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Longitudinal stability in reading comprehension is largely heritable from grades 1 to 6.
Soden B, Christopher ME, Hulslander J, Olson RK, Cutting L, Keenan JM, Thompson LA, Wadsworth SJ, Willcutt EG, Petrill SA
(2015) PLoS One 10: e0113807
MeSH Terms: Child, Comprehension, Female, Genetic Association Studies, Humans, Longitudinal Studies, Male, Models, Theoretical, Ohio, Reading, Schools, Twins
Show Abstract · Added February 15, 2016
Reading comprehension is a foundational academic skill and significant attention has focused on reading development. This report is the first to examine the stability and change in genetic and environmental influences on reading comprehension across Grades 1 to 6. This developmental range is particularly important because it encompasses the timespan in which most children move from learning how to read to using reading for learning. Longitudinal simplex models were fitted separately for two independent twin samples (N = 706; N = 976). Results suggested that the shared environment contributed to variance in early but not later reading. Instead, stability in reading development was largely mediated by continuous genetic influences. Thus, although reading is clearly a learned skill and the environment remains important for reading development, individual differences in reading comprehension appear to be also influenced by a core of genetic stability that persists through the developmental course of reading.
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12 MeSH Terms
The impact of tumor deposits on colonic adenocarcinoma AJCC TNM staging and outcome.
Jin M, Roth R, Rock JB, Washington MK, Lehman A, Frankel WL
(2015) Am J Surg Pathol 39: 109-15
MeSH Terms: Adenocarcinoma, Adult, Aged, Aged, 80 and over, Colonic Neoplasms, Female, Humans, Kaplan-Meier Estimate, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Ohio, Predictive Value of Tests, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors
Show Abstract · Added April 12, 2016
The definition of tumor deposits (TDs) in colonic adenocarcinoma has been modified in different editions of the AJCC/TNM staging system. Studies have shown that the presence of TD is associated with advanced tumor growth and poor prognosis. Most of these data were obtained in patients with simultaneous lymph node (LN) metastases. Reports focusing on the impact of TD in patients without LN metastasis are limited. We retrospectively restaged all right-sided colonic adenocarcinomas over a 10-year period using criteria from the fifth, sixth, and seventh AJCC edition. We compared the number of tumor nodule interpreted as LN and TD in each edition and evaluated the stage migration caused by TD definition change. We then assessed clinical significance of TD in the AJCC seventh edition by comparing 5-year overall survival of N1c patients versus other N category (N0, N1, N2) patients with similar T and M status. We showed that the average number of tumor nodules interpreted as LNs per case and the number of cases with positive LNs were significantly decreased with the seventh edition compared with fifth/sixth; however, numbers of cases with TDs and <12 LNs were significantly increased with the seventh edition compared with fifth/sixth. These changes, however, resulted in minimal effects on the final stage grouping. Our survival analysis showed that N1c patients had significantly worse survival compared with N0 patients. Although not statistically significant, the hazard ratios indicated that the N1c group might have worse survival than the N1 group and better survival than the N2 group. Therefore, we conclude that TDs predict patient outcome at least similarly to positive LNs.
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19 MeSH Terms
Incidence of hypercoagulable events after image-guided percutaneous cryoablation of renal tumors: a single-center experience.
Hartman JB, Bhojwani N, Corn DJ, Cooney MM, Haaga J, Ponsky L, Abouassaly R, Paspulati A, Prologo JD
(2014) J Vasc Interv Radiol 25: 776-9
MeSH Terms: Adult, Aged, Aged, 80 and over, Causality, Comorbidity, Cryosurgery, Female, Humans, Incidence, Kidney Neoplasms, Male, Middle Aged, Nephrectomy, Ohio, Postoperative Complications, Retrospective Studies, Risk Factors, Surgery, Computer-Assisted, Thrombosis, Tomography, X-Ray Computed, Treatment Outcome
Show Abstract · Added January 1, 2016
PURPOSE - To identify retrospectively hypercoagulable events that occurred over time in patients who underwent image-guided percutaneous renal cryoablation and compare the incidence with a cohort of patients who underwent surgical partial nephrectomy (PN) during the same time period.
