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Outbreak Response and Incident Management: SHEA Guidance and Resources for Healthcare Epidemiologists in United States Acute-Care Hospitals.
Get PDFThis expert guidance document was developed as a resource to provide healthcare epidemiologists working in acute-care hospitals with a high-level overview of incident management for infectious diseases outbreaks and to prepare them to work within an emergency response framework. It addresses how the epidemiologist’s skills and expertise apply to scenarios that require enhanced preparedness and response efforts, eg, when pathogens associated with outbreaks are poorly characterized or when outbreaks require additional interventions including, but not limited to, healthcare personnel education, enhanced infection prevention and control measures, added staffing, supplies, and resources, adjustments to clinical and support activities, and external communications. Its recommendations are not pathogen-specific and are meant to apply to a range of potential infectious diseases outbreaks. To provide high-level guidance and context for incident management, the authors specify recommendations for the healthcare epidemiologist, as well as involvement and responsibilities of the facility and other healthcare personnel (HCP)
Use of steroids for early stage ARDS in ICU patients
No full text2017 ASHP Midyear Clinical Meeting / Orlando, FL / Poster #10-085
Poster Presentation
Compare outcomes in patients treated with high-dose and low-dose corticosteroids in the early stage of Acute Respiratory Distress Syndrome (ARDS)
Drug screening to target nuclear orphan receptor NR4A2 for cancer therapeutics.
No full textBackground: Our previous study suggested NR4A2, a subfamily member of orphan nuclear receptors, is essential for survival of human cancer cells such as mucoepidermoid carcinoma (MEC).
Methods: We conducted high throughput drug screening for NR4A2 inhibitors as a novel therapeutic modality. Positive screening was performed using a luciferase reporter vector containing NR4A2 binding sequence, and a CRE-reporter control vector was used to eliminate false positives. In vitro assays for positive hits were conducted.
Results: A total of 23 Food and Drug Administration (FDA) and 43 Life Science Library compounds were identified, including several epidermal growth factor inhibitors and Src inhibitors. Subsequent
Conclusions: Further research should focus on homologue selectivity
Primary lung mucoepidermoid carcinoma: analysis of prognostic factors using surveillance, epidemiology and end results program.
No full textINTRODUCTION: Mucoepidermoid carcinoma (MEC) primarily occurs in salivary glands, but can also arise in other organs; however, the impact of primary location on patient prognosis is largely unknown.
METHODS: Using Surveillance, Epidemiology and End Results Program (SEER) data we investigated whether the clinical and prognostic features of MEC differed among multiple organ sites. The SEER-18 dataset from 18 cancer registries in the US between 1972 and 2012 was chosen. The common organ sites with 100 or more cases were further analyzed. Survival analysis included Log-rank tests of Kaplan-Meier curves and univariate/multivariate proportional hazard analysis.
