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

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.

Current status of the joint Mayo Clinic-IBM PACS project

NASA Astrophysics Data System (ADS)

Hangiandreou, Nicholas J.; Williamson, Byrn, Jr.; Gehring, Dale G.; Persons, Kenneth R.; Reardon, Frank J.; Salutz, James R.; Felmlee, Joel P.; Loewen, M. D.; Forbes, Glenn S.

1994-05-01

A multi-phase collaboration between Mayo Clinic and IBM-Rochester was undertaken, with the goal of developing a picture archiving and communication system for routine clinical use in the Radiology Department. The initial phase of this project (phase 0) was started in 1988. The current system has been fully integrated into the clinical practice and, to date, over 6.5 million images from 16 imaging modalities have been archived. Phase 3 of this project has recently concluded.

Success of a Faculty Development Program for Teachers at the Mayo Clinic

PubMed Central

Lee, Staci M.; Lee, Mark C.; Reed, Darcy A.; Halvorsen, Andrew J.; Berbari, Elie F.; McDonald, Furman S.; Beckman, Thomas J.

2014-01-01

Background There has been limited research on the improvement of underperforming clinical teachers. Objective To determine whether a faculty development program could improve the evaluations of clinical teachers in an internal medicine residency program. Methods A total of 123 teachers completed faculty development at the Mayo Clinic from 2009 to 2012. The faculty enhancement and education development program (FEED) consists of 6 interactive, small group, 2-hour sessions taught by experienced Mayo Clinic faculty over 1 year. These sessions address the following competencies: asking questions, diagnosing learners, giving feedback, using teaching frameworks, recognizing learning styles, and providing clinical supervision. Resident-of-faculty Mayo teaching effectiveness (MTE) scores have previously demonstrated content, internal structure, and criterion validity. Teachers were grouped into the top 80% or the bottom 20%, according to baseline MTE scores. Mixed linear models were used to compare these groups regarding changes in MTE scores after completion of FEED. Results were adjusted for teacher age, sex, medical specialty, academic rank, and teaching awards. Results For all participants combined, the adjusted MTE scores (mean; standard error) improved from baseline (3.80; 0.04) to completion of FEED (3.93; 0.04; P < .001). However, the bottom 20% had a significantly greater improvement in scores than the top 80% (score-change difference  =  0.166, P < .001). Conclusions We describe a low-intensity faculty development intervention that benefited all clinical teachers, but was particularly effective for underperforming teachers in internal medicine. The approach may be suitable for adoption or adaptation in other graduate medical education programs. PMID:26140122

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…

History of neurologic examination books

PubMed Central

2015-01-01

The objective of this study was to create an annotated list of textbooks dedicated to teaching the neurologic examination. Monographs focused primarily on the complete neurologic examination published prior to 1960 were reviewed. This analysis was limited to books with the word “examination” in the title, with exceptions for the texts of Robert Wartenberg and Gordon Holmes. Ten manuals met the criteria. Works dedicated primarily to the neurologic examination without a major emphasis on disease description or treatment first appeared in the early 1900s. Georg Monrad-Krohn's “Blue Book of Neurology” (“Blue Bible”) was the earliest success. These treatises served the important purpose of educating trainees on proper neurologic examination technique. They could make a reputation and be profitable for the author (Monrad-Krohn), highlight how neurology was practiced at individual institutions (McKendree, Denny-Brown, Holmes, DeJong, Mayo Clinic authors), and honor retiring mentors (Mayo Clinic authors). PMID:25829645

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.

Closing the Education Gap: A Mayo Clinic Approach to Academic Achievement.

ERIC Educational Resources Information Center

Sang, Herb A.

Despite recent efforts to provide equal education, agreement exists that blacks, females, and disadvantaged students as a group are outperformed in mathematics and science by white middle-class students. To help disadvantaged students, the Duval County Public Schools (Jacksonville, Florida) have developed a "Mayo Clinic" approach to…

Optimizing the patient transport function at Mayo Clinic.

