Use of International Classification of Diseases, Ninth Revision Codes for Obesity: Trends in the United States from an Electronic Health Record-Derived Database.

Obesity is a potentially modifiable risk factor for many diseases, and a better understanding of its impact on health care utilization, costs, and medical outcomes is needed. The ability to accurately evaluate obesity outcomes depends on a correct identification of the population with obesity. The primary objective of this study was to determine the prevalence and accuracy of International Classification of Diseases, Ninth Revision (ICD-9) coding for overweight and obesity within a US primary care electronic health record (EHR) database compared against actual body mass index (BMI) values from recorded clinical patient data; characteristics of patients with obesity who did or did not receive ICD-9 codes for overweight/obesity also were evaluated. The study sample included 5,512,285 patients in the database with any BMI value recorded between January 1, 2014, and June 30, 2014. Based on BMI, 74.6% of patients were categorized as being overweight or obese, but only 15.1% of patients had relevant ICD-9 codes. ICD-9 coding prevalence increased with increasing BMI category. Among patients with obesity (BMI ≥30 kg/m2), those coded for obesity were younger, more often female, and had a greater comorbidity burden than those not coded; hypertension, dyslipidemia, type 2 diabetes mellitus, and gastroesophageal reflux disease were the most common comorbidities. KEY FINDINGS: US outpatients with overweight or obesity are not being reliably coded, making ICD-9 codes undependable sources for determining obesity prevalence and outcomes. BMI data available within EHR databases offer a more accurate and objective means of classifying overweight/obese status

Power relations in IS projects – a critical review and a new research agenda

This paper seeks to review and examine the major theoretical underpinnings of research into power relations in IS projects. In order to keep the review manageable and to furnish a reasonable explanation of the ideas and papers referenced, the review is restricted to the ideas of Foucault, Giddens and Clegg. Partly, this restriction was due to the wish of the authors to deal seriously with the ideas presented, and not to produce an exhaustive but terse and taxonomic style review. Partly, the selection of the above theorists is due to the fact that the major IS papers on power relations have drawn on their work. This paper concludes with the presentation of a new theory of power and social influence from social psychology suitable for use in IS research. The ideas of this theory have not yet been examined empirically. Thus, IS researchers are challenged to employ these ideas in their empirical research.<br /

Socio-demographic, Clinical, and Genetic Determinants of Quality of Life in Lung Cancer Patients.

Patient reported health-related quality of life (QOL) is a major component of the overall well-being of cancer patients, with links to prognosis. In 6,420 lung cancer patients, we identified patient characteristics and genetic determinants of QOL. Patient responses from the SF-12 questionnaire was used to calculate normalized Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Further, we analyzed 218 single nucleotide polymorphisms (SNPs) in the p38 MAPK signaling pathway, a key mediator of response to cellular and environmental stress, as genetic determinants of QOL in a subset of the study population (N = 641). Trends among demographic factors for mean PCS and MCS included smoking status (PCS Ptrend &lt; 0.001, MCS Ptrend &lt; 0.001) and education (PCS Ptrend &lt; 0.001, MCS Ptrend &lt; 0.001). Similar relationships were seen for MCS. The homozygous rare genotype of MEF2B: rs2040562 showed an increased risk of a poor MCS (OR: 3.06, 95% CI: 1.05-8.92, P = 0.041). Finally, survival analysis showed that a low PCS or a MCS was associated with increased risks of five-year mortality (HR = 1.63, 95% CI: 1.51-1.77, HR = 1.23, 95% CI: 1.16-1.32, respectively) and there was a significant reduction in median survival time (Plog-rank &lt; 0.001). These findings suggest that multiple factors contribute to QOL in lung cancer patients, and baseline QOL can impact survival

Internal Versus External Recruitment – The Story of Three Consecutive Project Managers in an IT Project

As project managers (PMs) play an important role in project success, assigning PMs with appropriate skills and personalities to projects is a crucial task. Nevertheless, empirical research on skill requirements for information technology (IT) PMs is limited and little information systems literature focuses on the role of internally recruited IT PMs. This paper presents a case study of a troubled IT project led by three consecutive PMs, with a range of backgrounds, skills, and personality types. Across subjects, IT project management was found to be a necessity of project success. Additionally, it was observed that internally recruited PMs showed advantages in understanding organisational culture and business processes. Lessons learned from the three PMs confirm the importance of particular skills previously described in the literature, and the need for an additional focus on how an IT PM’s personality facilitates or inhibits IT project outcomes

