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Sanjay V Desai, David A Asch, Lisa M Bellini, Krisda H Chaiyachati, Manqing Liu, Alice L Sternberg, James Tonascia, Alyssa M Yeager, Jeremy M Asch, Joel T Katz, Mathias Basner, David W Bates, Karl Y Bilimoria, David F Dinges, Orit Even-Shoshan, David M Shade, Jeffrey H Silber, Dylan S Small, Kevin G Volpp, Judy A Shea
Background Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians. Methods We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off between shifts. Measures of educational experience included observations of the activities of interns (first-year residents), surveys of trainees (both interns and residents) and faculty, and intern examination scores...
March 20, 2018: New England Journal of Medicine
Anil Akoon, Louis C Grandizio, Gaurav G Mookerjee, Jove Graham, Joel C Klena
BACKGROUND: The purpose of this investigation is to compare the radiographic and intraoperative assessment of scaphotrapezoid (ST) joint arthritis in patients with end-stage carpometacarpal (CMC) arthritis of the thumb base. We aim to define the incidence of ST arthritis in this population and determine whether radiographic features such as lunate morphology, dorsal intercalated segment instability (DISI), and scapholunate (SL) diastasis are associated with the incidence of ST arthritis...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Gonzalo A Jaña, Fernanda Mendoza, Manuel I Osorio, Joel B Alderete, Pedro A Fernandes, Maria J Ramos, Verónica A Jiménez
In this work, QM/MM calculations were employed to examine the catalytic mechanism of the retaining glucosyltransferase GTF-SI enzyme, which participates in the process of caries formation. Our goal was to characterize, with atomistic details, the mechanism of sucrose hydrolysis and the catalytic factors that modulate this reaction. Our results suggest a concerted mechanism for sucrose hydrolysis in which the first event corresponds to the glycosidic bond breakage assisted by Glu515, followed by the nucleophilic attack of Asp477, leading to the formation of the Covalent Glycosyl Enzyme (CGE) intermediate...
March 20, 2018: Organic & Biomolecular Chemistry
Guneet K Jasuja, Shalender Bhasin, Adam J Rose, Joel I Reisman, Avy Skolnik, Dan R Berlowitz, Allen L Gifford
Testosterone supplementation has been widely used in those infected with human immunodeficiency virus (HIV) for hypogonadism, and wasting. But with effective antiretroviral therapy and increasing recognition of atherosclerotic disease and adults infected with HIV, the risks of inappropriate testosterone use in HIV-infected patients are far better recognized than previously. Testosterone use has expanded among U.S. males, but few studies have examined prescribing in those infected with HIV. In a national cohort of males with at least one outpatient prescription in the Veterans Health Administration (VHA), we examined 9475 HIV-infected males, including 2484 who had received testosterone and a randomly selected 6991 who had not...
March 19, 2018: AIDS Care
Sarah E Sartain, Nancy A Turner, Joel L Moake
Atypical hemolytic uremic syndrome (aHUS) and bone marrow transplantation-associated thrombotic microangiopathy (TA-TMA) are associated with excessive activation of the alternative complement pathway (AP) and with severe renal - and rarely, cerebral - microvascular damage. Here, we compared AP activation and regulation in human glomerular and brain microvascular endothelial cells (GMVECs and BMVECs, respectively) unstimulated or stimulated by the proinflammatory cytokine, tumor necrosis factor (TNF). Compared with GMVECs and under both experimental conditions, BMVECs had increased gene expression of the AP-related genes C3 , CFB , and C5 , and decreased expression of CFD This was associated with increased expression in BMVECs (relative to GMVECs) of the genes for surface and soluble regulatory molecules ( CD46 , THBD , CD55 , CFI , and CFH ) suppressing formation of the AP C3 and C5 convertases...
March 19, 2018: Journal of Biological Chemistry
Ana Patricia Ortiz, Daisy González, José Vivaldi-Oliver, Maira Castañeda, Vivian Rivera, Elba Díaz, Hilmaris Centeno, Cristina Muñoz, Joel Palefsky, Kaumudi Joshipura, Cynthia M Pérez
INTRODUCTION: Research on the association between periodontitis and oral human papilloma virus (HPV) infection is inconsistent. The cross-sectional association of severe periodontitis with oral HPV infection was investigated in a sample of Hispanic adults. METHODS: Data from the 2014-2016 San Juan Overweight Adults Longitudinal Study (n=740) was analyzed. Periodontitis assessment and self-collection of oral HPV samples followed the National Health and Nutrition Examination Survey methodology...
March 16, 2018: Papillomavirus Research
Sagar B Kudchodkar, Hyeree Choi, Emma L Reuschel, Rianne Esquivel, Jackie Jin-Ah Kwon, Moonsup Jeong, Joel N Maslow, Charles C Reed, Scott White, J Joseph Kim, Gary P Kobinger, Pablo Tebas, David B Weiner, Kar Muthumani
Vaccines are considered one of the greatest advances in modern medicine. The global burden of numerous infectious diseases has been significantly reduced, and in some cases, effectively eradicated through the deployment of specific vaccines. However, efforts to develop effective vaccines against infectious pathogens such as influenza, HIV, dengue virus (DENV), chikungunya virus (CHIKV), Ebola virus, and Zika virus (ZIKV) have proven challenging. Zika virus is a mosquito-vectored flavivirus responsible for periodic outbreaks of disease in Africa, Southeast Asia, and the Pacific Islands dating back over 50 years...