PubMed

Kuchera, Dustin; Rohleder, Thomas R

2011-01-01

In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.

Validation of the Mayo Clinic Staging System in Determining Prognoses of Patients With Perihilar Cholangiocarcinoma.

PubMed

Coelen, Robert J S; Gaspersz, Marcia P; Labeur, Tim A; van Vugt, Jeroen L A; van Dieren, Susan; Willemssen, François E J A; Nio, Chung Y; IJzermans, Jan N M; Klümpen, Heinz-Josef; Groot Koerkamp, Bas; van Gulik, Thomas M

2017-12-01

Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiologic variables, but has not yet been validated. We performed a retrospective study to validate the Mayo Clinic staging system. We identified consecutive patients with suspected PHC who were evaluated and treated at 2 tertiary centers in The Netherlands, from January 2002 through December 2014. Baseline characteristics (performance status, carbohydrate antigen 19-9 level) used in the staging system were collected from medical records and imaging parameters (tumor size, suspected vascular involvement, and metastatic disease) were reassessed by 2 experienced abdominal radiologists. Overall survival was analyzed using the Kaplan-Meier method and comparison of staging groups was performed using the log-rank test and Cox proportional hazard regression analysis. Discriminative performance was quantified by the concordance index and compared with the radiologic TNM staging of the American Joint Committee on Cancer (7th ed). PHCs from 600 patients were staged according to the Mayo Clinic model (23 stage I, 80 stage II, 357 stage III, and 140 stage IV). The median overall survival time was 11.6 months. The median overall survival times for patients with stages I, II, III, and IV were 33.2 months, 19.7 months, 12.1 months, and 6.0 months, respectively; with hazard ratios of 1.0 (reference), 2.02 (95% confidence interval [CI], 1.14-3.58), 2.71 (95% CI, 1.59-4.64), and 4.00 (95% CI, 2.30-6.95), respectively (P < .001). The concordance index score was 0.59 for the entire cohort (95% CI, 0.56-0.61). The Mayo Clinic model performed slightly better than the radiologic American Joint Committee on Cancer TNM system. In a retrospective study of 600 patients with PHC, we validated the Mayo Clinic system for staging PHC. This 4-tier staging system may aid

Performance of the Mayo-IBM PAC system

NASA Astrophysics Data System (ADS)

Persons, Kenneth R.; Reardon, Frank J.; Gehring, Dale G.; Hangiandreou, Nicholas J.

1994-05-01

The Mayo Clinic and IBM (at Rochester, Minnesota) have jointly developed a picture archived system for use with Mayo's MRI and CT imaging modalities. This PACS is made up of over 50 computers that work cooperatively to provide archival, retrieval and image distribution services for Mayo's Department of Radiology. This paper will examine the performance characteristics of the system.

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.

Clinical aspects of the Mayo/IBM PACS project

NASA Astrophysics Data System (ADS)

Forbes, Glenn S.; Morin, Richard L.; Pavlicek, William

1991-07-01

A joint project between Mayo Clinic and IBM to develop a picture archival and communications system has been under development for three years. This project began as a potential solution to a pressing archival problem in magnetic resonance imaging. The project has grown to encompass a much larger sphere of activity including workstations, image retrieval, and report archival. This report focuses on the clinical aspects involved in the design, development, and implementation of such a system. In particular, emphasis is placed on the clinical impact of the system both inside and outside of the radiology department. The primary concerns have centered on fidelity of archival data, ease of use, and diagnostic efficacy. The project to date has been limited to neuroradiology practice. This group consists of nine staff radiologists and fellows. Administrative policy decisions regarding the accessibility and available of digital data in the clinical environment have been much more difficult and complex than originally conceived. Based on the observations thus far, the authors believe the system will become a useful and valuable adjunct to clinical practice of radiology.

PhotoExam: adoption of an iOS-based clinical image capture application at Mayo Clinic.

