Impact of integrating genomic data into the electronic health record on genetics care delivery.

Purpose: Integrating genomic data into the electronic health record (EHR) is key for optimally delivering genomic medicine.

Methods: The PennChart Genomics Initiative (PGI) at the University of Pennsylvania is a multidisciplinary collaborative that has successfully linked orders and results from genetic testing laboratories with discrete genetic data in the EHR. We quantified the use of the genomic data within the EHR, performed a time study with genetic counselors, and conducted key informant interviews with PGI members to evaluate the effect of the PGI's efforts on genetics care delivery.

Chitin Prevalence and Function in Bacteria, Fungi and Protists.

Chitin is an important structural polysaccharide, which supports and organizes extracellular matrices in a variety of taxonomic groups including bacteria, fungi, protists, and animals. Additionally, chitin has been recognized as a molecule that is required for Rhizobia-legume symbiosis and involved in arbuscular mycorrhizal signaling in the symbiotic interaction between terrestrial plants and fungi. Moreover, it serves as a unique molecular pattern in the plant defense system against pathogenic fungi and parasites, and in the innate and adaptive immune response of mammals and humans.

Wireless EEG System Achieving High Throughput and Reduced Energy Consumption Through Lossless and Near-Lossless Compression.

This work presents a wireless multichannel electroencephalogram (EEG) recording system featuring lossless and near-lossless compression of the digitized EEG signal. Two novel, low-complexity, efficient compression algorithms were developed and tested in a low-power platform. The algorithms were tested on six public EEG databases comparing favorably with the best compression rates reported up to date in the literature.

Wearable EEG via lossless compression.

This work presents a wearable multi-channel EEG recording system featuring a lossless compression algorithm. The algorithm, based in a previously reported algorithm by the authors, exploits the existing temporal correlation between samples at different sampling times, and the spatial correlation between different electrodes across the scalp. The low-power platform is able to compress, by a factor between 2.

Two essential peritrophic matrix proteins mediate matrix barrier functions in the insect midgut.

The peritrophic matrix (PM) in the midgut of insects consists primarily of chitin and proteins and is thought to support digestion and provide protection from abrasive food particles and enteric pathogens. We examined the physiological roles of 11 putative peritrophic matrix protein (PMP) genes of the red flour beetle, Tribolium castaneum (TcPMPs). TcPMP genes are differentially expressed along the length of the midgut epithelium of feeding larvae.

Intermittent fetal bradycardia induced by midpregnancy fetal ultrasonographic study.

Fetal bradycardias were observed during fetal ultrasonographic and echocardiographic studies performed in the second trimester of pregnancy. The episodes of bradycardia were brief and recovery was usually rapid. Ultrasound transducer pressure applied to the maternal abdomen during the study provoked the phenomenon.

Asynchronous atrioventricular valve opening as it relates to right to left interatrial shunting in the normal newborn.

The opening of the tricuspid valve and the onset of right ventricular filling precede the opening of the mitral valve and the onset of flow in the normal adult. Sixty-five studies of atrioventricular flow with range-gated pulsed Doppler echocardiography, performed on 32 normal neonates, consistently demonstrated the reverse sequence. Further investigation showed that at the time of mitral valve opening, while the tricuspid valve was still closed, the valve of the foramen ovale began to bow posteriorly into the left atrium and remained posteriorly bowed for most of diastole.

Diagnosis of fetal arrhythmias using echocardiographic and Doppler techniques.

Fetal echocardiography is the most practical method for diagnosing prenatal arrhythmias. Because some prenatal tachyarrhythmias have been shown to respond to antiarrhythmic drugs, correctly diagnosing fetal arrhythmias has assumed new importance. With the aid of two-dimensional echocardiographic imaging, an M-mode cursor can be aligned to record atrial and ventricular wall motion--either independently or simultaneously.

Transplancental cardioversion of intrauterine supraventricular tachycardia with digitalis.

Intrauterine congestive heart-failure caused by a supraventricular tachyarrhythmia was diagnosed in a fetus at 29-30 weeks' gestation. Major congenital malformations were excluded by sonography, amniocentesis, and fetal abdominal paracentesis, and those of the heart by intrauterine fetal echocardiography. The mother was given digoxin and the fetal tachycardia converted to sinus rhythm.

Evaluating indirect blood pressure measurement techniques: a comparison of three systems in infants and children.

The systemic arterial blood pressures obtained in infants and children utilizing three indirect measuring devices--Arteriosonde 1010. Infrasonde 3000, Pedisphyg system--were compared to each other and to intra-arterial pressure measured directly. The results indicate that Arteriosonde performs considerably better than Infrasonde; nevertheless, the Arteriosonde values are often only approximations of true systole and diastole.

Sphygmomanometry in the pediatric patient.

The indirect measurement of blood pressure in the pediatric population is often difficult or impossible to perform and when values are obtained, they are often unreliable or inaccurate. An accurate measurement of arterial systolic pressure in the upper extremity is obtainable with a properly designed and sized occluding cuff and an ultrasonic device to detect the first Korotoff sound. For the detection of the first Korotkoff sound ultrasonic Doppler devices are superior to the stethoscope.

[Advances in sphygmomanometry (author's transl)].

Problems of the accuracy and reliability of Riva-Rocci's non-invasive method of measuring blood pressure always arise when the cuff does not fit well, i.e. with a very conical upper limb, adiposity or in neonates or patients in shock.

Left ventricle to aorta valved conduit for relief of diffuse left ventricular outflow tract obstruction.

Operative relief of congenital tunnel subaortic stenosis by means of local incision or excision, or both, has generally been unsatisfactory. The use of a valve-bearing conduit between the left ventricular apex and thoracic aorta offers a predictable means of bypassing the left ventricular outflow obstruction. The procedure was used in a 17 year old girl with an excellent hemodynamic result.

Late systolic murmur of rheumatic mitral insufficiency.

Of 184 patients with acute rheumatic fever and associated mitral insufficiency encountered during a 15 year period, 34 manifested a mid-late systolic murmur or a nonejection click, or both, during the course of follow-up. The mid-late systolic murmur later disappeared in four patients whose condition is now considered normal. In one of the four, systolic prolapse of the mitral valve was demonstrated on an angiocardiogram obtained when the systolic murmur was present.