Digital Commons Network^™

A Preliminary Survey Examining Predictors Of Burnout In Pain Medicine Physicians In The United States, Henry R. Kroll, Taylor Macaulay, Michelle T. Jesse

Anesthesiology Articles

BACKGROUND: Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, defined by 3 dimensions: exhaustion, depersonalization, and reduced personal accomplishment. While there is a growing body of research on burnout in physicians, there is a dearth of literature on burnout in pain medicine physicians.

OBJECTIVE: This study aimed to determine the incidence of burnout amongst pain medicine physicians and whether there are sociodemographic or psychological demand characteristics of the job setting that predict burnout in pain medicine physicians.

STUDY DESIGN AND SETTING: Cross-section survey of pain medicine physicians across the United States.

METHODS: Pain medicine …

Improving Transitions In Ckd: Failure Mode, Jerry Yee

Nephrology Articles

No abstract provided.

Characterization Of Salmonella Isangi Possessing A Ctx-M15 Esbl Associated With An Outbreak In A Us Hospital, Geehan Suleyman, Mary Perri, Dora Vager, Linoj Samuel, Marcus J. Zervos, George Alangaden, Robert J. Tibbetts

Pathology and Laboratory Medicine Articles

Over an approximately 50-day period in 2015, an outbreak of CTX-M-15 extended spectrum β-lactamase-(ESBL)-possessing Salmonella Isangi occurred among 19 adult surgical patients and one healthcare worker (HCW) at a large urban tertiary care hospital in the United States. A total of 45 S. Isangi isolates were isolated from stool (35), blood (4), urine (3), respiratory (2), and wound (1) cultures. Phenotypically, all but three isolates demonstrated resistance to ampicillin, ampicillin/sulbactam, ceftriaxone, and cefepime, and one isolate was resistant to ertapenem. Genotypically, a single CTX-M-15 ESBL was identified in all but three isolates by real-time PCR. Interestingly, two of the CTX-M-15 …

Adverse Drug Effects And Preoperative Medication Factors Related To Perioperative Low-Dose Ketamine Infusions., Eric S. Schwenk, Stephen F. Goldberg, Ronak D. Patel, Jon Zhou, Douglas R. Adams, Jaime L. Baratta, Eugene R. Viscusi, Richard H. Epstein

Department of Anesthesiology Faculty Papers

High-dose opioid administration is associated with significant adverse events. Evidence suggests that low-dose ketamine infusions improve perioperative analgesia over conventional opioid management, but usage is highly variable. Ketamine's adverse drug effects (ADEs) are well known, but their prevalence during low-dose infusions in a clinical setting and how often they lead to infusion discontinuation are unknown. The purposes of this study were 3-fold: (1) to identify patient factors associated with initiation of ketamine infusions during spine surgery, (2) to identify specific spine procedures in which ketamine has been used most frequently, and (3) to identify ADEs associated with postoperative ketamine infusions …

Placing Evidence-Based Interventions At The Fingertips Of School Social Workers, Jose Castillo, Tommi Rivers, Catherine Randall, Ken Gaughan, Tiina Ojanen, Oliver Tom Massey, Donna L. Burton

Psychology Faculty Publications

Through a university-community collaborative partnership, the perceived needs of evidence-based practices (EBPs) among school social workers (SSWs) in a large school district in central Florida was assessed. A survey (response rate = 83.6%) found that although 70% of SSWs claim to use EBPs in their everyday practice, 40% do not know where to find them, which may partially explain why 78% of respondents claim to spend 1 to 4 h every week looking for adequate EBPs. From this needs assessment, the translational model was used to address these perceived needs. A systematic review of the literature found 40 tier 2 …

Early Goal-Directed Therapy In Severe Sepsis And Septic Shock: Insights And Comparisons To Process, Promise, And Arise., H B. Nguyen, Anja K. Jaehne, Namita Jayaprakash, Matthew W. Semler, Sara Hegab, Angel C. Yataco, Geneva Tatem, Dhafer Salem, Steven Moore, Kamran Boka, Jasreen Gill, Jayna Gardner-Gray, Jacqueline Pflaum, Juan P. Domecq, Gina Hurst, Justin B. Belsky, Raymond Fowkes, Ronald B. Elkin, Steven Q. Simpson, Jay L. Falk, Daniel J. Singer, Emanuel Rivers

