Medicine and Health Sciences Commons^™

Trends In The Prevalence And Mortality Of Cognitive Impairment In The United States: Is There Evidence Of A Compression Of Cognitive Morbidity, Kenneth Langa, Eric Larson, Jason Karlawish, David Cutler, Mohammed Kabeto, Scott Kim, Allison Rosen

Jason Karlawish

BACKGROUND: Recent medical, demographic, and social trends might have had an important impact on the cognitive health of older adults. To assess the impact of these multiple trends, we compared the prevalence and 2-year mortality of cognitive impairment (CI) consistent with dementia in the United States in 1993 to 1995 and 2002 to 2004. METHODS: We used data from the Health and Retirement Study (HRS), a nationally representative population-based longitudinal survey of U.S. adults. Individuals aged 70 years or older from the 1993 (N = 7,406) and 2002 (N = 7,104) waves of the HRS were included. CI was determined …

Striving For Cultural Competence In An Hiv Program: The Transformative Impact Of A Microsystem In A Larger Health Network, Judith N Sabino, Timothy Friel, Lynn Deitrick, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

Long-Term Survival For Patients With Acute Decompensated Heart Failure According To Ejection Fraction Findings, Andrew Coles, Kimberly Fisher, Chad Darling, Jorge Yarzebski, David Mcmanus, Joel Gore, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Limited data exist about the long-term prognosis of patients with acute decompensated heart failure (ADHF) further stratified according to ejection fraction (EF) findings. The primary objective of this population-based observational study was to characterize and compare trends in long-term prognosis after an episode of ADHF across 3 EF strata. Hospital medical records were reviewed for 3,604 residents of the Worcester, Massachusetts, metropolitan area who were discharged after ADHF from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, and 2004 and had EF measurements during their index hospitalizations. The average age of this population was 75 years, most …

Effectiveness Of A Novel Spontaneous Carvacrol Nanoemulsion Against Salmonella Enterica Enteritidis And Escherichia Coli O157:H7 On Contaminated Mung Bean And Alfalfa Seeds, Kyle Landry, Yuhua Chang, David Julian Mcclements, Lynne Mclandsborough

Kyle S Landry

Diagnostic Performance Of Cardiac Troponin I For Early Rule-In And Rule-Out Of Acute Myocardial Infarction: Results Of A Prospective Multicenter Trial, Alan Storrow, Robert Christenson, Richard Nowak, Deborah Diercks, Adam Singer, Alan Wu, Erik Kulstad, Frank Lovecchio, Christian Fromm, Gary Headden, Tracie Potis, Christopher Hogan, Jon Schrock, Daniel Zelinski, Marna Greenberg, James Ritchie, Janna Chamberlin, Kurtis Bray, Daniel Rhodes, Deirdre Trainor, Dawn Holmes, Paula Southwick

Marna R Greenberg DO, MPH, FACEP

OBJECTIVES: To compare emergency department TnI serial sampling intervals, determine optimal diagnostic thresholds, and report representative diagnostic performance characteristics for early rule-in and rule-out of MI. METHODS: We prospectively measured TnI (AccuTnI+3™, Beckman Coulter) at serial time intervals in 1929 subjects with chest pain or equivalent ischemic symptoms suggestive of acute coronary syndromes at 14 medical centers. Diagnosis was adjudicated by an independent central committee. RESULTS: TnI ≥0.03ng/mL provided 96.0% sensitivity and 89.4% specificity at 1-3h after admission, and 94.9% sensitivity and 86.7% specificity at 3-6h. NPV (rule-out, non-MI) was 99.5% at 1-3h, and 99.0% at 3-6h when TnI is …

Pubertal And Adult Leydig Cell Function In Mullerian Inhibiting Substance-Deficient Mice, Xiufeng Wu, Ramamani Arumugam, Stephen Baker, Mary Lee

