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https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#1
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441499/low-loss-plasmonic-dielectric-nanoresonators
#2
Yi Yang, Owen Miller, Thomas Christensen, John D Joannopoulos, Marin Soljacic
Material losses in metals are a central bottleneck in plasmonics for many applications. Here we propose and theoretically demonstrate that metal losses can be successfully mitigated with dielectric particles on metallic films, giving rise to hybrid dielectric--metal resonances. In the far field, they yield strong and efficient scattering, beyond even the theoretical limits of all-metal and all-dielectric structures. In the near field, they offer high-Purcell-factor (${>}5000$), high-quantum-efficiency (${>}90\%$), and highly directional emission at visible and infrared wavelengths...
April 25, 2017: Nano Letters
https://www.readbyqxmd.com/read/28439273/expansion-of-fasl-expressing-cd5-b-cells-in-type-1-diabetes-patients
#3
Ankit Saxena, Hideo Yagita, Thomas W Donner, Abdel Rahim A Hamad
Fas ligand drives insulitis in the non-obese diabetic mouse model of type 1 diabetes (T1D) and negatively regulates IL-10-producing (IL-10(pos)) CD5(+) B cells in pancreata. Relevance of these phenomena to the human disease is poorly understood. Here, using splenocytes from T1D, autoantibody (Ab(+)), and non-diabetic (ND) human subjects, we show that a subpopulation of CD5(+) B cells that is characterized by expression of FasL (FasL(hi)CD5(+)) was significantly elevated in T1D subjects, many of whom had significantly reduced frequency of IL-10(pos)CD5(+) B cells compared to Ab(+) subjects...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28439127/diversity-and-evolution-of-sex-determination-systems-in-terrestrial-isopods
#4
Thomas Becking, Isabelle Giraud, Maryline Raimond, Bouziane Moumen, Christopher Chandler, Richard Cordaux, Clément Gilbert
Sex determination systems are highly variable in many taxa, sometimes even between closely related species. Yet the number and direction of transitions between these systems have seldom been characterized, and the underlying mechanisms are still poorly understood. Here we generated transcriptomes for 19 species of terrestrial isopod crustaceans, many of which are infected by Wolbachia bacterial endosymbionts. Using 88 single-copy orthologous genes, we reconstructed a fully resolved and dated phylogeny of terrestrial isopods...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28438193/pathos-a-decision-support-system-for-reporting-high-throughput-sequencing-of-cancers-in-clinical-diagnostic-laboratories
#5
Kenneth D Doig, Andrew Fellowes, Anthony H Bell, Andrei Seleznev, David Ma, Jason Ellul, Jason Li, Maria A Doyle, Ella R Thompson, Amit Kumar, Luis Lara, Ravikiran Vedururu, Gareth Reid, Thomas Conway, Anthony T Papenfuss, Stephen B Fox
BACKGROUND: The increasing affordability of DNA sequencing has allowed it to be widely deployed in pathology laboratories. However, this has exposed many issues with the analysis and reporting of variants for clinical diagnostic use. Implementing a high-throughput sequencing (NGS) clinical reporting system requires a diverse combination of capabilities, statistical methods to identify variants, global variant databases, a validated bioinformatics pipeline, an auditable laboratory workflow, reproducible clinical assays and quality control monitoring throughout...
April 24, 2017: Genome Medicine
https://www.readbyqxmd.com/read/28436392/the-dna-damage-response-in-neurons-die-by-apoptosis-or-survive-in-a-senescence-like-state
#6
Edward Fielder, Thomas von Zglinicki, Diana Jurk
Neurons are exposed to high levels of DNA damage from both physiological and pathological sources. Neurons are post-mitotic and their loss cannot be easily recovered from; to cope with DNA damage a complex pathway called the DNA damage response (DDR) has evolved. This recognizes the damage, and through kinases such as ataxia-telangiectasia mutated (ATM) recruits and activates downstream factors that mediate either apoptosis or survival. This choice between these opposing outcomes integrates many inputs primarily through a number of key cross-road proteins, including ATM, p53, and p21...
