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Meyer-Mueller, Cameron, Darlisha A. Williams, Michael Westerhaus y Radha Rajasingham. "1374. Clinical Outcomes of Sepsis According to Race at University of Minnesota Medical Center". Open Forum Infectious Diseases 8, Supplement_1 (1 de noviembre de 2021): S773—S774. http://dx.doi.org/10.1093/ofid/ofab466.1566.
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Abstract Background Sepsis is a life-threatening condition associated with significant in-hospital mortality. Sepsis disproportionately affects Black Americans and is a top-10 leading cause of death for Black people. Previous studies examining sepsis mortality rates by race have yielded inconsistent findings. This retrospective study evaluates the relationship between race and in-hospital sepsis-related mortality in adults at University of Minnesota Medical Center. Methods We reviewed all sepsis diagnoses in adults between January 1, 2020 and June 30, 2020 at the University of Minnesota Medical Center. Demographic information including age, sex, race, insurance status, primary language, expected and observed mortality score, discharge status, treatment information, and in-hospital mortality were also recorded. Self-reported race was categorized as African American, White, American Indian or Alaska Native, Asian, African, Hispanic or Latino, Hawaiian or other Pacific Islander, “some other race,” and “two or more races.” Statistical tests including χ 2 test, Student t test, Kaplan-Meier estimator, and binary logistic regression were performed. Results We identified 780 cases of sepsis. Black patients were consistently younger than White patients (median age of 50 years, compared to 61 years, p< 0.001). Black patients were more likely to have comorbidities at baseline. However, logistic regression analyses, after controlling for language, race, primary payer, and expected mortality, showed no association between sepsis outcome and race. Sepsis Cases at UMMC between January and June 2020 by Self-Reported Race *Other includes the categories “Some other race” and “Two or more races.” Hospital Outcomes by Race Patient Demographics by Race Conclusion While there was no significant difference between in-hospital mortality and race, Black patients were more likely to present at a younger age with more medical comorbidities than White patients. Disclosures All Authors: No reported disclosures
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Halcón, Linda, Barbara Leonard, Mariah Snyder, Ann Garwick y Mary Jo Kreitzer. "Incorporating Alternative and Complementary Health Practices Within University-Based Nursing Education". Complementary health practice review 6, n.º 2 (enero de 2001): 127–35. http://dx.doi.org/10.1177/153321010100600203.
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The University of Minnesota School of Nursing aims to fully incorporate comple mentary and alternative health philosophy and healing practices into its baccalau reate, master's and doctoral programs. A planning process (1998-99) included School of Nursing faculty, administrators, and representatives of the university's Center for Spirituality and Healing. A comprehensive course of action was devel oped that included strengthening didactic and experiential learning, offering indi vidualized plans of clinical study in a variety of modalities, improving access to an interdisciplinary graduate minor in Complementary Therapies and Healing Practic es, and encouraging faculty research initiatives and continuing education in CAM.
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Burnes, Todd A., Robert A. Blanchette, Jason A. Smith y James J. Luby. "Black Currant Clonal Identity and White Pine Blister Rust Resistance". HortScience 43, n.º 1 (febrero de 2008): 200–202. http://dx.doi.org/10.21273/hortsci.43.1.200.
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Gooseberries and currants (Ribes L.) are the alternate hosts for the fungus Cronartium ribicola J. C. Fischer, the causal agent of white pine blister rust. In this study, 16 black currant (R. nigrum L.) cultivars, including three accessions of the putatively immune cultivar ‘Consort’ and three cultivars developed at the University of Minnesota Horticultural Research Center, were screened for resistance to C. ribicola using artificial inoculation procedures. Twelve of these cultivars were grown in the field and observed for natural infection. Cultivars ‘Ben Sarek’, ‘Ben Lomond’, and ‘C2-2-1’ were infected naturally in the field at the University of Minnesota Horticultural Research Center in 2000, 2001, and 2004. Cultivars ‘Ben Sarek’, one mislabeled ‘Consort’ accession, R. nigrum ‘WI-1’, and ‘Ben Lomond’ had significantly more uredinial sori than other cultivars when inoculated artificially. To determine if the infected and noninfected ‘Consort’ clones were genetically related, DNA microsatellite genotyping was carried out to fingerprint these clones. One of the six microsatellite loci resulted in a polymorphism that indicated the infected clone was genetically different from the noninfected clones. In addition, the inoculation procedures used in these studies are generally efficacious for predicting resistance in the field because none of the field-infected cultivars were resistant in the greenhouse. This study confirms the Cr gene for resistance to C. ribicola in Ribes has remained effective for over 50 years.
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Hoffman, Megan C., Rachel Whitwam, Michelle Hoedeman, Brenda Prich, Joshua Fehrmann y Byron P. Vaughn. "409 Raising research awareness through StudyFinder". Journal of Clinical and Translational Science 7, s1 (abril de 2023): 122. http://dx.doi.org/10.1017/cts.2023.443.
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OBJECTIVES/GOALS: To increase public awareness and access to research opportunities at the University of Minnesota (UMN) utilizing StudyFinder, a public-facing website that features actively enrolling UMN research studies and directly connects website visitors with study teams. METHODS/STUDY POPULATION: Promote the University of Minnesota CTSI’s StudyFinder website to the public via social media ad campaigns and community outreach. Upon completion of the latest StudyFinder enhancement project in 2021, CTSI focused 2022 efforts on marketing and promotion of the site. CTSI created three StudyFinder social media ad campaigns in January, June, and October. CTSI also planned outreach events during the week of Clinical Trials Day, the Minnesota State Fair (1.8M attendees over 12 days), and the UMN’s Urban Research and Outreach-Engagement Center Community Day. RESULTS/ANTICIPATED RESULTS: Website traffic data from Google Analytics indicated a 72.76% increase in StudyFinder sessions from 2021 (Jan 1, 2021 to Nov 1, 2021) to 2022 (Jan 1, 2022 to Nov 1, 2022), with 16,262 sessions to 28,094 sessions, respectively. Direct emails from potential participants to study teams increased 89% in that same timeframe, from 3,082 emails to 5,819 emails. Targeted marketing campaigns and attending community events can improve the visibility of an institution’s research and connections of potential research participants to research teams. DISCUSSION/SIGNIFICANCE: Recruitment remains a main challenge in clinical and translational research. StudyFinder is an important patient-facing tool to connect individuals to specific studies. Future directions include expanding marketing efforts, events, and public feedback.
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Sperduto, Christina Maria, Yoichi Watanabe, John Mullan, Terry Hood, Gregg Dyste, Charles Watts, Gail Papermaster Bender y Paul Sperduto. "A validation study of a new prognostic index for patients with brain metastases: the Graded Prognostic Assessment". Journal of Neurosurgery 109, Supplement (diciembre de 2008): 87–89. http://dx.doi.org/10.3171/jns/2008/109/12/s14.
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Object The purpose of this study was to validate a new prognostic index for patients with brain metastases. This index, the Graded Prognostic Assessment (GPA), is based on an analysis of 1960 patients whose data were extracted from the Radiation Therapy Oncology Group (RTOG) database. The GPA is based on 4 criteria: age, Karnofsky Performance Scale score, number of brain metastases, and the presence/absence of extracranial metastases. Each of the 4 criteria is given a score of 0, 0.5, or 1.0, so the patient with best prognosis would have a GPA score of 4.0. Methods Between April 2005 and December 2006, 140 eligible patients with brain metastases were treated at the Gamma Knife Center at the University of Minnesota. The GPA score was calculated for each patient, and the score was then correlated with survival. Survival duration was calculated from the date treatment began for the brain metastases. Eligibility criteria included patients treated with whole-brain radiation therapy, stereotactic radiosurgery, or both. Results The median survival time in months observed in the RTOG and Minnesota data by GPA score was as follows: GPA 3.5–4.0, 11.0 and 21.7; GPA 3.0, 8.9 and 17.5; GPA 1.5–2.5, 3.8 and 5.9; and GPA 0–1.0, 2.6 and 3.0, respectively. Conclusions The University of Minnesota data correlate well with the RTOG data and validate the use of the GPA as an effective prognostic index for patients with brain metastases. Clearly, not all patients with brain metastases have the same prognosis, and treatment decisions should be individualized accordingly. The GPA score does appear to be as prognostic as the RPA and is less subjective (because the RPA requires assessment of whether the primary disease is controlled), more quantitative, and easier to use and remember. A multiinstitutional validation study of the GPA is ongoing.
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Rosenberg, Mark E., Jacqueline L. Gauer, Barbara Smith, Austin Calhoun, Andrew P. J. Olson y Emily Melcher. "Building a Medical Education Outcomes Center: Development Study". JMIR Medical Education 5, n.º 2 (31 de octubre de 2019): e14651. http://dx.doi.org/10.2196/14651.
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Background Medical education outcomes and clinical data exist in multiple unconnected databases, resulting in 3 problems: (1) it is difficult to connect learner outcomes with patient outcomes, (2) learners cannot be easily tracked over time through the education-training-practice continuum, and (3) no standard methodology ensures quality and privacy of the data. Objective The purpose of this study was to develop a Medical Education Outcomes Center (MEOC) to integrate education data and to build a framework to standardize the intake and processing of requests for using these data. Methods An inventory of over 100 data sources owned or utilized by the medical school was conducted, and nearly 2 dozen of these data sources have been vetted and integrated into the MEOC. In addition, the American Medical Association (AMA) Physician Masterfile data of the University of Minnesota Medical School (UMMS) graduates were linked to the data from the National Provider Identifier (NPI) registry to develop a mechanism to connect alumni practice data to education data. Results Over 160 data requests have been fulfilled, culminating in a range of outcomes analyses, including support of accreditation efforts. The MEOC received data on 13,092 UMMS graduates in the AMA Physician Masterfile and could link 10,443 with NPI numbers and began to explore their practice demographics. The technical and operational work to expand the MEOC continues. Next steps are to link the educational data to the clinical practice data through NPI numbers to assess the effectiveness of our medical education programs by the clinical outcomes of our graduates. Conclusions The MEOC provides a replicable framework to allow other schools to more effectively operate their programs and drive innovation.
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Twiggs, L. B., J. R. Carter, J. M. Fowler, L. F. Carson, W. Herrick, R. L. Kile y R. A. Potish. "An estimation of resource utilization with the introduction of laparoscopic pelvic lymphadenectomy prior to radical hysterectomy in early cervical carcinoma; a progress report from the Laparoscopic Study Group at the Women's Cancer Center at the University of Minnesota Health Science Center". International Journal of Gynecologic Cancer 6, n.º 4 (julio de 1996): 267–72. http://dx.doi.org/10.1136/ijgc-00009577-199607000-00004.
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In an observational study following the primary treatment of cervical carcinoma, financial data was gathered to address hospital and physician costs. This was done as a feasibility study to assess whether such data could be collected. As a corollary, we observed changes in these cost data relative to the implementation of laparoscopic lymphadenectomy in selected cases undergoing radical hysterectomy. Definition of costs were provided by Information Services Department of the University of Minnesota Hospital and Clinic (author W.H.). Twenty-seven apportionment codes were defined as standard categories to identify costs and were defined by patient accounting and assigned to every significant hospital event. Statistically, significant differences were noted in room and board costs, operating room cost, discharge needs, and miscellaneous services. Mean room and board costs were significantly less in those patients undergoing laparoscopic lymphadenectomy followed by a radical hysterectomy (Group B—defined in text). Miscellaneous service costs were also statistically, significantly different. However, with respect to those patients undergoing standard lymphadenectomy followed by radical hysterectomy (Group A), the operating room costs were statistically, significantly less. Overall adjusted hospital costs, which include professional services, were not different between the two groups. The feasibility of collecting data from the University of Minnesota Health System to access costs relative to a specific operative procedure, in this case radical hysterectomy, was evaluated. Significant requirements of time and labor costs were required, however. Timely, on-going assessment of hospital costs relative to hospital procedures would be a laudable goal for future assessments of resource allocation. The implementation of new technology in selected patients, in this case, laparoscopic lymphadenectomy, does not invariably increase cost in this health care system.
