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https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#1
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339269/portal-connecting-dark-photons-and-axions
#2
Kunio Kaneta, Hye-Sung Lee, Seokhoon Yun
The dark photon and the axion (or axionlike particle) are popular light particles of the hidden sector. Each of them has been actively searched for through the couplings called the vector portal and the axion portal. We introduce a new portal connecting the dark photon and the axion (axion-photon-dark photon, axion-dark photon-dark photon), which emerges in the presence of the two particles. This dark axion portal is genuinely new couplings, not just from a product of the vector portal and the axion portal, because of the internal structure of these couplings...
March 10, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28338470/reducing-scan-angle-using-adaptive-prior-knowledge-for-a-limited-angle-intrafraction-verification-live-system-for-conformal-arc-radiotherapy
#3
Yawei Zhang, Fang-Fang Yin, You Zhang, Lei Ren
PURPOSE: To develop an adaptive prior knowledge guided image estimation technique to reduce the scan angle needed in the Limited-Angle Intrafraction Verification (LIVE) system for 4D-CBCT reconstruction. METHOD: The LIVE system has been previously developed to reconstruct 4D volumetric images on-the-fly during arc treatment for intrafraction target verification and dose calculation. In this study, we developed an adaptive constrained free-form deformation reconstruction technique in LIVE to further reduce the scanning angle needed to reconstruct the 4D-CBCT images for faster intrafraction verification...
March 24, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28338118/unusual-discovery-after-an-examination-for-abdominal-pain-abernethy-1b-malformation-and-liver-adenomatosis-a-case-report
#4
Romeo Ioan Chira, Adriana Calauz, Simona Manole, Simona Valean, Petru Adrian Mircea
Congenital extrahepatic portosystemic shunt (Abernethy malformation) is a rare condition characterized by developmental abnormalities of the portal venous system resulting in the diversion of the portal blood from the liver to the systemic venous system through a complete or partial shunt of the portomesenteric blood. We report the case of an 18 year-old female examined for abdominal pain, presenting cholestasis syndrome and an elevated serum aspartate aminotransferase level. Liver ultrasound examination revealed the absence of the portal vein with a complete extrahepatic shunt of the portal blood, multiple focal liver lesions, and multiple associated vascular anomalies...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28336480/can-a-commercially-available-epid-dosimetry-system-detect-small-daily-patient-setup-errors-for-cranial-imrt-srs
#5
Emmelyn S Hsieh, Katherine S Hansen, Michael S Kent, Sanjeev Saini, Sonja Dieterich
PURPOSE: The purpose of this study was to determine if the Sun Nuclear PerFRACTION electronic portal imager device dosimetry software would be able to detect setup errors in a clinical setting and would be able to correctly identify the direction in which the setup error was introduced. METHODS AND MATERIALS: A 7-field intensity modulated radiation therapy (IMRT) treatment plan for a centrally located tumor was developed for 1 phantom and 5 canine cadaver heads...
December 24, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28336180/an-important-intestinal-transporter-that-regulates-the-enterohepatic-circulation-of-bile-acids-and-cholesterol-homeostasis-the-apical-sodium-dependent-bile-acid-transporter-slc10a2-asbt
#6
Ling Xiao, Guoyu Pan
The enterohepatic circulation of bile acids (BAs) is governed by specific transporters expressed in the liver and the intestine and plays a critical role in the digestion of fats and oils. During this process, the majority of the BAs secreted from the liver is reabsorbed in intestinal epithelial cells via the apical sodium-dependent bile acid transporter (ASBT/SLC10A2) and then transported into the portal vein. Previous studies revealed that regulation of the ASBT involves BAs and cholesterol. In addition, abnormal ASBT expression and function might lead to some diseases associated with disorders in the enterohepatic circulation of BAs and cholesterol homeostasis, such as diarrhoea and gallstones...
March 20, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28335998/point-shear-wave-elastography-to-evaluate-and-monitor-changing-portal-venous-pressure-in-patients-with-decompensated-cirrhosis
#7
Hao Han, Jian Yang, Yu-Zheng Zhuge, Ming Zhang, Min Wu
This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with portal venous pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP...
March 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28334991/frameworks-to-assess-health-systems-governance-a-systematic-review
#8
Thidar Pyone, Helen Smith, Nynke van den Broek
Governance of the health system is a relatively new concept and there are gaps in understanding what health system governance is and how it could be assessed. We conducted a systematic review of the literature to describe the concept of governance and the theories underpinning as applied to health systems; and to identify which frameworks are available and have been applied to assess health systems governance. Frameworks were reviewed to understand how the principles of governance might be operationalized at different levels of a health system...
March 3, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334276/motifmap-rna-a-genome-wide-map-of-rbp-binding-sites
#9
Yu Liu, Sha Sun, Timothy Bredy, Marcelo Wood, Robert C Spitale, Pierre Baldi
Motivation: RNA plays a critical role in gene expression and its regulation. RNA binding proteins (RBPs), in turn, are important regulators of RNA. Thanks to the availability of large scale data for RBP binding motifs and in vivo binding sites results in the form of eCLIP experiments, it is now possible to computationally predict RBP binding sites across the whole genome. Results: We describe MotifMap-RNA, an extension of MotifMap which predicts binding sites for RBP motifs across human and mouse genomes and allows large scale querying of predicted binding sites...
