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https://www.readbyqxmd.com/read/28199477/use-of-unsolicited-patient-observations-to-identify-surgeons-with-increased-risk-for-postoperative-complications
#1
William O Cooper, Oscar Guillamondegui, O Joe Hines, C Scott Hultman, Rachel R Kelz, Perry Shen, David A Spain, John F Sweeney, Ilene N Moore, Joseph Hopkins, Ira R Horowitz, Russell M Howerton, J Wayne Meredith, Nathan O Spell, Patricia Sullivan, Henry J Domenico, James W Pichert, Thomas F Catron, Lynn E Webb, Roger R Dmochowski, Jan Karrass, Gerald B Hickson
Importance: Unsolicited patient observations are associated with risk of medical malpractice claims. Because lawsuits may be triggered by an unexpected adverse outcome superimposed on a strained patient-physician relationship, a question remains as to whether behaviors that generate patient dissatisfaction might also contribute to the genesis of adverse outcomes themselves. Objective: To examine whether patients of surgeons with a history of higher numbers of unsolicited patient observations are at greater risk for postoperative complications than patients whose surgeons generate fewer such unsolicited patient observations...
February 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28191589/assessment-of-musculoskeletal-impairment-in-head-and-neck-cancer-patients
#2
Michael K Ghiam, Kyle Mannion, Mary S Dietrich, Kristen L Stevens, Jill Gilbert, Barbara A Murphy
PURPOSE: This study aims to describe the types of musculoskeletal impairment in head and neck cancer survivors and to evaluate objective and subjective measures of musculoskeletal impairment and identify areas of need in future studies. METHODS: This is a cross-sectional pilot study of 29 head and neck cancer patients who were treated with resection and reconstruction. Subjective measures of musculoskeletal impairment (Neck Disability Index, Shoulder Pain and Disability Index, Vanderbilt Head and Neck Symptom Survey, General Symptom Survey) were collected and compared to objective measures (Cervical Range of Motion Device, Inter-incisal Distance)...
February 13, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28164727/psychometric-properties-of-the-vanderbilt-adhd-diagnostic-rating-scale-completed-by-juvenile-corrections-staff
#3
Regina Bussing, Joseph C Gagnon, Cynthia W Garvan, Cecelia Ribuffo-Duggan, David Houchins
OBJECTIVE: This research tests the psychometric performance of the Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS) completed by juvenile corrections (JC) staff. METHOD: With institutional review board (IRB) approval and appropriate consents/assents, data were collected from case managers ( n = 18), teachers ( n = 9), youth ( n = 261), and an administrative database. Separate psychometric analyses were conducted for case managers and teachers. RESULTS: For both respondent groups, 2-week retest reliability and internal consistency were high for all four VADTRS subscales, and confirmatory factor analysis suggested fit with previously reported VADTRS subscale structure...
February 1, 2017: Journal of Attention Disorders
https://www.readbyqxmd.com/read/28141730/-footprints-in-the-bathroom-the-role-of-spirituality-in-patient-diagnosis
#4
Veronica Meneses, Douglas Vanderbilt, Linda Barnes, Marilyn Augustyn
Lucy is a 12-year-old Latina whose mother brought her to the pediatric clinic for help with her anxiety symptoms, "hearing voices," and episodes of "spacing out." Lucy did not cry at birth secondary to vocal cord paralysis and still has the tracheostomy performed at a few days of life. In addition to her neonatal intensive care unit stay, she has been hospitalized for pneumonia. Her mother says she is "sickly" and has a weak immune system due to her asthma symptoms. Lucy also experiences somatic complaints related to gastroesophageal reflux and constipation...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141716/apraxia-autism-attention-deficit-hyperactivity-disorder-do-we-have-a-new-spectrum
#5
Jayna Schumacher, Kristine E Strand, Marilyn Augustyn
Gio is a bilingual 6-year 10-month-old boy new to your practice who presents for an unscheduled visit with concerns for speech and language delay. He was born in Portugal, and his native language is Portuguese. When he was 21 months old, his family moved to Italy and then moved to the United States 3 years later. He had very little contact with other children while living in Italy, but his parents report that he has made friends quickly in the United States. His family speaks Portuguese at home, although his father is fluent in English...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141715/-when-the-prescription-pad-is-not-enough-attention-deficit-hyperactivity-disorder-management-2-0
#6
Jenny Radesky, Arathi Reddy, Naomi Steiner, Marilyn Augustyn
Jose is a 13-year-old boy who presents to his primary care provider after struggling in school for many years. When he was in the first grade, he was diagnosed at a tertiary center with attention-deficit hyperactivity disorder. Multiple medication trials have produced few benefits and many side effects including poor sleep, morbid thoughts, lack of motivation, and, according to his parents, "he seemed like a robot."He comes now for his annual physical in April, and the parents tell you that the school is threatening that he be retained in the seventh grade...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141707/bullying-and-adhd-which-came-first-and-does-it-matter
#7
Robert Keder, Robert Sege, Peter C Raffalli, Marilyn Augustyn
Aiden, a 13-year-old boy in the sixth grade who is relatively new to your practice, is seen for follow-up after his routine physical last month when you noted concerns for possible attention-deficit hyperactivity disorder (ADHD) and gave the family Vanderbilt Scales to complete. Aiden has a family history of ADHD, specific learning disabilities, and mood disorder.His mother reports that she is concerned about how Aiden is doing at school; his teachers are complaining that he is not doing his work, and she is worried that he may be kept back in school...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28132018/proportion-of-never-smoker-non-small-cell-lung-cancer-patients-at-three-diverse-institutions
#8
Lorraine Pelosof, Chul Ahn, Ang Gao, Leora Horn, Alejandra Madrigales, Joan Cox, Dauphne McGavic, John D Minna, Adi F Gazdar, Joan Schiller
BACKGROUND: Approximately 10% to 15% of lung cancer cases in the United States occur in never smokers, but there has been much debate about whether this rate is increasing. To determine whether the proportion of never smokers among lung cancer cases is increasing, we conducted a retrospective study using registries from The University of Texas Southwestern Medical Center, Parkland Hospital, and Vanderbilt University. METHODS: Registries were queried for demographic information from 1990 to 2013 including sex, age, stage, and self-reported smoking history...
