The Use of Telemetry Monitoring Among General Medicine Patients

Objective: To determine why and when general medicine non-ICU patients are upgraded from a non-telemetry level of care to telemetry monitoring at Thomas Jefferson University Hospital (TJUH). Comparison of the reasons for initiation of continuous ECG monitoring with the AHA and ACC guidelines would provide a greater understanding of the applicability of these recommendations to non-ICU general medicine patients. This information can provide guidance to identify areas of intervention to decrease inappropriate and/or overutilization of telemetry. The ultimate goal is to identify general medicine patients who are likely to benefit from continuous ECG monitoring, without negatively affecting clinical outcomes for those who do not receive cardiac monitoring.https://jdc.jefferson.edu/patientsafetyposters/1025/thumbnail.jp

Understanding Individual Experiences of Chronic Illness with Semantic Space Models of Electronic Discussions

Electronic discussion groups provide a convenient forum for individuals to share their experiences of chronic illness. The language use of individual participants, and the way their language shifts over time, may provide implicit indications of important shifts in sense-of-self. This paper relates experience with application of the hyperspace analogue to language (HAL) model for automatic construction of a dimensional model from a corpus of text. HAL is applied to 17 months of discussion on a closed list of 20 women coping with chronic illness. The discussion group was moderated for a focus the phenomenon of "Transition' - how people can learn to incorporate the consequences of illness into their lives. The current phase of research focuses on identification of clusters of words that can represent key aspects of Transition. The HAL models for two participants have been analyzed by experts in Transition to form candidate clusters. These clusters are then used as a basis for contrasting the language usage of an individual participant over time as compared to the entire corpus. We have not yet found a reliable basis for identifying transitions in an individual based on their entries into a discussion forum, although the clusters may have some inherent value for introspection on individual experiences and Transition in general. We report challenges for interpretation of the HAL model related to the correlation of dimensions and the impact of group dynamics

Spectral and Spatial Dependence of Diffuse Optical Signals in Response to Peripheral Nerve Stimulation

Using non-invasive, near-infrared spectroscopy we have previously reported optical signals measured at or around peripheral nerves in response to their stimulation. Such optical signals featured amplitudes on the order of 0.1% and peaked about 100 ms after peripheral nerve stimulation in human subjects. Here, we report a study of the spatial and spectral dependence of the optical signals induced by stimulation of the human median and sural nerves, and observe that these optical signals are: (1) unlikely due to either dilation or constriction of blood vessels, (2) not associated with capillary bed hemoglobin, (3) likely due to blood vessel(s) displacement, and (4) unlikely due to fiber-skin optical coupling effects. We conclude that the most probable origin of the optical response to peripheral nerve stimulation is from displacement of blood vessels within the optically probed volume, as a result of muscle twitch in adjacent areas.National Institutes of Health (R01-NS059933); U.S. Army Medical Acquisition Activity (W81XWH-07-2-0011

Pectoral muscle removal in mammogram images: A novel approach for improved accuracy and efficiency

PURPOSE: Accurate pectoral muscle removal is critical in mammographic breast density estimation and many other computer-aided algorithms. We propose a novel approach to remove pectoral muscles form mediolateral oblique (MLO) view mammograms and compare accuracy and computational efficiency with existing method (Libra). METHODS: A pectoral muscle identification pipeline was developed. The image is first binarized to enhance contrast and then the Canny algorithm was applied for edge detection. Robust interpolation is used to smooth out the pectoral muscle region. Accuracy and computational speed of pectoral muscle identification was assessed using 951 women (1,902 MLO mammograms) from the Joanne Knight Breast Health Cohort at Washington University School of Medicine. RESULTS: Our proposed algorithm exhibits lower mean error of 12.22% in comparison to Libra\u27s estimated error of 20.44%. This 40% gain in accuracy was statistically significant (p \u3c 0.001). The computational time for the proposed algorithm is 5.4 times faster when compared to Libra (5.1 s for proposed vs. 27.7 s for Libra per mammogram). CONCLUSION: We present a novel approach for pectoral muscle removal in mammogram images that demonstrates significant improvement in accuracy and efficiency compared to existing method. Our findings have important implications for the development of computer-aided systems and other automated tools in this field

Racial disparities in the incidence of colon cancer in patients with inflammatory bowel disease