April 18, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28436275/total-lumbar-facetectomy-without-fusion-short-and-long-term-follow-up-in-a-single-surgeon-series
#7
Mark A Pichelmann, John L D Atkinson, Nicolee C Fode-Thomas, Michael J Yaszemski
BACKGROUND: Total lumbar facetectomy may be advantageous for exposure or to completely free a constricted nerve root. OBJECTIVE: We retrospectively reviewed a single surgeon series without fusion for short and long term outcomes regarding radicular pain relief, subsequent relevant surgeries, and any identifiable instability. METHODS: All operations in which a single, total lumbar facetectomy was performed were reviewed. A total of 222 patients were identified with a minimal follow-up of 3 months; 187 (84...
April 24, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28436146/improving-zinc-accumulation-in-barley-endosperm-using-hvmtp1-a-transition-metal-transporter
#8
Paloma Menguer, Thomas Vincent, Anthony J Miller, James K M Brown, Eva Vincze, Søren Borg, Preben Bach Holm, Dale Sanders, Dorina Podar
Zinc (Zn) is essential for all life forms, including humans. It is estimated that around two billion people are deficient in their Zn intake. Human dietary Zn intake relies heavily on plants, which in many developing countries consists mainly of cereals. The inner part of cereal grain, the endosperm, is the part that is eaten after milling but contains only a quarter of the total grain Zn. Here we present results demonstrating that endosperm Zn content can be enhanced through expression of a transporter responsible for vacuolar Zn accumulation in cereals...
April 24, 2017: Plant Biotechnology Journal
https://www.readbyqxmd.com/read/28434406/efavirenz-based-simplification-after-successful-early-lopinavir-boosted-ritonavir-based-therapy-in-hiv-infected-children-in-burkina-faso-and-c%C3%A3-te-d-ivoire-the-monod-anrs-12206-non-inferiority-randomised-trial
#9
Désiré Lucien Dahourou, Madeleine Amorissani-Folquet, Karen Malateste, Clarisse Amani-Bosse, Malik Coulibaly, Carole Seguin-Devaux, Thomas Toni, Rasmata Ouédraogo, Stéphane Blanche, Caroline Yonaba, François Eboua, Philippe Lepage, Divine Avit, Sylvie Ouédraogo, Philippe Van de Perre, Sylvie N'Gbeche, Angèle Kalmogho, Roger Salamon, Nicolas Meda, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: The 2016 World Health Organization guidelines recommend all children <3 years start antiretroviral therapy (ART) on protease inhibitor-based regimens. But lopinavir/ritonavir (LPV/r) syrup has many challenges in low-income countries, including limited availability, requires refrigeration, interactions with anti-tuberculous drugs, twice-daily dosing, poor palatability in young children, and higher cost than non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Successfully initiating LPV/r-based ART in HIV-infected children aged <2 years raises operational challenges that could be simplified by switching to a protease inhibitor-sparing therapy based on efavirenz (EFV), although, to date, EFV is not recommended in children <3 years...
April 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28434397/watching-the-availability-and-use-of-rapid-diagnostic-tests-rdts-and-artemisinin-based-combination-therapy-act
#10
Richard W Steketee, Thomas P Eisele
At the turn of this new century and after much debate, the malaria community reckoned with failing first line therapies and moved to a global recommendation for deployment of an artemisinin-based combination therapy (ACT) to treat infections due to Plasmodium falciparum. No one said it was going to be easy. This series in the Malaria Journal reports longitudinal snapshots of how the core pillar of malaria elimination of ensuring universal access to malaria diagnosis and treatment is faring-it is safe to say "not so well"...
