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Find video protocols related to scientific articles indexed in Pubmed.
Constitutional promoter methylation and risk of familial melanoma.
Epigenetics
PUBLISHED: 02-13-2014
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Constitutional epigenetic changes detected in blood or non-disease involving tissues have been associated with disease susceptibility. We measured promoter methylation of CDKN2A (p16 and p14ARF) and 13 melanoma-related genes using bisulfite pyrosequencing of blood DNA from 114 cases and 122 controls in 64 melanoma-prone families (26 segregating CDKN2A germline mutations). We also obtained gene expression data for these genes using microarrays from the same blood samples. We observed that CDKN2A epimutation is rare in melanoma families, and therefore is unlikely to cause major susceptibility in families without CDKN2A mutations. Although methylation levels for most gene promoters were very low (<5%), we observed a significantly reduced promoter methylation (odds ratio = 0.63, 95% confidence interval = 0.50, 0.80, P<0.001) and increased expression (fold change = 1.27, P = 0.048) for TNFRSF10C in melanoma cases. Future research in large prospective studies using both normal and melanoma tissues is required to assess the significance of TNFRSF10C methylation and expression changes in melanoma susceptibility.
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LINE-1 methylation in peripheral blood and the risk of melanoma in melanoma-prone families with and without CDKN2A mutations.
Melanoma Res.
PUBLISHED: 06-19-2013
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Cutaneous malignant melanoma (CMM) is an etiologically heterogenous disease with genetic, environmental (sun exposure), and host (pigmentation/nevi) factors and their interactions contributing to risk. Recently, epigenetic changes involving reduced levels of global DNA methylation in blood have been associated with genomic instability and cancer risk. We thus examined whether global methylation was associated with CMM risk in individuals from melanoma-prone families with and without CDKN2A germline mutations. We measured global DNA methylation using bisulfite pyrosequencing at four CpG sites of the long interspersed nucleotide element-1 (LINE-1) sequences in peripheral blood mononuclear cells (PBMCs) from individuals in 64 melanoma-prone families including 114 CMM cases (45 CDKN2A-positive and 69 CDKN2A-negative) and 121 unaffected individuals (31 CDKN2A-positive and 90 CDKN2A-negative). We used unconditional logistic regression to evaluate the association between CMM status and LINE-1 methylation levels, adjusting for age at blood draw and accounting for familial correlation in the variance. We found that male sex was significantly associated with higher overall LINE-1 methylation (P=0.0001). However, the overall and site-specific levels of LINE-1 methylation did not vary significantly by CMM status (overall odds ratio: 1.57, 95% confidence interval: 0.84-2.95, P=0.16; comparing lowest to highest or reference methylation group). Similar results were obtained when CDKN2A-positive and CDKN2A-negative families were analyzed separately. Our findings did not support a significant association between constitutional LINE-1 methylation in PBMCs and risk of CMM in melanoma-prone families with or without CDKN2A mutations.
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Association of Genetic Variants in CDK6 and XRCC1 with the Risk of Dysplastic Nevi in Melanoma-Prone Families.
J. Invest. Dermatol.
PUBLISHED: 05-01-2013
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Dysplastic nevi (DN) is a strong risk factor for cutaneous malignant melanoma (CMM), and it frequently occurs in melanoma-prone families. To identify genetic variants for DN, we genotyped 677 tagSNPs in 38 melanoma candidate genes that are involved in pigmentation, DNA repair, cell cycle control, and melanocyte proliferation pathways in a total of 504 individuals (310 with DN, 194 without DN) from 53 melanoma-prone families (23 CDKN2A mutation positive and 30 negative). Conditional logistic regression, conditioning on families, was used to estimate the association between DN and each single-nucleotide polymorphism (SNP) separately, adjusted for age, sex, CMM, and CDKN2A status. P-values for SNPs in the same gene were combined to yield gene-specific P-values. Two genes, CDK6 (cyclin-dependent kinase 6) and XRCC1, were significantly associated with DN after Bonferroni correction for multiple testing (P=0.0001 and 0.00025, respectively), whereas neither gene was significantly associated with CMM. Associations for CDK6 SNPs were stronger in CDKN2A mutation-positive families (rs2079147, Pinteraction=0.0033), whereas XRCC1 SNPs had similar effects in mutation-positive and -negative families. The association for one of the associated SNPs in XRCC1 (rs25487) was replicated in two independent data sets (random-effect meta-analysis: P<0.0001). Our findings suggest that some genetic variants may contribute to DN risk independently of their association with CMM in melanoma-prone families.Journal of Investigative Dermatology advance online publication, 29 August 2013; doi:10.1038/jid.2013.316.
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The effect of an ambulance diversion ban on emergency department length of stay and ambulance turnaround time.
Ann Emerg Med
PUBLISHED: 01-24-2013
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Massachusetts became the first state in the nation to ban ambulance diversion in 2009. It was feared that the diversion ban would lead to increased emergency department (ED) crowding and ambulance turnaround time. We seek to characterize the effect of a statewide ambulance diversion ban on ED length of stay and ambulance turnaround time at Boston-area EDs.