PubMed

Wyatt, Kirk D; Willaert, Brian N; Pallagi, Peter J; Uribe, Richard A; Yiannias, James A; Hellmich, Thomas R

2017-12-01

Mayo Clinic developed an internal iOS-based, point-of-care clinical image capture application for clinicians. We aimed to assess the adoption and utilization of the application at Mayo Clinic. Metadata of 22,784 photos of 6417 patients taken by 606 users over 8040 clinical encounters between 3/1/2015 and 10/31/2015 were analyzed. A random sample of photos from 100 clinical encounters was assessed for quality using a five-item rubric. Use of traditional medical photography services before and after application launch were compared. The largest group of users was residents/fellows, accounting for 31% of users but only 18% of all photos. Attending physicians accounted for 29% of users and 30% of photos. Nurses accounted for 14% of users and 28% of photos. Surgical specialties had the most users (36% of users), followed by dermatology (14% of users); however, dermatology accounted for 54% of all photos, and surgery accounted for 26% of photos. Images received an average of 91% of possible points on the quality scoring rubric. Most frequent reasons for missing points were the location on the body not clearly being demonstrated (19% of encounters) and the perspective/scale not being clearly demonstrated (12% of encounters). There was no discernible pre-post effect of the application's launch on use of traditional medical photography services. Point-of-care clinical photography is a growing phenomenon with potential to become the new standard of care. Patient and provider attitudes and the impact on patient outcomes remain unclear. © 2017 The International Society of Dermatology.

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.

Shielding design of the Mayo Clinic Scottsdale cyclotron vault

NASA Astrophysics Data System (ADS)

Riper, Kenneth A. Van; Metzger, Robert L.; Nelson, Kevin

2017-09-01

Mayo Clinic Scottsdale (Scottsdale, Arizona) is building a cyclotron vault containing a cyclotron with adjacent targets and a beam line leading to an external target. The targets are irradiated by high energy (15 to 16.5 MeV) protons for the production of radioisotopes. We performed Monte Carlo radiation transport simulations to calculate the radiation dose outside of the vault during irradiation of the cyclotron and external targets. We present the Monte Carlo model including the geometry, sources, and variance reduction methods. Mesh tallies surrounding the vault show the external dose rate is within acceptable limits.

Cushing Syndrome in Carney Complex: Clinical, Pathologic, and Molecular Genetic Findings in the 17 Affected Mayo Clinic Patients.

PubMed

Lowe, Kathleen M; Young, William F; Lyssikatos, Charalampos; Stratakis, Constantine A; Carney, J Aidan

2017-02-01

Carney complex (CNC) is a rare dominantly inherited multiorgan tumoral disorder that includes Cushing syndrome (CS). To establish the Mayo Clinic experience with the CS component, including its clinical, laboratory, and pathologic findings, we performed a retrospective search of the patient and pathologic databases of Mayo Clinic in Rochester, MN, for patients with CNC and clinical or laboratory findings of CS. Thirty-seven patients with CNC were identified. Twenty-nine had clinical, pathologic, or laboratory evidence of an adrenocortical disorder. Seventeen had classic CS; 15 underwent bilateral, subtotal, or partial unilateral adrenalectomy, and 2 had no treatment. Pathologically, the glands were normal sized or slightly enlarged with multiple small (1 to 4 mm), brown, black, and yellow micronodules (primary pigmented nodular adrenocortical disease; PPNAD). Three glands each had a mass: a 2 cm adenoma, a 1.5 cm macronodule, and an unencapsulated 1.8 cm myelolipoma. Fourteen of the patients were alive at follow-up, and 3 were deceased; 2 of the latter had PPNAD at autopsy, and the third had PPNAD at surgery. Twelve patients without clinical features of classic CS had abnormal adrenocortical testing results; none developed classic CS during follow-up (mean, 10 y). Autopsy findings in 1 showed bilateral vacuolated cell cortical hyperplasia.

The founding of the Mayo School of Graduate Medical Education.

