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https://www.readbyqxmd.com/read/28806793/holding-providers-accountable-for-health-care-outcomes
#1
David W Baker, Mark R Chassin
Federal public reporting and payment programs have increasingly emphasized the measurement of outcomes (such as readmission, health care-associated infections, and mortality). Yet, the criteria for assessing whether outcome measures are accurate and valid enough to use for public reporting, payment, and accreditation are not well-defined. An outcome measure should be used only if the outcome can be influenced substantially by providers (that is, a strong process-outcome link exists) and statistical adjustment can be made for differences in patient populations across providers so that differences in outcomes are truly attributable to differences in the care provided...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28806778/serum-resistin-as-an-independent-marker-of-aortic-stiffness-in-patients-with-coronary-artery-disease
#2
Ji-Hung Wang, Chung-Jen Lee, Chiu-Fen Yang, Yu-Chih Chen, Bang-Gee Hsu
BACKGROUND: Subjects with higher carotid-femoral pulse wave velocity (cfPWV) will be at an increased risk for cardiovascular (CV) events in future. Resistin is an inflammatory mediator and a biomarker of CV diseases. We evaluated the association between serum resistin and aortic stiffness in patients with coronary artery disease (CAD). METHODS: A total of 104 patients with CAD were enrolled in this study. cfPWV was measured using the SphygmoCor system. Patients with cfPWV >10 m/s were defined as the high aortic stiffness group...
2017: PloS One
https://www.readbyqxmd.com/read/28806759/peculiar-genes-selection-a-new-features-selection-method-to-improve-classification-performances-in-imbalanced-data-sets
#3
Federica Martina, Marco Beccuti, Gianfranco Balbo, Francesca Cordero
High-Throughput technologies provide genomic and trascriptomic data that are suitable for biomarker detection for classification purposes. However, the high dimension of the output of such technologies and the characteristics of the data sets analysed represent an issue for the classification task. Here we present a new feature selection method based on three steps to detect class-specific biomarkers in case of high-dimensional data sets. The first step detects the differentially expressed genes according to the experimental conditions tested in the experimental design, the second step filters out the features with low discriminative power and the third step detects the class-specific features and defines the final biomarker as the union of the class-specific features...
2017: PloS One
https://www.readbyqxmd.com/read/28806749/defining-the-genetic-susceptibility-to-cervical-neoplasia-a-genome-wide-association-study
#4
Paul J Leo, Margaret M Madeleine, Sophia Wang, Stephen M Schwartz, Felicity Newell, Ulrika Kymmer, Kari Hemminki, Goran Hallmans, Sven Tiews, Winfried Steinberg, Janet S Rader, Felipe Castro, Mahboobeh Safaeian, Eduardo L Franco, François Coutlée, Claes Ohlsson, Adrian Cortes, Mhairi Marshall, Pamela Mukhopadhyay, Katie Cremin, Lisa G Johnson, Suzanne Garland, Sepehr N Tabrizi, Nicolas Wentzensen, Freddy Sitas, Julian Little, Maggie Cruickshank, Ian H Frazer, Allan Hildesheim, Matthew A Brown
A small percentage of women with cervical HPV infection progress to cervical neoplasia, and the risk factors determining progression are incompletely understood. We sought to define the genetic loci involved in cervical neoplasia and to assess its heritability using unbiased unrelated case/control statistical approaches. We demonstrated strong association of cervical neoplasia with risk and protective HLA haplotypes that are determined by the amino-acids carried at positions 13 and 71 in pocket 4 of HLA-DRB1 and position 156 in HLA-B...
August 14, 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28806722/spontaneous-modality-general-abstraction-of-a-ratio-scale
#5
Cory D Bonn, Jessica F Cantlon
The existence of a generalized magnitude system in the human mind and brain has been studied extensively but remains elusive because it has not been clearly defined. Here we show that one possibility is the representation of relative magnitudes via ratio calculations: ratios are a naturally dimensionless or abstract quantity that could qualify as a common currency for magnitudes measured on vastly different psychophysical scales and in different sensory modalities like size, number, duration, and loudness. In a series of demonstrations based on comparisons of item sequences, we demonstrate that subjects spontaneously use knowledge of inter-item ratios within and across sensory modalities and across magnitude domains to rate sequences as more or less similar on a sliding scale...
August 11, 2017: Cognition
https://www.readbyqxmd.com/read/28806693/persistence-of-urban-organic-aerosols-composition-decoding-their-structural-complexity-and-seasonal-variability
#6
João T V Matos, Regina M B O Duarte, Sónia P Lopes, Artur M S Silva, Armando C Duarte
Organic Aerosols (OAs) are typically defined as highly complex matrices whose composition changes in time and space. Focusing on time vector, this work uses two-dimensional nuclear magnetic resonance (2D NMR) techniques to examine the structural features of water-soluble (WSOM) and alkaline-soluble organic matter (ASOM) sequentially extracted from fine atmospheric aerosols collected in an urban setting during cold and warm seasons. This study reveals molecular signatures not previously decoded in NMR-related studies of OAs as meaningful source markers...
