enhanced CT in patients with stable estimated glomerular filtration rate (eGFR; 1112 patients with an eGFR = 30-44 mL/min/1.73 m and 86 patients with an eGFR < 30 mL/min/1.

Predictors of Long-Term and High-Dose Use of Zolpidem in Veterans.

Objective: Prescriptions for sedative hypnotics are routinely initiated and renewed to treat insomnia, despite evidence supporting nonpharmacologic treatments as comparable and more favorable over time. We used national Veterans Health Administration data to assess patient characteristics associated with high-dose and long-term zolpidem use.

Method: The study included outpatients with new zolpidem prescriptions (January 1, 2013, to June 3, 2014).

Responsiveness of Veterans Affairs Health Care System to Zolpidem Safety Warnings.

Study Objectives: Sedative hypnotic medications are routinely prescribed for insomnia treatment, but have been associated with significant risks of morning-after impairment. We evaluated responsiveness in the Veterans Health Administration (VHA) facilities to two drug safety warnings recommending against high-dose zolpidem use-a 2007 Veterans Administration Pharmacy Benefits Management Service warning and a 2013 Food and Drug Administration (FDA) warning.

Methods: We used interrupted time-series design to assess how the two warnings influenced prescribing within the VHA in outpatients from 2005 to 2014.

Electrocardiogram Monitoring After the Food and Drug Administration Warnings for Citalopram: Unheeded Alerts?

Objectives: To evaluate national trends in electrocardiogram (EKG) monitoring in Veterans Affairs (VA) beneficiaries prescribed high-dose citalopram before and after the 2011-12 Food and Drug Administration (FDA) safety warnings.

Design: Interrupted time-series analyses.

Setting: National VA healthcare system data linked to Medicare data for veterans dually eligible for VA and Medicare services.

Differences in Mental Health Service Use Among Unemployed Veterans of Different Eras.

Mental disorders have been linked to unemployment among veterans. Improving mental health conditions, such as depression, can improve veteran employment outcomes. This study compared mental health treatment among unemployed Operation Enduring Freedom (OEF; in Afghanistan) and Operation Iraqi Freedom (OIF; in Iraq) veterans and veterans from other service eras.

Assessing Responsiveness of Health Systems to Drug Safety Warnings.

Objective: In 2011-2012 the U.S. Food and Drug Administration (FDA) issued safety announcements cautioning providers against prescribing high doses of citalopram given concerns for QT prolongation.