Science.gov

Sample records for mayo clinic rochester

  1. Mayo Clinic: An Institutional History of General Thoracic Surgery.

    PubMed

    Gillaspie, Erin A; Nichols, Francis C; Allen, Mark S

    2015-01-01

    The Mayo Clinic was started in Rochester, MN after a 1883 tornado disaster. The Mayo brothers, William and Charles began thoracic surgical procedures early in their career. Dr. Samuel Robinson is recognized as the first thoracic surgeon at Mayo. He was followed by Drs. Harrington and Claret who became famous surgeons. Many other notable surgeons have help to build the thoracic surgical practice into what is today a world renown center of excellence in thoracic surgery. PMID:26811041

  2. A brief history of audiology at Mayo Clinic.

    PubMed

    Olsen, Wayne O; Rose, Darrell E; Hedgecock, Leroy D

    2003-01-01

    Audiometric hearing tests were conducted at the Mayo Clinic in Rochester at the beginning of the 1930s. The list price for one of its audiometers at that time was 3,500 dollars, which translates into approximately 37,000 dollars in 2003 currency. Physicians and residents in training were responsible for conducting hearing tests in the 1930s and 1940s. In the early 1940s a registered nurse was trained as an audiometrist to assist for some of the audiometric testing. The first "consulting audiologist" at the Mayo Clinic in Rochester was hired in 1949, early in the development of audiology as a profession. Growth in demand for audiologic services for larger numbers of patients and in the variety of services provided to them led to marked increases in personnel, space, and specialization over the years. PMID:12940701

  3. Mayo Clinic Zebrafish Facility Overview.

    PubMed

    Leveque, Ryan E; Clark, Karl J; Ekker, Stephen C

    2016-07-01

    The zebrafish (Danio rerio) is a premier nonmammalian vertebrate model organism. This small aquatic fish is utilized in multiple disciplines in the Mayo Clinic community and by many laboratories around the world because of its biological similarity to humans, its advanced molecular genetics, the elucidation of its genome sequence, and the ever-expanding and outstanding new biological tools now available to the zebrafish researcher. The Mayo Clinic Zebrafish Facility (MCZF) houses ∼2,000 tanks annotated using an in-house, Internet cloud-based bar-coding system tied to our established zfishbook.org web infrastructure. Paramecia are the primary food source for larval fish rearing, using a simplified culture protocol described herein. The MCZF supports the specific ongoing research in a variety of laboratories, while also serving as a local hub for new scientists as they learn to tap into the potential of this model system for understanding normal development, disease, and as models of health. PMID:27023741

  4. International market research at the Mayo Clinic.

    PubMed

    Hathaway, M; Seltman, K

    2001-01-01

    Mayo Clinic has a long international history and has been providing care to international patients since its inception. Despite its history and reputation, however, the marketing staff continues to monitor the international market to gauge the level of awareness, reputation, and attractiveness of Mayo Clinic around the world. Here's a look at how one institution has used word-of-mouth marketing to maintain its global reputation. PMID:11763648

  5. Research Guides Mayo Clinic's Recruitment, Retention Efforts.

    ERIC Educational Resources Information Center

    Nayar, Veena R.; Morrey, Michael A.; Schneider, Kenneth J.; Purrington, Anne W.; Wilshusen, Laurie L.; Mullen, Michael P.; Seltman, Kent D.

    2001-01-01

    Discusses a collaborative study between Mayo Clinic's departments of human resources and marketing to identify the factors that influence candidates' decisions to accept or decline job offers and the reasons behind staff resignations. Study aimed to increase the effectiveness of employee recruitment advertising, streamline its interviewing…

  6. Liver Transplantation at Mayo Clinic Florida.

    PubMed

    Lee, David D; Croome, Kristopher P; Perry, Dana K; Burns, Justin M; Nguyen, Justin H; Keaveny, Andrew P; Taner, C Burcin

    2014-01-01

    Over the sixteen year history of liver transplantation (LT) at Mayo Clinic in Jacksonville, Florida (MCF), we have maintained a practice devoted to excellence in pre- and post-LT management for patients suffering from end stage liver disease. With an emphasis on quality, MCF has made several adjustments with the goal of better utilizing marginal grafts for both successful post-transplant outcomes and minimizing waitlist mortality. This systematic approach is most exemplified in our experience with donation after cardiac death (DCD) liver allografts. Understanding the events during procurement has been critical to reducing the complications associated with donor warm ischemia time that are unique to DCD allografts. Better matching of donors to recipients has helped identify patients who are safe to receive more marginal grafts with successful patient and graft survival. Recognizing the spectrum of degree of sickness in patients undergoing LT, we implemented a multidisciplinary approach that allows for the avoidance of the intensive care unit after LT. In these ways, MCF continues to distinguish itself as an innovator in the field of transplantation for the benefit of continued better care for our patients suffering from end stage liver disease. PMID:26281131

  7. The Visiting Medical Student Clerkship Program at Mayo Clinic

    PubMed Central

    Mueller, Paul S.; McConahey, Linda L.; Orvidas, Laura J.; Jenkins, Sarah M.; Kasten, Mary J.

    2010-01-01

    OBJECTIVE: To describe the history, objectives, statistics, and initiatives used to address challenges associated with the Mayo Clinic Visiting Medical Student (VMS) Clerkship Program. MATERIALS AND METHODS: Mayo Clinic administrative records were reviewed for calendar years 1995 through 2008 to determine the effect of interventions to increase the numbers of appropriately qualified international VMSs and underrepresented minority VMSs. For numerical data, descriptive statistics were used; for comparisons, χ2 tests were performed. RESULTS: During the specified period, 4908 VMSs participated in the Mayo VMS Program (yearly mean [SD], 351 [24]). Most students were from US medical schools (3247 [66%]) and were male (3084 [63%]). Overall, 3101 VMSs (63%) applied for and 935 (30%) were appointed to Mayo Clinic residency program positions. Interventions to address the challenge of large numbers of international students who participated in our VMS program but did not apply for Mayo residency positions resulted in significantly fewer international students participating in our VMS program (P<.001), applying for Mayo residency program positions (P<.001), and being appointed to residency positions (P=.001). Interventions to address the challenge of low numbers of underrepresented minority students resulted in significantly more of these students participating in our VMS program (P=.005), applying for Mayo residency positions (P=.008), and being appointed to residency positions (P=.04). CONCLUSION: Our findings suggest that specific interventions can affect the characteristics of students who participate in VMS programs and who apply for and are appointed to residency program positions. PMID:20675510

  8. Minimally invasive thymectomy: the Mayo Clinic experience

    PubMed Central

    Rowse, Phillip G.; Roden, Anja C.; Corl, Frank M.; Allen, Mark S.; Cassivi, Stephen D.; Nichols, Francis C.; Shen, K. Robert; Wigle, Dennis A.

    2015-01-01

    Background The prevalence of minimally invasive thymectomy (MIT) is increasing and may have significant benefit to patients in terms of morbidity and post-operative recovery. Our aim was to review the Mayo Clinic experience of MIT. Methods We reviewed data from all MIT cases collected in a prospectively maintained database from January 1995 to February 2015. Data were collected regarding patient demographics, perioperative management and patient outcomes. Results A total of 510 thymectomies were performed in 20 years. Fifty-six patients underwent MIT (45 video-assisted thoracoscopy, 11 robotic-assisted). The median age was 55 years (range, 23-87 years) with male to female ratio of 25:31. Thymoma was the main pathologic diagnosis in 27/56 patients (48%), with 11/27 (41%) associated with myasthenia gravis (MG), and 16/27 (59%) non-MG. Other pathologies included 1/56 (2%) of each teratoma, lymphoma, lymphangioma, carcinoma and thymolipoma. There were 3/56 (5%) atrophic glands, 4/56 (7%) cysts, 6/56 (11%) benign glands and 11/56 (20%) hyperplastic. Mean blood loss (mL) and operative time (min) were significantly lower in the video-assisted thoracoscopic surgery (VATS) group compared to robotic (65±41 vs. 160±205 mL, P=0.04 and 102±39 vs. 178±53 min, P=0.001, respectively). There was no 30-day mortality. Post-operative morbidity occurred in 7/45 (16%) VATS patients (phrenic nerve palsy 7%, pericarditis 4%, atrial fibrillation 2%, pleural effusion 2%) and 1/11 (9%) robotic (urinary retention requiring self-catheterization). Reoperation was required in 1/3 of VATS patients with phrenic nerve palsy. There was no significant difference in length of hospital stay [VATS 1.5 days (range, 1-4 days) and robotic 2 days (range, 1-5 days) VATS; P=0.05]. Mean follow-up was 18.4 months (range, 1-50.4 months) with no tumor recurrences. Conclusions MIT can be performed with low morbidity and mortality. VATS is associated with reduced blood loss, operative times and earlier hospital

  9. Strategic performance management: development of a performance measurement system at the Mayo Clinic.

    PubMed

    Curtright, J W; Stolp-Smith, S C; Edell, E S

    2000-01-01

    Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis. PMID:11066953

  10. Twenty years of human immunodeficiency virus care at the Mayo Clinic: Past, present and future.

    PubMed

    Cummins, Nathan W; Badley, Andrew D; Kasten, Mary J; Sampath, Rahul; Temesgen, Zelalem; Whitaker, Jennifer A; Wilson, John W; Yao, Joseph D; Zeuli, John; Rizza, Stacey A

    2016-05-12

    The Mayo human immunodeficiency virus (HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a "Mayo Model" of HIV care that exceeds national outcomes and may be applicable in other settings. PMID:27175350

  11. The Mayo Clinic Author Catalog: A Living Repository of Medical Knowledge

    PubMed Central

    Key, Jack D.; Sholtz, Katherine J.

    1973-01-01

    Since 1907 records have been kept of publications by staff members of the Mayo Clinic, and this information has been invaluable. The Author Catalog has proved itself such a useful tool for the Mayo Clinic that other libraries, large and small, may wish to consider adopting such a service. The Mayo medical complex is a large institution with more than 500 staff and faculty members engaged in the publication of clinical, educational, and research findings. The great amount of cross-disciplinary cooperation and interdepartmental research makes essential an up-to-date record of what is going on. The Mayo Clinic Library developed a comprehensive computerized method for identifying research and for identifying and indexing publications of Mayo staff members. At the end of 1971 more than 25,000 citations had been stored on computer tape. Images PMID:4122094

  12. Review of Adjuvant Radiochemotherapy for Resected Pancreatic Cancer and Results From Mayo Clinic for the 5th JUCTS Symposium

    SciTech Connect

    Miller, Robert C. Iott, Matthew J.; Corsini, Michele M.

    2009-10-01

    Purpose: To present an overview of Phase III trials in adjuvant therapy for pancreatic cancer and review outcomes at the Mayo Clinic after adjuvant radiochemotherapy (RT/CT) for resected pancreatic cancer. Methods and Materials: A literature review and a retrospective review of 472 patients who underwent an R0 resection for T1-3N0-1M0 invasive carcinoma of the pancreas from 1975 to 2005 at the Mayo Clinic, Rochester, MN. Patients with metastatic or unresectable disease at the time of surgery, positive surgical margins, or indolent tumors and those treated with intraoperative radiotherapy were excluded from the analysis. Median radiotherapy dose was 50.4Gy in 28 fractions, with 98% of patients receiving concurrent 5-fluorouracil- based chemotherapy. Results: Median follow-up was 2.7 years. Median overall survival (OS) was 1.8 years. Median OS after adjuvant RT/CT was 2.1 vs. 1.6 years for surgery alone (p = 0.001). The 2-y OS was 50% vs. 39%, and 5-y was 28% vs. 17% for patients receiving RT/CT vs. surgery alone. Univariate and multivariate analysis revealed that adverse prognostic factors were positive lymph nodes (risk ratio [RR] 1.3, p < 0.001) and high histologic grade (RR 1.2, p < 0.001). T3 tumor status was found significant on univariate analysis only (RR 1.1, p = 0.07). Conclusions: Results from recent clinical trials support the use of adjuvant chemotherapy in resected pancreatic cancer. The role of radiochemotherapy in adjuvant treatment of pancreatic cancer remains a topic of debate. Results from the Mayo Clinic suggest improved outcomes after the administration of adjuvant radiochemotherapy after a complete resection of invasive pancreatic malignancies.

  13. Twenty years of human immunodeficiency virus care at the Mayo Clinic: Past, present and future

    PubMed Central

    Cummins, Nathan W; Badley, Andrew D; Kasten, Mary J; Sampath, Rahul; Temesgen, Zelalem; Whitaker, Jennifer A; Wilson, John W; Yao, Joseph D; Zeuli, John; Rizza, Stacey A

    2016-01-01

    The Mayo human immunodeficiency virus (HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a “Mayo Model” of HIV care that exceeds national outcomes and may be applicable in other settings. PMID:27175350

  14. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    PubMed Central

    Joglekar, Siddharth B.; Rose, Peter S.; Sim, Franklin; Okuno, Scott; Petersen, Ivy

    2011-01-01

    Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation. PMID:24212949

  15. Postradiation sarcoma of bone: review of 78 Mayo Clinic cases

    SciTech Connect

    Weatherby, R.P.; Dahlin, D.C.; Ivins, J.C.

    1981-05-01

    Postradiation sarcoma of bone is an uncommon but serious sequela of radiation therapy. Seventy-eight Mayo Clinic patients have been treated for sarcomas arising in irradiated bones. They received their initial radiotherapy for a wide variety of nonneoplastic and neoplastic conditions, both benign and malignant. Thirty-five sarcomas arose in bone that was normal at the time of radiotherapy, and 43 arose in irradiated preexisting osseous lesions. The latent period between radiotherapy and diagnosis of sarcoma averaged 14.3 years. Ninety percent of the postradiation sarcomas were either osteosarcomas or fibrosarcomas; chondrosarcoma, malignant (fibrous) histiocytoma, malignant lymphoma, Ewing's tumor, and metastasizing chondroblastoma also occurred. Prompt radical surgery, when feasible, is usually the treatment of choice for the sarcoma. About 30% of patients with sarcomas of the extremities or craniofacial bones survived 5 years without recurrence; there were no disease-free survivors among patients with tumors of the vertebral column, pelvis, or shoulder girdle. The low risk of sarcoma following radiotherapy for the treatment of cancer should not be a contraindication to its use in these patients; however, radiation therapy for benign bone tumors should be reserved for lesions that are not amenable to surgical treatment. An unusual case is also reported herein in which a fibrosarcoma was discovered in the humerus of a patient who had received radiotherapy 55 years previously for a verified osteosarcoma in the same site.

  16. One Thousand Patients With Primary Myelofibrosis: The Mayo Clinic Experience

    PubMed Central

    Tefferi, Ayalew; Lasho, Terra L.; Jimma, Thitina; Finke, Christy M.; Gangat, Naseema; Vaidya, Rakhee; Begna, Kebede H.; Al-Kali, Aref; Ketterling, Rhett P.; Hanson, Curtis A.; Pardanani, Animesh

    2012-01-01

    Objective To share our decades of experience with primary myelofibrosis and underscore the importance of outcomes research studies in designing clinical trials and interpreting their results. Patients and Methods One thousand consecutive patients with primary myelofibrosis seen at Mayo Clinic between November 4, 1977, and September 1, 2011, were considered. The International Prognostic Scoring System (IPSS), dynamic IPSS (DIPSS), and DIPSS-plus were applied for risk stratification. Separate analyses were included for patients seen at time of referral (N=1000), at initial diagnosis (N=340), and within or after 1 year of diagnosis (N=660). Results To date, 592 deaths and 68 leukemic transformations have been documented. Parameters at initial diagnosis vs time of referral included median age (66 vs 65 years), male sex (61% vs 62%), red cell transfusion need (24% vs 38%), hemoglobin level less than 10 g/dL (38% vs 54%), platelet count less than 100 × 109/L (18% vs 26%), leukocyte count more than 25 × 109/L (13% vs 16%), marked splenomegaly (21% vs 31%), constitutional symptoms (29% vs 34%), and abnormal karyotype (31% vs 41%). Mutational frequencies were 61% for JAK2V617F, 8% for MPLW515, and 4% for IDH1/2. DIPSS-plus risk distributions at time of referral were 10% low, 15% intermediate-1, 37% intermediate-2, and 37% high. The corresponding median survivals were 17.5, 7.8, 3.6, and 1.8 years vs 20.0, 14.3, 5.3, and 1.7 years for patients younger than 60 years of age. Compared with both DIPSS and IPSS, DIPSS-plus showed better discrimination among risk groups. Five-year leukemic transformation rates were 6% and 21% in low- and high-risk patients, respectively. Conclusion The current document should serve as a valuable resource for patients and physicians and provides context for the design and interpretation of clinical trials. PMID:22212965

  17. Catheter-based intervention for pulmonary vein stenosis due to fibrosing mediastinitis: The Mayo Clinic experience

    PubMed Central

    Ponamgi, Shiva P.; DeSimone, Christopher V.; Lenz, Charles J.; Coylewright, Megan; Asirvatham, Samuel J.; Holmes, David R.; Packer, Douglas L.

    2016-01-01

    Introduction Fibrosing mediastinitis (FM) is a rare but fatal disease characterized by an excessive fibrotic reaction in the mediastinum, which can lead to life-threatening stenosis of the pulmonary veins (PV). Catheter-based intervention is currently the only viable option for therapy. However, the current literature on how best to manage these difficult cases, especially in regards to sequential interventions and their potential complications is very limited. Methods We searched through a database of all patients who have undergone PV interventions at the Earl H. Wood Cardiac Catheterization Laboratory in Mayo Clinic, Rochester. From this collection, we selected patients that underwent PV intervention to relieve stenosis secondary to FM. Results Eight patients were identified, with a mean age of 41 years (24–59 years). Five were men, and three were women. Three patients underwent balloon angioplasty alone, and five patients had stents placed. The majority of patients had acute hemodynamic and symptomatic improvement. More than one intervention was required in five patients, four patients had at least one episode of restenosis, and four patients died within four weeks of their first PV intervention. Conclusions We describe the largest reported case series of catheter-based intervention for PV stenosis in FM. Although catheter-based therapy improved hemodynamics, short-term vascular patency, and patient symptoms, the rate of life-threatening complications, restenosis, and mortality associated with these interventions was found to be high. Despite these associated risks, catheter-based intervention is the only palliative option available to improve quality of life in severely symptomatic patients with PV stenosis and FM. Patients with PV stenosis and FM (especially those with bilateral disease) have an overall poor prognosis in spite of undergoing these interventions due to the progressive and recalcitrant nature of the disease. This underscores the need for

  18. Autoimmune Hemolytic Anemia in Children: Mayo Clinic Experience.

    PubMed

    Sankaran, Janani; Rodriguez, Vilmarie; Jacob, Eapen K; Kreuter, Justin D; Go, Ronald S

    2016-04-01

    We studied 35 pediatric patients with autoimmune hemolytic anemia seen at Mayo Clinic from 1994 to 2014. The median age was 10.0 years and 65.7% were males. Most had warm antibodies (80.0%) and some secondary to viral (14.3%) or autoimmune disorders (31.4%). Seven (20.0%) patients presented with Evans syndrome, 3 of whom also had common variable immunodeficiency. The median hemoglobin at diagnosis was 6.1 g/dL and 62.8% patients required red cell transfusions. The severity of anemia was worse among children below 10 years (median 5.5 vs. 7.0 g/dL, P=0.01). Steroid was the initial treatment for 88.5% patients, with overall response rate of 82.7% (68.5% complete, 14.2% partial) and median response duration of 10.7 months (range, 0.2 to 129.7+ mo). After median follow-up of 26.6 months, 8 (22.8%) patients relapsed. Salvage treatments included splenectomy, intravenous immunoglobulin, rituximab, and mycophenolate mofetil. Infectious complications occurred in 9 (25.7%) patients and 1 patient died of cytomegalovirus infection. Four patients had cold agglutinin disease and 3 (75.0%) responded to steroids. Autoimmune hemolytic anemia is a rare disorder in pediatric population and most respond well to steroids regardless of the type of antibody. Infectious complications are common and screening for immunodeficiency is recommended among those with Evans syndrome. PMID:26925716

  19. Performance and function of a high-speed multiple star topology image management system at Mayo Clinic Scottsdale.

    PubMed

    Pavlicek, W; Zavalkovskiy, B; Eversman, W G

    1999-05-01

    Mayo Clinic Scottsdale (MCS) is a busy outpatient facility (150,000 examinations per year) connected via asynchronous transfer mode (ATM; OC-3 155 MB/s) to a new Mayo Clinic Hospital (178 beds) located more than 12 miles distant. A primary care facility staffed by radiology lies roughly halfway between the hospital and clinic connected to both. Installed at each of the three locations is a high-speed star topology image network providing direct fiber connection (160 MB/s) from the local image storage unit (ISU) to the local radiology and clinical workstations. The clinic has 22 workstations in its star, the hospital has 13, and the primary care practice has two. In response to Mayo's request for a seamless service among the three locations, the vendor (GE Medical Systems, Milwaukee, WI) provided enhanced connectivity capability in a two-step process. First, a transfer gateway (TGW) was installed, tested, and implemented to provide the needed communication of the examinations generated at the three sites. Any examinations generated at either the hospital or the primary care facility (specified as the remote stars) automatically transfer their images to the ISU at the clinic. Permanent storage (Kodak optical jukebox, Rochester, NY) is only connected to the hub (Clinic) star. Thus, the hub ISU is provided with a copy of all examinations, while the two remote ISUs maintain local exams. Prefetching from the archive is intelligently accomplished during the off hours only to the hub star, thus providing the remote stars with network dependent access to comparison images. Image transfer is possible via remote log-on. The second step was the installation of an image transfer server (ITS) to replace the slower Digital Imaging and Communications in Medicine (DICOM)-based TGW, and a central higher performance database to replace the multiple database environment. This topology provides an enterprise view of the images at the three locations, while maintaining the high

  20. The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data.

    PubMed

    Chute, Christopher G; Beck, Scott A; Fisk, Thomas B; Mohr, David N

    2010-01-01

    Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions. PMID:20190054

  1. The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data

    PubMed Central

    Beck, Scott A; Fisk, Thomas B; Mohr, David N

    2010-01-01

    Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions. PMID:20190054

  2. The origins of the modern pain clinic at the Mayo Clinic.

    PubMed

    Weingarten, Toby N; Martin, David P; Bacon, Douglas R

    2011-07-01

    In the 1970s the practice of pain management evolved from the isolated anesthesiologist practicing pain "on the side" to a multi-disciplinary model. The impetus behind this change remains obscure. To understand how this national trend occurred locally and to examine national institutional challenges which should be reflected at the Mayo Clinic that stimulated the establishment of a modern academic pain practice, we interviewed appropriate staff members and reviewed relevant departmental meeting notes. Following the 1959 departure of Dr. John Lundy from Mayo, Dr. Robert Jones became the primary practitioner of pain procedures in addition to his anesthesiology practice. In 1973, close to his retirement, Jones wrote a letter to the department chairman, Dr. Richard Theye, expressing frustration because this divided practice hindered patient care, education, and research opportunities. In 1974 Dr. Lee Nauss joined Mayo upon residency completion at Virginia Mason where he received training in regional anesthesia and met Dr. John Bonica. Nauss introduced epidural steroid injections, which became in such great demand that other anesthesiologists needed to cover his rooms. Within two months, Theye asked Nauss to create a stand-alone pain clinic. Nauss recruited Dr. Tony Wang and opened the clinic that year. This pain clinic increased patient access, improved resident education, allowed for the establishment of a fellowship program, and produced ground-breaking research (e.g., the human administration of intrathecal morphine). The establishment of the pain clinic addressed the deficiencies of a mixed pain and anesthesia practice. The pain specialist could now focus attention on and provide better access for pain patients, keep current with clinical practice, engage in research, and educate future pain specialists. PMID:22849210

  3. Long term outcomes of cardiac transplant for immunoglobulin light chain amyloidosis: The Mayo Clinic experience

    PubMed Central

    Grogan, Martha; Gertz, Morie; McCurdy, Arleigh; Roeker, Lindsey; Kyle, Robert; Kushwaha, Sudhir; Daly, Richard; Dearani, Joseph; Rodeheffer, Richard; Frantz, Robert; Lacy, Martha; Hayman, Suzanne; McGregor, Christopher; Edwards, Brooks; Dispenzieri, Angela

    2016-01-01

    AIM: To determine the outcome of orthotopic heart transplantation (OHT) in immunoglobulin light chain (AL) amyloidosis. METHODS: The medical records of patients with AL who underwent orthotopic heart transplantation at the Mayo Clinic in Rochester Minnesota from 1992 to 2011 were reviewed. Patients met at least one of the following at: New York Heart Association class IV heart failure, ventricular thickness > 15 mm, ejection fraction < 40%. Selection guidelines for heart transplant included age < 60 years, absence of multiple myeloma and significant extra-cardiac organ involvement. Baseline characteristics including age, gender, organ involvement, and New York Heart Association functional class were recorded. Laboratory data, waiting time until heart transplant, and type of treatment of the underlying plasma cell disorder were recorded. Survival from the time of OHT was calculated using Kaplan-Meier survival curves. Survival of patients undergoing OHT for AL was compared to that of non-amyloid patients undergoing OHT during the same time period. RESULTS: Twenty-three patients (median age 53 years) with AL received OHT. There were no deaths in the immediate perioperative period. Twenty patients have died post OHT. For the entire cohort, the median overall survival was 3.5 years (95%CI: 1.2, 8.2 years). The 1-year survival post OHT was 77%, the 2-year survival 65%, and the 5-year survival 43%. The 5-year survival for non-amyloid patients undergoing OHT during the same era was 85%. Progressive amyloidosis contributed to death in twelve patients. Of those without evidence of progressive amyloidosis, the cause of death included complications of autologous hematopoietic stem cell transplantation for 3 patients, post-transplant lymphoproliferative disorder for 2 patients; and for the remaining one death was related to each of the following causes: acute rejection; cardiac vasculopathy; metastatic melanoma; myelodysplastic syndrome; and unknown. Eight patients had

  4. Detailed description of the Mayo/IBM PACS

    NASA Astrophysics Data System (ADS)

    Gehring, Dale G.; Persons, Kenneth R.; Rothman, Melvyn L.; Salutz, James R.; Morin, Richard L.

    1991-07-01

    The Mayo Clinic and IBM/Rochester have jointly developed a picture archiving system (PACS) for use with Mayo's MRI and Neuro-CT imaging modalities. The system was developed to replace the imaging system's vendor-supplied magnetic tape archiving capability. The system consists of seven MR imagers and nine CT scanners, each interfaced to the PACS via IBM Personal System/2(tm) (PS/2) computers, which act as gateways from the imaging modality to the PACS network. The PAC system operates on the token-ring component of Mayo's city-wide local area network. Also on the PACS network are four optical storage subsystems used for image archival, three optical subsystems used for image retrieval, an IBM Application System/400(tm) (AS/400) computer used for database management and multiple PS/2-based image display systems and their image servers.

  5. IBM Application System/400 as the foundation of the Mayo Clinic/IBM PACS project

    NASA Astrophysics Data System (ADS)

    Rothman, Melvyn L.; Morin, Richard L.; Persons, Kenneth R.; Gibbons, Patricia S.

    1990-08-01

    An IBM Application System/400 (AS/400) anchors the Mayo Clinic/IBM joint development PACS project. This paper highlights some of the AS/400's features and the resulting benefits which make it a strong foundation for a medical image archival and review system. Among the AS/400's key features are: 1. A high-level machine architecture 2. Object orientation 3. Relational data base and other functions integrated into the system's architecture 4. High-function interfaces to IBM Personal Computers and IBM Personal System/2s' (pS/2TM).

  6. A brief history of the early years of blood transfusion at the Mayo Clinic: the first blood bank in the United States (1935).

    PubMed

    Moore, S Breanndan

    2005-07-01

    At the Mayo Clinic in 1914, Francis McGrath modified an existing aspiration-injection apparatus and adapted it for arm-to-arm blood transfusions. Separately, in 1919, both Pemberton and Sanford described in detail the Mayo Clinic experience with more than 1000 transfusions between January 1915 and January 1918. Most transfusions were by the indirect citrate method from freshly drawn blood. In 1935, John Lundy established a bank of refrigerated blood for transfusions at Mayo Clinic and reported on the activity in that and subsequent years. The functioning clinical blood bank established by Lundy at Mayo Clinic predated that of Bernard Fantus in Chicago by almost 2 years. PMID:16010654

  7. An overview of transforming changes at Mayo Clinic Proceedings during 2005.

    PubMed

    Lanier, William L

    2005-01-01

    For the past 6 years, the Editorial Board and staff of Mayo Clinic Proceedings have dedicated ourselves to the progressive evolution of this journal. During this period, and for the foreseeable future, we have embraced change and improvement as themes for our daily efforts. As such, the changes identified in this communication are not a leap forward for the journal, they merely represent the next logical step in the growth of the journal. Given the momentum that has developed during the past few years, readers should expect to see further changes, all intended to better communicate with our principal readers, practicing physicians. In the final analysis, we are driven by a rededication of the journal to the primary value of Mayo Clinic: "The needs of the patient come first." While the journal's leadership has long looked to this statement for guidance, our approach to addressing this value in 2005 will require a considerable number of innovations. We look forward to sharing with you, our readers, these next steps in the journal's history. We trust that we will be able to learn and grow together so that, in the final analysis, the journal will build on its reputation as an authoritative and respected source of information. PMID:15667024

  8. Building a Protocol Expressway: The Case of Mayo Clinic Cancer Center

    PubMed Central

    McJoynt, Terre A.; Hirzallah, Muhanad A.; Satele, Daniel V.; Pitzen, Jason H.; Alberts, Steven R.; Rajkumar, S. Vincent

    2009-01-01

    Purpose Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. Methods A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Results Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P < .001) from 25.00 weeks (n = 41; range, 3.43 to 94.14 weeks) to 10.15 weeks (n = 14; range, 4.00 to 22.14 weeks). The mean turnaround time for externally authored protocols was improved (P < .001) from 20.61 weeks (n = 85; range, 3.29 to 108.57 weeks) to 7.79 weeks (n = 50; range, 2.00 to 20.86 weeks). Conclusion DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes. PMID:19564529

  9. Principles and process in the development of the Mayo Clinic's individual and institutional conflict of interest policy.

    PubMed

    Camilleri, Michael; Gamble, Gail L; Kopecky, Stephen L; Wood, Michael B; Hockema, Marianne L

    2005-10-01

    In 1995, federal regulations required all academic medical centers to implement policies to manage individual financial conflict of interest. At the Mayo Clinic, all staff are salaried, and all medically related intellectual property from the staff belongs to the clinic. Hence, it was necessary to develop a policy for institutional conflict of interest to complement the policy for individual conflicts of interest. This article addresses the principles and process that led to the development of the Mayo Clinic's policies that guide the management of conflict of interest of individuals and of the institution. Empowered by the Bayh-Dole Act, the Mayo Clinic participates in technology transfer through its entity Mayo Medical Ventures. Individual conflicts of interest arising from such technology transfer are associated with Institutional conflicts because all individual intellectual property belongs to the institution, per clinic policy. This policy addresses conflicts of interest that arise in research, leadership, clinical practice, investments, and purchasing. Associated with the statutory annual disclosure on personal consulting and other relationships with Industry, which are guided by federal regulations, all research protocols or grant applications require financial disclosure on initial submission and in annual progress reports. The clinic's Conflict of Interest Review Board was established to review each disclosure and recommend management of individual and institutional conflicts of interest according to policy. PMID:16212147

  10. Performance and function of a desktop viewer at Mayo Clinic Scottsdale.

    PubMed

    Eversman, W G; Pavlicek, W; Zavalkovskiy, B; Erickson, B J

    2000-05-01

    A clinical viewing system was integrated with the Mayo Clinic Scottsdale picture archiving and communication system (PACS) for providing images and the report as part of the electronic medical record (EMR). Key attributes of the viewer include a single user log-on, an integrated patient centric EMR image access for all ordered examinations, prefetching of the most recent prior examination of the same modality, and the ability to provide comparison of current and past exams at the same time on the display. Other functions included preset windows, measurement tools, and multiformat display. Images for the prior 12 months are stored on the clinical server and are viewable in less than a second. Images available on the desktop include all computed radiography (CR), chest, magnetic resonance images (MRI), computed tomography (CT), ultrasound (U/S), nuclear, angiographic, gastrointestinal (GI) digital spots, and portable C-arm digital spots. Ad hoc queries of examinations from PACS are possible for those patients whose image may not be on the clinical server, but whose images reside on the PACS archive (10TB). Clinician satisfaction was reported to be high, especially for those staff heavily dependent on timely access to images, as well as those having heavy film usage. The desktop viewer is used for resident access to images. It is also useful for teaching conferences with large-screen projection without film. We report on the measurements of functionality, reliability, and speed of image display with this application. PMID:10847386

  11. The Pine Ridge-Mayo National Aeronautics and Space Administration Telemedicine Project: Program Activities and Participant Reactions

    NASA Technical Reports Server (NTRS)

    Kottke, T. E.; Little Finger, L.; Trapp, M. A.; Panser, L. A.; Novotny, P. J.