MATERIALS AND METHODS - An electronic medical record database was queried for patients who underwent percutaneous image-guided renal mass cryoablation or PN between September 2006 and June 2012. Records were examined for thrombotic events during the year following the procedure in each group. Incidence rates, Kaplan-Meier estimates, and patient demographic variables were compared using the stratified log-rank test and t test for independent samples.
RESULTS - The study comprised 114 cryoablation cases. The cumulative incidence of thrombotic events after 1 year was 4.39%. The incidence per 100 person-years was 4.84. There were 105 PN cases. The cumulative incidence of thrombotic events after 1 year was 1.0%. The incidence per 100 person-years was 1.14. The person-time incidence rate difference for these two groups did not reach statistical significance (P = .0894).
CONCLUSIONS - The incidence of thrombotic events in patients who underwent percutaneous renal cryoablation in this study was not significantly different than a comparable cohort who underwent surgical PN during the same time period.
Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.
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21 MeSH Terms
Rotavirus-associated hospitalization and emergency department costs and rotavirus vaccine program impact.
Kilgore A, Donauer S, Edwards KM, Weinberg GA, Payne DC, Szilagyi PG, Rice M, Cassedy A, Ortega-Sanchez IR, Parashar UD, Staat MA
(2013) Vaccine 31: 4164-71
MeSH Terms: Anti-Bacterial Agents, Child, Preschool, Costs and Cost Analysis, Emergency Service, Hospital, Female, Hospitalization, Humans, Immunization Programs, Infant, Length of Stay, Male, Ohio, Rotavirus Infections, Rotavirus Vaccines, Tennessee
Show Abstract · Added May 28, 2014
OBJECTIVES - To determine the medical costs of laboratory-confirmed rotavirus hospitalizations and emergency department (ED) visits and estimate the economic impact of the rotavirus vaccine program.
PATIENTS AND METHODS - During 4 rotavirus seasons (2006-2009), children <3 years of age hospitalized or seen in the ED with laboratory-confirmed rotavirus were identified through active population-based rotavirus surveillance in three US counties. Medical costs were obtained from hospital and physician billing data, and factors associated with increased costs were examined. Annual national costs were estimated using rotavirus hospitalization and ED visit rates and medical costs for rotavirus hospitalizations and ED visits from our surveillance program for pre- (2006-2007) and post-vaccine (2008-2009) time periods.
RESULTS - Pre-vaccine, for hospitalizations, the median medical cost per child was $3581, the rotavirus hospitalization rate was 22.1/10,000, with an estimated annual national cost of $91 million. Post-vaccine, the median medical cost was $4304, the hospitalization rate was 6.3/10,000 and the estimated annual national cost was $31 million. Increased costs were associated with study site, age <3 months, underlying medical conditions and an atypical acute gastroenteritis presentation. For ED visits, the pre-vaccine median medical cost per child was $574, the ED visit rate was 291/10,000 resulting in an estimated annual national cost of $192 million. Post-vaccine, the median medical cost was $794, the ED visit rate was 71/10,000 with an estimated annual national cost of $65 million.
CONCLUSIONS - After implementation of rotavirus immunization, the total annual medical costs decreased from $283 million to $96 million, an annual reduction of $187 million.
Copyright © 2013 Elsevier Ltd. All rights reserved.
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15 MeSH Terms
Parkinson disease loci in the mid-western Amish.
