Where do Innovations Come From? Transformations in the U.S. Economy, 1970-2006

This article brings to bear new data on the issue of structuring national innovation systems. Drawing on a unique data set of prize winning innovations between 1971 and 2006, we document three key changes in the U.S. economy. The first is an expanding role of interorganizational collaborations in producing award winning innovations. The second is the diminishing role of the largest corporations as sources of innovation. The third is the expanded role of public institutions and public funding in the innovation process. This leads us to the surprising conclusion that the U.S. increasingly resembles a Developmental Network State in which government initiatives are critical in overcoming network failures and in providing critical funding for the innovation process. The paper concludes by addressing the implications of these finding for debates over the appropriate regime for intellectual property rights.

Evaluating cultural competency and patient satisfaction in an urban dermatology clinic.

Cultural competency continues to gain increased attention in medicine. Not only does it play a significant role in the delivery of health care and patient outcomes, but it also remains a major determinant of patient satisfaction. This study investigated how patients in an urban dermatology clinic rated their satisfaction with cultural competency. Compared to White patients, satisfaction scores were greater for Hispanic or Latino patients and less for Asian patients, while there was no significant difference for Black or African American patients. There were clear differences in patient satisfaction rates of various dimensions of cultural competency. A follow-up study with a larger sample size is needed for closer examination into the conclusions

Modernizing dermatology interest groups in medical school: Certificate programs

This commentary addresses the increasingly competitive nature of applying to dermatology residency programs and how both interest groups in medical schools and their dermatology departments can help to better prepare applicants. As previous literature argued that dermatology has been underemphasized in medical school curricula, we propose five fundamental options that interest groups can implement in order to offer increased exposure to our field in medical training. Furthermore, with the recent trend of many schools conferring certificates in various specialized concentrations, we also discuss interest groups pioneering certificate-granting programs in dermatology competency. The pros and cons of having a recognized certificate program in dermatology are presented. © 2017, Dermatology Online Journal. All rights reserved

Psoriasiform Sarcoidosis Presenting in Pregnancy and Treatment Considerations

Cutaneous sarcoidosis is a common presentation for patients with sarcoidosis. Rarely, patients can present with psoriasiform lesions mimicking chronic plaque psoriasis. Here, we present a case of psoriasiform sarcoidosis in a pregnant patient. Pregnancy represents a unique challenge to systemic treatments if topical management fails. Tumor necrosis factor alpha inhibitors warrant special consideration during pregnancy

Challenges to smartphone applications for melanoma detection

This commentary addresses the emerging market for health-related smartphone applications. Specific to dermatology, there has been a significant increase not only in applications that promote skin cancer awareness and education but also in those meant for detection. With evidence showing that 365 dermatology-related applications were available in 2014--up from 230 in 2012--and that 1 in 5 patients under the age of 50 have used a smartphone to help diagnose a skin problem, there is clearly a large subset of patients participating in this growing trend. Therefore, we are obligated to take a closer look into this phenomenon. Studies have shown that applications are inferior to in-person consultations with one study showing that 3 out of 4 applications incorrectly classified 30% or more melanomas as low-risk lesions. Although the FDA gained regulatory oversight over mobile health applications in 2012 and recently released their statement in 2015, their reach only extends to cover a selected portion of these applications, leaving many unregulated as they continue to be marketed toward our patients. Dermatologists should be updated on our current situation in order to properly counsel patients on the risks and benefits of these applications and whether they are acceptable for use. © 2016 by the article author(s)

Relationships between estimated autozygosity and complex traits in the UK Biobank

<div><p>Inbreeding increases the risk of certain Mendelian disorders in humans but may also reduce fitness through its effects on complex traits and diseases. Such inbreeding depression is thought to occur due to increased homozygosity at causal variants that are recessive with respect to fitness. Until recently it has been difficult to amass large enough sample sizes to investigate the effects of inbreeding depression on complex traits using genome-wide single nucleotide polymorphism (SNP) data in population-based samples. Further, it is difficult to infer causation in analyses that relate degree of inbreeding to complex traits because confounding variables (e.g., education) may influence both the likelihood for parents to outbreed and offspring trait values. The present study used runs of homozygosity in genome-wide SNP data in up to 400,000 individuals in the UK Biobank to estimate the proportion of the autosome that exists in autozygous tracts—stretches of the genome which are identical due to a shared common ancestor. After multiple testing corrections and controlling for possible sociodemographic confounders, we found significant relationships in the predicted direction between estimated autozygosity and three of the 26 traits we investigated: age at first sexual intercourse, fluid intelligence, and forced expiratory volume in 1 second. Our findings corroborate those of several published studies. These results may imply that these traits have been associated with Darwinian fitness over evolutionary time. However, some of the autozygosity-trait relationships were attenuated after controlling for background sociodemographic characteristics, suggesting that alternative explanations for these associations have not been eliminated. Care needs to be taken in the design and interpretation of ROH studies in order to glean reliable information about the genetic architecture and evolutionary history of complex traits.</p></div

Metabolomics Advanced and Applied: Shrinking the metabolomic knowledge gap by advancing and applying metabolomics in integrated multi-omics

Some of the most exciting questions in chemistry lay within the realm of molecular biology. Although different disciplines, throughout history we see chemists and chemical techniques leading the way in important biological discoveries. Metabolomics is a new, developing technique in molecular biology that is spurred on by technical innovations, primarily from the chemistry and engineering fields. Here, two different liquid chromatography mass spectrometry techniques and state-of-the-art bioinformatic tools are employed to help expand the field of metabolomics. In the application phase of this project, metabolomic techniques were applied in a multiomic experiment to elucidate the metabolic pathways used in Staphylococcus. Multi-omics are the coupling of multiple omics techniques such as metabolomics, genomics, and proteomics. In particular, an Ultra-Performance Liquid Chromatography-High Resolution Mass Spectrometry platform was used with a semi-targeted metabolomics technique. Large fold-changes are observed in metabolites mevalonate and phosphomevalonate, which are important distinguishing metabolites between the two isoprenoid synthesis routes. This is used to characterize isolates based on which metabolic pathway they use. This is further verified and expanded by the use of comparative genomics. In the developmental phase of this project, metabolomics techniques were advanced by testing and comparing different extraction methods for multiomic analyses. In this case, chloroform-based extractions were tested against methyl-tert-butyl ether-based extractions to collect metabolites, lipids, and proteins simultaneously. This was analyzed using a High-Performance Liquid Chromatography-High Resolution Mass Spectrometry platform with split-flow nano chromatography and electrospray ionization. Additionally, the cell lysis method is investigated to determine its impact on extraction efficiency and metabolite degradation. Optimizing extraction procedures will make multi-omics faster, easier, and more reliable, thereby facilitating greater use of metabolomics in multi-omics experiments