OMAE2009-79735 DESIGN GUIDELINE AND ACCEPTANCE CRITERIA FOR THE SAG BEND COMPRESSION OF STEEL CATENARY RISER

ABSTRACT Although steel catenary riser (SCR) is an efficient riser concept for the deepwater oil and gas production, SCR on a Semisubmersible is susceptible to compression at the sag bend region that may lead to over stress under extreme environmental conditions such as 100-year and 1000-year return hurricane in Gulf of Mexico (GOM). It is one of the challenges to SCR design. The paper covers a wide range of SCRs, ranging from 6 inch to 20 inch outer diameter and including production and export SCRs, under the 100-year and 1000-year return hurricane conditions in GOM. Both linear and nonlinear analysis is performed. The non-dimensional compression and stress/strain coefficients are proposed, and they reveal excellent correlations between them and the compression force and bending stress/strain despite of the different riser size and weight. These coefficients can be used to determine the level of compression and bending stress/strain before the detailed and lengthy calculations, which are very useful as design guidelines. The acceptance criteria for GOM 100-year and 1000-year return hurricanes are discussed. It is recommended that for the nonlinear strain-based design the collapsed-based strain acceptance criteria are not conservative. More stringent nonlinear strain-based criteria are recommended, such as fracture mechanics analysis and accumulated strain analysis to ensure the integrity of the SCR during its life span

Neuroprotective effects of blockers for T-type calcium channels

Cognitive and functional decline with age is correlated with deregulation of intracellular calcium, which can lead to neuronal death in the brain. Previous studies have found protective effects of various calcium channel blockers in pathological conditions. However, little has been done to explore possible protective effects of blockers for T-type calcium channels, which forms a family of FDA approved anti-epileptic drugs. In this study, we found that neurons showed an increase in viability after treatment with either L-type or T-type calcium channel antagonists. The family of low-voltage activated, or T-type calcium channels, comprise of three members (Cav3.1, Cav3.2, and Cav3.3) based on their respective main pore-forming alpha subunits: α1G, α1H, and α1I. Among these three subunits, α1H is highly expressed in hippocampus and certain cortical regions. However, T-type calcium channel blockers can protect neurons derived from α1H-/- mice, suggesting that neuroprotection demonstrated by these drugs is not through the α1H subunit. In addition, blockers for T-type calcium channels were not able to confer any protection to neurons in long-term cultures, while blockers of L-type calcium channels could protect neurons. These data indicate a new function of blockers for T-type calcium channels, and also suggest different mechanisms to regulate neuronal survival by calcium signaling pathways. Thus, our findings have important implications in the development of new treatment for age-related neurodegenerative disorders

Chloride channels regulate differentiation and barrier functions of the mammalian airway.

The conducting airway forms a protective mucosal barrier and is the primary target of airway disorders. The molecular events required for the formation and function of the airway mucosal barrier, as well as the mechanisms by which barrier dysfunction leads to early onset airway diseases, remain unclear. In this study, we systematically characterized the developmental landscape of the mouse airway using single-cell RNA sequencing and identified remarkably conserved cellular programs operating during human fetal development. We demonstrated that in mouse, genetic inactivation of chloride channel Ano1/Tmem16a compromises airway barrier function, results in early signs of inflammation, and alters the airway cellular landscape by depleting epithelial progenitors. Mouse Ano1-/-mutants exhibited mucus obstruction and abnormal mucociliary clearance that resemble the airway defects associated with cystic fibrosis. The data reveal critical and non-redundant roles for Ano1 in organogenesis, and show that chloride channels are essential for mammalian airway formation and function

MERCURY CONTROL WITH THE ADVANCED HYBRID PARTICULATE COLLECTOR

This project was awarded under U.S. Department of Energy (DOE) National Energy Technology Laboratory (NETL) Program Solicitation DE-PS26-00NT40769 and specifically addresses Technical Topical Area 4--Testing Novel and Less Mature Control Technologies on Actual Flue Gas at the Pilot Scale. The project team includes the Energy & Environmental Research Center (EERC) as the main contractor; W.L. Gore & Associates, Inc., as a technical and financial partner; and the Big Stone Plant operated by Otter Tail Power Company, host for the field testing portion of the research. Since 1995, DOE has supported development of a new concept in particulate control called the advanced hybrid particulate collector (AHPC). The AHPC has been licensed to W.L. Gore & Associates, Inc., and is now marketed as the Advanced Hybrid{trademark} filter by Gore. The AHPC combines the best features of electrostatic precipitators (ESPs) and baghouses in a unique configuration, providing major synergism between the two collection methods, both in the particulate collection step and in the transfer of dust to the hopper. The AHPC provides ultrahigh collection efficiency, overcoming the problem of excessive fine-particle emissions with conventional ESPs, and it solves the problem of reentrainment and re-collection of dust in conventional baghouses. The AHPC appears to have unique advantages for mercury control over baghouses or ESPs as an excellent gas-solid contactor. The objective of the three-task project is to demonstrate 90% total mercury control in the AHPC at a lower cost than current mercury control estimates. The approach includes bench-scale batch testing that ties the new work to previous results and links results with larger-scale pilot testing with real flue gas on a coal-fired combustion system, pilot-scale testing on a coal-fired combustion system with both a pulse-jet baghouse and an AHPC to prove or disprove the research hypotheses, and field demonstration pilot-scale testing at a utility power plant to prove scaleup and demonstrate longer-term mercury control. This project, if successful, will demonstrate at the pilot-scale level a technology that would provide a cost-effective technique to accomplish control of mercury emissions and, at the same time, greatly enhance fine particulate collection efficiency. The technology can be used to retrofit systems currently employing inefficient ESP technology as well as for new construction, thereby providing a solution to a large segment of the U.S. utility industry as well as other industries requiring mercury control