Davis MF, Cummings AC, D'Aoust LN, Jiang L, Velez Edwards DR, Laux R, Reinhart-Mercer L, Fuzzell D, Scott WK, Pericak-Vance MA, Lee SL, Haines JL
(2013) Hum Genet 132: 1213-21
MeSH Terms: Amish, Chromosomes, Human, Pair 10, Chromosomes, Human, Pair 5, Chromosomes, Human, Pair 6, Computational Biology, Genetic Linkage, Genetic Loci, Genetic Predisposition to Disease, Genome, Human, Genome-Wide Association Study, Genotype, Humans, Indiana, Ohio, Parkinson Disease, Pedigree, Polymorphism, Single Nucleotide
Show Abstract · Added February 22, 2016
Previous evidence has shown that Parkinson disease (PD) has a heritable component, but only a small proportion of the total genetic contribution to PD has been identified. Genetic heterogeneity complicates the verification of proposed PD genes and the identification of new PD susceptibility genes. Our approach to overcome the problem of heterogeneity is to study a population isolate, the mid-western Amish communities of Indiana and Ohio. We performed genome-wide association and linkage analyses on 798 individuals (31 with PD), who are part of a 4,998 member pedigree. Through these analyses, we identified a region on chromosome 5q31.3 that shows evidence of association (p value < 1 × 10(-4)) and linkage (multipoint HLOD = 3.77). We also found further evidence of linkage on chromosomes 6 and 10 (multipoint HLOD 4.02 and 4.35 respectively). These data suggest that locus heterogeneity, even within the Amish, may be more extensive than previously appreciated.
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17 MeSH Terms
Determining the effectiveness of the pentavalent rotavirus vaccine against rotavirus hospitalizations and emergency department visits using two study designs.
Donauer S, Payne DC, Edwards KM, Szilagyi PG, Hornung RW, Weinberg GA, Chappell J, Hall CB, Parashar UD, Staat MA
(2013) Vaccine 31: 2692-7
MeSH Terms: Case-Control Studies, Child, Child, Preschool, Cohort Studies, Emergency Service, Hospital, Female, Gastroenteritis, Hospitalization, Humans, Infant, Male, New York, Ohio, Proportional Hazards Models, Prospective Studies, Rotavirus, Rotavirus Infections, Rotavirus Vaccines, Tennessee, Vaccines, Attenuated
Show Abstract · Added May 28, 2014
The objective of this study is to determine the vaccine effectiveness (VE) of the pentavalent rotavirus vaccine (RV5) for preventing rotavirus-related hospitalizations and emergency department (ED) visits during the 2006-07 and 2007-08 rotavirus seasons using two study designs. Active, prospective population-based surveillance was conducted to identify cases of laboratory-confirmed rotavirus-related hospitalizations and ED visits to be used in case-cohort and case-control designs. VE was calculated using one comparison group for the case-cohort method and two comparison groups for the case-control method. The VE estimates produced by the three analyses were similar. Three doses of RV5 were effective for preventing rotavirus-related hospitalizations and ED visits in each analysis, with VE estimated as 92% in all three analyses. Two doses of RV5 were also effective, with VE ranging from 79% to 83%. A single dose was effective in the case-cohort analysis, but was not significant in either of the case-control analyses. The case-cohort and the case-control study designs produced the same VE point estimates for completion of the three dose series. Two and three doses of RV5 were effective in preventing rotavirus-related hospitalizations and ED visits.
Copyright © 2013 Elsevier Ltd. All rights reserved.
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20 MeSH Terms
The burden of influenza in young children, 2004-2009.
Poehling KA, Edwards KM, Griffin MR, Szilagyi PG, Staat MA, Iwane MK, Snively BM, Suerken CK, Hall CB, Weinberg GA, Chaves SS, Zhu Y, McNeal MM, Bridges CB
(2013) Pediatrics 131: 207-16
MeSH Terms: Child, Preschool, Cross-Sectional Studies, Emergency Service, Hospital, Female, Hospitalization, Humans, Immunization Programs, Infant, Influenza A Virus, H1N1 Subtype, Influenza Vaccines, Influenza, Human, Male, New York, Ohio, Outpatient Clinics, Hospital, Population Surveillance, Prospective Studies, Reverse Transcriptase Polymerase Chain Reaction, Seasons, Tennessee, Utilization Review
Show Abstract · Added December 10, 2013
OBJECTIVE - To characterize the health care burden of influenza from 2004 through 2009, years when influenza vaccine recommendations were expanded to all children aged ≥6 months.
