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Find video protocols related to scientific articles indexed in Pubmed.
Maintenance of Nucleosomal Balance in cis by Conserved AAA-ATPase Yta7.
Genetics
PUBLISHED: 11-20-2014
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The extent of chromatin compaction is a fundamental driver of nuclear metabolism. Yta7 is a chromatin-associated AAA-ATPase whose human ortholog ANCCA/ATAD2 transcriptionally activates pathways of malignancy in a broad range of cancers. Yta7 directly binds histone H3, and bulk chromatin exhibits increased nucleosomal density in yta7? mutants. The suppression of yta7? mutant growth and transcriptional phenotypes in budding yeast by decreased dosage of histones H3 and H4 indicates the acute sensitivity of cells to deviations in nucleosome spacing. This study investigated the global changes in chromatin structure upon Yta7 loss or over-expression and determined which of these effects reflected direct Yta7 activity. Metagene analysis of Yta7's genome-wide localization indicated peak binding of Yta7 just downstream of the transcription start site. Cells lacking Yta7 exhibited increased nucleosome density within genes downstream of the +1 nucleosome, as defined by decreased inter-nucleosomal distance, resulting in progressively 5'-shifted nucleosomes within the gene. In contrast, cells over-expressing Yta7 displayed profound 3'-shifts in nucleosome position and reduced nucleosome density within genes. Importantly, Yta7-bound regions were enriched for nucleosomal shifts, indicating that Yta7 acted locally to modulate nucleosome spacing. The phenotype of cells lacking both Yta7 and Rtt106, the histone H3/H4 chaperone, indicated that Yta7 functions in both Rtt106-dependent and Rtt106-independent ways to modulate nucleosome spacing within genes. This study suggested that Yta7 affected nucleosome density throughout the gene by both blocking Rtt106 from entering the gene, as shown previously at HTA1, and by facilitating the loss of nucleosomes from the 5'-end.
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Emergence of order from turbulence in an isolated planar superfluid.
Phys. Rev. Lett.
PUBLISHED: 10-17-2014
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We study the relaxation dynamics of an isolated zero temperature quasi-two-dimensional superfluid Bose-Einstein condensate that is imprinted with a spatially random distribution of quantum vortices. Following a period of vortex annihilation the remaining vortices self-organize into two macroscopic coherent "Onsager vortex" clusters that are stable indefinitely-despite the absence of driving or external dissipation in the dynamics. We demonstrate that this occurs due to a novel physical mechanism-the evaporative heating of the vortices-that results in a negative-temperature phase transition in the vortex degrees of freedom. At the end of our simulations the system is trapped in a nonthermal state. Our computational results provide a pathway to observing Onsager vortex states in a superfluid Bose gas.
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Using an international clinical registry of regional anesthesia to identify targets for quality improvement.
Reg Anesth Pain Med
PUBLISHED: 10-03-2014
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Despite the widespread use of regional anesthesia, limited information on clinical performance exists. Institutions, therefore, have little knowledge of how they are performing in regard to both safety and effectiveness. In this study, we demonstrate how a medical institution (or physician/physician group) may use data from a multicenter clinical registry of regional anesthesia to inform quality improvement strategies.
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Parental awareness and use of online physician rating sites.
Pediatrics
PUBLISHED: 09-22-2014
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The US public is increasingly using online rating sites to make decisions about a variety of consumer goods and services, including physicians. We sought to understand, within the context of other types of rating sites, parents' awareness, perceptions, and use of physician-rating sites for choosing primary care physicians for their children.
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Increasing hospitalizations in inflammatory bowel disease among children in the United States, 1988-2011.
Inflamm. Bowel Dis.
PUBLISHED: 09-05-2014
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Our objective was to characterize national trends in inflammatory bowel disease (IBD)-related hospitalizations for children. We hypothesized that over time, improvements in care would be associated with a decrease in hospitalization rates, similar to what has been observed in Canadian children with IBD.
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Spatio-temporal information and knowledge representation of disease incidence and respective intervention strategies.
Stud Health Technol Inform
PUBLISHED: 08-28-2014
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The supplementation of medical data with environmental data offers rich new insights that can improve decision-making within health systems and the healthcare profession. In this study, we simulate disease incidence for various scenarios using a mathematical model. We subsequently visualise the infectious disease spread in human populations over time and geographies. We demonstrate this for malaria, which is one of the top three causes of mortality for children under the age of 5 years in sub-Saharan Africa, and its associated interventions within Kenya. We demonstrate how information can be collected, analysed, and presented in new ways to inform key decision makers in understanding the prevalence of disease and the response to interventions.
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The first report of luminescent liver tissue in fishes: Evolution and structure of bioluminescent organs in the deep-sea naked barracudinas (Aulopiformes: Lestidiidae).
J. Morphol.
PUBLISHED: 08-27-2014
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Bioluminescent organs that provide ventral camouflage are common among fishes in the meso-bathypelagic zones of the deep sea. However, the anatomical structures that have been modified to produce light vary substantially among different groups of fishes. Although the anatomical structure and evolutionary derivation of some of these organs have been well studied, the light organs of the naked barracudinas have received little scientific attention. This study describes the anatomy and evolution of bioluminescent organs in the Lestidiidae (naked barracudinas) in the context of a new phylogeny of barracudinas and closely related alepisauroid fishes. Gross and histological examination of bioluminescent organs or homologous structures from preserved museum specimens indicate that the ventral light organ is derived from hepatopancreatic tissue and that the antorbital spot in Lestrolepis is, in fact, a second dermal light organ. In the context of the phylogeny generated from DNA-sequence data from eight gene fragments (7 nuclear and 1 mitochondrial), a complex liver with a narrow ventral strand running along the ventral midline evolves first in the Lestidiidae. The ventral hepatopancreatic tissue later evolves into a ventral bioluminescent organ in the ancestor of Lestidium and Lestrolepis with the lineage leading to the genus Lestrolepis evolving a dermal antorbital bioluminescent organ, likely for light-intensity matching. This is the first described hepatopancreatic bioluminescent organ in fishes. J. Morphol., 2014. © 2014 Wiley Periodicals, Inc.
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The Effects of Medical Management on the Progression of Diabetic Retinopathy in Persons with Type 2 Diabetes: The Action to Control Cardiovascular Risk in Diabetes Eye Study.
Ophthalmology
PUBLISHED: 08-26-2014
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To report additional ocular outcomes of intensive treatment of hyperglycemia, blood pressure, and dyslipidemia in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.
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The Trauma Center Organizational Culture Survey: development and conduction.