April 24, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28434106/what-do-patients-want-to-know-about-contraception-and-which-method-would-they-prefer
#11
Patricia G Oppelt, Friederike Baier, Christine Fahlbusch, Katharina Heusinger, Thomas Hildebrandt, Christiane Breuel, Ralf Dittrich
PURPOSE: The aim of this study was to determine the extent to which women's choice of contraceptive method depends on the advice received from their gynecologist and whether more intensive counseling might lead to more frequent use of long-acting reversible contraception (LARC). METHODS: A total of 1089 physicians and 18,521 women responded to 32 or 37 questions, respectively, using an online questionnaire. The women were asked about their current use of contraceptive methods, the extent of their satisfaction with them, their satisfaction with the counseling they had received, and whether they wanted to have more information about contraception...
April 22, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28433463/actin-regulation-by-tropomodulin-and-tropomyosin-in-neuronal-morphogenesis-and-function
#12
REVIEW
Kevin T Gray, Alla S Kostyukova, Thomas Fath
Actin is a profoundly influential protein; it impacts, among other processes, membrane morphology, cellular motility, and vesicle transport. Actin can polymerize into long filaments that push on membranes and provide support for intracellular transport. Actin filaments have polar ends: the fast-growing (barbed) end and the slow-growing (pointed) end. Depolymerization from the pointed end supplies monomers for further polymerization at the barbed end. Tropomodulins (Tmods) cap pointed ends by binding onto actin and tropomyosins (Tpms)...
April 19, 2017: Molecular and Cellular Neurosciences
https://www.readbyqxmd.com/read/28433015/probing-the-effects-of-surface-hydrophobicity-and-tether-orientation-on-antibody-antigen-binding
#13
Derek B Bush, Thomas A Knotts
Antibody microarrays have the potential to revolutionize molecular detection for many applications, but their current use is limited by poor reliability, and efforts to change this have not yielded fruitful results. One difficulty which limits the rational engineering of next-generation devices is that little is known, at the molecular level, about the antibody-antigen binding process near solid surfaces. Atomic-level structural information is scant because typical experimental techniques (X-ray crystallography and NMR) cannot be used to image proteins bound to surfaces...
April 21, 2017: Journal of Chemical Physics
https://www.readbyqxmd.com/read/28432211/recruiting-and-retaining-youth-and-young-adults-challenges-and-opportunities-in-survey-research-for-tobacco-control
#14
Jennifer Cantrell, Elizabeth C Hair, Alexandria Smith, Morgane Bennett, Jessica Miller Rath, Randall K Thomas, Mansour Fahimi, J Michael Dennis, Donna Vallone
INTRODUCTION: Evaluation studies of population-based tobacco control interventions often rely on large-scale survey data from numerous respondents across many geographic areas to provide evidence of their effectiveness. Significant challenges for survey research have emerged with the evolving communications landscape, particularly for surveying hard-to-reach populations such as youth and young adults. This study combines the comprehensive coverage of an address-based sampling (ABS) frame with the timeliness of online data collection to develop a nationally representative longitudinal cohort of young people aged 15-21...
April 21, 2017: Tobacco Control
https://www.readbyqxmd.com/read/28431579/protocole-of-a-controlled-before-after-evaluation-of-a-national-health-information-technology-based-program-to-improve-healthcare-coordination-and-access-to-information
#15
Florence Saillour-Glénisson, Sylvie Duhamel, Emmanuelle Fourneyron, Laetitia Huiart, Jean Philippe Joseph, Emmanuel Langlois, Stephane Pincemail, Viviane Ramel, Thomas Renaud, Tamara Roberts, Matthieu Sibé, Frantz Thiessard, Jerome Wittwer, Louis Rachid Salmi
BACKGROUND: Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization...
April 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28431536/-popping-nana-back-into-bed-a-qualitative-exploration-of-paramedic-decision-making-when-caring-for-older-people-who-have-fallen
#16
Paul Simpson, Ric Thomas, Jason Bendall, Bill Lord, Stephen Lord, Jacqueline Close
BACKGROUND: Older fallers constitute a large proportion of ambulance work, and as many as 25% are not transported to hospital following paramedic assessment. The objective of this study was to explore the decision making process used by paramedics when caring for older fallers. METHODS: A qualitative study was conducted using constructivist grounded theory methodology. Purposive sampling was used to recruit paramedics to participate in semi-structured interviews and focus groups...
