Single-Nucleotide Polymorphisms of TAS2R46 Affect the Receptor Downstream Calcium Regulation in Histamine-Challenged Cells.

Bitter taste receptors (TAS2Rs) expressed in extraoral tissues represent a whole-body sensory system, whose role and mechanisms could be of interest for the identification of new therapeutic targets. It is known that TAS2R46s in pre-contracted airway smooth muscle cells increase mitochondrial calcium uptake, leading to bronchodilation, and that several SNPs have been identified in its gene sequence. There are very few reports on the structure-function analysis of TAS2Rs.

Glucagon-like peptide 1 receptor is a T cell-negative costimulatory molecule.

Glucagon-like peptide-1 receptor (GLP-1R) is a key regulator of glucose metabolism known to be expressed by pancreatic β cells. We herein investigated the role of GLP-1R on T lymphocytes during immune response. Our data showed that a subset of T lymphocytes expresses GLP-1R, which is upregulated during alloimmune response, similarly to PD-1.

Reversal of Experimental Autoimmune Diabetes With an sCD39/Anti-CD3 Treatment.

Extracellular (e)ATP, a potent proinflammatory molecule, is released by dying/damaged cells at the site of inflammation and is degraded by the membrane ectonucleotidases CD39 and CD73. In this study, we sought to unveil the role of eATP degradation in autoimmune diabetes. We then assessed the effect of soluble CD39 (sCD39) administration in prevention and reversal studies in NOD mice as well as in mechanistic studies.

Estimating the workload of a multi-disciplinary care team using patient-level encounter histories.

Healthcare spending in the United States is concentrated on a small percentage of individuals, with 5% of the population accounting for 50% of annual spending. Many patients among the top 5% of spenders have complex health and social needs. Care coordination interventions, often led by a multidisciplinary team consisting of nurses, community health workers and social workers, are one strategy for addressing the challenges facing such patients.

Broadening horizons in mechanisms, management, and treatment of diabetic kidney disease.

Diabetic kidney disease (DKD) is the first cause of end-stage kidney disease in patients with diabetes and its prevalence is increasing worldwide. It encompasses histological alterations that mainly affect the glomerular filtration unit, which include thickening of the basement membrane, mesangial cell proliferation, endothelial alteration, and podocyte injury. These morphological abnormalities further result in a persistent increase of urinary albumin-to-creatinine ratio and in a reduction of the estimated glomerular filtration rate.

eATP and autoimmune diabetes.

Purpose Of Review: The purine nucleotide adenosine triphosphate (ATP) is released into extracellular spaces as extracellular ATP (eATP) as a consequence of cell injury or death and activates the purinergic receptors. Once released, eATP may facilitate T-lymphocyte activation and differentiation. The purpose of this review is to elucidate the role of ATP-mediated signaling in the immunological events related to type 1 diabetes (T1D).

A new mixed agent-based network and compartmental simulation framework for joint modeling of related infectious diseases- application to sexually transmitted infections.

Background: A model that jointly simulates infectious diseases with common modes of transmission can serve as a decision-analytic tool to identify optimal intervention combinations for overall disease prevention. In the United States, sexually transmitted infections (STIs) are a huge economic burden, with a large fraction of the burden attributed to HIV. Data also show interactions between HIV and other sexually transmitted infections (STIs), such as higher risk of acquisition and progression of co-infections among persons with HIV compared to persons without.

Prediction of water quality extremes with composite quantile regression neural network.

Water quality extremes, which water quality models often struggle to predict, are a grave concern to water supply facilities. Most existing water quality models use mean error functions to maximize the predictability of water quality mean value. This paper describes a composite quantile regression neural network (CQRNN) model, which simultaneously estimates non-crossing regression quantiles by minimizing the composite quantile regression error function.

Simple Heuristics for Near-Optimal Appointment Scheduling in Primary Care.

In primary care allocating appointments to sequential requests can result in sub-optimal scheduling. Optimal scheduling requires hiring of consultants to analyze historical patterns. Many practices focus their resources on larger problems instead of optimizing appointment schedules.

Agent-based evolving network modeling: a new simulation method for modeling low prevalence infectious diseases.

Agent-based network modeling (ABNM) simulates each person at the individual-level as agents of the simulation, and uses network generation algorithms to generate the network of contacts between individuals. ABNM are suitable for simulating individual-level dynamics of infectious diseases, especially for diseases such as HIV that spread through close contacts within intricate contact networks. However, as ABNM simulates a scaled-version of the full population, consisting of all infected and susceptible persons, they are computationally infeasible for studying certain questions in low prevalence diseases such as HIV.

Hypertension management in rural western Kenya: a needs-based health workforce estimation model.