J. Surg. Res.
PUBLISHED: 07-29-2014
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The Trauma Center Organizational Culture Survey (TRACCS) instrument was developed to assess organizational culture of trauma centers enrolled in the American College of Surgeons Trauma Quality Program (ACS TQIP). The objective is to provide evidence on the psychometric properties of the factors of TRACCS and describe the current organizational culture of TQIP-enrolled trauma centers.
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Nonequilibrium dynamics of one-dimensional hard-core anyons following a quench: complete relaxation of one-body observables.
Phys. Rev. Lett.
PUBLISHED: 07-29-2014
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We demonstrate the role of interactions in driving the relaxation of an isolated integrable quantum system following a sudden quench. We consider a family of integrable hard-core lattice anyon models that continuously interpolates between noninteracting spinless fermions and strongly interacting hard-core bosons. A generalized Jordan-Wigner transformation maps the entire family to noninteracting fermions. We find that, aside from the singular free-fermion limit, the entire single-particle density matrix and, therefore, all one-body observables relax to the predictions of the generalized Gibbs ensemble (GGE). This demonstrates that, in the presence of interactions, correlations between particles in the many-body wave function provide the effective dissipation required to drive the relaxation of all one-body observables to the GGE. This relaxation does not depend on translational invariance or the tracing out of any spatial domain of the system.
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Melatonin inhibits thermal injury-induced hyperpermeability in microvascular endothelial cells.
J Trauma Acute Care Surg
PUBLISHED: 07-23-2014
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Burns induce systemic inflammatory reactions and vascular hyperpermeability. Breakdown of endothelial cell adherens junctions is integral in this process, and reactive oxygen species (ROS) and proteolytic enzymes such as matrix metalloproteinase-9 (MMP-9) play pivotal roles therein. Outside trauma, melatonin has shown to exhibit anti-MMP activity and to be a powerful antioxidant. Consequently, we hypothesized that burn-induced junctional damage and hyperpermeability could be attenuated with melatonin.
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Efficacy and safety of aciclovir mucoadhesive buccal tablet in immunocompetent patients with labial herpes (LIP Trial): a double-blind, placebo-controlled, self-initiated trial.
J Drugs Dermatol
PUBLISHED: 07-10-2014
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Single-day, high-dose systemic antiviral drugs are effective in the treatment of labial herpes (herpes labialis [HL]). Aciclovir Lauriad® mucoadhesive buccal tablet (ABT) is an innovative drug delivery system providing high and prolonged exposure to aciclovir in the oral cavity, supporting its evaluation as a single low dose in HL.
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A framework for evaluating student perceptions of health policy training in medical school.
Acad Med
PUBLISHED: 07-10-2014
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Nearly half of graduating medical students in the United States report that medical school provides inadequate instruction in topics related to health policy. Although most medical schools report some form of policy education, there lacks a standard for teaching core concepts and evaluating student satisfaction.
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Emergency department and urgent care for children excluded from child care.
Pediatrics
PUBLISHED: 06-25-2014
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Children in child care are frequently unnecessarily excluded for illness. We investigated parental use of urgent medical evaluation for sick children unable to attend child care.
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Characterization of the novel positive allosteric modulator of the metabotropic glutamate receptor 4 ADX88178 in rodent models of neuropsychiatric disorders.
J. Pharmacol. Exp. Ther.
PUBLISHED: 06-19-2014
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There is growing evidence that activation of metabotropic glutamate receptor 4 (mGlu4) leads to anxiolytic- and antipsychotic-like efficacy in rodent models, yet its relevance to depression-like reactivity remains unclear. Here, we present the pharmacological evaluation of ADX88178 [5-methyl-N-(4-methylpyrimidin-2-yl)-4-(1H-pyrazol-4-yl)thiazol-2-amine], a novel potent, selective, and brain-penetrant positive allosteric modulator of the mGlu4 receptor in rodent models of anxiety, obsessive compulsive disorder (OCD), fear, depression, and psychosis. ADX88178 dose-dependently reduced the number of buried marbles in the marble burying test and increased open-arm exploration in the elevated plus maze (EPM) test, indicative of anxiolytic-like efficacy. Target specificity of the effect in the EPM test was confirmed using male and female mGlu4 receptor knockout mice. In mice, ADX88178 reduced the likelihood of conditioned freezing in the acquisition phase of the fear conditioning test, yet had no carryover effect in the expression phase. Also, ADX88178 dose-dependently reduced duration of immobility in the forced swim test, indicative of antidepressant-like efficacy. ADX88178 reduced DOI (2,5-dimethoxy-4-iodoamphetamine)-mediated head twitches (albeit with no dose-dependency), and MK-801 [(5S,10R)-(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine]-induced locomotor hyperactivity in mice, but was inactive in the conditioned avoidance response test in rats. The compound showed good specificity as it had no effect on locomotor activity in mice and rats at efficacious doses. Thus, allosteric activation of mGlu4 receptors can be a promising new therapeutic approach for treatment of anxiety, OCD, fear-related disorders, and psychosis.
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Imaging chronic traumatic brain injury as a risk factor for neurodegeneration.
Alzheimers Dement
PUBLISHED: 06-14-2014
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Population-based studies have supported the hypothesis that a positive history of traumatic brain injury (TBI) is associated with an increased incidence of neurological disease and psychiatric comorbidities, including chronic traumatic encephalopathy, Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. These epidemiologic studies, however, do not offer a clear definition of that risk, and leave unanswered the bounding criteria for greater lifetime risk of neurodegeneration. Key factors that likely mediate the degree of risk of neurodegeneration include genetic factors, significant premorbid and comorbid medical history (e.g. depression, multiple head injuries and repetitive subconcussive impact to the brain, occupational risk, age at injury, and severity of brain injury). However, given the often-described concerns in self-report accuracy as it relates to history of multiple TBIs, low frequency of patient presentation to a physician in the case of mild brain injuries, and challenges with creating clear distinctions between injury severities, disentangling the true risk for neurodegeneration based solely on population-based studies will likely remain elusive. Given this reality, multiple modalities and approaches must be combined to characterize who are at risk so that appropriate interventions to alter progression of neurodegeneration can be evaluated. This article presents data from a study that highlights uses of neuroimaging and areas of needed research in the link between TBI and neurodegenerative disease.
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Obesity prevalence among reproductive-aged women by number of live births: United States, 2001-2010.
Obstet Gynecol
PUBLISHED: 04-29-2014
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Despite intense clinical and public health attention, the high prevalence of obesity among U.S. women has persisted over the past decade. How childbirth may contribute to obesity prevalence at the population level is unclear. We evaluated a 10-year trend in obesity prevalence among women stratified by number of live births.
