Admission heart rate and in-hospital outcomes in patients hospitalized for heart failure in sinus rhythm and in atrial fibrillation.

Background: Prior studies have suggested an association between higher heart rate and higher mortality, particularly in chronic heart failure (HF). Whether this relationship holds true in patients hospitalized with HF and differs between patients in sinus rhythm (SR) and atrial fibrillation (AF) has not been well studied.

Methods: We examined 145,221 admissions for HF from 295 hospitals enrolled in Get With The Guidelines-Heart Failure from January 2005 through September 2011.

Second primary colorectal cancer in the era of prevalent screening and imaging.

Background: Oncology literature is increasingly recognizing prevalence of second primary cancers including several longitudinal studies showing an increased risk of colorectal cancer following a prostate cancer diagnosis. A retrospective study was conducted to examine the relationship between prior prostate cancer diagnoses and subsequent colorectal cancer diagnoses.

Methods: A multi-centre prospective colorectal cancer registry was queried for patients with a prior history of prostate, breast or lung cancer.

Chlorothiazide is a substrate for the human uptake transporters OAT1 and OAT3.

The thiazide diuretic chlorothiazide is poorly metabolized, and is predominantly excreted via the kidneys. We have previously shown that chlorothiazide is transported by ATP-binding cassette transporter G2, suggesting a potential role for this transporter in apical efflux of chlorothiazide in the kidney. However, because of the poor passive permeability of the drug, it is likely that uptake transporters on the basolateral membrane are also involved to facilitate vectorial transport in the renal proximal tubule.

High performance biomedical time series indexes using salient segmentation.

The advent of remote and wearable medical sensing has created a dire need for efficient medical time series databases. Wearable medical sensing devices provide continuous patient monitoring by various types of sensors and have the potential to create massive amounts of data. Therefore, time series databases must utilize highly optimized indexes in order to efficiently search and analyze stored data.

Dynamic self-adaptive remote health monitoring system for diabetics.

Diabetes is the seventh leading cause of death in the United States. In 2010, about 1.9 million new cases of diabetes were diagnosed in people aged 20 years or older.

Comprehensive developmental profiles of gene activity in regions and subregions of the Arabidopsis seed.

Seeds are complex structures that consist of the embryo, endosperm, and seed-coat regions that are of different ontogenetic origins, and each region can be further divided into morphologically distinct subregions. Despite the importance of seeds for food, fiber, and fuel globally, little is known of the cellular processes that characterize each subregion or how these processes are integrated to permit the coordinated development of the seed. We profiled gene activity genome-wide in every organ, tissue, and cell type of Arabidopsis seeds from fertilization through maturity.

Neurologic adverse effects of ranolazine in an elderly patient with renal impairment.

Ranolazine, an antianginal agent, has activity at muscle and neuronal sodium channels. Congenital genetic mutations to sodium channels in humans and supratherapeutic ranolazine concentrations in animal models have produced similar neurologic adverse reactions. We describe a case of neurologic adverse effects in an 81-year-old woman with coronary artery disease, renal impairment, and mild neurologic disease who received ranolazine for symptomatic control of a non-ST-segment elevation myocardial infarction.

Comparing predictive models of glioblastoma multiforme built using multi-institutional and local data sources.

The growing amount of electronic data collected from patient care and clinical trials is motivating the creation of national repositories where multiple institutions share data about their patient cohorts. Such efforts aim to provide sufficient sample sizes for data mining and predictive modeling, ultimately improving treatment recommendations and patient outcome prediction. While these repositories offer the potential to improve our understanding of a disease, potential issues need to be addressed to ensure that multi-site data and resultant predictive models are useful to non-contributing institutions.

Laparoscopic median arcuate ligament release: are we improving symptoms?

Background: Median arcuate ligament syndrome is a rare disorder characterized by postprandial abdominal pain, weight loss, and celiac stenosis. We report our experience using a laparoscopic approach for this uncommon diagnosis.

Study Design: This is an IRB-approved, prospectively collected retrospective analysis of patients treated with laparoscopic median arcuate ligament release at our institution.

A Monte Carlo Approach to Biomedical Time Series Search.

Time series subsequence matching (or signal searching) has importance in a variety of areas in health care informatics. These areas include case-based diagnosis and treatment as well as the discovery of trends and correlations between data. Much of the traditional research in signal searching has focused on high dimensional -NN matching.

An Approach for Incorporating Context in Building Probabilistic Predictive Models.

With the increasing amount of information collected through clinical practice and scientific experimentation, a growing challenge is how to utilize available resources to construct predictive models to facilitate clinical decision making. Clinicians often have questions related to the treatment and outcome of a medical problem for individual patients; however, few tools exist that leverage the large collection of patient data and scientific knowledge to answer these questions. Without appropriate context, existing data that have been collected for a specific task may not be suitable for creating new models that answer different questions.

Aggregated Indexing of Biomedical Time Series Data.

Remote and wearable medical sensing has the potential to create very large and high dimensional datasets. Medical time series databases must be able to efficiently store, index, and mine these datasets to enable medical professionals to effectively analyze data collected from their patients. Conventional high dimensional indexing methods are a two stage process.

Dynamic Task Optimization in Remote Diabetes Monitoring Systems.

