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https://www.readbyqxmd.com/read/28323839/on-dna-numerical-representations-for-genomic-similarity-computation
#1
Gerardo Mendizabal-Ruiz, Israel Román-Godínez, Sulema Torres-Ramos, Ricardo A Salido-Ruiz, J Alejandro Morales
Genomic signal processing (GSP) refers to the use of signal processing for the analysis of genomic data. GSP methods require the transformation or mapping of the genomic data to a numeric representation. To date, several DNA numeric representations (DNR) have been proposed; however, it is not clear what the properties of each DNR are and how the selection of one will affect the results when using a signal processing technique to analyze them. In this paper, we present an experimental study of the characteristics of nine of the most frequently-used DNR...
2017: PloS One
https://www.readbyqxmd.com/read/28319514/do-not-resuscitate-status-is-associated-with-increased-mortality-but-not-morbidity
#2
Elisa C Walsh, Ethan Y Brovman, Angela M Bader, Richard D Urman
BACKGROUND: Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28296534/trends-of-do-not-resuscitate-orders-hospice-care-utilization-and-late-referral-to-hospice-care-among-cancer-decedents-in-a-tertiary-hospital-in-taiwan-between-2008-and-2014-a-hospital-based-observational-study
#3
Tzu-Chien Shih, Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Tzeng-Ji Chen, Shinn-Jang Hwang
BACKGROUND: Out of respect for terminal patients' dignity and to decrease end-of-life suffering, patients in Taiwan can choose to sign do-not-resuscitate (DNR) orders and use hospice care when they are in a terminal condition. OBJECTIVES: To explore the trends and characteristics of hospice care utilization and DNR status among terminal cancer patients. Design and Setting/Subjects: A secondary data analysis was conducted to examine the rate of DNR orders, hospice care utilization, the survival time after DNR order, the duration of survival (DOS) after hospice care enrollment, and the rate of late referral to hospice care among patients who died from malignant cancers in a tertiary hospital in Taiwan between 2008 and 2014...
March 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28278611/specific-words-and-experience-matter-to-surrogates-when-making-end-of-life-decisions
#4
Dawn E Fairlie
This grant funded preliminary study investigated the relationship between end-of-life terminologies and decisional conflict in surrogate decision makers using a convenience sample of 234 adults aged 50 and older. Participants were randomized into two groups; each received a survey packet that varied only in the use of the words "Do Not Resuscitate (DNR)" and "Allow Natural Death (AND)." The Decisional Conflict Scale (DCS) was administered and demographic data were collected. No difference was found in the total DCS scores based on the AND and DNR versions...
February 17, 2017: Health Communication
https://www.readbyqxmd.com/read/28271120/code-status-reconciliation-to-improve-identification-and-documentation-of-code-status-in-electronic-health-records
#5
Viral G Jain, Peter J Greco, David C Kaelber
BACKGROUND: Code status (CS) of a patient (part of their end-of-life wishes) can be critical information in healthcare delivery, which can change over time, especially at transitions of care. Although electronic health record (EHR) tools exist for medication reconciliation across transitions of care, much less attention is given to CS, and standard EHR tools have not been implemented for CS reconciliation (CSR). Lack of CSR creates significant potential patient safety and quality of life issues...
March 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28251226/awareness-of-do-not-resuscitate-orders-in-the-outpatient-setting-in-saudi-arabia-perception-and-implications
#6
Mohammed A Al Sheef, Maha S Al Sharqi, Lina H Al Sharief, Tharaa Y Takrouni, Arshad M Mian
To determine the level of awareness of outpatients, their preferences regarding the appropriate time for discussions regarding do-not-resuscitate (DNR) order  in Saudi Arabia. Methods: This cross-sectional, self-administered survey was conducted at King Fahd Medical City, a tertiary care hospital in Riyadh, Saudi Arabia between December 2012 and January 2013. Demographic parameters of the participants were analyzed by frequency distribution, and the data on their responses by percentage analysis. Results: The survey participants constituted 307 randomly selected outpatients/caregivers presenting for outpatient care at primary and tertiary care centers, 70% were female...
March 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28214748/electrochemical-monitoring-of-biointeraction-by-graphene-based-material-modified-pencil-graphite-electrode
#7
Ece Eksin, Erhan Zor, Arzum Erdem, Haluk Bingol
Recently, the low-cost effective biosensing systems based on advanced nanomaterials have received a key attention for development of novel assays for rapid and sequence-specific nucleic acid detection. The electrochemical biosensor based on reduced graphene oxide (rGO) modified disposable pencil graphite electrodes (PGEs) were developed herein for electrochemical monitoring of DNA, and also for monitoring of biointeraction occurred between anticancer drug, Daunorubicin (DNR), and DNA. First, rGO was synthesized chemically and characterized by using UV-Vis, TGA, FT-IR, Raman Spectroscopy and SEM techniques...