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Impact of Medicare Part D on out-of-pocket drug costs and medical use for patients with cancer.
Cancer
PUBLISHED: 04-10-2014
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Medicare Part D was designed to reduce out-of-pocket (OOP) costs for Medicare beneficiaries, but to the authors' knowledge the extent to which this occurred for patients with cancer has not been measured to date. The objective of the current study was to examine the impact of Medicare Part D eligibility on OOP cost for prescription drugs and use of medical services among patients with cancer.
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Tumor necrosis factor-? disruption of brain endothelial cell barrier is mediated through matrix metalloproteinase-9.
Am. J. Surg.
PUBLISHED: 03-28-2014
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Traumatic brain injuries cause vascular hyperpermeability. Tumor necrosis factor-? (TNF-?), matrix metalloproteinase-9 (MMP-9), and caspase-3 may be important in these processes but the relationship between them has not been investigated. We hypothesized that TNF-? regulates caspase-3-mediated hyperpermeability and blood brain barrier damage and hyperpermeability directly or indirectly via activation of MMP-9. To test this, rat brain microvascular endothelial cells were treated with TNF-? with or without inhibition of MMP-9. Monolayer permeability was measured, zonula occludens-1 and F-actin configuration were examined, and MMP-9 and caspase-3 activities were quantified. TNF-? increased monolayer permeability, damaged zonula occludens-1, induced filamentous-actin stress fiber formation, and increased both MMP-9 and caspase-3 activities. Inhibition of MMP-9 attenuated these changes. These data highlight a novel link between TNF-? and MMP-9 and show that TNF-? regulated caspase-3-mediated hyperpermeability and vascular damage may be linked to MMP-9 in vitro. These findings augment the understanding of traumatic brain injury and pave the way for improved treatment.
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Pediatric Asthma Readmission: Asthma Knowledge Is Not Enough?
J. Pediatr.
PUBLISHED: 03-28-2014
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To characterize factors associated with readmission for acute asthma exacerbation, particularly around caregiver asthma knowledge, beliefs, and reported adherence to prescribed medication regimens.
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Specialist participation in healthcare delivery transformation: influence of patient self-referral.
Am J Manag Care
PUBLISHED: 03-28-2014
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Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base.
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Epidemiology of foot and ankle fractures in the United States: an analysis of the National Trauma Data Bank (2007 to 2011).
J Foot Ankle Surg
PUBLISHED: 03-17-2014
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Understanding the epidemiology of foot and ankle trauma could be useful in health services research and for policy makers. It can also define practice patterns. Using the National Trauma Data Bank data set from 2007 to 2011, we analyzed the frequency and proportion of each fracture in the foot and ankle in major trauma hospitals in the United States. A total of 280,933 foot and/or ankle fractures or dislocations were identified. Although oversampling of more severe trauma in younger patients might have occurred owing to the nature of the data set, we found that the most common fractures in the foot and ankle were ankle fractures. Midfoot fractures were the least common among all the foot and ankle fractures when categorized by anatomic location. Approximately 20% of all foot and ankle fractures were open.
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Outpatient laparoscopic appendectomy should be the standard of care for uncomplicated appendicitis.
J Trauma Acute Care Surg
PUBLISHED: 02-27-2014
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In 2012, a protocol for routine outpatient laparoscopic appendectomy for uncomplicated appendicitis was published reflecting high success, low morbidity, and significant cost savings. Despite this, national data reflect that the majority of laparoscopic appendectomies are performed with overnight admission. This study updates our experience with outpatient appendectomy since our initial report, confirming the efficacy of this approach.
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Extracellular Vesicles from Neural Stem Cells Transfer IFN-? via Ifngr1 to Activate Stat1 Signaling in Target Cells.
Mol. Cell
PUBLISHED: 02-25-2014
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The idea that stem cell therapies work only via cell replacement is challenged by the observation of consistent intercellular molecule exchange between the graft and the host. Here we defined a mechanism of cellular signaling by which neural stem/precursor cells (NPCs) communicate with the microenvironment via extracellular vesicles (EVs), and we elucidated its molecular signature and function. We observed cytokine-regulated pathways that sort proteins and mRNAs into EVs. We described induction of interferon gamma (IFN-?) pathway in NPCs exposed to proinflammatory cytokines that is mirrored in EVs. We showed that IFN-? bound to EVs through Ifngr1 activates Stat1 in target cells. Finally, we demonstrated that endogenous Stat1 and Ifngr1 in target cells are indispensable to sustain the activation of Stat1 signaling by EV-associated IFN-?/Ifngr1 complexes. Our study identifies a mechanism of cellular signaling regulated by EV-associated IFN-?/Ifngr1 complexes, which grafted stem cells may use to communicate with the host immune system.
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Community health workers and the Patient Protection and Affordable Care Act: an opportunity for a research, advocacy, and policy agenda.
J Health Care Poor Underserved
PUBLISHED: 02-11-2014
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Community health workers (CHWs), who have been shown to be effective in multiple roles in the provision of culturally appropriate health care in a variety of settings, have the potential to be important members of an interdisciplinary health care team. Recent efforts have started to explore how best to integrate CHWs into the health system. However, to date, there has been limited policy guidance, support, or evidence on how best to achieve this on a larger scale. The Patient Protection and Affordable Care Act (ACA), through several provisions, provides a unique opportunity to create a unified framework for workforce integration and wider utilization of CHWs. This review identifies four major opportunities to further the research, advocacy, and policy agenda for CHWs.
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Species-specific bioluminescence facilitates speciation in the deep sea.
Mar. Biol.
PUBLISHED: 02-05-2014
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The vast darkness of the deep sea is an environment with few obvious genetic isolating barriers, and little is known regarding the macroevolutionary processes that have shaped present-day biodiversity in this habitat. Bioluminescence, the production and emission of light from a living organism through a chemical reaction, is thought to occur in approximately 80 % of the eukaryotic life that inhabits the deep sea (water depth greater than 200 m). In this study, we show, for the first time, that deep-sea fishes that possess species-specific bioluminescent structures (e.g., lanternfishes, dragonfishes) are diversifying into new species at a more rapid rate than deep-sea fishes that utilize bioluminescence in ways that would not promote isolation of populations (e.g., camouflage, predation). This work adds to our understanding of how life thrives and evolution shaped present-day biodiversity in the deep sea, the largest and arguably least explored habitat on earth.
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Phase 3 trial evaluating the immunogenicity and safety of a three-dose BioThrax® regimen for post-exposure prophylaxis in healthy adults.
