1,015 research outputs found
Variation in Inpatient Rehabilitation Utilization After Hospitalization for Burn Injury in the United States.
Approximately 45,000 individuals are hospitalized annually for burn treatment. Rehabilitation after hospitalization can offer a significant improvement in functional outcomes. Very little is known nationally about rehabilitation for burns, and practices may vary substantially depending on the region based on observed Medicare post-hospitalization spending amounts. This study was designed to measure variation in rehabilitation utilization by state of hospitalization for patients hospitalized with burn injury. This retrospective cohort study used nationally collected data over a 10-year period (2001 to 2010), from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs). Patients hospitalized for burn injury (n = 57,968) were identified by ICD-9-CM codes and were examined to see specifically if they were discharged immediately to inpatient rehabilitation after hospitalization (primary endpoint). Both unadjusted and adjusted likelihoods were calculated for each state taking into account the effects of age, insurance status, hospitalization at a burn center, and extent of burn injury by TBSA. The relative risk of discharge to inpatient rehabilitation varied by as much as 6-fold among different states. Higher TBSA, having health insurance, higher age, and burn center hospitalization all increased the likelihood of discharge to inpatient rehabilitation following acute care hospitalization. There was significant variation between states in inpatient rehabilitation utilization after adjusting for variables known to affect each outcome. Future efforts should be focused on identifying the cause of this state-to-state variation, its relationship to patient outcome, and standardizing treatment across the United States
Fourier Magnetic Imaging with Nanoscale Resolution and Compressed Sensing Speed-up using Electronic Spins in Diamond
Optically-detected magnetic resonance using Nitrogen Vacancy (NV) color
centres in diamond is a leading modality for nanoscale magnetic field imaging,
as it provides single electron spin sensitivity, three-dimensional resolution
better than 1 nm, and applicability to a wide range of physical and biological
samples under ambient conditions. To date, however, NV-diamond magnetic imaging
has been performed using real space techniques, which are either limited by
optical diffraction to 250 nm resolution or require slow, point-by-point
scanning for nanoscale resolution, e.g., using an atomic force microscope,
magnetic tip, or super-resolution optical imaging. Here we introduce an
alternative technique of Fourier magnetic imaging using NV-diamond. In analogy
with conventional magnetic resonance imaging (MRI), we employ pulsed magnetic
field gradients to phase-encode spatial information on NV electronic spins in
wavenumber or k-space followed by a fast Fourier transform to yield real-space
images with nanoscale resolution, wide field-of-view (FOV), and compressed
sensing speed-up.Comment: 31 pages, 10 figure
Inter-rater agreement in the assessment of abnormal chest X-ray findings for tuberculosis between two Asian countries
<p>Abstract</p> <p>Background</p> <p>Inter-rater agreement in the interpretation of chest X-ray (CXR) films is crucial for clinical and epidemiological studies of tuberculosis. We compared the readings of CXR films used for a survey of tuberculosis between raters from two Asian countries.</p> <p>Methods</p> <p>Of the 11,624 people enrolled in a prevalence survey in Hanoi, Viet Nam, in 2003, we studied 258 individuals whose CXR films did not exclude the possibility of active tuberculosis. Follow-up films obtained from accessible individuals in 2006 were also analyzed. Two Japanese and two Vietnamese raters read the CXR films based on a coding system proposed by Den Boon et al. and another system newly developed in this study. Inter-rater agreement was evaluated by kappa statistics. Marginal homogeneity was evaluated by the generalized estimating equation (GEE).</p> <p>Results</p> <p>CXR findings suspected of tuberculosis differed between the four raters. The frequencies of infiltrates and fibrosis/scarring detected on the films significantly differed between the raters from the two countries (<it>P </it>< 0.0001 and <it>P </it>= 0.0082, respectively, by GEE). The definition of findings such as primary cavity, used in the coding systems also affected the degree of agreement.</p> <p>Conclusions</p> <p>CXR findings were inconsistent between the raters with different backgrounds. High inter-rater agreement is a component necessary for an optimal CXR coding system, particularly in international studies. An analysis of reading results and a thorough discussion to achieve a consensus would be necessary to achieve further consistency and high quality of reading.</p
Sensing remote nuclear spins
Sensing single nuclear spins is a central challenge in magnetic resonance
based imaging techniques. Although different methods and especially diamond
defect based sensing and imaging techniques in principle have shown sufficient
sensitivity, signals from single nuclear spins are usually too weak to be
distinguished from background noise. Here, we present the detection and
identification of remote single C-13 nuclear spins embedded in nuclear spin
baths surrounding a single electron spins of a nitrogen-vacancy centre in
diamond. With dynamical decoupling control of the centre electron spin, the
weak magnetic field ~10 nT from a single nuclear spin located ~3 nm from the
centre with hyperfine coupling as weak as ~500 Hz is amplified and detected.
