Luxurious Surfaces: Chinese Decorative Arts from the 15th to the Early 20th Century

Luxurious Surfaces: Chinese Decorative Arts from the Fifteenth to the Early Twentieth Century is a highly anticipated exhibition that highlights student learning in the art history program. The curators, William Caterham ’20, Ashley Jeffords ’20, Merlyn Maldonado Lopez ’22, Sarah Paul ’22, James Raphaelson ’21, Megan Reimer ’22, Shannon Zeltmann ’21 and Tianrun Zhao ’20, are students enrolled in the Art History Method class in Fall 2019. The exhibition examines the quintessential characteristics and the meaning of Chinese decorative arts embedded in the luxurious surfaces of sixteen carefully selected works from Gettysburg College’s Asian Art Collection.https://cupola.gettysburg.edu/artcatalogs/1032/thumbnail.jp

Magnetic susceptibility studies of the spin-glass and Verwey transitions in magnetite nanoparticles

Magnetite nanostructured powder samples were synthesized by aging chemical method. Phase, structural, and magnetic properties were characterized. X-ray diffraction patterns showed cubic magnetite pure phase, with average crystallite size, , equal to 40 nm. Susceptibility measurements showed the well-known Verwey transition at a temperature of 90 K. The decrease of Verwey transition temperature, with respect to the one reported in literature (125 K) was attributed to the low average crystallite size. Moreover, the spin-glass like transition was observed at 35 K. Activation energy calculated from susceptibility curves, with values ranging from 6.26 to 6.93 meV, showed a dependence of spin-glass transition on frequency. Finally, hysteresis loops showed that there is not an effect of Verwey transition on magnetic properties. On the other hand, a large increase of coercivity and remanent magnetization at a temperature between 5 and 50 K confirmed the presence of a magnetic transition at low temperatures

Direct hospitalization costs associated with chronic Hepatitis C in the Valencian Community in 2013

[ES] Fundamentos. Los costes hospitalarios asociados a la Hepatitis Crónica C (HCC) surgen en los estadíos finales de la enfermedad. Su cuantificación es de gran utilidad para estimar la carga de la enfermedad y establecer decisiones de financiación de los nuevos antivirales. Los costes más elevados son motivados por la descompensación de la cirrosis. Métodos. Estudio observacional de corte transversal de los costes hospitalarios de episodios con diagnóstico de HCC en la Comunidad Valenciana en 2013. Fuente de información: Conjunto mínimo básico de datos. Se estimaron los costes según las tarifas establecidas para los GRD (Grupos relacionados por el diagnóstico) asociados a los episodios con diagnóstico de hepatitis C. La supervivencia media de los pacientes desde que se inició la descompensación de su cirrosis se estimó mediante un modelo de Markov, según las probabilidades de evolución de la enfermedad existentes en la literatura. Resultados. Se registraron 4.486 episodios de hospitalización con diagnóstico de HCC, 1.108 fueron debidos a complicaciones de la HCC que generaron 6.713 estancias, tasa de reingresos del 28,2 % y mortalidad del 10,2%. El coste hospitalario ascendió a 8.788.593EUR: 3.306.333EUR correspondieron a Cirrosis (5.273EUR/paciente); 1.060.521EUR a Carcinoma (6.350EUR/ paciente) y 2.962.873EUR a trasplante (70.544EUR/paciente). La comorbilidad por Hepatitis C supuso 1.458.866EUR. Estos costes se mantienen durante una media de 4 años una vez comienza la descompensación de la cirrosis. Conclusiones. La cirrosis por HCC genera un coste muy elevado por hospitalización, la metodología utilizada en la estimación de estos costes a partir de los GRD puede ser de gran utilidad para evaluar la tendencia e impacto económico de esta enfermedad.[EN] Background. Hospital costs associated with Chronic Hepatitis C (HCC) arise in the final stages of the disease. Its quantification is very helpful in order to estimate and check the burden of the disease and to make financial decisions for new antivirals. The highest costs are due to the decompensation of cirrosis. Methods. Cross-sectional observational study of hospital costs of HCC diagnoses in the Valencian Community in 2013 (n= 4,486 hospital discharges). Information source: Minimum basic set of data/ Basic Minimum Data Set. The costs were considered according to the rates established for the DRG (Diagnosis related group) associated with the episodes with diagnosis of hepatitis C. The average survival of patients since the onset of the decompensation of their cirrhosis was estimated by a Markov model, according to the probabilities of evolution of the disease existing in Literatura. Results. There were 4,486 hospital episodes, 1,108 due to complications of HCC, which generated 6,713 stays, readmission rate of 28.2% and mortality of 10.2%. The hospital cost amounted to 8,788,593EUR: 3,306,333EUR corresponded to Cirrhosis (5,273EUR/patient); 1,060,521EUR to Carcinoma (6,350EUR/ patient) and 2,962,873EUR to transplantation (70,544EUR/paciente. Comorbidity was 1,458,866EUR. These costs are maintained for an average of 4 years once the cirrhosis decompensation begins. Conclusions. Cirrhosis due to HCC generates a very high hospitalization¿s costs. The methodology used in the estimation of these costs from the DRG can be very useful to evaluate the trend and economic impact of this disease.Barrachina Martínez, I.; Giner-Durán R; Vivas-Consuelo, D.; ANTONIO LOPEZ RODADO; Maldonado Segura, JA. (2018). Costes de hospitalización asociados a la Hepatitis crónica C en la Comunidad Valenciana en 2013. Revista Española de Salud Pública. 92:1-12. http://hdl.handle.net/10251/124218S1129