Vaccine
PUBLISHED: 01-23-2014
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This study was conducted to support licensure of a post-exposure prophylaxis indication for BioThrax(®) (anthrax vaccine adsorbed) concurrent with antimicrobials for individuals exposed to aerosolized anthrax spores.
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Public interest in medical research participation: differences by volunteer status and study type.
Clin Transl Sci
PUBLISHED: 01-23-2014
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We assessed national levels of public interest in medical research participation (MRP) and factors associated with interest as a healthy volunteer; as a diagnosed volunteer; and in seven study types.
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Ten-year follow-up of age-related macular degeneration in the age-related eye disease study: AREDS report no. 36.
JAMA Ophthalmol
PUBLISHED: 01-04-2014
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Providing long-term follow-up of the natural history of age-related macular degeneration (AMD) and associated risk factors will facilitate future epidemiologic studies and clinical trials.
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The covert world of fish biofluorescence: a phylogenetically widespread and phenotypically variable phenomenon.
PLoS ONE
PUBLISHED: 01-01-2014
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The discovery of fluorescent proteins has revolutionized experimental biology. Whereas the majority of fluorescent proteins have been identified from cnidarians, recently several fluorescent proteins have been isolated across the animal tree of life. Here we show that biofluorescence is not only phylogenetically widespread, but is also phenotypically variable across both cartilaginous and bony fishes, highlighting its evolutionary history and the possibility for discovery of numerous novel fluorescent proteins. Fish biofluorescence is especially common and morphologically variable in cryptically patterned coral-reef lineages. We identified 16 orders, 50 families, 105 genera, and more than 180 species of biofluorescent fishes. We have also reconstructed our current understanding of the phylogenetic distribution of biofluorescence for ray-finned fishes. The presence of yellow long-pass intraocular filters in many biofluorescent fish lineages and the substantive color vision capabilities of coral-reef fishes suggest that they are capable of detecting fluoresced light. We present species-specific emission patterns among closely related species, indicating that biofluorescence potentially functions in intraspecific communication and evidence that fluorescence can be used for camouflage. This research provides insight into the distribution, evolution, and phenotypic variability of biofluorescence in marine lineages and examines the role this variation may play.
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Doxycycline attenuates burn-induced microvascular hyperpermeability.
J Trauma Acute Care Surg
PUBLISHED: 11-22-2013
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Burns induce systemic microvascular hyperpermeability resulting in shock, and if untreated, cardiovascular collapse. Damage to the endothelial cell adherens junctional complex plays an integral role in the pathophysiology of microvascular hyperpermeability. We hypothesized that doxycycline, a known inhibitor of matrix metalloproteinases (MMPs), could attenuate burn-induced adherens junction damage and microvascular hyperpermeability.
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Infant hospitalizations for pertussis before and after Tdap recommendations for adolescents.
Pediatrics
PUBLISHED: 10-21-2013
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Recent universal vaccination efforts among children in the United States have markedly changed hospitalization patterns for many vaccine-preventable diseases. Infants with pertussis often require hospitalization to monitor for potentially life-threatening respiratory failure. In 2006, tetanus-diphtheria-acellular pertussis (Tdap) vaccination was recommended for universal administration to adolescents, a known source of pertussis in infants. By 2011, 78% of adolescents in the United States had received Tdap. We sought to understand if patterns of pertussis hospitalization for infants changed with adoption of Tdap vaccination among adolescents.
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Health Care Quality Improvement Publication Trends.
Am J Med Qual
PUBLISHED: 10-07-2013
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To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991.
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Pediatric hospital discharge interventions to reduce subsequent utilization: A systematic review.
J Hosp Med
PUBLISHED: 10-01-2013
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Reducing avoidable readmission and posthospitalization emergency department (ED) utilization has become a focus of quality-of-care measures and initiatives. For pediatric patients, no systematic efforts have assessed the evidence for interventions to reduce these events.
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A Prospective Evaluation of the Utility of the Prehospital 12-lead Electrocardiogram to Change Patient Management in the Emergency Department.
Prehosp Emerg Care
PUBLISHED: 09-12-2013
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Abstract Objective. Retrospective research has shown that 19% of 12-lead prehospital electrocardiograms (prehospital ECGs) had clinically significant abnormalities that were not captured on the initial emergency department (ED) ECG and had the potential to change medical management. The purpose of this study was to prospectively determine how many prehospital ECGs had clinically significant abnormalities not present on the initial ED ECG and determine how many prehospital ECGs changed physician management. Methods. We conducted a 3-month, prospective cohort study of patients who had a 12-lead prehospital ECG completed by EMS prior to arriving at one of two tertiary care EDs. STEMI bypass patients were excluded. Physicians reviewed the prehospital ECG to determine whether there were any clinically significant abnormalities present on the prehospital ECG not captured on the initial ED ECG. Physicians recorded if and how the prehospital ECG changed their management. Results. A total of 281 patients were enrolled. Thirty-five (12.5%; 95% CI: 9.1%, 16.8%) prehospital ECGs showed changes that were not captured on the initial ED ECG (11 ST depression, 5 T-wave inversion [TWI], 2 ST depression and TWI, 12 arrhythmia, 2 arrhythmia with ST depression, 2 ST elevation, 1 unknown). Fifty-two (18.5%; 95% CI: 14.4%, 23.5%) prehospital ECGs influenced physician management. There were 30 (10.7%) instances where physicians were willing to refer the patient to an inpatient service based on information captured on the prehospital ECG, regardless if the initial ED ECG was normal. Conclusions. Prehospital ECGs show clinically significant abnormalities that are not always captured on the initial ED ECG. Prehospital ECGs have the potential to change the management of patients in the ED.
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Potential adult medicaid beneficiaries under the patient protection and affordable care act compared with current adult medicaid beneficiaries.
Ann Fam Med
PUBLISHED: 09-11-2013
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Under health care reform, states will have the opportunity to expand Medicaid to millions of uninsured US adults. Information regarding this population is vital to physicians as they prepare for more patients with coverage. Our objective was to describe demographic and health characteristics of potentially eligible Medicaid beneficiaries.
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A generic open-source software framework supporting scenario simulations in bioterrorist crises.