January 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28129252/optimal-diagnostic-thresholds-for-diagnosis-of-orthostatic-hypotension-with-a-sit-to-stand-test
#9
Brett H Shaw, Emily M Garland, Bonnie K Black, Sachin Y Paranjape, Cyndya A Shibao, Luis E Okamoto, Alfredo Gamboa, André Diedrich, W Dale Plummer, William D Dupont, Italo Biaggioni, David Robertson, Satish R Raj
OBJECTIVE: This study aimed to identify optimal blood pressure cut-offs to diagnose orthostatic hypotension during a sit-to-stand manoeuvre. METHODS: This was a cross-sectional study of patients and healthy controls from the Vanderbilt Autonomic Dysfunction Center. Blood pressure was measured while supine, seated and standing. Blood pressure changes were calculated from supine-to-standing and seated-to-standing. Orthostatic hypotension was diagnosed on the basis of a supine-to-standing SBP drop at least 20 mmHg or a DBP drop at least 10 mmHg...
January 27, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28128605/metal-insulator-transition-and-topological-properties-of-pyrochlore-iridates
#10
Hongbin Zhang, Kristjan Haule, David Vanderbilt
Combining density functional theory (DFT) and embedded dynamical mean-field theory (DMFT) methods, we study the metal-insulator transition in R_{2}Ir_{2}O_{7} (R=Y, Eu, Sm, Nd, Pr, and Bi) and the topological nature of the insulating compounds. Accurate free energies evaluated using the charge self-consistent DFT+DMFT method reveal that the metal-insulator transition occurs for an A-cation radius between that of Nd and Pr, in agreement with experiments. The all-in-all-out magnetic phase, which is stable in the Nd compound but not the Pr one, gives rise to a small Ir^{4+} magnetic moment of ≈0...
January 13, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28107274/the-sluscore-a-novel-method-for-detecting-hazardous-hypotension-in-adult-patients-undergoing-noncardiac-surgical-procedures
#11
Wolf H Stapelfeldt, Hui Yuan, Jefferson K Dryden, Kristen E Strehl, Jacek B Cywinski, Jesse M Ehrenfeld, Pamela Bromley
BACKGROUND: It has been suggested that longer-term postsurgical outcome may be adversely affected by less than severe hypotension under anesthesia. However, evidence-based guidelines are unavailable. The present study was designed to develop a method for identifying patients at increased risk of death within 30 days in association with the severity and duration of intraoperative hypotension. METHODS: Intraoperative mean arterial blood pressure recordings of 152,445 adult patients undergoing noncardiac surgery were analyzed for periods of time accumulated below each one of the 31 thresholds between 75 and 45 mm Hg (hypotensive exposure times)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#12
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28101270/using-online-active-learning-techniques-to-convey-time-compensated-sun-compass-orientation-in-the-eastern-north-american-monarch
#13
Noah H Green, Douglas G McMahon, Cynthia Brame
A common tool that animals use to navigate in a constant direction is known as "time compensated sun compass orientation." This is a process by which animals use the position of the sun along with information from their internal circadian clocks to determine and maintain a directional heading. Many circadian scientists and educators use this process as an example of how the internal circadian clock can directly influence animal behavior. However, many students have difficulty grasping this biological process due to its multivariable nature...
December 2016: Journal of Microbiology & Biology Education: JMBE
https://www.readbyqxmd.com/read/28099177/medical-students-perspectives-on-implementing-curriculum-change-at-one-institution
#14
Aaron M Yengo-Kahn, Courtney E Baker, Kimberly D Lomis
Training physicians to be effective practitioners throughout their careers begins in undergraduate medical education with particular focus on self-directed inquiry, professional and interprofessional development, and competency-based assessment. A select number of medical schools are restructuring their curricula by placing the student at the center of content delivery to enhance the learning experience. While this restructuring may benefit the adult learner, administrators often make assumptions about how students will perceive and respond to such innovative and unfamiliar educational concepts...
