3,273 research outputs found

    Differences in GlycA and lipoprotein particle parameters may help distinguish acute kawasaki disease from other febrile illnesses in children.

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    BackgroundGlycosylation patterns of serum proteins, such as α1-acid glycoprotein, are modified during an acute phase reaction. The response of acute Kawasaki disease (KD) patients to IVIG treatment has been linked to sialic acid levels on native IgG, suggesting that protein glycosylation patterns vary during the immune response in acute KD. Additionally, the distribution and function of lipoprotein particles are altered during inflammation. Therefore, the aim of this study was to explore the potential for GlycA, a marker of protein glycosylation, and the lipoprotein particle profile to distinguish pediatric patients with acute KD from those with other febrile illnesses.MethodsNuclear magnetic resonance was used to quantify GlycA and lipoprotein particle classes and subclasses in pediatric subjects with acute KD (n = 75), post-treatment subacute (n = 36) and convalescent (n = 63) KD, as well as febrile controls (n = 48), and age-similar healthy controls (n = 48).ResultsGlycA was elevated in acute KD subjects compared to febrile controls with bacterial or viral infections, IVIG-treated subacute and convalescent KD subjects, and healthy children (P <0.0001). Acute KD subjects had increased total and small low density lipoprotein particle numbers (LDL-P) (P <0.0001) and decreased total high density lipoprotein particle number (HDL-P) (P <0.0001) compared to febrile controls. Consequently, the ratio of LDL-P to HDL-P was higher in acute KD subjects than all groups tested (P <0.0001). While GlycA, CRP, erythrocyte sedimentation rate, LDL-P and LDL-P/HDL-P ratio were able to distinguish patients with KD from those with other febrile illnesses (AUC = 0.789-0.884), the combinations of GlycA and LDL-P (AUC = 0.909) or GlycA and the LDL-P/HDL-P ratio (AUC = 0.910) were best at discerning KD in patients 6-10 days after illness onset.ConclusionsHigh levels of GlycA confirm enhanced protein glycosylation as part of the acute phase response in KD patients. When combined with common laboratory tests and clinical characteristics, GlycA and NMR-measured lipoprotein particle parameters may be useful for distinguishing acute KD from bacterial or viral illnesses in pediatric patients

    Effect of laser surface treatment on the corrosion and fatigue performance of aa5456-h116 alloys

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    Localized Strain and Associated Failure of Structural Materials

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    Aircraft are made primarily out of strong and lightweight aluminum alloys, which are relatively low cost, easy to produce, and have allowed for several innovations in the airplane industry. Even though these alloys are highly corrosion resistant, they are susceptible to failure since airplanes experience some of the harshest fatigue and corrosion conditions. Predicting the location of crack initiation on these corroded materials could lead to preventative safety of aluminum components on an aircraft. To study the mechanisms leading to cracking, precorroded AA7050 samples were fatigue loaded to failure, virtually reconstructed form post-mortem characterizations, and modeled accordingly to obtain the micromechanical state of the material. Fatigue indicator parameters were calculated from the resulting stresses and strains. The initial corrosion front was then analyzed at the reconstructed crack plane, using a metric that identifies the most active slip planes per grain. The reconstructed data is masked over onto planes that have the same orientation as the [111] slip planes. Then, the data is analyzed quantitatively for each slip plane, looking for the highest median fatigue indicator parameter value. The slip plane on the grain closest to the crack initiation site was found to have a slip plane roughly parallel to the crack plane. On this plane, many significantly larger fatigue indicator parameter values were found, with the highest value pinpointing the region where crack initiation was experimentally observed

    Exploring the Role of Contextual Integrity in Electronic Medical Record (EMR) System Workaround Decisions: An Information Security and Privacy Perspective

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    Many healthcare providers in the US are seeking increased efficiency and effectiveness by rapidly adopting information technology (IT) solutions such as electronic medical record (EMR) systems. Legislation such as the Health Information Technology for Economic and Clinical Health Act (HITECH), which codified the adoption and “meaningful use” of electronic records in the US, has further spurred the industry-wide adoption of EMR. However, despite what are often large investments in EMR, studies indicate that the healthcare industry maintains a culture of system workarounds. Though perhaps not uncommon, the creation of informal workflows among healthcare workers is problematic for assuring information security and patient privacy, particularly when involving decisions of information management (e.g., information storage, retrieval, and/or transmission). Drawing on the framework of contextual integrity, we assert that one can often explain workarounds involving information transmissions in terms of trade-offs informed by context-specific informational norms. We surveyed healthcare workers and analyzed their willingness to engage in a series of EMR workaround scenarios. Our results indicate that contextual integrity provides a useful framework for understanding information transmission and workaround decisions in the health sector. Armed with these findings, managers and system designers should be better able to anticipate healthcare workers’ information transmission principles (e.g., privacy norms) and workaround patterns (e.g., usage norms). We present our findings and discuss their significance for research and practice
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