Biosecur Bioterror
PUBLISHED: 08-27-2013
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Since the 2001 anthrax attack in the United States, awareness of threats originating from bioterrorism has grown. This led internationally to increased research efforts to improve knowledge of and approaches to protecting human and animal populations against the threat from such attacks. A collaborative effort in this context is the extension of the open-source Spatiotemporal Epidemiological Modeler (STEM) simulation and modeling software for agro- or bioterrorist crisis scenarios. STEM, originally designed to enable community-driven public health disease models and simulations, was extended with new features that enable integration of proprietary data as well as visualization of agent spread along supply and production chains. STEM now provides a fully developed open-source software infrastructure supporting critical modeling tasks such as ad hoc model generation, parameter estimation, simulation of scenario evolution, estimation of effects of mitigation or management measures, and documentation. This open-source software resource can be used free of charge. Additionally, STEM provides critical features like built-in worldwide data on administrative boundaries, transportation networks, or environmental conditions (eg, rainfall, temperature, elevation, vegetation). Users can easily combine their own confidential data with built-in public data to create customized models of desired resolution. STEM also supports collaborative and joint efforts in crisis situations by extended import and export functionalities. In this article we demonstrate specifically those new software features implemented to accomplish STEM application in agro- or bioterrorist crisis scenarios.
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Medical home disparities are not created equal: differences in the medical home for children from different vulnerable groups.
J Health Care Poor Underserved
PUBLISHED: 08-27-2013
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To identify components of the medical home that contribute to medical home disparities for vulnerable children.
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Variation in inpatient tonsillectomy costs within and between US hospitals attributable to postoperative complications.
Med Care
PUBLISHED: 08-24-2013
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Tonsillectomy is the second most common inpatient procedure in US children. However, the factors that influence tonsillectomy-related costs are unknown.
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Research participation by low-income and racial/ethnic minority groups: how payment may change the balance.
Clin Transl Sci
PUBLISHED: 07-29-2013
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Minorities are underenrolled in clinical research trials, and one-third of trials are underenrolled overall. The role of payment has not been studied at the national level as an explanation for enrollment patterns. Our objective was to examine the distribution of self-reported previous research participation across different sociodemographic groups; to assess the publics perception of fair payment for a low-risk medicine trial and the association between requested payment and sociodemographic characteristics; to estimate the amount of payment for a medication trial to achieve proportional representation of minorities and different socioeconomic groups. This was a cross-sectional study with nationally representative data collected in 2011 by the C.S. Mott Childrens Hospital National Poll on Childrens Health. To determine the relationship between perceived fair payment and individual-level characteristics, we used multivariable linear regression. With 60% participation rate, in a sample of 2,150 respondents 11% (n = 221) of the sample had previously participated in medical research. Requested payment differed significantly by racial/ethnic group with Hispanics requesting more payment than non-Hispanic whites (0.37 [95%CI 0.02, 0.72]) In contrast to payment at $49, $149, and $249, payment at $349 yielded proportional representation of racial/ethnic minority groups. Hispanics requested higher payment for research participation, suggesting a possible explanation for their underenrollment.
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The use of routine thoracoabdominal CT scans in the polytrauma patient to estimate obesity.
Obesity (Silver Spring)
PUBLISHED: 06-21-2013
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To utilize data from routine CT scans to quantify obesity in polytrauma patients without the need to obtain a height and weight.
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Progressive multifocal leukoencephalopathy as the first manifestation of occult sarcoidosis: case report and review of the literature.
Neurologist
PUBLISHED: 06-08-2013
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Progressive multifocal leukoencephalopathy (PML), a demyelinating disease of the central nervous system, is caused by reactivation of the JC virus. This disease is typically seen in individuals with known immune suppression. It has also been associated with other inflammatory conditions, such as sarcoidosis.
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Validity of self-report in type 1 diabetic subjects for laser treatment of retinopathy.
Ophthalmology
PUBLISHED: 05-30-2013
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This study sought to determine the validity of self-report of prior panretinal photocoagulation (PRP) and focal photocoagulation (FP) compared with fundus photography.
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Human liver finite element model validation using compressive and tensile experimental data - biomed 2013.
Biomed Sci Instrum
PUBLISHED: 05-21-2013
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Motor vehicle crashes commonly result in blunt abdominal trauma. Approximately 19,000 such injuries occur each year in the United States. While finite element models of the human body are becoming an important tool for injury assessment, their reliability depends on the accuracy of the material models used. Recently, Samur et al. proposed a hyperelastic and viscoelastic material model of the liver. The aim of this study was to compare the results of a computational model using this material law to uniaxial tension and compression data from biomechanical tests on liver samples by Kemper et al. In this study, the liver samples were modeled using the finite element method. Both the tension and compression test specimen geometries were created from descriptions in the literature. Each sample was meshed using four approaches: fine hexahedral, coarse hexahedral, fine tetrahedral, and coarse tetrahedral. The average element edge lengths of the coarse and fine meshes were 5 mm and 2.5 mm respectively. The samples were loaded in both tension and compression at four rates: 0.01 strain/sec, 0.1 strain/sec, 1 strain/sec, and 10 strain/sec. For each mesh type (n=4), strain rate (n=4), and loading condition (n=2), 32 simulations in total, the results were plotted against the published experimental data. The results were quantitatively evaluated for magnitude and phase agreement with the experimental data using an objective comparison software package, CORA. The model predicted the tensile response of the liver sample more accurately than the compressive response with an average CORA size error factor of 0.66 versus 0.19 for the compressive model (1 is a perfect match). The fine tetrahedral, fine hexahedral, and coarse hexahedral meshes predicted a similar response. The worst performing mesh was the coarse tetrahedral mesh, which had an average size error factor of 8.6% higher than the fine tetrahedral simulations. The peak stress in both tension and compression varied as a function of the loading rate. Peak tensile stress increased 13% from the lower to higher loading rate, and peak compressive stress increased 0.5%. These findings show evidence that the viscoelastic behavior is captured in the model, although it is under predicted in comparison to the literature. Future work will focus on other material models that better predict the experimentally observed loading observed in the literature. Validation of the liver model?s response to compressive and tensile loading conditions across multiple rates is important to ensure accurate injury predictions when used in a full body finite element model.
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Posttonsillectomy hemorrhage in children with von Willebrand disease or hemophilia.
JAMA Otolaryngol Head Neck Surg
PUBLISHED: 05-10-2013
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It is uncertain whether children with bleeding disorders are at higher risk of posttonsillectomy hemorrhage compared with the general pediatric population.
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Comparison of standardized clinical classification with fundus photograph grading for the assessment of diabetic retinopathy and diabetic macular edema severity.
Retina (Philadelphia, Pa.)
PUBLISHED: 04-26-2013
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To compare evaluation by clinical examination with image grading at a reading center for the classification of diabetic retinopathy and diabetic macular edema.
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Extent of sinus surgery, 2000 to 2009: A population-based study.