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Madsen, Paul E. "Has the Quality of Accounting Education Declined?" Accounting Review 90, n.º 3 (1 de octubre de 2014): 1115–47. http://dx.doi.org/10.2308/accr-50947.
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ABSTRACT For decades, prominent members of the accounting community have argued that the quality of accounting education is falling. Support for this claim is limited because of a scarcity of data characterizing the constructs of interest. This study is a comparative evaluation of the quality of accounting education from the 1970s to the 2000s using unique data to quantify education quality for accounting and many comparison disciplines. I find that, compared to most other types of college education, accounting education quality has been steady or increasing over the sample period. However, relative to other business degree programs, the evidence is mixed. The quality of students self-selecting non-accounting business degrees has increased while the quality of accounting students has not. The disparity in student quality is not reflected in the pay received by accounting graduates, which has remained stable relative to the pay received by graduates with other business degrees, although this result is likely influenced by regulatory changes during the 2000s, including Sarbanes-Oxley (SOX). Together, the evidence suggests that the quality of accounting education has not declined rapidly over the last four decades, but in the competition among business degree programs for high-quality students, accounting has underperformed. Data Availability: Data used in this study are available in the Freshman and Senior Surveys of the Cooperative Institutional Research Program's Higher Education Research Institute at the University of California, Los Angeles; the IPUMS-USA database, which is compiled and distributed by the Minnesota Population Center at the University of Minnesota; the National Survey of College Graduates, which is available from the National Science Foundation; and the General Social Survey, which is maintained by the National Opinion Research Center at The University of Chicago.
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Gumbiner, Jann, John V. Flowers, Shirley St. Peter y Curtis D. Booraem. "Adult Psychopathology on the MMPI and Dysfunctional Families of Origin". Psychological Reports 79, n.º 3 (diciembre de 1996): 1083–88. http://dx.doi.org/10.2466/pr0.1996.79.3.1083.
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Adults who were raised in dysfunctional families demonstrate psychopathology on the MMPI. 396 (140 men, 256 women) adult clients (mean age = 35 yr.) from dysfunctional families who were seeking treatment at a university counseling center were administered the Minnesota Multiphasic Personality Inventory. Analysis showed significantly elevated scores on F, Total Pathology, Depression, Psychopathic Deviance, Psychasthenia, Schizophrenia, and Social Introversion scales by these subjects from families with a history of physical, sexual, emotional abuse, or alcoholism. This study contributes to the growing body of empirical research on the relationship between dysfunctional families of origin and adult psychopathology.
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Kanani, Simeon S. "Study Abroad in Kenya: Now and in the Future". African Issues 28, n.º 1-2 (2000): 84–88. http://dx.doi.org/10.1017/s1548450500006922.
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As Kenya’s inbound tourism takes center stage as the country’s biggest income earner, study-abroad programs have emerged as the fastest growing subsector of the industry, making the country one of Africa’s most popular study-abroad destinations. In 1999 alone, a total of 22 credit-awarding academic study-abroad programs were operating in Kenya, an increase from 15 programs in 1998. Out of these 22 programs, 15 were from the United States, four were from Europe, and one was from Japan. In contrast, there were more than 80 noncredit study-abroad programs in 1999, most of which were short two-week study tours or field observation excursions. Of the noncredit study-abroad programs, 62 were from different African countries while 14 were from Europe and 12 were from the United States. This article describes the credit-awarding study-abroad programs and focuses on the University of Minnesota Studies in International Development (MSID) Kenya program.
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Bathke, Amber y Yang-Hyang (Ryoka) Kim. "Keep Calm and Study Abroad: The Effect of Learning Abroad on Student Mental Health". Frontiers: The Interdisciplinary Journal of Study Abroad 27, n.º 1 (28 de abril de 2016): 1–16. http://dx.doi.org/10.36366/frontiers.v27i1.371.
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This research set out to discover whether statistics would support the belief in the international education field that the stress of going abroad (adjusting to a new culture, missing home, being away from support network, etc.) can trigger mental health conditions in students participating in learning abroad programs. The study sought to glean on overall picture of student mental health abroad, as well as determine the percentage of students studying abroad who reported experiencing a diagnosed mental health condition while abroad, the nature of these diagnosed mental health conditions, the frequency of relapse/recurrence of existing conditions while abroad, the frequency and type of treatment received, and local attitude toward mental health conditions. The research was conducted by means of an online survey administered by the University of Minnesota’s Office of Measurement Services, which was sent by email to people who had participated in study abroad through the University of Minnesota’s Learning Abroad Center between Summer 2009 and Spring 2012, a total of 7,191 students. As the Learning Abroad Center, while serving University of Minnesota students first and foremost, also acts as a program provider recruiting students nationally, the participants’ home institutions were likely dozens of universities nationwide (though home institution information was not collected). We received 613 responses for a response rate of 8.52%. The data from the survey suggest, surprisingly, that in general, student mental health actually improves while abroad, an in fact, that skills learned during an international experience may contribute to improved mental health upon return.
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Odlaug, Brian L., Francoise Crevel, Nicole Tosun, Ryan Lee, Carrie McKenzie, Melena Bellin, Brenda Prich y Daniel Weisdorf. "39901 Breaking down silos to synergize clinical trial development and initiation: The Clinical Research Support Center, University of Minnesota". Journal of Clinical and Translational Science 5, s1 (marzo de 2021): 108–9. http://dx.doi.org/10.1017/cts.2021.677.
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ABSTRACT IMPACT: The model of the Clinical Research Support Center at the University of Minnesota of streamlining clinical trial infrastructure can be leveraged by the larger clinical trial community to create valuable efficiencies and facilitate faster initiation of research activities by supporting researchers from concept to dissemination. OBJECTIVES/GOALS: Substantial time, energy, and money are spent bridging disparate resources in research. We describe how the University of Minnesota’s (UMN) Clinical Research Support Center (CRSC) streamlines trial infrastructure, creating valuable efficiencies to support researchers from concept to dissemination. METHODS/STUDY POPULATION: The CRSC, established in 2018 through the Clinical and Translational Science Award (CTSA) program, brings resources together in a single, centralized, and convenient location to help researchers navigate the UMN clinical research startup process and specifically to assist with the development and initiation of a research study from feasibility assessment to project opening. Diverse expertise in components of human subject research is available to support the broad scope of projects at a large institution like the UMN. We present how CRSC services, when coordinated by Clinical Research Specialists, have been used to improve access to clinical research resources during the start up process. RESULTS/ANTICIPATED RESULTS: Since inception in 2018, the CRSC has provided support to over 1700 studies with 437 research projects referred to a Clinical Research Specialist within the CRSC. Of those projects, 97 (22.2%) received comprehensive support from the following expert groups: regulatory guidance (n=74), biostatistics (n=68), clinical (hospital or clinic) partners (n=60), recruitment (n=36), budget development assistance (n=30), and (bio)informatics (n=27). Successful examples of synergies to streamlining study start up include shortening the window between protocol development support from Clinical Research Specialists and IRB submission preparation through to Regulatory Specialists to 3 days. DISCUSSION/SIGNIFICANCE OF FINDINGS: Providing cross-functional support to research teams through the CRSC increases the likelihood of quicker and successful execution and completion of research initiation and subsequently impacts the dissemination of that research to patients and the broader community.
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Hall, Victoria, Carol Cardona, Kristelle Mendoza, Mia Torchetti, Kristina Lantz, Irene Bueno y Dana Franzen-Klein. "Surveillance for highly pathogenic avian influenza A (H5N1) in a raptor rehabilitation center—2022". PLOS ONE 19, n.º 4 (29 de abril de 2024): e0299330. http://dx.doi.org/10.1371/journal.pone.0299330.
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An ongoing, severe outbreak of highly pathogenic avian influenza virus (HPAI) A H5N1 clade 2.3.4.4b has been circulating in wild and domestic bird populations throughout the world, reaching North America in 2021. This HPAI outbreak has exhibited unique characteristics when compared to previous outbreaks. The global distribution of disease, prolonged duration, extensive number of species and individual wild birds affected, and the large impact on the global poultry industry have all exceeded historical impacts of previous outbreaks in North America. In this study, we describe the results of HPAI surveillance conducted at The Raptor Center, a wildlife rehabilitation hospital at University of Minnesota (Saint Paul, MN, U.S.A.), from March 28th–December 31, 2022. All wild raptors admitted to the facility were tested for avian influenza viruses using polymerase chain reaction (PCR) testing. All non-negative samples were submitted to the United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) National Veterinary Services Laboratories for confirmatory HPAI testing and genetic sequencing. During the study period, 996 individual birds representing 20 different species were tested for avian influenza, and 213 birds were confirmed HPAI positive. Highly pathogenic avian influenza surveillance conducted at The Raptor Center contributed 75% of the HPAI positive raptor detections within the state of Minnesota, located within the Mississippi flyway, significantly augmenting state wildlife surveillance efforts. The viral genotypes observed in birds sampled at The Raptor Center were representative of what was seen in wild bird surveillance within the Mississippi flyway during the same time frame. Wildlife rehabilitation centers provide an opportune situation to augment disease surveillance at the human, wildlife and domestic animal interface during ongoing infectious disease outbreaks.
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Garcia y Garcia, Axel y Jeffrey S. Strock. "Soil Water Content and Crop Water Use in Contrasting Cropping Systems". Transactions of the ASABE 61, n.º 1 (2018): 75–86. http://dx.doi.org/10.13031/trans.12118.
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Abstract. Practices to improve the efficient use of water are of high relevance in rainfed agriculture. The effect of cropping systems on soil available water and water use of crops grown in a humid and temperate climate was investigated. This study was conducted at the University of Minnesota Southwest Research and Outreach Center near Lamberton, Minnesota, during three growing seasons. The treatments studied included an extended 4-year crop rotation (oat/alfalfa-alfalfa-corn-soybean) using organic inputs or high external (mineral) inputs and the traditional 2-year corn-soybean rotation, with a prairie as the control treatment. Response variables included crop yield, soil moisture monitored at 0.10, 0.20, 0.40, 0.60, 1.00, and 2.00 m depths, root length density, and crop water use. We found that alfalfa depleted more water than the other crops, including the prairie. Regardless of the extent of the rotation and the type of input, the soil water depletion and crop water use followed the same pattern: alfalfa > corn > oat/alfalfa > soybean. For conditions in the humid and temperate climate of southwest Minnesota, the average water use of crops was 652 mm for alfalfa, 535 mm for corn, 340 mm for oat/alfalfa, and 484 mm for soybean. The average water use of the prairie was 604 mm. Keywords: Evapotranspiration, Farming systems, Rotation, Water balance, Water use efficiency.
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Ce, Win, Hanny Juwitasary y Hendro Hendro. "System Requirement in View Of Users and Process for Content Management and Academic Support System for Computer Laboratory (Case Study: Software Laboratory Center Binus University)". ComTech: Computer, Mathematics and Engineering Applications 6, n.º 1 (1 de marzo de 2015): 55. http://dx.doi.org/10.21512/comtech.v6i1.2286.
