Identification of colorectal cancer using structured and free text clinical data.

Colorectal cancer incidence has continually fallen among those 50 years old and over. However, the incidence has increased in those under 50. Even with the recent screening guidelines recommending that screening begins at age 45, nearly half of all early-onset colorectal cancer will be missed.

Neighborhood poverty is associated with failure to be waitlisted and death during liver transplantation evaluation.

Liver transplantation (LT) is the final step in a complex care cascade. Little is known about how race, gender, rural versus urban residence, or neighborhood socioeconomic indicators impact a patient's likelihood of LT waitlisting or risk of death during LT evaluation. We performed a retrospective cohort study of adults referred for LT to the Indiana University Academic Medical Center from 2011 to 2018.

Overview of Indian and Nepali representatives of the (Uéno, 1928) complex (Ephemeroptera, Ephemerellidae), with discussion about Allen, 1971 species complexes.

The concept of the (Uéno, 1928) (Ephemeroptera: Ephemerellidae) complex is clarified and Indian and Nepali representatives of the complex are reviewed. Four new species are described viz. Martynov & Palatov, , Martynov, Selvakumar, Palatov & Vasanth, , Martynov & Palatov, and Selvakumar, Martynov & Subramanian, The larva of (Braasch, 1981) is re-described, based on the holotype and paratypes.

Ephemeroptera of Canada.

Thus far, 335 currently valid species in 82 genera and 21 families of mayflies (Ephemeroptera) have been documented from Canada, remarkably representing a little more than half of the combined species richness of Canada, Mexico and the USA. The current known species richness for Canada represents an increase of 11.3% as compared to that reported in 1979.

Vedolizumab for Ulcerative Colitis: Treatment Outcomes from the VICTORY Consortium.

Objectives: We aimed to quantify the safety and effectiveness of vedolizumab (VDZ) when used for UC, and to identify predictors of response to treatment.

Methods: Retrospective review (May 2014-December 2016) of VICTORY Consortium data. Adults with follow-up after starting VDZ for clinically active UC were included.

Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis.

Objectives: The impact of recurrent acute pancreatitis (RAP) on quality of life (QOL) is unknown. We hypothesized that RAP would reduce QOL even in the absence of chronic pancreatitis (CP).

Methods: Data were pooled from three prospective, cross-sectional studies conducted across 27 U.

Alcohol and fat promote steatohepatitis: a critical role for fat-specific protein 27/CIDEC.

Alcoholic liver disease (ALD) is a major public health problem worldwide and is the leading cause of end-stage liver disease. While the ultimate control of ALD will require the prevention of alcohol abuse, better understanding of the mechanisms of alcohol-induced liver injury may lead to treatments of fatty liver, alcoholic hepatitis, and prevention or delay of occurrence of cirrhosis. The elucidation and the discovery of several new concepts in ALD pathogenesis have raised our understanding on the complex mechanisms and the potential in developing the new strategies for therapeutic benefits.

GLP-1 Agonists in Type 1 Diabetes Mellitus.

Objective: To review the use of GLP-1 agonists in patients with type 1 diabetes mellitus (T1DM).

Data Sources: A search using the MEDLINE database, EMBASE, and Cochrane Database was performed through March 2016 using the search terms glucagon-like peptide 1 (GLP-1) agonists, incretin, liraglutide, exenatide, albiglutide, dulaglutide, type 1 diabetes mellitus

Study Selection And Data Extraction: All English-language trials that examined glycemic end points using GLP-1 agonists in humans with T1DM were included.

Data Synthesis: A total of 9 clinical trials examining the use of GLP-1 agonists in T1DM were identified.

Strategies for the Management of Postoperative Anemia in Elective Orthopedic Surgery.

Objective: To assess the use of oral iron, intravenous (IV) iron, and erythropoiesis-stimulating agents (ESAs) for the prevention and management of perioperative anemia in elective orthopedic surgery patients, and to provide a clinical algorithm for use.