Emergency Medicine Articles

Prior to 2001 there was no standard for early management of severe sepsis and septic shock in the emergency department. In the presence of standard or usual care, the prevailing mortality was over 40-50 %. In response, a systems-based approach, similar to that in acute myocardial infarction, stroke and trauma, called early goal-directed therapy was compared to standard care and this clinical trial resulted in a significant mortality reduction. Since the publication of that trial, similar outcome benefits have been reported in over 70 observational and randomized controlled studies comprising over 70,000 patients. As a result, early goal-directed therapy was …

"A Dread Mystery, Compelling Adoration": Olaf Stapledon, Star Maker, And Totality, Gerry Canavan

English Faculty Research and Publications

Using research undertaken at the Olaf Stapledon archive at the University of Liverpool, this article explores the tension between cosmopolitan optimism and cosmic pessimism that structures Stapledon's 1937 novel Star Maker, and asks whether the novel succeeds in solving the philosophical problems that first spurred Stapledon to write it. I conclude, unhappily, that it does not: while an impressive achievement, and despite a surface optimism, the book's confrontation with infinity, totality, and the sublime is ultimately depressive rather than generative of a felicitous cosmological order, requiring Stapledon to try again and again to somehow solve this philosophical conundrum in …

Structure And Functions Of Angiotensinogen, Hong Lu, Lisa A. Cassis, Craig W. Vander Kooi, Alan Daugherty

Saha Cardiovascular Research Center Faculty Publications

Angiotensinogen (AGT) is the sole precursor of all angiotensin peptides. Although AGT is generally considered as a passive substrate of the renin–angiotensin system, there is accumulating evidence that the regulation and functions of AGT are intricate. Understanding the diversity of AGT properties has been enhanced by protein structural analysis and animal studies. In addition to whole-body genetic deletion, AGT can be regulated in vivo by cell-specific procedures, adeno-associated viral approaches and antisense oligonucleotides. Indeed, the availability of these multiple manipulations of AGT in vivo has provided new insights into the multifaceted roles of AGT. In this review, the combination of …

Validation Of Noninvasive Measures Of Left Ventricular Mechanics In Children: A Simultaneous Echocardiographic And Conductance Catheterization Study., Shahryar M. Chowdhury, Ryan J. Butts, Carolyn L. Taylor, Varsha M. Bandisode, Karen S. Chessa, Anthony M. Hlavacek, Girish S. Shirali, G Hamilton Baker

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The accuracy of echocardiography in evaluating left ventricular contractility has not been validated in children. The objective of this study was to compare echocardiographic measures of contractility with those derived from pressure-volume loop (PVL) analysis in children.

METHODS: Patients with relatively normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. The gold-standard measure of contractility, end-systolic elastance (Ees), was obtained via balloon occlusion of one or both vena cavae. Echocardiograms were performed immediately after PVL analysis under the same anesthetic conditions. Single-beat estimations of echocardiographic Ees were calculated using four different …

Impact Of Dietary Resistant Starch Type 4 On Human Gut Microbiota And Immunometabolic Functions, Bijaya Upadhyaya, Lacey Mccormack, Ali Reza Fardin-Kia, Robert M. Juenemann, Sailendra Nichenametla, Jeffrey A. Clapper, Bonny Specker, Moul Dey

Health and Nutritional Sciences Faculty Publications

Dietary modulation of the gut microbiota impacts human health. Here we investigated the hitherto unknown effects of resistant starch type 4 (RS4) enriched diet on gut microbiota composition and short-chain fatty acid (SCFA) concentrations in parallel with host immunometabolic functions in twenty individuals with signs of metabolic syndrome (MetS). Cholesterols, fasting glucose, glycosylated haemoglobin, and proinflammatory markers in the blood as well as waist circumference and % body fat were lower post intervention in the RS4 group compared with the control group. 16S-rRNA gene sequencing revealed a differential abundance of 71 bacterial operational taxonomic units, including the enrichment of three …

Mutation Linked To Autosomal Dominant Nocturnal Frontal Lobe Epilepsy Reduces Low-Sensitivity Α4Β2, And Increases Α5Α4Β2, Nicotinic Receptor Surface Expression, Weston A. Nichols, Brandon J. Henderson, Christopher B. Marotta, Caroline Y. Yu, Chris Richards, Dennis A. Dougherty, Henry A. Lester, Bruce N. Cohen