CD8+ DC, but Not CD8−DC, Isolated from BCG-Infected Mice Reduces Pathological Reactions Induced by Mycobacterial Challenge Infection

Tuberculosis is a mycobacterial infection causing worldwide public health problems but the available vaccine is far from ideal. Type-1 T cell immunity has been shown to be critical for host defence against tuberculosis infection, but the role of dendritic cell (DC) subsets in pathogenesis of mycobacterial infection remains unclear.We examined the effectiveness of dendritic cell (DC) subsets in BCG-infected mice in generating immune responses beneficial for pathogen clearance and reduction of pathological reactions in the tissues following challenge infection. Our data showed that only the adoptive transfer of the subset of CD8alpha+ DC isolated from infected mice (iCD8+ DC) generated significant protection, demonstrated by less mycobacterial growth and pathological changes in the lung and liver tissues in iCD8+ DC recipients than sham-treated control mice. The adoptive transfer of the CD8alpha(-)DC from the infected mice (iCD8(-) DC) not only failed to reduce bacterial growth, but enhanced inflammation characterized by diffuse heavy cellular infiltration. Notably, iCD8(-) DC produced significantly higher levels of IL-10 than iCD8+ DC and promoted more Th2 cytokine responses in in vitro DC-T cell co-culture and in vivo adoptive transfer experiments.The data indicate that in vivo BCG-primed CD8+ DC is the dominant DC subset in inducing protective immunity especially for reducing pathological reactions in infected tissues. The finding has implications for the rational improvement of the prophylactic and therapeutic approaches for controlling tuberculosis infection and related diseases

Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of the American Medical Informatics Association following peer review. The version of record is available online at: http://dx.doi.org/10.1093/jamia/ocv008[EN] [Objective] This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. [Material and Methods] Following the preferred reporting items for systematic reviews and meta-analyses systematic review methodology, the authors reviewed published papers between 2000 and 2013 that covered that semantic interoperability of EHRs, found by searching the PubMed, IEEE Xplore, and ScienceDirect databases. Additionally, after selection of a final group of articles, an inductive content analysis was done to summarize the steps and methodologies followed in order to build CIMs described in those articles. [Results] Three hundred and seventy-eight articles were screened and thirty six were selected for full review. The articles selected for full review were analyzed to extract relevant information for the analysis and characterized according to the steps the authors had followed for clinical information modeling. [Discussion] Most of the reviewed papers lack a detailed description of the modeling methodologies used to create CIMs. A representative example is the lack of description related to the definition of terminology bindings and the publication of the generated models. However, this systematic review confirms that most clinical information modeling activities follow very similar steps for the definition of CIMs. Having a robust and shared methodology could improve their correctness, reliability, and quality. [Conclusion] Independently of implementation technologies and standards, it is possible to find common patterns in methods for developing CIMs, suggesting the viability of defining a unified good practice methodology to be used by any clinical information modeler.This research has been partially funded by the Instituto de Salud Carlos III (Platform for Innovation in Medical Technologies and Health), grant PT13/0006/0036 and the Spanish Ministry of Economy and Competitiveness, grants TIN2010-21388-C02-01 and PTQ-12-05620.Moreno-Conde, A.; Moner Cano, D.; Da Cruz, WD.; Santos, MR.; Maldonado Segura, JA.; Robles Viejo, M.; Kalra, D. (2015). Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis. Journal of the American Medical Informatics Association. 22(4):925-934. https://doi.org/10.1093/jamia/ocv008S925934224Goossen W Goossen-Baremans A van der Zel M . Detailed clinical models: a review. Healthc Inform Res. 2010;16:201.Beeler, G. W. (1998). HL7 Version 3—An object-oriented methodology for collaborative standards development1Presented at the International Medical Informatics Association Working Group 16 Conference on Standardisation in Medical Informatics—Towards International Consensus and Cooperation, Bermuda, 12 September, 1997.1. International Journal of Medical Informatics, 48(1-3), 151-161. doi:10.1016/s1386-5056(97)00121-4Dolin, R. H., Alschuler, L., Boyer, S., Beebe, C., Behlen, F. M., Biron, P. V., & Shabo (Shvo), A. (2006). HL7 Clinical Document Architecture, Release 2. 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Methods Inf Med. 2009;48:170–177.Lopez DM Blobel B . Enhanced semantic interpretability by healthcare standards profiling. Stud Health Technol Inform. 2008;136:735.Knaup, P., Garde, S., & Haux, R. (2007). Systematic planning of patient records for cooperative care and multicenter research. International Journal of Medical Informatics, 76(2-3), 109-117. doi:10.1016/j.ijmedinf.2006.08.002Goossen, W. T. F., Ozbolt, J. G., Coenen, A., Park, H.-A., Mead, C., Ehnfors, M., & Marin, H. F. (2004). Development of a Provisional Domain Model for the Nursing Process for Use within the Health Level 7 Reference Information Model. Journal of the American Medical Informatics Association, 11(3), 186-194. doi:10.1197/jamia.m1085Anderson, H. V., Weintraub, W. S., Radford, M. J., Kremers, M. S., Roe, M. T., Shaw, R. E., … Tcheng, J. E. (2013). Standardized Cardiovascular Data for Clinical Research, Registries, and Patient Care. 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International Journal of Medical Informatics, 77(9), 576-588. doi:10.1016/j.ijmedinf.2007.11.005Bax, M. P., Kalra, D., & Santos, M. R. (2012). Dealing with the Archetypes Development Process for a Regional EHR System. Applied Clinical Informatics, 03(03), 258-275. doi:10.4338/aci-2011-12-ra-0074Moner D Moreno A Maldonado JA . Using archetypes for defining CDA templates. Stud Health Technol Inform. 2012;180:53–57.Moner D Maldonado JA Boscá D . CEN EN13606 normalisation framework implementation experiences. In: Seamless Care, Safe Care: The Challenges of Interoperability and Patient Safety in Health Care: Proceedings of the EFMI Special Topic Conference, June 2–4, 2010; Reykjavik, Iceland. IOS Press; 2010: 136.Marcos, M., Maldonado, J. A., Martínez-Salvador, B., Boscá, D., & Robles, M. (2013). Interoperability of clinical decision-support systems and electronic health records using archetypes: A case study in clinical trial eligibility. Journal of Biomedical Informatics, 46(4), 676-689. doi:10.1016/j.jbi.2013.05.004Leslie H . International developments in openEHR archetypes and templates. Health Inf Manag J. 2008;37:38.Kohl CD Garde S Knaup P . Facilitating secondary use of medical data by using openEHR archetypes. Stud Health Technol Inform. 2009;160:1117–1121.Garde, S., Hovenga, E., Buck, J., & Knaup, P. (2007). Expressing clinical data sets with openEHR archetypes: A solid basis for ubiquitous computing. International Journal of Medical Informatics, 76, S334-S341. doi:10.1016/j.ijmedinf.2007.02.004Garcia D Moro CM Cicogna PE . Method to integrate clinical guidelines into the electronic health record (EHR) by applying the archetypes approach. Stud Health Technol Inform. 2012;192:871–875.Duftschmid, G., Rinner, C., Kohler, M., Huebner-Bloder, G., Saboor, S., & Ammenwerth, E. (2013). The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes. International Journal of Medical Informatics, 82(12), 1195-1207. doi:10.1016/j.ijmedinf.2013.08.002Dias, R. D., Cook, T. W., & Freire, S. M. (2011). Modeling healthcare authorization and claim submissions using the openEHR dual-model approach. BMC Medical Informatics and Decision Making, 11(1). doi:10.1186/1472-6947-11-60Buck, J., Garde, S., Kohl, C. D., & Knaup-Gregori, P. (2009). Towards a comprehensive electronic patient record to support an innovative individual care concept for premature infants using the openEHR approach. International Journal of Medical Informatics, 78(8), 521-531. doi:10.1016/j.ijmedinf.2009.03.001Puentes, J., Roux, M., Montagner, J., & Lecornu, L. (2012). Development framework for a patient-centered record. 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Telemedicine and e-Health, 19(8), 632-642. doi:10.1089/tmj.2012.0189Jing, X., Kay, S., Marley, T., Hardiker, N. R., & Cimino, J. J. (2012). Incorporating personalized gene sequence variants, molecular genetics knowledge, and health knowledge into an EHR prototype based on the Continuity of Care Record standard. Journal of Biomedical Informatics, 45(1), 82-92. doi:10.1016/j.jbi.2011.09.001Hsu, W., Taira, R. K., El-Saden, S., Kangarloo, H., & Bui, A. A. T. (2012). Context-Based Electronic Health Record: Toward Patient Specific Healthcare. IEEE Transactions on Information Technology in Biomedicine, 16(2), 228-234. doi:10.1109/titb.2012.2186149Hoy D Hardiker NR McNicoll IT . Collaborative development of clinical templates as a national resource. Int J Med Inf. 2009;78:S3–S8.Buyl, R., & Nyssen, M. (2009). Structured electronic physiotherapy records. International Journal of Medical Informatics, 78(7), 473-481. doi:10.1016/j.ijmedinf.2009.02.007D’Amore JD Mandel JC Kreda DA . Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative. J Am Med Inform Assoc. 2014. Advance access published; doi:10.1136/amiajnl-2014-002883.Kalra D Tapuria A Austin T . Quality requirements for EHR archetypes. In: MIE; 2012: 48–52.Garde S Hovenga EJ Gränz J . Managing archetypes for sustainable and semantically interoperable electronic health records. Electron J Health Inform. 2007;2:e9.Madsen M Leslie H Hovenga EJS . Sustainable clinical knowledge management: an archetype development life cycle. Stud Health Technol Inform. 2010;151:115–132.Kohl CD Garde S Knaup P . Facilitating the openEHR approach-organizational structures for defining high-quality archetypes. Stud Health Technol Inform. 2008;136:437.Stroetmann VN Kalra D Lewalle P . Semantic interoperability for better health and safer healthcare. European Commission, Directorate-General Information Society and Media; 2009. http://dx.doi.org/10.2759/38514