June 15, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28209392/transfer-of-do-not-resuscitate-orders-to-the-emergency-department-from-extended-care-facilities
#8
Colleen M McQuown, Jennifer A Frey, Ahmad Amireh, Ali Chaudhary
PURPOSE/OBJECTIVE: With an elderly and chronically ill patient population visiting the emergency department, it is important to know patients' wishes regarding care preferences and advanced directives. Ohio law states DNR orders must be transported with the patient when they leave an extended care facility (ECF). We reviewed the charts of ECF patients to evaluate which patients presenting to the ED had their DNR status recognized by the physician and DNR orders that were made during their hospital stay...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#9
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28158232/the-effects-of-hospice-shared-care-for-gastric-cancer-patients
#10
Kun-Siang Huang, Shih-Ho Wang, Seng-Kee Chuah, Kun-Ming Rau, Yu-Hung Lin, Meng-Che Hsieh, Li-Hsueh Shih, Yen-Hao Chen
BACKGROUND: Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients. METHODS: A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81)...
2017: PloS One
https://www.readbyqxmd.com/read/28156564/advance-care-planning-and-specialty-palliative-care-utilization-for-patients-with-hematologic-malignancies-who-undergo-allogeneic-hematopoietic-cell-transplant
#11
Lisa M McNey, Erik Eckhert, Derek Galligan, Gabriel N Mannis
18 Background: Unlike most metastatic solid tumors, many advanced hematologic malignancies are treated with curative intent. Accordingly, aggressive interventions often continue until late in the disease course because it can be difficult to discern when cure is no longer possible. This is particularly true for recipients of allogeneic hematopoietic cell transplant (alloHCT). We hypothesized that alloHCT recipients and their providers would be less likely to utilize specialty Palliative Care (PC) services or to engage in early communication regarding advance care planning...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156550/advance-care-planning-and-palliative-care-consultation-for-stem-cell-transplant-patients
#12
Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric Roeland
113 Background: Advance care planning (ACP) in stem cell transplantation (SCT) is particularly challenging given the potential for cure for patients with blood cancers despite an increased risk of suffering and even death. Data regarding ACP and palliative care (PC) integration in SCT is limited. METHODS: A retrospective chart review was conducted of patients with hematologic malignancies who underwent SCT at UCSD from January 2011 to December 2015. The primary objective was to determine the medical discipline of the initial and last code status documentation...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156485/palliative-care-interventions-and-end-of-life-care-outcomes-for-hepatocellular-patients-pts-at-two-veterans-affairs-va-medical-centers
#13
Sarah Lee, Sejal Kothadia, Yucai Wang, Victor Tsu-Shih Chang, Yeun-Hee Anna Park, Ellen Olson, David Klein, Fengming Zhong
164 Background: Palliative care interventions and their effect on EOL outcomes for liver cancer pts have not been described. We investigated the association between palliative care intervention and EOL care outcomes. METHODS: We reviewed the charts of pts with hepatocellular carcinoma and who were seen by palliative care at 2 VA medical centers from 2006 to 2012. We investigated the association between EOL outcomes (number of ER visits, ICU visits, chemotherapy, place of death, number of hospitalizations during their last 30 days), and interventions such as early referral (within 30 days of diagnosis), defined goals of care, holding a family meeting, and symptom assessment and management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156477/a-comparison-of-patients-with-liver-cancer-receiving-palliative-care-at-two-veterans-affairs-va-medical-centers
#14
Zhen Wang, Sejal Kothadia, Yucai Wang, Ellen Olson, Yeun-Hee Anna Park, David Klein, Fengming Zhong, Victor Tsu-Shih Chang
75 Background: Liver cancer is a leading cause of death. Lack of data exists on palliative care in this group, and care varies by location. We aim to determine if there are differences in palliative care for patients (pts) with liver cancer by VA site. METHODS: In an IRB approved protocol, we reviewed medical records of pts at 2 VA medical centers (S1, S2) with liver cancer, who were seen by Palliative Care between 2006 and 2012. Veterans were compared by 1) demographics: Karnofsky performance status > 50 (KPS), marital status, DNR/DNI, 2) palliative intervention: goals of care discussion, referrals to psychology and PT/OT, and 3) outcomes: ED visit within 1 month (mo) of death, ED visit within 6 mo of death, ICU within 30 days of death, and hospice as site of death, time from diagnosis to palliative care, and time from DNR to death...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156462/patterns-of-palliative-care-utilization-and-end-of-life-care-in-adult-patients-with-cancer-who-died-as-inpatients-at-mayo-clinic
