Healthcare Analytics Leadership: Clinical & Business Intelligence Plan Development

Future healthcare leaders require expert knowledge and practical capabilities in the evaluation, selection, application and ongoing oversight of the best types of analytics to create continuous learning healthcare systems. These systems may result in continuously improving the demonstrable quality, safety and efficiency of healthcare organizations. Data is an asset for organizations. However, many companies do not know how to establish analytical road maps for future action. Population Health Intelligence describes a new discipline whose role is to collect, organize, harmonize, analyze, disseminate and act upon the data available to clinicians, health system leaders, the pharmaceutical and biotechnology industry, and healthcare payers. This webinar on Analytics Leadership will demonstrate how to create and implement Clinical & Business Intelligence Plans that transform data into actionable organizational insights. Agenda Introduction Healthcare Analytics Leadership: Clinical & Business Intelligence Plan Development Population Health Intelligence Presentation: 53:3

First detections of H¹³CO+ and HC¹⁵N in the disk around HD 97048: Evidence for a cold gas reservoir in the outer disk

Observations of different molecular lines in protoplanetary disks provide valuable information on the gas kinematics, as well as constraints on the radial density and temperature structure of the gas. With ALMA we have detected H¹³CO+ (J = 4–3) and HC¹⁵ N (J = 4–3) in the HD 97048 protoplanetary disk for the first time. We compare these new detections to the ringed continuum mm-dust emission and the spatially resolved CO (J = 3–2) and HCO+ (J = 4–3) emission. The radial distributions of the H¹²CO+ and HC¹⁵N emission show hints of ringed sub-structure whereas, the optically thick tracers, CO and HCO+, do not. We calculate the HCO+/H¹³CO+ intensity ratio across the disk and find that it is radially constant (within our uncertainties). We use a physio-chemical parametric disk structure of the HD 97048 disk with an analytical prescription for the HCO+ abundance distribution to generate synthetic observations of the HCO+ and H¹³CO+ disk emission assuming LTE. The best by-eye fit models require radial variations in the HCO+/H¹³CO+ abundance ratio and an overall enhancement in H¹³CO+ relative to HCO+. This highlights the need to consider isotope selective chemistry and in particular low temperature carbon isotope exchange reactions. This also points to the presence of a reservoir of cold molecular gas in the outer disk (T ~ 10 K, R ~ 200 au). Chemical models are required to confirm that isotope-selective chemistry alone can explain the observations presented here. With these data, we cannot rule out that the known dust substructure in the HD 97048 disk is responsible for the observed trends in molecular line emission, and higher spatial resolution observations are required to fully explore the potential of optically thin tracers to probe planet-carved dust gaps. We also report non-detections of H¹³CO+ and HC¹⁵N in the HD 100546 protoplanetary disk

Diversity of Zoanthids (Anthozoa: Hexacorallia) on Hawaiian Seamounts: Description of the Hawaiian Gold Coral and Additional Zoanthids

The Hawaiian gold coral has a history of exploitation from the deep slopes and seamounts of the Hawaiian Islands as one of the precious corals commercialised in the jewellery industry. Due to its peculiar characteristic of building a scleroproteic skeleton, this zoanthid has been referred as Gerardia sp. (a junior synonym of Savalia Nardo, 1844) but never formally described or examined by taxonomists despite its commercial interest. While collection of Hawaiian gold coral is now regulated, globally seamounts habitats are increasingly threatened by a variety of anthropogenic impacts. However, impact assessment studies and conservation measures cannot be taken without consistent knowledge of the biodiversity of such environments. Recently, multiple samples of octocoral-associated zoanthids were collected from the deep slopes of the islands and seamounts of the Hawaiian Archipelago. The molecular and morphological examination of these zoanthids revealed the presence of at least five different species including the gold coral. Among these only the gold coral appeared to create its own skeleton, two other species are simply using the octocoral as substrate, and the situation is not clear for the final two species. Phylogenetically, all these species appear related to zoanthids of the genus Savalia as well as to the octocoral-associated zoanthid Corallizoanthus tsukaharai, suggesting a common ancestor to all octocoral-associated zoanthids. The diversity of zoanthids described or observed during this study is comparable to levels of diversity found in shallow water tropical coral reefs. Such unexpected species diversity is symptomatic of the lack of biological exploration and taxonomic studies of the diversity of seamount hexacorals

Accuracy of nature of call screening tool in identifying patients requiring treatment for out of hospital cardiac arrest