    1996-01-01

    OBJECTIVE: To determine the response of participants to the Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project. DESIGN: We describe a 3-month demonstration project of medical education and clinical consultations conducted by means of satellite transmission. Postparticipation questionnaires and a postproject survey were used to assess the success of the activity. MATERIAL AND METHODS: Patients and employees at the Pine Ridge Indian Health Service Hospital in southwestern South Dakota and employees at Mayo Clinic Rochester participated in a telemedicine project, after which they completed exit surveys and a postproject questionnaire to ascertain the acceptability of this mode of health care. RESULTS: Almost all Pine Ridge and Mayo Clinic participants viewed the project as beneficial. The educational sessions received favorable evaluations, and almost two-thirds of the patients who completed evaluations thought the consultation had contributed to their medical care. More than 90% of the respondents from Pine Ridge and more than 85% of the respondents from Mayo Clinic Rochester said that they would recommend participation in this project to others. More than 90% of respondents from Pine Ridge and 80% of Mayo respondents agreed with the statement that the project should continue. CONCLUSION: These data suggest that a program of clinical consultation services, professional education, and patient education available by telemedicine might be viewed as beneficial.

  12. Long-term outcome of patients with POEMS syndrome: An update of the Mayo Clinic experience.

    PubMed

    Kourelis, Taxiarchis V; Buadi, Francis K; Kumar, Shaji K; Gertz, Morie A; Lacy, Martha Q; Dingli, David; Go, Ronald S; Kapoor, Prashant; Lust, John A; Hayman, Suzanne R; Hwa, Yi; Rajkumar, S Vincent; Zeldenrust, Steven R; Russell, Stephen J; Lin, Yi; Leung, Nelson; Kyle, Robert A; Gonsalves, Wilson I; Dispenzieri, Angela

    2016-06-01

    Over the past decade, a number of changes have occurred in the diagnostic evaluation, management, and long-term follow-up of patients with POEMS syndrome at our institution. This study included 291 patients with POEMS syndrome diagnosed at the Mayo Clinic between 1974 and 2014. Patients diagnosed after 2003 had more features of the syndrome identified at diagnosis and were more likely to receive an autologous transplant (49% versus 8%, P < 0.0001) and to have achieved a hematologic complete response (CR) to treatment (41% vs 25%, P < 0.0001). With 2273 person-years of follow-up, 10-year overall survival (OS) was 62% (95% C.I., 56%, 67%). On multivariate analysis, the three factors associated with superior OS were younger age (RR 0.98 [0.96-1.00]), albumin greater-than 3.2 g/dL (RR 0.5 [0.32-0.89]) and attainment of complete hematologic response (RR 0.4 [0.2, 0.9]). This study confirms the very good long-term outcomes of patients with POEMS syndrome and identifies two new prognostic risk factors: albumin at diagnosis and attainment of complete hematologic response. Am. J. Hematol. 91:585-589, 2016. © 2016 Wiley Periodicals, Inc. PMID:26972803

  13. Observations from the Mayo Clinic National Conference on Medicine and the Media.

    PubMed

    Lantz, Jane C; Lanier, William L

    2002-12-01

    In September 2002, the Mayo Clinic National Conference on Medicine and the Media convened to consider the accurate, timely, and responsible reporting of medical news to the public. The more than 500 participants included medical and health journalists, scientific journal editors, physicians and other health care professionals, industry representatives, government officials, institutional public information officers, public relations professionals, patients, and representatives of patient advocacy groups. The goal of the conference was to bring together all facets of the medical news dissemination process with the hope of identifying ways to serve the public more effectively. Several key observations emerged: Medical news reports may be confusing because the underlying scientific issues are unresolved and open to multiple interpretations. People who are ill have different information needs than the rest of the public. Journalists' primary concern is accurate, clear reporting, with secondary concern for a story's consequences. Journalists consider themselves primarily reporters rather than educators, but the public expects reporting to contain an educational element. Financial and other more subtle interests may influence the quality and content of scientific news releases, presentations in scientific journals, and stories covered by print and broadcast news media. Full disclosure of commercial support and affiliations, peer review of study reports, and formal guidelines for conduct may limit inappropriate financial influence. PMID:12479517

  14. Quadrilateral space syndrome: the Mayo Clinic experience with a new classification system and case series.

    PubMed

    Brown, Sherry-Ann N; Doolittle, Derrick A; Bohanon, Carol J; Jayaraj, Arjun; Naidu, Sailendra G; Huettl, Eric A; Renfree, Kevin J; Oderich, Gustavo S; Bjarnason, Haraldur; Gloviczki, Peter; Wysokinski, Waldemar E; McPhail, Ian R

    2015-03-01

    Quadrilateral space syndrome (QSS) arises from compression or mechanical injury to the axillary nerve or the posterior circumflex humeral artery (PCHA) as they pass through the quadrilateral space (QS). Quadrilateral space syndrome is an uncommon cause of paresthesia and an underdiagnosed cause of digital ischemia in overhead athletes. Quadrilateral space syndrome can present with neurogenic symptoms (pain and weakness) secondary to axillary nerve compression. In addition, repeated abduction and external rotation of the arm is felt to lead to injury of the PCHA within the QSS. This often results in PCHA thrombosis and aneurysm formation, with distal emboli. Because of relative infrequency, QSS is rarely diagnosed on evaluation of athletes with such symptoms. We report on 9 patients who presented at Mayo Clinic with QSS. Differential diagnosis, a new classification system, and the management of QSS are discussed, with a comprehensive literature review. The following search terms were used on PubMed: axillary nerve, posterior circumflex humeral artery, quadrilateral space, and quadrangular space. Articles were selected if they described patients with symptoms from axillary nerve entrapment or PCHA thrombosis, or if related screening or imaging methods were assessed. References available within the obtained articles were also pursued. There was no date or language restriction for article inclusion; 5 studies in languages besides English were reported in German, French, Spanish, Turkish, and Chinese. PMID:25649966

  15. Assessment of published models and prognostic variables in epithelial ovarian cancer at Mayo Clinic

    PubMed Central

    Hendrickson, Andrea Wahner; Hawthorne, Kieran M.; Goode, Ellen L.; Kalli, Kimberly R.; Goergen, Krista M.; Bakkum-Gamez, Jamie N.; Cliby, William A.; Keeney, Gary L.; Visscher, Dan W.; Tarabishy, Yaman; Oberg, Ann L.; Hartmann, Lynn C.; Maurer, Matthew J.

    2015-01-01

    Objectives Epithelial ovarian cancer (EOC) is an aggressive disease in which first line therapy consists of a surgical staging/debulking procedure and platinum based chemotherapy. There is significant interest in clinically applicable, easy to use prognostic tools to estimate risk of recurrence and overall survival. In this study we used a large prospectively collected cohort of women with EOC to validate currently published models and assess prognostic variables. Methods Women with invasive ovarian, peritoneal, or fallopian tube cancer diagnosed between 2000-2011 and prospectively enrolled into the Mayo Clinic Ovarian Cancer registry were identified. Demographics and known prognostic markers as well as epidemiologic exposure variables were abstracted from the medical record and collected via questionnaire. Six previously published models of overall and recurrence-free survival were assessed for external validity. In addition, predictors of outcome were assessed in our dataset. Results Previously published models validated with a range of c-statistics (0.587-0.827), though application of models containing variables not part of routine practice were somewhat limited by missing data; utilization of all applicable models and comparison of results is suggested. Examination of prognostic variables identified only the presence of ascites and ASA score to be independent predictors of prognosis in our dataset, albeit with marginal gain in prognostic information, after accounting for stage and debulking. Conclusions Existing prognostic models for newly diagnosed EOC showed acceptable calibration in our cohort for clinical application. However, modeling of prospective variables in our dataset reiterates that stage and debulking remain the most important predictors of prognosis in this setting. PMID:25620544

  16. CHRONIC OBSTRUCTIVE PULMONARY DISEASE IS ASSOCIATED WITH MILD COGNITIVE IMPAIRMENT: THE MAYO CLINIC STUDY OF AGING

    PubMed Central

    Singh, Balwinder; Parsaik, Ajay K; Mielke, Michelle M.; Roberts, Rosebud O.; Scanlon, Paul D.; Geda, Yonas E.; Pankratz, V. Shane; Christianson, Teresa; Yawn, Barbara; Petersen, Ronald C.

    2013-01-01

    Objectives To investigate the association of chronic obstructive pulmonary disease (COPD) with mild cognitive impairment (MCI) and MCI sub-types, amnestic MCI (a-MCI) and non-amnestic MCI (na-MCI), in a population-based study of elderly. Patients and Methods Participants included 1,927 individuals, aged 70 to 89 years, enrolled in the population-based, Mayo Clinic Study of Aging. Participants were evaluated with a nurse assessment, neurological evaluation, and neuropsychological testing and the diagnosis of MCI was made according to the standardized criteria by a consensus panel. COPD was identified by the review of medical records. The study was conducted from October 1, 2004, through July 31, 2007. The associations of COPD, and disease duration with MCI, and its subtypes were evaluated using logistic regression models adjusted for potential covariates. Results Of 1,927 subjects, 288 had COPD (men vs women 17.9% vs 11.8%, p<0.001). As compared to subjects without COPD, the subjects with COPD had higher prevalence of MCI (27.1% vs 14.6%, p<0.001). The odds ratio (OR) of MCI was almost two times higher in subjects with COPD (OR =1.90, 95 %CI =1.35 – 2.65), with a similar effect in men and women. The OR for MCI increased from 1.67 (97% CI, 1.00 – 2.69) in subjects with COPD duration of ≤ 5 years to 2.08 (95% CI, 1.36 – 3.14) in subjects > 5 years. Conclusion This population-based study suggests that COPD is associated with increased odds of having MCI and its sub-types. There was a dose-response association with duration of COPD, after controlling for the potential covariates. PMID:24182702

  17. An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis

    PubMed Central

    Salvarani, Carlo; Brown, Robert D.; Christianson, Teresa; Miller, Dylan V.; Giannini, Caterina; Huston, John; Hunder, Gene G.

    2015-01-01

    Abstract Primary central nervous system vasculitis (PCNSV) is an uncommon condition in which lesions are limited to vessels of the brain and spinal cord. Because the clinical manifestations are not specific, the diagnosis is often difficult, and permanent disability and death are frequent outcomes. This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnetic resonance imaging (MRI), along with less mortality and disability at last follow-up. The patients diagnosed by angiograms more frequently had at presentation hemiparesis or a persistent neurologic deficit or stroke, more frequent infarcts on MRI and an increased mortality. These differences were mainly related to the different size of the vessels involved in the 2 groups. Although most patients responded to therapy with glucocorticoids alone or in conjunction with cyclophosphamide and tended to improve during the follow-up period, an overall increased mortality rate was observed. Relapses occurred in one-quarter of the patients and were less frequent in patients treated with prednisone and cyclophosphamide compared with those treated with prednisone alone. The mortality rate and degree of disability at last follow-up were greater in those with increasing age, cerebral infarctions on MRI, angiographic large vessel involvement, and diagnosis made by angiography alone, but were lower in those with gadolinium-enhanced lesions on MRI and in those with

  18. Serum Adiponectin Levels, Neuroimaging, and Cognition in the Mayo Clinic Study of Aging

    PubMed Central

    Wennberg, Alexandra M. V.; Gustafson, Deborah; Hagen, Clinton E.; Roberts, Rosebud O.; Knopman, David; Jack, Clifford; Petersen, Ronald C.; Mielke, Michelle M.

    2016-01-01

    BACKGROUND Adiponectin, a protein involved in inflammatory pathways, may impact the development and progression of Alzheimer’s disease (AD). Adiponectin levels have been associated with mild cognitive impairment (MCI) and AD; however, its association with Alzheimer-associated neuroimaging and cognitive outcomes is unknown. OBJECTIVE Determine the cross-sectional association between plasma adiponectin and neuroimaging and cognitive outcomes in an older population-based sample. METHODS Multivariable adjusted regression models were used to investigate the association between plasma adiponectin and hippocampal volume (HVa), PiB-PET, FDG PET, cortical thickness, MCI diagnosis, and neuropsychological test performance. Analyses included 535 non-demented participants aged 70 and older enrolled in the Mayo Clinic Study of Aging. RESULTS Women had higher adiponectin than men (12,631 ng/mL vs. 8,908 ng/mL, P < .001). Among women, higher adiponectin was associated with smaller HVa (B=−0.595; 95% CI −1.19, −0.005), poorer performance in language (B−0.676; 95% CI −1.23, −0.121) and global cognition (B=−0.459; 95% CI −0.915, −0.002), and greater odds of a MCI diagnosis (OR=6.23; 95% CI 1.20, 32.43). In analyses stratified by sex and elevated amyloid (PiB-PET SUVR>1.4), among women with elevated amyloid, higher adiponectin was associated with smaller HVa (B=−0.723; 95% CI −1.43, −0.014), poorer performance in memory (B=−1.02; 95% CI −1.73, −0.312), language (B=−0.896; 95% CI −1.58, −0.212), and global (B=−0.650; 95% CI −1.18, −0.116) cognition, and greater odds of MCI (OR=19.34; 95% CI 2.72, 137.34). CONCLUSION Higher plasma adiponectin was associated with neuroimaging and cognitive outcomes among women. Longitudinal analyses are necessary to determine whether higher adiponectin predicts neurodegeneration and cognitive decline. PMID:27163809

  19. Patient quality of life in the Mayo Clinic Care Transitions program: a survey study

    PubMed Central

    Faucher, Joshua; Rosedahl, Jordan; Finnie, Dawn; Glasgow, Amy; Takahashi, Paul

    2016-01-01

    Background Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL). Aims To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT) program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care) aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16). Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21). Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant differences in self-reported general, physical, or mental health. Conclusion We detected no difference over time in QoL between MCCT patients and those receiving usual care, and a nonsignificant QoL decline in MCCT participants after 1 year. Progression of chronic disease may overwhelm any QoL improvement attributable to the MCCT intervention. The MCCT interventions may blunt expected declines in QoL, producing

  20. Colonic lipomas. Report of two unusual cases and review of the Mayo Clinic experience, 1976-1985.

    PubMed

    Taylor, B A; Wolff, B G

    1987-11-01

    Two cases of symptomatic submucosal lipomas of the large intestine are described. One occurred in a patient with familial multiple lipomatosis causing an intussusception and intermittent obstruction. The other caused subacute obstruction and rectal bleeding and was thought to represent a carcinoma. These two cases closely resemble those few patients with symptomatic lipomas of the colon that make up a small subgroup (6 percent) of a series of 91 patients with this diagnosis managed surgically at the Mayo Clinic between the years 1976 to 1985. The majority of patients in this series had lipomas that were entirely incidental findings usually associated with more significant pathology that dictated the operative procedures undertaken. Lipomas themselves may be managed by local excision only although segmental resection may be necessary in isolated cases. PMID:3677966

  1. Neurosurgery clinical registry data collection utilizing Informatics for Integrating Biology and the Bedside and electronic health records at the University of Rochester.

    PubMed

    Pittman, Christine A; Miranpuri, Amrendra S

    2015-12-01

    In a population health-driven health care system, data collection through the use of clinical registries is becoming imperative to continue to drive effective and efficient patient care. Clinical registries rely on a department's ability to collect high-quality and accurate data. Currently, however, data are collected manually with a high risk for error. The University of Rochester's Department of Neurosurgery in conjunction with the university's Clinical and Translational Science Institute has implemented the integrated use of the Informatics for Integrating Biology and the Bedside (i2b2) informatics framework with the Research Electronic Data Capture (REDCap) databases. PMID:26621414

  2. How well do whole exome sequencing results correlate with medical findings? A study of 89 Mayo Clinic Biobank samples

    PubMed Central

    Middha, Sumit; Lindor, Noralane M.; McDonnell, Shannon K.; Olson, Janet E.; Johnson, Kiley J.; Wieben, Eric D.; Farrugia, Gianrico; Cerhan, James R.; Thibodeau, Stephen N.

    2015-01-01

    Whole exome sequencing (WES) is increasingly being used for diagnosis without adequate information on predictive characteristics of reportable variants typically found on any given individual and correlation with clinical phenotype. In this study, we performed WES on 89 deceased individuals (mean age at death 74 years, range 28–93) from the Mayo Clinic Biobank. Significant clinical diagnoses were abstracted from electronic medical record via chart review. Variants [Single Nucleotide Variant (SNV) and insertion/deletion] were filtered based on quality (accuracy >99%, read-depth >20, alternate-allele read-depth >5, minor-allele-frequency <0.1) and available HGMD/OMIM phenotype information. Variants were defined as Tier-1 (nonsense, splice or frame-shifting) and Tier-2 (missense, predicted-damaging) and evaluated in 56 ACMG-reportable genes, 57 cancer-predisposition genes, along with examining overall genotype–phenotype correlations. Following variant filtering, 7046 total variants were identified (~79/person, 644 Tier-1, 6402 Tier-2), 161 among 56 ACMG-reportable genes (~1.8/person, 13 Tier-1, 148 Tier-2), and 115 among 57 cancer-predisposition genes (~1.3/person, 3 Tier-1, 112 Tier-2). The number of variants across 57 cancer-predisposition genes did not differentiate individuals with/without invasive cancer history (P > 0.19). Evaluating genotype–phenotype correlations across the exome, 202(3%) of 7046 filtered variants had some evidence for phenotypic correlation in medical records, while 3710(53%) variants had no phenotypic correlation. The phenotype associated with the remaining 44% could not be assessed from a typical medical record review. These data highlight significant continued challenges in the ability to extract medically meaningful predictive results from WES. PMID:26257771

  3. Pediatric follicular mucinosis: presentation, histopathology, molecular genetics, treatment, and outcomes over an 11-year period at the Mayo Clinic.

    PubMed

    Alikhan, Ali; Griffin, John; Nguyen, Nicholas; Davis, Dawn Marie R; Gibson, Lawrence E

    2013-01-01

    Follicular mucinosis (FM) and folliculotropic mycosis fungoides (MF) are rare in children, and data regarding long-term outcomes are limited. We sought to describe clinical and histopathologic findings of children with FM with and without MF, as well as treatments administered and clinical outcomes. We conducted a retrospective chart review of patients younger than 22 years (at time of diagnosis) with a biopsy demonstrating FM who were seen in the Dermatology Department at the Mayo Clinic from September 1, 1999, to September 1, 2010. Eleven patients (six male, five female) ages 11 to 19 years at the time of diagnosis met the inclusion criteria. Follow-up data were available for 10 patients, with a mean duration of 4.9 years. The head, neck, and extremities were the most common sites of involvement, and lesions were follicular-based papules (18%), scaly alopecic patches and plaques (45%), or a combination of the two (36%). Overall, three patients were confirmed to have MF. T-cell receptor gene rearrangement demonstrated clonality in two cases and was equivocal in one case. Treatments included topical corticosteroids, topical retinoids, oral minocycline, and, in patients with MF, ultraviolet light and topical bexarotene. Lesions resolved completely in seven patients, partially in one, and not at all in two (no follow-up data on one patient). Of the three patients with MF, two had complete resolution, and one has intermittent flares. To our knowledge, no patients developed other lymphoproliferative disorders. FM in children is rare. A histopathologic diagnosis of FM does not equate to folliculotropic MF in all cases. Most patients responded to treatment with topical steroids, topical retinoids, or phototherapy. In our series of patients, the disease ran a benign course. PMID:23278316

  4. Mortality in mild cognitive impairment varies by subtype, sex and lifestyle factors. The Mayo Clinic Study of Aging

    PubMed Central

    Vassilaki, Maria; Cha, Ruth H.; Aakre, Jeremiah A.; Therneau, Terry M.; Geda, Yonas E.; Mielke, Michelle M.; Knopman, David S.; Petersen, Ronald C.; Roberts, Rosebud O.

    2015-01-01

    Background Etiologic differences in mild cognitive impairment (MCI) subtypes may impact mortality. Objective To assess the rate of death in MCI overall, and by subtype, in the population-based Mayo Clinic Study of Aging. Methods Participants aged 70–89 years at enrollment were clinically evaluated at baseline and 15-month intervals to assess diagnoses of MCI and dementia. Mortality in MCI cases vs. cognitively normal (CN) individuals was estimated using Cox proportional hazards models. Results Over a median follow-up of 5.8 years, 331 of 862 (38.4%) MCI cases and 224 of 1292 (17.3%) cognitively normal participants died. Compared to CN individuals, mortality was elevated in persons with MCI (hazard ratio [HR] = 2.03; 95% CI: 1.61 to 2.55), and was higher for non-amnestic MCI (naMCI; HR = 2.47; 95% CI: 1.80 to 3.39) than for amnestic MCI (aMCI; HR = 1.89; 95% CI: 1.48 to 2.41) after adjusting for confounders. Mortality varied significantly by sex, education, history of heart disease, and engaging in moderate physical exercise (p for interaction <0.05 for all). Mortality rate estimates were highest in MCI cases who were men, did not exercise, had heart disease, and had higher education vs. CN without these factors, and for naMCI cases vs. aMCI cases without these factors. Conclusions These findings suggest stronger impact of etiologic factors on naMCI mortality. Prevention of heart disease, exercise vigilance, may reduce MCI mortality. Delayed MCI diagnosis in persons with higher education impacts mortality, and higher mortality in men may explain similar dementia incidence by sex in our cohort. PMID:25697699

  5. Predicting the risk of mild cognitive impairment in the Mayo Clinic Study of Aging

    PubMed Central

    Pankratz, V. Shane; Roberts, Rosebud O.; Mielke, Michelle M.; Knopman, David S.; Jack, Clifford R.; Geda, Yonas E.; Rocca, Walter A.

    2015-01-01

    Objective: We sought to develop risk scores for the progression from cognitively normal (CN) to mild cognitive impairment (MCI). Methods: We recruited into a longitudinal cohort study a randomly selected, population-based sample of Olmsted County, MN, residents, aged 70 to 89 years on October 1, 2004. At baseline and subsequent visits, participants were evaluated for demographic, clinical, and neuropsychological measures, and were classified as CN, MCI, or dementia. Using baseline demographic and clinical variables in proportional hazards models, we derived scores that predicted the risk of progressing from CN to MCI. We evaluated the ability of these risk scores to classify participants for MCI risk. Results: Of 1,449 CN participants, 401 (27.7%) developed MCI. A basic model had a C statistic of 0.60 (0.58 for women, 0.62 for men); an augmented model resulted in a C statistic of 0.70 (0.69 for women, 0.71 for men). Both men and women in the highest vs lowest sex-specific quartiles of the augmented model's risk scores had an approximately 7-fold higher risk of developing MCI. Adding APOE ε4 carrier status improved the model (p = 0.002). Conclusions: We have developed MCI risk scores using variables easily assessable in the clinical setting and that may be useful in routine patient care. Because of variability among populations, validation in independent samples is required. These models may be useful in identifying patients who might benefit from more expensive or invasive diagnostic testing, and can inform clinical trial design. Inclusion of biomarkers or other risk factors may further enhance the models. PMID:25788555

  6. Management of malignant airway compromise with laser and low dose rate brachytherapy. The Mayo Clinic experience

    SciTech Connect

    Schray, M.F.; McDougall, J.C.; Martinez, A.; Cortese, D.A.; Brutinel, W.M.

    1988-02-01

    Between January 1983 and October 1985, 65 patients with malignant airway compromise have had 93 flexible bronchoscopic placements of a nylon afterloading catheter for low dose rate iridium-192 temporary intraluminal brachytherapy. All patients received prior (59 patients) and/or concurrent (13 patients) external beam irradiation to tolerance and were not candidates for surgery. Forty of these patients also received neodymium-YAG laser treatment prior to brachytherapy in a planned combined approach to provide immediate symptomatic relief and facilitate catheter placement. A dose of 3000 cGy is prescribed to 5 mm and 10 mm radii over 20-40 hours in the bronchus and trachea, respectively. Of 59 patients treated with palliative intent, 40 patients (68%) have had follow-up bronchoscopy, 18 patients have had clinical follow-up only, and one patient was lost to follow-up. Of 40 patients examined by bronchoscope in follow-up, 24 (60%) responded, eight were stable, and eight progressed. Lack of progression after prior external beam radiation for periods of greater than 12 months, six-12 months and less than six months yielded response rates to brachytherapy in 83, 50 and 31%, respectively. Most patients with clinical follow-up only expired at early intervals with airway palliation from extra-airway disease progression. Four of five patients treated with curative intent are disease-free at a median of 16 months. Eleven patients have experienced fistula and/or hemorrhage, of which seven instances (11% of all patients) appear to be treatment-induced. This brachytherapy technique is simple, well tolerated, and convenient for the patient providing airway palliation in the significant majority of patients with acceptable risk.

  7. Pharmacoinvasive and Primary Percutaneous Coronary Intervention Strategies in ST-Elevation Myocardial Infarction (from the Mayo Clinic STEMI Network).

    PubMed

    Siontis, Konstantinos C; Barsness, Gregory W; Lennon, Ryan J; Holmen, Jody L; Wright, R Scott; Bell, Malcolm R; Gersh, Bernard J

    2016-06-15

    The effectiveness of a pharmacoinvasive strategy consisting of fibrinolysis and transfer for percutaneous coronary intervention (PCI) compared to primary PCI (PPCI) in patients presenting to non-PCI-capable hospitals with ST-elevation myocardial infarction (STEMI) is not well defined. We analyzed data from the Mayo Clinic STEMI database of patients treated with a pharmacoinvasive strategy (favored in those presenting early after symptom onset) or PPCI in a regional STEMI network from 2004 to 2012. A total of 364 and 1,337 patients were included in the pharmacoinvasive and PPCI groups, respectively. Patients in the PPCI group were older and more frequently had cardiogenic shock at the time of presentation (12.1% vs 7.7%, p = 0.018). Death from any cause occurred in 58 (16%) and 314 (23%) patients in the pharmacoinvasive and PPCI groups, respectively (median follow-up 3.9 and 4.4 years, respectively). In multivariate analyses adjusting for age, gender, and other variables for which the 2 groups differed at baseline, there was no significant difference between the 2 strategies for 30-day (hazard ratio 0.66, 95% confidence interval 0.36 to 1.21) or overall mortality (hazard ratio 0.84, 95% confidence interval 0.63 to 1.12). Shorter door-to-balloon time was associated with increased effectiveness of PPCI (p for trend = 0.015), but there was no difference between the 2 strategies even when considering only the patients with door-to-balloon time in the lowest quartile. In conclusion, fibrinolysis followed by transfer for PCI represents a reasonable alternative when PPCI is not readily available especially in patients presenting early after symptom onset. PMID:27131614

  8. FDG-PET and Neuropsychiatric Symptoms among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging.

    PubMed

    Krell-Roesch, Janina; Ruider, Hanna; Lowe, Val J; Stokin, Gorazd B; Pink, Anna; Roberts, Rosebud O; Mielke, Michelle M; Knopman, David S; Christianson, Teresa J; Machulda, Mary M; Jack, Clifford R; Petersen, Ronald C; Geda, Yonas E

    2016-07-14

    One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer's disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23-3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00-6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD. PMID:27447426

  9. FDG-PET and Neuropsychiatric Symptoms among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging

    PubMed Central

    Krell-Roesch, Janina; Ruider, Hanna; Lowe, Val J.; Stokin, Gorazd B.; Pink, Anna; Roberts, Rosebud O.; Mielke, Michelle M.; Knopman, David S.; Christianson, Teresa J.; Machulda, Mary M.; Jack, Clifford R.; Petersen, Ronald C.; Geda, Yonas E.

    2016-01-01

    One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer’s disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23–3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00–6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD. PMID:27447426

  10. A Multidisciplinary Biospecimen Bank of Renal Cell Carcinomas Compatible with Discovery Platforms at Mayo Clinic, Scottsdale, Arizona.

    PubMed

    Ho, Thai H; Nateras, Rafael Nunez; Yan, Huihuang; Park, Jin G; Jensen, Sally; Borges, Chad; Lee, Jeong Heon; Champion, Mia D; Tibes, Raoul; Bryce, Alan H; Carballido, Estrella M; Todd, Mark A; Joseph, Richard W; Wong, William W; Parker, Alexander S; Stanton, Melissa L; Castle, Erik P

    2015-01-01

    To address the need to study frozen clinical specimens using next-generation RNA, DNA, chromatin immunoprecipitation (ChIP) sequencing and protein analyses, we developed a biobank work flow to prospectively collect biospecimens from patients with renal cell carcinoma (RCC). We describe our standard operating procedures and work flow to annotate pathologic results and clinical outcomes. We report quality control outcomes and nucleic acid yields of our RCC submissions (N=16) to The Cancer Genome Atlas (TCGA) project, as well as newer discovery platforms, by describing mass spectrometry analysis of albumin oxidation in plasma and 6 ChIP sequencing libraries generated from nephrectomy specimens after histone H3 lysine 36 trimethylation (H3K36me3) immunoprecipitation. From June 1, 2010, through January 1, 2013, we enrolled 328 patients with RCC. Our mean (SD) TCGA RNA integrity numbers (RINs) were 8.1 (0.8) for papillary RCC, with a 12.5% overall rate of sample disqualification for RIN <7. Banked plasma had significantly less albumin oxidation (by mass spectrometry analysis) than plasma kept at 25 °C (P<.001). For ChIP sequencing, the FastQC score for average read quality was at least 30 for 91% to 95% of paired-end reads. In parallel, we analyzed frozen tissue by RNA sequencing; after genome alignment, only 0.2% to 0.4% of total reads failed the default quality check steps of Bowtie2, which was comparable to the disqualification ratio (0.1%) of the 786-O RCC cell line that was prepared under optimal RNA isolation conditions. The overall correlation coefficients for gene expression between Mayo Clinic vs TCGA tissues ranged from 0.75 to 0.82. These data support the generation of high-quality nucleic acids for genomic analyses from banked RCC. Importantly, the protocol does not interfere with routine clinical care. Collections over defined time points during disease treatment further enhance collaborative efforts to integrate genomic information with outcomes. PMID

  11. A Multidisciplinary Biospecimen Bank of Renal Cell Carcinomas Compatible with Discovery Platforms at Mayo Clinic, Scottsdale, Arizona

    PubMed Central

    Ho, Thai H.; Nateras, Rafael Nunez; Yan, Huihuang; Park, Jin G.; Jensen, Sally; Borges, Chad; Lee, Jeong Heon; Champion, Mia D.; Tibes, Raoul; Bryce, Alan H.; Carballido, Estrella M.; Todd, Mark A.; Joseph, Richard W.; Wong, William W.; Parker, Alexander S.; Stanton, Melissa L.; Castle, Erik P.