PubMed

Boes, Christopher J; Long, Timothy R; Rose, Steven H; Fye, W Bruce

2015-02-01

The Mayo Foundation for Medical Education and Research (hereafter the Mayo Foundation), the precursor to the Mayo School of Graduate Medical Education, was incorporated in 1915. The Mayo Foundation, which was affiliated with the University of Minnesota Graduate School, aimed to establish a higher standard for training medical specialists. Together, the University of Minnesota and the Mayo Foundation pioneered a graduate medical education program that allowed residents to earn master's and PhD degrees in clinical medicine and surgery. Unlike elsewhere in the United States, the residency training program was not pyramidal. (In a pyramidal residency program, each training year, some residents are systematically eliminated to reduce the number of more senior trainees.) All those who started the Mayo Foundation residency program had an opportunity to finish depending on their own merits. Louis B. Wilson, the first director of the Mayo Foundation, became a major figure in graduate medical education in the 1920s and 1930s. Although the granting of graduate degrees in medicine and surgery stopped over time, Mayo Clinic ultimately became the largest site of graduate medical education in the world. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Presidential address: The origins and evolution of the Mayo Clinic from 1864 to 1939: a Minnesota family practice becomes an international "medical Mecca".

PubMed

Fye, W Bruce

2010-01-01

This paper describes the origins and international impact of the Mayo Clinic through 1939. Multispecialty group practice was invented at the clinic a century ago. A visiting Canadian physician wrote in 1906, "Specialization and cooperation, with the best that can be had in each department, is here the motto. Cannot these principles be tried elsewhere?" Mayo Clinic's major (and underappreciated) role in the development of rigorous postgraduate (specialty) training is addressed. Unlike traditional academic medical centers that emphasize research, Mayo's main mission has always been patient care. This activity has been undertaken in an environment enriched by extensive programs devoted to specialty training and clinical research.

Building a protocol expressway: the case of Mayo Clinic Cancer Center.

PubMed

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

2009-08-10

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. 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. 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). DMAIC framework combined with Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.

What makes a Catholic hospital "Catholic" in an age of religious-secular collaboration? The case of the Saint Marys hospital and the Mayo Clinic.

PubMed

Swetz, Keith M; Crowley, Mary E; Maines, T Dean

2013-06-01

Mayo Clinic is recognized as a worldwide leader in innovative, high-quality health care. However, the Catholic mission and ideals from which this organization was formed are not widely recognized or known. From partnership with the Sisters of St. Francis in 1883, through restructuring of the Sponsorship Agreement in 1986 and current advancements, this Catholic mission remains vital today at Saint Marys Hospital. This manuscript explores the evolution and growth of sponsorship at Mayo Clinic, defined as "a collaboration between the Sisters of St. Francis and Mayo Clinic to preserve and promote key values that the founding Franciscan sisters and Mayo physicians embrace as basic to their mission, and to assure the Catholic identity of Saint Marys Hospital." Historical context will be used to frame the evolution and preservation of Catholic identity at Saint Marys Hospital; and the shift from a "sponsorship-by-governance" to a "sponsorship-by-influence" model will be highlighted. Lastly, using the externally-developed Catholic Identity Matrix (developed by Ascension Health and the University of St. Thomas, Minnesota), specific examples of Catholic identity will be explored in this joint venture of Catholic health care institution and a secular, nonprofit corporation (Mayo Clinic).

Clinical Features, Etiologic Factors, Associated Disorders, and Treatment of Palmoplantar Pustulosis: The Mayo Clinic Experience, 1996-2013.