Background: Studies have explored the relationship between inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and colon cancer (CC). Additionally, racial disparities in the incidence of CC is well known. However, the impact of racial disparity in IBD patients who develop CC remains unclear. The aim of this study is to address the knowledge gap in this particular group of patients. Methods: A retrospective analysis was done using the National Inpatient Sample (NIS) database from 2011. We included patients with IBD over age >= 18 years with a diagnosis of CC. Patients were stratified by race, gender, age, presence of IBD and CC. Statistical analysis was performed to compare the groups. Results: A total of 57,542 patients were included (CD: 36,357, UC: 21,001). Of all patients with and without IBD, advanced age, Black and Asian race conferred an increased risk of developing CC, whereas female gender, Hispanic and Native American race conferred a protective effect. In patients with IBD, advanced age conferred an increased risk for developing CC while female gender conferred a protective effect. In this subset of patients, black race conferred a protective effect. Conclusions: Racial disparity exists in the overall incidence of CC and among patients with IBD who develop CC. Interestingly, black race conferred a protective effect for patients with IBD, contrary to what is seen in the general population. These findings could be attributed to the environmental factors and genetic makeup between racial groups. Further studies are warranted to better understand these disparities.Open Access JournalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

A framework for bounding nonlocality of state discrimination

We consider the class of protocols that can be implemented by local quantum operations and classical communication (LOCC) between two parties. In particular, we focus on the task of discriminating a known set of quantum states by LOCC. Building on the work in the paper "Quantum nonlocality without entanglement" [BDF+99], we provide a framework for bounding the amount of nonlocality in a given set of bipartite quantum states in terms of a lower bound on the probability of error in any LOCC discrimination protocol. We apply our framework to an orthonormal product basis known as the domino states and obtain an alternative and simplified proof that quantifies its nonlocality. We generalize this result for similar bases in larger dimensions, as well as the "rotated" domino states, resolving a long-standing open question [BDF+99].Comment: 33 pages, 7 figures, 1 tabl

Shipping noise in a dynamic sea:a case study of grey seals in the Celtic Sea

Shipping noise is a threat to marine wildlife. Grey seals are benthic foragers, and thus experience acoustic noise throughout the water column, which makes them a good model species for a case study of the potential impacts of shipping noise. We used ship track data from the Celtic Sea, seal track data and a coupled ocean-acoustic modelling system to assess the noise exposure of grey seals along their tracks. It was found that the animals experience step changes in sound levels up to ~20dB at a frequency of 125Hz, and ~10dB on average over 10-1000Hz when they dive through the thermocline, particularly during summer. Our results showed large seasonal differences in the noise level experienced by the seals. These results reveal the actual noise exposure by the animals and could help in marine spatial planning

Metal organic frameworks with carbon black for the enhanced electrochemical detection of 2,4,6-trinitrotoluene

The sensing of explosives such as 2,4,6-trinitrotoluene (TNT) directly at an explosion site requires a fast, simple and sensitive detection method, to which electrochemical techniques are well suited. Herein, we report an electrochemical sensor material for TNT based on an ammonium hydroxide (NH4OH) sensitized zinc-1,4–benzenedicarboxylate Zn(BDC) metal organic framework (MOF) mixed with carbon black on a glassy carbon electrode. In the solvent modulation mechanism, by merely changing the concentration of NH4OH during synthesis, two Zn(BDC) MOFs with novel morphologies were fabricated via a hydrothermal approach. The as-prepared MOFs were characterized using X-ray powder diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS) and high-resolution field emission electron microscopy (FESEM) equipped with energy dispersive X-ray spectroscopy (EDS). The different morphologies of the MOFs, and their impact on the performance of the modified electrodes towards the electrochemical detection of TNT was investigated. Under optimum conditions, 0.7–Zn(BDC) demonstrated the best electrochemical response for TNT detection using square wave voltammetry (SWV) with a linear calibration response in the range of 0.3–1.0 M, a limit of detection (LOD) of 0.042 M, a limit of quantification (LOQ) of 0.14 M and a high rate of repeatability. Atomic-scale simulations based on density functional theory authenticated the efficient sensing properties of Zn(BDC) MOF towards TNT. Furthermore, the promising response of the sensors in real sample matrices (tap water and wastewater) was demonstrated, opening new avenues towards the real-time detection of TNT in real environmental samples

Papillary muscle infarction in relation to left ventricular infarct distribution and transmurality - assessment by delayed enhancement cardiac magnetic resonance imaging

This study used delayed enhancement CMR (DE-CMR) and invasive angiography to evaluate relationships between papillary muscle and left ventricular (LV) chamber wall infarction following ST segment elevation MI (STEMI). Results demonstrate that papillary muscle infarction (PMI) parallels infarct transmurality and contractile dysfunction within the adjacent LV wall

Disparities in risk perception of thyroid cancer recurrence and death

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154276/1/cncr32670.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154276/2/cncr32670_am.pd