216 research outputs found
Chronic Health Conditions as a Risk Factor for Falls among the Community-Dwelling US Older Adults: A Zero-Inflated Regression Modeling Approach
Falls are an important health concern among older adults due to age-related changes in the body. Having a medical history of chronic health condition may pose even higher risk of falling. Only few studies have assessed a number of chronic health conditions as risk factor for falls over a large nationally representative sample of US older adults. In this study, Behavioral Risk Factor Surveillance System (BRFSS) 2014 participants aged 65 years and older (n = 159,336) were evaluated. It was found that 29.7% (n = 44,550) of the sample experienced at least one fall and 16.3% (n = 20,444) experienced more than one fall in the past 12 months. According to the study findings, having a medical history of stroke, CKD, arthritis, depression, and diabetes independently predict the risk of first-time falling as well as the risk of recurrent falling in older adult population while controlling for other factors. On the other hand, having a medical history of the heart attack, angina, asthma, and COPD did not predict the risk of first-time falling, but did predict the risk of recurrent falling after experiencing the first fall in this population
Minimal connected enclosures on an embedded planar graph
We study five problems of finding minimal enclosures comprised of elements of a connected, planar graph with a plane embedding. The first three problems consider the identification of a shortest enclosing walk, cycle or trail surrounding a polygonal, simply connected obstacle on the plane. We propose polynomial algorithms that improve on existing algorithms. The last two problems consider the formation of minimal zones (sets of adjacent regions such that any pair of points in a zone can be connected by a non-zero width curve that lies entirely in the zone). Specifically, we assume that the regions of the graph have nonnegative weights and seek the formation of minimum weight zones containing a set of points or a set of regions. We prove that the last two problems are NP-hard and transform them to Steiner arboresccnce/fixed-charge flow problems
Primary Care Physicians’ Support of Shared Decision Making for Different Cancer Screening Decisions
Despite widespread advocacy, shared decision making (SDM) is not routinely used for cancer screening. To better understand implementation barriers, we describe primary care physicians’ (PCPs’) support for SDM across diverse cancer screening contexts
Use of graphene as protection film in biological environments
Corrosion of metal in biomedical devices could cause serious health problems to patients. Currently ceramics coating materials used in metal implants can reduce corrosion to some extent with limitations. Here we proposed graphene as a biocompatible protective film for metal potentially for biomedical application. We confirmed graphene effectively inhibits Cu surface from corrosion in different biological aqueous environments. Results from cell viability tests suggested that graphene greatly eliminates the toxicity of Cu by inhibiting corrosion and reducing the concentration of Cu(2+) ions produced. We demonstrated that additional thiol derivatives assembled on graphene coated Cu surface can prominently enhance durability of sole graphene protection limited by the defects in graphene film. We also demonstrated that graphene coating reduced the immune response to metal in a clinical setting for the first time through the lymphocyte transformation test. Finally, an animal experiment showed the effective protection of graphene to Cu under in vivo condition. Our results open up the potential for using graphene coating to protect metal surface in biomedical application
LGI1 encephalitis with squamous lung-cell carcinoma: Resolution after tumor resection.
