Virtual colonoscopy; real misses

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72356/1/j.1572-0241.2003.08448.x.pd

Relation between hospital orthopaedic specialisation and outcomes in patients aged 65 and older: retrospective analysis of US Medicare data

Objective To explore the relation between hospital orthopaedic specialisation and postoperative outcomes after total hip or knee replacement surgery

COST-EFFECTIVENESS OF AIRLINE DEFIBRILLATORS: IS PEACE OF MIND MORE IMPORTANT THAN SAVING LIVES?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74922/1/j.1524-4733.2001.40201-5.x.pd

Integration of deep transcriptome and proteome analyses reveals the components of alkaloid metabolism in opium poppy cell cultures

<p>Abstract</p> <p>Background</p> <p><it>Papaver somniferum </it>(opium poppy) is the source for several pharmaceutical benzylisoquinoline alkaloids including morphine, the codeine and sanguinarine. In response to treatment with a fungal elicitor, the biosynthesis and accumulation of sanguinarine is induced along with other plant defense responses in opium poppy cell cultures. The transcriptional induction of alkaloid metabolism in cultured cells provides an opportunity to identify components of this process via the integration of deep transcriptome and proteome databases generated using next-generation technologies.</p> <p>Results</p> <p>A cDNA library was prepared for opium poppy cell cultures treated with a fungal elicitor for 10 h. Using 454 GS-FLX Titanium pyrosequencing, 427,369 expressed sequence tags (ESTs) with an average length of 462 bp were generated. Assembly of these sequences yielded 93,723 unigenes, of which 23,753 were assigned Gene Ontology annotations. Transcripts encoding all known sanguinarine biosynthetic enzymes were identified in the EST database, 5 of which were represented among the 50 most abundant transcripts. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) of total protein extracts from cell cultures treated with a fungal elicitor for 50 h facilitated the identification of 1,004 proteins. Proteins were fractionated by one-dimensional SDS-PAGE and digested with trypsin prior to LC-MS/MS analysis. Query of an opium poppy-specific EST database substantially enhanced peptide identification. Eight out of 10 known sanguinarine biosynthetic enzymes and many relevant primary metabolic enzymes were represented in the peptide database.</p> <p>Conclusions</p> <p>The integration of deep transcriptome and proteome analyses provides an effective platform to catalogue the components of secondary metabolism, and to identify genes encoding uncharacterized enzymes. The establishment of corresponding transcript and protein databases generated by next-generation technologies in a system with a well-defined metabolite profile facilitates an improved linkage between genes, enzymes, and pathway components. The proteome database represents the most relevant alkaloid-producing enzymes, compared with the much deeper and more complete transcriptome library. The transcript database contained full-length mRNAs encoding most alkaloid biosynthetic enzymes, which is a key requirement for the functional characterization of novel gene candidates.</p

Hospital Variation in Survival Trends for In‐hospital Cardiac Arrest

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139094/1/jah3561.pd

Do fall additions of salmon carcasses benefit food webs in experimental streams?

This is the postprint version of the article. The printed version of the article can be found here: http://www.springerlink.com/content/jl0122219v283124/Research showing that salmon carcasses support the productivity and biodiversity of aquatic and riparian ecosystems has been conducted over a variety of spatial and temporal scales. In some studies, carcasses were manipulated in a single pulse or loading rate or manipulations occurred during summer and early fall, rather than simulating the natural dynamic of an extended spawning period, a gradient of loading rates, or testing carcass effects in late fall-early winter when some salmon stocks in the US Pacific Northwest spawn. To address these discrepancies, we manipulated salmon carcass biomass in 16 experimental channels located in the sunlit floodplain of the Cedar River, WA, USA between mid-September and mid-December, 2006. Total carcass loads ranged from 0–4.0 kg/m2 (0, 0.001, 0.01, 0.1, 0.5, 1.0, 2.0 and 4.0 kg/m2, n = 2 per treatment) and were added to mimic the temporal dynamic of an extended spawning period. We found little evidence that carcasses influenced primary producer biomass or fish growth; however, nutrients and some primary consumer populations increased with loading rate. These effects varied through time, however. We hypothesize that the variable effects of carcasses were a result of ambient abiotic condition, such as light, temperature and disturbance that constrained trophic response. There was some evidence to suggest peak responses for primary producers and consumers occurred at a loading rate of *1.0–2.0 kg/m2, which was similar to other experimental studies conducted during summer

Hospital characteristics and patient populations served by physician owned and non physician owned orthopedic specialty hospitals

<p>Abstract</p> <p>Background</p> <p>The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served.</p> <p>Methods</p> <p>We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR) (N = 10,478) and total knee replacement (TKR) (N = 15,312) in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR), hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data.</p> <p>Results</p> <p>Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P < .001), were less likely to be affiliated with a medical school (6% vs. 43%, P = .05), and were more likely to be for profit (94% vs. 28%, P = .001). Patients who underwent major joint replacement in physician owned specialty hospitals were less likely to be black than patients in non physician owned specialty hospitals (2.5% vs. 3.1% for THR, P = .15; 1.8% vs. 6.3% for TKR, P < .001), yet physician owned specialty hospitals were located in neighborhoods with a higher proportion of black residents (8.2% vs. 6.7%, P = .76). Patients in physician owned hospitals had lower rates of most common comorbid conditions including heart failure and obesity (P < .05 for both).</p> <p>Conclusion</p> <p>Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.</p