PubMed

Olazagasti, Jeannette M; Ma, Janice E; Wetter, David A

2017-09-01

To further characterize clinical characteristics, etiologic factors, associated disorders, and treatment of palmoplantar pustulosis (PPP). We conducted a retrospective review of patients with PPP at Mayo Clinic between January 1, 1996, and December 31, 2013. Of 215 patients with PPP identified, 179 (83%) were female, and the mean age at onset was 45.3 years. Most patients (n=165, 77%) were current or former smokers. At diagnosis, 15 patients (7%) had an anxiety diagnosis and 9 (4%) had an infection. Nineteen cases (9%) were drug induced. Comorbid conditions included thyroid disease in 18 patients (8%), gluten sensitivity in 3 (1%), and type 2 diabetes mellitus in 21 (10%). In all, 194 patients (90%) received topical corticosteroids, 55 (26%) received phototherapy, and 54 (25%) received systemic agents. More than three-fourths of the patients in this study had a history of smoking, which is considered a triggering or aggravating factor for PPP. Regarding comorbid conditions, gluten sensitivity and thyroid disease were found less frequently than previously reported in the literature. Treatment regimens and responses in this cohort varied considerably. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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

Decreasing Patient Stress and Physician/Medical Workforce Burnout Through Health Care Environments: Uncovering the Serious Leisure Perspective at Mayo Clinic's Campus in Rochester, Minnesota.

PubMed

Dieser, Rodney B; Edginton, Christopher R; Ziemer, Renee

2017-07-01

Health care environments are places of high stress for both patients and medical professionals. Although organizational efforts of workload and efficiency are often implemented to decrease both patient and physician/medical workforce stress, what is often overlooked is how leisure opportunities and programs located in day-to-day experiences and in physically built environments can increase both patient and medical staff enjoyment and pleasure, thus lowering patient stress and physician/medical staff burnout. Combining historical research on the leisure pursuits of Drs William J. Mayo and Charles H. Mayo, literature on leisure, stress, and burnout, and a case study methodology of Mayo Clinic's campus in Rochester, Minnesota, the purpose of this study was to describe how the Serious Leisure Perspective (SLP) exists at Mayo Clinic and contributes to relieving stress among patients and preventing burnout among physicians. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Use of Echocardiography in Olmsted County Outpatients With Chest Pain and Normal Resting Electrocardiograms Seen at Mayo Clinic Rochester.

PubMed

Gibbons, Raymond J; Carryer, Damita; Liu, Hongfang; Brady, Peter A; Askew, J Wells; Hodge, David; Ammash, Naser; Ebbert, Jon O; Roger, Veronique L

2015-11-01

To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). We performed a retrospective search of electronic medical records of all outpatients seen at Mayo Clinic Rochester from January 1, 2010, through December 31, 2013, to identify residents of Olmsted County, Minnesota, with stable chest pain and known or suspected coronary artery disease who underwent resting echocardiography and had normal resting ECGs and no other indication for echocardiography. Of the 8280 outpatients from Olmsted County who were evaluated at Mayo Clinic Rochester with chest pain, 590 (7.1%) had resting echocardiograms. Ninety-two of these 590 patients (15.6%) had normal resting ECGs. Thirty-three of these 92 patients (35.9%) had other indications for echocardiography. The remaining 59 patients (10.0% of all echocardiograms and 0.7% of all patients) had normal resting ECGs and no other indication for echocardiography. Fifty-seven of these 59 patients (96.6%) had normal echocardiograms. Thirteen of these 59 echocardiograms (22.0%) were "preordered" before the provider (physicians, nurses, physician assistants) visit. The overall rate of echocardiography in Olmsted County outpatients with chest pain seen at Mayo Clinic Rochester is low. Only 1 in 10 of these echocardiograms was performed in violation of the class III recommendation in the American College of Cardiology Foundation/American Heart Association guidelines for the management of stable angina. These unnecessary echocardiograms were almost always normal. The rate of unnecessary echocardiograms could be decreased by eliminating preordering. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Use of echocardiography in outpatients with chest pain and normal resting electrocardiograms referred to Mayo Clinic Rochester.