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The system for Laboratory Information will take focus on determining the need for information systems related to the management, content development and academic management in the laboratory. These processes will focus on understanding the need and system requirement for a laboratory information system that focus on content management and the way to design a process to make sure the continuation of content creation can be done. With the design of the laboratory information system is expected to serve as a sample in the development of similar application for the course in general. The methodology to be used is to use the study of literature, design, and testing of laboratory information systems.
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Bantle, Anne, Alison Alvear, Dan Knights, Lisa Chow y Abigail Johnson. "Weight Loss Associated With Time Restricted Eating Is Not Reflected in Changes in the Human Gut Microbiome". Current Developments in Nutrition 6, Supplement_1 (junio de 2022): 998. http://dx.doi.org/10.1093/cdn/nzac069.003.
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Abstract Objectives Time-restricted eating (TRE) is a novel approach to obesity treatment that recently received attention. Very limited data exist regarding gut microbiome changes during TRE interventions in humans. Our objective was to characterize the gut microbiome of human participants before and after a 12-week TRE intervention. Methods In a randomized controlled trial of an 8-hour TRE intervention in human participants over 12 weeks, Chow, et al. demonstrated reduction in weight, lean mass, and visceral fat with TRE compared to control. Stool samples were collected before and after the intervention by study participants using home kits, placed in RNAlater Stabilization Solution (Ambion), and kept < at room temperature for < 7 days before storage in a −80°C freezer. Samples were submitted as a batch to the University of Minnesota Genomics Center for DNA extraction, amplification, and shotgun metagenomic DNA sequencing (Illumina HiSeq platform). Quality-controlled sequences were aligned to the GTDB Genome Taxonomy Database (https://gtdb.ecogenomic.org). Results Sixteen study participants provided stool samples which were used in this analysis (8 TRE and 8 control). Participants undergoing the TRE intervention successfully restricted their eating window (mean ± SD 15.3 ± 0.8 hours at baseline to 9.3 ± 1.7 hours during intervention, p < 0.001). The control group's eating window remained unchanged. Weight loss, visceral fat loss, and BMI reduction were significantly greater for the TRE group. There was no significant effect of the TRE intervention on alpha diversity (Shannon index, Simpson index, and number of taxa, linear mixed models), beta diversity (Bray-curtis, PERMANOVA), or overall microbiome composition controlling for weight change and visceral fat change. Conclusions Our analyses did not show any difference in gut microbiome composition or diversity indices in participants completing a TRE intervention as compared to control, but are limited by small sample size, short study duration, and stool-sampling at only two study timepoints. Funding Sources This work was supported by the University of Minnesota and grants from the National Institute of Diabetes and Digestive and Kidney Diseases and National Center for Advancing Translational Sciences.
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Martinez, A., M. De Carolis, B. Marandyuk, S. Tremblay, G. Lodygensky, A. Birca y E. Pinchefsky. "P.090 Symptomatic neonatal seizure treatment duration and seizure recurrence: a retrospective single center study". Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 49, s1 (junio de 2022): S31—S32. http://dx.doi.org/10.1017/cjn.2022.186.
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Background: While seizures have adverse neurological effects, the prescribed antiseizure medications (ASMs) may also have a negative impact on neonatal brains and contribute to detrimental neurodevelopmental outcomes. The objectives were to evaluate: 1) the impact of implementing a neonatal seizure treatment protocol in 2016; 2) the influence of ASM duration and other clinical factors on seizure recurrence and epilepsy onset. Methods: Retrospective chart review of 139 term newborns born between 2013 and March 2021 admitted at Sainte-Justine University Center Hospital with acute symptomatic seizures. Associations were assessed using Student T-test and Fisher exact test. Results: We did not observe significant change in the number of ASMs prescribed for acute seizure control (33% required 33 ASMs before vs 22% after 2016) nor significant change in frequency of prescription of ASM at discharge over time. ASM continuation at discharge was not associated with seizure recurrence (p=0.14, OR 2.14, 95%CI 0.78-5.86) or epilepsy (p=0.78, OR 1.32, 95% CI 0.45-3.90). Epilepsy occurred in 15 (12%) of children between 15 days to 72 months of age. Conclusions: No association was found between ASM maintenance at discharge following acute symptomatic neonatal seizures and the occurrence of epilepsy. Discontinuation of ASMs should be considered prior to discharge.
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Barasinski, Chloé, Marina Stankovic, Anne Debost-Legrand, Amélie Delabaere, Françoise Vendittelli y Frédéric Dutheil. "Workplace Lactation Support: A Cross-Sectional Study in a University Hospital and a Perinatal Network". Nutrients 14, n.º 17 (24 de agosto de 2022): 3463. http://dx.doi.org/10.3390/nu14173463.
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Return to work negatively affects the initiation and duration of breastfeeding. Our study’s objective was to assess the percentage of departments in Auvergne with an appropriate space for pumping milk at work. Our cross-sectional survey investigated the arrangements for facilitating the continuation of breastfeeding on return to work at all departments at the Clermont-Ferrand University Hospital Center and perinatal (obstetric and pediatric) departments in this region. Our principal endpoint was the percentage of departments reporting that they had a lactation room—a room where nursing mothers can express milk—and whether it met the criteria defined by the French Labor Code. Among 98 respondents, 44 departments (44.9%) did not offer lactation rooms; of the remaining 54 departments, only 11 rooms met the legal requirements. All perinatal departments offered lactation rooms. The availability of a lactation room was associated with other breastfeeding support, such as a break period for expressing milk (p < 0.0001) and the availability of a refrigerator to store it (p = 0.01). Almost half the responding departments did not offer a lactation room where mothers could breastfeed or pump their milk. Measures must be envisioned to facilitate the pumping of breast milk by French women returning to work.
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Zhang, Ke, Pengfei Chen, Fangyu Xiang y Lei Li. "Study of the Dilemma of Continuing Professional Development and Coping Strategies of University Teachers in Remote Areas of China". International Journal of Higher Education 12, n.º 6 (7 de diciembre de 2023): 137. http://dx.doi.org/10.5430/ijhe.v12n6p137.
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The continual production and dissemination of diverse information in this digital age is driving higher education institutions to innovate and integrate their knowledge. This further encourages teachers to continually update their professional development. However, as university teachers still encounter numerous difficulties this respect, the purpose of his study is to conduct in-depth qualitative analysis to explore this issue from four perspectives: peer support, external support, collaborative development, and continuous professional development online. By conducting in-depth interviews with 28 administrators and teachers from four northwestern universities in China, this research adopts qualitative methods to explore the current dilemmas in teachers' continuing professional development and information technology ability, and proposes corresponding improvement strategies based on the dilemmas. The results are expected to show that the needs of individual teachers are neglected, there is no plan for complete professional development, and there is a lack of outstanding university management talents in this information society. Therefore, it is suggested that a clear plan for the continuation of teachers’ professional development should be proposed, along with the establishment of a professional development center. At the same time, university teachers should take the initiative to enhance their personal growth, and university administrators’ foresight should not be ignored. The continuing professional development of university teachers in remote areas can only be achieved with unified cooperation in various aspects.
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Prizment, Anna, Timothy R. Church, Dorothy Hatsukami, Robert Madoff, Christopher Staley, Robert J. Straka, Allison Iwan et al. "Abstract A26: Pilot trial to examine the effect of ginger on the gut microbiome: The Minnesota Cancer Clinical Trials Network". Cancer Epidemiology, Biomarkers & Prevention 29, n.º 9_Supplement (1 de septiembre de 2020): A26. http://dx.doi.org/10.1158/1538-7755.modpop19-a26.
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Abstract Experimental and epidemiologic evidence shows that the use of ginger root may reduce the incidence of colorectal cancer (CRC), but the mechanism through which ginger exerts its effect is unclear. Recently, an imbalanced gut microbiome was linked to inflammation, immune response, and CRC risk. Thus, we hypothesize that ginger intake may decrease CRC risk via changing the gut microbiome. The goals of this study are (1) assess whether ginger intake shifts the distribution of the gut microbiome from proinflammatory, CRC-predisposing bacteria and towards anti-inflammatory, CRC-protective bacteria and (2) evaluate the feasibility of conducting a large randomized clinical trial (RCT) leveraging the recently established Minnesota Cancer Clinical Trials Network (MNCCTN). We will conduct a pilot double-blind RCT, called “GINGER,” of 95-100 subjects aged 50-75 years old who were diagnosed with colorectal adenoma within the last 5 years (ClinicalTrials.gov NCT03268655). The subjects will be randomized to receive either 2,000 mg of ginger extract per day or matching placebo (1:1) for 6 weeks; the treatment phase will be followed by a 6-week washout. Fecal samples to characterize the gut microbiome will be collected at baseline, midpoint (week 6), and study end. Microbiome composition will be characterized by sequencing microbial 16S ribosomal RNA genes. In addition, pre- and postexposure urine samples will be collected to examine the correlation between bacteria and urinary metabolite of prostaglandin E2, which is an inflammatory biomarker and a putative biomarker for CRC. The methodology for “GINGER” was informed by an RCT recently completed by our group that involved aspirin as the intervention. In that RCT, which included 50 subjects and 5 stool collections within 12 weeks, 49 subjects completed the entire study and all stool collections. Adherence rates for the aspirin measured by pill count was at least 90%. Thus, these pilot data support the feasibility of the GINGER study. To implement the “GINGER,” we are using the resources of the MNCCTN, established in 2017. The MNCCTN, funded by Minnesota legislature and led by Masonic Cancer Center, University of Minnesota, will bring the “GINGER” and subsequent cancer clinical trials to communities throughout Minnesota, thus reducing the patients’ burden of travel and related costs. The network partners with Minnesota’s five largest health care providers (Essentia Health, Sanford Health, Mayo Clinic Cancer Center, Metro-Minnesota Community Oncology Research Consortium, and Fairview Health System) to provide infrastructure for conducting cancer trials at 18 sites outside the Twin-Cities metro area and Rochester, Minnesota. The “GINGER”—the first study conducted within the network—will begin recruitment in 3 sites by the end of November and in 6 sites by the end of 2018. Based on our previous experience, we expect to recruit 24-25 (25%) subjects in 3 months, 50%, in 6 months and all subjects by the end of 2019. Citation Format: Anna Prizment, Timothy R. Church, Dorothy Hatsukami, Robert Madoff, Christopher Staley, Robert J. Straka, Allison Iwan, Jenn Stromberg, Ya-Feng Wen, Cheryl Stibbe, Marie Rahne. Pilot trial to examine the effect of ginger on the gut microbiome: The Minnesota Cancer Clinical Trials Network [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr A26.
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Urbanski, Dana, Kamakshi Lakshminarayan, Maritza Steele, Farah Baig, Adrianna Rivera-Leon, Michelle Berning y Joseph Gaugler. "FORMING AGING RESEARCH TEAMS THROUGH SPECIAL INTEREST GROUPS: THE GRADUATE STUDENT EXPERIENCE". Innovation in Aging 7, Supplement_1 (1 de diciembre de 2023): 374. http://dx.doi.org/10.1093/geroni/igad104.1242.