Diabetes is the seventh leading cause of death in the United States, but careful symptom monitoring can prevent adverse events. A real-time patient monitoring and feedback system is one of the solutions to help patients with diabetes and their healthcare professionals monitor health-related measurements and provide dynamic feedback. However, data-driven methods to dynamically prioritize and generate tasks are not well investigated in the domain of remote health monitoring.

Multilevel whole-genome analysis reveals candidate biomarkers in clear cell renal cell carcinoma.

Renal cell carcinoma (RCC) is the most common neoplasm of the kidney. We conducted an integrated analysis of copy number, gene expression (mRNA and miRNA), protein expression, and methylation changes in clear cell renal cell carcinoma (ccRCC). We used a stepwise approach to identify the most significant copy number aberrations (CNA) and identified regions of peak and broad copy number gain and loss, including peak gains (3q21, 5q32, 5q34-q35, 7p11, 7q21, 8q24, 11q13, and 12q14) and deletions (1p36, 2q34-q37, 3p25, 4q33-q35, 6q23-q27, and 9p21).

Dehydrative cyclocondensation mechanisms of hydrogen thioperoxide and of alkanesulfenic acids.

Structural features of hydrogen thioperoxide (oxadisulfane, H-S-O-H) and of alkanesulfenic acids (R-S-O-H; R = CH3, CH2CH3, CH2CH2CH3, CH(CH3)2, C(CH3)3, CF3, CCl3) and the mechanisms of their dehydrative cyclocondensation to the respective sulfinothioic acid (H-(S═O)-S-H) and alkyl alkanethiosulfinates (R-(S═O)-S-R) have been studied using coupled cluster theory with single and double and perturbative triple excitations [CCSD(T)] and quadratic configuration interaction with single and double and perturbative triple excitations [QCISD(T)] with the cc-pVDZ basis set and also using second-order Møller-Plesset perturbation theory (MP2) and the hybrid density functionals B3LYP, B3PW91, and PBE1PBE with the 6-311+G(d,p) basis set. The concerted cyclodehydration mechanisms include cyclic five-center transition states with relatively long distance sulfur-sulfur bonding interactions. Attractive and repulsive nonbonding interactions are predicted in the sulfenic acids, transition states, and thiosulfinates.

Energy-efficient context classification with dynamic sensor control.

Energy efficiency has been a longstanding design challenge for wearable sensor systems. It is especially crucial in continuous subject state monitoring due to the ongoing need for compact sizes and better sensors. This paper presents an energy-efficient classification algorithm, based on partially observable Markov decision process (POMDP).

Elevated concentration of placental growth factor (PlGF) and long term risk in patients with acute coronary syndrome in the PROVE IT-TIMI 22 trial.

Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, acts via the flt-1 receptor and promotes endothelial activation and macrophage recruitment into atherosclerotic lesions. We investigated the relationship of PlGF with cardiovascular outcomes in a large cohort of patients presenting across the spectrum of ACS. PlGF was measured at baseline (n = 3,761) and at four-months (n = 3,369) in patients randomized to atorvastatin 80 mg or pravastatin 40 mg after ACS in the PROVE IT-TIMI 22 trial.

Toxicity from repeated doses of acetaminophen in children: assessment of causality and dose in reported cases.

Liver injury has been reported in children treated with repeated doses of acetaminophen. The objective of this study was to identify and validate reports of liver injury or death in children younger than 6 years who were administered repeated therapeutic doses of acetaminophen. We reviewed US Poison Center data, peer-reviewed literature, US Food and Drug Administration Adverse Event Reports, and US Manufacturer Safety Reports describing adverse effects after acetaminophen administration.

Integrated genomic characterization of the kallikrein gene locus in cancer.

Background: The kallikrein-related peptidases (KLKs) have been implicated in many types of cancer, including prostate and ovarian.

Materials And Methods: We performed a comprehensive in silico study to characterize the KLK locus using transcriptomic (gene expression) and genomic (mutations and DNA copy number) data in prostate cancer (n=194), serous ovarian cancer (n=506), glioblastoma multiforme (n=206), and sarcoma (n=207) from The Cancer Genome Atlas and independent publicly available datasets to assess KLKs as cancer biomarkers.

Results: Overall, there was mRNA overexpression in prostate and serous ovarian cancer and decreased expression in glioblastoma multiforme.

Context-based electronic health record: toward patient specific healthcare.

Due to the increasingly data-intensive clinical environment, physicians now have unprecedented access to detailed clinical information from a multitude of sources. However, applying this information to guide medical decisions for a specific patient case remains challenging. One issue is related to presenting information to the practitioner: displaying a large (irrelevant) amount of information often leads to information overload.

Intravascular ultrasound lumen area parameters for assessment of physiological ischemia by fractional flow reserve in intermediate coronary artery stenosis.

Background: A fractional flow reserve (FFR) of <0.8 is currently used to guide revascularization in lesions with intermediate coronary stenosis. Whether there is an intravascular ultrasound (IVUS) measurement or a cutoff value that can reliably determine which of these intermediate lesions requires intervention is unclear.

Making sanitation count: developing and testing a device for assessing latrine use in low-income settings.

While efforts are underway to expand latrine coverage to an estimated 2.6 billion people who lack access to improved sanitation, there is evidence that actual use of latrines is suboptimal, limiting the potential health and environmental gains from containment of human excreta. We developed a passive latrine use monitor (PLUM) and compared its ability to measure latrine activity with structured observation.