PubMed

Gibbons, Raymond J; Carryer, Damita; Liu, Hongfang; Brady, Peter A; Askew, John Wells; Hodge, David; Ammash, Naser; Ebbert, Jon O; Roger, Veronique L

2018-02-01

To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). There are scant data to indicate how often Class III recommendations are ignored in clinical practice. We searched electronically all medical records of referral outpatients seen at Mayo Clinic Rochester from January 1, 2010, through December 31, 2013, to identify patients with stable chest pain and known or suspected coronary artery disease who underwent resting echocardiography and had normal resting ECGs and no other indication for echocardiography. Of the 15,529 referral outpatients who were evaluated at Mayo Clinic Rochester with chest pain, 3976 (25.6%) had resting echocardiograms. Eight hundred seventy of these 3976 patients (21.9%) had normal resting ECGs. Six hundred nineteen of these 870 patients (71.1%) had other indications for echocardiography. The remaining 251 patients (6.3% of all echocardiograms and 1.6% of all patients) had normal resting ECGs and no other indication for echocardiography. Two hundred thirty-nine of these 251 patients (95.2%) had normal echocardiograms. Of the 12 abnormal echocardiograms, only 4 led to any change in clinical management. Sixty-one of these 251 echocardiograms (24.3%) were "preordered" before the provider (physicians, nurses, physician assistants) visit. Echocardiograms were performed in 1 in 4 referral outpatients with chest pain seen at Mayo Clinic Rochester. However, only 1 in 16 of these echocardiograms was performed in violation of the class III recommendation in the American College of Cardiology Foundation/American Heart Association guidelines for the management of stable angina. These unnecessary echocardiograms were almost always normal, and had little impact on clinical management. The rate of unnecessary echocardiograms could be decreased by eliminating preordering. Copyright © 2017 Elsevier Inc

Quest for quality: department of laboratory medicine and pathology, Mayo Clinic.

PubMed

Arney, Kris R; Hopper, Mary H; Tran, Sheryl A; Ward, Melissa M; Hanson, Curtis A

2004-01-01

This article describes our journey for quality in the Department of Laboratory Medicine and Pathology (DLMP) at Mayo Clinic. It provides the background of the department and the process for the development and implementation of the quality program. In addition, a quality conference and the development of a quality school are outlined. Throughout the course of this process, valuable lessons were learned and are discussed. We are pleased with the success of the quality journey. However, we realize that the quest has just begun. We look forward to the future and the challenges that lie ahead.

Mayo Alliance Prognostic Model for Myelodysplastic Syndromes: Integration of Genetic and Clinical Information.

PubMed

Tefferi, Ayalew; Gangat, Naseema; Mudireddy, Mythri; Lasho, Terra L; Finke, Christy; Begna, Kebede H; Elliott, Michelle A; Al-Kali, Aref; Litzow, Mark R; Hook, C Christopher; Wolanskyj, Alexandra P; Hogan, William J; Patnaik, Mrinal M; Pardanani, Animesh; Zblewski, Darci L; He, Rong; Viswanatha, David; Hanson, Curtis A; Ketterling, Rhett P; Tang, Jih-Luh; Chou, Wen-Chien; Lin, Chien-Chin; Tsai, Cheng-Hong; Tien, Hwei-Fang; Hou, Hsin-An