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Abstract The study of aging is inherently interdisciplinary, requiring formation of collaborative research teams that span a variety of fields and disciplinary backgrounds. This team approach is essential for answering complex, multifaceted questions about human aging; however, it may serve as a significant barrier to entry for graduate students interested in obtaining training and expertise in aging research. By and large, many graduate students are highly centralized in single academic departments and lack sufficient resources and opportunities to gain interdisciplinary research training and experience. The University of Minnesota Center for Healthy Aging and Innovation (CHAI) has created Special Interest Groups (SIGs) to facilitate team science and interdisciplinary collaboration by providing infrastructure and community for faculty, post-doctoral fellows, and—importantly—graduate students from across campus who have shared interests in aging. Here, we discuss a research project developed and organized by CHAI’s Aging and Chronic Disease Management SIG which has drawn substantial graduate student engagement. Together, eight graduate students representing four University of Minnesota colleges are working with faculty to conceptualize and complete a systematic literature review on caregiving for older adults with hypertension. Drawing on this example, we share early lessons learned as well as key challenges and opportunities for engaging graduate students in interdisciplinary aging research through SIGs. Additionally, we highlight student experiences and perspectives participating in CHAI SIGs, along with recommendations for recruitment and inclusion of graduate students in aging research teams.
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Wohlt, Paul D., Lizbeth A. Hansen y Jeffrey T. Fish. "Inappropriate Continuation of Stress Ulcer Prophylactic Therapy After Discharge". Annals of Pharmacotherapy 41, n.º 10 (octubre de 2007): 1611–16. http://dx.doi.org/10.1345/aph.1k227.
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Background: Medications for stress ulcer prophylaxis are appropriately started in critically ill patients with risks for developing stress ulcers. It is unknown whether these drugs are discontinued once the risk factors are removed. Objective: TO assess the duration of stress ulcer prophylactic therapy in critically ill patients. Methods: A retrospective chart review was conducted at a multidisciplinary, 24 bed medical/surgical intensive care unit (ICU) of a university-affiliated tertiary referral medical center. Three hundred ninety-four patients fulfilled eligibility criteria during the study period of July 1, 2005, through September 30, 2005. Patients were considered to be appropriately discharged from the hospital on gastric acid suppressants it they met any of the following criteria: continued mechanical ventilation, gastroesophageal reflux disease, peplic ulcer disease, history of gastrointestinal ulceration or bleeding within the past year, prescribed medications used for stress ulcer prophylaxis prior to admission, gastrointestinal bleed during hospitalization, or prescriber indication of reason to continue therapy. Results: Three hundred fifty-seven patients received stress ulcer prophylaxis during their ICU stay. Of these, 80% continued on gastric acid suppressants on transfer from the ICU, with 60% of the therapy being inappropriate. The percentage of critically ill patients discharged from the hospital with inappropriate prescription of gastric acid suppressants was 24.4%. Based on the average wholesale cost, the total cost for unnecessary gastric acid suppressant therapy within the follow-up period was $13,973. Conclusions: Gastric acid suppressant medications initially prescribed for stress ulcer prophylaxis are frequently prescribed inappropriately on discharge for patients who were initially admitted to the medical/surgical ICU.
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Chaudhri, Imran, Farrukh M. Koraishy, Olena Bolotova, Jeanwoo Yoo, Luis A. Marcos, Erin Taub, Haseena Sahib et al. "Outcomes Associated with the Use of Renin-Angiotensin-Aldosterone System Blockade in Hospitalized Patients with SARS-CoV-2 Infection". Kidney360 1, n.º 8 (22 de junio de 2020): 801–9. http://dx.doi.org/10.34067/kid.0003792020.
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BackgroundData regarding the benefits or harm associated with the continuation of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), especially the effect on inflammation, in patients who are hypertensive and hospitalized with coronavirus disease 2019 (COVID-19) in the United States are unclear.MethodsThis is a single-center cohort study of patients sequentially hospitalized with COVID-19 at Stony Brook University Medical Center from March 7, 2020 to April 1, 2020, inclusive of these dates. Data collection included history of known comorbidities, medications, vital signs, and laboratory values (at admission and during the hospitalization). Outcomes include inflammatory burden (composite scores for multiple markers of inflammation), AKI, admission to the intensive care unit (ICU), need for invasive mechanical ventilation, and mortality.ResultsOf the 300 patients in the study cohort, 80 patients (27%) had history of ACEI or ARB use before admission, with 61% (49/80) of these patients continuing the medications during hospitalization. Multivariable analysis revealed that the history of ACEI or ARB use before hospitalization was not associated with worse outcomes. In addition, the continuation of these agents during hospitalization was not associated with an increase in adverse outcomes and predicted fewer ICU admissions (odds ratio, 0.25; 95% CI, 0.08 to 0.81) with a decrease in the severity of inflammatory burden (peak C-reactive protein, 6.9±3.1 mg/dl, P=0.03; peak inflammation score, 2.3±1.1 unit reduction, P=0.04).ConclusionsUse of ACEI or ARBs before hospitalization was not associated with adverse outcomes in COVID-19, and the therapeutic benefits of continuing ACEI or ARB in patients hospitalized with COVID-19 was not offset by adverse outcomes.
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Ditchfield, Simon. "Introduction". Journal of Early Modern History 25, n.º 6 (6 de diciembre de 2021): 475–80. http://dx.doi.org/10.1163/15700658-12342696.
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Abstract After a discussion of the twentieth anniversary issue, the author of the book which is the subject of our “round table” review of this twenty-fifth anniversary issue: Merry Wiesner Hanks’ What is Early Modern History (2021) is introduced. This is followed by a brief account of the rationale behind the foundation of the JEMH in the 1990s and how, from the very first issue, the journal has tried to decolonize our understanding of the period 1300–1800, as exemplified by Antony Black’s warning that: “we should stop selling off second-hand concepts to unsuspecting non-European cultures.” Passing comment is made on the chronological (as well as geographical) breadth of the coverage of the JEMH which accords well with the recent merger of the Centers for Medieval and Early Modern History at the University of Minnesota (to form the Center for Premodern Studies). At a time when the advocacy of the study of pre-modern history is vital as never before, this situates the JEMH very well. The introduction closes with a series of acknowledgements and thanks not only directed to the editorial team both in Minnesota and Leiden for the support they have given me, as editor-in-chief, since July 2010, but also to the numerous authors and readers of manuscripts who have made the journal what it is today.
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Dwyer, Alexander J., Lindsey Mortensen, Beverly R. Wuertz y Frank G. Ondrey. "Abstract LB139: Disparities in oral precancerous lesion surveillance in the United States upper Midwest". Cancer Research 84, n.º 7_Supplement (5 de abril de 2024): LB139. http://dx.doi.org/10.1158/1538-7445.am2024-lb139.
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Abstract Objective: To determine whether geographic representation and race of patients in a regional oral cancer surveillance program (University of Minnesota Cancer Active Surveillance Population (UMN CASP)) mirror characteristics in the corresponding National Cancer Institute (NCI) designated comprehensive cancer center catchment. Introduction: Oral cancer poses a significant public health concern that may be mitigated through lesion surveillance. Representation of patients for clinical trials throughout an NCI cancer center catchment area is a crucial goal to promote improved health outcomes. This study investigates the demographic landscape of patients with preneoplastic oral lesions seen at the CASP. Methods: Through the UMN Clinical and Translational Sciences Institute, we queried 30 International Classification of Disease (ICD) 9 and 10 codes corresponding to 120 unique mucosal oral precancerous lesion descriptors of CASP patients. Automated extraction of electronic medical record (EMR) data for 4,496 patients treated by the senior author between 2011 and 2023 identified 1,375 patients with preneoplastic lesions. The proportion of patients residing in three-digit zip code regions of Minnesota were compared to 2021 American Community Survey state population data. Additionally, race data were compared between CASP patients and the UMN Masonic Cancer Center (MCC) patient catchment data. Results: CASP patients were over-represented relative to state population distributions within the Minneapolis-St. Paul metropolitan area and surrounding suburbs (region 554 p<0.0001 and region 551 p<0.0001). Under-representation of CASP patients was observed in all western and southern border regions (regions 559 p<0.0001, 560 p<0.0001, 561 p<0.0001, 562 p=0.0037, 565 p<0.0001, and 567 p=0.0006) as well as portions of central (563 p<0.0001), northern (566 p=0.0015), and north-eastern (558 p<0.0001) Minnesota. Proportional representation was observed in several regions of central (553 and 564), eastern (550), and north-eastern (557 and 556) Minnesota. Comparisons of CASP race data revealed a higher proportion of black patients (CASP 8.59% [95% CI 7.17-10.27%] vs. MCC 7.16% [95% CI 7.14-7.17%]) and a lower proportion of Asian/Pacific Islander patients (CASP 3.74% [95% CI 2.82-4.94%] vs. MCC 5.32% [95% CI 5.30-5.34%]) relative to MCC catchment patients. White, American Indian/Alaskan Native, and mixed-race groups were proportionally represented in both data sets. Conclusions: These data show that system wide EMR searches can be implemented to identify patients in an NCI cancer center catchment area with precancerous or other at-risk conditions for cancer. Importantly, Native patients were proportionally represented in the screening program while several rural locations were under-represented. This information can instruct the expenditure of additional resources for under-represented groups and permit streamlined enrollment of patients for cancer prevention clinical trials. Citation Format: Alexander J. Dwyer, Lindsey Mortensen, Beverly R. Wuertz, Frank G. Ondrey. Disparities in oral precancerous lesion surveillance in the United States upper Midwest [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB139.
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Hemmy, Laura, Nichole Morris y Kyle Shelton. "FOSTERING COLLABORATION TO BENEFIT OLDER DRIVERS". Innovation in Aging 7, Supplement_1 (1 de diciembre de 2023): 374. http://dx.doi.org/10.1093/geroni/igad104.1243.
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Abstract Access to transportation is a fundamental contributor to independence and quality of life, and for many independent driver status is a seminally important part of agency and self-concept. Driving is a lifelong skill utilizing a variety of physical, sensory and cognitive abilities, but also influenced by the community in which one lives, built infrastructure, vehicle design and engineering, social and family networks, and driver insight. Because older drivers are at increased risk for negative crash outcomes, generating knowledge about how to promote safe driving in the older population, when to consider retirement from driving, and compensatory sources of transportation, are of the utmost importance. Faculty and trainees with interest in these questions come from disparate and often unconnected parts of academic research institutions. The University of Minnesota (UMN) Center for Healthy Aging Innovation (CHAI) Special Interest Group (SIG) structure, in collaboration with the UMN Center for Transportation Studies (CTS), has served as a platform for connection. SIG members will share how the opportunity to connect across disciplines, schools and departments has led to new collaborative work to promote safe driving in older adults, including a state funded intervention study.
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Odlaug, Brian L., Francoise Crevel, Nicole Tosun, Ryan Lee, Carrie McKenzie, Melena Bellin, Brenda Prich y Daniel Weisdorf. "10040 Proactive and responsive COVID-19 multidisciplinary research support through the University of Minnesota’s Clinical Research Support Center". Journal of Clinical and Translational Science 5, s1 (marzo de 2021): 108. http://dx.doi.org/10.1017/cts.2021.676.