METHODS - Population-based surveillance for laboratory-confirmed influenza was performed among children aged <5 years presenting with fever and/or acute respiratory illness to inpatient and outpatient settings during 5 influenza seasons in 3 US counties. Enrolled children had nasal/throat swabs tested for influenza by reverse transcriptase-polymerase chain reaction and their medical records reviewed. Rates of influenza hospitalizations per 1000 population and proportions of outpatients (emergency department and clinic) with influenza were computed.
RESULTS - The study population comprised 2970, 2698, and 2920 children from inpatient, emergency department, and clinic settings, respectively. The single-season influenza hospitalization rates were 0.4 to 1.0 per 1000 children aged <5 years and highest for infants <6 months. The proportion of outpatient children with influenza ranged from 10% to 25% annually. Among children hospitalized with influenza, 58% had physician-ordered influenza testing, 35% had discharge diagnoses of influenza, and 2% received antiviral medication. Among outpatients with influenza, 7% were tested for influenza, 7% were diagnosed with influenza, and <1% had antiviral treatment. Throughout the 5 study seasons, <45% of influenza-negative children ≥6 months were fully vaccinated against influenza.
CONCLUSIONS - Despite expanded vaccination recommendations, many children are insufficiently vaccinated, and substantial influenza burden remains. Antiviral use was low. Future studies need to evaluate trends in use of vaccine and antiviral agents and their impact on disease burden and identify strategies to prevent influenza in young infants.
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21 MeSH Terms
Pharmacokinetics and pharmacodynamics of piperacillin-tazobactam in 42 patients treated with concomitant CRRT.
Bauer SR, Salem C, Connor MJ, Groszek J, Taylor ME, Wei P, Tolwani AJ, Fissell WH
(2012) Clin J Am Soc Nephrol 7: 452-7
MeSH Terms: Academic Medical Centers, Acute Kidney Injury, Adult, Aged, Alabama, Anti-Bacterial Agents, Chromatography, High Pressure Liquid, Drug Monitoring, Female, Humans, Kidney Failure, Chronic, Linear Models, Male, Middle Aged, Multivariate Analysis, Ohio, Penicillanic Acid, Piperacillin, Piperacillin, Tazobactam Drug Combination, Prospective Studies, Renal Dialysis
Show Abstract · Added August 21, 2013
BACKGROUND AND OBJECTIVES - Current recommendations for piperacillin-tazobactam dosing in patients receiving continuous renal replacement therapy originate from studies with relatively few patients and lower continuous renal replacement therapy doses than commonly used today. This study measured the pharmacokinetic and pharmacodynamic characteristics of piperacillin-tazobactam in patients treated with continuous renal replacement therapy using contemporary equipment and prescriptions.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS - A multicenter prospective observational study in the intensive care units of two academic medical centers was performed, enrolling patients with AKI or ESRD receiving piperacillin-tazobactam while being treated with continuous renal replacement therapy. Pregnant women, children, and patients with end stage liver disease were excluded from enrollment. Plasma and continuous renal replacement therapy effluent samples were analyzed for piperacillin and tazobactam levels using HPLC. Pharmacokinetic and pharmacodynamic parameters were calculated using standard equations. Multivariate analyses were used to examine the association of patient and continuous renal replacement therapy characteristics with piperacillin pharmacokinetic parameters.
RESULTS - Forty-two of fifty-five subjects enrolled had complete sampling. Volume of distribution (median=0.38 L/kg, intraquartile range=0.20 L/kg) and elimination rate constants (median=0.104 h(-1), intraquartile range=0.052 h(-1)) were highly variable, and clinical parameters could explain only a small fraction of the large variability in pharmacokinetic parameters. Probability of target attainment for piperacillin was 83% for total drug but only 77% when the unbound fraction was considered.
CONCLUSIONS - There is significant patient to patient variability in pharmacokinetic/pharmacodynamic parameters in patients receiving continuous renal replacement therapy. Many patients did not achieve pharmacodynamic targets, suggesting that therapeutic drug monitoring might optimize therapy.
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21 MeSH Terms
Development and testing of the fibromyalgia diagnostic screen for primary care.