    2015-01-01

    To address the need to study frozen clinical specimens using next-generation RNA, DNA, chromatin immunoprecipitation (ChIP) sequencing and protein analyses, we developed a biobank work flow to prospectively collect biospecimens from patients with renal cell carcinoma (RCC). We describe our standard operating procedures and work flow to annotate pathologic results and clinical outcomes. We report quality control outcomes and nucleic acid yields of our RCC submissions (N=16) to The Cancer Genome Atlas (TCGA) project, as well as newer discovery platforms, by describing mass spectrometry analysis of albumin oxidation in plasma and 6 ChIP sequencing libraries generated from nephrectomy specimens after histone H3 lysine 36 trimethylation (H3K36me3) immunoprecipitation. From June 1, 2010, through January 1, 2013, we enrolled 328 patients with RCC. Our mean (SD) TCGA RNA integrity numbers (RINs) were 8.1 (0.8) for papillary RCC, with a 12.5% overall rate of sample disqualification for RIN <7. Banked plasma had significantly less albumin oxidation (by mass spectrometry analysis) than plasma kept at 25°C (P<.001). For ChIP sequencing, the FastQC score for average read quality was at least 30 for 91% to 95% of paired-end reads. In parallel, we analyzed frozen tissue by RNA sequencing; after genome alignment, only 0.2% to 0.4% of total reads failed the default quality check steps of Bowtie2, which was comparable to the disqualification ratio (0.1%) of the 786-O RCC cell line that was prepared under optimal RNA isolation conditions. The overall correlation coefficients for gene expression between Mayo Clinic vs TCGA tissues ranged from 0.75 to 0.82. These data support the generation of high-quality nucleic acids for genomic analyses from banked RCC. Importantly, the protocol does not interfere with routine clinical care. Collections over defined time points during disease treatment further enhance collaborative efforts to integrate genomic information with outcomes. PMID

  12. Patterns in deer-related traffic injuries over a decade: the Mayo clinic experience

    PubMed Central

    2010-01-01

    Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC). We characterized injury patterns between motorcycle/all-terrain vehicles (MCC) and automobile (MVC) crashes related to dMVC (deer motor vehicle crash) with the hypotheses that MCC will present with higher Injury Severity Score (ISS) and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS). Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p < 0.001). Median Abbreviated Injury Score (AIS) of the spine for MCC riders was higher (3 vs 0, p < 0.001) if they swerved rather than collided. Seventy-seven percent of riders were not wearing a helmet which did not result in a statistically significant increase in median ISS (16 vs 10), head AIS (2 vs 0) or spine AIS (0 vs 0). Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5) and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained. PMID:20716341

  13. Surgical management and outcomes of type A dissection—the Mayo Clinic experience

    PubMed Central

    Cabasa, Alduz

    2016-01-01

    Background Type A aortic dissection (TAAD) is a complex cardiovascular disease that is associated with high perioperative morbidity and mortality. The most effective approach is still being debated—such as the best cannulation technique, and conservative versus extensive initial surgery. We reviewed our experience over the last 20 years and examined for variables that correlated with observed outcomes. Methods All patients who underwent TAAD repair were reviewed. Chi-Square tests, Fisher Exact tests and Wilcoxon tests were performed where appropriate. Survival and freedom from reoperations were analyzed with the Kaplan-Meier actuarial method. Results Acute TAAD was associated with a higher incidence of permanent stroke (P=0.010), renal failure (P=0.025), prolonged mechanical ventilator support (P=0.004), higher operative mortality (P=0.039) and higher 30-day mortality (P=0.003) compared to chronic TAAD. There was a trend towards higher risk for transient neurologic events among patients who were reoperated on (P=0.057). Extensive proximal repair led to longer perfusion and cross clamp times (P<0.001) and the need for temporary mechanical support post-operatively (P=0.011). More patients that had extensive distal repair underwent circulatory arrest (P=0.009) with no significant differences in the incidence of peri-operative complications, early, middle and long-term survival compared to the conservative management group. Overall survival in our series was 66.73% and 46.30% at 5 and 10 years respectively (median survival time: 9.38 years). There was a significant improvement in operative mortality (P=0.002) and 30-day mortality (P=0.033) in the second decade of our study. Discussion TAAD is a complex disease with several options for its surgical management. Each technique has its own advantages and complications and surgical management should be individualized depending on the clinical presentation. We propose our present approach to maximize benefits in both the

  14. Evaluation of the Mayo Clinic Phenotype-Based Genotype Predictor Score in Patients with Clinically Diagnosed Hypertrophic Cardiomyopathy

    PubMed Central

    Murphy, Sinead L.; Anderson, Jason H.; Kapplinger, Jamie D.; Kruisselbrink, Teresa M.; Gersh, Bernard J.; Ommen, Steve R.; Ackerman, Michael J.; Bos, J. Martijn

    2016-01-01

    Genetic testing for hypertrophic cardiomyopathy (HCM) can provide an important clinical marker for disease outcome and family screening. This study set out to validate our recently developed phenotype-based HCM genotype predictor score. Patients clinically diagnosed with HCM and evaluated by genetic counselors comprised the study cohort. Genotype score was derived based on clinical and echocardio-graphic variables. Total score was correlated with the yield of genetic testing. Of 564 HCM patients, 198 sought genetic testing (35 %; 55 % male; mean age at diagnosis, 50 ±20 years). Of these, 101 patients (51 %) were genotype positive for a HCM-associated genetic mutation (55 % male; mean age at diagnosis, 42 ± 18 years). Cochran-Armitage analysis showed similar, statistically significant trends of increased yields for higher genotype scores for both the original and study cohort. Validated by the current study, this scoring system provides an easy-to-use, clinical tool to aid in determining the likelihood of a positive HCM genetic test. PMID:26914223

  15. The beginnings of Orthopedic Surgery at the Mayo Clinic: A Review of the First Orthopedic Patients who Presented Over 100 Years Ago

    PubMed Central

    Camp, Christopher L.; Morrey, Bernard F; Trousdale, Robert T

    2016-01-01

    Background Formalized training in the specialty of orthopedic surgery began at the Mayo Clinic nearly 100 years ago, and treatment of patients with musculoskeletal injuries and disease began even earlier. A robust historical patient database provides the opportunity for review of the first recorded orthopedic cases at our institution, which date back to 1907. Methods The first 400 sequential medical charts of the Mayo Clinic’s patient record database were comprehensively reviewed in order to identify the first documented orthopedic cases. Results Of the first 400 patients reviewed, 15 (4%) received specific orthopedic diagnoses. All presented during a three week period in 1907, and they traveled from all over the region for evaluation. The diagnoses included skeletal tuberculosis (n=6), traumatic fracture (n=3), osteomyelitis (n=2), syphilitic pathologic fracture (n=1), syphilitic ostitis of the tibia and radius (n=1), painful flat foot (n=1), and Morton’s toe (n=1). Included with the records are patient demographics, diagnoses, symptoms, physical examination findings, radiograph reports, operative reports, and detailed drawings of symptomatology. Conclusion Although the technology and science has advanced since the early practice of orthopedic surgery that took place over a century ago, we consider ourselves to be merely an extension of those who established the field before us. Just as the past relies on the future for the continuation of what it began so many years ago, we rely on our founders for the groundwork that they laid in creating this field of surgical medicine PMID:27528834

  16. The Mayo brothers: an American surgical legacy.

    PubMed

    Toledo-Pereyra, Luis H

    2010-10-01

    Few in the history of surgery and just as few in the history of medicine can reach the level of clinical visibility as achieved by the Mayo brothers. The brothers changed the face of medicine while they were alive, and their fame and influence continued to grow after their death in 1939. The Mayo American surgical legacy had incredible proportions. The brothers systematically modified the field as few others had done before. They were great surgical innovators who took the surgical techniques of others and added a touch of their own to make the surgical procedure better and more secure. The Mayos were the stars regionally, nationally, and around the world. They attracted attention from their generation and occupied center stage long after. To speak of the Mayos is to speak of the quintessential American values of professionalism, respect, commitment, and caring for their fellow human beings. Their creation, the Mayo Clinic, surpassed the wildest hopes and predictions that anyone could have had regarding their best dreams. PMID:20874478

  17. Rochester Orients Lab around Microcomputers.

    ERIC Educational Resources Information Center

    Stinson, Stephen C.

    1982-01-01

    Describes integration of Commodore PET microcomputers into the chemical engineering curriculum at the University of Rochester. Includes advantages of using microcomputers in laboratories to analyze data and control processes. (SK)

  18. The Power of Effective Design in e-Learning: A Study of the "Mayo Effect" Video

    ERIC Educational Resources Information Center

    Fan, Jiang Ping

    2014-01-01

    When the Mayo Effect video went live on the Mayo intranet in June 2010, it was very well received at Mayo Clinic. The message in the video was so effectively delivered that it became an instant sensation across the institution. The video contains about 461 words. In such a short video, every part of its architectural design, whether it is visual,…

  19. Interprofessional Education in Gross Anatomy: Experience with First-Year Medical and Physical Therapy Students at Mayo Clinic

    ERIC Educational Resources Information Center

    Hamilton, Steven S.; Yuan, Brandon J.; Lachman, Nirusha; Hellyer, Nathan J.; Krause, David A.; Hollman, John H.; Youdas, James W.; Pawlina, Wojciech

    2008-01-01

    Interprofessional education (IPE) in clinical practice is believed to improve outcomes in health care delivery. Integrating teaching and learning objectives through cross discipline student interaction in basic sciences has the potential to initiate interprofessional collaboration at the early stages of health care education. Student attitudes and…

  20. Use of Candida antigen injections for the treatment of verruca vulgaris: A two-year mayo clinic experience.

    PubMed

    Alikhan, Ali; Griffin, John R; Newman, Catherine C

    2016-08-01

    Common warts (verruca vulgaris) are one of the most common problems encountered in dermatology and may present a difficult treatment dilemma, as no particular therapy has demonstrated complete efficacy. Intralesional injection of purified Candida antigen has produced impressive treatment results in small prospective and retrospective studies and is thought to produce its effect through stimulation of a cell-mediated immune response. We report a retrospective study of adult and pediatric patients treated with Candida antigen therapy in clinical practice. Of the 100 patients treated, 80% responded to therapy: 39% demonstrated a complete response and 41% demonstrated a partial response. In addition, 6 out of 7 immunocompromised patients who were treated demonstrated a partial or complete response. Injections were generally well-tolerated and adverse events were minimal and short-lived. Our data indicate that intralesional Candida antigen therapy for cutaneous warts is an efficacious option in a clinical practice setting. The treatment may also be effective in immunosuppressed patients with cutaneous warts. Our results add to the literature one of the largest retrospective series reported to date and treatment outcomes are similar to previously reported studies evaluating this therapeutic modality. PMID:26558635

  1. Phase II Trial of Gemcitabine and Tanespimycin (17AAG) in Metastatic Pancreatic Cancer: A Mayo Clinic Phase II Consortium Study

    PubMed Central

    Pedersen, Katrina S.; Kim, George P.; Foster, Nathan R.; Wang-Gillam, Andrea; Erlichman, Charles; McWilliams, Robert R.

    2016-01-01

    Objectives Heat Shock Protein 90 (HSP90) is a molecular chaperone that stabilizes many oncogenic proteins. HSP90 inhibitors may sensitize tumors to cytotoxic agents by causing client protein degradation. Gemcitabine, which has modest activity in pancreas cancer, activates Chk1, a client protein of HSP90. This phase II trial was designed to determine whether 17AAG could enhance the clinical activity of gemcitabine through degradation of Chk1 in patients with stage IV pancreatic cancer. Methods A multicenter, prospective study combining gemcitabine and 17AAG enrolled patients with stage IV pancreatic adenocarcinoma, adequate liver and kidney function, ECOG performance status 0-2, and no prior chemotherapy for metastatic disease. The primary goal was to achieve a 60% overall survival at six months. Sixty-six patients were planned for accrual, with an interim analysis after 25 patients enrolled. Results: After a futility analysis to achieve the endpoint, accrual was halted with 21 patients enrolled. No complete or partial responses were seen. 40% of patients were alive at 6 months. Median overall survival was 5.4 months. Tolerability was moderate, with 65% of patients having ≥ grade 3 adverse events (AE), and 15% having grade 4 events. Conclusions The lack of clinical activity suggests that targeting Chk1 by inhibiting HSP90 is not important in pancreatic cancer sensitivity to gemcitabine alone. Further studies of HSP90 targeted agents with gemcitabine alone are not warranted. PMID:25952464

  2. African American Women's Perceptions and Attitudes Regarding Participation in Medical Research: The Mayo Clinic/The Links, Incorporated Partnership

    PubMed Central

    Brewer, LaPrincess C.; Parker, Monica W.; Balls-Berry, Joyce E.; Halyard, Michele Y.; Pinn, Vivian W.; Radecki Breitkopf, Carmen

    2014-01-01

    Abstract Objective: To examine perceptions and attitudes toward health-related research participation among professional African American women. Methods: Participants were members of an African American women's service organization, The Links, Incorporated. Data were collected via self-administered questionnaires at The Links, Incorporated 2012 National Assembly. Sociodemographics, prior research experience, intention to participate (ITP), willingness to participate (WTP) in a variety of research studies and attitudes about research participation were measured. Results: A total of 381 surveys were analyzed. A majority of respondents were married (66%), employed (69%), and college educated (96%). Median age was 59; 38% reported prior research participation. Overall, 78% agreed with the statement, “Participation in research will mean better care,” 24% agreed “Participation in research is risky” and 3% agreed “Scientists cannot be trusted.” Fifty-two percent agreed with the statement, “Research conducted in the U.S. is ethical.” Mean ITP in research was 4.9±1.7 on a rating scale of 1 (“definitely no”) to 7 (“definitely yes”). WTP was highest for an interview study and providing a blood sample, and lowest for clinical trial and medical record review. Conclusion: Attitudes toward research participation were generally favorable among professional African American women; many expressed WTP in a variety of research study types. PMID:25046058

  3. Management of patients with chronic lymphocytic leukemia with a high risk of adverse outcome: the Mayo Clinic approach

    PubMed Central

    ZENT, CLIVE S.; KAY, NEIL E.

    2012-01-01

    Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) is usually an incidental diagnosis in patients with early–intermediate stage disease. However, most patients with a diagnosis of CLL will subsequently have significant morbidity and die from their disease and its complications. For these patients, CLL is not the ‘good leukemia’ with a predictably ‘benign’ outcome. Indeed, we can now identify a cohort of patients with high-risk CLL at diagnosis who will have rapid disease progression, poor response to treatment, and poor survival based on prognostic methods developed from an improved understanding of the biology of CLL. The concomitant development of improved treatments has led to risk-adjusted management approaches that could improve outcomes. We discuss the clinical and laboratory components of comprehensive risk evaluation of patients with CLL and our approach to the management of patients with a high to very high risk of disease progression and poor outcome. In addition, we review the challenges and prospects for improving prognostic precision and the development of new drugs to improve the treatment of patients with CLL with a high risk of adverse outcome. PMID:21649549

  4. Clinical care management and workflow by episodes.

    PubMed Central

    Claus, P. L.; Carpenter, P. C.; Chute, C. G.; Mohr, D. N.; Gibbons, P. S.

    1997-01-01

    This paper describes the implementation of clinically defined episodes of care and the introduction of an episode-based summary list of patient problems across Mayo Clinic Rochester in 1996 and 1997. Although Mayo's traditional paper-based system has always relied on a type of 'episode of care' (called the "registration") for patient and history management, a new, more clinically relevant definition of episode of care was put into practice in November 1996. This was done to improve care management and operational processes and to provide a basic construct for the electronic medical record. Also since November 1996, a computer-generated summary list of patient problems, the "Master Sheet Summary Report," organized by episode, has been placed in all patient histories. In the third quarter of 1997, the ability to view the episode-based problem summary online was made available to the 3000+ EMR-capable workstations deployed across the Mayo Rochester campus. In addition, the clinically oriented problem summarization process produces an improved basic "package" of clinical information expected to lead to improved analytic decision support, outcomes analysis and epidemiological research. PMID:9357595

  5. Rochester City School District Peer Assistance Review

    ERIC Educational Resources Information Center

    Chierichella, Patrick

    2010-01-01

    In this paper the author evaluates the Peer Assistance and Review (PAR) program in the Rochester City School District, Rochester, NY. The author evaluates the system's strengths and weaknesses and discusses the program's alignment with New York State requirements.

  6. 75 FR 36666 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-28

    ... National Park Service Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center... to repatriate cultural items in the possession of the Rochester Museum & Science Center, Rochester... Arts & Science (now Rochester Museum & Science Center), with the intent of both giving employment...

  7. 75 FR 23801 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... National Park Service Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center... to repatriate cultural items in the possession of the Rochester Museum & Science Center, Rochester... two small wooden medicine faces from Alvin Dewey, Rochester, NY. On March 25, 1922, Alvin...

  8. Prevalence of torus mandibularis in Rochester, New York, region.

    PubMed

    Romanos, Georgios E; Sarmiento, Hector L; Yunker, Michael; Malmstrom, Hans

    2013-01-01

    The purpose of this study was to investigate the prevalence of torus mandibularis within a population residing in the Rochester, New York, region. During a comprehensive initial exam, utilizing clinical inspection and palpation, 1,323 subjects were examined for any tori in the mandibular area. Of the 1,323 subjects studied, 37.8% had tori mandibularis, with a higher frequency occurring in male patients (overall mean age: 40 years). In the Rochester, New York, area the observations noted a high prevalence of torus mandibularis (37.8%), with a mean population age of 40 years; 52% of the tori were observed in men. PMID:23513545

  9. 75 FR 25290 - Notice of Intent To Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Rochester Museum & Science Center acquired from various sources 10 medicine faces made by members of the... National Park Service Notice of Intent To Repatriate Cultural Items: Rochester Museum & Science Center... to repatriate cultural items in the possession of the Rochester Museum & Science Center,...

  10. Mayo de Los Capomos, Sinaloa (Mayo of Los Capomos, Sinaloa).

    ERIC Educational Resources Information Center

    Freeze, Ray A.

    This document is one of 17 volumes on indigenous Mexican languages and is the result of a project undertaken by the Archivo de Lenguas Indigenas de Mexico. This volume contains information on Mayo, an indigenous language of Mexico spoken in Los Capomos, in the state of Sinaloa. The objective of collecting such a representative sampling of the…

  11. Rochester Focuses: A Community's Core Competence.

    ERIC Educational Resources Information Center

    Gabor, Andrea

    1991-01-01

    Rochester, New York, is globally competitive in optics manufacturing because of cooperative, strategic use of community resources: (1) collaboration of the University of Rochester and industry in the Center for Optics Manufacturing; (2) business cooperation in reform of the schools system; and (3) emphasis on total quality. (SK)

  12. The Mayo Innovation Scholars Program: Undergraduates Explore the Science and Economics of Medical Innovations

    ERIC Educational Resources Information Center

    Pellegrini, John J.; Jansen, Elizabeth

    2013-01-01

    The Mayo Innovation Scholars Program introduces undergraduates to technology transfer in biomedical sciences by having teams of students from multiple disciplines (e.g., biology, chemistry, economics, and business) analyze inventions in development at the Mayo Clinic. Over 6 months, teams consult with inventors, intellectual property experts, and…

  13. 75 FR 23800 - Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... National Park Service Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center... to repatriate one cultural item in the possession of the Rochester Museum & Science Center, Rochester... large wooden medicine face (AE 9499/ 61.334.1) from the Rochester Museum Association that previously...

  14. Design of an image-distribution service from a clinical PACS

    NASA Astrophysics Data System (ADS)

    Gehring, Dale G.; Persons, Kenneth R.; Rothman, Melvyn L.; Felmlee, Joel P.; Gerhart, D. J.; Hangiandreou, Nicholas J.; Reardon, Frank J.; Shirk, M.; Forbes, Glenn S.; Williamson, Byrn, Jr.

    1994-05-01

    A PACS system has been developed through a multi-phase collaboration between the Mayo Clinic and IBM/Rochester. The current system has been fully integrated into the clinical practice of the Radiology Department for the primary purpose of digital image archival, retrieval, and networked workstation review. Work currently in progress includes the design and implementation of a gateway device for providing digital image data to third-party workstations, laser printers, and other devices, for users both within and outside of the Radiology Department.

  15. 78 FR 50102 - Notice of Inventory Completion: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... National Park Service Notice of Inventory Completion: Rochester Museum & Science Center, Rochester, NY... has completed an inventory of associated funerary objects, in consultation with the appropriate Indian... (NAGPRA), 25 U.S.C. 3003, of the completion of an inventory of associated funerary objects under...

  16. 77 FR 19699 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... National Park Service Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center... & Science Center, in consultation with the appropriate Indian tribe, has determined that the cultural items... Rochester Museum & Science Center. DATES: Representatives of any Indian tribe that believes it has...

  17. 77 FR 19698 - Notice of Intent to Repatriate Cultural Items: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... and 1984, the Rochester Museum & Science Center acquired 36 medicine faces made by members of the... & Science Center) purchased one 19th century wooden medicine face (27.81.463/AE 1171) from the Opdyke estate.... In 1984, the Rochester Museum & Science Center purchased one 20th century cornhusk medicine face...

  18. The 2 + 1 paradigm: an efficient algorithm for central reading of Mayo endoscopic subscores in global multicenter phase 3 ulcerative colitis clinical trials.

    PubMed

    Ahmad, Harris A; Gottlieb, Klaus; Hussain, Fez

    2016-02-01

    Despite its importance and potential impact in clinical trials, central reading continues to be an under-represented topic in the literature about inflammatory bowel disease (IBD) clinical trials. Although several IBD studies have incorporated central reading to date, none have fully detailed the specific methodology with which the reads were conducted. Here we outline key principles for designing an efficient central reading paradigm for an ulcerative colitis (UC) study that addresses regulatory, operational and clinical expectations. As a step towards standardization of read methodology for the growing number of multicenter phase 3 clinical trials in IBD, we have applied these principles to the design of an optimal read methodology that we call the '2 + 1 paradigm.' The 2 + 1 paradigm involves the use of both site and central readers, validated scoring criteria and multiple measures for blinding readers, all of which contribute to reducing bias and generating a reliable endoscopic subscore that reflects endoscopic disease severity. The paradigm can be utilized while maintaining a practical workflow compatible with an operationally feasible clinical trial. The 2 + 1 paradigm represents a logical approach to endoscopic assessment in IBD clinical trials, one that should be considered attractive to prospective sponsors, contract research organizations, key opinion leaders and regulatory authorities and be ready for implementation and further evaluation. PMID:26361984

  19. The Rocky Road to Reform in Rochester.

    ERIC Educational Resources Information Center

    Koppich, Julia E.

    A profile of Rochester, New York, Public School District's educational reform efforts from 1987 to 1990 is offered in this case study. Following an overview of the city and its public schools, the impetus for educational reform is discussed, with attention given to the roles of the superintendent, teachers' union president, and school board.…

  20. 75 FR 23799 - Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... National Park Service Notice of Intent to Repatriate a Cultural Item: Rochester Museum & Science Center... to repatriate one cultural item in the possession of the Rochester Museum & Science Center, Rochester... small red stone medicine face (82.54.1). It appears to be a contemporary piece and was donated to...

  1. Practice effects and longitudinal cognitive change in normal aging vs. incident mild cognitive impairment and dementia in the Mayo Clinic Study of Aging

    PubMed Central

    Machulda, Mary M.; Pankratz, V. Shane; Christianson, Teresa J.; Ivnik, Robert J.; Mielke, Michelle M.; Roberts, Rosebud O.; Knopman, David S.; Boeve, Bradley F.; Petersen, Ronald C.

    2013-01-01

    The objective of this study was to examine practice effects and longitudinal cognitive change in a population based cohort classified as clinically normal at their initial evaluation. We examined 1390 individuals with a median age of 78.1 years and re-evaluated them up to four times at approximate 15 month intervals, with an average follow-up time of five years. Of the 1390 participants, 947 (69%) individuals remained cognitively normal, 397 (29%) progressed to mild cognitive impairment (MCI), and 46 (3%) to dementia. The stable normal group showed an initial practice effect in all domains which was sustained in memory and visuospatial reasoning. There was only a slight decline in attention and language after visit 3. We combined individuals with incident MCI and dementia to form one group representing those who declined. The incident MCI/dementia group showed an unexpected practice effect in memory from baseline to visit 2, with a significant decline thereafter. This group did not demonstrate practice effects in any other domain and showed a downward trajectory in all domains at each evaluation. Modeling cognitive change in an epidemiologic sample may serve as a useful benchmark for evaluating cognitive change in future intervention studies. PMID:24041121

  2. Mayo v. Prometheus: A Year Later

    PubMed Central

    2013-01-01

    Last year’s U.S. Supreme Court decision in Mayo v. Prometheus regarding the patent eligibility of diagnostic method claims will probably have the most profound lasting effect of any recent court decision on the biopharmaceutical industry. The Mayo decision changed the evaluation of patent eligibility of a method claim under 35 U.S.C. § 101. The new evaluation is a more difficult standard to clear and needs to be considered prior to filing a patent application. PMID:24900711

  3. Transforming Research Management Systems at Mayo Clinic

    ERIC Educational Resources Information Center

    Smith, Steven C.; Gronseth, Darren L.

    2011-01-01

    In order for research programs at academic medical centers and universities to survive and thrive in the increasingly challenging economic, political and regulatory environment, successful transformation is extremely important. Transformation and quality management techniques are increasingly well established in medical practice organizations. In…

  4. 78 FR 50108 - Notice of Intent To Repatriate Cultural Item: Rochester Museum & Science Center, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ...The Rochester Museum & Science Center, in consultation with the appropriate Indian tribes or Native Hawaiian organizations, has determined that the cultural item listed in this notice meets the definition of a sacred object and an object of cultural patrimony. Lineal descendants or representatives of any Indian tribe or Native Hawaiian organization not identified in this notice that wish to......

  5. Developing a publicity plan for library research: the Rochester Study.

    PubMed

    Smith, B T

    1992-01-01

    The hospital librarians in Rochester, New York and a research team developed and administered a questionnaire to measure the impact of information provided by the librarian on physicians' clinical decision making. While the research was underway, the librarians also developed a publicity plan. The goal of the plan was to create awareness of the study results in the local client population, as well as in the health care community at large. The plan served to describe and put in priority order the types of media that the librarians would use to publicize the study to target groups. This article includes examples of a nationwide and an institution-specific publicity plan. those developing publicity plans for future library research may want to allocate adequate funds to hire a media consultant to increase their prospects for national exposure. PMID:10124016

  6. Elton Mayo and Carl Rogers: A Tale of Two Techniques.

    ERIC Educational Resources Information Center

    Mahoney, Kevin T.; Baker, David B.

    2002-01-01

    Compares the simultaneous emergence of Mayo's nonauthoritarian interviewing approach and Rogers' nondirective counseling approach. Examines the influence of Piaget on Mayo and reviews the Hawthorne studies. Concludes that differences in the approaches outweigh similarities. (Contains 21 references.) (SK)

  7. Rochester area interactive telecommunications network (RAITN): A partnership in Rochester between educators and industry

    SciTech Connect

    O`Leary, C.T.

    1994-12-31

    Primarily funded by Rochester Telephone Corporation, the RAITN system connects five area high schools, Rochester Institute of Technology (RIT), and State University of New York at Brockport. Monroe No. 1 Board of Cooperative Educational Services coordinates the interactive programming which may originate from any of the sites. Course offerings on the network range from full credit college courses to high schools sharing unique classes to increase each partners` breadth of educational options. Special events dealing with a variety of interest areas such as teen health issues, professional development, guest speakers and political leaders, and multicultural diversity topics fill out the schedule of interactive programming. {open_quotes}Electronic field trips{close_quotes} allow students and staff to {open_quotes}virtually attend{close_quotes} seminars, science fairs, and teleconferences held at RIT without leaving their schools. Internet connectivity and a new group of high school, university and industry partners are the next additions to the network.

  8. The Arabic Version of the Mayo-Portland Adaptability Inventory 4: A Validation Study

    ERIC Educational Resources Information Center

    Hamed, Razan; Tariah, Hashem Abu; Malkawi, Somaya; Holm, Margo B.

    2012-01-01

    The Mayo-Portland Adaptability Inventory 4 (MPAI-4) is a valid and reliable assessment tool to detect clinical impairments in patients with acquired brain injury. The tool is widely used by rehabilitation therapists worldwide, given its good psychometric properties and its availability in several languages. The purpose of this study was to…

  9. Impacts of hospital budget limits in Rochester, New York.

    PubMed

    Friedman, B; Wong, H S

    1995-01-01

    During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end. PMID:10151889

  10. Impacts of Hospital Budget Limits in Rochester, New York

    PubMed Central

    Friedman, Bernard; Wong, Herbert S.

    1995-01-01

    During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end. PMID:10151889

  11. Update on the Rochester Optical Streak System

    NASA Astrophysics Data System (ADS)

    Jaanimagi, P. A.

    2005-10-01

    The Rochester Optical Streak System (ROSS) is a modern, self-calibrating, remotely controlled streak camera platform capable of accepting a variety of different streak tubes. The optical calibration module (OCM) for the ROSS camera has been completed and integrated with the main streak tube housing. The OCM incorporates an achromatic Offner triplet that allows fiber-delivered input and free-space propagated signals to be simultaneously relayed to the photocathode. It also encloses of the light sources and reticles required to accomplish a full suite of system calibrations including: autofocus of the input and electron optics, geometric distortion and flat-field correction, time base, system gain, and linearity. We will present data illustrating the system capabilities and our latest results comparing the dynamic performance of the P510 and P820 streak tubes. This work was supported by the U.S. Department of Energy Office of Inertial Confinement Fusion under Cooperative Agreement No. DE-FC52-92SF19460.

  12. William Worrall Mayo, social-radical and civic activist.

    PubMed

    Bloch, H

    1988-11-01

    Herein, the roots of Mayo's active radicalism on America's western frontier are traced to both his knowledge of conditions in Manchester, England during the first 26 years of his life and the impress of laissez faire in America. Books and a close friendship with the Populist and Farmer's Alliance leader Ignatius Donnelly only fortified Mayo's convictions. Mayo never flagged in his social activism nor sacrificed his radical ideology. PMID:3056058

  13. Against the Corporate Culture Ideology: An Interview with Peter Mayo

    ERIC Educational Resources Information Center

    Suoranta, Juha

    2010-01-01

    This article presents an interview with Peter Mayo, author and expert in the field of sociology of adult education, on his major influences in this area, his books, and his views on the role of radical adult education and radical scholarship in the future. In the interview, Peter Mayo states that his initial view of adult education was quite a…

  14. Bridge Builder: Susan Gibbons--University of Rochester, NY

    ERIC Educational Resources Information Center

    Library Journal, 2005

    2005-01-01

    There are many chasms in the library profession: among different libraries and between public services and technology staff, users and librarians, and research and practice. Susan Gibbons bridges all of them. As director of digital library initiatives at the University of Rochester River Campus Libraries, Gibbons was an early adopter of MIT's…

  15. Long-Range Strategic Planning: The Rochester Experience.

    ERIC Educational Resources Information Center

    Schultz, John M.; Anthony, Deborah L.

    The administration of Rochester Community Schools (Michigan) initiated a process for long-range strategic planning in 1984, described in this synopsis. Strategic planning is an ongoing, evolutionary process of defining the business one is in or should be in; establishing organizational goals and objectives; and developing and implementing…

  16. The Rochester (NY) School-to-Work Transition Initiative.

    ERIC Educational Resources Information Center

    Rochester City School District, NY.

    The Rochester (New York) School-to-Work Transition Initiative introduces career opportunities and choices to students from prekindergarten through 12th grade and beyond by preparing them for the workplace. The initiative helps students identify their interests and a career direction and enables them to pursue the education and technical training…

  17. Teaching as a Profession: The Rochester Case in Historical Perspective.

    ERIC Educational Resources Information Center

    Murray, Christine E.

    1992-01-01

    A case study of the Rochester (New York) school district illustrates the changes in teaching as a profession during three periods: (1) 1900-10, the growth in urban schools; (2) 1960-70, the rise in activism and teacher militancy; and (3) the 1980s, educational reform and teacher professionalization on the national agenda. (SK)

  18. The etiology and incidence of anaphylaxis in Rochester, Minnesota: A report from the Rochester Epidemiology Project

    PubMed Central

    Decker, Wyatt W.; Campbell, Ronna L.; Manivannan, Veena; Luke, Anuradha; St. Sauver, Jennifer L.; Weaver, Amy; Bellolio, M. Fernanda; Bergstralh, Eric J.; Stead, Latha G.; Li, James T. C.

