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Jarrod D Frizzell, Li Liang, Phillip J Schulte, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez, Deepak L Bhatt, Gregg C Fonarow, Warren K Laskey
Importance: Several attempts have been made at developing models to predict 30-day readmissions in patients with heart failure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach and may have potential advantages over traditional statistical modeling. Objective: To develop models using a ML approach to predict all-cause readmissions 30 days after discharge from a heart failure hospitalization and to compare ML model performance with models developed using "conventional" statistically based methods...
October 26, 2016: JAMA Cardiology
Karla A Mark, Kathleen J Dumas, Dipa Bhaumik, Birgit Schilling, Sonnet Davis, Tal Ronnen Oron, Dylan J Sorensen, Mark Lucanic, Rachel B Brem, Simon Melov, Arvind Ramanathan, Bradford W Gibson, Gordon J Lithgow
Vitamin D has multiple roles, including the regulation of bone and calcium homeostasis. Deficiency of 25-hydroxyvitamin D, the major circulating form of vitamin D, is associated with an increased risk of age-related chronic diseases, including Alzheimer's disease, Parkinson's disease, cognitive impairment, and cancer. In this study, we utilized Caenorhabditis elegans to examine the mechanism by which vitamin D influences aging. We found that vitamin-D3-induced lifespan extension requires the stress response pathway genes skn-1, ire-1, and xbp-1...
October 25, 2016: Cell Reports
Nancy W Selix, Stefan Rowniak
INTRODUCTION: Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population. METHODS: A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases...
October 26, 2016: Journal of Midwifery & Women's Health
Sharon M Moe
Calcium is an important ion in cell signaling, hormone regulation, and bone health. Its regulation is complex and intimately connected to that of phosphate homeostasis. Both ions are maintained at appropriate levels to maintain the extracellular to intracellular gradients, allow for mineralization of bone, and to prevent extra skeletal and urinary calcification. The homeostasis involves the target organs intestine, parathyroid glands, kidney, and bone. Multiple hormones converge to regulate the extracellular calcium level: parathyroid hormone, vitamin D (principally 25(OH)D or 1,25(OH)2D), fibroblast growth factor 23, and α-klotho...
September 15, 2016: Comprehensive Physiology
Colin H Brown
The posterior pituitary gland secretes oxytocin and vasopressin (the antidiuretic hormone) into the blood system. Oxytocin is required for normal delivery of the young and for delivery of milk to the young during lactation. Vasopressin increases water reabsorption in the kidney to maintain body fluid balance and causes vasoconstriction to increase blood pressure. Oxytocin and vasopressin secretion occurs from the axon terminals of magnocellular neurons whose cell bodies are principally found in the hypothalamic supraoptic nucleus and paraventricular nucleus...
September 15, 2016: Comprehensive Physiology
Joy Longo, Linda Cassidy, Rose Sherman
: HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo...
November 1, 2016: Journal of Continuing Education in Nursing
Ana Paula Morais de Carvalho Macedo, Clara Maria Faria Simães Mendes, Analisa Lia Silva Candeias, Marco Paulo Rodrigues Sousa, Louíse Viecili Hoffmeister, Maria Isabel Gomes Sousa Lage
Objective: to describe the process of adaptation and validation of the Nursing Activities Score to the Portuguese context. Method: this was a pilot study of adaptation and validation of the Nursing Activities Score with a sample consisting of 67 patients hospitalized in the intensive care units of three Portuguese hospitals. The construct validity was assessed through factor analysis procedures and the internal consistency of the items was measured through the Cronbach's alpha coefficient...
September 2016: Revista Brasileira de Enfermagem
Aline Cruz Esmeraldo Áfio, Aline Tomaz de Carvalho, Luciana Vieira de Caravalho, Andréa Soares Rocha da Silva, Lorita Marlena Freitag Pagliuca
Objective: to assess the automatic accessibility of assistive technology in online courses for the hearing impaired. Method: evaluation study guided by the Assessment and Maintenance step proposed in the Model of Development of Digital Educational Material. The software Assessor and Simulator for the Accessibility of Sites (ASES) was used to analyze the online course "Education on Sexual and Reproductive Health: the use of condoms" according to the accessibility standards of national and international websites...