April 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28430929/promoter-polymorphism-rs886205-genotype-interacts-with-dna-methylation-of-the-aldh2-regulatory-region-in-alcohol-dependence
#17
Hansi Pathak, Helge Frieling, Stefan Bleich, Alexander Glahn, Annemarie Heberlein, Mani Haschemi Nassab, Thomas Hillemacher, Alexandra Burkert, Mathias Rhein
Aims: Aldehyde dehydrogenase 2 (ALDH2) protects cells from ethanol toxicity by metabolizing acetaldehyde. We studied the single nucleotide polymorphism (SNP) rs886205s located between a negative and a positive regulating promoter element in the ALDH2 gene. The negative regulatory region was already associated with differential DNA methylation in the two allele variations of rs886205 SNP. Another CpG island, in the positive regulatory region of the ALDH2 promoter, extends through the SNP rs886205 and a nuclear receptor response element...
May 1, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28430190/tuning-underwater-adhesion-with-cation-%C3%AF-interactions
#18
Matthew A Gebbie, Wei Wei, Alex M Schrader, Thomas R Cristiani, Howard A Dobbs, Matthew Idso, Bradley F Chmelka, J Herbert Waite, Jacob N Israelachvili
Cation-π interactions drive the self-assembly and cohesion of many biological molecules, including the adhesion proteins of several marine organisms. Although the origin of cation-π bonds in isolated pairs has been extensively studied, the energetics of cation-π-driven self-assembly in molecular films remains uncharted. Here we use nanoscale force measurements in combination with solid-state NMR spectroscopy to show that the cohesive properties of simple aromatic- and lysine-rich peptides rival those of the strong reversible intermolecular cohesion exhibited by adhesion proteins of marine mussel...
May 2017: Nature Chemistry
https://www.readbyqxmd.com/read/28428613/differential-regulation-of-pkd-isoforms-in-oxidative-stress-conditions-through-phosphorylation-of-a-conserved-tyr-in-the-p-1-loop
#19
Mathias Cobbaut, Rita Derua, Heike Döppler, Hua Jane Lou, Sandy Vandoninck, Peter Storz, Benjamin E Turk, Thomas Seufferlein, Etienne Waelkens, Veerle Janssens, Johan Van Lint
Protein kinases are essential molecules in life and their crucial function requires tight regulation. Many kinases are regulated via phosphorylation within their activation loop. This loop is embedded in the activation segment, which additionally contains the Mg(2+) binding loop and a P + 1 loop that is important in substrate binding. In this report, we identify Abl-mediated phosphorylation of a highly conserved Tyr residue in the P + 1 loop of protein kinase D2 (PKD2) during oxidative stress. Remarkably, we observed that the three human PKD isoforms display very different degrees of P + 1 loop Tyr phosphorylation and we identify one of the molecular determinants for this divergence...
April 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28428155/using-persuasive-technology-to-increase-physical-activity-in-people-with-chronic-obstructive-pulmonary-disease-by-encouraging-regular-walking-a-mixed-methods-study-exploring-opinions-and-preferences
#20
Yvonne Kiera Bartlett, Thomas L Webb, Mark S Hawley
BACKGROUND: People with chronic obstructive pulmonary disease (PwCOPD) often experience breathlessness and fatigue, making physical activity challenging. Although many persuasive technologies (such as mobile phone apps) have been designed to support physical activity among members of the general population, current technologies aimed at PwCOPD are underdeveloped and only use a limited range of persuasive technology design principles. OBJECTIVE: The aim of this study was to explore how acceptable different persuasive technology design principles were considered to be in supporting and encouraging physical activity among PwCOPD...
April 20, 2017: Journal of Medical Internet Research
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