Clinicians as Secondary Users of Patient-Centered Mobile Technology in Complex Healthcare Settings

This paper describes the preliminary research findings and prototype development of a Personal Health Record mobile application. A pilot study about patient-clinician interaction guided by common ground theory was performed. The goal of the pilot study was to gather requirements to support development of a smartphone application to be used in a future experimental study. Findings from the pilot study suggest that smartphones could be used to manage health information considered important for a successful healthcare consultation

Spatially resolved velocity maps of halo gas around two intermediate-redshift galaxies

Absorption-line spectroscopy of multiply-lensed QSOs near a known foreground galaxy provides a unique opportunity to go beyond the traditional one-dimensional application of QSO probes and establish a crude three-dimensional map of halo gas around the galaxy that records the line-of-sight velocity field at different locations in the gaseous halo. Two intermediate-redshift galaxies are targeted in the field around the quadruply-lensed QSO HE 0435−1223 at redshift z = 1.689, and absorption spectroscopy along each of the lensed QSOs is carried out in the vicinities of these galaxies. One galaxy is a typical, star-forming L* galaxy at z = 0.4188 and projected distance of ρ = 50 kpc from the lensing galaxy. The other is a super-L* barred spiral at z = 0.7818 and ρ = 33 kpc. Combining known orientations of the quadruply-lensed QSO to the two foreground galaxies with the observed Mg ii λλ2796, 2803 absorption profiles along individual QSO sightlines has for the first time led to spatially resolved kinematics of tenuous halo gas on scales of 5–10 kpc at z > 0.2. A Mg ii absorber is detected in every sightline observed through the haloes of the two galaxies, and the recorded absorber strength is typical of what is seen in previous close QSO–galaxy pair studies. While the multisightline study confirms the unity covering fraction of Mg ii absorbing gas at ρ < 50 kpc from star-forming discs, the galaxies also present two contrasting examples of complex halo gas kinematics. Different models, including a rotating disc, collimated outflows and gaseous streams from either accretion or tidal/ram-pressure stripping, are considered for comparisons with the absorption-line observations, and infalling streams/stripped gas of width ≳10 kpc are found to best describe the observed gas kinematics across multiple sightlines. In addition, the observed velocity dispersion between different sightlines offers a crude estimate of turbulence in the Mg ii absorbing halo gas. The observations presented here demonstrate that multiple-QSO probes enable studies of spatially resolved gas kinematics around distant galaxies, which provide key insights into the physical nature of circumgalactic gas beyond the nearby Universe

Enabling the Discovery of Recurring Anomalies in Aerospace System Problem Reports using High-Dimensional Clustering Techniques

This paper describes the results of a significant research and development effort conducted at NASA Ames Research Center to develop new text mining techniques to discover anomalies in free-text reports regarding system health and safety of two aerospace systems. We discuss two problems of significant importance in the aviation industry. The first problem is that of automatic anomaly discovery about an aerospace system through the analysis of tens of thousands of free-text problem reports that are written about the system. The second problem that we address is that of automatic discovery of recurring anomalies, i.e., anomalies that may be described m different ways by different authors, at varying times and under varying conditions, but that are truly about the same part of the system. The intent of recurring anomaly identification is to determine project or system weakness or high-risk issues. The discovery of recurring anomalies is a key goal in building safe, reliable, and cost-effective aerospace systems. We address the anomaly discovery problem on thousands of free-text reports using two strategies: (1) as an unsupervised learning problem where an algorithm takes free-text reports as input and automatically groups them into different bins, where each bin corresponds to a different unknown anomaly category; and (2) as a supervised learning problem where the algorithm classifies the free-text reports into one of a number of known anomaly categories. We then discuss the application of these methods to the problem of discovering recurring anomalies. In fact the special nature of recurring anomalies (very small cluster sizes) requires incorporating new methods and measures to enhance the original approach for anomaly detection. ?& pant 0

Modeling Progressive Fibrosis with Pluripotent Stem Cells Identifies an Anti-fibrotic Small Molecule.