    2009-01-01

    Background Reported incidences of anaphylaxis range from 3.2 to 20 per 100,000 population. The incidence and trend over time has meaningful public health implications but has not been well characterized because of a lack of a standard definition and deficiencies in reporting of events. Objective We sought to determine the incidence and cause of anaphylaxis over a 10-year period. Methods We performed a population-based incidence study that was conducted in Rochester, Minnesota, from 1990 through 2000. Anaphylaxis episodes were identified on the basis of symptoms and signs of mast cell and basophil mediator release plus mucocutaneous, gastrointestinal tract, respiratory tract, or cardiovascular system involvement. Results Two hundred eleven cases of anaphylaxis were identified (55.9% in female subjects). The mean age was 29.3 years (SD, 18.2 years; range, 0.8–78.2 years). The overall age-and sex-adjusted incidence rate was 49.8 (95% CI, 45.0–54.5) per 100,000 person-years. Age-specific rates were highest for ages 0 to 19 years (70 per 100,000 person-years). Ingested foods accounted for 33.2% (70 cases), insect stings accounted for 18.5% (39 cases), medication accounted for 13.7% (29 cases), radiologic contrast agent accounted for 0.5% (1 case), “other” causes accounted for 9% (19 cases), and “unknown” causes accounted for 25.1% (53 cases). The “other” group included cats, latex, cleaning agents, environmental allergens, and exercise. There was an increase in the annual incidence rate during the study period from 46.9 per 100,000 persons in 1990 to 58.9 per 100,000 persons in 2000 (P = .03). Conclusion The overall incidence rate is 49.8 per 100,000 person-years, which is higher than previously reported. The annual incidence rate is also increasing. Food and insect stings continue to be major inciting agents for anaphylaxis. PMID:18992928

  19. Medical information retrieval and WWW browsers at Mayo.

    PubMed Central

    Chute, C. G.; Crowson, D. L.; Buntrock, J. D.

    1995-01-01

    Medical information retrieval from "Master Sheet" entries specially indexed for research retrieval has been part of the Mayo culture since 1909. Providing easy to use and universally available WWW access to these and other patient information databases at Mayo via browsers, shines a bright light on issues of privacy and confidentiality, user authentication, need to know, data transmission security, and technical details of interfacing disparate databases on a spectrum of platforms to many types of workstations using a variety of browsers. We review our recent experience, and generalize pertinent issues. PMID:8563423

  20. Technology Transfer and Outreach for SNL/Rochester ALPHA Project.

    SciTech Connect

    Sinars, Daniel

    2016-01-01

    This report describes the next stage goals and resource needs for the joint Sandia and University of Rochester ARPA-E project. A key portion of this project is Technology Transfer and Outreach, with the goal being to help ensure that this project develops a credible method or tool that the magneto-inertial fusion (MIF) research community can use to broaden the advocacy base, to pursue a viable path to commercial fusion energy, and to develop other commercial opportunities for the associated technology. This report describes an analysis of next stage goals and resource needs as requested by Milestone 5.1.1.

  1. Developing a medical humanities concentration in the medical curriculum at the University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.

    PubMed

    Spike, Jeffrey Philip

    2003-10-01

    To the author's knowledge, the University of Rochester School of Medicine and Dentistry is the only medical school in the United States that offers a concentration or minor in medical humanities for medical students. This article presents how the author first thought of offering a concentration in medical humanities and explains the educational elements students must satisfy. In 1998, the university underwent a major curriculum revision, dubbed the "double-helix" curriculum because of its goal of intertwining basic science and clinical medicine over all four years of medical school. As course director of the Medical Humanities Seminars for more than ten years, the author saw this change as an opportunity to expand the humanities curriculum. The number of sessions and courses offered in the first two years doubled as part of the transition to the new curriculum. In addition, the author proposed to the medical school curriculum steering committee to approve a concentration in clinical ethics and humanities. The concentration option motivates students to continue to pursue their humanistic interests in the third and fourth years of medical school. About 25% of the student body has signed up in the first two years the concentration has been available. PMID:14534093

  2. An Academic Healthcare Twitter Account: The Mayo Clinic Experience.

    PubMed

    Widmer, R Jay; Engler, Nicole B; Geske, Jeffrey B; Klarich, Kyle W; Timimi, Farris K

    2016-06-01

    With more than 300 million monthly active users, Twitter is a powerful social media tool in healthcare, yet the characterization of an academic healthcare Twitter account remains poor to date. We assessed basic gender and geographic data on the account's "followers," as well as categorization of each tweet based on content type. We analyzed the impressions, engagements, retweets, favorites, replies, hashtag clicks, and detail expansions using both Sprinklr and Twitter Analytics. Over a period of 12 months, the account amassed 1,235 followers, with 54 percent being male and 68 percent residing in the United States. Of the 1,635 tweets sent out over the life of the account, we report more than 382,464 impressions, 6,023 engagements, 1,255 retweets, 776 favorites, and 1,654 embedded media clicks in this period. When broken down by tweet category, publication tweets garnered the highest engagement with an estimated mean number of clicks per tweet of 8.2 ± 81.9. Original content had higher total engagement per tweet than retweeted material (2.8 ± 9.2 vs. 0.2 ± 0.9 engagements per tweet; p < 0.0001). Tweets regarding internal, national, and continuing medical education events had similar engagement. Herein is the first publication within the medical literature describing a "case series" of cardiovascular tweets over 12 months. We highlight a rapidly emerging group of interactive followers, a successful means by which to disseminate and engage in breaking topics throughout the cardiovascular field, and the importance of combining physician-led knowledge with intermittent marketing messages. PMID:27327062

  3. Adjuvant therapy for ampullary carcinomas: The Mayo Clinic experience

    SciTech Connect

    Bhatia, Sumita; Miller, Robert C. . E-mail: miller.robert@mayo.edu; Haddock, Michael G.; Donohue, John H.; Krishnan, Sunil

    2006-10-01

    Purpose: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. Methods and Materials: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. Results: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p = 0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p = 0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. Conclusions: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed.

  4. A resolution commemorating the 150th anniversary of Mayo Clinic.

    THOMAS, 113th Congress

    Sen. Franken, Al [D-MN

    2014-01-27

    02/10/2014 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Passed SenateHere are the steps for Status of Legislation:

  5. 33 CFR 162.165 - Buffalo and Rochester Harbors, New York.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Engineers also has regulations dealing with these areas in 33 CFR Part 207. ..., New York. 162.165 Section 162.165 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... and Rochester Harbors, New York. In Buffalo and Rochester Harbors, no vessel may exceed 6 miles...

  6. A Formative Evaluation of Two Gallaudet University/Rochester Institute of Technology Courses Offered via Teleconferencing.

    ERIC Educational Resources Information Center

    McKee, Barbara G.; Scherer, Marcia J.

    Two pilot telecourses were offered in fall 1991 at Rochester Institute of Technology and Gallaudet University. The course "Black Civil Rights in the Twentieth Century" was taught by a Rochester faculty member with a Gallaudet teacher as resource or co-teacher. The other course, "Mass Media and Deaf History," was taught from Gallaudet with a…

  7. Australian influences on Elton Mayo: the construct of Revery in industrial society.

    PubMed

    Griffin, Mark A; Landy, Frank J; Mayocchi, Lisa

    2002-11-01

    Elton Mayo was born in Australia and spent most of his first 42 years living in that country. This article explores the Australian context in which he developed his views views of Australia compared with that of the United States during the time that Mayo developed his approach to psychology and the role of workers in industry. In addition, the social context in which Mayo established his career was shaped by significant political events in Australia. The construct of revery, which describes a specific state of consciousness, is central to Mayo's early theorizing and was developed by Mayo partly in reaction to political and industrial conflict occurring in Australia. PMID:12465617

  8. Geohydrology of the Irondequoit Creek Basin near Rochester, New York

    USGS Publications Warehouse

    Yager, Richard M.; Zarriello, Phillip J.; Kappel, William M.

    1985-01-01

    Geohydrologic information on the area within and surrounding the Irondequoit Creek basin near Rochester, in north-central New York, is presented on five maps at 1:24,000 scale indicating: (1) locations of glacial geomorphic features, (2) surficial geology, (3) soil permeability, (4) potentiometric-surface altitude and directions of groundwater movement, and (5) groundwater recharge and flow patterns. Also included are 20 geologic sections showing statigraphic relationships, aquifer composition, and depth to bedrock. Each map includes a short text and a list of references. Results indicate that groundwater within the basin flows northward to Irondequoit Bay and Lake Ontario and that the groundwater drainage system is considerably smaller than the overlying surface drainage area. These maps, based on available records and published data, depict the location of major recharge areas, relative rates of recharge, and the direction and rates of groundwater flow within the basin for use in aquifer management. (USGS)

  9. Remembering Joseph Mayo and His Contributions to Animal Science | Poster

    Cancer.gov

    By Carolynne Keenan, Guest Writer In the 1990s, when Joseph Mayo, D.V.M, ran out of gas leading coworkers home from a meeting in Bethesda, he pulled over to the side of the road on I-270 and waited for help. He didn’t have to wait long; within a few minutes a passing motorist took pity on the group of scientists and offered them a lift back to Fort Detrick.

  10. Impact melting in the Cumberland Falls and Mayo Belwa aubrites

    NASA Astrophysics Data System (ADS)

    Rubin, Alan E.

    2010-02-01

    Six chondritic clasts in the Cumberland Falls polymict breccia were examined: four texturally resemble ordinary chondrites (OCs) and two are impact melt breccias containing shocked OC clasts adjacent to a melt matrix. The six chondritic clasts are probably remnants of a single OC projectile that was heterogeneously shocked when it collided with the Cumberland Falls host. Mayo Belwa is the first known aubrite impact melt breccia. It contains coarse enstatite grains exhibiting mosaic extinction; the enstatite grains are surrounded by a melt matrix composed of 3-16 μm-size euhedral and subhedral enstatite grains embedded in sodic plagioclase. Numerous vugs, ranging from a few micrometers to a few millimeters in size, constitute ~5 vol% of the meteorite. They occur nearly exclusively within the Mayo Belwa matrix; literature data show that some vugs are lined with bundles of acicular grains of the amphibole fluor-richterite. This phase has been reported previously in only two other enstatite meteorites (Abee and St. Sauveur), both of which are EH-chondrite impact melt breccias. It seems likely that in Mayo Belwa, volatiles were vaporized during an impact event and formed bubbles in the melt. As the melt solidified, the bubbles became cavities; plagioclase and fluor-richterite crystallized at the margins of these cavities via reaction of the melt with the vapor.

  11. Overview perspective of west elevation, looking east. MonacaRochester Bridge in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Overview perspective of west elevation, looking east. Monaca-Rochester Bridge in background. - Pittsburgh & Lake Erie Railroad, Ohio River Bridge, Spanning Ohio River, West of Beaver River, Beaver, Beaver County, PA

  12. Developing a clinical trial unit to advance research in an academic institution.

    PubMed

    Croghan, Ivana T; Viker, Steven D; Limper, Andrew H; Evans, Tamara K; Cornell, Alissa R; Ebbert, Jon O; Gertz, Morie A

    2015-11-01

    Research, clinical care, and education are the three cornerstones of academic health centers in the United States. The research climate has always been riddled with ebbs and flows, depending on funding availability. During a time of reduced funding, the number and scope of research studies have been reduced, and in some instances, a field of study has been eliminated. Recent reductions in the research funding landscape have led institutions to explore new ways to continue supporting research. Mayo Clinic in Rochester, MN has developed a clinical trial unit within the Department of Medicine, which provides shared resources for many researchers and serves as a solution for training and mentoring new investigators and study teams. By building on existing infrastructure and providing supplemental resources to existing research, the Department of Medicine clinical trial unit has evolved into an effective mechanism for conducting research. This article discusses the creation of a central unit to provide research support in clinical trials and presents the advantages, disadvantages, and required building blocks for such a unit. PMID:26454064

  13. Ten-Year Study of the Stringently Defined Otitis-prone Child in Rochester, NY.

    PubMed

    Pichichero, Michael E

    2016-09-01

    This review summarizes a prospective, longitudinal 10-year study in Rochester, NY, with virtually every clinically diagnosed acute otitis media (AOM) confirmed by bacterial culture of middle ear fluid. Children experiencing 3 episodes within 6 months or 4 episodes in 12 months were considered stringently defined otitis prone (sOP). We found stringent diagnosis compared with clinical diagnosis reduced the frequency of children meeting the OP definition from 27% to 6% resulting in 14.8% and 2.4% receiving tympanostomy tubes, respectively. Significantly more often respiratory syncytial virus infection led to AOM in sOP than non-otitis-prone children that correlated with diminished total respiratory syncytial virus-specific serum IgG. sOP children produced low levels of antibody to Streptococcus pneumoniae and Haemophilus influenzae candidate vaccine protein antigens and to routine pediatric vaccines. sOP children generated significantly fewer memory B cells, functional and memory T cells to otopathogens following nasopharyngeal colonization and AOM than non-otitis-prone children and they had defects in antigen-presenting cells. PMID:27273691

  14. Imagine Astronomy at the Rochester Institute of Technology

    NASA Astrophysics Data System (ADS)

    Rapson, Valerie; Almeyda, T.; Freeman, M.; Lena, D.; Principe, D.; Punzi, K.; Sargent, B. A.; Vaddi, S.; Vazquez, B.; Vorobiev, D.

    2014-01-01

    The Imagine RIT Innovation and Creativity Festival is an annual free event held each year on the campus of the Rochester Institute of Technology (RIT). The purpose of the festival is to showcase the work and research conducted by students and faculty at RIT, and get the public excited about science and technology. For the past three years, graduate students, post-docs and faculty in the Astrophysical Sciences and Technology graduate program at RIT have participated in the festival by showcasing their astronomy research in a fun, interactive and hands on way. We have presented work conducted with various telescopes in the fields of star formation and galaxy evolution. Here, we present our three unique exhibits and the public’s reception to each exhibit. We found that interactive games such as astro-trivia, and hands on activities such as building a scale model of the Hubble Space Telescope were the most exciting for visitors. Interactive pieces of the exhibit in general acquired the most attention, whereas posters and videos, despite their pictorial nature, were not as well received. The most successful piece of our exhibit each year has been solar observing through eclipse glasses and telescopes. Most people who observed the sun at our exhibit were left awe-struck because this was their first experience viewing an astronomical object through a telescope. We plan to improve upon our exhibit by introducing more hands-on activities that will engage the public in current astronomy research at RIT.

  15. Improving Clinical Access and Continuity through Physician Panel Redesign

    PubMed Central

    Banerjee, Ritesh; Denton, Brian; Naessens, James; Stahl, James

    2010-01-01

    Background Population growth, an aging population and the increasing prevalence of chronic disease are projected to increase demand for primary care services in the United States. Objective Using systems engineering methods, to re-design physician patient panels targeting optimal access and continuity of care. Design We use computer simulation methods to design physician panels and model a practice’s appointment system and capacity to provide clinical service. Baseline data were derived from a primary care group practice of 39 physicians with over 20,000 patients at the Mayo Clinic in Rochester, MN, for the years 2004–2006. Panel design specifically took into account panel size and case mix (based on age and gender). Measures The primary outcome measures were patient waiting time and patient/clinician continuity. Continuity is defined as the inverse of the proportion of times patients are redirected to see a provider other than their primary care physician (PCP). Results The optimized panel design decreases waiting time by 44% and increases continuity by 40% over baseline. The new panel design provides shorter waiting time and higher continuity over a wide range of practice panel sizes. Conclusions Redesigning primary care physician panels can improve access to and continuity of care for patients. PMID:20549379

  16. Ten-Year Study of Acute Otitis Media in Rochester, NY.

    PubMed

    Pichichero, Michael E

    2016-09-01

    This review summarizes a prospective, longitudinal 10-year study in Rochester, NY, involving 760 children where virtually all clinically diagnosed acute otitis media (AOM) was confirmed by bacterial culture of middle ear fluid. This review describes detection of otopathogens in middle ear fluid, nasopharyngeal (NP) otopathogen colonization patterns, AOM risk factor analysis, biomarkers of AOM and antibody responses to NP colonization by otopathogens. After licensure of PCV13, there was an immediate drop in AOM caused by Streptococcus pneumoniae (Spn) vaccine serotypes and shortly thereafer an increase in nonvaccine types 16, 21 and 35B. When NP co-colonization occurred, nontypeable Haemophilus influenzae (NTHi) predominated over Spn to cause AOM, and NTHi and Spn both predominated over Moraxella catarrhalis. Transcriptome analysis of peripheral blood mononuclear cells identified unique signatures for NTHi AOM compared with Spn AOM. Elevation of 3 cytokines in serum (S100A12, intercellular adhesion molecule 1 and interleukin 10) accurately predicted the presence and recovery from AOM and the likely otopathogen. NP colonization was an immunizing event. PMID:27182898

  17. Validation of the Mayo Sleep Questionnaire to Screen for REM Sleep Behavior Disorder in a Community-Based Sample

    PubMed Central

    Boeve, Bradley F.; Molano, Jennifer R.; Ferman, Tanis J.; Lin, Siong-Chi; Bieniek, Kevin; Tippmann-Peikert, Maja; Boot, Brendon; St. Louis, Erik K.; Knopman, David S.; Petersen, Ronald C.; Silber, Michael H.

    2013-01-01

    Objective: To validate a questionnaire focused on REM sleep behavior disorder (RBD) in a community-based sample. Background: RBD is a parasomnia manifested by recurrent dream enactment behavior during REM sleep. While confirmation of RBD requires the presence of REM sleep without atonia on polysomnography (PSG), a screening measure for RBD validated in older adults would be desirable for clinical and research purposes. Methods: We had previously developed the Mayo Sleep Questionnaire (MSQ) to screen for the presence of RBD and other sleep disorders. We assessed the validity of the MSQ by comparing the responses of subjects' bed partners with the findings on PSG. All subjects recruited from 10/04 to 12/08 in the Mayo Clinic Study of Aging—a population-based study of aging in Olmsted County, Minnesota—who had also undergone a previous PSG were the focus of this analysis. Results: The study sample included 128 subjects (104 male; median age 77 years [range 67-90]), with the following clinical diagnoses at baseline assessment: normal (n = 95), mild cognitive impairment (n = 30), and mild Alzheimer disease (n = 3). Nine (5%) subjects had RBD based on history and PSG evidence of REM sleep without atonia. The core question on recurrent dream enactment behavior yielded sensitivity (SN) of 100% and specificity (SP) of 95% for the diagnosis of RBD. The profile of responses on four additional subquestions on RBD improved specificity. Conclusions: These data suggest that the MSQ has adequate SN and SP for the diagnosis of RBD among elderly subjects in a community-based sample. Citation: Boeve BF; Molano JR; Ferman TJ; Lin Siong-Chi; Bieniek K; Tippmann-Peikert M; Boot B; St. Louis EK; Knopman DS; Petersen RC; Silber MH. Validation of the Mayo Sleep Questionnaire to screen for REM sleep behavior disorder in a community-based sample. J Clin Sleep Med 2013;9(5):475-480. PMID:23674939

  18. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review.

    PubMed

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin

    2016-07-01

    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P < 0.0001), lower time to positivity (P < 0.0001), immunosuppression (P = 0.03), and recommendation made by an infectious disease consultant (P = 0.0005). On multivariable analysis, infectious diseases consultation (P = 0.03), higher number of positive blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs

  19. Descriptive epidemiology of neural tube defects, Rochester, New York, 1918-1938.

    PubMed

    Biggar, R J; Mortimer, E A; Haughie, G E

    1976-07-01

    This study examines the secular distribution of births, sex, and age at death of 330 cases of anencephaly and spina bifida and 62 cases of "monstrosity" recorded on City of Rochester death certificates between 1918 and 1938. The results show that death certificates may be used as a source of data (with inherent biases) and that persons diagnosed as monstrosity had similar epidemiologic characteristics to those diagnosed as anencephalic during this period. In Rochester the rise in prevalence at birth of neural tube defects was similar to, and occurred at approximately the same years as, the rises reported in Boston and Providence. PMID:779463

  20. 76 FR 25300 - Foreign-Trade Zone 141-Rochester, NY; Application for Manufacturing Authority, Firth Rixson, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Foreign-Trade Zones Board Foreign-Trade Zone 141--Rochester, NY; Application for Manufacturing Authority, Firth Rixson, Inc. d/b/a Firth Rixson Monroe (Aircraft Turbine Components), Rochester, NY A request has been submitted to the Foreign-Trade...

  1. Antimicrobial Susceptibility and Clonality of Clinical Ureaplasma Isolates in the United States.

    PubMed

    Fernández, Javier; Karau, Melissa J; Cunningham, Scott A; Greenwood-Quaintance, Kerryl E; Patel, Robin

    2016-08-01

    Ureaplasma urealyticum and Ureaplasma parvum are pathogens involved in urogenital tract and intrauterine infections and also in systemic diseases in newborns and immunosuppressed patients. There is limited information on the antimicrobial susceptibility and clonality of these species. In this study, we report the susceptibility of 250 contemporary isolates of Ureaplasma (202 U. parvum and 48 U. urealyticum isolates) recovered at Mayo Clinic, Rochester, MN. MICs of doxycycline, azithromycin, ciprofloxacin, tetracycline, erythromycin, and levofloxacin were determined by broth microdilution, with MICS of the last three interpreted according to CLSI guidelines. Levofloxacin resistance was found in 6.4% and 5.2% of U. parvum and U. urealyticum isolates, respectively, while 27.2% and 68.8% of isolates, respectively, showed ciprofloxacin MICs of ≥4 μg/ml. The resistance mechanism of levofloxacin-resistant isolates was due to mutations in parC, with the Ser83Leu substitution being most frequent, followed by Glu87Lys. No macrolide resistance was found among the 250 isolates studied; a single U. parvum isolate was tetracycline resistant. tet(M) was found in 10 U. parvum isolates, including the single tetracycline-resistant isolate, as well as in 9 isolates which had low tetracycline and doxycycline MICs. Multilocus sequence typing (MLST) performed on a selection of 46 isolates showed high diversity within the clinical Ureaplasma isolates studied, regardless of antimicrobial susceptibility. The present work extends previous knowledge regarding susceptibility to antimicrobial agents, resistance mechanisms, and clonality of Ureaplasma species in the United States. PMID:27246773

  2. “We feel deep compassion for patients...” | NIH MedlinePlus the Magazine

    MedlinePlus

    ... a potentially fatal protein buildup in the skeletal muscles. Once that was made—and it was made solely because of this program—she got a stem-cell transplant at the Mayo Clinic in Rochester, Minn., ...

  3. Intensive Blood Sugar Control May Be Too Much for Some with Type 2 Diabetes

    MedlinePlus

    ... intensive treatment nearly doubled the risk of severe hypoglycemia requiring medical attention, including hospitalization," said lead author ... endocrinologist at the Mayo Clinic in Rochester, Minn. Hypoglycemia (low blood sugar) is a serious potential complication ...

  4. Identity Formation through Participation in the Rochester New Horizons Band Programme

    ERIC Educational Resources Information Center

    Dabback, William M.

    2008-01-01

    Results of this qualitative study suggest that membership in the Rochester New Horizons Band programme provides an important vehicle for identity construction and revision in later life. Identities emerge from and are shaped by the social interactions among members in the ensemble setting. Players form new musical identities, reclaim identities…

  5. Conceptual design report for the University of Rochester cryogenic target delivery system

    SciTech Connect

    Fagaly, R.L.; Alexander, N.B.; Bourque, R.F.; Dahms, C.F.; Lindgren, J.R.; Miller, W.J.; Bittner, D.N.; Hendricks, C.D.

    1993-05-01

    The upgrade of the Omega laser at the University of Rochester`s Laboratory for Laser Energetics (UR/LLE) will result in a need for large targets filled with D{sub 2} or Dt and maintained at cryogenic temperatures. This mandates a cryogenic target delivery system capable of filling, layering, characterizing and delivering cryogenic targets to the Omega Upgrade target chamber. The program goal is to design, construct, and test the entire target delivery system by June 1996. When completed (including an operational demonstration), the system will be shipped to Rochester for reassembly and commissioning in time for the Omega Upgrade cryogenic campaign, scheduled to start in 1998. General Atomics has been assigned the task of developing the conceptual design for the cryogenic target delivery system. Design and fabrication activities will be closely coordinated with the University of Rochester, Lawrence Livermore National laboratory (LLNL) and Los Alamos National Laboratory (LANL), drawing upon their knowledge base in fuel layering and cryogenic characterization. The development of a target delivery system for Omega could also benefit experiments at Lawrence Livermore National Laboratory and the other ICF Laboratories in that the same technologies could be applied to NOVA, the National Ignition Facility or the future Laboratory Microfusion Facility.

  6. The business of precision optics manufacturing: photonics in the Rochester region

    NASA Astrophysics Data System (ADS)

    Mandina, Michael P.

    2003-05-01

    Many changes have occurred in business strategies for precision optics manufacturing. The author reacts to two papers published by D. Reid, R. DeMartino, and S. Zyglidopoulous titled "An Emerging Photonics Industry: The success Vulnerability Paradigm" and "New Business Creation and Technology Transfer in the Rochester Cluster."

  7. Interdistrict Choice as a Policy Solution: Examining Rochester's Urban-Suburban Interdistrict Transfer Program (USITP)

    ERIC Educational Resources Information Center

    Finnigan, Kara S.; Stewart, Tricia J.

    2009-01-01

    This study examines one of the longest standing interdistrict choice programs in the country: Rochester, New York's Urban-Suburban Interdistrict Transfer Program (USITP). Based upon quantitative and qualitative data, including analysis of approximately forty years of program records, review of program documents and newspaper articles, and…

  8. Site-Based Management in Education: Rochester City School District Case Study.

    ERIC Educational Resources Information Center

    Gross, Alan

    This paper describes outcomes of a partnership between the Rochester City School District (New York) and the Kodak 21st Century Learning Challenge consulting program for improving school-based planning team (S-BPT) operations. The purpose of the school-based planning team is to involve the entire school community in improving school effectiveness.…

  9. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor...

  10. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor...

  11. 33 CFR 207.600 - Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Rochester (Charlotte) Harbor, N.Y.; use, administration, and navigation. 207.600 Section 207.600 Navigation and Navigable Waters CORPS OF... (Charlotte) Harbor, N.Y.; use, administration, and navigation. (a)-(b) (c) No vessel shall moor or anchor...

  12. 78 FR 28012 - Tier One Environmental Impact Statement for the Rochester, Minnesota to Twin Cities, Minnesota...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... FRA's Procedures for Considering Environmental Impacts (64 FR 28546) (Environmental Procedures), in... connection to the Twin Cities. A trip by automobile between the Twin Cities and Rochester is approximately 1... intercity travelers a reasonable alternative to automobile travel. Project Purpose and Need: The purpose...

  13. Process and Results of an Immunization Requirement at the University of Rochester.

    ERIC Educational Resources Information Center

    Hopkins, Ruth A.; And Others

    1984-01-01

    The University of Rochester (New York) has implemented a process to ensure that all students receive necessary immunizations. The immunization requirement is combined with a required health history form and has helped the college facilitate significant increases in immunity to rubella, measles, mumps, and tetanus. A description of the program is…

  14. SOURCE CHARACTERIZATION AND CONTROL TECHNOLOGY ASSESSMENT OF METHYLENE CHLORIDE EMISSIONS FROM EASTMAN KODAK COMPANY, ROCHESTER, NY

    EPA Science Inventory

    The report gives results of an assessment of potential control technologies for methylene chloride (also known as dichloromethane or DCM) emission sources at Eastman Kodak Company's Kodak Park facility in Rochester, NY. DCM is a solvent used by Kodak in the manufacture of cellulo...

  15. 33 CFR 162.165 - Buffalo and Rochester Harbors, New York.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Engineers also has regulations dealing with these areas in 33 CFR Part 207. ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Buffalo and Rochester Harbors... SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY INLAND WATERWAYS NAVIGATION REGULATIONS § 162.165...

  16. Risk Factors for Pancreatic Neuroendocrine Tumors (PNETs): A Clinic-Based Case-Control study

    PubMed Central

    Halfdanarson, Thorvardur R.; Bamlet, William R.; McWilliams, Robert R; Hobday, Timothy J.; Burch, Patrick A.; Rabe, Kari G.; Petersen, Gloria M.

    2014-01-01

    Objectives Pancreatic neuroendocrine tumors (PNETs) are uncommon, and little is known about their risk factors and association with other cancers. We evaluated whether risk factors known to be associated with pancreatic adenocarcinoma are also associated with PNETs: smoking, alcohol use, family history of PNET and other cancers, and personal history of diabetes as potential risk factors. Methods Patients with PNETs seen at Mayo Clinic Rochester between 2000 and 2011 were compared to controls seen for a general medical evaluation. Patients and controls completed the same questionnaires. After excluding insulinoma and high-grade PNETs, 355 cases were evaluated, and 309 were matched to 602 controls (2:1) on age, sex, and region of residence. Results Personal smoking history was not associated with PNETs. Alcohol use was less common among cases (54% vs. 67%, p<0.001). Cases were more likely to report a family member with sarcoma (p=0.02), PNET (p=0.02), gall bladder cancer (p=0.02), ovarian cancer (p=0.04) and gastric cancer (p=0.01). There was no association with other cancers in family members. Diabetes was more commonly reported by cases than controls (19% vs. 11%, p<0.001). Conclusions With the exception of diabetes, risk factors that are associated with pancreatic adenocarcinoma are not risk factors for PNETs. PMID:25291526

  17. 1991 Summer research program for high school juniors at the University of Rochester`s Laboratory for Laser Energetics. Student research reports

    SciTech Connect

    Not Available

    1991-09-01

    Ten students participated in the 1991 summer high school student research program at the University of Rochester`s Laboratory for Laser Energetics (LLE). The participants spent 8 weeks working and learning at LLE. They spent most of their time working on individual research projects. Each student was assigned a project, upon which he/she worked under the direct supervision of one of the staff members of the laboratory. The students, their high schools, and their projects are listed in Table 1. The program culminated in oral and written reports describing their work. The oral reports were presented at a symposium on 23 August 1991, at which the student`s parents and teachers and members of the LLE staff were present. The written reports are collected in this volume. The titles of the works are UV alignment table; neutron yields can be measured by using the relative gain of a photomultiplier tube; scattering in isotropic and anisotropic media; a better approximation of the diffusion equation; use of the SLAC code to produce a photoemissive electrostatic electron gun; spatial resolution deteriorates with increasing film exposure; analysis of refractive image distortion; making of pinholes for x-ray pinhole cameras; does perturbation theory accurately describe multiphoton ionization? and wave front analysis using shearing interferometry.

  18. Conceptual design report for the University of Rochester cryogenic target delivery system

    SciTech Connect

    Fagaly, R.L.; Alexander, N.B.; Bourque, R.F.; Dahms, C.F.; Lindgren, J.R.; Miller, W.J. ); Bittner, D.N.; Hendricks, C.D. )

    1993-05-01

    The upgrade of the Omega laser at the University of Rochester's Laboratory for Laser Energetics (UR/LLE) will result in a need for large targets filled with D[sub 2] or Dt and maintained at cryogenic temperatures. This mandates a cryogenic target delivery system capable of filling, layering, characterizing and delivering cryogenic targets to the Omega Upgrade target chamber. The program goal is to design, construct, and test the entire target delivery system by June 1996. When completed (including an operational demonstration), the system will be shipped to Rochester for reassembly and commissioning in time for the Omega Upgrade cryogenic campaign, scheduled to start in 1998. General Atomics has been assigned the task of developing the conceptual design for the cryogenic target delivery system. Design and fabrication activities will be closely coordinated with the University of Rochester, Lawrence Livermore National laboratory (LLNL) and Los Alamos National Laboratory (LANL), drawing upon their knowledge base in fuel layering and cryogenic characterization. The development of a target delivery system for Omega could also benefit experiments at Lawrence Livermore National Laboratory and the other ICF Laboratories in that the same technologies could be applied to NOVA, the National Ignition Facility or the future Laboratory Microfusion Facility.