Transforming Growth Factor-β3 Regulates Adipocyte Number in Subcutaneous White Adipose Tissue.

White adipose tissue (WAT) mass is determined by adipocyte size and number. While adipocytes are continuously turned over, the mechanisms controlling fat cell number in WAT upon weight changes are unclear. Herein, prospective studies of human subcutaneous WAT demonstrate that weight gain increases both adipocyte size and number, but the latter remains unaltered after weight loss. Transcriptome analyses associate changes in adipocyte number with the expression of 79 genes. This gene set is enriched for growth factors, out of which one, transforming growth factor-β3 (TGFβ3), stimulates adipocyte progenitor proliferation, resulting in a higher number of cells undergoing differentiation in vitro. The relevance of these observations was corroborated in vivo where Tgfb3+/- mice, in comparison with wild-type littermates, display lower subcutaneous adipocyte progenitor proliferation, WAT hypertrophy, and glucose intolerance. TGFβ3 is therefore a regulator of subcutaneous adipocyte number and may link WAT morphology to glucose metabolism

Thymidylate synthase gene variants as predictors of clinical response and toxicity to fluoropyrimidine-based chemotherapy for colorectal cancer

Abstract Background: Fluoropyrimidines form the chemotherapy backbone of advanced and metastatic colorectal cancer (CRC). These drugs are frequently associated with toxicity events that result in dose adjustments and even suspension of the treatment. The thymidylate synthase (TYMS) gene is a potential marker of response and toxicity to fluoropyirimidines as this enzyme is the molecular target of these drugs. Our aim was to assess the association between variants of TYMS with response and toxicity to fluoropyrimidines in patients with CRC in independent retrospective and prospective studies. Methods: Variants namely rs45445694, rs183205964, rs2853542 and rs151264360 of TYMS were genotyped in 105 CRC patients and were evaluated to define their association with clinical response and toxicity to fluoropyrimidines. Additionally, the relationship between genotypes and tumor gene expression was analyzed by quantitative polymerase chain reaction. Results: The 2R/2R (rs45445694) was associated with clinical response (p = 0.05, odds ratio (OR) = 3.45) and severe toxicity (p = 0.0014, OR = 5.21, from pooled data). Expression analysis in tumor tissues suggested a correlation between the 2R/2R genotype and low TYMS expression. Conclusions: The allele 2R (rs45445694) predicts severe toxicity and objective response in advanced CRC patients. In addition, the alleles G(rs2853542) and 6bp-(rs151264360) are independent predictors of response failure to chemotherapy. This is the first study made on a Latin American population that points out TYMS gene variants have predictive values for response and toxicity in patients with CRC treated with fluoropyrimidine-based chemotherapy