2,127 research outputs found
Intramedullary knee spacer in 2-stage revision knee surgery with segmental bone loss: A technical note involving 6 cases
Physicians Infrequently Adhere to Hepatitis Vaccination Guidelines for Chronic Liver Disease
Background and Goals:Hepatitis A (HAV) and hepatitis B (HBV) vaccination in patients with chronic liver disease is an accepted standard of care. We determined HAV and HBV vaccination rates in a tertiary care referral hepatology clinic and the impact of electronic health record (EHR)-based reminders on adherence to vaccination guidelines.Methods:We reviewed the records of 705 patients with chronic liver disease referred to our liver clinic in 2008 with at least two follow-up visits during the subsequent year. Demographics, referral source, etiology, and hepatitis serology were recorded. We determined whether eligible patients were offered vaccination and whether patients received vaccination. Barriers to vaccination were determined by a follow-up telephone interview.Results:HAV and HBV serologic testing prior to referral and at the liver clinic were performed in 14.5% and 17.7%; and 76.7% and 74% patients, respectively. Hepatologists recommended vaccination for HAV in 63% and for HBV in 59.7% of eligible patients. Patient demographics or disease etiology did not influence recommendation rates. Significant variability was observed in vaccination recommendation amongst individual providers (30-98.6%), which did not correlate with the number of patients seen by each physician. Vaccination recommendation rates were not different for Medicare patients with hepatitis C infection for whom a vaccination reminder was automatically generated by the EHR. Most patients who failed to get vaccination after recommendation offered no specific reason for noncompliance; insurance was a barrier in a minority.Conclusions:Hepatitis vaccination rates were suboptimal even in an academic, sub-speciality setting, with wide-variability in provider adherence to vaccination guidelines. © 2013 Thudi et al
Self-Affirmation Improves Problem-Solving under Stress
High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings. © 2013 Creswell et al
Virologic, serologic, and biochemical outcomes through 2 years of treatment with entecavir and lamivudine in nucleoside-naïve Chinese patients with chronic hepatitis B: a randomized, multicenter study
Shaping bursting by electrical coupling and noise
Gap-junctional coupling is an important way of communication between neurons
and other excitable cells. Strong electrical coupling synchronizes activity
across cell ensembles. Surprisingly, in the presence of noise synchronous
oscillations generated by an electrically coupled network may differ
qualitatively from the oscillations produced by uncoupled individual cells
forming the network. A prominent example of such behavior is the synchronized
bursting in islets of Langerhans formed by pancreatic \beta-cells, which in
isolation are known to exhibit irregular spiking. At the heart of this
intriguing phenomenon lies denoising, a remarkable ability of electrical
coupling to diminish the effects of noise acting on individual cells.
In this paper, we derive quantitative estimates characterizing denoising in
electrically coupled networks of conductance-based models of square wave
bursting cells. Our analysis reveals the interplay of the intrinsic properties
of the individual cells and network topology and their respective contributions
to this important effect. In particular, we show that networks on graphs with
large algebraic connectivity or small total effective resistance are better
equipped for implementing denoising. As a by-product of the analysis of
denoising, we analytically estimate the rate with which trajectories converge
to the synchronization subspace and the stability of the latter to random
perturbations. These estimates reveal the role of the network topology in
synchronization. The analysis is complemented by numerical simulations of
electrically coupled conductance-based networks. Taken together, these results
explain the mechanisms underlying synchronization and denoising in an important
class of biological models
Fragile X syndrome: Diagnostic and carrier testing
The following are the recommendations of the American College of Medical Genetics (ACMG) Professional Practice and Guidelines Committee, convened to assist health care professionals in making decisions regarding genetic diagnosis and testing. The purpose of this document is to provide a brief overview of fragile X syndrome (FXS), and to make recommendations that can serve as general guidelines to aid clinicians in making referrals for diagnostic and carrier testing for this condition. Fragile X syndrome is the most common cause of inherited mental retardation and is caused by a mutation in the X-linked FMR1 gene. DNA studies are used for testing individuals with symptoms of FXS and individuals at risk for carrying the mutation. Genotypes are determined by examining the size of the trinucleotide repeat segment and the methylation status of the FMR1 gene. These guidelines supersede the 1994 ACMG statement of the same name
Examining the demographic profile and attitudes of citizens, in areas where organised crime groups proliferate
Whilst studies refer to the community impact of Organized Crime (OC), no survey currently exists to examine the views of those citizens who reside in areas where Organized Crime Groups (OCGs) proliferate. 431 questionnaires from households co-existing in high density OCGs areas were analysed in relation to: a) demographic information; b) views on the community and the police; and c) how they expected other residents to react to illegal incidents. Overall respondents thought the average citizen would refuse to intervene in 10% - 48% of illegal incidents, with the specific case influencing whether and how they would respond. The analysis then compared three communities who lived in high density OCG areas with a control community (n=343). The ‘OCG’ communities were more likely to report low collective efficacy and were least likely to expect their neighbours to confront a crime in action. Conversely, whilst the control group showed higher levels of collective efficacy and expected the average resident more likely to confront illegal behaviour, this trend did not extend to street drug dealing and serious crime associated with OC. The study discusses the unreported intimidation associated with OCGs and the challenges of policing hostile environments
Phosphoenolpyruvate carboxylase dentified as a key enzyme in erythrocytic Plasmodium falciparum carbon metabolism
Phospoenolpyruvate carboxylase (PEPC) is absent from humans but encoded in thePlasmodium falciparum genome, suggesting that PEPC has a parasite-specific function. To investigate its importance in P. falciparum, we generated a pepc null mutant (D10Δpepc), which was only achievable when malate, a reduction product of oxaloacetate, was added to the growth medium. D10Δpepc had a severe growth defect in vitro, which was partially reversed by addition of malate or fumarate, suggesting that pepc may be essential in vivo. Targeted metabolomics using 13C-U-D-glucose and 13C-bicarbonate showed that the conversion of glycolytically-derived PEP into malate, fumarate, aspartate and citrate was abolished in D10Δpepc and that pentose phosphate pathway metabolites and glycerol 3-phosphate were present at increased levels. In contrast, metabolism of the carbon skeleton of 13C,15N-U-glutamine was similar in both parasite lines, although the flux was lower in D10Δpepc; it also confirmed the operation of a complete forward TCA cycle in the wild type parasite. Overall, these data confirm the CO2 fixing activity of PEPC and suggest that it provides metabolites essential for TCA cycle anaplerosis and the maintenance of cytosolic and mitochondrial redox balance. Moreover, these findings imply that PEPC may be an exploitable target for future drug discovery
Analysis of surgical and oncological outcome in internal and external hemipelvectomy in 34 patients above the age of 65 years at a mean follow-up of 56 months
“Soft” policing at hot spots—do police community support officers work? A randomized controlled trial
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