  19. 78 FR 14528 - Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... Energy Regulatory Commission Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and Soliciting Comments and Motions To Intervene On November 20, 2012, Mayo Hydropower, LLC (transferor) and Avalon Hydropower, LLC (transferee) filed an application for transfer of...

  20. Matters of Priority: Herbert Mayo, Charles Bell and Discoveries in the Nervous System

    PubMed Central

    Bradley, James

    2014-01-01

    Between 1822 and the late 1830s a highly personal priority dispute was fought between the celebrated surgeon and anatomist Sir Charles Bell and his ex-student Herbert Mayo. The dispute was over the motor and sensory functions of the Vth and VIIth cranial nerves. Over the course of the 1820s and the 1830s, the competing claims of Bell and Mayo were presented in newspapers, journals, and textbooks. But by the time of Bell’s death in 1842, Mayo had been discredited, a seemingly tragic footnote in the history of nervous discovery. And yet, with the benefit of hindsight, Bell’s case was at best disingenuous. His success was not due to any intrinsic scientific merit in his argument, but rather his ability to create a narrative that undermined the credibility of Mayo. However, only when Mayo’s public performances elided with Bell’s descriptions did this ploy succeed. As a result, the dispute illuminates the importance of credibility to the creation of an idealised scientific medical practitioner. PMID:25284895

  1. University of Rochester Child and Family Study: risk research in progress.

    PubMed

    Wynne, L C; Cole, R E; Perkins, P

    1987-01-01

    The University of Rochester Child and Family Study (URCAFS) is a risk research program concerned with cross-sectional and developmental relationships among three areas: parental psychopathology and health, family system functioning and dysfunctioning, and child psychopathology and health. The preliminary findings indicate that both parental psychopathology and family variables predict significantly to independent measures of school functioning of index sons during their childhood and early adolescence. Although the offspring have not yet reached the age of major risk for schizophrenia, 52 percent of the families have one or more offspring either in psychiatric treatment or for whom treatment had been recommended. PMID:3477019

  2. The Rochester Epidemiology Project: exploiting the capabilities for population-based research in rheumatic diseases

    PubMed Central

    Kremers, Hilal Maradit; Myasoedova, Elena; Crowson, Cynthia S.; Savova, Guergana; Gabriel, Sherine E.

    2011-01-01

    The Rochester Epidemiology Project (REP) is a patient record-based database based upon a medical records-linkage system for all residents of the Olmsted County, MN, USA. This comprehensive system includes all health-care providers of patients resident in this geographically defined region. It uniquely enables long-term population-based studies of all medical conditions occurring in this population; their incidence and prevalence; permits examination of disease risk and protective factors, health resource utilization and cost as well as translational studies in rheumatic diseases. PMID:20627969

  3. Use and abuse of medical service marks.

    PubMed

    Helminski, F

    1993-12-01

    Medical service marks, like other service marks and trademarks, are subject to public misuse and infringement. Such misuses are sometimes innocent and sometimes fraudulently motivated. For example, throughout the history of the Mayo Clinic, the Mayo name has been publicly appropriated by unauthorized users attempting to claim an endorsement or affiliation with the clinic. On at least two occasions, the Mayo Clinic has sued misusers. Mayo prevailed in a 1962 appeal in the Minnesota Supreme Court against a business incorporating into its name the word "Mayo" and selling medicinal products in the Rochester, Minnesota, area. The supreme court banned such deceptive use, finding that persons would associate the name Mayo on medically related products with the Mayo Clinic. Mayo did not prevail, however, in a 1972 federal appeal against a food company attempting to register a trademark of "mayo" and "7" for mayonnaise. The court found that purchasers would not associate the "mayo" on a food product with the Mayo Clinic. From 1989 to 1991, a fraudulent "Mayo Diet Pill" circulated in Europe, where advertisements suggested that it originated at the Mayo Clinic. Its sale was stopped only after the Mayo reputation incurred an undetermined amount of damage in Europe. Public misuse of medical service marks is likely to increase as the health-care marketplace becomes more competitive. PMID:8246627

  4. Part-of-speech tagging for clinical text: wall or bridge between institutions?

    PubMed Central

    Fan, Jung-wei; Prasad, Rashmi; Yabut, Rommel M.; Loomis, Richard M.; Zisook, Daniel S.; Mattison, John E.; Huang, Yang

    2011-01-01

    Part-of-speech (POS) tagging is a fundamental step required by various NLP systems. The training of a POS tagger relies on sufficient quality annotations. However, the annotation process is both knowledge-intensive and time-consuming in the clinical domain. A promising solution appears to be for institutions to share their annotation efforts, and yet there is little research on associated issues. We performed experiments to understand how POS tagging performance would be affected by using a pre-trained tagger versus raw training data across different institutions. We manually annotated a set of clinical notes at Kaiser Permanente Southern California (KPSC) and a set from the University of Pittsburg Medical Center (UPMC), and trained/tested POS taggers with intra- and inter-institution settings. The cTAKES POS tagger was also included in the comparison to represent a tagger partially trained from the notes of a third institution, Mayo Clinic at Rochester. Intra-institution 5-fold cross-validation estimated an accuracy of 0.953 and 0.945 on the KPSC and UPMC notes respectively. Trained purely on KPSC notes, the accuracy was 0.897 when tested on UPMC notes. Trained purely on UPMC notes, the accuracy was 0.904 when tested on KPSC notes. Applying the cTAKES tagger pre-trained with Mayo Clinic’s notes, the accuracy was 0.881 on KPSC notes and 0.883 on UPMC notes. After adding UPMC annotations to KPSC training data, the average accuracy on tested KPSC notes increased to 0.965. After adding KPSC annotations to UPMC training data, the average accuracy on tested UPMC notes increased to 0.953. The results indicated: first, the performance of pre-trained POS taggers dropped about 5% when applied directly across the institutions; second, mixing annotations from another institution following the same guideline increased tagging accuracy for about 1%. Our findings suggest that institutions can benefit more from sharing raw annotations but less from sharing pre-trained models

  5. Secondary School Profiles, 1985-1986. Rochester City School District. Includes New York State Comprehensive Assessment Report Data.

    ERIC Educational Resources Information Center

    Rochester City School District, NY.

    The 1985-86 profiles for the Rochester City School District's (New York) 11 secondary schools and four alternative program schools are tabulated in extensive charts. Information is provided on: (1) special instructional programs; (2) district achievement testing; (3) competency testing; (4) student attainment (percent of students enrolled in ninth…

  6. 77 FR 2268 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of intent to extend public...

  7. 76 FR 78235 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Availability of a...

  8. 77 FR 41369 - Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF AGRICULTURE Rural Utilities Service Dairyland Power Cooperative: CapX 2020 Hampton-Rochester-La Crosse Transmission Line Project AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Availability of a...

  9. Bakhtinian grotesque realism and the subversion of biblical authority in Rochester's sodom.

    PubMed

    Frontain, R J

    1997-01-01

    Rather than signalling Rochester's agreement with the presumptive biblical imprecation against sodomy and consequent divine vengeance, the apocalyptic denouement of The Farce of Sodom bespeaks defiance of divine judgement and a willingness to persevere in the pleasure of homosexual anal sex despite what might seem certain divine retribution. A Bakhtinian reading of the play's carnivalesque features concludes that it is the failure of all sexual endeavor, rather than of sodomy per se, that is dramatized in the farce's concluding scene. Sodom anticipates both the modern attitude towards the open male body that has come to dominate contemporary gay discourse, and the transgressive uses to which modern writers have put the Bible by which they undercut its authority and the presumptive morality that it is otherwise used to sanction. PMID:9378943

  10. Flood of July 5-7, 1978, on the South Fork Zumbro River at Rochester, Minnesota

    USGS Publications Warehouse

    Latkovich, V.J.

    1979-01-01

    The intense thunderstorm of July 5-6, 1978, caused record flooding on the South Fork Zumbro River at Rochester, Minnesota. The peak discharge on July 6 was 30,500 cubic feet per second compared with 19,600 cubic feet per second for the flood of March 1965, which was the largest previously known. The 1965 flood had a recurrence interval of about 30 years, whereas the 1978 flood had a recurrence interval exceeding 100 years. The flood waters claimed at least 5 lives and 5,000 people were forced to leave their homes. Millions of dollars in flood damage was reported, and this report summarizes some of the flood data and a photomosaic map shows the inundated area.

  11. The Rochester OSA Optics Suitcase: 13 years of middle school outreach

    NASA Astrophysics Data System (ADS)

    Canavesi, Cristina; Donlon, Theresa M.; Jacobs, Stephen D.

    2012-10-01

    The Rochester Section of the Optical Society of America (ROSA) developed a youth outreach program in 1999 to be presented in middle schools by scientists, engineers and engineering students. The objective was to kindle interest in technology careers, especially those related to optics, photonics, and optical engineering. Three in-class experiments using individual take-home theme packets that explore color in white light were devised early in the program, and these have proven to be the key to its success. Over the past 13 years, with financial support from a variety of organizations and individuals, ROSA has manufactured and delivered over 450 Optics Suitcases to groups in 34 US states and 54 countries. The presentation guide is now available in 4 languages besides English. In this paper, the elements of an Optics Suitcase presentation are reviewed, and examples of outreach events are used to document its success.

  12. Aeroallergens in dairy barns near Cooperstown, New York and Rochester, Minnesota

    SciTech Connect

    Campbell, A.R.; Swanson, M.C.; Fernandez-Caldas, E.; Reed, C.E.; May, J.J.; Pratt, D.S. )

    1989-08-01

    We sampled atmospheric barn air using a volumetric air sampler in ten barns near Cooperstown, NY and six barns near Rochester, MN, and, with radioimmunoassays, measured allergens of Aspergillus fumigatus, Thermoactinomyces vulgaris, Micropolyspori faeni, short ragweed, rye grass group I pollen, Alternaria (Alt-1), Dermatophagoides sp. Lepidoglyphus destructor, common insect allergen, mouse urine, rat urine, and cattle epithelium. The most abundant allergen present was A. fumigatus followed by L. destructor. This study provides initial data on barn aerobiology and demonstrates for the first time the abundance of L. destructor allergens in North American dairy barns. More comprehensive study of barns, poultry houses, confinement houses for swine, and other agricultural environments from various geographic locations is needed to define the allergen levels to which millions of farm workers are exposed each day. While most of the allergens were expected, the presence of airborne allergens reactive with antisera to Dermatophagoides suggests indirectly that substantial amounts of pyroglyphid mites are present in some barns.

  13. Medulloblastoma--prognostic factors and outcome of treatment: Review of the Mayo Clinic experience

    SciTech Connect

    Garton, G.R.; Schomberg, P.J.; Scheithauer, B.W.; Shaw, E.G.; Ilstrup, D.M.; Blackwell, C.R.; Laws, E.R. Jr.; Earle, J.D. )

    1990-08-01

    From March 1965 through December 1984, 58 patients (35 male and 23 female patients; median age, 17 years) with posterior fossa (PF) medulloblastoma underwent surgical treatment and postoperative radiation therapy at our institution. Radiation fields were the craniospinal axis in 39 patients, PF plus spinal axis in 12, PF in 6, and whole brain in 1. Median radiation doses were 43 Gy (22 to 60 Gy) to the PF and 34 Gy (6.2 to 50 Gy) to the spinal axis. Overall 5- and 10-year survivals were 50% and 33%, respectively; 5- and 10-year relapse-free survivals were 46% and 32%. Treatment failed in 34 patients (59%): in 18 who had irradiation to the craniospinal axis (13 had received 50 Gy or less to the PF) and in 16 who had a radiation field of less than the craniospinal axis. A statistically significant (P less than 0.05) improvement in 10-year survival was associated with the following prognostic variables: PF dose of 50 Gy or more, whole-brain irradiation, and spinal axis irradiation. In comparison with subtotal resection, total resection was correlated with better 10-year relapse-free survival but not overall survival. All five patients with initial treatment failure only in the spine had received a radiation dose of 30 Gy or less to the spinal axis. The 2-year survival after relapse was 46% with salvage chemotherapy or irradiation in 23 patients and 0% in the 11 patients who received no further treatment (P less than 0.01).

  14. Radiotherapy for malignancy in patients with scleroderma: The Mayo Clinic experience

    SciTech Connect

    Gold, Douglas G.; Miller, Robert C.; Petersen, Ivy A.; Osborn, Thomas G.

    2007-02-01

    Purpose: To determine the frequency of acute and chronic adverse effects in patients with scleroderma who receive radiotherapy for treatment of cancer. Methods and Materials: Records were reviewed of 20 patients with scleroderma who received radiotherapy. Acute and chronic toxic effects attributable to radiotherapy were analyzed, and freedom from radiation-related toxicity was calculated. Results: Of the 20 patients, 15 had acute toxic effects, with Grade 3 or higher toxicity for 3 patients. Seven patients had self-limited Grade 1 or 2 radiation dermatitis, and no patient had Grade 3 or higher radiation dermatitis. Thirteen patients had chronic toxic effects, with Grade 3 or higher chronic toxicity for 3 patients. The median estimated time to any grade chronic toxicity was 0.4 years, and the median estimated time to Grade 3 or higher chronic toxicity has not been reached. Conclusions: The results suggest that although some patients with scleroderma treated with radiation experience considerable toxic effects, the occurrence of Grade 3 or higher toxicity may be less than previously anticipated.

  15. The state of the science of whole blood: lessons learned at Mayo Clinic

    PubMed Central

    Stubbs, James R.; Zielinski, Martin D.; Jenkins, Donald

    2016-01-01

    AABB Standards specify that ABO group-specific whole blood is the only acceptable choice for whole blood transfusions. Although universal donor group O stored whole blood (SWB) was used extensively by the military during the wars of the mid-twentieth century, its use has fallen out of favor and has never been used to great extent in the civilian trauma population. Interest in the use of whole blood has been renewed, particularly in light of its potential value in far-forward military and other austere environments. Evidence of preserved platelet function in SWB has heightened enthusiasm for a “one stop shop” resuscitation product providing volume, oxygen carrying capacity, and hemostatic effects. Experience with universal donor group O SWB is required to ascertain whether its use will be an advance in trauma care. Described here is the process of establishing a universal donor group O SWB at a civilian trauma center in the United States. PMID:27100754

  16. The practical application of narrative medicine at Mayo Clinic: imagining the scaffold of a worthy house.

    PubMed

    Rian, Johanna; Hammer, Rachel

    2013-12-01

    American health care institutions increasingly recognize narrative medicine as a means to developing quality patient care. More commonly applied in health care professional development settings, narrative medicine is less overtly employed with patient populations. In this article, we describe the application of various narrative practices in the patient care and medical education programs of a major health care center in Minnesota. We discuss the impact of these programs on their participants in relation to the evidence based in current scholarship. Further, we examine narrative externalization of illness in Katherine Butler Hathaway's disability memoir "The Little Locksmith," a text which implicates the work of metaphor-making as a transformative step in healing. While several reports demonstrate that patients can find creative writing during times of illness to be therapeutic, there are many for whom the practice is problematic or unattractive, obstacles to practice implementation that the authors discuss. However, based on the experience of our institution, for health care institutions seeking to build a legacy of leadership in empathic patient care, narrative--employed in mentoring physicians in training and in establishing strong, dialogic relationships with patients and colleagues--should serve as a central strategy, or scaffold. PMID:24130048

  17. Renal complications in chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis: the Mayo Clinic experience

    PubMed Central

    Strati, Paolo; Nasr, Samih H.; Leung, Nelson; Hanson, Curtis A.; Chaffee, Kari G.; Schwager, Susan M.; Achenbach, Sara J.; Call, Timothy G.; Parikh, Sameer A.; Ding, Wei; Kay, Neil E.; Shanafelt, Tait D.

    2015-01-01

    While the renal complications of plasma cell dyscrasia have been well-described, most information in patients with chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis is derived from case reports. This is a retrospective analysis of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who underwent kidney biopsy for renal insufficiency and/or nephrotic syndrome. Between January 1995 and June 2014, 49 of 4,024 (1.2%) patients with chronic lymphocytic leukemia (n=44) or monoclonal B-cell lymphocytosis (n=5) had a renal biopsy: 34 (69%) for renal insufficiency and 15 (31%) for nephrotic syndrome. The most common findings on biopsy were: membranoproliferative glomerulonephritis (n=10, 20%), chronic lymphocytic leukemia interstitial infiltration as primary etiology (n=6, 12%), thrombotic microangiopathy (n=6, 12%), and minimal change disease (n=5, 10%). All five membranoproliferative glomerulonephritis patients treated with rituximab, cyclophosphamide and prednisone-based regimens had recovery of renal function compared to 0/3 patients treated with rituximab with or without steroids. Chronic lymphocytic leukemia infiltration as the primary cause of renal abnormalities was typically observed in relapsed/refractory patients (4/6). Thrombotic microangiopathy primarily occurred as a treatment-related toxicity of pentostatin (4/6 cases), and resolved with drug discontinuation. All cases of minimal change disease resolved with immunosuppressive agents only. Renal biopsy plays an important role in the management of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who develop renal failure and/or nephrotic syndrome. PMID:26088927

  18. Systemic Lupus Erythematosus, Radiotherapy, and the Risk of Acute and Chronic Toxicity: The Mayo Clinic Experience

    SciTech Connect

    Pinn, Melva E.; Gold, Douglas G. M.; Petersen, Ivy A.; Osborn, Thomas G.; Brown, Paul D.; Miller, Robert C.

    2008-06-01

    Purpose: To determine the acute and chronic toxic effects of radiotherapy in patients with systemic lupus erythematosus (SLE). Methods and Materials: Medical records of 21 consecutive patients with SLE, who had received 34 courses of external beam radiotherapy and one low-dose-rate prostate implant, were retrospectively reviewed. Patients with discoid lupus erythematosus were excluded. Results: Median survival was 2.3 years and median follow-up 5.6 years. Eight (42%) of 19 patients evaluable for acute toxicity during radiotherapy experienced acute toxicity of Grade 1 or greater, and 4 (21%) had acute toxicity of Grade 3 or greater. The 5- and 10-year incidence of chronic toxicity of Grade 1 or greater was 45% (95% confidence interval [CI], 22-72%) and 56% (95% CI, 28-81%), respectively. The 5- and 10-year incidence of chronic toxicity of Grade 3 or greater was 28% (95% CI, 18-60%) and 40% (95% CI, 16-72%), respectively. Univariate analysis showed that chronic toxicity of Grade 1 or greater correlated with SLE renal involvement (p < 0.006) and possibly with the presence of five or more American Rheumatism Association criteria (p < 0.053). Chronic toxicity of Grade 3 or greater correlated with an absence of photosensitivity (p < 0.02), absence of arthritis (p < 0.03), and presence of a malar rash (p < 0.04). Conclusions: The risk of acute and chronic toxicity in patients with SLE who received radiotherapy was moderate but was not prohibitive of the use of radiotherapy. Patients with more advanced SLE may be at increased risk for chronic toxicity.

  19. Multiple sclerosis, brain radiotherapy, and risk of neurotoxicity: The Mayo Clinic experience

    SciTech Connect

    Miller, Robert C. . E-mail: miller.robert@mayo.edu; Lachance, Daniel H.; Lucchinetti, Claudia F.; Keegan, B. Mark; Gavrilova, Ralitza H.; Brown, Paul D.; Weinshenker, Brian G.; Rodriguez, Moses

    2006-11-15

    Purpose: The aim of this study was a retrospective assessment of neurotoxicity in patients with multiple sclerosis (MS) receiving external beam radiotherapy (EBRT) to the brain. Methods and Materials: We studied 15 consecutively treated patients with MS who received brain EBRT. Neurologic toxicity was assessed with the Common Toxicity Criteria v.3.0. Results: Median follow-up for the 5 living patients was 6.0 years (range, 3.3-27.4 years). No exacerbation of MS occurred in any patient during EBRT. Five patients had Grade 4 neurologic toxicity and 1 had possible Grade 5 toxicity. Kaplan-Meier estimated risk of neurotoxicity greater than Grade 4 at 5 years was 57% (95% confidence interval, 27%-82%). Toxicity occurred at 37.5 to 54.0 Gy at a median of 1.0 year (range, 0.2-4.3 years) after EBRT. Univariate analysis showed an association between opposed-field irradiation of the temporal lobes, central white matter, and brainstem and increased risk of neurotoxicity (p < 0.04). Three of 6 cases of toxicity occurred in patients treated before 1986. Conclusions: External beam radiotherapy of the brain in patients with MS may be associated with an increased risk of neurotoxicity compared with patients without demyelinating illnesses. However, this risk is associated with treatment techniques that may not be comparable to modern, conformal radiotherapy.

  20. The Use of the Mayo Clinic System for Differential Diagnosis of Dysarthria.

    ERIC Educational Resources Information Center

    Simmons, Katharine C.; Mayo, Robert

    1997-01-01

    A survey of 100 speech-language pathologists involved in the assessment and treatment of patients with dysarthria investigated their attitudes toward the Darley, Aronson, and Brown (DAB) method of classification. Results indicated that most clinicians, believing it helps in the design of a treatment protocol, used the DAB classification system.…

  1. Three-dimensional Physical Modeling: Applications and Experience at Mayo Clinic.

    PubMed

    Matsumoto, Jane S; Morris, Jonathan M; Foley, Thomas A; Williamson, Eric E; Leng, Shuai; McGee, Kiaran P; Kuhlmann, Joel L; Nesberg, Linda E; Vrtiska, Terri J

    2015-01-01

    Radiologists will be at the center of the rapid technologic expansion of three-dimensional (3D) printing of medical models, as accurate models depend on well-planned, high-quality imaging studies. This article outlines the available technology and the processes necessary to create 3D models from the radiologist's perspective. We review the published medical literature regarding the use of 3D models in various surgical practices and share our experience in creating a hospital-based three-dimensional printing laboratory to aid in the planning of complex surgeries. PMID:26562234

  2. Radioactive colloidal gold in the treatment of endometrial cancer: Mayo Clinic experience, 1952-1976

    SciTech Connect

    Fountain, K.S.; Malkasian, G.D. Jr.

    1981-05-15

    A review of 1670 patients with endometrial cancer who were treated between 1952 and 1976 revealed that 15 patients had received radioactive colloidal gold as an adjunct to surgery. Most of the patients had follow-up more than ten years, and all had microscopic tumor contamination of the peritoneal cavity. Of the 15 patients, 13 had biopsy of peritoneal metastases and underwent resection of gross metastatic lesions that were more than 2 mm in diameter. The other two patients had direct extension of the tumor through the uterus into the peritoneal cavity without visible metastasis. The radiogold was inserted from 4-37 days after the initial surgical procedure. The dosage ranged from 100-140 mCi. At follow-up, from 11 years seven months to 24 years two months after treatment, seven patients were alive without evidence of disease. Three died of intercurrent disease, 16 years, and 14 years, and 14 years two months after treatment. Five patients died of cancer, two with local recurrence and three with distant metastases to lung or bone (or both).

  3. Radioactive colloidal gold in the treatment of endometrial cancer: Mayo Clinic experience, 1952 to 1976

    SciTech Connect

    Fountain, K.S.; Malkasian, G.D. Jr.

    1981-05-15

    A review of 1670 patients with endometrial cancer who were treated between 1952 and 1976 revealed that 15 patients had received radioactive colloidal gold as an adjunct to surgery. Most of the patients had follow-up of more than ten years, and all had microscopic tumor contamination of the peritoneal cavity. Of the 15 patients, 13 had biopsy of peritoneal metastases and underwent resection of gross metastatic lesions that were more than 2 mm in diameter. The other two patients had direct extension of the tumor through the uterus into the peritoneal cavity without visible metastasis. The radiogold was inserted from 4 to 37 days after the initial surgical procedure. The dosage ranged from 100 to 140 mCi. At follow-up, from 11 years seven months to 24 years two months after treatment, seven patients were alive without evidence of disease. Three died of intercurrent disease, 16, 14 years, and 14 years two months after treatment. Five patients died of cancer, two with local recurrence and three with distant metastases to lung or bone (or both).

  4. Renal complications in chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis: the Mayo Clinic experience.

    PubMed

    Strati, Paolo; Nasr, Samih H; Leung, Nelson; Hanson, Curtis A; Chaffee, Kari G; Schwager, Susan M; Achenbach, Sara J; Call, Timothy G; Parikh, Sameer A; Ding, Wei; Kay, Neil E; Shanafelt, Tait D

    2015-09-01

    While the renal complications of plasma cell dyscrasia have been well-described, most information in patients with chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis is derived from case reports. This is a retrospective analysis of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who underwent kidney biopsy for renal insufficiency and/or nephrotic syndrome. Between January 1995 and June 2014, 49 of 4,024 (1.2%) patients with chronic lymphocytic leukemia (n=44) or monoclonal B-cell lymphocytosis (n=5) had a renal biopsy: 34 (69%) for renal insufficiency and 15 (31%) for nephrotic syndrome. The most common findings on biopsy were: membranoproliferative glomerulonephritis (n=10, 20%), chronic lymphocytic leukemia interstitial infiltration as primary etiology (n=6, 12%), thrombotic microangiopathy (n=6, 12%), and minimal change disease (n=5, 10%). All five membranoproliferative glomerulonephritis patients treated with rituximab, cyclophosphamide and prednisone-based regimens had recovery of renal function compared to 0/3 patients treated with rituximab with or without steroids. Chronic lymphocytic leukemia infiltration as the primary cause of renal abnormalities was typically observed in relapsed/refractory patients (4/6). Thrombotic microangiopathy primarily occurred as a treatment-related toxicity of pentostatin (4/6 cases), and resolved with drug discontinuation. All cases of minimal change disease resolved with immunosuppressive agents only. Renal biopsy plays an important role in the management of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who develop renal failure and/or nephrotic syndrome. PMID:26088927

  5. Model to predict survival after surgical resection of intrahepatic cholangiocarcinoma: the Mayo Clinic experience

    PubMed Central

    Ali, Shahzad M; Clark, Clancy J; Mounajjed, Taofic; Wu, Tsung-Teh; Harmsen, William S; Reid-Lombardo, KMarie; Truty, Mark J; Kendrick, Michael L; Farnell, Michael B; Nagorney, David M; Que, Florencia G

    2015-01-01

    Background The 7th edition of the American Joint Committee on Cancer (AJCC) staging system has recently been validated and shown to predict survival in patients with intrahepatic cholangiocarcinoma (ICC). The present study attempted to investigate the validity of these findings. Methods A single-centre, retrospective cohort study was conducted. Histopathological restaging of disease subsequent to primary surgical resection was carried out in all consecutive ICC patients. Overall survival was compared using Kaplan–Meier estimates and log-rank tests. Results A total of 150 patients underwent surgery, 126 (84%) of whom met the present study's inclusion criteria. Of these 126 patients, 68 (54%) were female. The median length of follow-up was 4.5 years. The median patient age was 58 years (range: 24–79 years). Median body mass index was 27 kg/m2 (range: 17–46 kg/m2). Staging according to the AJCC 7th edition categorized 33 (26%) patients with stage I disease, 27 (21%) with stage II disease, five (4%) with stage III disease, and 61 (48%) with stage IVa disease. The AJCC 7th edition failed to accurately stratify survival in the current cohort; analysis revealed significantly worse survival in those with microvascular invasion, tumour size of >5 cm, grade 4 disease, multiple tumours and positive lymph nodes (P < 0.001). A negative resection margin was associated with improved survival (P < 0.001). Conclusions The AJCC 7th edition did not accurately predict survival in patients with ICC. A multivariable model including tumour size and differentiation in addition to the criteria used in the AJCC 7th edition may offer a more accurate method of predicting survival in patients with ICC. PMID:25410716

  6. Mayo Clinic Experience with Unfavorable Results After Free Tissue Transfer to Head and Neck.

    PubMed

    Nagel, Thomas H; Hayden, Richard E

    2016-10-01

    Free tissue transfer to the head and neck in the modern era has a high success rate. To maximize success with reconstructive surgery in the head and neck region, it helps to understand those factors that present unique challenges. These factors include contamination by the upper aerodigestive tract, tissue mobility, and a high percentage of patients receiving radiotherapy for oncologic treatment. This article reviews the authors' experience in the head and neck, specifically how addressing these factors can best lead to successful functional and aesthetic outcomes. The authors share surgical techniques and lessons learned from their successes and failures. PMID:27601391

  7. The state of the science of whole blood: lessons learned at Mayo Clinic.

    PubMed

    Stubbs, James R; Zielinski, Martin D; Jenkins, Donald

    2016-04-01

    AABB Standards specify that ABO group-specific whole blood is the only acceptable choice for whole blood transfusions. Although universal donor group O stored whole blood (SWB) was used extensively by the military during the wars of the mid-twentieth century, its use has fallen out of favor and has never been used to great extent in the civilian trauma population. Interest in the use of whole blood has been renewed, particularly in light of its potential value in far-forward military and other austere environments. Evidence of preserved platelet function in SWB has heightened enthusiasm for a "one stop shop" resuscitation product providing volume, oxygen carrying capacity, and hemostatic effects. Experience with universal donor group O SWB is required to ascertain whether its use will be an advance in trauma care. Described here is the process of establishing a universal donor group O SWB at a civilian trauma center in the United States. PMID:27100754

  8. Recipient Clinical Risk Factors Predominate in Possible Transfusion-Related Acute Lung Injury

    PubMed Central

    Toy, Pearl; Bacchetti, Peter; Grimes, Barbara; Gajic, Ognjen; Murphy, Edward L.; Winters, Jeffrey L.; Gropper, Michael A.; Hubmayr, Rolf D.; Matthay, Michael A.; Wilson, Gregory; Koenigsberg, Monique; Lee, Deanna C.; Hirschler, Nora V.; Lowell, Clifford A.; Schuller, Randy M.; Gandhi, Manish J.; Norris, Philip J.; Mair, David C.; Rosen, Rosa Sanchez; Looney, Mark R.

    2014-01-01

    Background Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. Study Design and Methods In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California, San Francisco and the Mayo Clinic, Rochester. Results For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (OR 0.82, 95% CI 0.29 – 2.3, p=0.70), total number of units transfused (OR 0.99, 95% CI 0.89 – 1.10, p=0.86), and number of red blood cell and whole blood units transfused (OR 0.78, 95% CI 0.59 –1.03, p=0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR 12.5, 95% CI 2.8 – 55, p<0.001), current smoker (OR 4.2, 95% CI 1.67 – 10.8, p=0.0024), shock before transfusion (OR 4.6, 95% CI 2.0 – 10.7, p<0.001), and positive fluid balance before transfusion (OR 1.32 per liter, 95% CI 1.20 – 1.44, p<0.001). Conclusion Recipient risk factors for ARDS rather than transfusion risk factors predominate in pTRALI. PMID:25488517

  9. Rudolf Kingslake: accomplishments before joining the University of Rochester's Institute of Optics

    NASA Astrophysics Data System (ADS)

    Johnson, R. Barry

    2011-12-01

    Rudolf Kingslake (1903 to 2003) is perhaps the most widely-known name in lens design and is arguably recognized as the father of lens design in the United States. Although his contributions in optical design, engineering, and education after he moved to the United States in 1929 are generally well-known, little has been written about his technical activities beforehand. In the early summer of 1929, the president of the University of Rochester, Rush Rhees, visited England to recruit faculty members for the new Institute of (Applied) Optics and hired 26-year-old Rudolf Kingslake as its first faculty member, and appointed him as assistant professor of geometrical optics and optical design. The following review of Kingslake's nine published papers while at the Imperial College illustrates his early and already remarkable talents in the field of optical engineering and justifies Dr. Rhees' insightful decision. Kingslake made significant contributions in the area of optical testing. In particular, he expanded the utility of the Hartmann test to measure oblique aberrations and improved the metrology for large optics, and was the first to mathematically analyze interferograms to obtain the primary aberration coefficients.