September 2016: Revista Brasileira de Enfermagem
Jonathan D Hibshman, Anthony Hung, L Ryan Baugh
Maternal effects of environmental conditions produce intergenerational phenotypic plasticity. Adaptive value of these effects depends on appropriate anticipation of environmental conditions in the next generation, and mismatch between conditions may contribute to disease. However, regulation of intergenerational plasticity is poorly understood. Dietary restriction (DR) delays aging but maternal effects have not been investigated. We demonstrate maternal effects of DR in the roundworm C. elegans. Worms cultured in DR produce fewer but larger progeny...
October 2016: PLoS Genetics
Ji-Jin Yao, Guan-Qun Zhou, Fan Zhang, Wang-Jian Zhang, Li Lin, Ling-Long Tang, Yan-Ping Mao, Jun Ma, Ying Sun
PURPOSE: To compare the outcomes of patients with ascending type (T4&N0-1) and descending type (T1-2&N3) of nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy (CCRT), neoadjuvant chemotherapy (NACT) + intensity-modulated radiotherapy (RT) or NACT + CCRT. METHODS: Retrospective analysis of 839 patients with ascending or descending types of NPC treated at a single institution between October 2009 to February 2012. CCRT was delivered to 236 patients, NACT + RT to 302 patients, and NACT + CCRT to 301 patients...
2016: PloS One
Michel Tchuenche, Eurica Palmer, Vibhuti Haté, Ananthy Thambinayagam, Dayanund Loykissoonlal, Emmanuel Njeuhmeli, Steven Forsythe
Given compelling evidence associating voluntary medical male circumcision (VMMC) with men's reduced HIV acquisition through heterosexual intercourse, South Africa in 2010 began scaling up VMMC. To project the resources needed to complete 4.3 million circumcisions between 2010 and 2016, we (1) estimated the unit cost to provide VMMC; (2) assessed cost drivers and cost variances across eight provinces and VMMC service delivery modes; and (3) evaluated the costs associated with mobilize and motivate men and boys to access VMMC services...
2016: PloS One
Carlo Signorelli, Veronica Ciorba, Federica Pezzetti, Anna Odone, Armando Gozzini, Antonello Zangrandi
Health authorities, medical directors and managers are called to face increasing and inter-related challenges regarding the ongoing financial crisis, aging of the population and the need to acquire innovative medical technologies. These challenges need to be tackled in order to ensure sustainability of the healthcare systems and appropriateness and quality of healthcare services. In Italy, the role of medical directors has progressively evolved over the years and now requires strengthened managerial skills and additional professional expertise and skills to plan, implement and evaluate the new systems of government...
July 2016: Igiene e Sanità Pubblica
Samuel Stolpe, Michel A Kroes, Neil Webb, Tami Wisniewski
BACKGROUND: Diabetes care is associated with a considerable burden to the health care system in the United States, and measuring the quality of health care is an important development goal of the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. Diabetes is a priority disease within the National Quality Strategy and should therefore remain a focus in the measurement of health care quality. Despite the importance of measuring quality in diabetes care management, no quality measure is currently associated with adherence to insulin treatment, and measuring adherence to insulin is known to be complicated...
November 2016: Journal of Managed Care & Specialty Pharmacy
Anastasia Kruchinina, Elias Rudberg, Emanuel H Rubensson
Parameterless stopping criteria for recursive polynomial expansions to construct the density matrix in electronic structure calculations are proposed. Based on convergence order estimation the new stopping criteria automatically and accurately detect when the calculation is dominated by numerical errors and continued iteration does not improve the result. Difficulties in selecting a stopping tolerance and appropriately balancing it in relation to parameters controlling the numerical accuracy are avoided. Thus, our parameterless stopping criteria stand in contrast to the standard approach to stop as soon as some error measure goes below a user-defined parameter or tolerance...
October 26, 2016: Journal of Chemical Theory and Computation
Taku Yamashita, Koji Araki, Masayuki Tomifuji, Yuya Tanaka, Eiko Harada, Tatsutoshi Suzuki, Shunsuke Miyamoto, Akihiro Shiotani
AIM: It has been well established that patients with head and neck cancer (HNC) have an elevated risk of developing a second primary cancer (SPC), owing to the common carcinogenic risk factors, including tobacco and alcohol consumption, and inactive aldehyde dehydrogenase-2 genotype. Here we investigated the current state of SPC in Japanese HNC patients. METHODS: We retrospectively investigated the incidence and treatment outcomes of synchronous and metachronous SPCs among 434 newly diagnosed HNC patients...