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ABSTRACT IMPACT: In a global pandemic where data development and dissemination are integral to combating the disease, the Clinical Research Support Center at the University of Minnesota provides a model of comprehensive virtual support, helping to attain and disseminate novel research on COVID-19, its individual and community impact, and treatment initiatives/outcomes. OBJECTIVES/GOALS: The pandemic created massive disruption to the conduct of clinical research with an unprecedented reorientation towards COVID-19. In this fast-paced environment, the Clinical Research Support Center (CRSC) rapidly developed innovative means of supporting diverse research initiatives. METHODS/STUDY POPULATION: The CRSC rapidly transitioned into a virtual environment and developed tools for the clinical research community to enhance remote clinical trial start up. This includes supporting remote consent, eBinders, COVID-19 research training for clinical staff, and easier identification of potential participants for COVID-19 studies; all through virtual support. Support provided research teams guidance on study protocols, regulatory requirements, informatics, biostatistics, financial management, recruitment strategies to support critical, urgent COVID-19 research. We outline proactive examples of how the CRSC now provides support to research teams through the pandemic. RESULTS/ANTICIPATED RESULTS: From March-November 2020, 116 COVID-19 projects received virtual support from the CRSC for COVID-19 research: disease understanding (n=27), treatment (n=23), pandemic impact (n=20), clinical care innovation (n=18), disease control and surveillance (n=10), prevention (n=9), detection (n=5), and impact on minorities (n=4). The diversity of these studies demonstrates the demand for and benefit from multidisciplinary expertise supporting study design and implementation. Through successful articulation and acceleration of research activities, the CRSC met the need for speed and rapidly adapted to new challenges created by the pandemic. DISCUSSION/SIGNIFICANCE OF FINDINGS: In a global pandemic where rapidly changing barriers to research is ongoing, through multidisciplinary efforts, the CRSC continues to provide comprehensive, virtual support to attain and disseminate novel research on COVID-19, its individual and community impact, and treatment initiatives/outcomes.
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Munger, Meghan E., Brian Po-Jung Chen, Bruce A. MacWilliams, Mark L. McMulkin y Michael H. Schwartz. "Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol". BMJ Open 9, n.º 6 (junio de 2019): e027486. http://dx.doi.org/10.1136/bmjopen-2018-027486.
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IntroductionSpasticity is one of the primary pathologies associated with cerebral palsy (CP), yet no definitive evidence exists to guide the appropriate level of spasticity management for an individual. Spasticity management strategies often differ by center. On one end of this strategy spectrum is a highly-interventional approach, characterized by treatments such as a selective dorsal rhizotomy (SDR), intrathecal baclofen pump (ITB), and anti-spasticity injections and medications. On the other end of the spectrum is a less interventional approach, involving minimal use of these treatments, and no SDR.Methods and analysisA retrospectively-matched, multi-center study protocol is described that comprehensively compares the long-term outcomes of a highly-interventional versus a minimally-interventional spasticity management strategy. We will analyze two groups of adults with spastic bilateral CP (≥21 years). In one group are individuals who underwent an SDR between the ages of 4 and 10 years, along with ongoing spasticity management during childhood and adolescence. In the other group are individuals who received minimal spasticity management and did not undergo an SDR. Individuals with prolonged use of an intrathecal baclofen (ITB) pump will be excluded. The two groups will be matched for spasticity and other important clinical characteristics at baseline. This study design improves on many of the limitations found in the existing outcome literature.Ethics and disseminationThis study received necessary approval from the University of Minnesota and Western Institutional Review Boards. Results will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberNCT03789786.
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Tallaksen, Joel. "189 Swine Production and Greenhouse Gases". Journal of Animal Science 100, Supplement_2 (12 de abril de 2022): 91–92. http://dx.doi.org/10.1093/jas/skac064.150.
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Abstract Like much of agriculture, the swine industry is being asked to improve the sustainability of their production systems. In an integrated project, swine researchers, agronomists, and renewable energy scientists collected data to analyze the greenhouse gas and fossil energy footprints from Minnesota commercial swine production facilities as well as cropping and swine production data from the University of Minnesota West Central Research and Outreach Center. These environmental impacts were assessed using life cycle assessment (LCA) methodology in a cradle to farm gate study that examined the impacts on a per unit of liveweight pork produced basis. In the average commercial system, the GHG emissions were 2.41 kg CO2 equiv. per kg hog LW, with 75% emitted during the grow-finish phase, 6% in farrowing, 9% in the nursery phase, 7% in gestation, and 2% in gilt development. GHG emissions for direct operation of swine facilities were 0.15 kg CO2 equiv. per kg and accounted for 6% of emissions in the average commercial scenario. The majority of GHG emissions were in the production of crops and the breakdown of manure during storage. This talk will explore the methods, data, and results from this study and other similar environmental impact studies for swine production. It will also discuss how producers can measure impacts at their farms and implement changes to improve their environmental impacts. An important consideration in the discussion is the ability of producers to directly reduce fossil energy and its carbon footprint, because fossil energy consumption impacts both the environmental and economic aspects of swine production.
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Alferova, Elena V. "The Rule of Law in the context of solving problems of interaction between international and national courts I.A. Umnova-Konyukhova. National justice and international justice: theory and practice of interaction in public-legal relations (principles of sta". Gosudarstvo i pravo, n.º 8 (2021): 183. http://dx.doi.org/10.31857/s102694520016392-2.
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The review presents an analysis and assessment of the main problems considered in the monograph "National justice and international justice: theory and practice of interaction in public-legal relations (principles of statehood and human rights)". The author is the head of the scientific direction of constitutional and legal research of the Center for the study of problems of justice of the Russian state University of justice, Doctor of Law, Professor, Honorary worker of higher professional education of the Russian Federation I.A. Umnova-Konyukhova. It is noted that this work is a continuation of the scientific research carried out by I.A. Umnova-Konyukhova, has a fundamental character and is distinguished by a deep systematic analysis of relevant aspects of the interaction of national and international justice. The conclusion is made about the high theoretical and practical significance of the reviewed monograph.
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Shrivastava, MK, RR Singh y GS Shah. "Breast feeding pattern in teaching districts of a health sciences university in eastern Nepal". Health Renaissance 11, n.º 3 (17 de enero de 2014): 192–97. http://dx.doi.org/10.3126/hren.v11i3.9631.
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Background: Adequate nutrition early in life has an important role in determining infants’ growth and development, and in preventing many adult diseases. Over 2/3rd of under-5 child deaths in the world is associated with inappropriate feeding practices and occurs during infancy. Yet, only 1/3rd of world’s infants are optimally fed. Objectives: To investigate breast feeding patterns and its relation to sociodemographic factors; and to identify factors associated with initiation, continuation, and maintenance of breast-feeding. Methods: Cross-sectional, semistructured questionnaire based study. 508 mothers of infants attending health center were interviewed about feeding patterns and socioeconomic variables. Data were analyzed using appropriate statistical methods. Results: 55.9% infants were breastfed within first hour of life and 90% within the first day. Rapid decline in exclusive-breastfeeding was seen with infant’s age (78.6% at 1 month, 37.3% at 1-3 months, 35.4% at 3-6 months). Factors significantly associated with exclusive breast- feeding were maternal age and education, family income and type. 17.9% infants were given pre-lacteals where as 92.9% received Colostrum. Major factors associated with early initiation of breast-feeding were maternal age and education, family type and mode of delivery. Conclusion: The results show that national guidelines, public messages, and educational campaigns need to be strengthened to achieve desired goals regarding breast feeding. DOI: http://dx.doi.org/10.3126/hren.v11i3.9631 Health Renaissance 2013;11(3):191-197
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Jacobsen, Annie M., Jenny Poynter, Michaela Richardson, Phuong L. Nguyen, Betsy A. Hirsch, Adina Cioc, Michelle A. Roesler y Erica D. Warlick. "Factors Predicting Early Mortality in Newly Diagnosed Myelodysplastic Syndrome (MDS): A Population Based Study". Blood 132, Supplement 1 (29 de noviembre de 2018): 4369. http://dx.doi.org/10.1182/blood-2018-99-112319.
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Abstract Myelodysplastic syndromes (MDS) are a heterogeneous collection of clonal disorders of hematopoietic stem cells characterized by ineffective hematopoiesis, dysplasia, and risk of progression to secondary acute myeloid leukemia (AML). Despite the development of numerous prognostic scoring systems (MDS Comorbidity Index (MDS-CI),International Prognostic Scoring System (IPSS) and IPSS-R, updated WHO classifications, and WHO prognostic scoring system (WPSS)), little prospective data regarding the influence of these and other factors on patient outcomes is available. To better elucidate the features of early mortality in MDS we compare characteristics of patients dying within one year of MDS diagnosis with those surviving longer in our Adults in Minnesota with MDS (AIMMS) population based case-control study. The AIMMS study is a statewide prospective population-based case-control study (R01 CA142714) conducted by the University of Minnesota (UMN), Mayo Clinic, and the Minnesota Department of Health. Adults (age 20-85 years) with a new diagnosis of MDS between April 2010 and October 2014 were recruited through the Minnesota Cancer Surveillance System. Patients completed a comprehensive questionnaire to capture retrospective epidemiologic data. All cases went through central medical review including pathology review by two independent hematopathologists, cytogenetic analyses, and oncologist medical record review with assignment of IPSS, IPSS-R, WPSS 1.2 noting past medical history, exposures, and treatment history and response. Annual clinical review of all patient cases for four years after initial enrollment is ongoing in a batched, non-real time manner. Three hundred and ninety-nine patients with a confirmed diagnosis of MDS based on central review and one year of clinical follow-up review were included in the analysis. For the entire group, we observed early mortality in those with abnormal cytogenetics, three or greater cytogenetic abnormalities, treatment at a community medical center only (versus academic), and with 2-3 concurrent medical comorbidities (Table 1). Treatment with hypomethylating agents also correlated with early mortality but when adjusted for WPSS and IPSS-R, this association was no longer significant. To investigate varied impact of disease and patient characteristics within different groups of MDS patients, we did multivariable regression analysis within the following categories: High/Very High Risk IPSS-R; Very low/Low/Intermediate Risk IPSS-R; Treated Patients; Supportive Care Only Patients. In patients with high or very high risk IPSS-R, the presence of 3 or more cytogenetic abnormalities was the only significant predictor early mortality in a multivariable adjusted model (OR: 3.66, 95% CI: 1.57-8.53). Similarly, in those with very low, low, or intermediate IPSS-R, abnormal cytogenetics was the only significant predictor of early mortality in an adjusted model (OR: 3.71, 95% CI 1.49-9.26). In patients receiving supportive care only, early mortality was seen in those who had diabetes (OR: 3.06, 95% CI 1.11-8.42), had complex cytogenetics (OR for ≥ 3 abnormalities: 4.94, 95% CI 1.25-19.46), and had very high or high IPSS-R (OR: 4.20, 95% CI 1.43-12.34). Likewise, complex cytogenetics remained the sole significant predictor of early mortality in treated patients (OR: 4.84, 95% CI 1.43-16.37). Complex cytogenetics and prognostic risk category (either by WPSS or IPSS-R) have previously been associated with higher risk disease and early mortality without intervention. Our data confirm this association in a large prospectively followed MDS cohort and highlight the significance of cytogenetic abnormalities and complexity regardless of IPSS-R risk categorization or treatment. Disclosures No relevant conflicts of interest to declare.
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Rudzinska, Ieva y Monta Jakovleva. "HEALTH CARE AND SPORT STUDENT ENGLISH LANGUAGE LEARNING STRATEGIES IN A LATVIAN HEI". SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 3 (21 de mayo de 2019): 563. http://dx.doi.org/10.17770/sie2019vol3.4009.
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The aim of the research is to find out the characteristics of the English language learning strategy use in the students of two study Programs – Sport Science and Healthcare (Physiotherapy) in a Latvian higher education institution, using LLSU Inventory, developed in CARLA Center, University of Minnesota. The results show that both Program students are aware of the strategies and quite use them, mean = 2.63 for Listening Strategy and Vocabulary learning Strategy use, SD= .36 and .40 respectively. However, Physiotherapy student, e.g., use Listening Strategies more that the researched Sport Science students (Sig. (2-tailed) = .02, i.e., < .05)). Physiotherapy students more often “Plan out what to say or write in my own language and then translate it into the target language” (t=-2.12, Sig. (2-tailed) <.001).Although statistically significant small differences between both Program student languages learning strategy use were found, yet the strategy use of both Program students is generally the same. Program developers should consider the differences of student learning strategies; need to know which they students prefer, and which are still to develop.
