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https://www.readbyqxmd.com/read/29653198/the-m3-multimorbidity-index-outperformed-both-charlson-and-elixhauser-indices-when-predicting-adverse-outcomes-in-people-with-diabetes
#1
Jason K Gurney, James Stanley, Diana Sarfati
OBJECTIVE: Multimorbidity is common among those living with diabetes. The purpose of this manuscript was to assess the performance of the recently developed M3 multimorbidity index within a large, well-defined cohort of patients with diabetes. STUDY DESIGN AND SETTING: We compared regression model performance between three morbidity indices (M3, Charlson, Elixhauser) for important adverse outcomes (hospitalisation, amputation, and mortality) among 217,207 patients with diabetes, and compared the real-world applied impact of these indices for modelling these diabetes outcomes against two key exposure variables (ethnicity and deprivation)...
April 10, 2018: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29622543/postoperative-death-after-lower-limb-amputation-in-a-national-prevalent-cohort-of-patients-with-diabetes
#2
Jason K Gurney, James Stanley, Juliet Rumball-Smith, Steve York, Diana Sarfati
OBJECTIVE: The objectives of this study were to 1 ) describe postoperative mortality after lower-limb amputation in a national prevalent cohort of patients with diabetes, and 2 ) investigate whether postoperative mortality differs by demographic subgroup, patient morbidity level, and health system factors related to the facility in which the amputation occurred. RESEARCH DESIGN AND METHODS: A national prevalent cohort of 302,339 individuals diagnosed with diabetes between 2005 and 2014 were followed until the end of 2014 for major and minor lower-limb amputation and subsequent postoperative mortality by using national health data collections...
April 5, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29618059/-co-operation-and-communism-cannot-work-side-by-side-organized-consumers-and-the-early-cold-war-in-britain
#3
Peter Gurney
This article contributes to a better understanding of labour anti-communism in Britain through an exploration of the evolution of ideas and attitudes within the co-operative movement during the early Cold War. It demonstrates that the period witnessed an increasingly rigid separation of co-operation from communism and argues that this separation made it harder for activists within the co-operative movement to imagine a total or utopian alternative to capitalism. Drawing particularly on a close reading of the co-operative press as well as other sources, the study is divided into three main parts...
April 2, 2018: 20 Century British History
https://www.readbyqxmd.com/read/29617445/comparison-of-six-fit-algorithms-for-the-intra-voxel-incoherent-motion-model-of-diffusion-weighted-magnetic-resonance-imaging-data-of-pancreatic-cancer-patients
#4
Oliver J Gurney-Champion, Remy Klaassen, Martijn Froeling, Sebastiano Barbieri, Jaap Stoker, Marc R W Engelbrecht, Johanna W Wilmink, Marc G Besselink, Arjan Bel, Hanneke W M van Laarhoven, Aart J Nederveen
The intravoxel incoherent motion (IVIM) model for diffusion-weighted imaging (DWI) MRI data bears much promise as a tool for visualizing tumours and monitoring treatment response. To improve the currently poor precision of IVIM, several fit algorithms have been suggested. In this work, we compared the performance of two Bayesian IVIM fit algorithms and four other IVIM fit algorithms for pancreatic cancer imaging. DWI data were acquired in 14 pancreatic cancer patients during two MRI examinations. Three different measures of performance of the fitting algorithms were assessed: (i) uniqueness of fit parameters (Spearman's rho); (ii) precision (within-subject coefficient of variation, wCV); and (iii) contrast between tumour and normal-appearing pancreatic tissue...
2018: PloS One
https://www.readbyqxmd.com/read/29614077/a-probabilistic-distributed-recursive-mechanism-for-decision-making-in-the-brain
#5
Javier A Caballero, Mark D Humphries, Kevin N Gurney
Decision formation recruits many brain regions, but the procedure they jointly execute is unknown. Here we characterize its essential composition, using as a framework a novel recursive Bayesian algorithm that makes decisions based on spike-trains with the statistics of those in sensory cortex (MT). Using it to simulate the random-dot-motion task, we demonstrate it quantitatively replicates the choice behaviour of monkeys, whilst predicting losses of otherwise usable information from MT. Its architecture maps to the recurrent cortico-basal-ganglia-thalamo-cortical loops, whose components are all implicated in decision-making...
