A Social Network Study To Improve Collaborative Partnerships Among the Southeastern Health Equity Council (SHEC)

This report presents research conducted on the relationships among and attributes of members of the Southeastern Health Equity Council (SHEC, herein Council) to provide recommendations for partnerships, collaboration, and the recruitment of new members. The background, methods, results, and recommendations are outlined in detail throughout this report. Social networks are measured and defined as connections among people, organization, and/or other units. SNA is a valuable and innovative tool for recognizing strengths and weaknesses in collaborative partnerships. The evaluative study presented herein can be replicated in other councils within the Regional Health Equity Councils to improve collaborations not only among SHEC partnerships, but also the nine remaining regions as well. Among the SHEC, social networking models will be designed in an efforts to better understand partnerships, reach the desire goal to analyze partnerships among SHEC, and develop a better understanding of the broad-based constituency served by the Council for the purposes of improving collaborative partnerships

Infrared Diode Laser Spectrometer for the Study of Jet Cooled Gases

We have constructed a tunable, high resolution, infrared diode laser spectrometer and combined it with a pulsed supersonic jet expansion. A modified version of the Perry multipass cell has been incorporated into the spectrometer to increase the effective absorption path length. Performance capabilities of the spectrometer are evaluated by examining ro-vibrational spectra for the carbon monoxide molecule in the five micron region of the infrared. From these measurements, an instrumental absorption sensitivity is determined. Finally, since one of our immediate goals is the infrared study of jet cooled transition metal carbonyls, we present high resolution data obtained by entraining the vapor above a solid metal carbonyl and injecting it into the pulsed jet expansion

Building research capacity for evidence-informed tobacco control in Canada: a case description

Tobacco use remains the leading cause of death and disability in Canada. Insufficient research capacity can inhibit evidence-informed decision making for tobacco control. This paper outlines a Canadian project to build research capacity, defined as a community's ability to produce research that adequately informs practice, policy, and future research in a timely, practical manner. A key component is that individuals and teams within the community must mutually engage around common, collectively negotiated goals to address specific practices, policies or programs of research. An organizing framework, a set of activities to build strategic recruitment, productivity tools, and procedures for enhancing social capital are described. Actions are intended to facilitate better alignment between research and the priorities of policy developers and service providers, enhance the external validity of the work performed, and reduce the time required to inform policy and practice

Large-Scale Discovery of ERK2 Substrates Identifies ERK-Mediated Transcriptional Regulation by ETV3

The mitogen-activated protein kinase (MAPK) extracellular signal–regulated kinase 2 (ERK2) is ubiquitously expressed in mammalian tissues and is involved in a wide range of biological processes. Although MAPKs have been intensely studied, identification of their substrates remains challenging. We have optimized a chemical genetic system using analog-sensitive ERK2, a form of ERK2 engineered to use an analog of adenosine 5′-triphosphate (ATP), to tag and isolate ERK2 substrates in vitro. This approach identified 80 proteins phosphorylated by ERK2, 13 of which are known ERK2 substrates. The 80 substrates are associated with diverse cellular processes, including regulation of transcription and translation, mRNA processing, and regulation of the activity of the Rho family guanosine triphosphatases. We found that one of the newly identified substrates, ETV3 (a member of the E twenty-six family of transcriptional regulators), was extensively phosphorylated on sites within canonical and noncanonical ERK motifs. Phosphorylation of ETV3 regulated transcription by preventing its binding to DNA at promoters for several thousand genes, including some involved in negative feedback regulation of itself and of upstream signals.Massachusetts Institute of Technology (Eugene Bell Career Development Chair)David H. Koch Institute for Integrative Cancer Research at MIT (Graduate Fellowship)Massachusetts Institute of Technology (Whitaker Health Science Fellowship)National Science Foundation (U.S.) (Graduate Research Fellowship)Pfizer Inc.National Institutes of Health (U.S.) (grant ES002109)National Institutes of Health (U.S.) (grant R01DK42816)National Institutes of Health (U.S.) (grant R01CA118705)National Institutes of Health (U.S.) (grant U54CA112967

Surgeons' Volume-Outcome Relationship for Lobectomies and Wedge Resections for Cancer Using Video-Assisted Thoracoscopic Techniques

This study examined the effect of surgeons' volume on outcomes in lung surgery: lobectomies and wedge resections. Additionally, the effect of video-assisted thoracoscopic surgery (VATS) on cost, utilization, and adverse events was analyzed. The Premier Hospital Database was the data source for this analysis. Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume was represented by the aggregate experience level of the surgeon in a six-month window before each surgery. A positive volume-outcome relationship was found with some notable features. The relationship is stronger for cost and utilization outcomes than for adverse events; for thoracic surgeons as opposed to other surgeons; for VATS lobectomies rather than VATS wedge resections. While there was a reduction in cost and resource utilization with greater experience in VATS, these outcomes were not associated with greater experience in open procedures

Minithoracotomy for mitral valve repair improves inpatient and postdischarge economic savings