Progressive organ fibrosis accounts for one-third of all deaths worldwide, yet preclinical models that mimic the complex, progressive nature of the disease are lacking, and hence, there are no curative therapies. Progressive fibrosis across organs shares common cellular and molecular pathways involving chronic injury, inflammation, and aberrant repair resulting in deposition of extracellular matrix, organ remodeling, and ultimately organ failure. We describe the generation and characterization of an in&nbsp;vitro progressive fibrosis model that uses cell types derived from induced pluripotent stem cells. Our model produces endogenous activated transforming growth factor β (TGF-β) and contains activated fibroblastic aggregates that progressively increase in size and stiffness with activation of known fibrotic molecular and cellular changes. We used this model as a phenotypic drug discovery platform for modulators of fibrosis. We validated this platform by identifying a compound that promotes resolution of fibrosis in in&nbsp;vivo and ex&nbsp;vivo models of ocular and lung fibrosis

Evaluation of Hemoglobin A1c Criteria to Assess Preoperative Diabetes Risk in Cardiac Surgery Patients

Objective: Hemoglobin A1c (A1C) has recently been recommended for diagnosing diabetes mellitus and diabetes risk (prediabetes). Its performance compared with fasting plasma glucose (FPG) and 2-h post-glucose load (2HPG) is not well delineated. We compared the performance of A1C with that of FPG and 2HPG in preoperative cardiac surgery patients. Methods: Data from 92 patients without a history of diabetes were analyzed. Patients were classified with diabetes or prediabetes using established cutoffs for FPG, 2HPG, and A1C. Sensitivity and specificity of the new A1C criteria were evaluated. Results: All patients diagnosed with diabetes by A1C also had impaired fasting glucose, impaired glucose tolerance, or diabetes by other criteria. Using FPG as the reference, sensitivity and specificity of A1C for diagnosing diabetes were 50% and 96%, and using 2HPG as the reference they were 25% and 95%. Sensitivity and specificity for identifying prediabetes with FPG as the reference were 51% and 51%, respectively, and with 2HPG were 53% and 51%, respectively. One-third each of patients with prediabetes was identified using FPG, A1C, or both. When testing A1C and FPG concurrently, the sensitivity of diagnosing dysglycemia increased to 93% stipulating one or both tests are abnormal; specificity increased to 100% if both tests were required to be abnormal. Conclusions: In patients before cardiac surgery, A1C criteria identified the largest number of patients with diabetes and prediabetes. For diagnosing prediabetes, A1C and FPG were discordant and characterized different groups of patients, therefore altering the distribution of diabetes risk. Simultaneous measurement of FGP and A1C may be a more sensitive and specific tool for identifying high-risk individuals with diabetes and prediabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90436/1/dia-2E2011-2E0074.pd

Single Photon Counting UV Solar-Blind Detectors Using Silicon and III-Nitride Materials

Ultraviolet (UV) studies in astronomy, cosmology, planetary studies, biological and medical applications often require precision detection of faint objects and in many cases require photon-counting detection. We present an overview of two approaches for achieving photon counting in the UV. The first approach involves UV enhancement of photon-counting silicon detectors, including electron multiplying charge-coupled devices and avalanche photodiodes. The approach used here employs molecular beam epitaxy for delta doping and superlattice doping for surface passivation and high UV quantum efficiency. Additional UV enhancements include antireflection (AR) and solar-blind UV bandpass coatings prepared by atomic layer deposition. Quantum efficiency (QE) measurements show QE > 50% in the 100–300 nm range for detectors with simple AR coatings, and QE ≅ 80% at ~206 nm has been shown when more complex AR coatings are used. The second approach is based on avalanche photodiodes in III-nitride materials with high QE and intrinsic solar blindness

Identification of a pan-cancer oncogenic microRNA superfamily anchored by a central core seed motif

MicroRNAs modulate tumorigenesis through suppression of specific genes. As many tumour types rely on overlapping oncogenic pathways, a core set of microRNAs may exist, which consistently drives or suppresses tumorigenesis in many cancer types. Here we integrate The Cancer Genome Atlas (TCGA) pan-cancer data set with a microRNA target atlas composed of publicly available Argonaute Crosslinking Immunoprecipitation (AGO-CLIP) data to identify pan-tumour microRNA drivers of cancer. Through this analysis, we show a pan-cancer, coregulated oncogenic microRNA ‘superfamily’ consisting of the miR-17, miR-19, miR-130, miR-93, miR-18, miR-455 and miR-210 seed families, which cotargets critical tumour suppressors via a central GUGC core motif. We subsequently define mutations in microRNA target sites using the AGO-CLIP microRNA target atlas and TCGA exome-sequencing data. These combined analyses identify pan-cancer oncogenic cotargeting of the phosphoinositide 3-kinase, TGFβ and p53 pathways by the miR-17-19-130 superfamily members