#15
Shivani S Shinde, Pashtoon Murtaza Kasi, Mark Robert Litzow, Jeanne M Huddleston
60 Background: A significant number of patients with advanced cancer die in the hospital. Examination of patterns of care and palliative care (PC) involvement may identify opportunities for process of care improvements for this vulnerable population. METHODS: Patients were identified using the institutional mortality review system registry (Mayo Clinic hospitals from July, 2013-June, 2014). Within this group, patients with a diagnosis of terminal malignancy were identified by chart review and ICD-9 codes...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156439/are-patients-with-cancer-concerned-about-burdening-their-families
#16
Kelly Choi, Ruth Pe Benito, Victoria DeVincenzo, Emily Sassano, Brooke Gruman, Katherine DeMarco, Jose Contreras, Kathryn Tanenbaum, Jennifer Covington, Dhakshila Paramanathan, Stuart L Goldberg
86 Background: A diagnosis of advanced cancer frequently thrusts family members into the role of caregiver. Although caregiver burdens have been well documented, less is known about the level of concern borne by the patient (pt) with cancer in placing a family member in this role, known as self-perceived burden (SPB). METHODS: As part of the larger "Living with Cancer" project we prospectively surveyed 1307 pts with advanced malignancies receiving treatment with non-curative intent at 17 New Jersey cancer programs within the Regional Cancer Care Associates network between Sept 2015 and Apr 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152940/code-status-documentation-in-the-electronic-medical-record-for-patients-with-stage-iv-pancreatic-cancer
#17
Janet M Armstrong, Joseph D Ma, Carolyn Revta, Eric Roeland
125 Background: Improving incidence of code status documentation in the electronic medical record (EMR) has been suggested a better guidance for clinical care compared with a traditional advance directive. We have previously reported that in the absence of a template in the EMR, code status documentation was 36% and inconsistent in patients with advanced cancer. Utilizing a different cohort of patients with metastatic pancreatic cancer, we examined the prevalence of EMR code status documentation. METHODS: A retrospective analysis in patients with analytic metastatic pancreatic cancer (2008-2014) was conducted at a single, academic medical center...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28130945/a-snapshot-of-advance-directives-in-long-term-care-how-often-is-do-not-done
#18
Sheril Perry, Christina Lawand
Advance directives allow individuals and their families or legal guardians to communicate preferences for interventions and treatments in the event that these individuals are no longer able to make decisions for themselves. This study examines how often do-not-hospitalize (DNH) and do-not-resuscitate (DNR) directives were recorded for residents in 982 reporting Canadian long-term care facilities between 2009-2010 and 2011-2012 and, to the extent possible, whether these directives were followed in acute care settings...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28112576/atp-binding-casette-transporter-expression-in-acute-myeloid-leukemia-association-with-in-vitro-cytotoxicity-and-prognostic-markers
#19
Savitha Varatharajan, Ajay Abraham, Sreeja Karathedath, Sukanya Ganesan, Kavitha M Lakshmi, Nancy Arthur, Vivi M Srivastava, Biju George, Alok Srivastava, Vikram Mathews, Poonkuzhali Balasubramanian
INTRODUCTION: Drug resistance and relapse are considered to be the major reasons for treatment failure in acute myeloid leukemia (AML). There is limited data on the role of ABC transporter expression on in vitro sensitivity to cytarabine (Ara-C) and daunorubicin (Dnr) in primary AML cells. PATIENTS & METHODS: RNA expression levels of 12 ABC transporters were analyzed by real-time quantitative PCR in 233 de novo adult acute myeloid leukemia patients. Based on cytarabine or Dnr IC50, the samples were categorized as sensitive, intermediate and resistant...
February 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28108837/can-mechanical-imaging-increase-the-specificity-of-mammography-screening
#20
Magnus Dustler, Daniel Förnvik, Pontus Timberg, Ingvar Andersson, Hannie Petersson, Håkan Brorson, Anders Tingberg, Sophia Zackrisson
OBJECTIVES: This study aimed to investigate the effects of adding adjunct mechanical imaging to mammography breast screening. We hypothesized that mechanical imaging could detect increased local pressure caused by both malignant and benign breast lesions and that a pressure threshold for malignancy could be established. The impact of this on breast screening was investigated with regard to reductions in recall and biopsy rates. METHODS: 155 women recalled from breast screening were included in the study, which was approved by the regional ethical review board (dnr 2013/620)...
January 20, 2017: European Radiology
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