Laryngoscope
PUBLISHED: 04-21-2013
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Sinus surgery is one of the most frequently performed surgical operations. The objective was to determine if rates of surgery have changed over the last 10 years.
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Immunogenicity and safety of an investigational hepatitis B vaccine with a Toll-like receptor 9 agonist adjuvant (HBsAg-1018) compared to a licensed hepatitis B vaccine in healthy adults 40-70 years of age.
Vaccine
PUBLISHED: 04-19-2013
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The currently licensed hepatitis B vaccines have limitations including hyporesponsiveness in older adults, poor compliance, and the extended time for most persons to develop seroprotection (e.g. >6months). A vaccine containing HBsAg combined with a Toll-like receptor 9 agonist adjuvant (HBsAg-1018) has been developed to overcome these limitations.
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Related functions of mGlu4 and mGlu8.
Pharmacol. Biochem. Behav.
PUBLISHED: 04-04-2013
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Metabotropic glutamate receptors modulate glutamatergic and GABAergic neurotransmission. Our previous pharmacological data indicate that metabotropic receptor 4 (mGlu4) and metabotropic receptor 8 (mGlu8) might have related and overlapping functions. We explored this by analyzing the behavioral phenotypes of mice deficient in either (mGlu4(-/-) or mGlu8(-/-)) or both receptors (mGlu4/8(-/-)). Our analysis focused on measures of anxiety in the open field and elevated zero maze, sensorimotor function on the rotarod and fear conditioning, as mGlu4 and/or mGlu8 were shown to affect performance in these tests. mGlu8(-/-) mice weighed more than mGlu4/8(-/-) mice. In the open field, mGlu4(-/-) mice showed lower levels of anxiety than mGlu8(-/-) and mGlu4/8(-/-) mice. In the elevated zero maze, mGlu4(-/-) mice showed lower levels of anxiety than wild-type, mGlu8(-/-) and mGlu4/8(-/-) mice. In the open field, but not elevated zero maze, mGlu4(-/-) mice showed lower activity levels than wild-type, mGlu8(-/-) and mGlu4/8(-/-) mice. mGlu4/8(-/-) female mice showed less contextual freezing than wild-type and mGlu4(-/-) female mice and there was a trend toward less freezing in male mGlu4/8(-/-) than wild-type male mice. There were no genotype differences in cued fear conditioning. There were significant negative correlations between body weight and fall latency on the rotarod in wild-type, mGlu8(-/-) and mGlu4/8(-/-), but not mGlu4(-/-), mice. These data suggest related functions of mGlu4 and mGlu8 in behavioral performance.
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Varying whole body vibration amplitude differentially affects tendon and ligament structural and material properties.
J Biomech
PUBLISHED: 03-28-2013
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Whole Body Vibration (WBV) is becoming increasingly popular for helping to maintain bone mass and strengthening muscle. Vibration regimens optimized for bone maintenance often operate at hypogravity levels (<1G) and regimens for muscle strengthening often employ hypergravity (>1G) vibrations. The effect of vibratory loads on tendon and ligament properties is unclear though excessive vibrations may be injurious. Our objective was to evaluate how tendon gene expression and the mechanical/histological properties of tendon and ligament were affected in response to WBV in the following groups: no vibration, low vibration (0.3G peak-to-peak), and high vibration (2G peak-to-peak). Rats were vibrated for 20 min a day, 5 days a week, for 5 weeks. Upon sacrifice, the medial collateral ligament (MCL), patellar tendon (PT), and the Achilles Tendon (AT) were isolated with insertion sites intact. All tissues were tensile tested to determine structural and material properties or used for histology. Patellar tendon was also subjected to quantitative RT-PCR to evaluate expression of anabolic and catabolic genes. No differences in biomechanical data between the control and the low vibration groups were found. There was evidence of significant weakness in the MCL with high vibration, but no significant effect on the PT or AT. Histology of the MCL and PT showed a hypercellular tissue response and some fiber disorganization with high vibration. High vibration caused an increase in collagen expression and a trend for an increase in IGF-1 expression suggesting a potential anabolic response to prevent tendon overuse injury.
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Early effects of whole-body (56)Fe irradiation on hippocampal function in C57BL/6J mice.
Radiat. Res.
PUBLISHED: 03-19-2013
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Relatively little is known about early irradiation effects on hippocampal function in wild-type mice. In this study, the effects of (56)Fe irradiation on hippocampal function were assessed starting 2 weeks after whole-body irradiation. Compared to sham irradiation, radiation impaired novel object recognition in female and male C57BL/6J wild-type mice. There were no effects of irradiation on contextual fear conditioning or spatial memory retention in the water maze. It is possible that oxidative damage might contribute to radiation-induced cognitive changes. Therefore, hippocampal and cortical levels of 3-nitrotyrosine (3NT) and lipid peroxidation, measures of oxidative damage were assessed. There were no effects of irradiation on these measures of oxidative damage. As (56)Fe irradiation can increase reactive oxygen species (ROS) levels, which may contribute to the impairments in novel object recognition, the effects of the antioxidant alpha-lipoic acid (ALA) on cognition following sham irradiation and irradiation were also assessed. ALA did not prevent radiation-induced impairments in novel object recognition and impaired spatial memory retention of sham-irradiated and irradiated mice in the probe trial after the first day of hidden platform training in the water maze. Thus, the novel object recognition test is particularly sensitive to detect early cognitive effects of (56)Fe irradiation through a mechanism unlikely involving ROS or oxidative damage.
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Goal directed fluid resuscitation decreases time for lactate clearance and facilitates early fascial closure in damage control surgery.
Am. J. Surg.
PUBLISHED: 03-18-2013
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Damage-control surgery frequently results in open abdomen. The objective of this study was to determine whether resuscitation with goal-directed fluid therapy (GDT) using "dynamic" hemodynamic indices via modern pulse contour analysis devices such as the FloTrac Vigileo monitor leads to lower fluid requirements, subsequent quicker abdominal closure, and overall improved outcomes in these patients.
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High-energy Femur Fractures Increase Morbidity but not Mortality in Elderly Patients.
Clin. Orthop. Relat. Res.
PUBLISHED: 03-13-2013
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Trauma centers are projected to have an increase in the number of elderly patients with high-energy femur fractures. Greater morbidity and mortality have been observed in these patients. Further clarification regarding the impact of high-energy femur fractures is necessary in this population.
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Association of a Modified Frailty Index With Mortality After Femoral Neck Fracture in Patients Aged 60 Years and Older.
Clin. Orthop. Relat. Res.
