Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit.

Background: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Task Force recently introduced a new clinical score termed quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) for identification of patients at risk of sepsis outside the intensive care unit (ICU). We attempted to compare the discriminatory capacity of the qSOFA versus the Systemic Inflammatory Response Syndrome (SIRS) score for predicting mortality, ICU-free days, and organ dysfunction-free days in patients with suspicion of infection outside the ICU.

Methods: The Weill Cornell Medicine Registry and Biobank of Critically Ill Patients is an ongoing cohort of critically ill patients, for whom biological samples and clinical information (including vital signs before and during ICU hospitalization) are prospectively collected.

Dynamics and flight control of a flapping-wing robotic insect in the presence of wind gusts.

With the goal of operating a biologically inspired robot autonomously outside of laboratory conditions, in this paper, we simulated wind disturbances in a laboratory setting and investigated the effects of gusts on the flight dynamics of a millimetre-scale flapping-wing robot. Simplified models describing the disturbance effects on the robot's dynamics are proposed, together with two disturbance rejection schemes capable of estimating and compensating for the disturbances. The proposed methods are experimentally verified.

Bronchoscopic intubation is an effective airway strategy in critically ill patients.

Purpose: American Society of Anesthesiologists guidelines recommend the use of bronchoscopic intubation as a rescue technique in critically ill patients. We sought to assess the safety and efficacy of bronchoscopic intubation as an initial approach in critically ill patients.

Methods: We performed a retrospective cohort study of patients who underwent endotracheal intubation in the medical intensive care unit of a tertiary urban referral center over 1 academic year.

Preservation of epithelial progenitor cells from collagenase-digested oral mucosa during ex vivo cultivation.

To avoid xenogeneic infection, we report a novel protocol for producing animal-derived component-free oral mucosal epithelial cells (OMECs) sheet for transplantation, in which collagenase was used to replace dispase II/trypsin-EDTA for digesting oral mucosal tissue, and human platelet-derived PLTMax to replace fetal bovine serum. The resulting epithelial aggregates were expanded on de-epithelialized amniotic membranes without 3T3 feeder cells, and serum-free EpiLife was used to reduce contamination by submucosal mesenchymal cells. The OMEC sheets thus generated showed similar positive keratin 3/76-positive and keratin 8-negative staining patterns compared with those generated by the original protocol.

PHENOTYPING CHOROIDEREMIA AND ITS CARRIER STATE WITH MULTIMODAL IMAGING TECHNIQUES.

Purpose: To describe findings in a patient with choroideremia (CHM) and his mother, an obligate CHM carrier.

Methods: Case report.

Results: A 25-year-old man with nyctalopia and poor peripheral vision since childhood, as well as a family history consistent with an X-linked retinal disorder was diagnosed with CHM.

Atypical Rapidly Enlarging Orbital Schwannoma.

Orbital schwannomas are typically slow-growing benign tumors that can cause gradual loss of vision, proptosis, and limitation of ocular motility. The authors present an atypical case of a rapidly growing orbital apex schwannoma in a patient with preexisting vision loss secondary to presumed sarcoidal optic neuritis. Contrary to the slowly progressive nature of a typical orbital schwannoma, the lesion was observed to enlarge from radiologically undiscernible to 3.

Bacteremia due to carbapenem-resistant Enterobacteriaceae in neutropenic patients with hematologic malignancies.

Objectives: To determine the prevalence, risk factors, treatments, and outcomes of bloodstream infections (BSIs) due to carbapenem-resistant Enterobacteriaceae (CRE) in adult neutropenic patients with hematologic malignancies.

Methods: We reviewed all BSIs between 2008 and 2012 in this population at two New York City oncology centers. A case-control study was conducted to identify CRE BSI risk factors, using three controls of non-CRE BSIs per case.

Foundations and Emerging Paradigms for Computing in Living Cells.

Genetic circuits, composed of complex networks of interacting molecular machines, enable living systems to sense their dynamic environments, perform computation on the inputs, and formulate appropriate outputs. By rewiring and expanding these circuits with novel parts and modules, synthetic biologists have adapted living systems into vibrant substrates for engineering. Diverse paradigms have emerged for designing, modeling, constructing, and characterizing such artificial genetic systems.

Diagnosis and management of latent tuberculosis.

Purpose Of Review: Latent tuberculosis infection (LTBI) may affect over two billion individuals and serves as a potential reservoir for future active tuberculosis. The identification and treatment of LTBI in those at highest risk for progression is an essential part of tuberculosis control.

Recent Findings: Interferon-γ release assays are increasingly used for targeted testing and diagnosis of latent disease.

Pathophysiology of Pulmonary Hypertension in Chronic Parenchymal Lung Disease.

Pulmonary hypertension commonly complicates chronic obstructive pulmonary disease and interstitial lung disease. The association of chronic lung disease and pulmonary hypertension portends a worse prognosis. The pathophysiology of pulmonary hypertension differs in the presence or absence of lung disease.

Preservation of human limbal epithelial progenitor cells on carbodiimide cross-linked amniotic membrane via integrin-linked kinase-mediated Wnt activation.