February 22, 2017: Bioinformatics
https://www.readbyqxmd.com/read/28333016/predictors-of-liver-toxicity-following-stereotactic-body-radiation-therapy-for-hepatocellular-carcinoma
#10
Michael Velec, Carol R Haddad, Tim Craig, Lisa Wang, Patricia Lindsay, James Brierley, Anthony Brade, Jolie Ringash, Rebecca Wong, John Kim, Laura A Dawson
PURPOSE: To identify risk factors associated with a decline in liver function after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma. METHODS AND MATERIALS: Data were analyzed from patients with hepatocellular carcinoma treated on clinical trials of 6-fraction SBRT. Liver toxicity was defined as an increase in Child-Pugh (CP) score ≥2 three months after SBRT. Clinical factors, SBRT details, and liver dose-volume histogram (DVH) parameters were tested for association with toxicity using logistic regression...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28332992/clinical-implementation-of-a-model-based-in%C3%A2-vivo-dose-verification-system-for-stereotactic-body-radiation-therapy-volumetric-modulated-arc-therapy-treatments-using-the-electronic-portal-imaging-device
#11
Peter M McCowan, Ganiyu Asuni, Eric Van Uytven, Timothy VanBeek, Boyd M C McCurdy, Shaun K Loewen, Naseer Ahmed, Bashir Bashir, James B Butler, Amitava Chowdhury, Arbind Dubey, Ahmet Leylek, Maged Nashed
PURPOSE: To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically. METHODS AND MATERIALS: From December 2013 to July 2016, 117 stereotactic body radiation therapy-volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28332100/expression-of-programmed-death-1-and-its-ligands-in-the-liver-of-biliary-atresia
#12
Pan-Liang Wang, Jun Wang, Ying Zhou, Xiao-Song Chen, Ke-Jun Zhou, Jie Wen, Jian-Jun Zhang, Wei Cai
BACKGROUND: An aberrant immune response is the predominant pathogenetic factor in biliary atresia (BA). Programmed death-1 (PD-1) and its two ligands, programmed death ligand-1 and programmed death ligand-2 (PD-L1 and PD-L2, respectively) play an important inhibitory role in immune reactions. We aimed to illustrate the expression of these molecules in BA. METHODS: Liver specimens were obtained from infants with BA during the Kasai procedure (early BA) and liver transplantation (late BA)...
March 22, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28331640/a-case-of-hepatic-portal-venous-gas-hypothesis-of-a-transient-direct-communication-between-a-penetrating-antral-gastric-ulcer-and-mesenteric-varices
#13
Hassan M Ghoz, Shamlan M Sheikh, Kanika Khandelwal, Joseph Fiore, Nicholas James, Joel Weinstock
Hepatic portal venous gas (HPVG) is a rare radiological sign that usually signifies an acute intra-abdominal process, most commonly bowel ischemia and sepsis. Few reports described an association with underlying gastric pathologies. We report a 60-year-old patient who presented with melena and chills and was discovered to have a gastric ulcer that appeared to have penetrated into a mesenteric varix. This, in turn, likely caused development of HPVG associated with fungemia. Treatment with a proton pump inhibitor and bowel rest was sufficient to resolve symptoms and the HPVG...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28331456/primary-care-practice-reengineering-and-associations-with-patient-portal-use-service-utilization-and-disease-control-among-patients-with-hypertension-and-or-diabetes
#14
Eboni G Price-Haywood, Qingyang Luo
BACKGROUND: We describe the role of primary care reengineering in the Ochsner Health System (OHS) patient portal implementation strategy and compare subsequent trends in service utilization and disease control among portal users vs nonusers within this context. METHODS: This retrospective cohort study includes 101,019 patients with hypertension or diabetes who saw an OHS primary care provider (PCP) between 2012 and 2014. Inverse probability treatment weighting was used to reduce case-mix differences between study groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331452/balloon-occlusion-technique-for-managing-portal-vein-hemorrhage-in-liver-transplantation
#15
John B Seal, Humberto Bohorquez, Naren Battula, Lucia DeGregorio, Emily Bugeaud, David S Bruce, Ian C Carmody, Ari J Cohen, George E Loss
BACKGROUND: Portal vein thrombosis (PVT) is relatively common among candidates for liver transplantation and can present significant intraoperative challenges. Depending on the extent of PVT, thromboendovenectomy (TEV), portal bypass, or systemic inflow may be required to restore portal inflow. While TEV is the most commonly used approach to restore anatomic portal inflow, portal vein injury and life-threatening hemorrhage are risks with this technique. CASE REPORT: We present a salvage technique for managing portal vein injury during TEV using intraluminal balloon occlusion of the portal vein during portal vein repair and reconstruction...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331142/usefulness-of-color-coding-resected-samples-from-a-pancreaticoduodenectomy-with-tissue-marking-dyes-for-a-detailed-examination-of-surgical-margin-surrounding-the-uncinate-process-of-the-pancreas
#16
Satoshi Mizutani, Hideyuki Suzuki, Takayuki Aimoto, Seiji Yamagishi, Keisuke Mishima, Masanori Watanabe, Yasuhiko Kitayama, Norio Motoda, Saiko Isshiki, Eiji Uchida
BACKGROUND: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy. The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28330599/impact-of-graft-preservation-solutions-for-liver-transplantation-on-early-cytokine-release-and-postoperative-organ-dysfunctions-a-pilot-study
#17
H Brisson, C Arbelot, A Monsel, C Parisot, M Girard, E Savier, C Vezinet, Q Lu, J-C Vaillant, J-L Golmard, G Gorochov, O Langeron, J-J Rouby
INTRODUCTION: During liver transplantation, graft ischemia-reperfusion injury leads to a systemic inflammatory response producing postoperative organ dysfunctions. The aim of this observational and prospective study was to compare the impact of Solution de conservation des organes et tissus (SCOT) 15 and University of Wisconsin (UW) preservation solutions on early cytokine release, postreperfusion syndrome and postoperative organ dysfunctions. METHODS: Thirty-seven liver transplantations were included: 21 in UW Group and 16 in SCOT 15 group...
