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https://www.readbyqxmd.com/read/28340503/risk-factors-for-lymph-node-metastases-in-women-with-endometrial-cancer-a-population-based-nation-wide-register-study-on-behalf-of-the-swedish-gynecological-cancer-group-swegcg
#1
K Stålberg, P Kjølhede, M Bjurberg, C Borgfeldt, P Dahm-Kähler, H Falconer, E Holmberg, C Staf, B Tholander, E Åvall-Lundqvist, P Rosenberg, T Högberg
The role of lymphadenectomy in the management of early endometrial cancer is still controversial. In the recent ESMO-ESGO-ESTRO guidelines, lymphadenectomy is recommended for patients with endometrioid adenocarcinoma grade 3 with deep myometrial invasion, but complete agreement was not achieved. In Sweden, DNA aneuploidy has been included as a high-risk factor. The aim of our study was to evaluate the impact of tumor histology, FIGO grade, DNA ploidy and myometrial invasion (MI) on occurrence of lymph node metastasis (LNM) in patients with endometrial cancer...
March 24, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28340479/additive-effects-prevail-the-response-of-biota-to-multiple-stressors-in-an-intensively-monitored-watershed
#2
Alexander Gieswein, Daniel Hering, Christian K Feld
Freshwater ecosystems are impacted by a range of stressors arising from diverse human-caused land and water uses. Identifying the relative importance of single stressors and understanding how multiple stressors interact and jointly affect biology is crucial for River Basin Management. This study addressed multiple human-induced stressors and their effects on the aquatic flora and fauna based on data from standard WFD monitoring schemes. For altogether 1095 sites within a mountainous catchment, we used 12 stressor variables covering three different stressor groups: riparian land use, physical habitat quality and nutrient enrichment...
March 21, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28340472/characterization-of-an-unknown-impurity-in-doxofylline-using-lc-ms-and-nmr
#3
Peixi Zhu, Jingxian Lu, Liya Hong, Weike Su, Ann Van Schepdael, Erwin Adams
During quality control of doxofylline, a novel impurity was detected, which was above the identification threshold defined by ICH. First, a liquid chromatographic method compatible with mass spectrometric (MS) detection was developed. Based on tandem multistage MS and high resolution MS data, the unknown impurity was found to consist of two theophylline groups connected by a methylene group. The structure was further confirmed by 1D and 2D nuclear magnetic resonance (NMR) experiments after semi-preparative isolation...
March 18, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#4
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340206/monitoring-the-quality-of-cardiac-surgery-based-on-three-or-more-surgical-outcomes-using-a-new-variable-life-adjusted-display
#5
Fah Fatt Gan, Xu Tang, Yexin Zhu, Puay Weng Lim
Quality problem or issue: The traditional variable life-adjusted display (VLAD) is a graphical display of the difference between expected and actual cumulative deaths. The VLAD assumes binary outcomes: death within 30 days of an operation or survival beyond 30 days. Full recovery and bedridden for life, for example, are considered the same outcome. This binary classification results in a great loss of information. Initial assessment: Although there are many grades of survival, the binary outcomes are commonly used to classify surgical outcomes...
March 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28340111/assessment-of-patient-reported-outcome-instruments-to-assess-chronic-low-back-pain
#6
Abhilasha Ramasamy, Mona L Martin, Steven I Blum, Hiltrud Liedgens, Charles Argoff, Rainer Freynhagen, Mark Wallace, Kelly P McCarrier, Donald M Bushnell, Noël V Hatley, Donald L Patrick
Objective. : To identify patient-reported outcome (PRO) instruments that assess chronic low back pain (cLBP) symptoms (specifically pain qualities) and/or impacts for potential use in cLBP clinical trials to demonstrate treatment benefit and support labeling claims. Design. : Literature review of existing PRO measures. Methods. : Publications detailing existing PRO measures for cLBP were identified, reviewed, and summarized. As recommended by the US Food & Drug Administration (FDA) PRO development guidance, standard measurement characteristics were reviewed, including development history, psychometric properties (validity and reliability), ability to detect change, and interpretation of observed changes...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340086/real-world-massage-therapy-produces-meaningful-effectiveness-signal-for-primary-care-patients-with-chronic-low-back-pain-results-of-a-repeated-measures-cohort-study
#7
William G Elder, Niki Munk, Margaret M Love, Geza G Bruckner, Kathryn E Stewart, Kevin Pearce
Objective.:  While efficacy of massage and other nonpharmacological treatments for chronic low back pain is established, stakeholders have called for pragmatic studies of effectiveness in "real-world" primary health care. The Kentucky Pain Research and Outcomes Study evaluated massage impact on pain, disability, and health-related quality of life for primary care patients with chronic low back pain. We report effectiveness and feasibility results, and make comparisons with established minimal clinically important differences...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340082/disparities-in-health-care-quality-among-asian-children-with-special-health-care-needs
#8
Esther Son, Susan L Parish, Leah Igdalsky
There is a dearth of information on the quality of health care for Asian American children and particularly Asian children with special health care needs (CSHCN). The goal of this article was to determine whether there were disparities in quality of health care for Asian CSHCN, whose experiences have not been studied. Data were derived from the 2009-2010 National Survey of Children with Special Health Care Needs (ns = 355 non-Hispanic Asian children and 4,343 non-Hispanic white CSHCN). Bivariate and multivariate logistic regression analyses were conducted to examine the relationship between racial identity (that is, non-Hispanic white and non-Hispanic Asian) and quality of health care...