Chemistry Faculty Publications

A number of mutations in α4β2-containing (α4β2*) nicotinic acetylcholine (ACh) receptors (nAChRs) are linked to autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), including one in the β2 subunit called β2V287L. Two α4β2* subtypes with different subunit stoichiometries and ACh sensitivities co-exist in the brain, a high-sensitivity subtype with (α4)₂(β2)₃ subunit stoichiometry and a low-sensitivity subtype with (α4)₃(β2)₂ stoichiometry. The α5 nicotinic subunit also co-assembles with α4β2 to form a high-sensitivity α5α4β2 nAChR. Previous studies suggest that the β2V287L mutation suppresses low-sensitivity α4β2* nAChR expression in a knock-in mouse model and also that α5 co-expression …

Training To Promote Dementia Support., J Kwakwa, H Ashforth, A Pritchard, R Trout

Peninsula Medical School

Inadequate care has been identified for those with dementia at all stages, from pre-diagnosis to end-of-life care. Nationally, two levels of initiatives are evolving: basic awareness skilling of frontline care staff and changing services at the strategic level. Senior clinical staff have the potential to fill the gap between the two levels and drive speedier service change. This article describes a multidisciplinary programme developed by Central London Community Healthcare Trust to provide dementia care champions, at the advanced tier 3 level, to drive a range of service improvements across north-west London.

Characterization Of The Microbiome Of Nipple Aspirate Fluid Of Breast Cancer Survivors., Alfred A Chan, Mina Bashir, Magali N Rivas, Karen Duvall, Peter A Sieling, Thomas R Pieber, Parag A Vaishampayan, Susan M Love, Delphine J Lee

Articles, Abstracts, and Reports

The microbiome impacts human health and disease. Until recently, human breast tissue and milk were presumed to be sterile. Here, we investigated the presence of microbes in the nipple aspirate fluid (NAF) and their potential association with breast cancer. We compared the NAF microbiome between women with a history of breast cancer (BC) and healthy control women (HC) using 16S rRNA gene amplicon sequencing. The NAF microbiome from BC and HC showed significant differences in community composition. Two Operational Taxonomic Units (OTUs) showed differences in relative abundances between NAF collected from BC and HC. In NAF collected from BC, there …

Staphylococcus Aureus Coordinates Leukocidin Expression And Pathogenesis By Sensing Metabolic Fluxes Via Rpirc, Divya Balasubramanian, Elizabeth A Ohneck, Jessica Chapman, Andy Weiss, Min Kyung Kim, Tamara Reyes-Robles, Judy Zhong, Lindsey N. Shaw, Desmond S. Lun, Beatrix Ueberheide, Bo Shopsin, Victor J Torres

Molecular Biosciences Faculty Publications

Staphylococcus aureus is a formidable human pathogen that uses secreted cytolytic factors to injure immune cells and promote infection of its host. Of these proteins, the bicomponent family of pore-forming leukocidins play critical roles in S. aureus pathogenesis. The regulatory mechanisms governing the expression of these toxins are incompletely defined. In this work, we performed a screen to identify transcriptional regulators involved in leukocidin expression in S. aureus strain USA300. We discovered that a metabolic sensor-regulator, RpiRc, is a potent and selective repressor of two leukocidins, LukED and LukSF-PV. Whole-genome transcriptomics, S. aureus exoprotein proteomics, and metabolomic analyses revealed that …

A Randomized, Double-Blind, Placebo-Controlled Phase Ii Trial Investigating The Safety And Immunogenicity Of Modified Vaccinia Ankara Smallpox Vaccine (Mva-Bn®) In 56-80-Year-Old Subjects, Richard N. Greenberg, Christine M. Hay, Jack T. Stapleton, Thomas C. Marbury, Eva Wagner, Eva Kreitmeir, Siegfried Röesch, Alfred Von Krempelhuber, Philip Young, Richard Nichols, Thomas P. Meyer, Darja Schmidt, Josef Weigl, Garth Virgin, Nathaly Arndtz-Wiedemann, Paul Chaplin

Internal Medicine Faculty Publications

Background Modified Vaccinia Ankara MVA-BN^® is a live, highly attenuated, viral vaccine under advanced development as a non-replicating smallpox vaccine. In this Phase II trial, the safety and immunogenicity of Modified Vaccinia Ankara MVA-BN^® (MVA) was assessed in a 56–80 years old population.