2018-06-01

To develop a new risk model for primary myelodysplastic syndromes (MDS) that integrates information on mutations, karyotype, and clinical variables. Patients with World Health Organization-defined primary MDS seen at Mayo Clinic (MC) from December 28, 1994, through December 19, 2017, constituted the core study group. The National Taiwan University Hospital (NTUH) provided the validation cohort. Model performance, compared with the revised International Prognostic Scoring System, was assessed by Akaike information criterion and area under the curve estimates. The study group consisted of 685 molecularly annotated patients from MC (357) and NTUH (328). Multivariate analysis of the MC cohort identified monosomal karyotype (hazard ratio [HR], 5.2; 95% CI, 3.1-8.6), "non-MK abnormalities other than single/double del(5q)" (HR, 1.8; 95% CI, 1.3-2.6), RUNX1 (HR, 2.0; 95% CI, 1.2-3.1) and ASXL1 (HR, 1.7; 95% CI, 1.2-2.3) mutations, absence of SF3B1 mutations (HR, 1.6; 95% CI, 1.1-2.4), age greater than 70 years (HR, 2.2; 95% CI, 1.6-3.1), hemoglobin level less than 8 g/dL in women or less than 9 g/dL in men (HR, 2.3; 95% CI, 1.7-3.1), platelet count less than 75 × 10 9 /L (HR, 1.5; 95% CI, 1.1-2.1), and 10% or more bone marrow blasts (HR, 1.7; 95% CI, 1.1-2.8) as predictors of inferior overall survival. Based on HR-weighted risk scores, a 4-tiered Mayo alliance prognostic model for MDS was devised: low (89 patients), intermediate-1 (104), intermediate-2 (95), and high (69); respective median survivals (5-year overall survival rates) were 85 (73%), 42 (34%), 22 (7%), and 9 months (0%). The Mayo alliance model was subsequently validated by using the external NTUH cohort and, compared with the revised International Prognostic Scoring System, displayed favorable Akaike information criterion (1865 vs 1943) and area under the curve (0.87 vs 0.76) values. We propose a simple and contemporary risk model for MDS that is based on a limited set of genetic and clinical variables

Erysipelothrix rhusiopathiae bloodstream infection - A 22-year experience at Mayo Clinic, Minnesota.

PubMed

Tan, E M; Marcelin, J R; Adeel, N; Lewis, R J; Enzler, M J; Tosh, P K

2017-11-01

Erysipelothrix rhusiopathiae is a facultatively anaerobic Gram-positive bacillus found mostly in swine, fish and sheep. E. rhusiopathiae classically causes cutaneous eruptions in butchers, fish handlers and veterinarians. Based solely on case reports, 90% of E. rhusiopathiae bloodstream infections (BSI) have been associated with infective endocarditis (IE). To assess the true frequency of IE in E. rhusiopathiae BSI as well as other clinical associations, we performed a retrospective cohort analysis of E. rhusiopathiae BSI at Mayo Clinic. This is a single-centre, retrospective study conducted between 1/1/1994 and 20/6/2016 at Mayo Clinic in Rochester, MN. Medical records were reviewed for demographics, E. rhusiopathiae BSI, anti-microbial susceptibilities, incidence of IE, patient comorbidities, intensive care unit (ICU) admission and duration of antibiotics. Five cases of E. rhusiopathiae BSI were identified. Risk factors included animal exposures, immunosuppression, diabetes and kidney disease. All cases involved penicillin-sensitive strains and high-grade BSI. Four cases showed no signs of IE on transesophageal echocardiogram. All patients recovered fully with intravenous antibiotics. Our retrospective review illustrates that E. rhusiopathiae can cause invasive BSI in the absence of IE and that the previously reported 90% association between BSI and IE may be overestimated due to reporting bias. E. rhusiopathiae should be suspected in any patient with Gram-positive bacilli in blood cultures and the aforementioned risk factors. A limitation of our study was the low sample size, and future studies may involve multicentre collaborations and the use of polymerase chain reaction (PCR) or serologic testing to increase the number of diagnoses.. © 2017 Blackwell Verlag GmbH.

The Social Media DNA of Mayo Clinic-and Health Care.

PubMed

Kotsenas, Amy L; Aase, Lee; Arce, Makala; Timimi, Farris K; Dacy, Matthew; Young, Colleen; Wald, John T

2018-01-01

Hippocrates' admonition and the medical community's aversion to risk have caused many physicians and institutions to resist participation in modern social media sites such as Facebook (Facebook, Inc, Menlo Park, California, USA), Twitter (Twitter Inc, San Francisco, California, USA), and YouTube (San Mateo, California, USA). However, because Mayo Clinic's founders were champions of analog social networking, it was among the earliest hospitals worldwide to create official accounts on these digital platforms. A proper understanding of the traditional mechanisms of knowledge diffusion in medicine and of the nature of social media sites should help professionals see and embrace the opportunities for positive engagement in social media. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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.

