Lessons Learned From the Spirit of E.A.G.L.E.S. Community Program Networks Program

The Spirit of E.A.G.L.E.S. is the only national CNP working specifically with American Indian and Alaska Native Populations. The 2007 Annual Report to the Nation from NCI provided an in-depth look at the cancer health disparities related to the AIAN people. Dr. Kaur will address the historical patterns of cancer in AIAN communities and the need for community based participatory research to overcome many barriers to comprehensive cancer control

The Perioperative Surgical Home: A New Paradigm in a Surgical Episode of Care

An overview and review of a Perioperative Surgical Home (PSH) pilot developed using hte guiding principles of the patient-centered medical home. The PSH coordinates care and decisions from the decision to operate through return to primary care. The pilot demonstrated that a PSH improves efficiencies, decreases waste, improves patient and physician satisfaction and decreases care costs

Primary Care and the Perioperative Surgical Home

Our team partnered with UMass Memorial Medical Center’s Urology and Anesthesiology departments on a pilot patient-centered, physician-led, multidisciplinary team-based system of coordinated care for the surgical patient. The goals were to improve the patient experience, improve health care and reduce costs. Primary care physicians were surveyed to understand how surgical teams can better coordinate care with primary care. The results of the survey show that concise, useful communication about mutual patients is important to primary care physicians; there is no need for immediate follow-up appointments with primary care physicians unless necessary – appointments are recommended for two to four weeks after discharge; and defining the roles of primary care physicians and the surgeon is important

Breast Cancer Incidence Among American Indian and Alaska Native Women: US, 1999–2004

BACKGROUND. Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race. METHODS. Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of AI/AN race: linking cases to Indian Health Service (IHS) patient services database, restricting analyses to Contract Health Service Delivery Area counties, and stratifying results by IHS region. RESULTS. Breast cancer incidence rates among AI/AN women varied nearly 3- fold across IHS regions. The highest rates were in Alaska (134.8) and the Plains (Northern, 115.9; Southern, 115.7), and the lowest rates were in the Southwest (50.8). The rate in Alaska was similar to the rate among non-Hispanic white (NHW) women in Alaska. Overall, AI/AN women had lower rates of breast cancer than NHW women, but AI/AN women were more likely to be diagnosed with late-stage disease. CONCLUSIONS. To the authors’ knowledge, this report provides the most comprehensive breast cancer incidence data for AI/AN women to date. The wide regional variation indicates an important need for etiologic and health services research, and the large percentage of AI/AN women with late-stage disease demands innovative approaches for increasing access to screening

On the use and abuse of networks in academia

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Maintaining Blood Glucose Levels in Range (70–150 mg/dL) is Difficult in COVID-19 Compared to Non-COVID-19 ICU Patients—A Retrospective Analysis

Beta cell dysfunction is suggested in patients with COVID-19 infections. Poor glycemic control in ICU is associated with poor patient outcomes. This is a single center, retrospective analysis of 562 patients in an intensive care unit from 1 March to 30 April 2020. We review the time in range (70–150 mg/dL) spent by critically ill COVID-19 patients and non-COVID-19 patients, along with the daily insulin use. Ninety-three in the COVID-19 cohort and 469 in the non-COVID-19 cohort were compared for percentage of blood glucose TIR (70–150 mg/dL) and average daily insulin use. The COVID-19 cohort spent significantly less TIR (70–150 mg/dL) compared to the non-COVID-19 cohort (44.4% vs. 68.5%). Daily average insulin use in the COVID-19 cohort was higher (8.37 units versus 6.17 units). ICU COVID-19 patients spent less time in range (70–150 mg/dL) and required higher daily insulin dose. A higher requirement for ventilator and days on ventilator was associated with a lower TIR. Mortality was lower for COVID-19 patients who achieved a higher TIR.Authors would like to acknowledge Chris C. Naum for his assistance with payment of the article processing fee

Photosensitized INA-Labelled protein 1 (PhIL1) is novel component of the inner membrane complex and is required for Plasmodium parasite development.

Plasmodium parasites, the causative agents of malaria, possess a distinctive membranous structure of flattened alveolar vesicles supported by a proteinaceous network, and referred to as the inner membrane complex (IMC). The IMC has a role in actomyosin-mediated motility and host cell invasion. Here, we examine the location, protein interactome and function of PhIL1, an IMC-associated protein on the motile and invasive stages of both human and rodent parasites. We show that PhIL1 is located in the IMC in all three invasive (merozoite, ookinete-, and sporozoite) stages of development, as well as in the male gametocyte and locates both at the apical and basal ends of ookinete and sporozoite stages. Proteins interacting with PhIL1 were identified, showing that PhIL1 was bound to only some proteins present in the glideosome motor complex (GAP50, GAPM1-3) of both P. falciparum and P. berghei. Analysis of PhIL1 function using gene targeting approaches indicated that the protein is required for both asexual and sexual stages of development. In conclusion, we show that PhIL1 is required for development of all zoite stages of Plasmodium and it is part of a novel protein complex with an overall composition overlapping with but different to that of the glideosome