Methods MVA with a virus titer of 1 x 10⁸ TCID₅₀/dose was administered via subcutaneous injection to 56–80 year old vaccinia-experienced subjects (N = 120). Subjects received either two injections of MVA (MM group) or one injection of Placebo and one injection of MVA (PM group) four weeks apart. Safety was evaluated …

The Brain Imaging Data Structure, A Format For Organizing And Describing Outputs Of Neuroimaging Experiments, Krzysztof Gorgolewski, Tibor Auer, Vince Calhoun, R Cameron Craddock, Samir Das, Eugene Duff, Guillaume Flandin, Tristan Glatard, Yaroslav Halchenko

Dartmouth Scholarship

The development of magnetic resonance imaging (MRI) techniques has defined modern neuroimaging. Since its inception, tens of thousands of studies using techniques such as functional MRI and diffusion weighted imaging have allowed for the non-invasive study of the brain. Despite the fact that MRI is routinely used to obtain data for neuroscience research, there has been no widely adopted standard for organizing and describing the data collected in an imaging experiment. This renders sharing and reusing data (within or between labs) difficult if not impossible and unnecessarily complicates the application of automatic pipelines and quality assurance protocols. To solve this …

De Novo Deciphering Three-Dimensional Chromatin Interaction And Topological Domains By Wavelet Transformation Of Epigenetic Profiles., Yong Chen, Yunfei Wang, Zhenyu Xuan, Min Chen, Michael Q Zhang

College of Science & Mathematics Departmental Research

Defining chromatin interaction frequencies and topological domains is a great challenge for the annotations of genome structures. Although the chromosome conformation capture (3C) and its derivative methods have been developed for exploring the global interactome, they are limited by high experimental complexity and costs. Here we describe a novel computational method, called CITD, for de novo prediction of the chromatin interaction map by integrating histone modification data. We used the public epigenomic data from human fibroblast IMR90 cell and embryonic stem cell (H1) to develop and test CITD, which can not only successfully reconstruct the chromatin interaction frequencies discovered by …

Consistency Of Hemoglobin A1c Testing And Cardiovascular Outcomes In Medicare Patients With Diabetes, Philip P. Goodney, Karina A. Newhall, Kimon Bekelis, Daniel Gottlieb, Richard Comi, Sushela Chaudrain, Adrienne E. Faerber, Todd A. Mackenzie, Jonathan S. Skinner

Dartmouth Scholarship

Background:

Annual hemoglobin A1c testing is recommended for patients with diabetes mellitus. However, it is unknown how consistently patients with diabetes mellitus receive hemoglobin A1c testing over time, or whether testing consistency is associated with adverse cardiovascular outcomes.

Methods and Results:

We identified 1 574 415 Medicare patients (2002–2012) with diabetes mellitus over the age of 65. We followed each patient for a minimum of 3 years to determine their consistency in hemoglobin A1C testing, using 3 categories: low (testing in 0 or 1 of 3 years), medium (testing in 2 of 3 years), and high (testing in all 3 …

Pik3ca-Associated Developmental Disorders Exhibit Distinct Classes Of Mutations With Variable Expression And Tissue Distribution, Ghayda Mirzaa, Andrew E Timms, Valerio Conti, Evan August Boyle, Katta M Girisha, Beth Martin, Martin Kircher, Carissa Olds, Jane Juusola, Sarah Collins, Kaylee Park, Melissa Carter, Ian Glass, Inge Krägeloh-Mann, David Chitayat, Aditi Shah Parikh, Rachael Bradshaw, Erin Torti, Stephen Braddock, Leah Burke, Sondhya Ghedia, Mark Stephan, Fiona Stewart, Chitra Prasad, Melanie Napier, Sulagna Saitta, Rachel Straussberg, Michael Gabbett, Bridget C O'Connor, Catherine E Keegan, Lim Jiin Yin, Angeline Hwei Meeng Lai, Nicole Martin, Margaret Mckinnon, Marie-Claude Addor, Luigi Boccuto, Charles E Schwartz, Agustina Lanoel, Robert L Conway, Koenraad Devriendt, Katrina Tatton-Brown, Mary Ella Pierpont, Michael Painter, Lisa Worgan, James Reggin, Raoul Hennekam, Karen Tsuchiya, Colin C Pritchard, Mariana Aracena, Karen W Gripp, Maria Cordisco, Hilde Van Esch, Livia Garavelli, Cynthia Curry, Anne Goriely, Hulya Kayserilli, Jay Shendure, John Graham, Renzo Guerrini, William B Dobyns