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Telomere length and the risk of cutaneous malignant melanoma in melanoma-prone families with and without CDKN2A mutations.
PLoS ONE
PUBLISHED: 01-01-2013
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Recent evidence suggests a link between constitutional telomere length (TL) and cancer risk. Previous studies have suggested that longer telomeres were associated with an increased risk of melanoma and larger size and number of nevi. The goal of this study was to examine whether TL modified the risk of melanoma in melanoma-prone families with and without CDKN2A germline mutations.
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Effect of rituximab on physical function and quality of life in patients with rheumatoid arthritis previously untreated with methotrexate.
Arthritis Care Res (Hoboken)
PUBLISHED: 05-11-2011
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To assess the effect of rituximab plus methotrexate (MTX) compared with MTX alone on patient-reported outcomes (PROs) and health-related quality of life (HRQOL) in patients with active early rheumatoid arthritis (RA) previously untreated with MTX.
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Emergency department utilization after the implementation of Massachusetts health reform.
Ann Emerg Med
PUBLISHED: 01-06-2011
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Health care reform in Massachusetts improved access to health insurance, but the extent to which reform affected utilization of the emergency department (ED) for conditions potentially amenable to primary care is unclear. Our objective is to determine the relationship between health reform and ED use for low-severity conditions.
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Factors affecting home care patients acceptance of a web-based interactive self-management technology.
J Am Med Inform Assoc
PUBLISHED: 12-03-2010
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With the advent of personal health records and other patient-focused health technologies, there is a growing need to better understand factors that contribute to acceptance and use of such innovations. In this study, we employed the Unified Theory of Acceptance and Use of Technology as the basis for determining what predicts patients acceptance (measured by behavioral intention) and perceived effective use of a web-based, interactive self-management innovation among home care patients.
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Technology-enhanced practice for patients with chronic cardiac disease: home implementation and evaluation.
Heart Lung
PUBLISHED: 08-10-2010
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This 3-year field experiment engaged 60 nurses and 282 patients in the design and evaluation of an innovative home-care nursing model, referred to as technology-enhanced practice (TEP).
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Do outcomes of near syncope parallel syncope?
Am J Emerg Med
PUBLISHED: 06-23-2010
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Limited information on the evaluation of emergency department (ED) patients complaining of "near syncope" exists. Multiple studies of syncope exclude near syncope claiming near syncope is poorly defined and its definition is nonuniform.
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AcuteCare for Elders (ACE) tracker and e-Geriatrician: methods to disseminate ACE concepts to hospitals with no geriatricians on staff.
J Am Geriatr Soc
PUBLISHED: 02-04-2010
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This article describes an innovative method to disseminate the Acute Care for Elders (ACE) model of care for hospitalized older patients implemented at 11 community hospitals in Wisconsin. The ACE Tracker is a computer-generated checklist of all older patients in a facility that takes information from multiple areas of the electronic medical record to identify the older patients risk factors for functional decline and poor outcomes. The ACE Tracker report was validated against in-person observation of the older patients and found to be accurate. Interdisciplinary teams on medical-surgical units use this summary report to review each patients plan of care and to efficiently assess the patients who are vulnerable to poor hospital outcomes. The ACE Tracker is also used during regular consultation provided through teleconferencing between an off-site geriatrician (e-Geriatrician) and the local ACE team. The effect of the ACE Tracker and e-Geriatrician models was assessed by measuring use of urinary catheters, physical restraints, high-risk medications, and social service evaluation at a single hospital for the 6 months before and after implementation of the models. There were significant improvements in urinary catheter and physical therapy referrals but no significant changes in the other outcomes. There was no change in the length of stay or in the rate of hospital readmission within 30 days.
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Human factors and ergonomics in home care: Current concerns and future considerations for health information technology.
Work
PUBLISHED: 08-29-2009
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Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management. Currently, a variety of health information technologies (HITs) are being promoted as possible solutions to those problems, but those same technologies bring with them a new set of HFE concerns. This paper reviews the HFE considerations for information access, communication, and patients self-monitoring and self-management, discusses how HIT can potentially mitigate current problems, and explains how the design and implementation of HIT itself requires careful HFE attention.
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An IT innovation for individualizing care: success with clinicians leading the way.
Stud Health Technol Inform
PUBLISHED: 07-14-2009
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In 2004, the Knowledge-based Nursing Initiative (KBNI) began as a partnership between a university-based college of nursing, an informatics vendor, and a large, integrated health care system. The goal was to develop a process for translating evidence into actionable recommendations, embedding the recommendations into the computerized decision support and documentation systems, and supporting nurses use of the nursing process to individualize care. This paper will describe the essential administrative, information technology (IT), educational and clinical support activities that were used to deploy this innovation into the electronic health record (EHR) and workflow of nurses on two acute care medical pilot units in July of 2008. The project supported every nurse to document their evidenced-based practice with each patient contact and populate the EHR database with rich, nursing sensitive, retrievable data for quality improvement and research. The results included verifying data reliability and validity, evaluating go-live preparation, and summarizing the qualitative and quantitative findings. Two critical factors that made this implementation a success were that the project had a transformational vision and that it was led by the clinical team and strongly supported by the IT team. The lessons learned in the adoption phase will be diffused to the rest of the health care system and beyond.