March 16, 2018: Microbes and Infection
Nathaniel E Kallmyer, Joseph Musielwicz, Joel Sutter, Nigel Forest Reuel
Hydrolytic enzymes are a topic of continual study and improvement due to their industrial impact and biological implications; however, the ability to measure the activity of these enzymes, especially in high-throughput assays, is limited to an established, few enzymes and often involves the measurement of secondary byproducts or the design of a complex degradation probe. Herein, a versatile single-walled carbon nanotube (SWNT)-based biosensor that is straightforward to produce and measure is described. The hydrolytic enzyme substrate is rendered as an amphiphilic polymer which is then used to solubilize the hydrophobic nanotubes...
March 20, 2018: Analytical Chemistry
Shannon McGinnis, Susan Spencer, Aaron Firnstahl, Joel Stokdyk, Mark Borchardt, David T McCarthy, Heather M Murphy
Combined sewer overflows (CSOs) are a known source of human fecal pollution and human pathogens in urban water bodies, which may present a significant public health threat. To monitor human fecal contamination in water, bacterial fecal indicator organisms (FIOs) are traditionally used. However, because FIOs are not specific to human sources and do not correlate with human pathogens, alternative fecal indicators detected using qPCR are becoming of interest to policymakers. For this reason, this study measured correlations between the number and duration of CSOs and mm of rainfall, concentrations of traditional FIOs and alternative indicators, and the presence of human pathogens in two urban creeks...
February 28, 2018: Science of the Total Environment
Alexandra Vlassova, Joel Pearson
The idea that unconscious input can result in long-term learning or task improvement has been debated for decades, yet there is still little evidence to suggest that learning outside of awareness can produce meaningful changes to decision-making. Here we trained participants using noisy motion stimuli, which require the gradual accumulation of information until a decision can be reached. These stimuli were suppressed from conscious awareness by simultaneously presenting a dynamic dichoptic mask. We show that a short period of training on either a partially or fully suppressed motion stimulus resulted in improved accuracy when tested on a partially suppressed motion stimulus traveling in the orthogonal direction...
March 16, 2018: Cognition
George A Karpouzas, Joel Estis, Panteha Rezaeian, John Todd, Matthew J Budoff
Objectives: Patients with RA display greater occult coronary atherosclerosis burden and experience higher cardiovascular morbidity and mortality compared with controls. We here explored whether pro-inflammatory cytokines and high-sensitivity cardiac troponin I (hs-cTnI), a biomarker of myocardial injury, correlated with plaque burden and cardiovascular events (CVEs) in RA. Methods: We evaluated 150 patients with 64-slice coronary CT angiography. Coronary artery calcium, number of segments with plaque (segment involvement score), stenotic severity and plaque burden were assessed...
March 14, 2018: Rheumatology
Wudan Yan
After suffering a stroke-perhaps a blood clot gets lodged in the brain or a blood vessel near the brain bursts-a person may suddenly not be able to hear, talk, or see. He or she might have trouble walking or exhibit a speech impediment. In fact, one of the greatest challenges of treating patients affected by stroke is that it's a heterogeneous condition, says Joel Stein, a physiatrist specializing in physical medicine and rehabilitation at Columbia University and Weill Cornell Medical College in New York City (Figure 1)...
March 2018: IEEE Pulse
Nicole M Sachs, Joel Miller
The specific responsivity principle advises us to provide offenders with treatment that takes into account their responsiveness to treatment, tied for example to their learning style, motivation, and gender. We examine challenges to service engagement and attendance in a community-based program in a reentry setting, and consider how far they correspond with these factors. Drawing on qualitative accounts of parolee engagement in services provided by parolees, service providers, case managers, and parole officers, we identify a number of difficulties faced by clients...
March 1, 2018: International Journal of Offender Therapy and Comparative Criminology
Behdod Poushanchi, Hiren Vallabh, Gorman Joel Reynolds
Ipilimumab is a monoclonal antibody that works as an immunotherapeutic agent through selective targeting of T cells to strengthen the response to metastatic melanoma. It is well known that this pharmaceutical agent can cause the adverse effect of colitis. We report a rare presentation of ileocolitis refractory to both glucocorticosteroids and infliximab with a resultant pneumatosis and perforation requiring subtotal colectomy and end ileostomy.