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DeSantis, John W., Julie M. Vandenbossche, Kevin Alland y John Harvey. "Development of Artificial Neural Networks for Predicting the Response of Bonded Concrete Overlays of Asphalt for Use in a Faulting Prediction Model". Transportation Research Record: Journal of the Transportation Research Board 2672, n.º 40 (14 de mayo de 2018): 360–70. http://dx.doi.org/10.1177/0361198118758637.
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Transverse joint faulting is a common distress in bonded concrete overlays of asphalt pavements (BCOAs), also known as whitetopping. However, to date, there is no predictive faulting model available for these structures. To account for conditions unique to BCOA, a computational model was developed using a three-dimensional finite element program, ABAQUS, to predict the response of these structures. The model was validated with falling weight deflectometer (FWD) data from existing field sections at the Minnesota Road Research Facility (MnROAD) as well as at the University of California Pavement Research Center (UCPRC). A large database of analyses was then developed using a fractional factorial design. The database is used to develop predictive models, based on artificial neural networks (ANNs), to rapidly estimate the structural response at the joint in BCOA to environmental and traffic loads. The structural response will be related to damage using the differential energy concept. Future work includes the implementation of the developed ANNs in this study into a faulting prediction model for designing BCOA.
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Kim, Jong T. y Neil S. Harris. "Utilization Review of Paraneoplastic Neurological Syndrome Antibody Screening Panels: Experience at a Tertiary Academic Health Center". Journal of Applied Laboratory Medicine 4, n.º 1 (1 de julio de 2019): 19–29. http://dx.doi.org/10.1373/jalm.2018.028480.
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Abstract Background Pathology departments play a pivotal role in managing laboratory test utilization in healthcare, and inappropriate resource deployment can contribute to unnecessary healthcare costs. Here we share our experience reviewing a send-out test and implementing a utilization strategy. Antibody testing is often considered in the workup for patients with unexplained paraneoplastic syndrome–like neurological presentations. It has been unclear how helpful these antibody tests are. The goal of study is to evaluate diagnostic utility of antibody screening panel results in patients suspicious for paraneoplastic neurological syndrome and possibly underlying occult malignancy. Methods We retrospectively reviewed the paraneoplastic neurological syndrome antibody test results. The positive predictive value and negative predictive value were calculated. The proportion of the antibody screening results were compared between groups with and without tumor with 2-sided χ2 test statistics. Results In total 348 panels were sent to 2 reference laboratories. From ARUP (Associated Regional and University Pathologists; Salt Lake City, Utah), 2 out of 232 screening panels yielded positive results (0.86%) and from the Mayo Clinic (Rochester, Minnesota), 26 out of 116 screening panels yielded positive results (22.4%). The overall positive predictive value was 3.57% (1/28) and the overall negative predictive value was 91.2% (292/320). There were no statistically significant differences between the antibody screening test results between the 2 groups with and without tumor. Conclusion We found the diagnostic utility and yield for the paraneoplastic antibody panel to be low. Following a multidisciplinary team review of the study results, the pathology department has implemented several new utilization strategies.
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MacMillan, Margaret L., Bruce R. Blazar, Todd E. Defor, Kathryn E. Dusenbery, Michael R. Verneris, Heather Zierhut y John E. Wagner. "Alternative Donor Hematopoietic Cell Transplantation In 94 Patients with Fanconi Anemia at the University of Minnesota". Blood 116, n.º 21 (19 de noviembre de 2010): 3526. http://dx.doi.org/10.1182/blood.v116.21.3526.3526.
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Abstract Abstract 3526 Alternative donor hematopoietic cell transplantation (AD-HCT) for patients with Fanconi anemia (FA) is challenging. We report on the outcomes of 94 patients with FA, median age 9.0 (range 1–33) years, who underwent AD-HCT at our institution from 1999–2010, using one of three consecutive prospective phase II total body irradiation (TBI) containing clinical trials. With each trial, one change was made from the previous trial to systematically study the optimal AD-HCT approach for FA patients. In Trial 1, from 1999–2003, fludarabine (FLU) 140 mg/m2 was added to the conventional cyclophosphamide (CY), antithymocyte globulin (ATG), TBI 450 cGy preparative regimen to overcome the high risk of graft failure. In Trial 2, from 2003–2006, CT guided thymic shielding (TS) was included during TBI to improve immune reconstitution. In Trial 3, from 2006–2010, a TBI dose-de-escalation trial with TS was performed to determine the lowest possible dose of TBI required for engraftment. All patients received CY 40 mg/kg, FLU 140 mg/m2, ATG and single fraction TBI using 150, 300 or 450 cGy, with or without TS as per specific protocol. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A and methylprednisolone. Graft sources included T-cell depleted bone marrow (BM; n=75), single umbilical cord blood (UCB, n=17) or double UCB (n=2). At the time of HCT, 74 patients had aplastic anemia (AA) and 16 patients demonstrated early MDS defined as refractory anemia (RA, n=8), refractory anemia with ringed sideroblasts (RARS), RA with multilineage dysplasia (RCMD, n=4) or RCMD and ringed sideroblasts (RCMD-RS, n=4). One patient had RA with excess blasts-2 (RAEB-2) and 3 patients had acute myeloid leukemia (AML). For the entire cohort of 94 patients, probabilities of neutrophil and platelet engraftment were 97% and 75%, respectively. In Trial 3, two recipients of TBI 150 cGy developed secondary graft failure and dose de-escalation was stopped at TBI 300 cGy. For all patients, probabilities of grade II-IV and grade III-IV acute GVHD were 23% and 10%. Probability of chronic GVHD was 13%. In multivariate analysis of 89 patients (excluding 3 patients with GFR <40 and 2 recipients of TBI 150), higher 3-year mortality was associated with older age (>10 years), and any transfusions prior to HCT. Lower 3-year mortality was associated with Trial 3 (Table). Of the 8 patients in Trial 3 who were <10 years of age and never received transfusions before HCT, 7 are alive and well. Immune reconstitution and infectious disease data analyses are in progress. Table: Factors Associated with 3 Year Survival after HCT: Multiple Regression Analysis Factors N Relative Risk (95% CI) P-value Trial 1: Cy-Flu-ATG-TBI 450* 43 1.0 2: Cy-Flu-ATG-TBI 450+TS 16 0.7 (0.3–1.7) 0.39 3: Cy-Flu–ATG-TBI 300+TS 30 0.4 (0.1–1.0) 0.04 Age 210* 49 1.0 >10 40 2.1 (1.0–4.4) 0.05 Prior Transfusions None* 27 1.0 1–20 45 2.7 (1.0–7.5) 0.05 >20 17 2.9 (1.0–8.8) 0.06 * reference Based on the results of the largest single center analysis of alternative donor HCT for FA patients, four findings emerge: (1) TBI 300 cGy +TS with CY-FLU-ATG is sufficient for consistent engraftment but TBI 150 cGy +TS is not adequate; (2) rates of GVHD are low with T cell depletion; (3) patients with FA and marrow failure should be referred to HCT before receiving transfusions, and (4) superior survival is associated with CY-FLU-ATG-TBI 300+TS followed by T-cell depleted AD-BM or unmanipulated UCB, potentially due to enhanced immune recovery. Longer follow-up is required to determine whether this approach is associated with reduced late effects, particularly endocrinopathies and malignancy. Disclosures: Wagner: CORD:USE: Membership on an entity's Board of Directors or advisory committees; VidaCord: Membership on an entity's Board of Directors or advisory committees.
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Habibi Saravi, Reza, Yahya Saleh Tabari, Seyed Hosein Hoseini, Fariba Ghasemi Hamedani y Zoya Hadinejad. "Evaluation of Operational Readiness of Prehospital Emergency Department of Mazandaran University of Medical Sciences in Encountering COVID-19 Epidemic in 2020". Health in Emergencies & Disasters Quarterly 6, n.º 4 (1 de julio de 2021): 217–24. http://dx.doi.org/10.32598/hdq.6.4.35.3.
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Background: The ability to respond to any emergency before happening is a potential issue that manifests as operational readiness. This study aimed to evaluate the preparedness of prehospital emergency services of Mazandaran University of Medical Sciences in response to the epidemic of COVID-19. Materials and Methods: This cross-sectional study was performed in April 2020 using a translated standard checklist of the Pan American World Health Organization (PAHO). The list consists of four components of call management (6 items), first responders (operational codes with 3 items), medical transportation (including primary and interhospital with 16 items), and emergency medical services administration (including medical guidelines, human resources, and education with 11 items). Results: There were 168 operational logistics facilities and 555 personnel to cover organizational missions. Except for two items that scored half a point, the rest of the measures received total points (35 out of a maximum of 36 points with 97% of the total points). According to the complete scores, operational readiness was at a good level. Conclusion: The preparedness of the Center for Disaster Management and Medical Emergencies at Mazandaran University of Medical Sciences in the face of the COVID-19 epidemic has been at a good level. However, because of the continuation of the epidemic, strengthening the supply chain and empowering personnel are essential to sustainable readiness.
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Kashparov, Dmitry, Natalya Kubina, Lyudmila Puryzhova, Irina Kravchenko y Anastasia Kashparova. "Research of doctors’ innovative KPIs of clinical diagnostic center in goal-setting sustainable development". E3S Web of Conferences 291 (2021): 06001. http://dx.doi.org/10.1051/e3sconf/202129106001.
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Modern challenges have increased attention to the effective operation of medical institutions of various types. At first glance, the tools for achieving the goals of medical organizations have been studied and tested. However, the scientific description and research of the doctors’ KPIs of a polyclinic medical organization within in goal-setting sustainable development in the context of a changing situation with a pandemic has not been sufficiently clarified. The paper presents the current forms and systems of remuneration, KPIs for employees of polyclinic medical organization, as well as a study of the motivational components of the doctors at the Clinical Diagnostic Center (CDC) of Immanuel Kant Baltic Federal University (IKBFU), functional expectations (requirements) from the CDC management with subsequent development of innovative KPIs for doctors as a key category of employees of the research object. The results of the study make it possible to develop a methodology for calculating the integral indicator of KPIs with options for the concept of remuneration for doctors in CDC. The research includes a content analysis of the sources characterizing the current scientific and practical state of the formation and application of doctors’ KPIs. The basis of the study implies a comparison of the formulated tasks of CDC with the tasks of the doctors and their motivational components, followed by the formulation of indicators of doctors’ performance in the context of current forms and systems of remuneration of doctors in Russia and abroad. The continuation of the research in a practical aspect will be associated with developing and implementing the integral indicator of doctors’ KPIs in the approbation process. Future theoretical research is related to the formation of a methodological tool for a flexible system of remuneration for doctors based on changing challenges in goal-setting sustainable development
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Šitum, Ivan, Ante Erceg, Anja Mandarić, Nikolina Džaja, Glorija Mamić y Daniel Lovrić. "Decision day – A retrospective analysis of COVID-19 patients treated with high PEEP non-invasive ventilation". Romanian Journal of Medical Practice 19, n.º 1 (31 de marzo de 2024): 12–15. http://dx.doi.org/10.37897/rjmp.2024.1.5.