April 2018: PLoS Computational Biology
https://www.readbyqxmd.com/read/29606685/en-route-critical-care-transfer-from-a-role-2-to-a-role-3-medical-treatment-facility-in-afghanistan
#6
Amanda M Staudt, Shelia C Savell, Kimberly A Biever, Jennifer D Trevino, Krystal K Valdez-Delgado, Mithun Suresh, Jennifer M Gurney, Stacy A Shackelford, Joseph K Maddry, Elizabeth A Mann-Salinas
BACKGROUND: En route care is the transfer of patients requiring combat casualty care within the US military evacuation system. No reports have been published about en route care of patients during transfer from a forward surgical facility (role 2) to a combat support hospital (role 3) for comprehensive care. OBJECTIVE: To describe patients transferred from a role 2 to a role 3 US military treatment facility in Afghanistan. METHODS: A retrospective review of data from the Joint Trauma System Role 2 Database was conducted...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29590008/health-related-quality-of-life-analysis-from-keynote-045-a-phase-iii-study-of-pembrolizumab-versus-chemotherapy-for-previously-treated-advanced-urothelial-cancer
#7
David J Vaughn, Joaquim Bellmunt, Yves Fradet, Jae Lyun Lee, Lawrence Fong, Nicholas J Vogelzang, Miguel A Climent, Daniel P Petrylak, Toni K Choueiri, Andrea Necchi, Winald Gerritsen, Howard Gurney, David I Quinn, Stephane Culine, Cora N Sternberg, Yabing Mai, Haojie Li, Rodolfo F Perini, Dean F Bajorin, Ronald de Wit
Purpose In the phase III KEYNOTE-045 study ( ClinicalTrials.gov identifier: NCT02256436), pembrolizumab significantly prolonged overall survival compared with investigator's choice of chemotherapy in patients with previously treated advanced urothelial cancer. Here, we report the results of health-related quality-of-life (HRQoL) analyses from the KEYNOTE-045 trial. Patients and Methods Patients were randomly assigned 1:1 to pembrolizumab 200 mg or investigator's choice of docetaxel 75 mg/m2 , paclitaxel 175 mg/m2 , or vinflunine 320 mg/m2 administered intravenously every 3 weeks...
March 28, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29562145/nivolumab-plus-ipilimumab-versus-sunitinib-in-advanced-renal-cell-carcinoma
#8
Robert J Motzer, Nizar M Tannir, David F McDermott, Osvaldo Arén Frontera, Bohuslav Melichar, Toni K Choueiri, Elizabeth R Plimack, Philippe Barthélémy, Camillo Porta, Saby George, Thomas Powles, Frede Donskov, Victoria Neiman, Christian K Kollmannsberger, Pamela Salman, Howard Gurney, Robert Hawkins, Alain Ravaud, Marc-Oliver Grimm, Sergio Bracarda, Carlos H Barrios, Yoshihiko Tomita, Daniel Castellano, Brian I Rini, Allen C Chen, Sabeen Mekan, M Brent McHenry, Megan Wind-Rotolo, Justin Doan, Padmanee Sharma, Hans J Hammers, Bernard Escudier
Background Nivolumab plus ipilimumab produced objective responses in patients with advanced renal-cell carcinoma in a pilot study. This phase 3 trial compared nivolumab plus ipilimumab with sunitinib for previously untreated clear-cell advanced renal-cell carcinoma. Methods We randomly assigned adults in a 1:1 ratio to receive either nivolumab (3 mg per kilogram of body weight) plus ipilimumab (1 mg per kilogram) intravenously every 3 weeks for four doses, followed by nivolumab (3 mg per kilogram) every 2 weeks, or sunitinib (50 mg) orally once daily for 4 weeks (6-week cycle)...
March 21, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29533860/quantitation-of-the-anticancer-drug-abiraterone-and-its-metabolite-%C3%AE-4-abiraterone-in-human-plasma-using-high-resolution-mass-spectrometry
#9
Atul Bhatnagar, Matthew J McKay, Megan Crumbaker, Ketan Ahire, Peter Karuso, Howard Gurney, Mark P Molloy
Abiraterone acetate is administered as a prodrug to patients with metastatic, castration-resistant prostate cancer (mCRPC) and is readily metabolized into the potent 17a-hydroxylase/17,20-lyase (CYP17) enzyme inhibitor and androgen receptor inhibitor abiraterone and Δ(4)-abiraterone (D4A), respectively. To investigate pharmacokinetic variability in abiraterone acetate metabolism we developed highly sensitive liquid chromatography/mass spectrometry (LC/MS) assays for the simultaneous quantitation of abiraterone and D4A in human plasma using high-resolution mass spectrometry (HRMS) on an Orbitrap mass spectrometer...