Unlabelled: The Wnt pathway is a major signaling pathway that regulates corneal epithelial stem cells. However, little is known about how the ultrastructure of the limbal epithelial basement membrane (EBM) affects Wnt activity. Due to its enhanced matrix stability, the cross-linked amniotic membrane (AM) has gained increasing interest in the field of regenerative medicine.

Design and development of an ethnically-diverse imaging informatics-based eFolder system for multiple sclerosis patients.

Purpose: MRI has been used to identify multiple sclerosis (MS) lesions in brain and spinal cord visually. Integrating patient information into an electronic patient record system has become key for modern patient care in medicine in recent years. Clinically, it is also necessary to track patients' progress in longitudinal studies, in order to provide comprehensive understanding of disease progression and response to treatment.

Multidimensional Interactive Radiology Report and Analysis: Standardization of workflow and reporting for renal mass tracking and quantification.

A conventional radiology report primarily consists of a large amount of unstructured text, and lacks clear, concise, consistent and content-rich information. Hence, an area of unmet clinical need consists of developing better ways to communicate radiology findings and information specific to each patient. Here, we design a new workflow and reporting system that combines and integrates advances in engineering technology with those from the medical sciences, the Multidimensional Interactive Radiology Report and Analysis (MIRRA).

Effective staging of fibrosis by the selected texture features of liver: Which one is better, CT or MR imaging?

Purpose: Texture patterns of hepatic fibrosis are one of the important biomarkers to diagnose and classify chronic liver disease from initial to end stage on computed tomography (CT) or magnetic resonance (MR) images. Computer-aided diagnosis (CAD) of liver cirrhosis using texture features has become popular in recent research advances. To date, however, properly selecting effective texture features and image parameters is still mostly undetermined and not well-defined.

Controlling free flight of a robotic fly using an onboard vision sensor inspired by insect ocelli.

Scaling a flying robot down to the size of a fly or bee requires advances in manufacturing, sensing and control, and will provide insights into mechanisms used by their biological counterparts. Controlled flight at this scale has previously required external cameras to provide the feedback to regulate the continuous corrective manoeuvres necessary to keep the unstable robot from tumbling. One stabilization mechanism used by flying insects may be to sense the horizon or Sun using the ocelli, a set of three light sensors distinct from the compound eyes.

Adaptive control of a millimeter-scale flapping-wing robot.

Challenges for the controlled flight of a robotic insect are due to the inherent instability of the system, complex fluid-structure interactions, and the general lack of a complete system model. In this paper, we propose theoretical models of the system based on the limited information available from previous work and a comprehensive flight controller. The modular flight controller is derived from Lyapunov function candidates with proven stability over a large region of attraction.

Medical imaging informatics simulators: a tutorial.

Purpose: A medical imaging informatics infrastructure (MIII) platform is an organized method of selecting tools and synthesizing data from HIS/RIS/PACS/ePR systems with the aim of developing an imaging-based diagnosis or treatment system. Evaluation and analysis of these systems can be made more efficient by designing and implementing imaging informatics simulators. This tutorial introduces the MIII platform and provides the definition of treatment/diagnosis systems, while primarily focusing on the development of the related simulators.

Controlled flight of a biologically inspired, insect-scale robot.

Flies are among the most agile flying creatures on Earth. To mimic this aerial prowess in a similarly sized robot requires tiny, high-efficiency mechanical components that pose miniaturization challenges governed by force-scaling laws, suggesting unconventional solutions for propulsion, actuation, and manufacturing. To this end, we developed high-power-density piezoelectric flight muscles and a manufacturing methodology capable of rapidly prototyping articulated, flexure-based sub-millimeter mechanisms.

Simulation studies of structure and edge tension of lipid bilayer edges: effects of tail structure and force-field.

Molecular dynamics simulations of lipid bilayer ribbons have been performed to investigate the structures and line tensions associated with free bilayer edges. Simulations carried out for dioleoyl phosphatidylcholine with three different force-field parameter sets yielded edge line tensions of 45 ± 2 pN, over 50% greater than the most recently reported experimentally determined value for this lipid. Edge tensions obtained from simulations of a series of phosphatidylcholine lipid bilayer ribbons with saturated acyl tails of length 12-16 carbons and with monounsaturated acyl tails of length 14-18 carbons could be correlated with the excess area associated with forming the edge, through a two-parameter fit.

Dynamics of the gel to fluid phase transformation in unilamellar DPPC vesicles.

The dynamics of the gel to fluid phase transformation in 100 nm large unilamellar vesicles (LUV) of 1,2-dipalmitoyl(d62)-sn-glycero-3-phosphocholine (d62-DPPC), has been studied by laser-induced temperature-jump initiation coupled with time-resolved infrared spectroscopy and by MD simulations. The infrared transients that characterize the temperature dependent phase transformation are complex, extending from the nanosecond to the millisecond time scales. An initial fast (submicrosecond) component can be modeled by partial melting of the gel domains, initiated at pre-existing defects at the edges of the faceted structure of the gel phase.