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Background and objectives. This retrospective analysis investigates the effect of high levels of Positive End-Expiratory Pressure (PEEP) during Non-Invasive Ventilation (NIV) in patients with COVID 19 Acute Respiratory Distress Syndrome (ARDS). Materials and methods. In the University Hospital Center Zagreb from October 2021 to February 2022, the study analyzed data from 97 patients who received NIV for acute respiratory support during ICU stay. The effect of NIV on survival, the length of stay in the ICU as well as the duration of the support itself was investigated. Results. Results show that despite low mortality in patients with NIV support, mortality is quite high in patients who required intubation. There is also a divergence of the respiratory support level parameter after the 3rd day on NIV, which suggests that moment as pivotal for assessing the continuation of NIV support. Conclusions. The results show that high level PEEP is a viable option for starting respiratory support in ARDS, but also the importance of timely assessment to optimize patient outcomes.
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Hansen, Anna C., Roger D. Moon, Marcia I. Endres, Glenda M. Pereira y Bradley J. Heins. "The Defensive Behaviors and Milk Production of Pastured Dairy Cattle in Response to Stable Flies, Horn Flies, and Face Flies". Animals 13, n.º 24 (14 de diciembre de 2023): 3847. http://dx.doi.org/10.3390/ani13243847.
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Thirty-four crossbred dairy cows were observed on pasture six times per week from June to August 2014 at the University of Minnesota West Central Research and Outreach Center grazing dairy in Morris, MN, for defensive behaviors in response to three species of muscid flies. Counts of stable flies (Stomoxys calcitrans (L.)), horn flies (Haematobia irritans (L.)), and face flies (Musca autumnalis DeGeer) were recorded before and after pasture observation. Individual cows were monitored for 5 min intervals to observe the frequencies of five different defensive behaviors: front and back leg stomps, head tosses, skin twitches, and tail swishes. Fly numbers averaged 5 stable flies per leg, 37 horn flies per side, and 1 face fly per face during the study. The fly counts and behavior frequencies increased with ambient temperature. The results showed a very strong relationship between the numbers of flies and numbers of defensive behaviors, though correlations between specific flies and behaviors were low. Younger cows had fewer stable flies and horn flies than older cows. The thresholds of flies to lower production for pastured organic dairy cows may be greater than 5 for stable flies, 37 for horn flies, and 1 for face flies.
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Bhatia, Smita, Andrea Carter, Liton Francisco, K. S. Baker, Stephen J. Forman, Marcia Grant, Leslie L. Robison, Daniel J. Weisdorf y James G. Gurney. "Health Care Utilization by Hematopoietic Cell Transplantation (HCT) Survivors: A Report from the Bone Marrow Transplant Survivor Study." Blood 104, n.º 11 (16 de noviembre de 2004): 2196. http://dx.doi.org/10.1182/blood.v104.11.2196.2196.
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Abstract HCT is increasingly being used to successfully treat a variety of malignant and nonmalignant disorders with an attendant growing population of survivors. We determined the type of outpatient medical care reported by adult survivors of HCT and examined factors associated with limited medical care. Eligible subjects were individuals who had undergone HCT at either City of Hope Cancer Center or the University of Minnesota between 1974 and 1998, were age 21 years or older at time of transplant, and had survived two or more years after HCT. We analyzed data from 755 adult HCT survivors enrolled in this retrospective cohort study who had completed a 255-item health questionnaire (Allogeneic HCT: n=424; autologous HCT: n=331), representing over 70 percent participation among those successfully contacted. Because of the widely divergent health-related issues among the autologous and allogeneic HCT recipients, the results of the analysis for the two groups are presented separately. Median age at HCT for the allogeneic and autologous HCT survivors was 35.4 and 39.5 years respectively, and the median length of follow-up 7.3 and 6.2 years respectively. Four self-reported outcome measures were used to determine outpatient medical care in the most recent 2-year period: general contact with health care system, general physical examination, HCT-related medical visit, and medical visit at a cancer center, with the percentage of patients reporting such visits shown in the Table below. Among allogeneic HCT recipients, the risk of not reporting a general physical examination, HCT-related visit, or a cancer center visit was decreased among male survivors (OR=0.46, 95% CI, 0.29–0.73) when compared with females, and among patients who received cyclosporine as part of their GVH prophylaxis (OR=0.42, 95% CI, 0.24 to 0.74), when compared with those who had not. Among autologous HCT recipients, the risk of not reporting a medical visit was increased among patients who reported a lack of concern for future health (OR=6.3, 95% CI, 1.4–27.8) and decreased among older survivors (>45 yr. at HCT, OR=0.47, 95% CI, 0.3–0.8). The likelihood of reporting a general physical examination increased as the interval from HCT to questionnaire completion increased (p<0.001), while the likelihood of reporting an HCT-related or cancer center visit decreased (p<0.001). This study demonstrates that although 20% of the allogeneic survivors continued to report a cancer-center visit 18 years on average from HCT, primary care physicians provide health care for most of this growing high-risk population, necessitating effective and ongoing communication between cancer centers and primary care physicians. Health care Utilization by HCT Survivors HCT Type General Medical Contact General Physical Examination HCT-related visit Cancer center visit Allogeneic HCT 98% 67.8% 81.5% 54.3% Autologous HCT 97% 73.3% 80.8% 53.3%
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Nichols, Courtney, Mahdee Sobhanie, Lynn Wardlow y Kelci E. Coe. "272. Clinical Outcomes with Continuation of Combination Antibiotic Therapy versus De-escalation to Monotherapy for Patients with MRSA Bacteremia". Open Forum Infectious Diseases 7, Supplement_1 (1 de octubre de 2020): S137. http://dx.doi.org/10.1093/ofid/ofaa439.316.
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Abstract Background Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with increased morbidity and mortality. Previous studies have demonstrated lower mortality with combination therapy (CT) compared to monotherapy (MT) for MRSA bacteremia; however, there is a lack of evidence to favor continued CT over de-escalation to MT for completion of treatment after clearance of bacteremia. Methods This was a single-center, retrospective study at The Ohio State University Wexner Medical Center in patients with MRSA bacteremia from November 2011 to July 2019. The primary composite outcome included inpatient infection-related mortality, 60-day readmission and 60-day bacteremia recurrence in patients receiving daptomycin and ceftaroline CT for greater than 10 days against those who received three to ten days of CT and were then de-escalated to either daptomycin, ceftaroline, or vancomycin MT. Statistical analysis used simple and multivariate logistic regression models to estimate crude and adjusted odds ratios and the 95% confidence interval to assess the relationship between the composite outcome for the MT and CT groups, while controlling for proven cofounders. Results A total of 286 patients with MRSA bacteremia were identified with 146 patients omitted based on exclusion criteria. The study population included 66 in the CT group and 74 in the MT group. Of those in the MT group 20 received ceftaroline, 29 received daptomycin, and 25 received vancomycin. Median age was 46 years (IQR 34.5–61), 60% required intensive care unit stay (n=84), and patients were 51% female (n=71) and 78% white (n=109). Bacteremia source was primarily intravenous drug use (40%) or line-related (16%). No significant difference was observed in the primary composite outcome (21% CT group vs 24% MT group; p=0.66). Within this outcome, there was no significant difference in readmission within 60 days (20% CT group vs 18% MT group; p=0.75), bacteremia recurrence within 60 days (3% CT group vs 7% MT group; p=0.45), or inpatient infection-related mortality (2% CT group vs 5% MT group; p=1.00). Conclusion No significant difference was found in the composite clinical outcome for MRSA bacteremia patients with continued CT versus those who were switched to MT. Disclosures All Authors: No reported disclosures
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Pease, Daniel, Julie A. Ross, Phuong L. Nguyen, Betsy Hirsch, Adina Cioc, Angela R. Smith, Michelle A. Roesler, Rachel K. Fonstad y Erica D. Warlick. "Differences In Community and Academic Practice Patterns For Newly Diagnosed Myelodysplastic Syndromes (MDS) Patients In Minnesota: A Population Based Study". Blood 122, n.º 21 (15 de noviembre de 2013): 2798. http://dx.doi.org/10.1182/blood.v122.21.2798.2798.
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Abstract Introduction Expanding treatment options for MDS have changed therapeutic decision-making for clinicians. To better characterize therapeutic choices in newly diagnosed MDS, we report the practice patterns captured during the first year of MDS diagnosis for patients enrolled in our statewide population-based study. We highlight a comparison of treatment in community and academic centers. Methods Adults in Minnesota with MDS (AIMMS) is a statewide prospective population-based study conducted by the University of Minnesota (UMN), Mayo Clinic, and Minnesota Department of Health. Starting in April 2010, all newly diagnosed adult cases (ages 20+) of MDS were invited to participate. After patient enrollment, central review was performed consisting of independent hematopathology and cytogenetic review coupled with oncologist chart review assigning prognostic risk scores [International Prognostic Scoring System (IPSS) and IPSS-R (Revised)] and abstracting treatment exposures. All enrolled patients with one year follow-up were included in this analysis. Treatment was divided into supportive, active, transplant, or other. Supportive care included observation, growth factors, and transfusions. Active care included azacitidine, decitabine, lenalidomide, or 7+3 chemotherapy. Academic centers were defined as the UMN and Mayo Clinic; all other centers were designated as community based practices. Results The median patient age was 73 years, with 68% males. IPSS and IPSS-R risk scores were calculated for 100% and 97% of patients, respectively. Treatment choices stratified by IPSS risk group showed 89% low risk, 53% INT-1, 31% INT-2, and 13% high risk with supportive care; active and transplant strategies were utilized for 9% low risk, 44% INT-1, 64% INT-2, and 88% high risk. INT-1 in the community received 70% supportive treatment, in academic 35%. Active treatment for INT-1 was 30% in community and 45% in academic. Community INT-2 received supportive care in 45% of cases, in academic 23%. Transplants were limited to academic centers, with the highest rate in INT-2 at 34%. Among community diagnoses, 100% of high risk, 52% INT-2, 26% INT-1, and 13% low risk were referred to an academic center. Comparison of age <65 and 65+ years showed 83% of transplants occurred in those <65. INT-2/high risk group patients <65 received 95% active therapy or transplant, compared to 51% of those 65+. Discussion This prospective, population based study provides a well-defined patient cohort based on central review of pathologic and clinical data. Evaluation of practice patterns during the first year after diagnosis showed higher utilization of active and transplant treatment strategies as IPSS risk score increased. Further, compared to community, higher utilization occurred for patients at academic centers, suggesting more aggressive treatment in these settings. Age was also a predictor of treatment choice. In addition, referral patterns followed IPSS score. Whether these treatment differences are driven by patient preference and/or translate into improved disease control and decreased mortality requires continued prospective analysis and will be detailed in future reports. Disclosures No relevant conflicts of interest to declare.
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Akpek, Görgün, Stephanie J. Lee, Mary E. Flowers, Steven Z. Pavletic, Mukta Arora, Shing Lee, Steven Piantadosi et al. "Performance of a new clinical grading system for chronic graft-versus-host disease: a multicenter study". Blood 102, n.º 3 (1 de agosto de 2003): 802–9. http://dx.doi.org/10.1182/blood-2002-10-3141.