2018: Case Reports in Gastrointestinal Medicine
Richard A Hansen, Natalie Hohmann, Matthew L Maciejewski, Marisa E Domino, Neepa Ray, Nirosha Mahendraratnam, Joel F Farley
Objectives: Adults with schizophrenia and cardiometabolic conditions may be good candidates for co-management by primary care prescribers and specialists. Associated risks for discontinuity in medication management have not been well-studied. This study examines whether medication adherence, inpatient admissions, and emergency department (ED) visits vary by the number and types of prescribers seen by adults with schizophrenia and cardiometabolic conditions. Methods: This study used a retrospective cohort of 4,223 adult Medicaid enrollees with schizophrenia and hypertension, hyperlipidemia, and/or diabetes from three states in 2009-2010...
March 2018: Journal of Pharmaceutical Health Services Research
Désirée E S Larenas Linnemann, Margarita Fernández Vega, Jorge Agustín Luna Pech, Jimena Villaverde Rosas, José Antonio Ortega Martell, Blanca Estela Del Río Navarro, María Del Carmen Cano Salas, Jade Romero Lombard, Erika Del Carmen López Estrada, Monica Rodriguez-González, José Luis Mayorga Butrón, Jorge Salas Hernández, Juan Carlos Vázquez García, Ignacio Ortiz Aldana, Mario Humberto Vargas Becerra, Martín Bedolla Barajas, Noel Rodríguez Pérez, Ambrocio Aguilar Aranda, Carlos Adrián Jiménez González, Carlos García Bolaños, Claudia Garrido Galindo, David Alejandro Mendoza Hernández, Enrique Mendoza López, Gerardo López Pérez, Guillermo Hideo Wakida Kuzonoki, Héctor Hernán Ruiz Gutiérrez, Héctor León Molina, Héctor Martínez de la Lanza, Héctor Stone Aguilar, Javier Gómez Vera, Jorge Olvera Salinas, José Joel Oyoqui Flores, José Luis Gálvez Romero, José Santos Lozano Saenz, Juan Ignacio Salgado Gama, Marcos Alejandro Jiménez Chobillon, Martha Angélica García Avilés, Martha Patricia Guinto Balanzar, Miguel Alejandro Medina Ávalos, Robert Camargo Angeles, Rogelio García Torrentera, Saraí Toral Freyre, Gabriel Montes Narvaez, Héctor Solorio Gómez, Juan Rosas Peña, Sergio Jesús Romero Tapia, Adela Reyes Herrera, Francisco Cuevas Schacht, Joaquín Esquer Flores, José Antonio Sacre Hazouri, Lorenzo Compean Martínez, Pablo Julián Medina Sánchez, Sergio Garza Salinas, Carlos Baez Loyola, Iraís Romero Alvarado, José Luis Miguel Reyes, Laura Elizabeth Huerta Espinosa, Manuel Ángel Correa Flores, Ricardo Castro Martínez
No abstract text is available yet for this article.
March 15, 2018: Annals of Allergy, Asthma & Immunology
Jill M Binkley, Paul Stratford, Stephanie Kirkpatrick, Clara R Farley, Joel Okoli, Sheryl Gabram
BACKGROUND: Activity limitations as well as impairments such as pain, numbness, limitation of shoulder range of motion, and weakness are common and well documented during and after treatment for breast cancer. There is limited information regarding the measurement properties of patient-reported outcome measures of upper extremity activity limitation in this population. This study examined the reliability and validity of the Upper Extremity Functional Index (UEFI) in patients after surgery for breast cancer...
February 21, 2018: Clinical Breast Cancer
Joel King, Fiona Leow, Sonja Cabarkapa, Chee Ng
No abstract text is available yet for this article.
March 1, 2018: Australian and New Zealand Journal of Psychiatry
Luis Angel Martínez-Martínez, Matthew Du, Raphael Florentino Ribeiro, Stéphane Kéna-Cohen, Joel Yuen-Zhou
Singlet fission is an important candidate to increase energy conversion efficiency in organic pho- tovoltaics; it provides a pathway to increase the quantum yield of excitons per photon absorbed in select materials. We investigate the dependence of exciton quantum yield for acenes in the strong light-matter interaction (polariton) regime, where the materials are embedded in optical microcavi- ties. Starting from an open-quantum-systems approach, we build a kinetic model for time-evolution of species of interest in the presence of quenchers and show that polaritons can decrease or increase exciton quantum yields compared to the cavity-free case...
March 18, 2018: Journal of Physical Chemistry Letters
Joel Lexchin, Jillian Clare Kohler, Marc André Gagnon, James Crombie, Paul Thacker, Adrienne Shnier
Corruption in healthcare generally and specifically in the pharmaceutical arena has recently been highlighted in reports by Transparency International. This article focuses on four areas of corruption: legislative/regulatory, financial, ideological/ethical, and communications. The problems identified and the solutions considered focus on structural considerations affecting how pharmaceuticals are discovered, developed, distributed, and ultimately used in clinical settings. These include recourse to user fees in the regulatory sphere, application of intellectual property rights to medical contexts (patents and access to research data), commercial sponsorship of ghost writing and guest authors, linkage/delinkage of the funding of research and overall health objectives to/from drug pricing and sales, transparency of payments to healthcare professionals and institutions, and credible regulatory sanctions...
March 15, 2018: Indian Journal of Medical Ethics
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