March 2, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28340058/predictive-modeling-for-monitoring-egg-freshness-during-variable-temperature-storage-conditions
#9
S M Yimenu, J Y Kim, J Koo, B S Kim
The overall aim of this research was to develop egg freshness prediction models in terms of selected quality indices. Six experiments (4 constant temperatures and 2 variable temperatures) were carried out on hen eggs for a total period of 10, 21, 26, 13, and 105 d at storage temperatures of 30, 20, 20 to 10, 30 to 10, and 5 and 10°C, to observe trends in the relative weight loss (RWL), Haugh unit (HU), yolk index (YI), albumin index (AI), yolk pH, and albumin pH. The results showed that there was an increasing trend in the RWL and a decreasing trend in the YI, AI, and HU for all temperature conditions...
March 2, 2017: Poultry Science
https://www.readbyqxmd.com/read/28340044/oral-ghrelin-receptor-agonist-mk-0677-increases-serum-insulin-like-growth-factor-1-in-hemodialysis-patients-a-randomized-blinded-study
#10
Garland A Campbell, James T Patrie, Bruce D Gaylinn, Michael O Thorner, Warren K Bolton
Background: . Protein-energy wasting (PEW) in end-stage renal disease (ESRD) patients is associated with increased morbidity and mortality, but options for treatment are limited. Growth hormone (GH) increases insulin-like growth factor 1 (IGF-1), with improved nutritional parameters, but must be given subcutaneously and does not provide normal GH secretion patterns. MK-0677, an oral ghrelin receptor agonist (GRA), maintains normal GH secretion and increases lean body mass in normal subjects; it has not been studied in dialysis patients, an essential step in assessing efficacy and safety prior to clinical trials...
March 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28340009/designing-an-optimal-screening-program-for-unknown-atrial-fibrillation-a-cost-effectiveness-analysis
#11
Mattias Aronsson, Emma Svennberg, Mårten Rosenqvist, Johan Engdahl, Faris Al-Khalili, Leif Friberg, Viveka Frykman, Lars-Åke Levin
Aims: The primary objective of this study was to use computer simulations to suggest an optimal age for initiation of screening for unknown atrial fibrillation and to evaluate if repeated screening will add value. Methods and results: In the absence of relevant clinical studies, this analysis was based on a simulation model. More than two billion different designs of screening programs for unknown atrial fibrillation were simulated and analysed. Data from the published scientific literature and registries were used to construct the model and estimate lifelong effects and costs...
March 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339976/effects-of-two-different-broiler-flooring-systems-on-production-performances-welfare-and-environment-under-commercial-production-conditions
#12
H Li, X Wen, R Alphin, Z Zhu, Z Zhou
Research comparing conventional litter and alternative perforated flooring (netting) systems is relatively limited under commercial production conditions. A comprehensive comparison of broiler production performances, welfare quality, and housing environment of two broiler houses with conventional litter and new perforated plastic floors was conducted over four flocks for eight months in eastern China. The two broiler houses each had 31,700 broilers per flock on average and were ventilated using a negative-pressure system...
March 3, 2017: Poultry Science
https://www.readbyqxmd.com/read/28339972/factors-associated-with-sickness-absence-among-employees-with-chronic-conditions
#13
L Meng, K T Robinson, M L Smith
Background: The growing prevalence of chronic conditions in the ageing workforce has been shown to have a negative impact in terms of optimal work performance and quality of life. It is therefore important to understand the factors associated with sickness absence due to health problems. Aims: To examine the socio-demographics, health status indicators, barriers to self-care and social support associated with working adults missing work because of chronic conditions...