January 17, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28093821/decreasing-rates-of-pediatric-bipolar-within-an-outpatient-practice
#15
Daniel Wesemann
PROBLEM: Pediatric bipolar disorder (PBD) prevalence is estimated to be 1-3%. Nationally and internationally, rates of PBD have increased by over 400%. However, in Iowa and at one psychiatric clinic in Iowa, from 2008-2013, there was a decrease in PBD diagnosis of 33 and 51.2% respectively. This study examined the diagnosing practices of PBD by local providers in one outpatient mental health center. METHOD: Parents completed a screening packet to differentiate between PBD and attention deficit hyperactivity disorder (ADHD) using three tools: Child Mania Rating Scale (CMRS), Child Behavior Checklist-Mania Scale (CBCL-MS), and the NICHQ Vanderbilt...
January 16, 2017: Journal of Child and Adolescent Psychiatric Nursing
https://www.readbyqxmd.com/read/28078188/new-innovations-for-deep-partial-thickness-burn-treatment-with-acell-matristem-matrix
#16
Justine S Kim, Alexander J Kaminsky, J Blair Summitt, Wesley P Thayer
Objective: Burn injuries remain a large financial burden on the healthcare system. According to CDC statistics (2010), nonfatal and hospitalized burns in the U.S. cost $1.8 billion for an annual incidence of ∼486,000 cases. To date, no technique proves to be the ideal therapy of deep partial-thickness burns. In this study, we review a trial usage of ACell (ACell, Inc.) wound matrix on deep partial-thickness burns. Approach: Burn patients were admitted through the Vanderbilt Emergency Department. Three were consented to receive ACell therapy...
December 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/28076356/the-limitations-of-the-gre-in-predicting-success-in-biomedical-graduate-school
#17
Liane Moneta-Koehler, Abigail M Brown, Kimberly A Petrie, Brent J Evans, Roger Chalkley
Historically, admissions committees for biomedical Ph.D. programs have heavily weighed GRE scores when considering applications for admission. The predictive validity of GRE scores on graduate student success is unclear, and there have been no recent investigations specifically on the relationship between general GRE scores and graduate student success in biomedical research. Data from Vanderbilt University Medical School's biomedical umbrella program were used to test to what extent GRE scores can predict outcomes in graduate school training when controlling for other admissions information...
2017: PloS One
https://www.readbyqxmd.com/read/28060078/validation-of-international-chronic-ocular-graft-versus-host-disease-gvhd-group-diagnostic-criteria-as-a-chronic-ocular-gvhd-specific-metric
#18
Yuna Rapoport, Thomas Freeman, Tatsuki Koyama, Brian G Engelhardt, Madan Jagasia, Bipin N Savani, Uyen Tran, Adetola A Kassim
PURPOSE: To validate the International Chronic Ocular GVHD Consensus Group (ICCGVHD) diagnostic criteria for chronic ocular chronic graft-versus-host disease (GVHD), by comparing results with comprehensive ophthalmic evaluation after allogeneic hematopoietic stem cell transplantation. METHODS: A single-institution retrospective chart review was conducted on patients who underwent hematopoietic stem cell transplantation at Vanderbilt University Medical Center in Nashville, TN, from January 1, 2002, through April 17, 2014...
February 2017: Cornea
https://www.readbyqxmd.com/read/28052061/integrated-genomic-characterization-of-oesophageal-carcinoma
#19
(no author information available yet)
Oesophageal cancers are prominent worldwide; however, there are few targeted therapies and survival rates for these cancers remain dismal. Here we performed a comprehensive molecular analysis of 164 carcinomas of the oesophagus derived from Western and Eastern populations. Beyond known histopathological and epidemiologic distinctions, molecular features differentiated oesophageal squamous cell carcinomas from oesophageal adenocarcinomas. Oesophageal squamous cell carcinomas resembled squamous carcinomas of other organs more than they did oesophageal adenocarcinomas...
January 12, 2017: Nature
https://www.readbyqxmd.com/read/28036224/flux-states-and-topological-phases-from-spontaneous-time-reversal-symmetry-breaking-in-crsi-ge-te_-3-based-systems
#20
Jianpeng Liu, Se Young Park, Kevin F Garrity, David Vanderbilt
We study adatom-covered single layers of CrSiTe_{3} and CrGeTe_{3} using first-principles calculations based on hybrid functionals. We find that the insulating ground state of a monolayer of La (Lu) deposited on single-layer CrSiTe_{3} (CrGeTe_{3}) carries spontaneously generated current loops around the Cr sites. These "flux states" induce antiferromagnetically ordered orbital moments on the Cr sites and are also associated with nontrivial topological properties. The calculated Chern numbers for these systems are predicted to be ±1 even in the absence of spin-orbit coupling, with sizable gaps on the order of 100 meV...
December 16, 2016: Physical Review Letters
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