March 6, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29521470/behavioral-symptoms-and-psychiatric-disorders-in-child-and-adolescent-long-term-survivors-of-childhood-acute-lymphoblastic-leukemia-treated-with-chemotherapy-only
#10
Wei Liu, Yin Ting Cheung, Tara M Brinkman, Pia Banerjee, Deokumar Srivastava, Vikki G Nolan, Hongmei Zhang, James G Gurney, Ching-Hon Pui, Leslie L Robison, Melissa M Hudson, Kevin R Krull
BACKGROUND: Prevalence of emotional, behavioral, and psychiatric outcomes in child and adolescent survivors of childhood acute lymphoblastic leukemia treated on a chemotherapy-only protocol were not well defined. METHODS: Self- and parent-reported emotional and behavioral symptoms were assessed for 161 survivors of childhood acute lymphoblastic leukemia (51.0% female; mean [SD] age 12.1[2.6] years; 7.5[1.6] years post-diagnosis). Age- and sex-adjusted scores were calculated for standardized measures and compared with 90th percentile of norms...
March 9, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29516998/casio-3-perovskite-in-diamond-indicates-the-recycling-of-oceanic-crust-into-the-lower-mantle
#11
F Nestola, N Korolev, M Kopylova, N Rotiroti, D G Pearson, M G Pamato, M Alvaro, L Peruzzo, J J Gurney, A E Moore, J Davidson
Laboratory experiments and seismology data have created a clear theoretical picture of the most abundant minerals that comprise the deeper parts of the Earth's mantle. Discoveries of some of these minerals in 'super-deep' diamonds-formed between two hundred and about one thousand kilometres into the lower mantle-have confirmed part of this picture. A notable exception is the high-pressure perovskite-structured polymorph of calcium silicate (CaSiO3 ). This mineral-expected to be the fourth most abundant in the Earth-has not previously been found in nature...
March 7, 2018: Nature
https://www.readbyqxmd.com/read/29507190/long-term-urban-carbon-dioxide-observations-reveal-spatial-and-temporal-dynamics-related-to-urban-characteristics-and-growth
#12
Logan E Mitchell, John C Lin, David R Bowling, Diane E Pataki, Courtenay Strong, Andrew J Schauer, Ryan Bares, Susan E Bush, Britton B Stephens, Daniel Mendoza, Derek Mallia, Lacey Holland, Kevin R Gurney, James R Ehleringer
Cities are concentrated areas of CO2 emissions and have become the foci of policies for mitigation actions. However, atmospheric measurement networks suitable for evaluating urban emissions over time are scarce. Here we present a unique long-term (decadal) record of CO2 mole fractions from five sites across Utah's metropolitan Salt Lake Valley. We examine "excess" CO2 above background conditions resulting from local emissions and meteorological conditions. We ascribe CO2 trends to changes in emissions, since we did not find long-term trends in atmospheric mixing proxies...
March 5, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29484542/evolution-of-neurocognitive-function-in-long-term-survivors-of-childhood-acute-lymphoblastic-leukemia-treated-with-chemotherapy-only
#13
Wei Liu, Yin Ting Cheung, Heather M Conklin, Lisa M Jacola, DeoKumar Srivastava, Vikki G Nolan, Hongmei Zhang, James G Gurney, I-Chan Huang, Leslie L Robison, Ching-Hon Pui, Melissa M Hudson, Kevin R Krull
PURPOSE: The purpose of this study was to determine the evolution of neurocognitive problems from therapy completion to long-term follow-up in survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only. METHODS: We evaluated whether attention problems observed at therapy completion evolve into long-term executive dysfunction in 158 survivors treated on a single institution protocol. Treatment data (high-dose intravenous methotrexate exposure [serum concentration] and triple intrathecal chemotherapy injections) were collected...
February 27, 2018: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29476781/repeatability-and-correlations-of-dynamic-contrast-enhanced-and-t2-mri-in-patients-with-advanced-pancreatic-ductal-adenocarcinoma
#14
Remy Klaassen, Oliver J Gurney-Champion, Johanna W Wilmink, Marc G Besselink, Marc R W Engelbrecht, Jaap Stoker, Aart J Nederveen, Hanneke W M van Laarhoven
BACKGROUND: In current oncological practice of pancreatic ductal adenocarcinoma (PDAC), there is a great demand for response predictors and markers for early treatment evaluation. In this study, we investigated the repeatability and the interaction of dynamic contrast enhanced (DCE) and T2* MRI in patients with advanced PDAC to enable for such evaluation using these techniques. MATERIALS & METHODS: 15 PDAC patients underwent two DCE, T2* and anatomical 3 T MRI sessions before start of treatment...