October 26, 2016: Asia-Pacific Journal of Clinical Oncology
A Arias, O A Peters, I L Broyles
AIM: To develop, implement and evaluate an innovative curriculum in biostatistics in response to the needs of fostering critical thinking in graduate health care education for evidence-based practice and life-long learning education. METHODOLOGY: The curriculum was designed for first-year residents in a postgraduate endodontic program using a six-step approach to curriculum development to provide sufficient understanding to critically evaluate biomedical publications, to design the best research strategy to address a specific problem and to analyse data by appropriate statistical test selection...
October 26, 2016: International Endodontic Journal
Paola Sebastiani, Bharat Thyagarajan, Fangui Sun, Lawrence S Honig, Nicole Schupf, Stephanie Cosentino, Mary F Feitosa, Mary Wojczynski, Anne B Newman, Monty Montano, Thomas T Perls
OBJECTIVES: To determine reference values for laboratory tests in individuals aged 85 and older. DESIGN: Cross-sectional cohort study. SETTING: International. PARTICIPANTS: Long Life Family Study (LLFS) participants (N~5,000, age: range 25-110, median 67, 45% male). MEASUREMENTS: Serum biomarkers were selected based on association with aging-related diseases and included complete blood count, lipids (triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol), 25-hydroxyvitamin D2 and D3, vitamin D epi-isomer, diabetes mellitus-related biomarkers (adiponectin, insulin, insulin-like growth factor 1, glucose, glycosylated hemoglobin, soluble receptor for advanced glycation endproduct), kidney disease-related biomarkers (albumin, creatinine, cystatin), endocrine biomarkers (dehydroepiandrosterone, sex-hormone binding globulin, testosterone), markers of inflammation (interleukin 6, high-sensitivity C-reactive protein, N-terminal pro b-type natriuretic peptide), ferritin, and transferrin...
October 26, 2016: Journal of the American Geriatrics Society
S Mahesh, V Lekha, John Mathew Manipadam, A Venugopal, H Ramesh
The aim of this study is to analyze the outcomes of patients with chronic pancreatitis who underwent the Frey procedure and who had a histologic evidence of adenocarcinoma in the cored out specimen.The type of analysis is retrospective. Out of 523 patients who underwent Frey procedure for chronic pancreatitis, seven (five males and two females; age range 42 to 54 years) had histologically proven adenocarcinoma. In the first four cases, intraoperative frozen section was not done. The diagnosis was made on routine histopathology and only one out of four could undergo attempted curative therapy...
October 26, 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Osvalda De Giglio, Giovanna Barbuti, Paolo Trerotoli, Silvia Brigida, Angelantonio Calabrese, Giuseppe Di Vittorio, Grazia Lovero, Giuseppina Caggiano, Vito Felice Uricchio, Maria Teresa Montagna
This study represents the first investigation of microbiological groundwater pollution as a function of aquifer type and season for the Apulia region of southern Italy. Two hundred and seven wells were randomly selected from those monitored by the Regional Agency for Environmental Protection for emergency use. Both compulsory (Escherichia coli, Total Coliform, and Enterococci) and optional (Pseudomonas aeruginosa, Salmonella spp., Heterotrophic Plate Count at 37 and 22 °C) microbiological parameters were assessed regularly at these wells...
November 2016: Environmental Monitoring and Assessment
F G A Silva, M F S F de Moura, N Dourado, J Xavier, F A M Pereira, J J L Morais, M I R Dias, P J Lourenço, F M Judas
Fracture characterization of human cortical bone under mode II loading was analyzed using a miniaturized version of the end-notched flexure test. A data reduction scheme based on crack equivalent concept was employed to overcome uncertainties on crack length monitoring during the test. The crack tip shear displacement was experimentally measured using digital image correlation technique to determine the cohesive law that mimics bone fracture behavior under mode II loading. The developed procedure was validated by finite element analysis using cohesive zone modeling considering a trapezoidal with bilinear softening relationship...
October 25, 2016: Medical & Biological Engineering & Computing
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