Assessing the performance of the Asian/Pacific islander identification algorithm to infer Hmong ethnicity from electronic health records in California.

OBJECTIVE:This study assesses the performance of the North American Association of Central Cancer Registries Asian/Pacific Islander Identification Algorithm (NAPIIA) to infer Hmong ethnicity. DESIGN AND SETTING:Analyses of electronic health records (EHRs) from 1 January 2011 to 1 October 2015. The NAPIIA was applied to the EHR data, and self-reported Hmong ethnicity from a questionnaire was used as the gold standard. Sensitivity, specificity, positive (PPV) and negative predictive values (NPVs) were calculated comparing the source data ethnicity inferred by the algorithm with the self-reported ethnicity from the questionnaire. PARTICIPANTS:EHRs indicating Hmong, Chinese, Vietnamese and Korean ethnicity who met the original study inclusion criteria were analysed. RESULTS:The NAPIIA had a sensitivity of 78%, a specificity of 99.9%, a PPV of 96% and an NPV of 99%. The prevalence of Hmong population in the sample was 3.9%. CONCLUSION:The high sensitivity of the NAPIIA indicates its effectiveness in detecting Hmong ethnicity. The applicability of the NAPIIA to a multitude of Asian subgroups can advance Asian health disparity research by enabling researchers to disaggregate Asian data and unmask health challenges of different Asian subgroups

Technology and Caregiving: Emerging Interventions and Directions for Research.

An array of technology-based interventions has increasingly become available to support family caregivers, primarily focusing on health and well-being, social isolation, financial, and psychological support. More recently the emergence of new technologies such as mobile and cloud, robotics, connected sensors, virtual/augmented/mixed reality, voice, and the evermore ubiquitous tools supported by advanced data analytics, coupled with the integration of multiple technologies through platform solutions, have opened a new era of technology-enabled interventions that can empower and support family caregivers. This paper proposes a conceptual framework for identifying and addressing the challenges that may need to be overcome to effectively apply technology-enabled solutions for family caregivers. The paper identifies a number of challenges that either moderate or mediate the full use of technologies for the benefit of caregivers. The challenges include issues related to equity, inclusion, and access; ethical concerns related to privacy and security; political and regulatory factors affecting interoperability and lack of standards; inclusive/human-centric design and issues; and inherent economic and distribution channel difficulties. The paper concludes with a summary of research questions and issues that form a framework for global research priorities

Are providers prepared for genomic medicine: interpretation of Direct-to-Consumer genetic testing (DTC-GT) results and genetic self-efficacy by medical professionals.

BACKGROUND:Precision medicine is set to deliver a rich new data set of genomic information. However, the number of certified specialists in the United States is small, with only 4244 genetic counselors and 1302 clinical geneticists. We conducted a national survey of 264 medical professionals to evaluate how they interpret genetic test results, determine their confidence and self-efficacy of interpreting genetic test results with patients, and capture their opinions and experiences with direct-to-consumer genetic tests (DTC-GT). METHODS:Participants were grouped into two categories, genetic specialists (genetic counselors and clinical geneticists) and medical providers (primary care, internists, physicians assistants, advanced nurse practitioners, etc.). The survey (full instrument can be found in the Additional file 1) presented three genetic test report scenarios for interpretation: a genetic risk for diabetes, genomic sequencing for symptoms report implicating a potential HMN7B: distal hereditary motor neuropathy VIIB diagnosis, and a statin-induced myopathy risk. Participants were also asked about their opinions on DTC-GT results and rank their own perceived level of preparedness to review genetic test results with patients. RESULTS:The rates of correctly interpreting results were relatively high (74.4% for the providers compared to the specialist's 83.4%) and age, prior genetic test consultation experience, and level of trust assigned to the reports were associated with higher correct interpretation rates. The self-selected efficacy and the level of preparedness to consult on a patient's genetic results were higher for the specialists than the provider group. CONCLUSION:Specialists remain the best group to assist patients with DTC-GT, however, primary care providers may still provide accurate interpretation of test results when specialists are unavailable

Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States.