BackgroundA new pre-triage screening tool, Nature of Call (NoC), has been introduced into the telephone triage system of UK ambulance services which employ National Health Service Pathways (NHSP). Its function is to provide rapid recognition of patients who may need immediate ambulance dispatch for out-of-hospital cardiac arrest (OHCA) and withholding dispatch for other calls while further triage is undertaken. In this study, we evaluated the accuracy of NoC and NHSP in identifying patients with potentially treatable or imminent OHCA.MethodsThis retrospective, observational study reviewed consecutive calls to a UK ambulance service between October 2016 and February 2017 in which NOC, and then NHSP were applied sequentially. Only those calls for which a corresponding electronic Patient Clinical Record was available were included. Sensitivity and specificity of NOC and NHSP for recognition of an OHCA were determined by comparing allocated priority dispositions with an OHCA Treatment Registry (OHCATR).ResultsOf 96 423 calls received, 71 373 were reviewed. For 590 (0.8%) of these calls, the patients received treatment for OHCA. NOC identified 458 OHCATR patients; NHSP identified 467; together they identified 496. NoC captured 29 patients not identified by NHSP; NHSP captured 38 patients not identified by NOC. For NOC sensitivity was 77.6% (95% CI 74.1 to 80.8) and specificity 86.9% (95% CI 86.6 to 87.1). NHSP sensitivity was 79.2% (95% CI 75.7 to 82.2) and specificity 93.4% (95% CI 93.2 to 93.6). NoC and NHSP combined had a sensitivity of 84.1% (95% CI 80.9 to 86.8) and specificity of 85.3% (95% CI 85.1 to 85.6).ConclusionsNoC and NHSP call categorisation each achieved similar sensitivity for the identification of OHCATR, identifying most of the same patients, but each captured unique patients. Using both methods sequentially improved accuracy. The 16% of OHCATR patients not identified by either method present a challenge to ambulance dispatch systems.</jats:sec

An inherited complex organic molecule reservoir in a warm planet-hosting disk

Quantifying the composition of the material in protoplanetary disks is essential to determining the potential for exoplanetary systems to produce and support habitable environments. When considering potential habitability, complex organic molecules are relevant, key among which is methanol (CH3OH). Methanol primarily forms at low temperatures via the hydrogenation of CO ice on the surface of icy dust grains and is a necessary basis for the formation of more complex species such as amino acids and proteins. We report the detection of CH3OH in a disk around a young, luminous A-type star, HD 100546. This disk is warm and therefore does not host an abundant reservoir of CO ice. We argue that the CH3OH cannot form in situ, and hence that this disk has probably inherited complex-organic-molecule-rich ice from an earlier cold dark cloud phase. This is strong evidence that at least some interstellar organic material survives the disk-formation process and can then be incorporated into forming planets, moons and comets. Therefore, crucial pre-biotic chemical evolution already takes place in dark star-forming clouds

Efficacy of a synthetic calcium phosphate with submicron surface topography as autograft extender in lapine posterolateral spinal fusion.

Posterolateral spinal fusion (PLF) is a common procedure in orthopedic surgery that is performed to fuse adjacent vertebrae to reduce symptoms related to spinal conditions. In the current study, a novel synthetic calcium phosphate with submicron surface topography was evaluated as an autograft extender in a validated rabbit model of PLF. Fifty-nine skeletally mature New Zealand white rabbits were divided into three groups and underwent single-level intertransverse process PLF at L4-5 using (1) autologous bone graft (ABG) alone or in a 1:1 combination with (2) calcium phosphate granules (ABG/BCPgranules ), or (3) granules embedded in a fast-resorbing polymeric carrier (ABG/BCPputty ). After 6, 9, and 12 weeks, animals were sacrificed and spinal fusion was assessed by manual palpation, Radiographs, micro-CT, mechanical testing (12 weeks only), histology, and histomorphometry. Based on all endpoints, all groups showed a gradual progression in bone formation and maturation during time, leading to solid fusion masses between the transverse processes after 12 weeks. Fusion assessments by manual palpation, radiography and histology were consistent and demonstrated equivalent fusion rates between groups, with high bilateral fusion rates after 12 weeks. Mechanical tests after 12 weeks indicated substantially lower range of motion for all groups, compared to non-operated controls. By histology and histomorphometry, the gradual formation and maturation of bone in the fusion mass was confirmed for each graft type. With these results, we describe the equivalent performance between autograft and a novel calcium phosphate material as an autograft extender in a rabbit model of PLF using an extensive range of evaluation techniques. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res B Part B, 2019

Amyloid-β nanotubes are associated with prion protein-dependent synaptotoxicity

Growing evidence suggests water-soluble, non-fibrillar forms of amyloid-β protein (Aβ) have important roles in Alzheimer's disease with toxicities mimicked by synthetic Aβ1-42. However, no defined toxic structures acting via specific receptors have been identified and roles of proposed receptors, such as prion protein (PrP), remain controversial. Here we quantify binding to PrP of Aβ1-42 after different durations of aggregation. We show PrP-binding and PrP-dependent inhibition of long-term potentiation (LTP) correlate with the presence of protofibrils. Globular oligomers bind less avidly to PrP and do not inhibit LTP, whereas fibrils inhibit LTP in a PrP-independent manner. That only certain transient Aβ assemblies cause PrP-dependent toxicity explains conflicting reports regarding the involvement of PrP in Aβ-induced impairments. We show that these protofibrils contain a defined nanotubular structure with a previously unidentified triple helical conformation. Blocking the formation of Aβ nanotubes or their interaction with PrP might have a role in treatment of Alzheimer's disease