RESULTS: A total of 7,191 MEC cases with survival data were identified in the SEER data. Major salivary gland (MSG) was the primary site in 52.9% of cases, followed by gum and other mouth (23.6%), lung (5.9%), tongue (3.4%) and others. Compared to MSG-MEC, primary lung MEC had significantly more patients with age
CONCLUSIONS: This study suggests that there is a major difference in prognosis of MEC among primary sites. Primary lung MEC might have poor prognosis over MSG-MEC
Is time to thrombolytic therapy a predictor of mortality in patients with severe PE
No full textPoster Presentation
Venous thromboembolism (VTE) which comprises pulmonary embolism (PE) and deep vein thrombosis (DVT) has been a public health concern for several years. VTE accounts for an estimated 60,000 to 100,000 deaths per year in the United States. Specifically, patients who present with an acute PE, it has been estimated 25% of these patients have sudden death as the first symptom. Clinical presentation of an acute PE can manifest as nonspecific symptoms which may include: chest pain, cough, hemoptysis, dyspnea, tachypnea, shortness of breath, wheeze, and some patients may present in cardiopulmonary arrest. Severe acute PE can be classified as either massive or submassive PE. A patient with a massive PE would present with signs and symptoms of shock and persistent arterial hypotension. Patients with submassive PE present with hemodynamic stability but positive biomarkers (troponin and BNP) and right ventricular dysfunction. Patients who present with PE are at higher risk of death and adverse outcomes with increasing severity of illness and thrombolytic therapy is indicated in massive PE and may be frequently utilized in submassive PE. Prior studies have identified APACHE II score and need for mechanical ventilation as predictors of mortality in ICU patients, while thrombolytic therapy was identified as protective, however, the urgency of thrombolytic therapy administration has not been evaluated in severely ill patients. The purpose of this study is to evaluate if time to thrombolytic therapy can be used as a predictor of mortality in patients receiving intravenous thrombolysis for severe acute P
Defining Digital Self-Harm
No full textFull text granted access through link
CSCW \u2717: Proceedings of the 2017 ACM Conference on Computer Supported Cooperative Work and Social Computing
Self-harm is the infliction of pain or injury onto oneself. Though historically these behaviors were relegated to the fringes of communities, information technology now enables new ways to foster and encourage these dangerous activities. This paper defines the concept of digital self-harm as the online communication and activity that leads to, supports, or exacerbates, non-suicidal yet intentional harm or impairment of an individual\u27s physical wellbeing. We outline a research agenda for the CSCW community to understand the correlation and possible causation of offline self-harm behaviors due to online activities, and to design and assess technologies focused on prevention, mitigation and treatment.
CAUTION: This paper includes media that could potentially be triggering to those dealing with an eating disorder or with other self-harm related illnesses. Please use caution when reading or disseminating this paper
Comparing grounded theory and topic modeling: Extreme divergence or unlikely convergence
No full textResearchers in information science and related areas have developed various methods for analyzing textual data, such as survey responses. This article describes the application of analysis methods from two distinct fields, one method from interpretive social science and one method from statistical machine learning, to the same survey data. The results show that the two analyses produce some similar and some complementary insights about the phenomenon of interest, in this case, nonuse of social media. We compare both the processes of conducting these analyses and the results they produce to derive insights about each method\u27s unique advantages and drawbacks, as well as the broader roles that these methods play in the respective fields where they are often used. These insights allow us to make more informed decisions about the tradeoffs in choosing different methods for analyzing textual data. Furthermore, this comparison suggests ways that such methods might be combined in novel and compelling ways
Endoscopic Mucosal Resection of Granular Cell Tumors in the Esophagus: a Study of Four Cases and Brief Literature Review
No full text, GCTs are extremely rare lesions that can affect the esophagus. Although all of our cases presented with gastrointestinal symptoms, it is likely that GCTs are much more prevalent than what is documented in the literature, given their indolent nature. Tumors greater than 2 cm may require more extensive resection with endoscopic submucosal dissection (ESD) which may allow for en bloc resection of larger lesions. Because these lesions are usually confined to layers 1 through 3 (mucosa to submucosa), almost all should be amendable to advanced endoscopic resection techniques which reduce morbidity and cost for patients compared to conventional surgical options. Complications and R0 resection are operator dependent and complication rates are decreased in the setting of an experienced advanced interventional endoscopist. Our experience with EMR helps to prove that it is a safe and effective treatment option for GCTs. Although our follow-up is limited, we have not experienced any complications or recurrences. EMR is a low-risk, efficacious treatment that can be used to resect GCTs confined to the mucosal and submucosal layers
Perceptions of College Student-Athletes Regarding the Long-Term Effects of Concussions.
No full textA comprehensive review of the literature was completed to investigate college student-athletes\u27 perceptions regarding the long-term effects of concussions. Based on the findings, it was determined that there is a need for more education among student-athletes regarding this topic. This was a quantitative, cross-sectional, nonexperimental study with a descriptive design. A survey with 7 demographic and 17 Likert-type statements was collected from 100 student-athletes in a Midwestern college at their specified team practice sites for data collection