  10. ISOKINETIC AND FUNCTIONAL EVALUATION OF DISTAL BICEPS RECONSTRUCTION USING THE MAYO MINI-DOUBLE ROUTE TECHNIQUE

    PubMed Central

    Júnior, José Carlos Garcia; de Castro Filho, Carlos Daniel Candido; de Castro Mello, Tadeu Fujita; de Vasconcelos, Rodrigo Antunes; Zabeu, José Luís Amim; Garcia, Jesely Pereira Myrrha

    2015-01-01

    Objective: To evaluate the functional outcome among patients with distal biceps injuries who were operated using the Mayo mini-double route technique, with a minimum follow-up of six months after surgery, through digital isokinetic dynamometry, goniometry and subjective scores in order to establish objective and subjective improvement patterns and discuss the effectiveness of the procedure. Methods: Nine patients who underwent surgery to treat distal biceps injury were evaluated by means of Cybex digital dynamometry using an angular velocity of 30°/s with five repetitions and 120°/s with 15 repetitions, in comparison with the uninjured side. DASH (Disabilities of the arm, shoulder and hand), Mayo elbow score and conventional goniometry were also used. Results: Digital dynamometer showed that using the angular velocity of 30°/s with five repetitions, there was an average flexion deficit of 9.6% and an average supination deficit of -28.97%. Using an angular velocity of 120°/s with fifteen repetitions, the average flexion deficit was 4.43% and the average supination deficit was -24.1%. Conclusions: The loss of flexion followed the pattern already shown in the literature. However, in our series, there were supination strength gains, possibly due to the strict rehabilitation protocol. The technique used in this study was safe and low-cost, with few complications and good functional results. PMID:27047869

  11. The Hand That Gives the Rose

    PubMed Central

    Pawlina, Wojciech; Hammer, Rachel R.; Strauss, Jeffrey D.; Heath, Shaun G.; Zhao, Kristin D.; Sahota, Shawn; Regnier, Terry D.; Freshwater, Dawn R.; Feeley, Mary A.

    2011-01-01

    “Convocation of Thanks” is the annual ceremony commemorating the gift of body donation to the Mayo Clinic Bequest program in the Department of Anatomy, College of Medicine, Mayo Clinic in Rochester, MN. For 26 years, this ceremony of gratitude has given students, researchers, faculty, and family members an opportunity to reflect on the immeasurable value of these gifts. The authors describe the significance of ceremonies such as these in historical context and provide abridged transcripts of participants' speeches. PMID:21282487

  12. "Where Brains Had a Chance": William Mayo and Rhetorical Instruction at East Texas Normal College, 1889-1917

    ERIC Educational Resources Information Center

    Gold, David

    2005-01-01

    The rhetorical training of students at East Texas Normal College is examined with reference to the rhetorical practices and educational ideologies of William Mayo, the experiences of his students and the features of his teaching. Examination of the history of schools like East Texas Normal College helps in dealing with concerns regarding…

  13. Mayo, Myriad, America Invents Act and BPCIA: how has the United States biopharmaceutical market been affected?

    PubMed

    Finston, Susan K; Davey, Neil S; Davé, Elina; Ravichandran, Varsha; Davey, Sonya R; Davé, Raj S

    2016-05-01

    This paper discusses how the United States biopharmaceutical market has been affected by recent changes in patent law resulting from United States legislations (Biologics Price Competition and Innovation Act and the Leahy-Smith America Invents Act) and Supreme Court precedents (Mayo Collaborative Services v. Prometheus Laboratories, Inc. and Molecular Pathology v. Myriad Genetics). The authors interviewed eight key opinion leaders from the United States knowledgeable in biopharmaceuticals, including industry veterans, patent counsel, senior scientists and jurists. This paper summarizes the opinions of the key opinion leaders. This paper explains the impact of these Supreme Court decisions - i.e., broadening the exceptions to patent eligibility for law of nature and natural phenomenon - on biopharmaceutical innovations and provides future perspectives. PMID:27087460

  14. Elemental composition of Usnea sp lichen from Potter Peninsula, 25 de Mayo (King George) Island, Antarctica.

    PubMed

    Bubach, Débora; Catán, Soledad Perez; Di Fonzo, Carla; Dopchiz, Laura; Arribére, Maria; Ansaldo, Martin

    2016-03-01

    Several pollutants, which include metals, are present in the Antarctic atmosphere, snow, marine and terrestrial organisms. This work reports the elements incorporated by Usnea sp thalli in Potter Peninsula, 25 de Mayo (King George) Island, South Shetlands, Antarctica. Geological origin was analyzed as possible sources of elements. For this purpose, correlations were done using a geochemical tracer, principal component analysis and enrichment factors were computed. Lithophile elements from particulate matter were present in most of the sampling sites. Bromine, Se and Hg showed the highest enrichment factors suggesting other sources than the particulate matter. Mercury values found in Usnea sp were in the same range as those reported for Deception Island (South Shetlands) and remote areas from the Patagonia Andes. PMID:26741560

  15. Genetics in medical school curriculum: A look at the University of Rochester School of Medicine and Dentistry

    PubMed Central

    Robinson, Deanne M.; Fong, Chin-To

    2008-01-01

    Genetics is assuming an increasingly important role in medicine. As a result, the teaching of genetics should also be increased proportionally to ensure that future physicians will be able to take advantage of the new genetic technology, and to understand the associated ethical, legal and social issues. At the University of Rochester School of Medicine and Dentistry, we have been able to incorporate genetic education into a four-year medical curriculum in a fully integrated fashion. This model may serve as a template for other medical curriculum still in development. PMID:18196607

  16. Design and testing of a compact X-ray diode. 1998 summer research program for high school juniors at the University of Rochester`s Laboratory for Laser Energetics: Student research reports

    SciTech Connect

    Stern, A.

    1999-03-01

    Omega, the University of Rochester`s high powered laser dedicated to fusion research gives off x-rays with different energy levels. Measuring the number of x-rays and the energy of each is important in understanding what happens in the target chamber when Omega is fired. Existing x-ray detectors are expensive, big, and cumbersome. Imaging detectors such as x-ray pinhole cameras which record onto film, x-ray framing cameras which make videos, and most often, x-ray streak cameras which measure time dependences of x-rays. They require a lot of maintenance and are difficult to keep operational. Lawrence Livermore National Laboratory has developed the Dante Diode. The Dante diode array on Omega functions as a group of 12 diodes which take up a 24 inch port in the target chamber, making it space-consuming and difficult to move for alternate views. In designing a new detector, space was the main issue. The smallest possible functional diode, without losing accuracy was desired. Since the laser pulse only lasts a few nanoseconds it is important that the x-ray detector have a response time of a few tenths of a nanosecond. Other criteria include that it be easy to use for measuring the energy and number of x-ray photons and that cost be kept down. This report discusses the design process and testing of the new diode.

  17. Seroprevalence and correlates of Toxoplasma gondii infection in Yoremes (Mayos) in Mexico: a cross-sectional study

    PubMed Central

    Alvarado-Esquivel, Cosme; Rascón-Careaga, Antonio; Hernández-Tinoco, Jesús; Corella-Madueño, María Alba Guadalupe; Sánchez-Anguiano, Luis Francisco; Aldana-Madrid, María Lourdes; Almada-Balderrama, Gerardo Javier; Nuñez-Aguirre, Alan Daniel; Liesenfeld, Oliver

    2016-01-01

    Objectives We sought to determine the prevalence of anti-Toxoplasma gondii antibodies in Yoremes and to identify associations of T. gondii exposure with sociodemographic, clinical and behavioural characteristics of Yoremes. Design A cross-sectional survey. Setting Yoremes were enrolled in the locality of Tierra Blanca in the municipality of Navojoa in Sonora State, Mexico. Participants We studied 200 Yoremes (Mayos); they are an indigenous ethnic group living in a coastal region in northwestern Mexico. Primary and secondary outcome measures We assessed the prevalence of anti-Toxoplasma IgG and IgM antibodies in participants using enzyme-linked immunoassays. We used a standardised questionnaire to obtain the characteristics of Yoremes. The association of T. gondii exposure and Yoremes’ characteristics was assessed by bivariate and multivariate analyses. Results Of the 200 Yoremes studied (mean age: 31.50±18.43 years), 26 (13.0%) were positive for anti-T. gondii IgG antibodies and 19 (73.1%) of them were also positive for anti-T. gondii IgM antibodies. Seroprevalence of T. gondii infection did not vary with sex, educational level, occupation or socioeconomic status. In contrast, multivariate analysis of sociodemographic and behavioural characteristics showed that T. gondii exposure was associated with increasing age (OR=1.02; 95% CI 1.00 to 1.04; p=0.03) and consumption of squirrel meat (OR=4.99; 95% CI 1.07 to 23.31; p=0.04). Furthermore, seroprevalence of T. gondii infection was significantly higher in Yoremes with a history of lymphadenopathy (p=0.03) and those suffering from frequent abdominal pain (p=0.03). In women, T. gondii exposure was associated with a history of caesarean sections (p=0.03) and miscarriages (p=0.02). Conclusions We demonstrate, for the first time, serological evidence of T. gondii exposure among Yoremes in Mexico. Results suggest that infection with T. gondii might be affecting the health of Yoremes. Results may be useful for an

  18. Development of the Mayo Investigational Neuromodulation Control System: toward a closed-loop electrochemical feedback system for deep brain stimulation

    PubMed Central

    Chang, Su-Youne; Kimble, Christopher J.; Kim, Inyong; Paek, Seungleal B.; Kressin, Kenneth R.; Boesche, Joshua B.; Whitlock, Sidney V.; Eaker, Diane R.; Kasasbeh, Aimen; Horne, April E.; Blaha, Charles D.; Bennet, Kevin E.; Lee, Kendall H.

    2014-01-01

    Object Conventional deep brain stimulation (DBS) devices continue to rely on an open-loop system in which stimulation is independent of functional neural feedback. The authors previously proposed that as the foundation of a DBS “smart” device, a closed-loop system based on neurochemical feedback, may have the potential to improve therapeutic outcomes. Alterations in neurochemical release are thought to be linked to the clinical benefit of DBS, and fast-scan cyclic voltammetry (FSCV) has been shown to be effective for recording these evoked neurochemical changes. However, the combination of FSCV with conventional DBS devices interferes with the recording and identification of the evoked analytes. To integrate neurochemical recording with neurostimulation, the authors developed the Mayo Investigational Neuromodulation Control System (MINCS), a novel, wirelessly controlled stimulation device designed to interface with FSCV performed by their previously described Wireless Instantaneous Neurochemical Concentration Sensing System (WINCS). Methods To test the functionality of these integrated devices, various frequencies of electrical stimulation were applied by MINCS to the medial forebrain bundle of the anesthetized rat, and striatal dopamine release was recorded by WINCS. The parameters for FSCV in the present study consisted of a pyramidal voltage waveform applied to the carbon-fiber microelectrode every 100 msec, ramping between −0.4 V and +1.5 V with respect to an Ag/AgCl reference electrode at a scan rate of either 400 V/sec or 1000 V/sec. The carbon-fiber microelectrode was held at the baseline potential of −0.4 V between scans. Results By using MINCS in conjunction with WINCS coordinated through an optic fiber, the authors interleaved intervals of electrical stimulation with FSCV scans and thus obtained artifact-free wireless FSCV recordings. Electrical stimulation of the medial forebrain bundle in the anesthetized rat by MINCS elicited striatal dopamine

  19. Polyphenolic substrates and dyes degradation by yeasts from 25 de Mayo/King George Island (Antarctica).

    PubMed

    Rovati, José I; Pajot, Hipólito F; Ruberto, Lucas; Mac Cormack, Walter; Figueroa, Lucía I C

    2013-11-01

    Antarctica offers a range of extreme climatic conditions, such as low temperatures, high solar radiation and low nutrient availability, and constitutes one of the harshest environments on Earth. Despite that, it has been successfully colonized by ’cold-loving’ fungi, which play a key role in decomposition cycles in cold ecosystems. However, knowledge about the ecological role of yeasts in nutrient or organic matter recycling/mineralization remains highly fragmentary. The aim of this work was to study the yeast microbiota in samples collected on 25 de Mayo/King George Island regarding the scope of their ability to degrade polyphenolic substrates such as lignin and azo dyes. Sixty-one yeast isolates were obtained from 37 samples, including soil, rocks, wood and bones. Molecular analyses based on rDNA sequences revealed that 35 yeasts could be identified at the species level and could be classified in the genera Leucosporidiella, Rhodotorula, Cryptococcus, Bullera and Candida. Cryptococcus victoriae was by far the most ubiquitous species. In total, 33% of the yeast isolates examined showed significant activity for dye decolorization, 25% for laccase activity and 38% for ligninolytic activity. Eleven yeasts did not show positive activity in any of the assays performed and no isolates showed positive activity across all tested substrates. A high diversity of yeasts were isolated in this work, possibly including undescribed species and conspicuous Antarctic yeasts, most of them belonging to oligotrophic, slow-growing and metabolically diverse basidiomycetous genera. PMID:24298603

  20. Prospective Study on the Clinical Course and Outcomes in Transfusion-Related Acute Lung Injury

    PubMed Central

    Looney, Mark R.; Roubinian, Nareg; Gajic, Ognjen; Gropper, Michael A.; Hubmayr, Rolf D.; Lowell, Clifford A.; Bacchetti, Peter; Wilson, Gregory; Koenigsberg, Monique; Lee, Deanna C.; Wu, Ping; Grimes, Barbara; Norris, Philip J.; Murphy, Edward L.; Gandhi, Manish J.; Winters, Jeffrey L.; Mair, David C.; Schuller, Randy M.; Hirschler, Nora V.; Rosen, Rosa Sanchez; Matthay, Michael A.; Toy, Pearl

    2014-01-01

    Objective Transfusion-related acute lung injury is the leading cause of transfusion-related mortality. A prospective study using electronic surveillance was conducted at two academic medical centers in the United States with the objective to define the clinical course and outcomes in transfusion-related acute lung injury cases. Design Prospective case study with controls. Setting University of California, San Francisco and Mayo Clinic, Rochester. Patients We prospectively enrolled 89 patients with transfusion-related acute lung injury, 164 transfused controls, and 145 patients with possible transfusion-related acute lung injury. Interventions None. Measurements and Main Results Patients with transfusion-related acute lung injury had fever, tachycardia, tachypnea, hypotension, and prolonged hypoxemia compared with controls. Of the patients with transfusion-related acute lung injury, 29 of 37 patients (78%) required initiation of mechanical ventilation and 13 of 53 (25%) required initiation of vasopressors. Patients with transfusion-related acute lung injury and possible transfusion-related acute lung injury had an increased duration of mechanical ventilation and increased days in the ICU and hospital compared with controls. There were 15 of 89 patients with transfusion-related acute lung injury (17%) who died, whereas 61 of 145 patients with possible transfusion-related acute lung injury (42%) died and 7 of 164 of controls (4%) died. Patients with transfusion-related acute lung injury had evidence of more systemic inflammation with increases in circulating neutrophils and a decrease in platelets compared with controls. Patients with transfusion-related acute lung injury and possible transfusion-related acute lung injury also had a statistically significant increase in plasma interleukin-8, interleukin-10, and interleukin-1 receptor antagonist posttransfusion compared with controls. Conclusions In conclusion, transfusion-related acute lung injury produced a condition

  1. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial.

    PubMed

    West, Colin P; Dyrbye, Liselotte N; Rabatin, Jeff T; Call, Tim G; Davidson, John H; Multari, Adamarie; Romanski, Susan A; Hellyer, Joan M Henriksen; Sloan, Jeff A; Shanafelt, Tait D

    2014-04-01

    IMPORTANCE Despite the documented prevalence and clinical ramifications of physician distress, few rigorous studies have tested interventions to address the problem. OBJECTIVE To test the hypothesis that an intervention involving a facilitated physician small-group curriculum would result in improvement in well-being. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 74 practicing physicians in the Department of Medicine at the Mayo Clinic in Rochester, Minnesota, conducted between September 2010 and June 2012. Additional data were collected on 350 nontrial participants responding to annual surveys timed to coincide with the trial surveys. INTERVENTIONS The intervention involved 19 biweekly facilitated physician discussion groups incorporating elements of mindfulness, reflection, shared experience, and small-group learning for 9 months. Protected time (1 hour of paid time every other week) for participants was provided by the institution. MAIN OUTCOMES AND MEASURES Meaning in work, empowerment and engagement in work, burnout, symptoms of depression, quality of life, and job satisfaction assessed using validated metrics. RESULTS Empowerment and engagement at work increased by 5.3 points in the intervention arm vs a 0.5-point decline in the control arm by 3 months after the study (P = .04), an improvement sustained at 12 months (+5.5 vs +1.3 points; P = .03). Rates of high depersonalization at 3 months had decreased by 15.5% in the intervention arm vs a 0.8% increase in the control arm (P = .004). This difference was also sustained at 12 months (9.6% vs 1.5% decrease; P = .02). No statistically significant differences in stress, symptoms of depression, overall quality of life, or job satisfaction were seen. In additional comparisons including the nontrial physician cohort, the proportion of participants strongly agreeing that their work was meaningful increased 6.3% in the study intervention arm but decreased 6.3% in the study control arm

  2. Computer-aided design and modeling of nickel dithiolene near-infrared dyes. 1998 summer research program for high school juniors at the University of Rochester`s Laboratory for Laser Energetics: Student research reports

    SciTech Connect

    Corsello, S.

    1999-03-01

    Recent advances in computational chemistry have made it feasible to design many types of molecules and predict their properties theoretically. The author applied these techniques to the design of organometallic transition-metal dyes absorbing in the near-infrared region of the spectrum which possess the combination of a large molar extinction coefficient, good chemical and thermal stability, and a high solubility in liquid crystal (LC) hosts. These properties are required for the dye to function as a near-infrared (IR) attenuator in a liquid crystal point diffraction interferometer (LCPDI) device that will be used as a beam diagnostic on the 60-beam OMEGA solid-state Nd:glass laser system at the University of Rochester`s Laboratory for Laser Energetics. Using commercially available software, both the absorption spectra and solubility characteristics of bis[1,2-di-(p-n alkoxyphenyl)ethane-1,2-dithione] nickel dye complexes were modeled in an isotropic host (cyclohexane) and, in most cases, excellent agreement was found with experimental data. Two additional compounds utilizing the same nickel dithiolene core but with alkylthio and phenylalkylthio terminal groups have been designed and show excellent potential to produce dramatic improvements in both solubility and optical density (absorbance) in liquid crystalline hosts. Based upon my work, a new dye not previously reported, 2(C{sub 4}S)2(C{sub 4}SPh)DTNi, has been proposed to satisfy the LCPDI device requirements. The nickel dithiolene dyes may also find important applications in other technology areas such as near-IR photography and laser-based near-IR communications.

  3. Know Your Students: Rochester's Two-Year Ethnographic Study Reveals What Students Do on Campus and How the Library Fits In

    ERIC Educational Resources Information Center

    Marshall, Ann; Burns, Vicki; Briden, Judi

    2007-01-01

    In this article, the authors discuss how the University of Rochester's two-year ethnographic study reveals what students do on campus and how the library fits in. Under Nancy Fried Foster's guidance, teams of librarians and staff conducted a two-year investigation. The goal: to improve the libraries' reference services, facilities, and web pages…

  4. Improving Special Education in the Rochester City Schools: Report of the Strategic Support Team of the Council of the Great City Schools, Winter 2008-09

    ERIC Educational Resources Information Center

    Council of the Great City Schools, 2009

    2009-01-01

    This report by the Council of the Great City Schools to the Rochester City School District presents the organization's findings and recommendations for improving the special education program in the school system, placing special emphasis on the organizational structure of the program, accountability, and how the instructional program generally…

  5. Seeking Pathways to a Coordinated System of Health and Human Services for High-risk Urban Children and Families: The Rochester, New York Experience.

    PubMed

    Weitzman, M; Doniger, A S; Partner, S F

    1994-01-01

    The Rochester, New York community has undergone major changes over the past 20 years. Like many other industrial areas, it has seen an erosion of its manufacturing base and a flight of employment opportunities and population from the city to the suburbs. While commonly misperceived as an affluent, white-collar community, in reality there are many families, particularly within the city of Rochester, that are afflicted by some of the most devastating health and social problems facing the United States today.(1) It was against this backdrop that, in 1991, an ongoing effort was begun to develop a system of coordinated health and human services to more effectively address the needs of Rochester's children and families. As a first step, a study was conducted to obtain a detailed picture of the current service system in Rochester; lay out a series of recommendations to improve collaboration and communication; and foster coordinated and integrated services for high-risk youth and families in the community. Key indicators of child and family health were collected, collated, and analyzed, and extensive interviews were conducted with humanservice and medical providers, government officials, education professionals, and parents. This paper describes the process that was used in the study and the recommendations that were included in the final report, which is intended to create a framework for the creation of a comprehensive, needs-based health care system for impoverished and at-risk children and families, including the effective integration of health services into the human service network. PMID:19313106

  6. Direct-Drive Inertial Fusion Research at the University of Rochester's Laboratory for Laser Energetics: A Review

    SciTech Connect

    McCrory, R.L.; Meyerhofer, D.D.; Loucks, S.J.; Skupsky, S.; Bahr, R.E.; Betti, R.; Boehly, T.R.; Craxton, R.S.; Collins, T.J.B.; Delettrez, J.A.; Donaldson, W.R.; Epstein, R.; Fletcher, K.A.; Freeman, C.; Frenje, J.A.; Glebov, V.Yu.; Goncharov, V.N.; Harding, D.R.; Jaanimagi, P.A.; Keck, R.L.; Kelly, J.H.; Kessler, T.J.; Kilkenny, J.D.; Knauer, J.P.; Li, C.K.; Lund, L.D.; Marozas, J.A.; McKenty, P.W.; Marshall, F.J.; Morse, S.F.B.; Padalino, S.; Petrasso, R.D.; Radha, P.B.; Regan, S.P.; Roberts, S.; Sangster, T.C.; Seguin, F.H.; Seka, W.; Smalyuk, V.A.; Soures, J.M.; Stoeckl, C.; Thorp, K.A.; Yaakobi, B.; Zuegel, J.D.

    2010-04-16

    This paper reviews the status of direct-drive inertial confinement fusion (ICF) research at the University of Rochester's Laboratory for Laser Energetics (LLE). LLE's goal is to demonstrate direct-drive ignition on the National Ignition Facility (NIF) by 2014. Baseline "all-DT" NIF direct-drive ignition target designs have been developed that have a predicted gain of 45 (1-D) at a NIF drive energy of ~1.6 MJ. Significantly higher gains are calculated for targets that include a DT-wicked foam ablator. This paper also reviews the results of both warm fuel and initial cryogenic-fuel spherical target implosion experiments carried out on the OMEGA UV laser. The results of these experiments and design calculations increase confidence that the NIF direct-drive ICF ignition goal will be achieved.

  7. Determination of CA-41, I-129 and OS-187 in the Rochester tandem accelerator and some applications of these isotopes

    NASA Technical Reports Server (NTRS)

    Fehn, U.; Elmore, D.; Gove, H. E.; Kubik, P.; Teng, R.; Tubbs, L.

    1986-01-01

    The measurement of Ca-41 and I-129 utilizing the Rochester Tanden Accelerator Mass Spectrometer (TAMS) is discussed. Ca-41, having a half-life of 100,000 yrs., is of potential use for the dating of ground water as well as of bones in the age range between 50,000 and 1 million yrs. A major problem for the measurement of Ca-41 with TAMS is the fact that calcium does not readily form negative atomic ions. It does, however, form negative molecular ions. The production of CaO ions from compounds such as CaO and CaCO3 and from free Ca molecules sprayed with oxygen gas was studied. A project to utilize I-129 as a tracer for hydrothermal convection in sediment-covered oceanic crust is also briefly described. Finally, plans to use the Os-187/Os-186 ratio for the determination of extraterrestrial material in the Ries crater in Germany are summarized.

  8. Toxicity of waters from the Rochester Embayment Area of Concern to the plankton species Pseudokirchneriella subcapitata and Ceriodaphnia dubia

    USGS Publications Warehouse

    Baldigo, Barry P.; Duffy, Brian T.; Smith, Alexander J; George, Scott D.

    2016-01-01

    The lower Genesee River and Rochester Embayment of Lake Ontario are a designated Area of Concern (AOC) under the binational Great Lakes Water Quality Agreement. The “degradation of phytoplankton and zooplankton populations” or plankton Beneficial Use Impairment (BUI) was classified as unknown and in need of further assessment in this AOC because water quality data suggested plankton communities could be effected and community data were either unavailable or indicated impacts. The plankton BUI may now be obsolete because local contaminant sources have been largely eliminated. The present study was conducted between July 2013 and August 2014 to assess the BUI-removal criteria: “AOC plankton bioassays confirm that toxicity in ambient waters (i.e., no growth inhibition) is not significantly higher than comparable non-AOC controls”. Acute and chronic toxicity of waters from 13 sites were quantified seasonally using standardized bioassays with the green alga Pseudokirchneriella subcapitata and water flea Ceriodaphnia dubia to test the hypothesis that toxicity of waters from AOC sites was not higher than that of waters from comparable non-AOC reference sites. Survival and reproduction of C. dubia did not differ significantly between site types, systems, or months. The growth of P. subcapitata did not differ between site types, but differed among systems and months. All results indicate that waters from AOC sites were no more toxic to both plankton species than waters from reference sites. Assuming test species represent natural plankton assemblages, water quality should not negatively affect survival and growth of resident plankton populations in the Rochester Embayment AOC.

  9. Utility of Double Inversion Recovery Sequences in MRI.

    PubMed

    Ryan, Maura E

    2016-04-01

    Investigators from the Mayo Clinic, Rochester Minnesota investigated the utility of three-dimensional (3D) double inversion recovery (DIR) sequences in magnetic resonance imaging (MRI) detection of focal cortical dysplasia (FCD) in children and young adults with epilepsy. PMID:27617491

  10. Are Cancer Survivors/Patients Knowledgeable about Osteoporosis? Results from a Survey of 285 Chemotherapy-Treated Cancer Patients and Their Companions

    ERIC Educational Resources Information Center

    McKean, Heidi; Looker, Sherry; Hartmann, Lynn C.; Hayman, Suzanne R.; Kaur, Judith S.; McWilliams, Robert R.; Peethambaram, Prema P.; Stahl, Jean F.; Jatoi, Aminah

    2008-01-01

    Objective: This study assessed osteoporosis knowledge deficits among cancer patients and their spouses/partners. Design: Single-institution survey (modified version of the Osteoporosis Knowledge Assessment Tool). Setting: The Mayo Clinic in Rochester, Minnesota. Participants: Consecutive chemotherapy-treated cancer patients (n = 285) with their…

  11. Refertilization process in the Patagonian subcontinental lithospheric mantle of Estancia Sol de Mayo (Argentina)

    NASA Astrophysics Data System (ADS)

    Melchiorre, Massimiliano; Coltorti, Massimo; Gregoire, Michel; Benoit, Mathieu

    2015-05-01

    Anhydrous mantle xenoliths equilibrated at 1003-1040 °C from Estancia Sol de Mayo (ESM, Central Patagonia, Argentina) and entrained in post-plateau alkaline lavas belonging to Meseta Lago Buenos Aires have been investigated aiming at reconstructing the depletion and enrichment processes that affected this portion of the Patagonia lithospheric mantle. Xenoliths are characterized by a coarse-grained protogranular texture and are devoid of evident modal metasomatism. They show two texturally different clinopyroxenes: protogranular (cpx1) and texturally related to spinel (cpx2). Three different types of orthopyroxenes are also recognized: large protogranular crystals with exsolution lamellae (opx1); small clean and undeformed grains without exsolution lamellae (opx2) and small grains arranged in a vein (opx3). Major element composition of clinopyroxenes and orthopyroxenes highlights two different trends characterized by i) a high Al2O3 content at almost constant mg# and ii) a slight increase in Al2O3 content with decreasing mg#. Clinopyroxenes are enriched in LREE and are characterized by prominent to slightly negative Nb, Zr and Ti anomalies. No geochemical differences are observed between cpx1 and cpx2, while a discrimination can be observed between opx1 and opx2 (LREE-depleted; prominent to slightly negative Ti and Zr anomalies) and opx3 (prominent positive Zr anomaly). Partial melting modeling using both major and trace elements indicates a melting degree between ~ 5% and ~ 13% (up to ~ 23% according to major element modeling) for lherzolites and between ~ 20% and ~ 30% for harzburgites (down to ~ 5% according to trace element modeling). La/Yb and Al2O3, as well as Sr and Al2O3 negative correlations in clinopyroxenes point to a refertilization event affecting this lithospheric mantle. The agent was most probably a transitional alkaline/subalkaline melt, as indicated by the presence of orthopyroxene in the vein and the similar geochemical features of ESM

  12. Arthrodesis versus Mayo resection: the management of the first metatarsophalangeal joint in reconstruction of the rheumatoid forefoot.

    PubMed

    Grondal, L; Broström, E; Wretenberg, P; Stark, A

    2006-07-01

    In a prospective randomised study 31 patients were allocated to either arthrodesis or Mayo resection of the first metatarsophalangeal joint as part of a total reconstruction of the rheumatoid forefoot. Of these, 29 were re-examined after a mean of 72 months (57 to 80), the Foot Function Index was scored and any deformity measured. Load distribution was analysed using a Fscan mat in 14 cases, and time and distance were measured in 12 of these patients using a 3D Motion system. We found excellent patient satisfaction and a significant, lasting reduction of the Foot Function Index, with no statistically significant differences between the groups. There were no significant differences in recurrence of the deformity, the need for special shoes, gait velocity, step length, plantar moment, mean pressure or the position of the centre of force under the forefoot. The cadence was higher and the stance phase shorter in the fusion group. These results suggest that a Mayo resection may be an equally good option for managing the first metatarsophalangeal joint in reconstruction of the rheumatoid forefoot. PMID:16798995

  13. 1991 Summer research program for high school juniors at the University of Rochester's Laboratory for Laser Energetics

    SciTech Connect

    Meyerhofer, David D.

    1991-09-01

    Ten students participated in the 1991 summer high school student research program at the University of Rochester's Laboratory for Laser Energetics (LLE). The participants spent 8 weeks working and learning at LLE. They spent most of their time working on individual research projects. Each student was assigned a project, upon which he/she worked under the direct supervision of one of the staff members of the laboratory. The students, their high schools, and their projects are listed in Table 1. The program culminated in oral and written reports describing their work. The oral reports were presented at a symposium on 23 August 1991, at which the student's parents and teachers and members of the LLE staff were present. The written reports are collected in this volume. The titles of the works are UV alignment table; neutron yields can be measured by using the relative gain of a photomultiplier tube; scattering in isotropic and anisotropic media; a better approximation of the diffusion equation; use of the SLAC code to produce a photoemissive electrostatic electron gun; spatial resolution deteriorates with increasing film exposure; analysis of refractive image distortion; making of pinholes for x-ray pinhole cameras; does perturbation theory accurately describe multiphoton ionization and wave front analysis using shearing interferometry.

  14. Differential prognostic effect of IDH1 versus IDH2 mutations in myelodysplastic syndromes: a Mayo Clinic study of 277 patients.

    PubMed

    Patnaik, M M; Hanson, C A; Hodnefield, J M; Lasho, T L; Finke, C M; Knudson, R A; Ketterling, R P; Pardanani, A; Tefferi, A

    2012-01-01

    Unlike the case with acute myeloid leukemia, there is limited information on the prognostic impact of isocitrate dehydrogenase (IDH) mutations in myelodysplastic syndromes (MDS). In the current study of 277 patients with MDS, IDH mutations were detected in 34 (12%) cases: 26 IDH2 (all R140Q) and 8 IDH1 (6 R132S and 2 R132C). Mutational frequency was 4% (2 of 56) in refractory anemia with ring sideroblasts, 12% (16 of 130) in refractory cytopenia with multilineage dysplasia, 14% (2 of 14) in MDS-unclassifiable, 14% (6 of 42) in refractory anemia with excess blasts (RAEB)-1 and 23% (8 of 35) in RAEB-2. Normal karyotype was noted in all but one IDH1-mutated cases and 13 IDH2-mutated cases. Multivariable analysis identified presence of mutant IDH1 (P=0.0004; hazard ration 4.0, 95% confidence interval 1.9-8.8), revised International Prognostic Scoring System risk category (P<0.0001), and red cell transfusion need (P=0.002) as independent predictors of inferior survival. In a similar multivariable analysis, mutant IDH1 was the only variable associated with shortened leukemia-free survival (P=0.001; hazard ration 7.0, 95% confidence interval 2.3-20.8). The presence of IDH2R140Q did not affect the overall (P=0.54) or leukemia-free (P=0.81) survival. The current study suggests a powerful adverse prognostic effect for mutant IDH1 in MDS. PMID:22033490

  15. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    PubMed

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes. PMID:20067999

  16. Validation of the revised International Prognostic Score of Thrombosis for Essential Thrombocythemia (IPSET-thrombosis) in 585 Mayo Clinic patients.