February 21, 2018: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29474372/zinc-pyrithione-activates-k-channels-and-hyperpolarizes-the-membrane-of-rat-pulmonary-artery-smooth-muscle-cells
#15
Basma G Eid, Alison M Gurney
The membrane potential helps determine pulmonary artery smooth muscle cell (PASMC) contraction. The Kv7 channel activators, retigabine and flupirtine, are thought to dilate pulmonary arteries by hyperpolarising PASMC. Zinc pyrithione activates Kv7 channels by a mechanism distinct from retigabine and with different Kv7 subunit selectivity. This study aimed to determine if zinc pyrithione selectively activates Kv7 channels in rat PASMC to evoke pulmonary artery dilation. Zinc pyrithione relaxed pulmonary arteries with half-maximal effect at 4...
2018: PloS One
https://www.readbyqxmd.com/read/29470190/blood-transfusion-management-in-the-severely-bleeding-military-patient
#16
Jennifer M Gurney, Philip C Spinella
PURPOSE OF REVIEW: Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29467606/integrating-brain-and-biomechanical-models-a-new-paradigm-for-understanding-neuro-muscular-control
#17
Sebastian S James, Chris Papapavlou, Alexander Blenkinsop, Alexander J Cope, Sean R Anderson, Konstantinos Moustakas, Kevin N Gurney
To date, realistic models of how the central nervous system governs behavior have been restricted in scope to the brain, brainstem or spinal column, as if these existed as disembodied organs. Further, the model is often exercised in relation to an in vivo physiological experiment with input comprising an impulse, a periodic signal or constant activation, and output as a pattern of neural activity in one or more neural populations. Any link to behavior is inferred only indirectly via these activity patterns...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29466560/comparison-of-military-and-civilian-methods-for-determining-potentially-preventable-deaths-a-systematic-review
#18
Jud C Janak, Jonathan A Sosnov, Joan M Bares, Zsolt T Stockinger, Harold R Montgomery, Russ S Kotwal, Frank K Butler, Stacy A Shackelford, Jennifer M Gurney, Mary Ann Spott, Louis N Finelli, Edward L Mazuchowski, David J Smith
Importance: Military and civilian trauma experts initiated a collaborative effort to develop an integrated learning trauma system to reduce preventable morbidity and mortality. Because the Department of Defense does not currently have recommended guidelines and standard operating procedures to perform military preventable death reviews in a consistent manner, these performance improvement processes must be developed. Objectives: To compare military and civilian preventable death determination methods to understand the existing best practices for evaluating preventable death...
February 21, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29465284/accuracy-of-intravenous-infusion-flow-regulators-in-the-prehospital-environment
#19
Carly Loner, Nicole M Acquisto, Heather Lenhardt, Benjamin Sensenbach, Julie Purick, Courtney M C Jones, Jeremy T Cushman
OBJECTIVE: To assess the accuracy of multiple Intravenous Infusion Flow Regulators (IIFRs) at infusion rates and hanging heights common to the prehospital setting. METHODS: Five different manufacturer's IIFRs were tested over a range of infusion rates while hanging at heights equivalent to the gurney pole, ambulance ceiling hook, and manufacturer's recommended height (if available). Each IIFR was run over a 15-minute period at each infusion rate and height three times...
February 21, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29462088/vascular-surgery-during-u-s-combat-operations-from-2002-2016-analysis-of-vascular-procedures-performed-to-inform-military-training
#20
Caryn A Turner, Capt Zsolt T Stockinger, Col Jennifer M Gurney
BACKGROUND: Vascular surgery constitutes approximately 6.5% of surgical procedures performed for combat injuries, yet general surgeons are increasingly unfamiliar with vascular surgery. This study examines the frequency and type of vascular surgical procedures performed during recent U.S. Military operations from 2002-2016. METHODS: A retrospective analysis of the Department of Defense Trauma Registry (DoDTR) was performed for all Role 2 and Role 3 MTFs, from January 2002 to May 2016...
February 17, 2018: Journal of Trauma and Acute Care Surgery
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