Arnold LM, Stanford SB, Welge JA, Crofford LJ
(2012) J Womens Health (Larchmt) 21: 231-9
MeSH Terms: Academic Medical Centers, Adult, Aged, Comorbidity, Delphi Technique, Female, Fibromyalgia, Humans, Logistic Models, Male, Middle Aged, Ohio, Physical Examination, Physicians, Primary Health Care, ROC Curve
Show Abstract · Added September 18, 2013
BACKGROUND - The Fibromyalgia Diagnostic Screen was developed for use by primary care clinicians to assist in the diagnostic evaluation of fibromyalgia, a disorder that predominantly affects women.
METHODS - The screen was designed to have a patient-completed questionnaire and a clinician-completed section, which included a brief physical examination pertinent to the differential diagnosis of fibromyalgia. The items in the questionnaire were based on patient focus groups and clinician and patient Delphi exercises, which resulted in a ranking of the most common and troublesome fibromyalgia symptoms. One hundred new chronic pain patients (pain > 30 days) and their primary care physicians completed the screen. The patients were grouped as fibromyalgia or nonfibromyalgia by an independent fibromyalgia specialist, who was blind to screen responses. Logistic regression was used to model the probability of fibromyalgia as a function of physician-reported and patient-reported variables. Best subset regression was used to identify a subset of symptoms that were summed to form a single measure. Receiver operating characteristic (ROC) analysis was then used to select thresholds for continuous variables. The symptom and clinical variables were combined to create candidate prediction rules that were compared in terms of sensitivity and specificity to select the best criterion.
RESULTS - Two final models were selected based on overall accuracy in predicting fibromyalgia: one used the patient-reported questionnaire only, and the other added a subset of the physical examination items to this patient questionnaire.
CONCLUSION - A patient-reported questionnaire with or without a brief physical examination may improve identification of fibromyalgia patients in primary care settings.
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16 MeSH Terms
Professional outcomes of completing a clinical nutrition fellowship: Cleveland Clinic's 16-year experience.
Rivera R, Kirby DF, Steiger E, Seidner DL
(2010) Nutr Clin Pract 25: 497-501
MeSH Terms: Academic Medical Centers, Ambulatory Care Facilities, Attitude of Health Personnel, Career Choice, Clinical Competence, Data Collection, Education, Medical, Continuing, Fellowships and Scholarships, Gastroenterology, Humans, Motivation, Nutritional Sciences, Ohio, Physicians, Professional Practice
Show Abstract · Added September 30, 2015
BACKGROUND - Cleveland Clinic has trained 17 physician nutrition specialists since the establishment of its clinical nutrition fellowship (CNF) in 1994. The paths taken by the graduates and whether they continue to practice clinical nutrition are largely unknown.
METHODS - To investigate the professional outcomes of completing a CNF, a survey of graduates was conducted.
RESULTS - Fifty-seven percent of respondents (n = 8) applied to another fellowship prior to applying to a CNF. The 2 most common reasons for applying to a CNF were to increase knowledge of clinical nutrition and increase the chance of acquiring a gastroenterology fellowship. Eighty-five percent (n = 10) of graduates found the CNF to be valuable. Eighty-six percent (n = 12) went on to complete a gastroenterology fellowship, and 67% (n = 8) of graduates believed that completing a CNF increased their chances of gaining acceptance to a gastroenterology fellowship. Only 42% (n = 6) of the graduates currently hold professions that specifically dictate the use of clinical nutrition, but 61% (n = 8) reported using clinical nutrition in their daily or weekly practice. Fifty percent (n = 7) of graduates believed that completing a CNF made them more competitive job candidates, but only 21% (n = 3) said that their extra training is reflected in their current salary.
CONCLUSIONS - It appears that CNFs are being used as a method of subsequently acquiring a gastroenterology or other medical fellowships. Although not working in defined clinical nutrition professions, >50% of graduates continue to apply their CNF skills after completing their training. A small percentage have found dedicated nutrition-based clinical professions.
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15 MeSH Terms