PUBLISHED: 03-13-2013
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Frailty, a multidimensional syndrome entailing loss of energy, physical ability, cognition, and health, plays a significant role in elderly morbidity and mortality. No study has examined frailty in relation to mortality after femoral neck fractures in elderly patients.
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Effects of (56)Fe radiation on hippocampal function in mice deficient in chemokine receptor 2 (CCR2).
Behav. Brain Res.
PUBLISHED: 02-26-2013
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(56)Fe irradiation affects hippocampus-dependent cognition. The underlying mechanisms may involve alterations in neurogenesis, expression of the plasticity-related immediate early gene Arc, and inflammation. Chemokine receptor-2 (CCR2), which mediates the recruitment of infiltrating and resident microglia to sites of CNS inflammation, is upregulated by (56)Fe irradiation. CCR2 KO and wild-type mice were used to compare effects of (56)Fe radiation (600MeV, 0.25Gy) on hippocampal function using contextual fear conditioning involving tone shock pairing during training (+/+) and exposure to the same environment without tone shock pairings (-/-). In the -/- condition, irradiation enhanced habituation in WT mice, but not CCR2 KO mice, suggesting that a lack of CCR2 was associated with reduced cognitive performance. In the +/+ condition, irradiation reduced freezing but there was no genotype differences. There were no significant correlations between the number of Arc-positive cells in the dentate gyrus and freezing in either genotype. While measures of neurogenesis and gliogenesis appeared to be modulated by CCR2, there were no effects of genotype on the total numbers of newly born activated microglia before or after irradiation, indicating that other mechanisms are involved in the genotype-dependent radiation response.
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Parents interest in whole-genome sequencing of newborns.
Genet. Med.
PUBLISHED: 02-18-2013
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Purpose:The aim of this study was to assess parents interest in whole-genome sequencing for newborns.Methods:We conducted a survey of a nationally representative sample of 1,539 parents about their interest in whole-genome sequencing of newborns. Participants were randomly presented with one of two scenarios that differed in the venue of testing: one offered whole-genome sequencing through a state newborn screening program, whereas the other offered whole-genome sequencing in a pediatricians office.Results:Overall interest in having future newborns undergo whole-genome sequencing was generally high among parents. If whole-genome sequencing were offered through a states newborn-screening program, 74% of parents were either definitely or somewhat interested in utilizing this technology. If offered in a pediatricians office, 70% of parents were either definitely or somewhat interested. Parents in both groups most frequently identified test accuracy and the ability to prevent a child from developing a disease as "very important" in making a decision to have a newborns whole genome sequenced.Conclusion:These data may help health departments and childrens health-care providers anticipate parents level of interest in genomic screening for newborns. As whole-genome sequencing is integrated into clinical and public health services, these findings may inform the development of educational strategies and outreach messages for parents.Genet Med advance online publication 6 June 2013Genetics in Medicine (2013); doi:10.1038/gim.2013.76.
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When coverage expands: childrens health insurance program as a natural experiment in use of health care services.
Acad Emerg Med
PUBLISHED: 02-15-2013
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Expanding insurance coverage is designed to improve access to primary care and reduce use of emergency department (ED) services. Whether expanding coverage achieves this is of paramount importance as the United States prepares for the Affordable Care Act.
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Effects of whole body (56)Fe radiation on contextual freezing and Arc-positive cells in the dentate gyrus.
Behav. Brain Res.
PUBLISHED: 02-14-2013
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The space radiation environment contains high-energy charged particles such as (56)Fe, which could pose a significant hazard to hippocampal function in astronauts during and after the mission(s). The mechanisms underlying impairments in cognition are not clear but might involve alterations in the percentage of neurons in the dentate gyrus expressing the plasticity-related immediate early gene Arc. Previously, we showed effects of cranial (56)Fe irradiation on hippocampus-dependent contextual freezing and on the percentage of Arc-positive cells in the enclosed, but not free, blade. Because it is unclear whether whole body (56)Fe irradiation causes similar effects on these markers of hippocampal function, in the present study we quantified the effects of whole body (56)Fe irradiation (600MeV, 0.5 or 1Gy) on hippocampus-dependent and hippocampus-independent cognitive performance and determined whether these effects were associated with changes in Arc expression in the enclosed and free blades of the dentate gyrus. Whole body (56)Fe irradiation impacted contextual but not cued fear freezing and the percentage of Arc-positive cells in the enclosed and free blades. In mice tested for contextual freezing, there was a correlation between Arc-positive cells in the enclosed and free blades. In addition, in mice irradiated with 0.5Gy, contextual freezing in the absence of aversive stimuli correlated with the percentage of Arc-positive cells in the enclosed blade. In mice tested for cued freezing, there was no correlation between Arc-positive cells in the enclosed and free blades. In contrast, cued freezing in the presence or absence of aversive stimuli correlated with Arc-positive cells in the free blade. In addition, in mice irradiated with 1Gy cued freezing in the absence of aversive stimuli correlated with the percentage of Arc-positive neurons in the free blade. These data indicate that while whole body (56)Fe radiation affects contextual freezing and Arc-positive cells in the dentate gyrus, the enclosed blade might be more important for contextual freezing while the free blade might be more important for cued freezing.
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The effect of the oral PKC ? inhibitor ruboxistaurin on vision loss in two phase 3 studies.
Invest. Ophthalmol. Vis. Sci.
PUBLISHED: 02-14-2013
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To assess the effect of ruboxistaurin (RBX) on vision loss through a prospectively defined combined analysis of two phase 3 trials (MBDL and MBCU).
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Are commercial negative pressure systems worth the cost in open abdomen management?
J. Am. Coll. Surg.
PUBLISHED: 02-13-2013
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A commercial negative pressure product is compared with the Barker technique (sterile x-ray cassette cover, lap pads, adhesive drape with negative pressure) for temporary abdominal closure in open abdomen management.
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Randomized controlled effectiveness trial of reciprocal peer support in heart failure.
Circ Heart Fail
PUBLISHED: 02-06-2013
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Although disease management programs for patients hospitalized with heart failure (HF) are effective, they are, however, often resource intensive, limiting their uptake. Peer support programs have led to improved outcomes among patients with other chronic conditions and may result in similar improvements for patients with HF.
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Exploring power and parameter estimation of the BiSSE method for analyzing species diversification.
BMC Evol. Biol.
PUBLISHED: 01-24-2013
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There has been a considerable increase in studies investigating rates of diversification and character evolution, with one of the promising techniques being the BiSSE method (binary state speciation and extinction). This study uses simulations under a variety of different sample sizes (number of tips) and asymmetries of rate (speciation, extinction, character change) to determine BiSSEs ability to test hypotheses, and investigate whether the method is susceptible to confounding effects.
