196 research outputs found
Doctors at Risk: A Problem As Viewed by Decision Analysis
The authors closely analyze a case in which a Peer Review Organization cited a physician for treatment with potential for significant adverse effect. They also critique the regulatory scheme under which peer review occurs and conclude that such regulation interferes with physicians\u27 primary obligations, fails to encourage cost-effective behavior and may decrease the quality of medical care
Vol. 35, No. 3
A Primer on the Illinois Education-Based Funding for Student Success Act, by Robert Bloch, A. Lynn Himes, Terry L. Hodges, Mitch Roth, Barbara Erickson, and Jack Vrett
Recent Developmentshttps://scholarship.kentlaw.iit.edu/iperr/1105/thumbnail.jp
Genetic Risk Score Predicts Late-Life Cognitive Impairment
Introduction. A family history of Alzheimer's disease is a significant risk factor for its onset, but the genetic risk associated with possessing multiple risk alleles is still poorly understood. Methods. In a sample of 95 older adults (Mean age = 75.1, 64.2% female), we constructed a genetic risk score based on the accumulation of risk alleles in BDNF, COMT, and APOE. A neuropsychological evaluation and consensus determined cognitive status (44 nonimpaired, 51 impaired). Logistic regression was performed to determine whether the genetic risk score predicted cognitive impairment above and beyond that associated with each gene. Results. An increased genetic risk score was associated with a nearly 4-fold increased risk of cognitive impairment (OR = 3.824, P = .013) when including the individual gene polymorphisms as covariates in the model. Discussion. A risk score combining multiple genetic influences may be more useful in predicting late-life cognitive impairment than individual polymorphisms
Correlation functions quantify super-resolution images and estimate apparent clustering due to over-counting
We present an analytical method to quantify clustering in super-resolution
localization images of static surfaces in two dimensions. The method also
describes how over-counting of labeled molecules contributes to apparent
self-clustering and how the effective lateral resolution of an image can be
determined. This treatment applies to clustering of proteins and lipids in
membranes, where there is significant interest in using super-resolution
localization techniques to probe membrane heterogeneity. When images are
quantified using pair correlation functions, the magnitude of apparent
clustering due to over-counting will vary inversely with the surface density of
labeled molecules and does not depend on the number of times an average
molecule is counted. Over-counting does not yield apparent co-clustering in
double label experiments when pair cross-correlation functions are measured. We
apply our analytical method to quantify the distribution of the IgE receptor
(Fc{\epsilon}RI) on the plasma membranes of chemically fixed RBL-2H3 mast cells
from images acquired using stochastic optical reconstruction microscopy (STORM)
and scanning electron microscopy (SEM). We find that apparent clustering of
labeled IgE bound to Fc{\epsilon}RI detected with both methods arises from
over-counting of individual complexes. Thus our results indicate that these
receptors are randomly distributed within the resolution and sensitivity limits
of these experiments.Comment: 22 pages, 5 figure
Hubble Space Telescope NICMOS Polarization Observations of Three Edge-on Massive YSOs
Massive young stellar objects (YSOs), like low-mass YSOs, appear to be
surrounded by optically thick envelopes and/or disks and have regions, often
bipolar, that are seen in polarized scattered light at near-infrared
wavelengths. We are using the 0.2'' spatial resolution of NICMOS on Hubble
Space Telescope to examine the structure of the disks and outflow regions of
massive YSOs in star-forming regions within a few kpc of the Sun. Here we
report on 2 micron polarimetry of NGC 6334 V and S255 IRS1. NGC 6334 V consists
of a double-lobed bright reflection nebula seen against a dark region, probably
an optically thick molecular cloud. Our polarization measurements show that the
illuminating star lies ~ 2'' south of the line connecting the two lobes; we do
not detect this star at 2 micron, but there are a small radio source and a
mid-infrared source at this location. S255 IRS1 consists of two YSOs (NIRS1 and
NIRS3) with overlapping scattered light lobes and luminosities corresponding to
early B stars. Included in IRS1 is a cluster of stars from whose polarization
we determine the local magnetic field direction. Neither YSO has its scattered
light lobes aligned with this magnetic field. The line connecting the scattered
light lobes of NIRS1 is twisted symmetrically around the star; the best
explanation is that the star is part of a close binary and the outflow axis of
NIRS1 is precessing as a result of non-coplanar disk and orbit. The star NIRS3
is also offset from the line connecting its two scattered light lobes. We
suggest that all three YSOs show evidence of episodic ejection of material as
they accrete from dense, optically thick envelopes.Comment: 39 pages, 7 figures, 4 tables To be published in The Astrophysical
Journa
The American Association for the Surgery of Trauma renal injury grading scale: Implications of the 2018 revisions for injury reclassification and predicting bleeding interventions.
BackgroundIn 2018, the American Association for the Surgery of Trauma (AAST) published revisions to the renal injury grading system to reflect the increased reliance on computed tomography scans and non-operative management of high-grade renal trauma (HGRT). We aimed to evaluate how these revisions will change the grading of HGRT and if it outperforms the original 1989 grading in predicting bleeding control interventions.MethodsData on HGRT were collected from 14 Level-1 trauma centers from 2014 to 2017. Patients with initial computed tomography scans were included. Two radiologists reviewed the scans to regrade the injuries according to the 1989 and 2018 AAST grading systems. Descriptive statistics were used to assess grade reclassifications. Mixed-effect multivariable logistic regression was used to measure the predictive ability of each grading system. The areas under the curves were compared.ResultsOf the 322 injuries included, 27.0% were upgraded, 3.4% were downgraded, and 69.5% remained unchanged. Of the injuries graded as III or lower using the 1989 AAST, 33.5% were upgraded to grade IV using the 2018 AAST. Of the grade V injuries, 58.8% were downgraded using the 2018 AAST. There was no statistically significant difference in the overall areas under the curves between the 2018 and 1989 AAST grading system for predicting bleeding interventions (0.72 vs. 0.68, p = 0.34).ConclusionAbout one third of the injuries previously classified as grade III will be upgraded to grade IV using the 2018 AAST, which adds to the heterogeneity of grade IV injuries. Although the 2018 AAST grading provides more anatomic details on injury patterns and includes important radiologic findings, it did not outperform the 1989 AAST grading in predicting bleeding interventions.Level of evidencePrognostic and Epidemiological Study, level III
Impaired perceptual learning in a mouse model of Fragile X syndrome is mediated by parvalbumin neuron dysfunction and is reversible.
To uncover the circuit-level alterations that underlie atypical sensory processing associated with autism, we adopted a symptom-to-circuit approach in the Fmr1-knockout (Fmr1-/-) mouse model of Fragile X syndrome. Using a go/no-go task and in vivo two-photon calcium imaging, we find that impaired visual discrimination in Fmr1-/- mice correlates with marked deficits in orientation tuning of principal neurons and with a decrease in the activity of parvalbumin interneurons in primary visual cortex. Restoring visually evoked activity in parvalbumin cells in Fmr1-/- mice with a chemogenetic strategy using designer receptors exclusively activated by designer drugs was sufficient to rescue their behavioral performance. Strikingly, human subjects with Fragile X syndrome exhibit impairments in visual discrimination similar to those in Fmr1-/- mice. These results suggest that manipulating inhibition may help sensory processing in Fragile X syndrome
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National Bureau of Standards Reports
Report issued by the Bureau of Standards over studies on the benefits of computerized record-keeping. Medical records were chosen for the studies, and they also focus on patient privacy and rights. This report includes tables, and illustrations
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