The quantum nature of the coupling is confirmed and precise position and the
vector components of the nuclear field are determined. Given the distance over
which nuclear magnetic fields can be detected the technique marks a firm step
towards imaging, detecting and controlling nuclear spin species external to the
diamond sensor
Diabetes Is the Main Factor Accounting for Hypomagnesemia in Obese Subjects
OBJECTIVE: Type 2 diabetes (T2DM) and obesity are associated with magnesium deficiency. We aimed to determine whether the presence of type 2 diabetes and the degree of metabolic control are related to low serum magnesium levels in obese individuals. METHODS: A) Case-control study: 200 obese subjects [50 with T2DM (cases) and 150 without diabetes (controls)] prospectively recruited. B) Interventional study: the effect of bariatric surgery on serum magnesium levels was examined in a subset of 120 obese subjects (40 with type 2 diabetes and 80 without diabetes). RESULTS: Type 2 diabetic patients showed lower serum magnesium levels [0.75Β±0.07 vs. 0.81Β±0.06 mmol/L; mean difference -0.06 (95% CI -0.09 to -0.04); p<0.001] than non-diabetic patients. Forty-eight percent of diabetic subjects, but only 15% of non-diabetic subjects showed a serum magnesium concentration lower than 0.75 mmol/L. Significant negative correlations between magnesium and fasting plasma glucose, HbA1c, HOMA-IR, and BMI were detected. Multiple linear regression analysis showed that fasting plasma glucose and HbA1c independently predicted serum magnesium. After bariatric surgery serum magnesium increased only in those patients in whom diabetes was resolved, but remain unchanged in those who not, without difference in loss weight between groups. Changes in serum magnesium negatively correlated with changes in fasting plasma glucose and HbA1c. Absolute changes in HbA1c independently predicted magnesium changes in the multiple linear regression analysis. CONCLUSIONS: Our results provide evidence that the presence of diabetes and the degree of metabolic control are essential in accounting for the lower levels of magnesium that exist in obese subjects
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Purification and functional characterisation of rhiminopeptidase A, a novel aminopeptidase from the venom of Bitis gabonica rhinoceros
This study describes the discovery and characterisation of a novel aminopeptidase A from the venom of B. g. rhinoceros and highlights its potential biological importance. Similar to mammalian aminopeptidases, rhiminopeptidase A might be capable of playing roles in altering the blood pressure and brain function of victims. Furthermore, it could have additional effects on the biological functions of other host proteins by cleaving their N-terminal amino acids. This study points towards the importance of complete analysis of individual components of snake venom in order to develop effective therapies for snake bites
Acute Effects of Sex Steroid Hormones on Susceptibility to Cardiac Arrhythmias: A Simulation Study
Acute effects of sex steroid hormones likely contribute to the observation that post-pubescent males have shorter QT intervals than females. However, the specific role for hormones in modulating cardiac electrophysiological parameters and arrhythmia vulnerability is unclear. Here we use a computational modeling approach to incorporate experimentally measured effects of physiological concentrations of testosterone, estrogen and progesterone on cardiac ion channel targets. We then study the hormone effects on ventricular cell and tissue dynamics comprised of Faber-Rudy computational models. The βfemaleβ model predicts changes in action potential duration (APD) at different stages of the menstrual cycle that are consistent with clinically observed QT interval fluctuations. The βmaleβ model predicts shortening of APD and QT interval at physiological testosterone concentrations. The model suggests increased susceptibility to drug-induced arrhythmia when estradiol levels are high, while testosterone and progesterone are apparently protective. Simulations predict the effects of sex steroid hormones on clinically observed QT intervals and reveal mechanisms of estrogen-mediated susceptibility to prolongation of QT interval. The simulations also indicate that acute effects of estrogen are not alone sufficient to cause arrhythmia triggers and explain the increased risk of females to Torsades de Pointes. Our results suggest that acute effects of sex steroid hormones on cardiac ion channels are sufficient to account for some aspects of gender specific susceptibility to long-QT linked arrhythmias
On Random Subspace Optimization-Based Hybrid Computing Models Predicting the California Bearing Ratio of Soils
The California Bearing Ratio (CBR) is an important index for evaluating the bearing capacity of pavement subgrade materials. In this research, random subspace optimization-based hybrid computing models were trained and developed for the prediction of the CBR of soil. Three models were developed, namely reduced error pruning trees (REPTs), random subsurface-based REPT (RSS-REPT), and RSS-based extra tree (RSS-ET). An experimental database was compiled from a total of 214 soil samples, which were classified according to AASHTO M 145, and included 26 samples of A-2-6 (clayey gravel and sand soil), 3 samples of A-4 (silty soil), 89 samples of A-6 (clayey soil), and 96 samples of A-7-6 (clayey soil). All CBR tests were performed in soaked conditions. The input parameters of the models included the particle size distribution, gravel content (G), coarse sand content (CS), fine sand content (FS), silt clay content (SC), organic content (O), liquid limit (LL), plastic limit (PL), plasticity index (PI), optimum moisture content (OMC), and maximum dry density (MDD). The accuracy of the developed models was assessed using numerous performance indexes, such as the coefficient of determination, relative error, MAE, and RMSE. The results show that the highest prediction accuracy was obtained using the RSS-based extra tree optimization technique
Breast imaging technology: Application of magnetic resonance imaging to angiogenesis in breast cancer
Magnetic resonance imaging (MRI) techniques enable vascular function to be mapped with high spatial resolution. Current methods for imaging in breast cancer are described, and a review of recent studies that compared dynamic contrast-enhanced MRI with histopathological indicators of tumour vascular status is provided. These studies show correlation between in vivo dynamic contrast measurements and in vitro histopathology. Dynamic contrast enhanced MRI is also being applied to assessment of the response of breast tumours to treatment
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