Encephalitis with leucine-rich glioma-inactivated-1 (LGI1) immunoglobulin G (IgG) anti-bodies classically presents with cognitive impairment and characteristic faciobrachial dystonicseizures.1In a murine model, human LGI1 IgG caused reduction of Kv1.1 channels andα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor receptors resulting in neuro-nal hyperexcitability indicating probable pathogenicity of LGI1 antibodies.2LGI1 autoimmu-nity is associated with malignancy in less than 10% of cases, including small cell lung cancer,prostate and colon cancer, squamous cell skin carcinoma, and neuroendocrine pancreaticcancer.3,4We present a case of LGI1 encephalitis only partially responsive to immunotherapywith eventual complete resolution after resection of a squamous cell lung carcinoma
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Effect of Canopy Location on Yield Components and Fruit Composition in Pinot noir Grapevines Trained to the Scott Henry Trellis System
Pinot noir vines, trained to the Scott Henry trellising system were separated into four different quadrants: Bottom canopy, trained toward the ground; Top canopy, trained upwards; East orientation, receiving the morning sunlight; and West orientation, receiving afternoon sunlight. Yield components and fruit composition were measured for each canopy, orientation, and then for each quadrant. The bottom canopy had higher yield, cluster weight, titratable acidity, and total sugar per vine, than did the top canopy. Must soluble solids were not significantly different between the two canopies. The top canopy had a significantly higher pH. The East side of the vine, the side that receives direct morning sunlight, had a higher yield, cluster weight, and total sugar per vine than did the West side of the vine. The West side of the vine, the side that receives direct afternoon sunlight, had higher titratable acidity than did the East side of the vine. Must soluble solids were not significantly different between the two sides of the vine. The bottom-east quadrant had a significantly higher yield, and total sugar per vine, than did the other three quadrants
Generalized Algebraic Algorithm for Scene-based Nonuniformity Correction
ABSTRACT This paper presents an overview of three recently developed scene-based nonuniformity correction techniques, namely, the algebraic scene-based algorithm (ASBA), the extended radiometrically accurate scene-based algorithm (RASBA) and the generalized algebraic scene-based algorithm (GASBA). The ASBA uses pairs of image frames that exhibit one-dimension sub-pixel motion to algebraically extract estimates of bias nonuniformity. The RASBA incorporates arbitrary sub-and super-pixel two-dimensional motion in conjunction with limited perimeter-only absolute calibration to obtain radiometrically accurate estimates of the bias nonuniformity. The RASBA provides the advantage of being able to maintain radiometry in the interior photodetectors without interrupting their operation. The GASBA is a generalized non-radiometric form of the algorithm that uses image pairs with arbitrary two-dimensional motion and encompasses both the ASBA and RASBA algorithms. This generalization is accomplished by initially guaranteeing bias uniformity in the perimeter detectors. This uniformity can be achieved by first applying the ASBA estimates. The generalized algorithm is then able to automatically maintain perimeter uniformity without the need for re-application of the ASBA. Thus, the GASBA is able to operate completely in a non-radiometric mode, alleviating the need for the perimeter calibration system if desired. The generalized algorithm is applied to real infrared imagery obtained from both cooled and uncooled infrared cameras. A hardware implementation of the proposed algorithm will also be discussed along with several ongoing commercial applications of the technology
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Development of Viticultural Practices to Improve Winegrape Performance : Experiment II: Effect of Canopy Location on Yield Components and Fruit Composition in Pinot noir Grapevines Trained to the Scott Henry Trellis System
For this trial, established Pinot noir vines, located on the valley floor of the Umpqua Valley in Oregon were used. In 1996 and 1997 sixteen vines trained to the Scott Henry trellising system were separated into four different quadrants, determined by shoot orientation: Bottom canopy, shoots trained toward the ground; top canopy, shoots trained upwards; east orientation, shoots receiving the morning sunlight; and west orientation, shoots receiving afternoon sunlight. Yield components and fruit composition were measured for each quadrant. In 1996, wines were produced from fruit harvested by quadrant and subjected to sensory analysis. In 1996 the bottom canopy had higher yield, cluster weight, and titratable acidity than did the top canopy. In 1997 the top canopy had a higher yield than did the bottom canopy. In 1996 the east oriented canopy had a higher yield, cluster weight, and skin anthocyanins than did the west oriented canopy. Must soluble solids were not significantly different between vine canopy or orientation in 1996. In 1997 the west oriented canopy had higher brix, pH, and lower titratable acidity than the east oriented canopy. The bottom-east quadrant had a significantly higher yield than did the other three quadrants in 1996. There were no significant differences seen in quadrant yields in 1997. Significant differences were seen in wine attributes between the quadrants
Use of graphene as protection film in biological environments
Corrosion of metal in biomedical devices could cause serious health problems to patients. Currently ceramics coating materials used in metal implants can reduce corrosion to some extent with limitations. Here we proposed graphene as a biocompatible protective film for metal potentially for biomedical application. We confirmed graphene effectively inhibits Cu surface from corrosion in different biological aqueous environments. Results from cell viability tests suggested that graphene greatly eliminates the toxicity of Cu by inhibiting corrosion and reducing the concentration of Cu2+ ions produced. We demonstrated that additional thiol derivatives assembled on graphene coated Cu surface can prominently enhance durability of sole graphene protection limited by the defects in graphene film. We also demonstrated that graphene coating reduced the immune response to metal in a clinical setting for the first time through the lymphocyte transformation test. Finally, an animal experiment showed the effective protection of graphene to Cu under in vivo condition. Our results open up the potential for using graphene coating to protect metal surface in biomedical application
Online Patient Portals: If You Build It, Who Will Come?