March 15, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28328972/altered-gut-microbiome-in-a-mouse-model-of-gulf-war-illness-causes-neuroinflammation-and-intestinal-injury-via-leaky-gut-and-tlr4-activation
#18
Firas Alhasson, Suvarthi Das, Ratanesh Seth, Diptadip Dattaroy, Varun Chandrashekaran, Caitlin N Ryan, Luisa S Chan, Traci Testerman, James Burch, Lorne J Hofseth, Ronnie Horner, Mitzi Nagarkatti, Prakash Nagarkatti, Stephen M Lasley, Saurabh Chatterjee
Many of the symptoms of Gulf War Illness (GWI) that include neurological abnormalities, neuroinflammation, chronic fatigue and gastrointestinal disturbances have been traced to Gulf War chemical exposure. Though the association and subsequent evidences are strong, the mechanisms that connect exposure to intestinal and neurological abnormalities remain unclear. Using an established rodent model of Gulf War Illness, we show that chemical exposure caused significant dysbiosis in the gut that included increased abundance of phylum Firmicutes and Tenericutes, and decreased abundance of Bacteroidetes...
2017: PloS One
https://www.readbyqxmd.com/read/28328941/cynomolgus-monkeys-are-successfully-and-persistently-infected-with-hepatitis-e-virus-genotype-3-hev-3-after-long-term-immunosuppressive-therapy
#19
Noemi Rovaris Gardinali, Juliana Rodrigues Guimarães, Juliana Gil Melgaço, Yohan Britto Kevorkian, Fernanda de Oliveira Bottino, Yasmine Rangel Vieira, Aline Campos de Azevedo da Silva, Douglas Pereira Pinto, Laís Bastos da Fonseca, Leandro Schiavo Vilhena, Edilson Uiechi, Maria Cristina Carlan da Silva, Julio Moran, Renato Sérgio Marchevsky, Oswaldo Gonçalves Cruz, Rodrigo Alejandro Arellano Otonel, Amauri Alcindo Alfieri, Jaqueline Mendes de Oliveira, Ana Maria Coimbra Gaspar, Marcelo Alves Pinto
Epidemiological studies found that hepatitis E virus genotype 3 (HEV-3) infection was associated with chronic hepatitis and cirrhosis in immunocompromised patients. Our study aimed to investigate the relationship between the host immunosuppressive status and the occurrence of HEV-related chronic hepatitis. Here we describe a successful experimental study, using cynomolgus monkeys previously treated with tacrolimus, a potent calcineurin inhibitor immunosuppressant, and infected with a Brazilian HEV-3 strain isolated from naturally infected pigs...
2017: PloS One
https://www.readbyqxmd.com/read/28328234/quantification-of-basal-insulin-peglispro-and-human-insulin-in-adipose-tissue-interstitial-fluid-by-open-flow-microperfusion
#20
Katrin Tiffner, Beate Boulgaropoulos, Christian Höfferer, Thomas Birngruber, Niels Porksen, Helle Linnebjerg, Parag Garhyan, Eric Chen Quin Lam, Mary Pat Knadler, Thomas R Pieber, Frank Sinner
BACKGROUND: Restoration of the physiologic hepatic-to-peripheral insulin gradient may be achieved by either portal vein administration or altering insulin structure to increase hepatic specificity or restrict peripheral access. Basal insulin peglispro (BIL) is a novel, PEGylated basal insulin with a flat pharmacokinetic and glucodynamic profile and altered hepatic-to-peripheral action gradient. We hypothesized reduced BIL exposure in peripheral tissues explains the latter, and in this study assessed the adipose tissue interstitial fluid (ISF) concentrations of BIL compared with human insulin (HI)...
March 22, 2017: Diabetes Technology & Therapeutics
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