Articles, Abstracts, and Reports

Mosaicism is increasingly recognized as a cause of developmental disorders with the advent of next-generation sequencing (NGS). Mosaic mutations of PIK3CA have been associated with the widest spectrum of phenotypes associated with overgrowth and vascular malformations. We performed targeted NGS using 2 independent deep-coverage methods that utilize molecular inversion probes and amplicon sequencing in a cohort of 241 samples from 181 individuals with brain and/or body overgrowth. We identified PIK3CA mutations in 60 individuals. Several other individuals (n = 12) were identified separately to have mutations in PIK3CA by clinical targeted-panel testing (n = 6), whole-exome sequencing ( …

Asfotase Alfa Therapy For Children With Hypophosphatasia, Michael P. Whyte, Katherine L. Madson, Dawn Phillips, Amy L. Reeves, William H. Mcalister, Amy Yakimoski, Karen E. Mack, Kim Hamilton, Kori Kagan, Kenji P. Fujita, David D. Thompson, Scott Moseley, Tatjana Odrljin, Cheryl Rockman-Greenberg

Open Access Publications

No abstract provided.

Identification Of Ecdysone Hormone Receptor Agonists As A Therapeutic Approach For Treating Filarial Infections, Amruta S Mhashilkar, Sai L Vankayala, Canhui Liu, Fiona Kearns, Priyanka Mehrotra, George Tzertzinis, Subba R Palli, H. Lee Woodcock Iii, Thomas R Unnasch

Chemistry Faculty Publications

BACKGROUND: A homologue of the ecdysone receptor has previously been identified in human filarial parasites. As the ecdysone receptor is not found in vertebrates, it and the regulatory pathways it controls represent attractive potential chemotherapeutic targets.

METHODOLOGY/ PRINCIPAL FINDINGS: Administration of 20-hydroxyecdysone to gerbils infected with B. malayi infective larvae disrupted their development to adult stage parasites. A stable mammalian cell line was created incorporating the B. malayi ecdysone receptor ligand-binding domain, its heterodimer partner and a secreted luciferase reporter in HEK293 cells. This was employed to screen a series of ecdysone agonist, identifying seven agonists active at sub-micromolar concentrations. …

Identification Of Ecdysone Hormone Receptor Agonists As A Therapeutic Approach For Treating Filarial Infections, Amruta S. Mhashilkar, Sai L. Vankayala, Canhui Liu, Fiona Kearns, Priyanka Mehrotra, George Tzertzinis, Subba R. Palli, H. Lee Woodcock, Thomas R. Unnasch

Entomology Faculty Publications

Background A homologue of the ecdysone receptor has previously been identified in human filarial parasites. As the ecdysone receptor is not found in vertebrates, it and the regulatory pathways it controls represent attractive potential chemotherapeutic targets.

Methodology/ Principal Findings Administration of 20-hydroxyecdysone to gerbils infected with B. malayi infective larvae disrupted their development to adult stage parasites. A stable mammalian cell line was created incorporating the B. malayi ecdysone receptor ligand-binding domain, its heterodimer partner and a secreted luciferase reporter in HEK293 cells. This was employed to screen a series of ecdysone agonist, identifying seven agonists active at …

A Technology-Mediated Behavioral Weight Gain Prevention Intervention For College Students: Controlled, Quasi-Experimental Study, Delia Smith West, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Beth Sundstrom, Chelsea Larsen, Karen Magradey, Sara Wilcox, Heather M. Brandt

Faculty Publications

BACKGROUND: Both men and women are vulnerable to weight gain during the college years, and this phenomenon is linked to an increased risk of several chronic diseases and mortality. Technology represents an attractive medium for the delivery of weight control interventions focused on college students, given its reach and appeal among this population. However, few technology-mediated weight gain prevention interventions have been evaluated for college students. OBJECTIVE: This study examined a new technology-based, social media-facilitated weight gain prevention intervention for college students. METHODS: Undergraduates (n =58) in two sections of a public university course were allocated to either a behavioral …