Research Objective: Many primary care practices have purchased electronic health records (EHRs) and accompanying patient portals. The role online portals may play in quality and outcome improvement will depend not only on who is using such technology, but how it is used. We evaluate the characteristics of patients using an online portal in comparison to those not using, and examine the portal features and functionalities accessed by users.Study Design: Observational, cohort study for which data were obtained from EHR and health system administrative data. Patient-level data (including demographic information, service use, and portal activation and use) were joined with information characterizing clinics in which patients received care (e.g., medical teaching on site, size, and urban/suburban location). The primary study outcome, portal use, was defined by the initiation of at least one online session. Among users, user-initiated clicks were used to determine specific features accessed. Logistic regression models with random effects were fit using the PROC GLIMMIX procedure (SAS software, Version 9.4) to test the role of clinic- and patient-level variables on patient portal activation. Subjects were blocked by physician, nested within clinic, and the Laplace method was used for likelihood approximation.Population Studied: Study eligible patients were aged 18 years and older with an office visit between 4/1/2013 and 3/31/2014 to a primary care physician practicing in one of the 26 primary care clinics of an integrated delivery system serving Detroit, Michigan and the surrounding suburban areas (N=20,282 patients).Principal Findings: As implemented in December 2012, the online portal enabled users to securely schedule appointments, receive appointment reminders, pay bills online, view lab and other test results, manage information about their health, and communicate with care teams via a secure messaging system. Cohort patients were on average 68.7 years of age (SD=14.7), predominately white (65%) or black (30%) race, and 60% female. Within 18 months of implementation, 33% had an activated account, with African Americans (OR=0.50, 95% CI 0.46-0.56), Hispanics (OR=0.63, 95% CI 0.47-0.84), those over aged 70 years (OR=0.48, 95% CI 0.44-0.52), and those preferring a language other than English (OR=0.43, 95% CI 0.31-0.59) less likely to be a portal user. Patients who were married (OR=0.55, 95% CI 1.44-1.67) and more connected with the clinic, as measured by visit frequency and health maintenance visit use, were more likely to be portal users (OR=1.08, 95% CI 1.05-1.10 and OR=1.39, 95% CI 1.27-1.52, respectively). Among users, the medical record access and management feature (95.9%) was most commonly accessed, most often to obtain laboratory testing results (91.7%). The majority of users also accessed appointment management (76.6%) and messaging (59.1%) functionalitiesConclusions: While the diversity of functions accessed by those with a portal account bodes well for the ability of portals to engage patients, without purposeful intervention enhancements to care delivery afforded by portals may be inaccessible to many, including racial/ethnic minorities and those less connected to traditional care services.Implications for Policy or Practice: Online portals have the potential to extend care beyond the confines of traditional office visits, but inattention to who uses portals may exacerbate known disparities in health care access and outcomes
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