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Abstract We recently reported 3 risk factors (RFs) at diagnosis of chronic graft-versus-host disease (cGVHD) that were significantly associated with increased nonrelapse mortality. These included extensive skin involvement (ESI), thrombocytopenia (TP), and progressive type of onset (PTO). The hazard ratio (HR) for mortality of the patients with prognostic score (PS) between 0 and 2 (intermediate-risk; 1 RF) compared to those with PS 0 (favorable-risk; 0 RF) was 3.7 (95% CI, 1.4, 9.3); the HR for patients with PS equal to or more than 2 (high-risk; > 1 RF) compared with intermediate-risk group was 6.9 (3.8, 12.4). A rare presentation of TP and PTO without ESI yielded a PS of 1.8 (intermediate-risk). This paper reports the performance of the prognostic model and the individual RFs using data from an additional 1105 patients from University of Nebraska (n = 60), International Bone Marrow Transplantation Registry (n = 708), Fred Hutchinson Cancer Research Center (n = 188), and University of Minnesota (n = 149). The extent of skin involvement was quantified in 3 cohorts using the available data collected in different formats before the analysis. Although the HR for mortality of the patients in the intermediate-risk group versus those in the favorable-risk group ranged from 2.3 to 8.9 across the centers, it was between 1.6 to 6.9 for patients in the high-risk group versus those in the intermediate-risk group. Although TP itself was uniformly associated with increased risk of mortality across all test samples, ESI and PTO showed statistically significant associations with mortality in 1 and 2 cohorts, respectively. In conclusion, the model was predictive of cGVHD-specific survival, but the mortality hazard associated with ESI was lower in each of these test samples compared with the learning sample. Although the new clinical grading based on the model is promising because of its utility across multiple independent data sets, prospective validation is needed.
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Csókási, Krisztina, Rita Hargitai, Róbert Járai, László Nagy, László Czirják y Enikő C. Kiss. "Personality and Psychopathology in Patients with Systemic Sclerosis". Open Psychology Journal 10, n.º 1 (28 de abril de 2017): 41–48. http://dx.doi.org/10.2174/1874350101710010041.
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Background: Systemic sclerosis is an autoimmune connective tissue disease with significant pain, fatigue, and disability. Patients with systemic sclerosis are at increased risk for psychiatric disorders. Objective: This study assessed the personality and psychopathological characteristics of scleroderma patients. Method: Consecutive, in-patient female cases with systemic sclerosis (N=72) from the tertiary care center of the University of Pécs and age- and sex-matched healthy volunteers (N=56) and fifty patients with rheumatoid arthritis were enrolled. Participants completed the Minnesota Multiphasic Personality Inventory-2. Demographical and clinical data were also collected. Results: Rheumatoid arthritis and scleroderma patients had similar profiles with high scores (≥65T) on Scales 1, 2 and 3. Additionally, they achieved moderate scores on Scales 5 and 0. The Scale 7 was elevated only in females with rheumatoid arthritis distinctively. Conclusion: High scores on Scales 1, 2 and 3 may reflect the severe somatic symptoms of systemic sclerosis (and rheumatoid arthritis), but may also refer to the disease-related emotional distress, anxiety and depression. Likewise, social withdrawal and less feminine interests may be the results of the chronic and disabling illness. The minor differences between the patient groups indicate that females with systemic sclerosis may be less vulnerable to specific anxiety disorders (obsessive-compulsive disorders, phobias). Study results highlight the importance of developing psychosocial interventions designed to meet the needs of scleroderma patients.
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Rudelt, Amanda, Simone French y Lisa Harnack. "Fourteen-year trends in sodium content of menu offerings at eight leading fast-food restaurants in the USA". Public Health Nutrition 17, n.º 8 (10 de septiembre de 2013): 1682–88. http://dx.doi.org/10.1017/s136898001300236x.
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AbstractObjectiveTo examine changes in the Na content of lunch/dinner menu offerings at eight of the leading fast-food restaurants in the USA between 1997/1998 and 2009/2010.DesignMenu offerings and nutrient composition information for the menu items were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center (NCC) Food and Nutrient Database. Nutrient composition information for lunch/dinner menu items sold by the fast-food restaurants included in the present study was updated in the database biannually. Menus were analysed for changes in mean Na content of all menu offerings (except beverages) and specific categories of menu items among all restaurants and for each individual restaurant.SettingUSA.SubjectsLunch/dinner food menu of eight leading US fast-food restaurants.ResultsBetween 1997/1998 and 2009/2010 the mean Na content of menu offerings across the eight restaurants increased by 23·4 %. Examining specific food categories, mean Na content of entrées by increased 17·2 % and that of condiments increased by 26·1 %. Only side dishes showed a decrease of 6·6 %. None of the restaurants examined had a decrease in Na across the lunch/dinner menu offerings over the 14 years examined.ConclusionsResults suggest that over the time period studied there has been no meaningful reduction in the Na content of lunch/dinner menu offerings at the leading fast-food restaurants examined in the present study.
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Drakul, Dragana, Dragana Sokolović, Milica Radanović, Nikolina Dukić, Milica Kunarac, Branislava Ćurčić, Dragana Pavlović y Radmil Marić. "Sex Differences in the Use of Cardiovascular Drugs: A Survey of Patients in a Single Center". Acta Medica Academica 50, n.º 3 (12 de febrero de 2022): 351. http://dx.doi.org/10.5644/ama2006-124.353.
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<p><strong>Objective</strong>. Patients and medical professionals have a common misconception that cardiovascular diseases (CVD) predominantly affect men, which can lead to less prescribing of cardiovascular drugs to women. This study examined whether there were sex differences in the administration of cardiovascular (CV) drugs in patients admitted to the intensive care unit of the Internal Medicine Clinic of Foča University Hospital (ICFUH).</p><p><strong>Materials and Methods</strong>. The study comprised 332 patients hospitalized at the ICFUH from January 1st to June 30th, 2019. The following data on leading CVD and risks related to CV drug administration were collected: age, hyperlipidemia (HLD), diabetes mellitus (DM), chronic kidney disease (CKD), liver disease (LD), heart failure (HF), hypertension (HTN), myocardial infarction (MI), and stroke (S). The amount of the CV drugs of interest (statins, antiplatelet drugs, calcium channel blockers, ACE inhibitors, beta blockers, diuretics) administered during hospitalization was expressed as the Defined Daily Dose (DDD)/100 bed-days (BD) for patients of both sexes separately.</p><p><strong>Results</strong>. During hospitalization in the intensive care unit of ICFUH, female patients were less likely to be treated with statins than male patients (30.1 vs. 57.5 DDD/100 BD, P<0.05). There was no difference between sexes regarding the use of antihypertensive drugs. Women were less likely to be treated by antiplatelet therapy, more precisely by acetylsalicylic acid (30.4 vs. 36.9 DDD/100 BD, P<0.05).</p><p><strong>Conclusion</strong>. Our study indicates that there were sex differences in CV drug administration in ICFUH. Presuming that drugs used during hospitalization were at least partially a continuation of the previous therapy prescribed by the family doctor, it is possible that such differences exist in primary care.</p>
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Dewi, SE.,MM, Dr Dian Masita, Ikhwan Faisal, Anisa Yulia Al Munawaroh1, Ririn Kurniawati y Anton Yuda Sumanto. "Pelatihan Pembuatan Natural Bar Soap Berbasis Eco Enzyme Bersama Pkk Kecamatan Beruntung Baru, Kalimantan Selatan". Jurnal Pengabdian ILUNG (Inovasi Lahan Basah Unggul) 3, n.º 2 (21 de noviembre de 2023): 341. http://dx.doi.org/10.20527/ilung.v3i2.10287.
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This Community Service Program is a continuation program of the socialization and training program including the use of eco enzyme with the PKK Beruntung Baru District in 2021. The community has felt the benefits and has proven the benefits of eco enzyme for agriculture, health and even for a substitute for bath soap. However, eco enzyme has disadvantages for some people including not foaming and feeling sticky on the skin and some people do not like the aroma. Eco enzyme has social value so it is not allowed to be traded. Based on this background, the PKM team took the initiative to carry out a follow-up program, namely training in making natural bar soap based on eco enzyme which is competitive and has high economic value so that it can improve the economy and welfare of the Beruntung Baru sub-district community. The methods that will be used in this PKM activity are lectures, simulations or demonstrations and direct practice of making eco enzyme-based natural bar soap. Based on the results of the evaluation of the Eco Enzyme-based Natural Bar Soap Making Training activities carried out by the PDWA Year 2023 Team from the Lambung Mangkurat University Eco Enzyme Study Center, this is the right solution in overcoming partner problems and the results of the pre and post test evaluation of the entire PDWA Th 2023 program implemented by the ULM Eco Enzyme Study Center through the Eco Enzyme-Based Natural Bar Soap Making Training at PKK Kec. Beruntung Baru, Kab. Banjar, South Kalimantan Province can be categorized as very successful
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Kumano, Kazuo, Shinji Yokota, Tadasu Sakai, Haruki Kazama y Katsuyoshi Sofue. "Minimizing the Drainage Period for Continuous Ambulatory Peritoneal Dialysis". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 14, n.º 1 (enero de 1994): 52–55. http://dx.doi.org/10.1177/089686089401400110.
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Objectives To examine features of drainage flow and to determine whether the drainage period could be safely reduced in continuous ambulatory peritoneal dialysis (CAPD) patients. Design Open nonrandomized prospective study in CAPD patients. Setting The kidney center in a tertiary care university hospital. Patients Fourteen CAPD patients with good catheter function. Interventions Drainage flow pattern was studied using a 2-L dialysate. The drainage period was reduced from 28 minutes (mean) to 10 minutes throughout a short-term, 2-month study period and a long-term, 6-month study period for 10 patients. Main Outcome Measures Ultrafiltration volume, body weight, and peritoneal clearance. Results A kinetics analysis of the drainage period and volume indicated a positive linear correlation with two different slopes: one for rapid drainage for the first 5–7 minutes and one for subsequent slow drainage. The effluent exceded 80% in the former period. Ultrafiltration volume and body weight showed no change due to the reduction. Improved peritoneal clearance of small molecular substances could not be confirmed despite a 5% increase in the effective dialysis period. Nearly all patients were satisfied with the reduction and desired its continuation. Conclusions Ten minutes is a sufficient drainage period for most CAPD patients with a 2-L dialysate volume. This may possibly allow an increase in daily activities and an effective peritoneal membrane dialysate contact period.
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Kumar, Jessica, Isabelle Sy, Felix Wei, Jane de Lemos, Gabriel Loh, Megan Harbin y Karen Dahri. "Evaluation of the Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease in Hospitalized Patients". Journal of Pharmacy Technology 36, n.º 5 (26 de agosto de 2020): 187–95. http://dx.doi.org/10.1177/8755122520942762.
Texto completoResumen
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are estimated to cost $1.5 billion annually in Canada. Previous studies have shown that barely half of all patients receive ideal care in hospitals. Deviations from guideline-defined optimal care lead to longer hospital stays, readmissions, and increased mortality. Objective: To determine the proportion of patients admitted to hospital for AECOPD who received treatment adherent to guidelines. Methods: A retrospective cohort study was conducted with ethics approval from the University of British Columbia Clinical Research Ethics Board. Patients hospitalized for ≥24 hours with an AECOPD at a tertiary care center and a community hospital were assessed. Guideline-adherent treatment was defined as appropriate use of supplemental oxygen, inhaled bronchodilators, systemic corticosteroids, antibiotics, venous thromboembolism prophylaxis, initiation/continuation of nicotine replacement therapy for current smokers, and vaccination optimization, reflecting international standards of care. Outcomes were assessed using descriptive statistics. Results: A random sample of 210 patients were selected of which 99 met inclusion criteria. Only 4% received therapy that met all recommendations. Differences in management were found between sites, specifically the appropriate use of bronchodilators, corticosteroids, antibiotics, and supplemental oxygen. Venous thromboembolism prophylaxis and smoking cessation rates were 97% and 94%, respectively, at the tertiary care center, compared with 73% and 100% at the community hospital. Additionally, less than half of all patients had their immunization history verified. Conclusion: Gaps in the inpatient management of AECOPD continue to exist. Initiatives must be targeted to optimize management and reduce the burden of the disease.