    PubMed

    Haider, Mahnur; Gangat, Naseema; Lasho, Terra; Abou Hussein, Ahmed K; Elala, Yoseph C; Hanson, Curtis; Tefferi, Ayalew

    2016-06-01

    The primary objective of treatment in essential thrombocythemia (ET) is to prevent thromboembolic complications. In this regard, advanced age and thrombosis history have long distinguished "low" from "high" risk patients. More recently, JAK2V617F and cardiovascular (CV) risk factors were identified as additional modifiers, leading to the development of a 3-tiered International Prognostic Score of Thrombosis for ET (IPSET-thrombosis): "low," "intermediate," and "high". The international data set used to develop IPSET-thrombosis was recently re-analyzed in order to quantify the additional pro-thrombotic effect of JAK2V617F and CV risk factors in specific risk subcategories. The revised IPSET-thrombosis identified four risk categories based on three adverse variables (thrombosis history, age >60 years and JAK2V617F): very low (no adverse features), low (presence of JAK2V617F), intermediate (age >60 years) and high (presence of thrombosis history or presence of both advanced age and JAK2V617F). In this study of 585 patients with ET (median age 68 years; 61% female), we validated the revised IPSET-thrombosis by confirming significant differences in thrombosis risk between "very low" and "low" (HR 2.4, 95% CI 1.1 - 5.3) and between "intermediate" and "high" (HR 2.3, 95% CI 1.1 - 5.2) risk patients. Furthermore, in multivariable analysis, only JAK2V617F (HR=1.8, CI= 1.07 - 2.94) and history of thrombosis (HR=2.1, CI= 1.20 - 3.58) were independently predictive of future thrombotic events. The revised IPSET-thrombosis needs confirmation in prospective studies, especially in terms of risk-adapted therapy that includes the need for aspirin therapy in very low risk, twice-daily aspirin therapy for low risk and cytoreductive therapy for low or intermediate risk patients. PMID:26799697

  17. Metronidazole- and Carbapenem-Resistant Bacteroides thetaiotaomicron Isolated in Rochester, Minnesota, in 2014

    PubMed Central

    Sadarangani, Sapna P.; Cunningham, Scott A.; Jeraldo, Patricio R.; Wilson, John W.; Khare, Reeti

    2015-01-01

    Emerging antimicrobial resistance in members of the Bacteroides fragilis group is a concern in clinical medicine. Although metronidazole and carbapenem resistance have been reported in Bacteroides thetaiotaomicron, a member of the B. fragilis group, they have not, to the best of our knowledge, been reported together in the same B. thetaiotaomicron isolate. Herein, we report isolation of piperacillin-tazobactam-, metronidazole-, clindamycin-, ertapenem-, and meropenem-resistant B. thetaiotaomicron from a patient with postoperative intra-abdominal abscess and empyema. Whole-genome sequencing demonstrated the presence of nimD with at least a portion of IS1169 upstream, a second putative nim gene, two β-lactamase genes (one of which has not been previously reported), two tetX genes, tetQ, ermF, two cat genes, and a number of efflux pumps. This report highlights emerging antimicrobial resistance in B. thetaiotaomicron and the importance of identification and antimicrobial susceptibility testing of selected anaerobic bacteria. PMID:25941219

  18. 1999 Summer Research Program for High School Juniors at the University of Rochester's Laboratory for Laser Energetics

    SciTech Connect

    2002-10-09

    oak-B202--During the summer of 1999, 12 students from Rochester-area high schools participated in the Laboratory for Laser Energetics' Summer High School Research Program. The goal of this program is to excite a group of high school students about careers in the areas of science and technology by exposing them to research in a state-of-the-art environment. Too often, students are exposed to ''research'' only through classroom laboratories that have prescribed procedures and predictable results. In LLE's summer program, the students experience all of the trials, tribulations, and rewards of scientific research. By participating in research in a real environment, the students often become more enthusiastic about careers in science and technology. In addition, LLE gains from the contributions of the many highly talented students who are attracted to the program. The students spent most of their time working on their individual research projects with members of LLE's technical staff. The projects were related to current research activities at LLE and covered a broad range of areas of interest including laser modeling, diagnostic development, chemistry, liquid crystal devices, and opacity data visualization. The students, their high schools, their LLE supervisors and their project titles are listed in the table. Their written reports are collected in this volume. The students attended weekly seminars on technical topics associated with LLE's research. Topics this year included lasers, fusion, holography, optical materials, global warming, measurement errors, and scientific ethics. The students also received safety training, learned how to give scientific presentations, and were introduced to LLE's resources, especially the computational facilities. The program culminated with the High School Student Summer Research Symposium on 25 August at which the students presented the results of their research to an audience that included parents, teachers, and members of LIX. Each

  19. Gastrointestinal helminths of Gentoo penguins (Pygoscelis papua) from Stranger Point, 25 de Mayo/King George Island, Antarctica.

    PubMed

    Diaz, Julia Inés; Fusaro, Bruno; Longarzo, Lucrecia; Coria, Néstor Rubén; Vidal, Virginia; Jerez, Silvia; Ortiz, Juana; Barbosa, Andrés

    2013-05-01

    The aim of this work is to contribute to the knowledge of gastrointestinal parasites of the Gentoo penguin (Pygoscelis papua) from 25 de Mayo/King George Island (South Shetlands, Antarctica). Gastrointestinal tracts of 37 fresh dead individuals (21 chicks, 10 juveniles, and 6 adults) were collected from December 2006 to February 2012 and examined for macroparasites. Four adult parasite species were found: one Cestoda species (Parorchites zederi), two Nematoda species (Stegophorus macronectes and Tetrameres wetzeli), and one Acanthocephalan (Corynosoma shackletoni). Two species of immature acanthocephalans, Corynosoma hamanni and Corynosoma bullosum, were found in a single host. This is the first record of Tetrameres wetzeli in Gentoo penguins. The low parasite richness observed could be related to the stenophagic and pelagic diet of this host species which feeds almost exclusively on krill. PMID:23435921

  20. Ambulatory cardiovascular monitoring of healthy adults in Rochester, Minnesota: chronobiologic assessment.

    PubMed

    Zachariah, P K; Cornélissen, G; Halberg, F

    1990-01-01

    To serve as a tentative reference group for clinical health, 107 adults measured their systolic (S) and diastolic (D) blood pressure (BP) with an ambulatory Del Mar Avionics monitor (Irvine, California). Data were collected over approximately 24 hours at 7.5-minute intervals during waking and at 15-minute intervals during sleep. An echocardiogram served to determine the left ventricular mass (LVM), septal wall thickness (SWT), posterior wall thickness (PWT), ejection fraction (EjFr), and left atrial size (LAS). Each data series was analyzed by single cosinor. A statistically significant circadian rhythm (P less than 0.05) was found in 96 subjects (89.7 percent) for SBP and in 86 subjects (80.4 percent) for DBP. A population-mean cosinor reveals a highly significant circadian rhythm (P less than 0.001) for both variables in men (n = 44) as well as in women (n = 63), with an acrophase around 14:15. The double circadian amplitude, a measure of the total predictable change within a day, averages 10 (women) and 11 (men) mm Hg for DBP and 14 (women) and 17 (men) mm Hg for SBP. The midline-estimating statistic of rhythm (MESOR) of SBP is found to be higher for men (125 mm Hg) than for women (120 mm Hg), P = 0.018, whereas no difference in MESOR is found for DBP (71 mm Hg). A statistically significant correlation with age is found for the MESOR of SBP in both men (r = 0.352; P = 0.018) and women (r = 0.336; P = 0.007). The MESOR of SBP is also found to correlate with LVM in men (r = 0.300; P = 0.046), but not in women (r = 0.181; P = 0.153), whereas the MESOR of DBP correlates with LVM in women (R = 0.316; P = 0.011) but not in men (r = 0.117; P = 0.543). A positive correlation is also found between the MESOR of SBP and SWT as well as with EjFr, which is more prominent in women; between the MESOR of DBP and LAS, which is more prominent in men; and a negative correlation is found for women but not men between the circadian amplitude of both SBP and DBP and EjFr. Blood

  1. The Rochester Initiative.

    ERIC Educational Resources Information Center

    Whitmore, Kay R.

    This paper argues for the participation and partnership of diverse elements in the community in order to achieve the goals of educational reform, and especially to encourage academic achievement among minority students. In a speech before the Forum '88 conference of the National Action Council for Minorities in Engineering, the cooperative…

  2. Obtaining oblique technique source-to-skin distances for irregular field (Clarkson) calculations: The Mayo Off-axis Distance Indicator

    SciTech Connect

    Lajoie, W.N. )

    1988-09-01

    Significant dose inhomogeneities may exist between the supraclavicular fossa (SCF) and the internal mammary chain (IMC) regions in the irregular L-shaped (hockey stick) field associated with breast cancer treatments. This dose inhomogeneity exists, in part, because of a positive air gap in the SCF and a negative air gap in the IMC locations. Independent of treatment technique, (i.e., whether anterior-posterior (AP) or oblique fields are used), accurate source-to-skin distance (SSD) values for the SCF, IMC, and axilla are necessary when doing an irregular field (Clarkson) dose calculation. However, when an oblique technique is used to treat the hockey stick field, obtaining non-central-axis SSDs is not as straightforward as when an AP technique is employed. The Mayo Off-axis Distance Indicator was constructed to slide into the blocking tray slot of the simulator or treatment machine. This mechanical measuring device provides quick and accurate SSD measurements for non-central-axis points under either AP or, more importantly, oblique treatment conditions.

  3. Outcome prediction in home- and community-based brain injury rehabilitation using the Mayo-Portland Adaptability Inventory.

    PubMed

    Malec, James F; Parrot, Devan; Altman, Irwin M; Swick, Shannon

    2015-01-01

    The objective of the study was to develop statistical formulas to predict levels of community participation on discharge from post-hospital brain injury rehabilitation using retrospective data analysis. Data were collected from seven geographically distinct programmes in a home- and community-based brain injury rehabilitation provider network. Participants were 642 individuals with post-traumatic brain injury. Interventions consisted of home- and community-based brain injury rehabilitation. The main outcome measure was the Mayo-Portland Adaptability Inventory (MPAI-4) Participation Index. Linear discriminant models using admission MPAI-4 Participation Index score and log chronicity correctly predicted excellent (no to minimal participation limitations), very good (very mild participation limitations), good (mild participation limitations), and limited (significant participation limitations) outcome levels at discharge. Predicting broad outcome categories for post-hospital rehabilitation programmes based on admission assessment data appears feasible and valid. Equations to provide patients and families with probability statements on admission about expected levels of outcome are provided. It is unknown to what degree these prediction equations can be reliably applied and valid in other settings. PMID:25708369

  4. Source characterization and control technology assessment of methylene chloride emissions from Eastman Kodak Company, Rochester, NY. Final report, July 1988-April 1989

    SciTech Connect

    Walata, S.A.; Rehm, R.M.

    1989-07-01

    This report gives results of an assessment of potential control technologies for methylene chloride (also known as dichloromethane or DCM) emission sources at Eastman Kodak Company's Kodak Park facility in Rochester, NY. DCM is a solvent used by Kodak in the manufacture of cellulose triacetate film support. Work has involved: a plant visit where major DCM emission sources were inspected, and evaluation of current and potential control technologies for the DCM emission sources. The report contains information gathered during the plant visit to the Kodak Park facility. Included are emission estimates determined by Kodak of all emission points greater than 8000 lb (3600 kg)/yr DCM, as well as a description of each point observed during the visit. Also included are results of an evaluation of control technologies that might be applied to the major emission sources. A cost analysis of different add-on control devices is provided for four of the uncontrolled emission points.

  5. The gender-specific apolipoprotein E genotype influence on the distribution of plasma lipids and apolipoproteins in the population of Rochester, Minnesota. II. Regression relationships with concomitants

    SciTech Connect

    Reilly, S.L.; Sing, C.F. ); Ferrell, R.E. ); Kottke, B.A. )

    1992-12-01

    The influence of the apolipoprotein E (Apo E) polymorphism and gender on the regression relationships between each of nine plasma lipid and apolipoprotein traits (total cholesterol; ln triglycerides; high-density-lipoprotein chloesterol; apolipoproteins AI, AII, B, and CII; ln CIII; and ln E) and four concomitants (age, weight, waist-to-hip ratio, and smoking) was studied in 507 unrelated individuals representative of the adult population of Rochester, MN. Analyses are presented separately for females and males. Each lipid and apolipoprotein trait exhibited at least one Apo E genotype-specific regression relationship with the concomitants investigated in this study. In most cases the heterogeneity of regression was associated with differences between the [var epsilon]32 and [var epsilon]33 genotype. This study documents that the influence of Apo E genotype on average levels of plasma lipids and apolipoproteins varies among subdivisions of the population defined by age, body size, and smoking status. 61 refs., 1 fig., 5 tabs.

  6. Proceedings of the Annual National Clinic on Technical Education (13th, Monroe Community College, Rochester, New York, March 24-26, 1976).

    ERIC Educational Resources Information Center

    Bureau of Occupational and Adult Education (DHEW/OE), Washington, DC. Div. of Vocational and Technical Education.

    The keynote address, "Productivity as a Means of Economic Development," by Donald C. Burnham, and 20 other conference presentations on technical education are included in these proceedings. Titles are as follows: A Technical College Responds to a Need for Productivity; The Industrial Answer to Productivity Through Technical Education; An Overview…

  7. Using Large Clinical Corpora for Query Expansion in Text-based Cohort Identification

    PubMed Central

    Zhu, Dongqing; Wu, Stephen; Carterette, Ben; Liu, Hongfang

    2014-01-01

    In light of the heightened problems of polysemy, synonymy, and hyponymy in clinical text, we hypothesize that patient cohort identification can be improved by using a large, in-domain clinical corpus for query expansion. We evaluate the utility of four auxiliary collections for the Text REtrieval Conference task of IR-based cohort retrieval, considering the effects of collection size, the inherent difficulty of a query, and the interaction between the collections. Each collection was applied to aid in cohort retrieval from the Pittsburgh NLP Repository by using a mixture of relevance models. Measured by mean average precision, performance using any auxiliary resource (MAP=0.386 and above) is shown to improve over the baseline query likelihood model (MAP=0.373). Considering subsets of the Mayo Clinic collection, we found that after including 2.5 billion term instances, retrieval is not improved by adding more instances. However, adding the Mayo Clinic collection did improve performance significantly over any existing setup, with a system using all four auxiliary collections obtaining the best results (MAP=0.4223). Because optimal results in the mixture of relevance models would require selective sampling of the collections, the common sense approach of “use all available data” is inappropriate. However, we found that it was still beneficial to add the Mayo corpus to any mixture of relevance models. On the task of IR-based cohort identification, query expansion with the Mayo Clinic corpus resulted in consistent and significant improvements. As such, any IR query expansion with access to a large clinical corpus could benefit from the additional resource. Additionally, we have shown that more data is not necessarily better, implying that there is value in collection curation. PMID:24680983

  8. Using RxNorm and NDF-RT to Classify Medication Data Extracted from Electronic Health Records: Experiences from the Rochester Epidemiology Project

    PubMed Central

    Pathak, Jyotishman; Murphy, Sean P.; Willaert, Brian N.; Kremers, Hilal M.; Yawn, Barbara P.; Rocca, Walter A.; Chute, Christopher G.

    2011-01-01

    RxNorm and NDF-RT published by the National Library of Medicine (NLM) and Veterans Affairs (VA), respectively, are two publicly available federal medication terminologies. In this study, we evaluate the applicability of RxNorm and National Drug File-Reference Terminology (NDF-RT) for extraction and classification of medication data retrieved using structured querying and natural language processing techniques from electronic health records at two different medical centers within the Rochester Epidemiology Project (REP). Specifically, we explore how mappings between RxNorm concept codes and NDF-RT drug classes can be leveraged for hierarchical organization and grouping of REP medication data, identify gaps and coverage issues, and analyze the recently released NLM’s NDF-RT Web service API. Our study concludes that RxNorm and NDF-RT can be applied together for classification of medication extracted from multiple EHR systems, although several issues and challenges remain to be addressed. We further conclude that the Web service APIs developed by the NLM provide useful functionalities for such activities. PMID:22195170

  9. The gender-specific apolipoprotein E genotype influence on the distribution of plasma lipids and apolipoproteins in the population of Rochester, MN. III. Correlations and covariances

    SciTech Connect

    Reilly, S.L.; Sing, C.F.; Ferrell, R.E.

    1994-11-01

    The gender-specific influence that the apolipoprotein E (Apo E) polymorphism has on the correlations and covariances between pairs of nine plasma lipid and apolipoprotein traits (total cholesterol; ln triglycerides; high-density-lipoprotein cholesterol; apolipoproteins AI, AII, B, CII, lnCIII, and lnE) was studied in 507 unrelated individuals representative of the adult population of Rochester, MN. Analyses are presented separately for females and males. The Apo E polymorphism had a significant influence on a large number (10 of 36) of correlations and covariances in females and on a small number of (3 of 36) in males. The contribution of allelic variation in the Apo E gene to the definition of multivariate measures of the 36-dimensional correlation structure was evaluated. The influence of APo E genotype on correlation structure was gender dependent. These findings were used to demonstrate how heterogeneity of risk-factor correlations and covariances among genotype-gender subgroups of the population at large may influence the evaluation of risk of coronary artery disease. 73 refs., 8 figs., 4 tabs.

  10. Survey of Lake Ontario bottom sediment off Rochester, New York, to define the extent of jettisoned World War II material and its potential for sediment contamination

    USGS Publications Warehouse

    Kennedy, Gregory; Kappel, William M.

    2000-01-01

    Military-type mat??riel was recovered from the bottom of Lake Ontario near Rochester, N.Y., during bottom-trawl, fish-stock surveys at depths of 75 to 180 feet each year from 1978 through 1996. The recovered mat??riel included many shell-detonator nose cones (2 inches in diameter by about 3.5 inches long); several electronic components; one corroded box of detonators; a corrugated container of mercury-filled capsules; and corroded batteries. Most of the recovered mat??riel has been identified as defective components of shell detonators (proximity-fuze assemblies) that were jettisoned in the lake to protect them from discovery during World War II. Side-scan SONAR, metal-detector, and ROV (remotely-operated-vehicle) surveys found no evidence of any large piles of mat??riel containing potentially hazardous, toxic, or polluting materials within the 17-square-mile study site. Many scattered magnetic anomalies were detected in this area, but chemical analysis of bottom sediment and of zebra- and quagga-mussel (Dreissena spp.) tissue indicate that the concentrations of mercury and other heavy metals are within the previously documented ranges for Lake Ontario sediment. The failure of ROV videos and of SCUBA-diver surveys and probes of the lake bottom to locate any debris indicates that most, if not all, of the debris is scattered and buried under a layer of fine-grained sediment and, possibly, mussels.

  11. Clinical course of light-chain smouldering multiple myeloma (idiopathic Bence Jones proteinuria): a retrospective cohort study

    PubMed Central

    Kyle, Robert A; Larson, Dirk R; Therneau, Terry M; Dispenzieri, Angela; Melton, L Joseph; Benson, Joanne T; Kumar, Shaji; Rajkumar, S Vincent

    2014-01-01

    Summary Background Bence Jones proteinuria is a disorder that is defined by the excretion of monoclonal light-chain protein. About 15–20% of patients with multiple myeloma secrete monoclonal light chains only, without expression of the normal immunoglobulin heavy chain, which constitutes light-chain multiple myeloma. The definition, prevalence, and progression of these premalignant phases of light-chain multiple myeloma have not been fully characterised. We aimed to identify a subset of patients with idiopathic Bence Jones proteinuria who had a high risk of progression to light-chain multiple myeloma analogous to that seen in patients with smouldering multiple myeloma. Methods In this retrospective cohort study, we studied all patients seen at the Mayo Clinic (Rochester, MN, USA) within 30 days of diagnosis of idiopathic Bence Jones proteinuria between Jan 1, 1960, and June 30, 2004. Inclusion criteria were monoclonal light chain in the urine (≥0·2 g/24 h), absence of intact monoclonal immunoglobulin (M protein) in the serum, and no evidence of multiple myeloma, light-chain amyloidosis, or other related plasma-cell proliferative disorders. The primary endpoint was progression to symptomatic multiple myeloma or light-chain amyloidosis. We examined the cumulative probability of progression and the association of potential risk factors on progression rates to identify patients with a high risk of progression to multiple myeloma or light-chain amyloidosis. Findings We identified 101 patients with idiopathic Bence Jones proteinuria. During 901 total person-years of follow-up, 27 (27%) patients developed multiple myeloma and seven (7%) developed light-chain amyloidosis. The major risk factors for progression were amount of urinary excretion of M protein per 24 h, proportion of bone marrow plasma cells, presence of a markedly abnormal free-light-chain ratio (<0·01 or >100), and reduction of all three uninvolved immunoglobulins. Based on the risk of progression

  12. Chemistry and origin of the Mayo Kila sapphires, NW region Cameroon (Central Africa): Their possible relationship with the Cameroon volcanic line

    NASA Astrophysics Data System (ADS)

    Paul Mbih, Kemeng; Meffre, Sebastien; Yongue, Rose Fouateu; Kanouo, Nguo Sylvestre; Jay, Thomson

    2016-06-01

    Mineralogical, chemical and geochronological studies constrained the origin of sapphires from Mayo Kila, Northwest Cameroon. The sapphires are mostly blue, with sizes ranging from 2 to 5 mm. The pale blue grains are transparent, whereas, other corundums are transparent to translucent and/or opaque. The sapphires are dominantly euhedral to sub-hedral with few polished lustrous grains, acquired features during moderate to short distance transport from a proximal source rock. Solid inclusions are limited to rutile and zircon. Trace element analysis of sapphires shows significant concentration (in ppm) in some elements: Fe (2208-14,473), Ti (82-1783), Ga (77-512), Mg (0.9-264.9), Cr (b.d.l -168) and V (1.3-82). The other elements (e.g. Sn, Nb, Ta, Th, Zr, Ni, Ce) are generally below 10 ppm. The calculated ratios for some of the selected elements show an extreme variation: Fe/Mg (43-3043), Fe/Ti (2-76), Ti/Mg (1-328), and Ga/Mg (0.4-363). They are dominantly corundum crystallized in alkaline magma (s) with few from metamorphic source (s). Trace elemental features with Hf (13,354-26,238 ppm), Th (4018-45,584 ppm) and U (7825-17,175 ppm), and Th/U (0.39-2.65) found in zircon inclusions are compatible with quantified values in magmatic crystallized zircons. The Cenozoic age (mean of 30.78 ± 0.28 Ma) obtained for zircon inclusions is close to the age of some igneous rocks found within the Cameroon Volcanic Line (e.g. rocks of the Mount Oku: 31-22 Ma), showing the same period of formation. The most probable source of the zircon host sapphires is the Oku Mountain located SW of Mayo Kila.

  13. An evaluation of computer assisted clinical classification algorithms.

    PubMed

    Chute, C G; Yang, Y; Buntrock, J

    1994-01-01

    The Mayo Clinic has a long tradition of indexing patient records in high resolution and volume. Several algorithms have been developed which promise to help human coders in the classification process. We evaluate variations on code browsers and free text indexing systems with respect to their speed and error rates in our production environment. The more sophisticated indexing systems save measurable time in the coding process, but suffer from incompleteness which requires a back-up system or human verification. Expert Network does the best job of rank ordering clinical text, potentially enabling the creation of thresholds for the pass through of computer coded data without human review. PMID:7949912

  14. Improved modeling of multiple scattering in hyperspectral BRDF of coastal sediments observed using the Goniometer of the Rochester Institute of Technology (GRIT)

    NASA Astrophysics Data System (ADS)

    Bachmann, Charles M.; Peck, Douglas S.; Ambeau, Brittany; Harms, Justin; Schultz, Malachi

    2015-09-01

    Approximate solutions to the Radiative transfer equation for granular media have been previously developed1. To apply these models to coastal sediments, modifications are needed to account for observed phenomenology. This study uses a new hyperspectral goniometer system, the Goniometer of the Rochester Institute of Technology (GRIT), designed for both field and laboratory settings, to compare observed bidirectional reflectance distribution function (BRDF) measurements with outcomes predicted by the approximate radiative transfer solutions. In previous laboratory studies,2 using a more limited hyperspectral goniometer observing in the principle plane, we had seen that the degree of optical contrast between coastal sand constituents was indicative of whether these models accurately predict the observed BRDF dependence on sediment density. Our earlier measurements using another field hyperspectral goniometer also demonstrated results consistent with the laboratory measurements as well as with CASI- 1500 airborne hyperspectral measurements3,4. In our earlier work,2 the presence of highly contrasting constituents (translucent quartz and more opaque fractions composed of minerals such as magnetite) led to greater reflectance as density decreased, exactly the opposite of what was anticipated from radiative transfer models for a more uniform sand. The present study shows that the illumination zenith angle also plays a significant role in whether or not BRDF dependency exhibits behavior predicted by current radiative transfer theory, and this distinction is directly related to the degree of multiple scattering, which depends on the illumination zenith angle. We also investigate a novel sampling paradigm that constrains the measurements to constant phase angle and reveals when the multiple scattering component of models departs from the assumptions of current theory. For the multiple scattering term, we also propose and analyze a simple modification which removes the

  15. Making Canada a Destination for Medical Tourists: Why Canadian Provinces Should Not Try to Become “Mayo Clinics of the North”

    PubMed Central

    Turner, Leigh

    2012-01-01

    When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists. PMID:23634159

  16. The Rochester Optical Streak System

    NASA Astrophysics Data System (ADS)

    Jaanimagi, P. A.; Boni, R.; Keck, R. L.; Donaldson, W. R.; Meyerhofer, D. D.

    2004-11-01

    A modern, self-calibrating, remotely controlled streak camera platform capable of accepting a variety of different streak tubes has been developed. Our current systems include P510, P820, and PJX streak tubes with both S-1 and S-20 photocathodes. The input may be either fiber delivery or free-space propagation and is relayed to the photocathode with an achromatic Offner triplet. Calibration functions include autofocus of the input and electron optics, geometric distortion and flat-field correction, system gain, and linearity. The four remotely selectable sweep speeds are calibrated with an on-board optical comb generator. The recording system is a fiber-coupled back-illuminated CCD camera. We will present data illustrating the many features of the ROSS camera as applied to laser and plasma diagnostics. This work was supported by the U.S. Department of Energy Office of Inertial Confinement Fusion under Cooperative Agreement No. DE-FC52-92SF19460.

  17. Descriptive Analysis of Medication Administration During Inpatient Cardiopulmonary Arrest Resuscitation (from the Mayo Registry for Telemetry Efficacy in Arrest Study).

    PubMed

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2016-05-15

    Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p <0.001). The proportion of patients who died during the arrest was 12.5% in those who received epinephrine alone, 30.0% in those who received only epinephrine and bicarbonate, and 46.7% to 57.9% in the remaining groups. Patients receiving only epinephrine had shorter resuscitation durations compared to that of the other groups (p <0.001) and improved survival (p = 0.003). In conclusion, providers frequently use nonguideline medications in resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. PMID:27015887

  18. Development of a Multidisciplinary, Multicampus Subspecialty Practice in Endocrine Cancers

    PubMed Central

    Bible, Keith C.; Smallridge, Robert C.; Morris, John C.; Molina, Julian R.; Suman, Vera J.; Copland, John A.; Rubin, Joseph; Menefee, Michael E.; Sideras, Kostandinos; Maples, William J.; McIver, Bryan; Fatourechi, Vahab; Hay, Ian; Foote, Robert L.; Garces, Yolanda I.; Kasperbauer, Jan L.; Thompson, Geoffrey B.; Grant, Clive S.; Richards, Melanie L.; Sebo, Thomas; Lloyd, Ricardo; Eberhardt, Norman L.; Reddi, Honey V.; Casler, John D.; Karlin, Nina J.; Westphal, Sydney A.; Richardson, Ronald L.; Buckner, Jan C.; Erlichman, Charles

    2012-01-01

    Purpose: Relative to more abundant neoplasms, endocrine cancers have been historically neglected, yet their incidence is increasing. We therefore sought to build interest in endocrine cancers, improve physician experience, and develop innovative approaches to treating patients with these neoplasms. Methods: Between 2005 and 2010, we developed a multidisciplinary Endocrine Malignancies Disease Oriented Group involving all three Mayo Clinic campuses (Rochester, MN; Jacksonville, FL; and Scottsdale, AZ). In response to higher demand at the Rochester campus, we sought to develop a Subspecialty Tumor Group and an Endocrine Malignancies Tumor Clinic within the Division of Medical Oncology. Results: The intended groups were successfully formed. We experienced difficulty in integration of the Mayo Scottsdale campus resulting from local uncertainty as to whether patient volumes would be sufficient to sustain the effort at that campus and difficulty in developing enthusiasm among clinicians otherwise engaged in a busy clinical practice. But these obstacles were ultimately overcome. In addition, with respect to the newly formed medical oncology subspecialty endocrine malignancies group, appointment volumes quadrupled within the first year and increased seven times within two years. The number of active therapeutic endocrine malignancies clinical trials also increased from one in 2005 to five in 2009, with all three Mayo campuses participating. Conclusion: The development of subspecialty tumor groups for uncommon malignancies represents an effective approach to building experience, increasing patient volumes and referrals, and fostering development of increased therapeutic options and clinical trials for patients afflicted with otherwise historically neglected cancers. PMID:22942830

  19. Towards temporal relation discovery from the clinical narrative.

    PubMed

    Savova, Guergana; Bethard, Steven; Styler, Will; Martin, James; Palmer, Martha; Masanz, James; Ward, Wayne

    2009-01-01

    Disease progression and understanding relies on temporal concepts. Discovery of automated temporal relations and timelines from the clinical narrative allows for mining large data sets of clinical text to uncover patterns at the disease and patient level. Our overall goal is the complex task of building a system for automated temporal relation discovery. As a first step, we evaluate enabling methods from the general natural language processing domain - deep parsing and semantic role labeling in predicate-argument structures - to explore their portability to the clinical domain. As a second step, we develop an annotation schema for temporal relations based on TimeML. In this paper we report results and findings from these first steps. Our next efforts will scale up the data collection to develop domain-specific modules for the enabling technologies within Mayo's open-source clinical Text Analysis and Knowledge Extraction System. PMID:20351919

  20. Eventos de Mayo (May Events).

    ERIC Educational Resources Information Center

    Toro, Leonor; Pla, Myrna

    Designed as a resource for teachers, this booklet, written in Spanish, contains brief information on seven May events: La Semana de la Educacion (first Friday in May), Harry S. Truman (May 8), Dia de las Madres (second Sunday in May), Luis Llorens Torres (May 14), La Cruz Roja (May 21), John F. Kennedy (May 29), and El Dia De Conmemoracion (May…

  1. Analysis of Medication and Indication Occurrences in Clinical Notes

    PubMed Central

    Sohn, Sunghwan; Liu, Hongfang

    2014-01-01

    A medication indication is a valid reason to use medication. Comprehensive information on medication and its intended indications has valuable potential applications for patient treatments, quality improvements, and clinical decision support. Though there are some publicly available medication resources, this medication and indication information is comprised primarily of labeled uses approved by the FDA. Additionally, linking those medications and the corresponding indications is not easy to accomplish. Furthermore, research that analyzes actual medication and indication occurrences used in real clinical practice is limited. In this study, we compiled clinician-asserted medication and indication pairs from a large cohort of Mayo Clinic electronic medical records (EMRs) and normalized them to the standard forms (ie, medication to the RxNorm ingredient and indication to SNOMED-CT). We then analyzed medication and indication occurrences and compared them with the public resource in various ways, including off-label statistics. PMID:25954414

  2. AQP4 autoantibody assay performance in clinical laboratory service

    PubMed Central

    Fryer, J.P.; Lennon, V.A.; Pittock, S.J.; Jenkins, S.M.; Fallier-Becker, P.; Clardy, S.L.; Horta, E.; Jedynak, E.A.; Lucchinetti, C.F.; Shuster, E.A.; Weinshenker, B.G.; Wingerchuk, D.M.