March 8, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/28339941/productive-performance-egg-quality-and-hatching-traits-of-japanese-quail-reared-under-different-levels-of-glycerin
#14
A Ghayas, J Hussain, A Mahmud, K Javed, A Rehman, S Ahmad, S Mehmood, M Usman, H M Ishaq
This study evaluated subsequent effects of glycerin on productive performance, egg quality, and hatching traits in Japanese quail. A total of 200 birds was arranged according to a completely randomized design into 5 treatment groups having 5 replicates of 8 birds each (6 females and 2 males). Treatments consisted 5 levels of glycerin, i.e., 2.5, 5, 7.5, and 10% and the control group. Birds were fed with different levels of glycerin during a rearing period of 6 wk and their subsequent effects on productive performance, egg quality, and hatching traits were observed...
March 2, 2017: Poultry Science
https://www.readbyqxmd.com/read/28339923/measuring-patient-experience-a-systematic-review-to-evaluate-psychometric-properties-of-patient-reported-experience-measures-prems-for-emergency-care-service-provision
#15
Leanne Male, Adam Noble, Jessica Atkinson, Tony Marson
Purpose: Knowledge about patient experience within emergency departments (EDs) allows services to develop and improve in line with patient needs. There is no standardized instrument to measure patient experience. The aim of this study is to identify patient reported experience measures (PREMs) for EDs, examine the rigour by which they were developed and their psychometric properties when judged against standard criteria. Data sources: Medline, Scopus, CINAHL, PsycINFO, PubMed and Web of Science were searched from inception to May 2015...
March 2, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339854/prediction-versus-aetiology-common-pitfalls-and-how-to-avoid-them
#16
Merel van Diepen, Chava L Ramspek, Kitty J Jager, Carmine Zoccali, Friedo W Dekker
Prediction research is a distinct field of epidemiologic research, which should be clearly separated from aetiological research. Both prediction and aetiology make use of multivariable modelling, but the underlying research aim and interpretation of results are very different. Aetiology aims at uncovering the causal effect of a specific risk factor on an outcome, adjusting for confounding factors that are selected based on pre-existing knowledge of causal relations. In contrast, prediction aims at accurately predicting the risk of an outcome using multiple predictors collectively, where the final prediction model is usually based on statistically significant, but not necessarily causal, associations in the data at hand...
February 27, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339793/lameness-assessment-with-automatic-monitoring-of-activity-in-commercial-broiler-flocks
#17
A M Silvera, T G Knowles, A Butterworth, D Berckmans, E Vranken, H J Blokhuis
The possibility of using automatic recordings of broiler chicken activity in commercial flocks to assess the birds΄ walking ability (lameness) was investigated. Data were collected from 5 commercial broiler farms in 4 European countries, using 16 flocks and 33 assessment occasions. Lameness was assessed using established gait scoring methods (Kestin et al., 1992; Welfare Quality®, 2009) and took place at 3, 4, and 5 wk of age. Gait score (GS) was used to assess the birds' walking ability, and automatic recordings of bird activity were collected using the eYeNamic™ camera system before, during, and after an assessor walked through the house...
February 23, 2017: Poultry Science
https://www.readbyqxmd.com/read/28339771/implementing-patient-reported-outcome-surveys-as-part-of-routine-care-lessons-from-an-academic-radiation-oncology-department
#18
Lisa S Rotenstein, Ankit Agarwal, Kelly O'Neil, Andrea Kelly, Maureen Keaty, Colleen Whitehouse, Barbara Kalinowski, Peter F Orio, Neil Wagle, Neil E Martin
Patient reported outcomes (PROs) are reports of health conditions that come directly from patients. Use of PROs has been associated with improved patient outcomes, enhanced quality of life, and reduced end-of-life spending. Yet there are still outstanding questions regarding the process of implementing PRO collection in routine practice. In this article, we describe the experience of selecting and implementing PROs in a multisite, multidisease academic medical center-based radiation oncology practice and demonstrate that such large-scale rollout is feasible...
March 2, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339735/triage-quality-control-is-missing-tools-a-new-observation-technique-for-ed-quality-improvement
#19
Tomi Malmström, Veli-Pekka Harjola, Paulus Torkki, Salla Kumpulainen, Raija Malmström
Objective: Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339698/learning-from-errors-analysis-of-medication-order-voiding-in-cpoe-systems
#20
Thomas G Kannampallil, Joanna Abraham, Anna Solotskaya, Sneha G Philip, Bruce L Lambert, Gordon D Schiff, Adam Wright, William L Galanter
Objective: Medication order voiding allows clinicians to indicate that an existing order was placed in error. We explored whether the order voiding function could be used to record and study medication ordering errors. Materials and Methods: We examined medication orders from an academic medical center for a 6-year period (2006-2011; n  = 5 804 150). We categorized orders based on status (void, not void) and clinician-provided reasons for voiding. We used multivariable logistic regression to investigate the association between order voiding and clinician, patient, and order characteristics...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
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