Mary M. Lee

Mullerian inhibiting substance (MIS) causes Mullerian duct regression during sexual differentiation and regulates postnatal Leydig cell development. MIS knockout (MIS-KO) mice with targeted deletions of MIS develop Leydig cell hyperplasia, but their circulating androgen concentrations are reportedly unaltered. We compared reproductive hormone profiles, androgen biosynthesis, and the expression of key steroidogenic and metabolic enzymes in MIS-KO and wild-type (WT) mice at puberty (36 d) and sexual maturity (60 d). In pubertal animals, basal testosterone and LH concentrations in plasma were lower in MIS-KO than WT mice, whereas human chorionic gonadotropin-stimulated testosterone concentrations were similar. In adults, basal LH, and both …

Characterization Of A Recently Purified Thermophilic Dnase From A Novel Thermophilic Fungus, Kyle Landry, Robert Levin

Kyle S Landry

Models For Improving Patient Throughput And Waiting At Hospital Emergency Departments, Jomon Aliyas Paul, Lin Li

Jomon Aliyas Paul

Background: Overcrowding diminishes Emergency Department (ED) care delivery capabilities.

Objectives: We developed a generic methodology to investigate the causes of overcrowding and to identify strategies to resolve them, and applied it in the ED of a hospital participating in the study.

Methods: We utilized Discrete Event Simulation (DES) to capture the complex ED operations. Using DES results, we developed parametric models for checking the effectiveness and quantifying the potential gains from various improvement alternatives. We performed a follow-up study to compare the outcomes before and after the model recommendations were put into effect at the hospital participating …

Lead In Green Turf, Shawn Gerstenberger

Shawn Gerstenberger

Green turf. You see it everywhere: football fields, day care centers, parks.... But is it safe? A UNLV professor says it can release lead, which people could inhale or ingest. But the Synthetic Turf Council says no one has reported bad effects. How safe is the turf we play on? How can we change it? The research professor breaks down the green turf situation for us.

A Randomized, Double-Blind, Placebo-Controlled Study To Assess The Effect Of Recombinant Human Erythropoietin On Functional Outcomes In Anemic, Critically Ill, Trauma Subjects: The Long Term Trauma Outcomes Study, Fred Luchette, Michael Pasquale, Timothy Fabian, Wayne Langholff, Marsha Wolfson

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: Achieving a higher hemoglobin (Hb) level might allow the anemic, critically ill, trauma patient to have an improved outcome during rehabilitation therapy. METHODS: Patients with major blunt trauma orthopedic injuries were administered epoetin alfa or placebo weekly both in hospital and for up to 12 weeks after discharge or until the Hb level was >12.0 g/dL, whichever occurred first. The 36-question Short Form Health Assessment questionnaire (SF-36) was used to evaluate physical function (PF) outcomes at baseline, at hospital discharge, and at several time points posthospital discharge. RESULTS: One hundred ninety-two patients were enrolled (epoetin alfa [n = 97], …

Rapid Door To Balloon Time In The Treatment Of Acute St- Elevation Myocardial Infarction Meaningfully Reduces Overall Hospital Stay, Amit N. Nanavati Md, Nainesh Patel Md, Bruce Feldman Do, J Patrick Kleaveland Md, Orlando E. Rivera Rn, David A. Cox Md

Bruce A. Feldman DO

No abstract provided.

Development Of A Novel Affinity Membrane Purification System For Deoxyribonuclease, Kyle Landry, Robert Levin

Kyle S Landry

Purification Of An Inducible Dnase From A Thermophilic Fungus, Kyle Landry, Andrea Vu, Robert Levin

Kyle S Landry

Purification And Characterization Of Iso-Ribonucleases From A Novel Thermophilic Fungus, Kyle Landry, Robert Levin

Kyle S Landry

Modeling The Longitudinality Of User Acceptance Of Technology With An Evidence-Adaptive Clinical Decision Support System, Michael P. Johnson Jr., Kai Zheng, Rema Padman

Michael P. Johnson

This paper presents multiple innovations associated with an electronic health record system developed to support evidence-based medicine practice, and highlights a new construct, based on the technology acceptance model, to explain end users' acceptance of this technology through a lens of continuous behavioral adaptation and change. We show that this new conceptualization of technology acceptance reveals a richer level of detail of the developmental course whereby individuals adjust their behavior gradually to assimilate technology use. We also show that traditional models such as technology acceptance model (TAM) are not capable of delineating this longitudinal behavioral development process. Our TAM-derived analysis …