    2014-01-01

    Objective: To compare performance of contemporary aquaporin-4–immunoglobulin (Ig) G assays in clinical service. Methods: Sera from neurologic patients (4 groups) and controls were tested initially by service ELISA (recombinant human aquaporin-4, M1 isoform) and then by cell-based fluorescence assays: fixed (CBA, M1-aquaporin-4, observer-scored) and live (fluorescence-activated cell sorting [FACS], M1 and M23 aquaporin-4 isoforms). Group 1: all Mayo Clinic patients tested from January to May 2012; group 2: consecutive aquaporin-4-IgG–positive patients from September 2011 (Mayo and non-Mayo); group 3: suspected ELISA false-negatives from 2011 to 2013 (physician-reported, high likelihood of neuromyelitis optica spectrum disorders [NMOSDs] clinically); group 4: suspected ELISA false-positives (physician-reported, not NMOSD clinically). Results: Group 1 (n = 388): M1-FACS assay performed optimally (areas under the curves: M1 = 0.64; M23 = 0.57 [p = 0.02]). Group 2 (n = 30): NMOSD clinical diagnosis was confirmed by: M23-FACS, 24; M1-FACS, 23; M1-CBA, 20; and M1-ELISA, 18. Six results were suspected false-positive: M23-FACS, 2; M1-ELISA, 2; and M23-FACS, M1-FACS, and M1-CBA, 2. Group 3 (n = 31, suspected M1-ELISA false-negatives): results were positive for 5 sera: M1-FACS, 5; M23-FACS, 3; and M1-CBA, 2. Group 4 (n = 41, suspected M1-ELISA false-positives): all negative except 1 (positive only by M1-CBA). M1/M23-cotransfected cells expressing smaller membrane arrays of aquaporin-4 yielded fewer false- positive FACS results than M23-transfected cells. Conclusion: Aquaporin-4-transfected CBAs, particularly M1-FACS, perform optimally in aiding NMOSD serologic diagnosis. High-order arrays of M23-aquaporin-4 may yield false-positive results by binding IgG nonspecifically. PMID:25340055

  3. The case for implementing activity based costing.

    PubMed

    Monge, Paul H; Bolinger-Perez, Nicole; Boysen, Kent

    2012-01-01

    ABC identifies profitable volumes to give managers information to better manage volumes. Managers must balance the demand for service while maintaining a reasonable profit margin. Disparate systems work extremely well for their intended purposes, but they do not communicate with one another. The strength of the data they hold individually may be leveraged when implementing ABC methodology. Mayo Clinic in Rochester, Minnesota implemented a pilot of ABC to evaluate CT services where there is a high volume, multiple service location for cost comparison, variety of patient acuity and service mix, and large capital investments.The goal was to reveal the actual cost of CT services at the procedural level. PMID:23270120

  4. Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

    PubMed Central

    Raeissadat, Seyed Ahmad; Sedighipour, Leyla; Rayegani, Seyed Mansoor; Bahrami, Mohammad Hasan; Bayat, Masume; Rahimi, Rosa

    2014-01-01

    Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P > 0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P < 0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion. PMID:24579044

  5. Anaphoric relations in the clinical narrative: corpus creation

    PubMed Central

    Chapman, Wendy W; Zheng, Jiaping; Crowley, Rebecca S

    2011-01-01

    Objective The long-term goal of this work is the automated discovery of anaphoric relations from the clinical narrative. The creation of a gold standard set from a cross-institutional corpus of clinical notes and high-level characteristics of that gold standard are described. Methods A standard methodology for annotation guideline development, gold standard annotations, and inter-annotator agreement (IAA) was used. Results The gold standard annotations resulted in 7214 markables, 5992 pairs, and 1304 chains. Each report averaged 40 anaphoric markables, 33 pairs, and seven chains. The overall IAA is high on the Mayo dataset (0.6607), and moderate on the University of Pittsburgh Medical Center (UPMC) dataset (0.4072). The IAA between each annotator and the gold standard is high (Mayo: 0.7669, 0.7697, and 0.9021; UPMC: 0.6753 and 0.7138). These results imply a quality corpus feasible for system development. They also suggest the complementary nature of the annotations performed by the experts and the importance of an annotator team with diverse knowledge backgrounds. Limitations Only one of the annotators had the linguistic background necessary for annotation of the linguistic attributes. The overall generalizability of the guidelines will be further strengthened by annotations of data from additional sites. This will increase the overall corpus size and the representation of each relation type. Conclusion The first step toward the development of an anaphoric relation resolver as part of a comprehensive natural language processing system geared specifically for the clinical narrative in the electronic medical record is described. The deidentified annotated corpus will be available to researchers. PMID:21459927

  6. Predicting Clinical Scores from Magnetic Resonance Scans in Alzheimer's Disease

    PubMed Central

    Stonnington, Cynthia M.; Chu, Carlton; Klöppel, Stefan; Jack, Clifford R; Ashburner, John; Frackowiak, Richard S.J.

    2010-01-01

    Machine learning and pattern recognition methods have been used to diagnose Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI) from individual MRI scans. Another application of such methods is to predict clinical scores from individual scans. Using relevance vector regression (RVR), we predicted individuals' performances on established tests from their MRI T1 weighted image in two independent datasets. From Mayo Clinic, 73 probable AD patients and 91 cognitively normal (CN) controls completed the Mini-Mental State Examination (MMSE), Dementia Rating Scale (DRS), and Auditory Verbal Learning Test (AVLT) within 3 months of their scan. Baseline MRI's from the Alzheimer's disease Neuroimaging Initiative (ADNI) comprised the other dataset; 113 AD, 351 MCI, and 122 CN subjects completed the MMSE and Alzheimer's Disease Assessment Scale—Cognitive subtest (ADAS-cog) and 39 AD, 92 MCI, and 32 CN ADNI subjects completed MMSE, ADAS-cog, and AVLT. Predicted and actual clinical scores were highly correlated for the MMSE, DRS, and ADAS-cog tests (P<.0001). Training with one dataset and testing with another demonstrated stability between datasets. DRS, MMSE, and ADAS-Cog correlated better than AVLT with whole brain grey matter changes associated with AD. This result underscores their utility for screening and tracking disease. RVR offers a novel way to measure interactions between structural changes and neuropsychological tests beyond that of univariate methods. In clinical practice, we envision using RVR to aid in diagnosis and predict clinical outcome. PMID:20347044

  7. Marble Table Top, Agra India.

    PubMed

    Wentz, Margaret R

    2016-09-01

    Recognizing the contribution art has had in the Mayo Clinic environment since the original Mayo Clinic Building was finished in 1914, Mayo Clinic Proceedings features some of the numerous works of art displayed throughout the buildings and grounds on Mayo Clinic campuses as researched and interpreted by the author. PMID:27594196

  8. Lessons learned from starting Rochester Precision Optics

    NASA Astrophysics Data System (ADS)

    Hurley, William P.

    2014-12-01

    Thank you very much for coming to attend this talk. I see a few familiar faces in the crowd that have had their own journeys, and if you're thinking of starting your own optics business, this is not the authoritative talk on how to do. It's just a talk on what I've learned from my journey and some of my own stories on Lessons Learned. It does tie into some of the previous talks, and I do give credit to some mentors. The developments I've been involved with do make use of the ability to adapt and change, and there have been Bumps in the Road here and there, and I'll tell you a little bit more about that during this Talk.

  9. University of Rochester, Laboratory for Laser Energetics

    NASA Astrophysics Data System (ADS)

    1987-01-01

    In FY86 the Laboratory has produced a list of accomplishments in which it takes pride. LLE has met every laser-fusion program milestone to date in a program of research for direct-drive ultraviolet laser fusion originally formulated in 1981. LLE scientists authored or co-authored 135 scientific papers during 1985 to 1986. The collaborative experiments with NRL, LANL, and LLNL have led to a number of important ICF results. The cryogenic target system developed by KMS Fusion for LLE will be used in future high-density experiments on OMEGA to demonstrate the compression of thermonuclear fuel to 100 to 200 times that of solid (20 to 40 g/cm) in a test of the direct-drive concept, as noted in the National Academy of Sciences' report. The excellence of the advanced technology efforts at LLE is illustrated by the establishment of the Ultrafast Science Center by the Department of Defense through the Air Force Office of Scientific Research. Research in the Center will concentrate on bridging the gap between high-speed electronics and ultrafast optics by providing education, research, and development in areas critical to future communications and high-speed computer systems. The Laboratory for Laser Energetics continues its pioneering work on the interaction of intense radiation with matter. This includes inertial-fusion and advanced optical and optical electronics research; training people in the technology and applications of high-power, short-pulse lasers; and interacting with the scientific community, business, industry, and government to promote the growth of laser technology.

  10. Clinical Outcomes of Radial Shortening Osteotomy and Vascularized Bone Graft in Kienböck's Disease

    PubMed Central

    Dehghani, Mohammad; Nouraei, Mohammad Hadi; Dehghani, Shaghayegh; Gholshahi, Maryam

    2014-01-01

    The aim of this study was to compare two surgery methods including radial shortening and radial shortening combined with vascularized bone graft for treatment of stage II or IIIa of Kienböck's disease. It is a randomized, controlled clinical trial, which was carried out in 2011–2013. Twenty-four patients were assigned equally to radial shortening group (A) or radial shortening combined with vascularized bone graft group (B). The outcome was assessed by Mayo Wrist score before and 9 months after surgery. The mean Mayo Wrist score (SD) was 27.1 (15.4) and 32.5 (18.3) before surgery and 74.6 (5.4) and 85.8 (5.1) after surgery for groups A and B, respectively. The mean score increased in both groups, and it was higher in group B significantly. Radial shortening combined with vascularized bone graft is a valuable method which can be more effective than radial shortening alone, in early stages of Kienböck's disease. This trial is registered with IRCT201404127841N5.

  11. Clinical monitoring: infliximab biosimilar CT-P13 in the treatment of Crohn’s disease and ulcerative colitis

    PubMed Central

    Keil, Radan; Wasserbauer, Martin; Zádorová, Zdena; Hajer, Jan; Drastich, Pavel; Wohl, Pavel; Beneš, Marek; Bojková, Martina; Svoboda, Pavel; Konečný, Michal; Falt, Přemysl; Vaňásek, Tomáš; Pešta, Martin; Pešek, František; Bouchner, Luděk; Koželuhová, Jana; Novotný, Aleš; Bartůsková, Lucie; Špičák, Julius

    2016-01-01

    Abstract Objective: The infliximab biosimilar CT-P13 (Remsima®, Inflectra®) was approved in Europe for the treatment of inflammatory bowel disease (IBD) based on extrapolation of data from patients with rheumatic disease. Because there are limited published reports on clinical outcomes for IBD patients treated with CT-P13, we monitored responses to induction treatment with this biosimilar in patients with Crohn’s disease (CD) or ulcerative colitis (UC) in centres across the Czech Republic. Material and methods: Fifty-two patients with CD (n = 30) or UC (n = 22) were treated with 5 mg/kg CT-P13 for up to 14 weeks. Effectiveness of therapy was evaluated with the Crohn’s Disease Activity Index (CDAI) or the Mayo Scoring System (MSS) in patients with CD or UC, respectively, before and after 14 weeks. Additional goals were to evaluate weight changes, serum C-reactive protein (CRP) levels, and complications/adverse events. Results: In patients with CD, remission (CDAI <150) was achieved in 50.0% of cases, and partial response (≥70-point decrease in CDAI score from baseline) in the remaining 50.0%. In patients with UC, remission (total score on partial Mayo index ≤2 points) was achieved in 40.9% of cases, partial response (≥2-point decrease in partial Mayo score from baseline) in 54.5%, and no response in 4.5%. There were statistically significant improvements in CDAI, MSS and CRP serum levels after 14 weeks of therapy, and body weight increased. Four adverse events were identified (n = 1 each): lower-extremity phlebothrombosis, herpes labialis, pneumonia and allergic reaction. Conclusions: This prospective observational study provides evidence of the effectiveness of CT-P13 in IBD. PMID:27002981

  12. Patients' Perspective on Full Disclosure and Informed Consent Regarding Postoperative Visual Loss Associated With Spinal Surgery in the Prone Position

    PubMed Central

    Corda, David M.; Dexter, Franklin; Pasternak, Jeffrey J.; Trentman, Terrence L.; Nottmeier, Eric W.; Brull, Sorin J.

    2011-01-01

    OBJECTIVE: To determine patients' opinions regarding the person, method, and timing for disclosure of postoperative visual loss (POVL) associated with high-risk surgery. PATIENTS AND METHODS: On the basis of findings of a pilot study involving 219 patients at Mayo Clinic in Florida, we hypothesized that at least 80% of patients would prefer disclosure of POVL by the surgeon, during a face-to-face discussion, before the day of scheduled surgery. To test the hypothesis, we sent a questionnaire to 437 patients who underwent prolonged prone spinal surgical procedures at Mayo Clinic in Rochester, MN, or Mayo Clinic in Arizona from December 1, 2008, to December 31, 2009. RESULTS: Among the 184 respondents, 158 patients gave responses supporting the hypothesis vs 26 with at least 1 response not supporting it, for an observed incidence of 86%. The 2-sided 95% confidence interval is 80% to 91%. CONCLUSION: At least 80% of patients prefer full disclosure of the risk of POVL, by the surgeon, during a face-to-face discussion before the day of scheduled surgery. This finding supports development of a national patient-driven guideline for disclosing the risk of POVL before prone spinal surgery. PMID:21878598

  13. Utilisation of Clinical Networks to Facilitate Elective Surgical Workload; A Preliminary Analysis.

    PubMed

    Burke, T; Waters, P; Waldron, R M; Joyce, K; Khan, I; Khan, W; Kerin, M; Barry, K

    2015-01-01

    Clinical networks have potential to increase elective surgical workload for benign conditions in non-cancer centres. The aims of this study were to determine outcomes for elective laparoscopic cholecystectomy in our unit and to evaluate early experience in managing benign surgical workload referred from the tertiary centre within our clinical network. An analysis of cholecystectomies performed at Mayo General Hospital was conducted (2003-2013). A review of elective procedures more recently referred from Galway University Hospital (GUH) waiting lists was also conducted. 1937 consecutive cholecystectomies were performed with an overall laparoscopic conversion rate of 1.7% (33/1875). The total major complication rate was 0.93% (18/1937). 151 selected procedures originating from GUH have been performed since December 2013 without adverse events. Laparoscopic cholecystectomy can be performed in significant volume in the general hospital environment. This and other appropriate benign surgical procedures may be performed outside of tertiary units according to network agreements. PMID:26817285

  14. Takotsubo cardiomyopathy systematic review: Pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy.

    PubMed

    Ono, Ryohei; Falcão, L Menezes

    2016-04-15

    Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular apical ballooning with the absence of coronary occlusion, which typically occurs in older women after emotional or physical stress. The pathophysiology of TTC is not well established, though several possible causes such as catecholamine cardiotoxicity, metabolic disturbance, coronary microvascular impairment and multivessel epicardial coronary artery spasm have been proposed. A number of diagnostic criteria have been suggested in the world and not unified as single, but the most common accepted one is Mayo Clinic proposed criteria. Since the clinical presentation of TTC is usually similar to acute coronary syndrome, differential diagnosis is essential to exclude other diseases and also for its treatment. Imaging modality including echocardiogram, angio CT and cardiac MRI, and lab tests for catecholamine, troponin T, creatine kinase MB and B-type natriuretic peptide can be useful to differentiate TTC from other diseases. Prognosis is generally favorable and in-hospital mortality is from 0% to within 10%. PMID:26896623

  15. Representing Mutually Exclusive Knowledge in a Property Hierarchy for a Reasoning System in Clinical Gynecology

    PubMed Central

    Small, Steven L.; Muechler, Eberhard K.

    1985-01-01

    The education and practice of clinical medicine can benefit significantly from the use of computational assistants. This article describes the development of a prototype system called SURGES (Strong/University of Rochester Gynecological Expert System) for representing medical knowledge and then applying this knowledge to suggest diagnostic procedures in medical gynecology. The paper focuses on the representation technique of property inheritance, which facilitates the simple common sense reasoning required to enable execution of the more complex medical inferences. Such common sense can be viewed as a collection mundane inferences, which are the simple conclusions drawn from knowledge that an exclusive or (XOR) relation (i.e., mutual exclusion) holds among a number of facts. The paper discusses the use of a property hierarchy for this purpose and shows how it simplifies knowledge representation in medical artificial intelligence (AIM) computer systems.

  16. Phase II Evaluation of Gefitinib in Patients With Newly Diagnosed Grade 4 Astrocytoma: Mayo/North Central Cancer Treatment Group Study N0074

    SciTech Connect

    Uhm, Joon H.; Ballman, Karla V.; Wu Wenting; Giannini, Caterina; Krauss, J.C.; Buckner, Jan C.; James, C.D.; Scheithauer, Bernd W.; Behrens, Robert J.; Flynn, Patrick J.; Schaefer, Paul L.; Dakhill, Shaker R.; Jaeckle, Kurt A.

    2011-06-01

    Purpose: Amplification of the epidermal growth factor receptor (EGFR) gene represents one of the most frequent gene alterations in glioblastoma (GBM). In the current study, we evaluated gefitinib, a potent EGFR inhibitor, in the treatment of adults with newly diagnosed GBM. Methods and Materials: Ninety-eight patients (96 evaluable) were accrued between May 18, 2001, and August 2, 2002. All were newly diagnosed GBM patients who were clinically and radiographically stable/improved after radiation treatment (enrollment within 5 weeks of radiation completion). No prior chemotherapy was permitted. EGFR amplification/mutation, as assessed by fluorescence in situ hybridization and immunohistochemistry, was not required for treatment with gefitinib but was studied when tissues were available. Gefitinib was administered at 500 mg each day; for patients receiving dexamethasone or enzyme-inducing (CYP3A4) agents, dose was escalated to a maximum of 1,000 mg QD. Treatment cycles were repeated at 4-week intervals with brain magnetic resonance imaging at 8-week intervals. Results: Overall survival (OS; calculated from time of initial surgery) at 1 year (primary end point) with gefitinib was 54.2%, which was not statistically different compared with that of historical control population (48.9%, data from three previous Phase III North Central Cancer Treatment Group studies of newly diagnosed GBM patients). Progression-free survival (PFS) at 1 year post-RT (16.7%) was also not significantly different to that of historical controls (30.3%). Clinical outcome was not affected by EGFR status (amplification or vIII mutation). Fatigue (41%), rash (62%), and loose stools (58%) constituted the most frequent adverse events, the majority of these being limited to Grade 1/2. Of note, the occurrence of drug-related adverse effects, such as loose stools was associated with improved OS. Conclusions: In our evaluation of nearly 100 patients with newly diagnosed GBM, treatment with adjuvant

  17. Chronic Myelomonocytic Leukemia: Focus on Clinical Practice.

    PubMed

    Patnaik, Mrinal M; Tefferi, Ayalew

    2016-02-01

    Chronic myelomonocytic leukemia (CMML) is a clonal stem cell disorder with features that overlap those of myelodysplastic syndromes (MDSs) and myeloproliferative neoplasms (MPNs). Chronic myelomonocytic leukemia often results in peripheral blood monocytosis and has an inherent tendency to transform to acute myeloid leukemia. Clonal cytogenetic changes are seen in approximately 30% of patients, and molecular abnormalities are seen in more than 90%. Gene mutations involving TET2 (∼60%), SRSF2 (∼50%), ASXL1 (∼40%), and RAS (∼30%) are frequent, with nonsense and frameshift ASXL1 mutations being the only mutations identified thus far to have an independent negative prognostic effect on overall survival. Contemporary molecularly integrated prognostic models (inclusive of ASXL1 mutations) include the Molecular Mayo Model and the Groupe Français des Myélodysplasies model. Given the lack of formal treatment and response criteria, management of CMML is often extrapolated from MDS and MPN, with allogeneic stem cell transplant being the only curative option. Hydroxyurea and other cytoreductive agents have been used to control MPN-like features, while epigenetic modifiers such as hypomethylating agents have been used for MDS-like features. Given the relatively poor response to these agents and the inherent risks associated with hematopoietic stem cell transplant, newer drugs exploiting molecular and epigenetic abnormalities in CMML are being developed. The creation of CMML-specific response criteria is a much needed step in order to improve clinical outcomes. PMID:26848006

  18. Intra-Gene DNA Methylation Variability Is a Clinically Independent Prognostic Marker in Women’s Cancers

    PubMed Central

    Bartlett, Thomas E.; Jones, Allison; Goode, Ellen L.; Fridley, Brooke L.; Cunningham, Julie M.; Berns, Els M. J. J.; Wik, Elisabeth; Salvesen, Helga B.; Davidson, Ben; Trope, Claes G.; Lambrechts, Sandrina; Vergote, Ignace; Widschwendter, Martin

    2015-01-01

    We introduce a novel per-gene measure of intra-gene DNA methylation variability (IGV) based on the Illumina Infinium HumanMethylation450 platform, which is prognostic independently of well-known predictors of clinical outcome. Using IGV, we derive a robust gene-panel prognostic signature for ovarian cancer (OC, n = 221), which validates in two independent data sets from Mayo Clinic (n = 198) and TCGA (n = 358), with significance of p = 0.004 in both sets. The OC prognostic signature gene-panel is comprised of four gene groups, which represent distinct biological processes. We show the IGV measurements of these gene groups are most likely a reflection of a mixture of intra-tumour heterogeneity and transcription factor (TF) binding/activity. IGV can be used to predict clinical outcome in patients individually, providing a surrogate read-out of hard-to-measure disease processes. PMID:26629914

  19. CLINICAL BIOCHEMISTRY

    EPA Science Inventory

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  20. Word sense disambiguation in the clinical domain: a comparison of knowledge-rich and knowledge-poor unsupervised methods

    PubMed Central

    Chasin, Rachel; Rumshisky, Anna; Uzuner, Ozlem; Szolovits, Peter

    2014-01-01

    Objective To evaluate state-of-the-art unsupervised methods on the word sense disambiguation (WSD) task in the clinical domain. In particular, to compare graph-based approaches relying on a clinical knowledge base with bottom-up topic-modeling-based approaches. We investigate several enhancements to the topic-modeling techniques that use domain-specific knowledge sources. Materials and methods The graph-based methods use variations of PageRank and distance-based similarity metrics, operating over the Unified Medical Language System (UMLS). Topic-modeling methods use unlabeled data from the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC II) database to derive models for each ambiguous word. We investigate the impact of using different linguistic features for topic models, including UMLS-based and syntactic features. We use a sense-tagged clinical dataset from the Mayo Clinic for evaluation. Results The topic-modeling methods achieve 66.9% accuracy on a subset of the Mayo Clinic's data, while the graph-based methods only reach the 40–50% range, with a most-frequent-sense baseline of 56.5%. Features derived from the UMLS semantic type and concept hierarchies do not produce a gain over bag-of-words features in the topic models, but identifying phrases from UMLS and using syntax does help. Discussion Although topic models outperform graph-based methods, semantic features derived from the UMLS prove too noisy to improve performance beyond bag-of-words. Conclusions Topic modeling for WSD provides superior results in the clinical domain; however, integration of knowledge remains to be effectively exploited. PMID:24441986

  1. Clinical Research and Clinical Trials

    MedlinePlus

    ... you can get involved. Doing your own clinical research project? Then select the Guidance for Clinical Researchers link to learn more about the NICHD's clinical research processes and policies. Last Reviewed: 03/06/2012 ...

  2. Patients' Attitudes and Preferences About Participation and Recruitment Strategies in Clinical Trials

    PubMed Central

    Sood, Amit; Prasad, Kavita; Chhatwani, Laveena; Shinozaki, Eri; Cha, Stephen S.; Loehrer, Laura L.; Wahner-Roedler, Dietlind L.

    2009-01-01

    OBJECTIVE: To assess attitudes of patients about participation in clinical trials. PATIENTS AND METHODS: This is a self-report survey of 400 patients who underwent general medical evaluations between September and November 2006 at a tertiary care academic medical center in Rochester, MN. We measured knowledge of access to clinical trials, attitudes toward participation, recruitment preferences, and beliefs about research integrity. RESULTS: Of 485 consecutive patients, 400 (82%) completed the survey. Previous participation in clinical trials was reported by 112 patients (28%). Most were unaware of online information about clinical trials (330 [82%]), were satisfied with their current knowledge (233 [58%]), expected their treating physician to inform them about current trials (304 [76%]), and showed equal interest in participating in conventional or complementary intervention trials (174 [44%]). Of the 400 respondents, 321 (80%) found it appropriate to be contacted by mail and 253 (63%) by telephone regarding study participation. Most patients (364 [91%]) wanted to be informed about research findings or else would not participate in future clinical trials (272 [68%]). The most frequently expected compensation was free parking (234 [58%]). Most thought that their safety (373 [93%]) and privacy (376 [94%]) would be guarded. CONCLUSION: Patients are interested in participating in clinical trials but commonly lack adequate information. If patients received more information (through their treating physicians), enrollment might improve. This single-site study has limited generalizability. Future studies involving a diverse group of patients from a broader geographic distribution will help provide more definitive results. PMID:19252111

  3. Clinical Preceptor.

    ERIC Educational Resources Information Center

    Gardipee, Sheila; Clemens, Glenna

    A clinical preceptor is an employed registered nurse in a clinical facility who supervises and evaluates a student's performance independent of a clinical instructor. This manual is intended to assist the clinical preceptor, especially the preceptor dealing with re-entry nursing students. It encompasses a practical approach with actual situations…

  4. A controlled trial of automated classification of negation from clinical notes

    PubMed Central

    Elkin, Peter L; Brown, Steven H; Bauer, Brent A; Husser, Casey S; Carruth, William; Bergstrom, Larry R; Wahner-Roedler, Dietlind L

    2005-01-01

    Background Identification of negation in electronic health records is essential if we are to understand the computable meaning of the records: Our objective is to compare the accuracy of an automated mechanism for assignment of Negation to clinical concepts within a compositional expression with Human Assigned Negation. Also to perform a failure analysis to identify the causes of poorly identified negation (i.e. Missed Conceptual Representation, Inaccurate Conceptual Representation, Missed Negation, Inaccurate identification of Negation). Methods 41 Clinical Documents (Medical Evaluations; sometimes outside of Mayo these are referred to as History and Physical Examinations) were parsed using the Mayo Vocabulary Server Parsing Engine. SNOMED-CT™ was used to provide concept coverage for the clinical concepts in the record. These records resulted in identification of Concepts and textual clues to Negation. These records were reviewed by an independent medical terminologist, and the results were tallied in a spreadsheet. Where questions on the review arose Internal Medicine Faculty were employed to make a final determination. Results SNOMED-CT was used to provide concept coverage of the 14,792 Concepts in 41 Health Records from John's Hopkins University. Of these, 1,823 Concepts were identified as negative by Human review. The sensitivity (Recall) of the assignment of negation was 97.2% (p < 0.001, Pearson Chi-Square test; when compared to a coin flip). The specificity of assignment of negation was 98.8%. The positive likelihood ratio of the negation was 81. The positive predictive value (Precision) was 91.2% Conclusion Automated assignment of negation to concepts identified in health records based on review of the text is feasible and practical. Lexical assignment of negation is a good test of true Negativity as judged by the high sensitivity, specificity and positive likelihood ratio of the test. SNOMED-CT had overall coverage of 88.7% of the concepts being negated

  5. Debridement Arthroplasty for Post-traumatic Stiff Elbow: Intraoperative Factors Affecting the Clinical Results of Surgical Treatment

    PubMed Central

    Cho, Nam Su; Lim, Chan Teak; Yi, Jin Woong

    2009-01-01

    Background This study evaluated the outcomes of debridement arthroplasty for stiff elbows, as well as the factors affecting clinical outcomes after surgical treatment. Methods Eighteen patients with post-traumatic stiff elbows were treated with debridement arthroplasty using a posterior approach. The mean patient age was 33 years (range, 16 to 59 years), and the average follow-up period was 59 months (range, 24 to 141 months). The patient's ability to perform activities of daily living, including combing their hair, feeding themselves, performing hygiene, and putting on shirt and shoes, were evaluated using the Mayo Elbow Performance Score. Results At the last follow-up, 16 elbows had painless motion. Two patients continued to complain of mild intermittent pain. The flexion and extension improved to 121° and 10° after surgery, respectively, indicating an average 34° increase in elbow flexion range and an average 25° increase in elbow extension range (p < 0.001, p < 0.001). The Mayo Elbow Performance Score at the last follow-up was excellent in nine elbows (50%) and good in nine elbows (50%). Conclusions Debridement arthroplasty is a predictable procedure for the treatment of intractable stiff elbow, provided that the elbow is stable and congruous. PMID:19884994

  6. Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial

    PubMed Central

    2014-01-01

    Background Lateral humeral epicondylitis, or ‘tennis elbow’, is a common condition with a variety of treatment options. Platelet-rich plasma (PRP) and Autologous Whole Blood (AWB) represent new therapeutic options for chronic tendinopathies including tennis elbow. The aim of the present study was to compare the long term effects of PRP versus autologous whole blood local injection in patients with chronic tennis elbow. Methods Seventy six patients with chronic lateral humeral epicondylitis with duration of symptoms more than 3 months were included in this study and randomized into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous leukocyte rich PRP (4.8 times of plasma) and group 2 with 2 mL of AWB. Tennis elbow strap, stretching and strengthening exercises were administered for both groups. Pain and functional improvements were assessed using visual analogue scale (VAS), Mayo score (modified Mayo Clinic performance index for the elbow) and pressure pain threshold (PPT) at 0, 4, 8 weeks and 6 and 12 months. Results All pain variables including VAS, PPT and Mayo scores improved significantly in both groups at each follow up intervals compared to baseline. No statistically significant difference was noted between groups regarding pain, functional scores and treatment success rates in all follow up examinations (P >0/05). Conclusion PRP and autologous whole blood injections are both effective methods to treat chronic lateral epicondylitis and their efficacy persisted during long term follow up. PRP was not superior to AWB in long term follow up. PMID:24635909

  7. Difficulty and Discrimination Parameters of Boston Naming Test Items in a Consecutive Clinical Series

    PubMed Central

    Pedraza, Otto; Sachs, Bonnie C.; Ferman, Tanis J.; Rush, Beth K.; Lucas, John A.

    2011-01-01

    The Boston Naming Test is one of the most widely used neuropsychological instruments; yet, there has been limited use of modern psychometric methods to investigate its properties at the item level. The current study used Item response theory to examine each item's difficulty and discrimination properties, as well as the test's measurement precision across the range of naming ability. Participants included 300 consecutive referrals to the outpatient neuropsychology service at Mayo Clinic in Florida. Results showed that successive items do not necessarily reflect a monotonic increase in psychometric difficulty, some items are inadequate to distinguish individuals at various levels of naming ability, multiple items provide redundant psychometric information, and measurement precision is greatest for persons within a low-average range of ability. These findings may be used to develop short forms, improve reliability in future test versions by replacing psychometrically poor items, and analyze profiles of intra-individual variability. PMID:21593059

  8. Clinical Trials

    MedlinePlus

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  9. Clinical Trials

    MedlinePlus

    Clinical trials are research studies that test how well new medical approaches work in people. Each study ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to ...

  10. 76 FR 34865 - Safety Zone; Rochester Harbor Festival, Genesee River, Rochester, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... MST3 Rory Boyle, Marine Events Coordinator, U.S. Coast Guard Sector Buffalo; telephone 716-843-9343, e... the Captain of the Port (COTP) Buffalo from protecting the public and vessels from the hazards... Buffalo has determined that waterborne fireworks displays present significant hazards to vessels...