August 11, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28806631/unraveling-complex-relationships-among-dysphoric-disorder-localization-related-epilepsy-and-mood-disorders
#7
Tetsufumi Suda, Yasutaka Tatsuzawa, Taichi Mogi, Aihide Yoshino
BACKGROUND: Dysphoric disorder (DD), characterized by intermittent pleomorphic symptoms, has been believed to be specific to epilepsy. However, our previous study revealed that DD in patients with localization-related epilepsy was associated with a lifetime diagnosis of mood disorders. The present study was conducted to estimate the prevalence of DD in patients with mood disorders, but not epilepsy, and to identify the clinical similarities and differences of DD in patients with either epilepsy or mood disorders...
August 11, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28806614/altered-interaction-with-environmental-reinforcers-in-major-depressive-disorder-relationship-to-anhedonia
#8
Joanna E Szczepanik, Maura L Furey, Allison C Nugent, Ioline D Henter, Carlos A Zarate, Carl W Lejuez
Anhedonia-defined as loss of interest or pleasure-is one of two core symptoms of major depressive disorder (MDD). Anhedonia may involve decreased enjoyment of potentially rewarding activities and decreased motivation to engage in such activities. Increased engagement with reinforcers-activities with the potential to be positive experiences-is a frequent target of cognitive-behavioral therapies. Nevertheless, how environmental reinforcers are perceived, and how decisions to approach or avoid them are made by individuals with MDD, is largely unknown...
August 3, 2017: Behaviour Research and Therapy
https://www.readbyqxmd.com/read/28806545/improvement-of-the-drought-indicators-system-in-the-j%C3%A3%C2%BAcar-river-basin-spain
#9
Tatiana Ortega-Gómez, Miguel A Pérez-Martín, Teodoro Estrela
Droughts are one of the gravest natural threats currently existing in the world and their occurrence and intensity might be exacerbated in the coming years due to climate change. The severe impacts that droughts cause to inland water resources and to the associated socio-economic activities justify the continuous monitoring of the drought. The case study presented shows a practical application of a distributed drought monitoring system implemented in a real river basin district, the Júcar River Basin District (43,000km(2)), where drought periods of marked intensity have occurred historically and the climate ranges from humid in the north to semiarid in the south...
August 11, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28806527/a-2d-substitutional-solid-solution-through-hydrogen-bonding-of-molecular-building-blocks
#10
Jennifer M Macleod, Josh Lipton-Duffin, Chaoying Fu, Tyler Taerum, Dmitrii F Perepichka, Federico Rosei
Two-dimensional (2D) molecular self-assembly allows for the formation of well-defined supramolecular layers with tailored geometrical, compositional and chemical properties. To date, random intermixing and entropic effects in these systems have largely been associated with crystalline disorder and glassy phases. Here we describe a 2D crystalline self-assembled molecular system that exhibits random incorporation of substitutional molecules. The lattice is formed from a mixture of trimesic acid (TMA) and terthienobenzenetricarboxylic acid (TTBTA), C3-symmetric hydrogen-bonding units of very different sizes (0...
August 14, 2017: ACS Nano
https://www.readbyqxmd.com/read/28806508/cubic-fluorite-type-cah2-with-a-small-bandgap
#11
Hiroshi Mizoguchi, SangWon Park, Takashi Honda, Kazutaka Ikeda, Toshiya Otomo, Hideo Hosono
A cubic variant of CaH2 adopting a fluorite-type crystal structure was synthesized by cationic substitution with La or Y, yielding the first alkaline earth hydride-based with fluorite-type framework. The material has a bandgap of ∼2.5 eV (greenish yellow in color), which is much smaller than that of orthorhombic PbCl2-type CaH2 (4.4 eV) and is, in fact, the smallest among alkaline or alkaline earth metal hydrides reported to date. Analysis of the density functional theory band structure of cubic-CaH2 indicates that its conduction band minimum is formed mainly by the interaction between the Ca 3d eg orbitals around the crystallographic cavity defined by cubes of H(-) ions...
August 14, 2017: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/28806476/dna-trojan-horses-the-self-assembled-floxuridine-containing-dna-polyhedra-for-cancer-therapy
#12
Quanbing Mou, Yuan Ma, Gaifang Pan, Bai Xue, Deyue Yan, Chuan Zhang, Xinyuan Zhu
Based on the structural similarity, herein, nucleoside analogue therapeutics were integrated into DNA strands through conventional solid-phase synthesis. By elaborately designing their sequences, floxuridine-integrated DNA strands were synthesized and self-assembled into well-defined DNA polyhedra with definite drug loading ratio as well as tunable size and morphology. As a novel drug delivery system, these drug-containing DNA polyhedra could ideally mimic the Trojan Horse to deliver chemotherapeutics into tumor cells and fight against cancer...