Background: Elevated blood pressure is the leading risk for mortality in the world. Task redistribution has been shown to be efficacious for hypertension management in low- and middle-income countries. However, the workforce requirements for such a task redistribution strategy are largely unknown.

Neonatal Cerebral Air Embolism.

Background: Vascular air embolism (VAE) is rare but potentially lethal condition, and survival is rarely reported in newborn.

Characteristics: A preterm (27+1 weeks) neonate on Continuous positive airway pressure developed sudden cardiac asystole on day 3 of life and required 30 minutes of cardiopulmonary resuscitation.

Observation: Infant had air embolism in liver and brain.

Panel Size, Office Visits, and Care Coordination Events: A New Workload Estimation Methodology Based on Patient Longitudinal Event Histories.

Panel size, or the number of patients a primary care physician (PCP) and her care team can feasibly manage as part of a practice, remains a vital question in primary care. To Illustrate a new methodology for quantifying two types of workload associated with a panel size: 1) the PCP weekly office visit distribution and 2) the weekly distribution of non-PCP events (subspecialty visits, emergency room visits, hospitalizations) that potentially require non-face-to-face coordination. We assemble granular individual-level histories of events in the health system using the Medical Expenditure Panel Survey from 2011.

Meconium Evacuation for Facilitating Feed Tolerance in Preterm Neonates: A Systematic Review and Meta-Analysis.

Background: A delayed passage of meconium is considered as a risk factor for feed intolerance in preterm neonates.

Objectives: The aim of this study was to review the effects of different therapeutic agents for meconium evacuation on feed tolerance in preterm neonates.

Methods: A systematic review of randomised controlled trials (RCTs) of different therapeutic agents for meconium evacuation in preterm neonates (gestation <32 weeks and/or birth weight <1,500 g) using the Cochrane systematic review methodology was undertaken.

Using Computer Simulation to Study Nurse-to-Patient Ratios in an Emergency Department.

Objective: To study the impact of nurse-to-patient ratios on patient length of stay (LOS) in computer simulations of emergency department (ED) care.

Methods: Multiple 24-hour computer simulations of emergency care were used to evaluate the impact of different minimum nurse-to-patient ratios related to ED LOS, which is composed of wait (arrival to bed placement) and bedtime (bed placement to leave bed).

Results: Increasing the number of patients per nurse resulted in increased ED LOS.

The impact of age and gender on resource utilization and profitability in ED patients seen and released.

Objective: To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED).

Methods: Billing data for patients seen and released from an Emergency Department (ED) with >100,000 annual visits between 2003 and 2009 were collected. Resource utilization was measured by length of stay (placement in ED bed to leaving the bed) and direct clinical costs (e.

Balancing clinical experience in outpatient residency training.

Background: To receive adequate training experience, resident panels in teaching clinics must have a sufficiently diverse patient case-mix. However, case-mix can differ from one resident panel to another, resulting in inconsistent training.

Method: Encounter data from primary care residency clinics at Massachusetts General Hospital from July 2008 to May 2010 (64 residents and ~3800 patients) were used to characterize patients by gender, age, major disease category (both acute and chronic, e.

Dynamic allocation of same-day requests in multi-physician primary care practices in the presence of prescheduled appointments.

Appointments in primary care are of two types: 1) prescheduled appointments, which are booked in advance of a given workday; and 2) same-day appointments, which are booked as calls come during the workday. The challenge for practices is to provide preferred time slots for prescheduled appointments and yet see as many same-day patients as possible during regular work hours. It is also important, to the extent possible, to match same-day patients with their own providers (so as to maximize continuity of care).

The impact of case mix on timely access to appointments in a primary care group practice.

At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel.

Optimization of PSA screening policies: a comparison of the patient and societal perspectives.

Objective: To estimate the benefit of PSA-based screening for prostate cancer from the patient and societal perspectives.

Method: A partially observable Markov decision process model was used to optimize PSA screening decisions. Age-specific prostate cancer incidence rates and the mortality rates from prostate cancer and competing causes were considered.

Improving clinical access and continuity through physician panel redesign.

Background: Population growth, an aging population and the increasing prevalence of chronic disease are projected to increase demand for primary care services in the United States.

Objective: Using systems engineering methods, to re-design physician patient panels targeting optimal access and continuity of care.

Design: We use computer simulation methods to design physician panels and model a practice's appointment system and capacity to provide clinical service.

A discrete event simulation model to evaluate operational performance of a colonoscopy suite.

Background And Aims: Colorectal cancer, a leading cause of cancer death, is preventable with colonoscopic screening. Colonoscopy cost is high, and optimizing resource utilization for colonoscopy is important. This study's aim is to evaluate resource allocation for optimal use of facilities for colonoscopy screening.