Data Sources: A PubMed and MEDLINE search was conducted from 1964 through March 2016 using the following search terms alone or in combination: orthopedic, surgery, elective, anemia, blood transfusion, iron, erythropoiesis-stimulating agents, and erythropoietin.

Study Selection And Data Extraction: All English-language prospective and retrospective human studies and meta-analyses evaluating oral iron, IV iron, or ESA alone or in combination in elective orthopedic surgery patients were evaluated, provided they reported blood transfusion outcomes.

Optimizing Guideline-Recommended Antibiotic Doses for Pediatric Infective Endocarditis.

The American Heart Association recently published an updated scientific statement on the management of infective endocarditis in childhood. The recommendations included for vancomycin, aminoglycoside, and β-lactam dosing and monitoring are based primarily on expert opinion and do not consider available evidence for dose optimization based on pharmacokinetic and pharmacodynamic principles in pediatric patients. This is concerning because even when clinically necessary, some practitioners may be hesitant to deviate from guideline-recommended doses.

Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: a quasi-experimental study.

Objectives: To determine the impact of tethered personal health record (PHR) use on patient engagement and intermediate health outcomes among patients with coronary artery disease (CAD).

Methods: Adult CAD patients (N = 200) were enrolled in this prospective, quasi-experimental observational study. Each patient received a PHR account and training on its use.

A Clinically Relevant Method of Analyzing Continuous Change in Robotic Upper Extremity Chronic Stroke Rehabilitation.

Background: Robots designed for rehabilitation of the upper extremity after stroke facilitate high rates of repetition during practice of movements and record precise kinematic data, providing a method to investigate motor recovery profiles over time.

Objective: To determine how motor recovery profiles during robotic interventions provide insight into improving clinical gains.

Methods: A convenience sample (n = 22), from a larger randomized control trial, was taken of chronic stroke participants completing 12 sessions of arm therapy.

Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.

Objective: Clinicians at our institution typically respond to about half of the prompts they are given by the clinic's computer decision support system (CDSS). We sought to examine factors associated with clinician response to CDSS prompts as part of a larger, ongoing quality improvement effort to optimize CDSS use.

Methods: We examined patient, prompt, and clinician characteristics associated with clinician response to decision support prompts from the Child Health Improvement through Computer Automation (CHICA) system.

Mismatch repair proteins recruit DNA methyltransferase 1 to sites of oxidative DNA damage.

At sites of chronic inflammation, epithelial cells are exposed to high levels of reactive oxygen species and undergo cancer-associated DNA methylation changes, suggesting that inflammation may initiate epigenetic alterations. Previously, we demonstrated that oxidative damage causes epigenetic silencing proteins to become part of a large complex that is localized to GC-rich regions of the genome, including promoter CpG islands that are epigenetically silenced in cancer. However, whether these proteins were recruited directly to damaged DNA or during the DNA repair process was unknown.

Trends and Patterns in Age Discrimination in Employment Act (ADEA) Charges.

The Age Discrimination in Employment Act (ADEA) protects individuals aged 40 years and over from discrimination throughout the employment process. Using data on ADEA charges from the Equal Employment Opportunity Commission from 1993 to 2010, we present labor force-adjusted charge rates demonstrating that the highest charge rates are among those in the preretirement age range, and only the rate of charges among those aged 65 years and older has not decreased. We examine characteristics of ADEA charges including the prevalence of different alleged discriminatory actions (or issues) and highlight the increasing proportion of age discrimination charges that are jointly filed with other antidiscrimination statutes.

Late-Occurring Vancomycin-Associated Acute Kidney Injury in Children Receiving Prolonged Therapy.

Background: Acute kidney injury (AKI) in patients receiving vancomycin has been associated with trough concentrations ≥15 mg/L and longer therapy duration. The objective of this study was to determine the incidence and factors associated with late AKI in children receiving ≥8 days of vancomycin therapy.

Methods: Children aged 30 days to 17 years who were admitted to our institution and received intravenous vancomycin for at least 8 days during January to December of 2007 and 2010 and had a suspected or proven gram-positive infection were included.