August 14, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28806423/new-synthetic-lipid-antigens-for-rapid-serological-diagnosis-of-tuberculosis
#13
Alison Jones, Mark Pitts, Juma'a R Al Dulayymi, James Gibbons, Andrew Ramsay, Delia Goletti, Christopher D Gwenin, Mark S Baird
BACKGROUND: During pulmonary tuberculosis (PTB) antibodies are generated to trehalose esters of mycolic acids which are cell wall lipids of Mycobacterium tuberculosis (Mtb). Attempts have been made to use these complex natural mixtures in serological tests for PTB diagnosis. AIM: The aim of this work was to determine whether a serological test based on a panel of defined individual trehalose esters of characteristic synthetic mycolic acids has improved diagnostic accuracy in distinguishing patients with culture positive PTB from individuals who were Mtb culture negative...
2017: PloS One
https://www.readbyqxmd.com/read/28806393/craf-gene-fusions-in-pediatric-low-grade-gliomas-define-a-distinct-drug-response-based-on-dimerization-profiles
#14
P Jain, T M Fierst, H J Han, T E Smith, A Vakil, P J Storm, A C Resnick, A J Waanders
Pediatric low-grade gliomas (PLGGs) are commonly associated with BRAF gene fusions that aberrantly activate the mitogen-activated protein kinase (MAPK) signaling pathway. This has led to PLGG clinical trials utilizing RAF- and MAPK pathway-targeted therapeutics. Whole-genome profiling of PLGGs has also identified rare gene fusions involving another RAF isoform, CRAF/RAF1, in PLGGs and cancers occuring in adults. Whereas BRAF fusions primarily dysregulate MAPK signaling, the CRAF fusions QKI-RAF1 and SRGAP3-RAF1 aberrantly activate both the MAPK and phosphoinositide-3 kinase/mammalian target of rapamycin (PI3K/mTOR) signaling pathways...
August 14, 2017: Oncogene
https://www.readbyqxmd.com/read/28806372/exploring-rural-disparities-in-medical-diagnoses-among-veterans-with-transgender-related-diagnoses-utilizing-veterans-health-administration-care
#15
Leigh A Bukowski, John Blosnich, Jillian C Shipherd, Michael R Kauth, George R Brown, Adam J Gordon
OBJECTIVES: Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806367/creating-a-toolkit-to-reduce-disparities-in-patient-engagement
#16
Shimrit Keddem, Aneeza Z Agha, Judith A Long, Rachel M Werner, Judy A Shea
BACKGROUND: Patient engagement has become a major focus of health care improvement efforts nationally. Although evidence suggests patient engagement can be beneficial to patients, it has not been consistently defined, operationalized, or translated into practice. OBJECTIVES: Our objective was to develop a toolkit to help providers increase patient engagement and reduce disparities in patient engagement. RESEARCH DESIGN: We used qualitative interviews and observations with staff at primary care sites nationally to identify patient engagement practices and resources used to engage patients...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806300/improving-benchmarks-for-global-surgery-nationwide-enumeration-of-operations-performed-in-ghana
#17
Adam Gyedu, Barclay Stewart, Cameron Gaskill, Godfred Boakye, Ebenezer Appiah-Denkyira, Peter Donkor, Ronald Maier, Robert Quansah, Charles Mock
OBJECTIVE: To evaluate the operation rate in Ghana and characterize it by types of procedures and hospital level. BACKGROUND: The Lancet Commission on Global Surgery recommended an annual rate of 5000 operations/100,000 people as a benchmark at which low- and middle-income countries could achieve most of the population-wide benefits of surgery, but did not define procedure-type benchmarks. METHODS: Data on operations performed from June 2014 to May 2015 were obtained from representative samples of 48 of 124 district-level (first-level) hospitals, 9 of 11 regional (referral) hospitals, and 3 of 5 tertiary hospitals, and scaled-up to nationwide estimates...
August 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28806274/transfusion-related-immunomodulation-a-reappraisal
#18
Lyla A Youssef, Steven L Spitalnik
PURPOSE OF REVIEW: This review summarizes current and prior observations regarding transfusion-related immunomodulation (TRIM) and puts these ideas into a modern immunological context, incorporating concepts from innate, adaptive, and nutritional immunity. We propose that TRIM research focus on determining whether there are specific, well-defined immunosuppressive effects from transfusing 'pure' red blood cells (RBCs) themselves, along with the by-products produced by the stored RBCs as a result of the 'storage lesion...
August 12, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28806214/choroidal-nevi-with-focal-choroidal-excavation-and-polypoidal-choroidal-neovascularization
#19
Daniel Simhaee, Rosa Dolz-Marco, K Bailey Freund
PURPOSE: To report two cases of choroidal nevi associated with focal choroidal excavation (FCE) and polypoidal choroidal neovascularization (PCN). METHODS: Report of two patients with choroidal nevi showing FCE and PCN who underwent multimodal imaging including color fundus photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, spectral domain optical coherence tomography, swept-source optical coherence tomography, and optical coherence tomography angiography...
August 10, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#20
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
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