Refinement of the taxonomic structure of 16SrXI and 16SrXIV phytoplasmas of gramineous plants using multilocus sequence typing

Phytoplasmas that infect gramineous plants, including Napier grass stunt, sugarcane whiteleaf, sugarcane grassy shoot, and Bermuda grass whiteleaf, have been classified into two closely related groups, 16SrXI and 16SrXIV, based on the 16S ribosomal RNA (rRNA) gene. Subsequently, phytoplasmas associated with coconut and Areca palm in southern India and Sri Lanka have been added into the 16SrXI group. However, the 16S rRNA gene gives relatively poor resolution between these phytoplasmas. In this study, a new set of universal phytoplasma primers that amplify approximately 1 kb of the leucyl transfer RNA synthetase (leuS) gene have been validated on a broad range of phytoplasma taxonomic groups. These have been used along with partial sequences of the secA gene to clarify the taxonomic classification of 16SrXI and 16SrXIV phytoplasmas. Based on this data, the sugarcane whiteleaf and grassy shoot phytoplasmas appear to be the same phytoplasma. The Napier grass stunt phytoplasma forms a distinct group from the Bermuda grass whiteleaf and sugarcane phytoplasmas, suggesting that Napier grass stunt should be in its own ‘Candidatus Phytoplasma sp.’. The phytoplasmas associated with coconut and arecanut in southern India and Sri Lanka, which are in the same 16SrXI group, appear in different groups based on secA analysis

Randomised Control Study Comparing the Haemodynamic Changes to Intubation using Levitan Optical Stylet alone Versus Intubation using Levitan Optical Stylet along with Macintosh Laryngoscope

Endotracheal intubation and laryngoscopy are very essential tools in the hands of anaesthesiologist in maintaining airway. Airway management is the fundamental aspect of anaesthetic practice, emergency and critical care medicine. Endotracheal intubation incur haemodynamic responses like increase in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure. Since the upper airway is highly innervated, airway instrumentation results in significant haemodynamic responses. Anaesthesiologist found a technique of intubation which minimized the stimulation of the upper airway. Levitan optical stylet gained its importance, since its introduction by Dr. Richard Levitan. The shorter length resembles standard stylet making it useful in every laryngoscopy, handling and shaping of the tracheal tubewhile offering a fibreoptic intubation and immediate visual confirmation of intratracheal placement. The primary objective of this study was to compare the haemodynamic responses to intubation using Levitan optical stylet alone versus intubation using levitan optical stylet along with Macintosh laryngoscope. Secondary outcome measures the ease of intubation, intubation time with two techniques, complications and failure rate. We recruited 80 patients in this prospective study, after obtaining ethical committee approval. These patients were aged between 18-60 yrs belonging to ASA I and ASA II with MPC I and MPC II and thyromental distance >6.5 cm. Hypertensive patients, difficult airway and cardiovascular patients were excluded from the study. They were divided into two groups. Group A – intubation carried with Levitan optical stylet, Group B - intubation carried out with Levitan optical stylet along with Macintosh laryngoscope. These patients were evaluated for the haemodynamic responses at preintubation, postintubation (0min), 1min, 3min, 5min and 10 min respectively. The time taken for intubation, ease of intubation in both the groups were also noted down. Postoperatively patients were monitored for complications such as sorethroat, hoarseness of voice and bleeding. These results were tabulated and analysed using SPSS software version 22. The two groups were comparable in terms of age, weight and sex. Other parameters such as ASA, thyromental distance, interincisor gap were also comparable. The stress response associated with endotracheal intubation was more with group B (patients intubated with Macintosh laryngoscope) than with group A (intubation with Levitan alone) at post intubation 0min,1min and 3 min as the p valve was 0.00. The mean time taken for intubation in group A (55 seconds) was longer than group B (20 seconds) and the p value was 0.00 and found to be statistically significant. The success rate of intubation in group B was 100% whereas in group A was 95%. The failure rate of intubation was 5% in group A. No serious complications were encountered in both the groups. Hence we concluded that Levitan optical stylet was more superior than conventional Macintosh laryngoscope in the aspect of haemodynamic responses