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HeartCareII: patients use of a home care web resource.
Stud Health Technol Inform
PUBLISHED: 07-14-2009
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In a six-month randomized field experiment our team evaluated the impact of a technology-enhanced practice (TEP) model compared to the usual care delivered by home care nurses. Research staff provided computers and technical assistance; home care visit nurses trained patients in the use of the components of the HeartCareII website most relevant to their care needs. The purpose of this paper is to explore participant exposure to the web-based HeartCareII resources, the technical core of the TEP. To assess exposure to the HeartCareII resources we counted logins, the number of accesses to the system, over each participants study period. We determined that more logins occurred during the first four weeks of the participants time in the study, with 50 percent continuing to logon after 4 weeks. The number of participants accessing the system declined during the ensuing weeks to approximately one-third at eight weeks; almost 15 percent consistently logged in throughout their 24-week course in the experiment. This pattern of exposure to such web-based resources is consistent with findings of prior studies; it may support an episodic need for health resources in the home based on changing health demands.
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A theory-based problem-solving approach to recruitment challenges in a large randomized field trial.
Appl Nurs Res
PUBLISHED: 05-26-2009
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Despite best-laid plans, recruitment problems arise in large field trials. Research teams must work hard on problem solving and push comfort zones to sustain recruitment and accrual levels. A systematic theory-based problem-solving approach helped us look deeply for challenges and implement strategies continuously to sustain accrual to our target enrollment.
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Emergency department use by the uninsured after health care reform in Massachusetts.
Intern Emerg Med
PUBLISHED: 03-12-2009
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The objective of this article is to determine if health care reform in Massachusetts in 2006 was associated with a change in ED utilization by the uninsured for asthma and upper respiratory tract infection (URI). We performed a retrospective pre-post study in an urban tertiary-care teaching hospital. Subjects included all patients, ages 2-54, who presented to the ED with asthma or URI from January 1 to July 31 for each of the 3 years before health care reform and for the period after the insurance mandate officially went into effect on January 1, 2008. We used chi-square analysis to compare the frequency of utilization of the ED by uninsured patients before and after the implementation of an individual health insurance mandate in Massachusetts. For the period before the implementation of health reform, an annual average of 301 ED visits for patients with either URI (average n = 131) or asthma (average n = 170) were identified. After health care reform, there were 366 visits found for URI (n = 132) and asthma (n = 234) over a similar time period. There was a statistically significant decrease in ED utilization by the uninsured for URI but not for asthma. As a secondary analysis, visits for patients covered by the uncompensated care pool (UCP) before health care reform was not different from the combined frequency of visits by the remaining uninsured covered by a health safety net pool and those who qualified for the state subsidized Commonwealth Care program after health care reform. In this study, health care reform was associated with a decrease in the number of uninsured patients who presented to the ED with URI but not asthma. This study is limited by its analysis of a single large institution and a limited set of diagnoses.
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On the interplay of telomeres, nevi and the risk of melanoma.
PLoS ONE
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The relationship between telomeres, nevi and melanoma is complex. Shorter telomeres have been found to be associated with many cancers and with number of nevi, a known risk factor for melanoma. However, shorter telomeres have also been found to decrease melanoma risk. We performed a systematic analysis of telomere-related genes and tagSNPs within these genes, in relation to the risk of melanoma, dysplastic nevi, and nevus count combining data from four studies conducted in Italy. In addition, we examined whether telomere length measured in peripheral blood leukocytes is related to the risk of melanoma, dysplastic nevi, number of nevi, or telomere-related SNPs. A total of 796 cases and 770 controls were genotyped for 517 SNPs in 39 telomere-related genes genotyped with a custom-made array. Replication of the top SNPs was conducted in two American populations consisting of 488 subjects from 53 melanoma-prone families and 1,086 cases and 1,024 controls from a case-control study. We estimated odds ratios for associations with SNPs and combined SNP P-values to compute gene region-specific, functional group-specific, and overall P-value using an adaptive rank-truncated product algorithm. In the Mediterranean population, we found suggestive evidence that RECQL4, a gene involved in genome stability, RTEL1, a gene regulating telomere elongation, and TERF2, a gene implicated in the protection of telomeres, were associated with melanoma, the presence of dysplastic nevi and number of nevi, respectively. However, these associations were not found in the American samples, suggesting variable melanoma susceptibility for these genes across populations or chance findings in our discovery sample. Larger studies across different populations are necessary to clarify these associations.
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Applying the Boston syncope criteria to near syncope.
J Emerg Med
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We recently demonstrated that near-syncope patients are as likely as syncope patients to experience adverse outcomes. The Boston Syncope Criteria (BSC) identify patients with syncope unlikely to have adverse outcomes and reduce hospitalizations. It is unclear whether these guidelines could reduce hospitalization in near syncope as well.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.