3-Year Outcomes In High-Risk Patients Who Underwent Surgical Or Transcatheter Aortic Valve Replacement., G Michael Deeb, Michael J Reardon, Stan Chetcuti, Himanshu J Patel, P Michael Grossman, Steven J Yakubov, Neal S Kleiman, Joseph S Coselli, Thomas G Gleason, Joon Sup Lee, James B Hermiller, John Heiser, William Merhi, George L Zorn, Peter Tadros, Newell Robinson, George Petrossian, G Chad Hughes, J Kevin Harrison, Brijeshwar Maini, Mubashir Mumtaz, John Conte, Jon Resar, Vicken Aharonian, Thomas Pfeffer, Jae K Oh, Hongyan Qiao, David H Adams, Jeffrey J Popma

Heart and Vascular Articles

BACKGROUND: In patients with severe aortic stenosis at increased risk for surgery, self-expanding transcatheter aortic valve replacement (TAVR) is associated with improved 2-year survival compared with surgery.

OBJECTIVES: This study sought to determine whether this clinical benefit was sustained over time.

METHODS: Patients with severe aortic stenosis deemed at increased risk for surgery by a multidisciplinary heart team were randomized 1:1 to TAVR or open surgical valve replacement (SAVR). Three-year clinical and echocardiographic outcomes were obtained in those patients with an attempted procedure.

RESULTS: A total of 797 patients underwent randomization at 45 U.S. centers; 750 patients underwent an attempted …

Smartphone Apps: A Patient's New Best Friend?, Tejas Desai, Jerry Yee, Sandeep Soman

Nephrology Articles

No abstract provided.

The Respiratory Protection Effectiveness Clinical Trial (Respect): A Cluster-Randomized Comparison Of Respirator And Medical Mask Effectiveness Against Respiratory Infections In Healthcare Personnel., Lewis J Radonovich, Mary T Bessesen, Derek A Cummings, Aaron Eagan, Charlotte Gaydos, Cynthia Gibert, Geoffrey J Gorse, Ann-Christine Nyquist, Nicholas G Reich, Maria Rodrigues-Barradas, Connie Savor-Price, Ronald E Shaffer, Michael S Simberkoff, Trish M Perl

Medicine Faculty Publications

BACKGROUND: Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts.

METHODS: The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to …

Therapy For Tuberculous Meningitis, Praveen Sudhindra, John Nowakowski

NYMC Faculty Publications

No abstract provided.

American Academy Of Neurology Guidelines And The Neurologic Determination Of Death-Reply, David M. Greer, Panayiotis N. Varelas, Eelco Fm Wijdicks

Neurology Articles

No abstract provided.

Impact Of A Videoconference Educational Intervention On Physical Restraint And Antipsychotic Use In Nursing Homes: Results From The Echo-Age Pilot Study, Stephen E. Gordon, Alyssa B. Dufour, Sara M. Monti, Melissa L P Mattison, Angela G. Catic, Cindy P. Thomas, Lewis A. Lipsitz

Project ECHO Bibliography

OBJECTIVES: US nursing homes care for increasing numbers of residents with dementia and associated behavioral problems. They often lack access to specialized clinical expertise relevant to managing these problems. Project ECHO-AGE provides this expertise through videoconference sessions between frontline nursing home staff and clinical experts at an academic medical center. We hypothesized that ECHO-AGE would result in less use of physical and chemical restraints and other quality improvements in participating facilities.

DESIGN: A 2:1 matched-cohort study comparing quality of care outcomes between ECHO-AGE facilities and matched controls for the period July 2012 to December 2013.

SETTING: Eleven nursing homes in …

A Clinical Score To Predict Dose Reductions Of Antidiabetes Medications With Intentional Weight Loss: A Retrospective Cohort Study., Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Vimal Ravi, Rohit C Khanna, Scott Kahan, Lawrence J Cheskin

Health Policy and Management Faculty Publications

Abstract

Background

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: “WIG”) to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss.

Methods

Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed.

Results

Mean period of follow-up was 12.5 ± 3.5 months. To derive the “WIG” scoring algorithm, one point each was assigned to “W” (loss of 5% of initial body weight within the first 3 months of attempting weight loss), “I” (triglyceride [TGL]/highdensity lipoprotein ratio >3 …