Age Differences in the Association Between Body Mass Index Class and Annualized Medicare Expenditures.

Objective: The aim of the study is to assess the relationship between body mass index (BMI) class and Medicare claims among young-old (65-69), old (70-74), and old-old (75+) adults over a 10-year period.

Method: We assessed costs by BMI class and age group among 9,300 respondents to the 1998 Health and Retirement Study (HRS) with linked 1998-2008 Medicare claims data. BMI was classified as normal (18.

Beyond the dyad: an assessment of sexual assault prevention education focused on social determinants of sexual assault among college students.

Sexual assault is prevalent in the United States, particularly among college women. Prevention programs are implemented to combat assault, yet rates have not changed for five decades. A course designed to deconstruct contextualized factors contributing to assault was developed as an alternative prevention initiative.

"Respect the way I need to communicate with you": Healthcare experiences of adults on the autism spectrum.

Our objective was to obtain an in-depth understanding of autistic adults' experiences with healthcare and their recommendations for improving care. Our academic-community partnership used a community-based participatory research approach to conduct semi-structured, open-ended interviews with 39 autistic adults and 16 people who had experience supporting autistic adults in healthcare settings. Participants identified patient-level, autism-related factors that impact healthcare interactions, including verbal communication skills, sensory sensitivities, challenges with body awareness, slow processing speed, atypical non-verbal communication, and challenges with organization.

Design and Evaluation of an Electronic Override Mechanism for Medication Alerts to Facilitate Communication Between Prescribers and Pharmacists.

Background: Computerized medication alerts can often be bypassed by entering an override rationale, but prescribers' override reasons are frequently ambiguous to pharmacists who review orders.

Objective: To develop and evaluate a new override mechanism for adverse reaction and drug-drug interaction alerts. We hypothesized that the new mechanism would improve usability for prescribers and increase the clinical appropriateness of override reasons.

Update on Pharmacotherapy for Prevention and Treatment of Post-operative Delirium: A Systematic Evidence Review.

Delirium is highly prevalent among elderly post-operative patients with no pharmacological intervention approved by the Food and Drug Administration for prevention or treatment. We conducted a systematic evidence review to critically appraise literature related to the pharmacotherapy of post-operative delirium. Ten studies fulfilled our inclusion criteria with two interventions for delirium treatment and eight interventions for delirium prevention in post-operative patients.

Supporting interoperability of genetic data with LOINC.

Electronic reporting of genetic testing results is increasing, but they are often represented in diverse formats and naming conventions. Logical Observation Identifiers Names and Codes (LOINC) is a vocabulary standard that provides universal identifiers for laboratory tests and clinical observations. In genetics, LOINC provides codes to improve interoperability in the midst of reporting style transition, including codes for cytogenetic or mutation analysis tests, specific chromosomal alteration or mutation testing, and fully structured discrete genetic test reporting.

Implementing extended-infusion cefepime as standard of care in a children's hospital: a prospective descriptive study.

Background: Extended-infusion cefepime (EIC) has been associated with decreased mortality in adults, but to our knowledge, there are no studies in children.

Objective: The objective of this study was to determine the feasibility of implementing EIC as the standard dosing strategy in a pediatric population.

Methods: This was a descriptive study of children aged 1 month to 17 years, including patients in the intensive care unit, who received cefepime after admission to a freestanding, tertiary care children's hospital.

The relationship of weekend admission and mortality on the public medical wards at a Kenyan referral hospital.

Background: Research has demonstrated disparities in the outcomes of patients admitted to hospital on weekends in high-income countries. No published research has evaluated if any similar discrepancy exists in low-resource settings.

Methods: To determine if any difference in mortality exists between weekend and weekday admissions on the public medical wards at a Kenyan referral hospital, we performed a retrospective observational study of inpatients over a 3-month study period.

Network morphospace.

The structure of complex networks has attracted much attention in recent years. It has been noted that many real-world examples of networked systems share a set of common architectural features. This raises important questions about their origin, for example whether such network attributes reflect common design principles or constraints imposed by selectional forces that have shaped the evolution of network topology.