BackgroundGender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol.MethodsUsing the 2014-2015 National Alcohol Survey and 2015 National Alcohol's Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women's economic equality) and binge drinking cultures (rates of men's and women's binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses.ResultsIn main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure.ConclusionsDetrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men's drinking

Performance test of QU-fitting in cosmic magnetism study

QU-fitting is a standard model-fitting method to reconstruct distribution of magnetic fields and polarized intensity along a line of sight (LOS) from an observed polarization spectrum. In this paper, we examine the performance of QU-fitting by simulating observations of two polarized sources located along the same LOS, varying the widths of the sources and the gap between them in Faraday depth space, systematically. Markov Chain Monte Carlo (MCMC) approach is used to obtain the best-fit parameters for a fitting model, and Akaike and Bayesian Information Criteria (AIC and BIC, respectively) are adopted to select the best model from four fitting models. We find that the combination of MCMC and AIC/BIC works fairly well in model selection and estimation of model parameters in the cases where two sources have relatively small widths and a larger gap in Faraday depth space. On the other hand, when two sources have large width in Faraday depth space, MCMC chain tends to be trapped in a local maximum so that AIC/BIC cannot select a correct model. We discuss the causes and the tendency of the failure of QU-fitting and suggest a way to improve it.Comment: 8 pages, 9 figures, submitted to MNRA

Approach to wild-type gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GISTs) arise from the intestinal pacemaker cells of Cajal. Wild-type gastrointestinal stromal tumors (WT-GIST) are a unique and uncommon subtype of GISTs that lack activating mutations in the tyrosine kinase c-KIT or platelet derived growth factor receptor alpha (PDGFRA) receptors. The lack of these growth-stimulating mutations renders tyrosine kinase receptor inhibitors, such as imatinib mesylate, relatively ineffective against these tumors. WT-GIST arises most commonly due to underlying alternate proliferative signals associated with germ-line, genetic mutations. WT-GIST frequently arises in patients with BRAF mutations, Carney’s Triad or neurofibromatosis type-1 (NF-1). All patients with WT-GIST require a careful examination for germ-line mutations and very close observation for recurrent tumors. Surgery remains a mainstay therapy for these patients. This review aims to discuss the most recent data available on the diagnosis and treatment of WT-GIST

Lateral Connectivity in the Olfactory Bulb is Sparse and Segregated

Lateral connections in the olfactory bulb were previously thought to be organized for center–surround inhibition. However, recent anatomical and physiological studies showed sparse and distributed interactions of inhibitory granule cells (GCs) which tended to be organized in columnar clusters. Little is known about how these distributed clusters are interconnected. In this study, we use transsynaptic tracing viruses bearing green or red fluorescent proteins to further elucidate mitral- and tufted-to-GC connectivity. Separate sites in the glomerular layer were injected with each virus. Columns with labeling from both viruses after transsynaptic spread show sparse red or green GCs which tended to be segregated. However, there was a higher incidence of co-labeled cells than chance would predict. Similar segregation of labeling is observed from dual injections into olfactory cortex. Collectively, these results suggest that neighboring mitral and tufted cells receive inhibitory inputs from segregated subsets of GCs, enabling inhibition of a center by specific and discontinuous lateral elements

A Multicenter Observer Performance Study of 3D JPEG2000 Compression of Thin-Slice CT

The goal of this study was to determine the compression level at which 3D JPEG2000 compression of thin-slice CTs of the chest and abdomen–pelvis becomes visually perceptible. A secondary goal was to determine if residents in training and non-physicians are substantially different from experienced radiologists in their perception of compression-related changes. This study used multidetector computed tomography 3D datasets with 0.625–1-mm thickness slices of standard chest, abdomen, or pelvis, clipped to 12 bits. The Kakadu v5.2 JPEG2000 compression algorithm was used to compress and decompress the 80 examinations creating four sets of images: lossless, 1.5 bpp (8:1), 1 bpp (12:1), and 0.75 bpp (16:1). Two randomly selected slices from each examination were shown to observers using a flicker mode paradigm in which observers rapidly toggled between two images, the original and a compressed version, with the task of deciding whether differences between them could be detected. Six staff radiologists, four residents, and six PhDs experienced in medical imaging (from three institutions) served as observers. Overall, 77.46% of observers detected differences at 8:1, 94.75% at 12:1, and 98.59% at 16:1 compression levels. Across all compression levels, the staff radiologists noted differences 64.70% of the time, the resident’s detected differences 71.91% of the time, and the PhDs detected differences 69.95% of the time. Even mild compression is perceptible with current technology. The ability to detect differences does not equate to diagnostic differences, although perception of compression artifacts could affect diagnostic decision making and diagnostic workflow