A Bulloch Tapestry

The title for this collection was inspired by a poem by Rita Turner Wall. The poem is included in this book, along with articles by C.D. Sheley, Daniel Good, James D. Morgan, Gregory Alan Baker, Paul T. Marlott, and Charles Bonds, David R. Williams. Topics covered by these articles are the history of the Bill Olliff House; the historical geography of Arcola, New Hope, and Denmark, Georgia; the lives of Luetta Leverette Moore and Amanda Love Smith; and the letters of Confederate soldier Asbury Wesley Hodges. Also included are letters to Union soldier Perry Lovejoy, submitted by Bill Lovejoy and transcribed by Evelyn Mabry. The index to this collection was compiled by Julius Ariail.https://digitalcommons.georgiasouthern.edu/bchs-pubs/1001/thumbnail.jp

Coding for Damage-Control Surgery

The American College of Surgeons (ACS) General Surgery Coding and Reimbursement Committee (GSCRC) frequently receives questions regarding appropriate coding for “damage-control laparotomy” or “damage-control surgery.” Damage-control surgery typically involves a multistage approach and is performed with the intention to first avoid or correct the lethal triad of hypothermia, acidosis, and coagulopathy before definitive management of injuries. The general concept is the expedient control of life-threatening bleeding and contamination, usually terminated as soon as possible in order for the patient to undergo correction of physiologic abnormalities due to hemorrhagic shock or sepsis. Subsequent stages of surgery address definitive management when the patient is stable and able to undergo more prolonged procedures. Initially developed by the military and major trauma centers, the concept of damage-control surgery is now widely accepted and may be applied to the chest, abdomen, or extremities

Development and validation of the early warning system scores ontology

Abstract Background Clinical early warning scoring systems, have improved patient outcomes in a range of specializations and global contexts. These systems are used to predict patient deterioration. A multitude of patient-level physiological decompensation data has been made available through the widespread integration of early warning scoring systems within EHRs across national and international health care organizations. These data can be used to promote secondary research. The diversity of early warning scoring systems and various EHR systems is one barrier to secondary analysis of early warning score data. Given that early warning score parameters are varied, this makes it difficult to query across providers and EHR systems. Moreover, mapping and merging the parameters is challenging. We develop and validate the Early Warning System Scores Ontology (EWSSO), representing three commonly used early warning scores: the National Early Warning Score (NEWS), the six-item modified Early Warning Score (MEWS), and the quick Sequential Organ Failure Assessment (qSOFA) to overcome these problems. Methods We apply the Software Development Lifecycle Framework—conceived by Winston Boyce in 1970—to model the activities involved in organizing, producing, and evaluating the EWSSO. We also follow OBO Foundry Principles and the principles of best practice for domain ontology design, terms, definitions, and classifications to meet BFO requirements for ontology building. Results We developed twenty-nine new classes, reused four classes and four object properties to create the EWSSO. When we queried the data our ontology-based process could differentiate between necessary and unnecessary features for score calculation 100% of the time. Further, our process applied the proper temperature conversions for the early warning score calculator 100% of the time. Conclusions Using synthetic datasets, we demonstrate the EWSSO can be used to generate and query health system data on vital signs and provide input to calculate the NEWS, six-item MEWS, and qSOFA. Future work includes extending the EWSSO by introducing additional early warning scores for adult and pediatric patient populations and creating patient profiles that contain clinical, demographic, and outcomes data regarding the patient

Health Literacy and Health Information Technology Adoption: The Potential for a New Digital Divide

This article discusses whether health literacy is associated with pateints' use of four types of health information technology (HIT) tools: fitness and nutrition apps, activity trackers, and patient portals

Disease-Specific Amino Acid Infusion (F080) in Hepatic Encephalopathy: A Prospective, Randomized, Double-Blind, Controlled Trial

Seventy-five patients with acute hepatic decompensation superimposed on chronic alcoholic cirrhosis were prospectively randomized for a blinded trial of the treatment of hepatic encephalopathy. The control group received 4 g of enteral neomycin daily along with 25% dextrose by a central venous catheter. The experimental group received a placebo resembling neomycin and isocaloric dextrose plus a modified amino acid mixture enriched with branched-chain amino acids to 36% and deficient in aromatic amino acids and methionine. Thirty patients in the F080 group and 29 in the control group completed the trial. The group receiving the modified amino acid mixture demonstrated a statistically significant improvement in encephalopathy as compared to the neomycin group, while maintaining nitrogen equilibrium. Survival and discharge from the hospital were statistically greater in the group treated with the modified amino acid solution and hypertonic dextrose. Treatment of hepatic encephalopathy in the presence of hepatic decompensation with an amino acid solution formulated for its treatment seems to produce faster, more complete recovery with improved capacity for nutritional support. (Journal of Parenteral and Enteral Nutrition 9:288-295, 1985

Phase II study of single-agent navitoclax (ABT-263) and biomarker correlates in patients with relapsed small cell lung cancer

PURPOSE: Bcl-2 is a critical regulator of apoptosis that is overexpressed in the majority of small cell lung cancers (SCLC). Nativoclax (ABT-263) is a potent and selective inhibitor of Bcl-2 and Bcl-x(L). The primary objectives of this phase IIa study included safety at the recommended phase II dose and preliminary, exploratory efficacy assessment in patients with recurrent and progressive SCLC after at least one prior therapy. EXPERIMENTAL DESIGN: Thirty-nine patients received navitoclax 325 mg daily, following an initial lead-in of 150 mg daily for 7 days. Study endpoints included safety and toxicity assessment, response rate, progression-free and overall survival (PFS and OS), as well as exploratory pharmacodynamic correlates. RESULTS: The most common toxicity associated with navitoclax was thrombocytopenia, which reached grade III–IV in 41% of patients. Partial response was observed in one (2.6%) patient and stable disease in 9 (23%) patients. Median PFS was 1.5 months and median OS was 3.2 months. A strong association between plasma pro–gastrin-releasing peptide (pro-GRP) level and tumor Bcl-2 copy number (R = 0.93) was confirmed. Exploratory analyses revealed baseline levels of cytokeratin 19 fragment antigen 21-1, neuron-specific enolase, pro-GRP, and circulating tumor cell number as correlates of clinical benefit. CONCLUSION: Bcl-2 targeting by navitoclax shows limited single-agent activity against advanced and recurrent SCLC. Correlative analyses suggest several putative biomarkers of clinical benefit. Preclinical models support that navitoclax may enhance sensitivity of SCLC and other solid tumors to standard cytotoxics. Future studies will focus on combination therapies