ObjectiveSmall series of thoracotomy for mitral valve repair have demonstrated clinical benefit. This multi-institutional administrative database analysis compares outcomes of thoracotomy and sternotomy approaches for mitral repair.MethodsThe Premier database was queried from 2007 to 2011 for mitral repair hospitalizations. Premier contains billing, cost, and coding data from more than 600 US hospitals, totaling 25 million discharges. Thoracotomy and sternotomy approaches were identified through expert rules; robotics were excluded. Propensity matching on baseline characteristics was performed. Regression analysis of surgical approach on outcomes and costs was modeled.ResultsExpert rule analysis positively identified thoracotomy in 847 and sternotomy in 566. Propensity matching created 2 groups of 367. Mortalities were similar (thoracotomy 1.1% vs sternotomy 1.9%). Sepsis and other infections were significantly lower with thoracotomy (1.1% vs 4.4%). After adjustment for hospital differences, thoracotomy carried a 17.2% lower hospitalization cost (−$8289) with a 2-day stay reduction. Readmission rates were significantly lower with thoracotomy (26.2% vs 35.7% at 30 days and 31.6% vs 44.1% at 90 days). Thoracotomy was more common in southern and northeastern hospitals (63% vs 37% and 64% vs 36%, respectively), teaching hospitals (64% vs 36%) and larger hospitals (>600 beds, 78% vs 22%).ConclusionsRelative to sternotomy, thoracotomy for mitral repairs provides similar mortality, less morbidity, fewer infections, shorter stay, and significant cost savings during primary admission. The markedly lower readmission rates for thoracotomy will translate into additional institutional cost savings when a penalty on hospitals begins under the Affordable Care Act's Hospital Readmissions Reduction Program

The cost of a single concussion in American high school football: A retrospective cohort study

Aim: The potential financial burden of American football-related concussions (FRC) is unknown. Our objective was to describe the healthcare costs associated with an FRC and determine factors associated with increased costs. Methodology/results: A retrospective cohort study of concussed high school football players presenting between November 2017 and March 2020 was undertaken; 144 male high school football players were included. Total costs were about $115,000, for an average direct healthcare cost of$800.10/concussion. Visiting the emergency department (β = 502.29, 95% CI: 105.79-898.61; p = 0.01), the initial post-concussion symptom scale score (β = 0.39, 95% CI: 0.11-0.66; p = 0.01) and a post-concussion syndrome diagnosis (β = 670.37, 95% CI: 98.96-1241.79; p = 0.02) were each independently associated with total costs. Conclusion: A granular understanding of cost-driving factors associated with FRC is the first step in understanding the cost-effectiveness of prevention and treatment methods

Epigenetics in Society

Would you take a potentially life-saving drug if you knew that your children and grandchildren might suffer the side effects? Would you change your lifestyle if it meant you could reverse disadvantages built into your genes? Would you be comfortable if corporations could infer intimate details about your life history without asking? What if that data could improve your quality of life? Epigenetics - our epigenome - controls how our genes behave without altering their sequence. Just about everything affects it, from nutrition, drugs, and toxins to child rearing, culture, and society. Many diseases, from obesity to addiction to cancer, can be linked to epigenetic modifications. Furthermore, throughout development and life, from conception to death, the exposures you have will not only affect your own epigenome, but potentially also your child’s, and your grandchild’s. This rapidly expanding field of biological, physiological, sociological, and psychological research could be key to discovering why, and more importantly how, we are the way we are. Epigenetics has consequences for medicine, pregnancy, childcare, law and how we live on an everyday basis. This book will provide a comprehensive introduction to the mechanisms and real-life consequences of epigenetics, and will arm the reader with the knowledge necessary to make informed decisions about the future of epigenetics in modern society. This is a call for serious consideration about the effects of epigenetics on society. Epigenetics has been independently peer-reviewed for accuracy by international experts. It is written by students of diverse disciplines, and intended for students and educated lay people.https://scholar.uwindsor.ca/emergingscholarspress/1000/thumbnail.jp

Sebaceous adenitis in Swedish dogs, a retrospective study of 104 cases

<p>Abstract</p> <p>Background</p> <p>Sebaceous adenitis (SA) is an uncommon, immune mediated skin disease in dogs. The aim was to retrospectively investigate SA in dogs in Sweden with respect to breed, sex and age distribution. A second aim was to retrospectively compare clinical signs in dogs with generalized SA and to estimate the survival after diagnosis in the English springer spaniel, standard poodle and the akita.</p> <p>Methods</p> <p>In total 34 Swedish veterinarians contributed with 104 clinically and histologically verified SA cases. Breed, gender and age at diagnosis were registered for each case. The degree of clinical signs at time for diagnosis and at follow-up and information about treatments, concurrent diseases and euthanasia were recorded for the springer spaniels, standard poodles and akitas using a standardized questionnaire.</p> <p>Results</p> <p>A total of 104 cases of SA were included; most cases were recorded for the springer spaniel (n = 25), standard poodle (n = 21) and the akita (n = 10). These three breeds, together with the lhasa apso and the chow-chow, were the most common when national registry data from the Swedish Board of Agriculture and Swedish Kennel Club were considered. The mean age at diagnosis was 4.8 years. The proportion of males was 61%. When the springer spaniels, standard poodles and the akitas with generalized signs were compared (n = 51), the spaniels showed significantly more severe clinical signs than the poodles at diagnosis regarding alopecia, seborrhoea, pyoderma and the overall severity of clinical signs. At follow-up, the degree of clinical signs for otitis externa and pyoderma differed significantly between the breeds. The estimated median survival time was 42 months.</p> <p>In dogs where data regarding survival was available at the end of the study (n = 44), SA was reported to be the reason for euthanasia in 14 dogs, whereof 7 within 24 months after diagnosis.</p> <p>Conclusion</p> <p>The result of this study implicates that the English springer spaniel is a breed predisposed to SA and that it has more severe clinical signs than the standard poodle. A large proportion of the dogs (spaniel, poodle and akita) investigated regarding survival were reported to have been euthanized to great extent due to the disease.</p