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Public participation in, and awareness about, medical research opportunities in the era of clinical and translational research.
Clin Transl Sci
PUBLISHED: 01-14-2013
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In the United States, levels of public participation in medical research in the era of Clinical and Translational Science Awards (CTSAs) are unknown.
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Long-term effects of vitamins C and E, ?-carotene, and zinc on age-related macular degeneration: AREDS report no. 35.
Ophthalmology
PUBLISHED: 01-07-2013
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To describe the long-term effects (10 years) of the Age-Related Eye Disease Study (AREDS) formulation of high-dose antioxidants and zinc supplement on progression of age-related macular degeneration (AMD).
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An ACACB variant implicated in diabetic nephropathy associates with body mass index and gene expression in obese subjects.
PLoS ONE
PUBLISHED: 01-07-2013
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Acetyl coenzyme A carboxylase B gene (ACACB) single nucleotide polymorphism (SNP) rs2268388 is reproducibly associated with type 2 diabetes (T2DM)-associated nephropathy (DN). ACACB knock-out mice are also protected from obesity. This study assessed relationships between rs2268388, body mass index (BMI) and gene expression in multiple populations, with and without T2DM. Among subjects without T2DM, rs2268388 DN risk allele (T) associated with higher BMI in Pima Indian children (n?=?2021; p-additive?=?0.029) and African Americans (AAs) (n?=?177; p-additive?=?0.05), with a trend in European Americans (EAs) (n?=?512; p-additive?=?0.09), but not Germans (n?=?858; p-additive?=?0.765). Association with BMI was seen in a meta-analysis including all non-T2DM subjects (n?=?3568; p-additive?=?0.02). Among subjects with T2DM, rs2268388 was not associated with BMI in Japanese (n?=?2912) or EAs (n?=?1149); however, the T allele associated with higher BMI in the subset with BMI?30 kg/m(2) (n?=?568 EAs; p-additive?=?0.049, n?=?196 Japanese; p-additive?=?0.049). Association with BMI was strengthened in a T2DM meta-analysis that included an additional 756 AAs (p-additive?=?0.080) and 48 Hong Kong Chinese (p-additive?=?0.81) with BMI?30 kg/m(2) (n?=?1575; p-additive?=?0.0033). The effect of rs2268388 on gene expression revealed that the T risk allele associated with higher ACACB messenger levels in adipose tissue (41 EAs and 20 AAs with BMI>30 kg/m(2); p-additive?=?0.018) and ACACB protein levels in the liver tissue (mixed model p-additive?=?0.03, in 25 EA bariatric surgery patients with BMI>30 kg/m(2) for 75 exams). The T allele also associated with higher hepatic triglyceride levels. These data support a role for ACACB in obesity and potential roles for altered lipid metabolism in susceptibility to DN.
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RAC1P29S is a spontaneously activating cancer-associated GTPase.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 01-02-2013
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RAC1 is a small, Ras-related GTPase that was recently reported to harbor a recurrent UV-induced signature mutation in melanoma, resulting in substitution of P29 to serine (RAC1(P29S)), ranking this the third most frequently occurring gain-of-function mutation in melanoma. Although the Ras family GTPases are mutated in about 30% of all cancers, mutations in the Rho family GTPases have rarely been observed. In this study, we demonstrate that unlike oncogenic Ras proteins, which are primarily activated by mutations that eliminate GTPase activity, the activated melanoma RAC1(P29S) protein maintains intrinsic GTP hydrolysis and is spontaneously activated by substantially increased inherent GDP/GTP nucleotide exchange. Determination and comparison of crystal structures for activated RAC1 GTPases suggest that RAC1(F28L)--a known spontaneously activated RAC1 mutant--and RAC1(P29S) are self-activated in distinct fashions. Moreover, the mechanism of RAC1(P29S) and RAC1(F28L) activation differs from the common oncogenic mutations found in Ras-like GTPases that abrogate GTP hydrolysis. The melanoma RAC1(P29S) gain-of-function point mutation therefore represents a previously undescribed class of cancer-related GTPase activity.
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Temporal patterns of diversification across global cichlid biodiversity (Acanthomorpha: Cichlidae).
PLoS ONE
PUBLISHED: 01-01-2013
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The contrasting distribution of species diversity across the major lineages of cichlids makes them an ideal group for investigating macroevolutionary processes. In this study, we investigate whether different rates of diversification may explain the disparity in species richness across cichlid lineages globally. We present the most taxonomically robust time-calibrated hypothesis of cichlid evolutionary relationships to date. We then utilize this temporal framework to investigate whether both species-rich and depauperate lineages are associated with rapid shifts in diversification rates and if exceptional species richness can be explained by clade age alone. A single significant rapid rate shift increase is detected within the evolutionary history of the African subfamily Pseudocrenilabrinae, which includes the haplochromins of the East African Great Lakes. Several lineages from the subfamilies Pseudocrenilabrinae (Australotilapiini, Oreochromini) and Cichlinae (Heroini) exhibit exceptional species richness given their clade age, a net rate of diversification, and relative rates of extinction, indicating that clade age alone is not a sufficient explanation for their increased diversity. Our results indicate that the Neotropical Cichlinae includes lineages that have not experienced a significant rapid burst in diversification when compared to certain African lineages (rift lake). Neotropical cichlids have remained comparatively understudied with regard to macroevolutionary patterns relative to African lineages, and our results indicate that of Neotropical lineages, the tribe Heroini may have an elevated rate of diversification in contrast to other Neotropical cichlids. These findings provide insight into our understanding of the diversification patterns across taxonomically disparate lineages in this diverse clade of freshwater fishes and one of the most species-rich families of vertebrates.
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Medical home disparities for Latino children by parental language of interview.
J Health Care Poor Underserved
PUBLISHED: 11-15-2011
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Examination of Latino children in aggregate ignores important subgroup differences due to the parents English language ability. Previous reports of the pediatric medical home have not stratified Latino children by parental language differences to compare the two groups directly. We analyzed the 2007 National Survey of Childrens Health to determine medical home prevalence among Latino children, stratified by language of parental interview. Most Latino children with a Spanish-language parental interview had a usual source of care, but only one-quarter had a medical home. Striking medical home disparities persisted for Latino children with a Spanish-language interview, even after adjustment for potential confounders. Lack of a medical home was associated with disparities in the quality of care, more so than access disparities. Addressing health care disparities for Latino children requires particular attention to the unique needs of Latino children with parents who may experience language barriers during health care encounters.
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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.