Performance characteristics of the Mayo/IBM PACS

NASA Astrophysics Data System (ADS)

Persons, Kenneth R.; Gehring, Dale G.; Pavicic, Mark J.; Ding, Yingjai

1991-07-01

The Mayo Clinic and IBM (at Rochester, Minnesota) have jointly developed a picture archiving system for use with Mayo's MRI and Neuro CT imaging modalities. The communications backbone of the PACS is a portion of the Mayo institutional network: a series of 4-Mbps token rings interconnected by bridges and fiber optic extensions. The performance characteristics of this system are important to understand because they affect the response time a PACS user can expect, and the response time for non-PACS users competing for resources on the institutional network. The performance characteristics of each component and the average load levels of the network were measured for various load distributions. These data were used to quantify the response characteristics of the existing system and to tune a model developed by North Dakota State University Department of Computer Science for predicting response times of more complex topologies.

Quality improvement education incorporated as an integral part of critical care fellows training at the Mayo Clinic.

PubMed

Kashani, Kianoush B; Ramar, Kannan; Farmer, J Christopher; Lim, Kaiser G; Moreno-Franco, Pablo; Morgenthaler, Timothy I; Dankbar, Gene C; Hale, Curt W

2014-10-01

The Accreditation Council for Graduate Medical Education emphasizes quality improvement (QI) education in residency/fellowship training programs. The Mayo Clinic Combined Critical Care Fellowship (CCF) program conducted a pilot QI education program to incorporate QI training as a required curriculum for the 2010-2011 academic year. CCF collaborated with the Mayo Quality Academy to customize and teach the existing Mayo Quality Fellows curriculum to the CCF fellows with the help of two quality coaches over five months starting July 2010. All fellows were to achieve Bronze and Silver certification prior to graduation. Silver required passing four written exams and submitting a health care QI project. Five projects were selected on the basis of the Impact-Effort Prioritization matrix, and DMAIC (Define, Measure, Analyze, Improve, and Control) methodology was used to complete the projects. The primary outcome was to assess learners' satisfaction, knowledge, and skill transfer. All 20 fellows were Bronze certified, and 14 (70%) were Silver certified by the time of graduation. All five QI projects were completed and showed positive impacts on patient safety and care. Surveys showed improved learner satisfaction. Graduates felt the QI training improved their QI skills and employment and career advancement. The QI curriculum had appropriate content and teaching pace and did not significantly displace other important clinical core curriculum topics. The pilot was successfully implemented in the CCF program and now is in the fourth academic year as an established and integral part of the fellowship core curriculum.

The Mayo Clinic Arizona Spasmodic Dysphonia Experience: A Demographic Analysis of 718 Patients.

PubMed

Patel, Alpen B; Bansberg, Stephen F; Adler, Charles H; Lott, David G; Crujido, Lisa

2015-11-01

Analyze demographic data collected over a 25-year experience of 718 patients with spasmodic dysphonia (SD) who have been treated with botulinum toxin-A (BoNT-A) and compare our data with previously published studies. Seven hundred eighteen patients with SD were treated with 6621 BoNT-A injections at Mayo Clinic Arizona between 1989 and 2014. All patients were treated by the same physician team. Background demographic data for each patient were recorded. Of 718 patients, 557 patients were female (77.6%). Six hundred sixty of 718 (91.8%) patients had adductor SD (AdSD), and 58 of 718 (8.1%) patients had abductor SD (AbSD). Average age of onset was 51 years. Of 718 patients, 378 (52.6%) had vocal tremor (VT); VT was present in 54.4% of AdSD patients and 32.1% of AbSD patients. Thirty-seven of 718 (5.2%) patients had other dystonias, including cervical dystonia (2.3%), blepharospasm (1.4%), limb dystonia (1.1%), and oromandibular dystonia (0.3%). A positive family history of SD was present in only 6 of 718 patients (0.8%) and of other dystonias in 11 of 718 patients (1.5%). Spasmodic dysphonia is a chronic and potentially disabling focal laryngeal dystonia. The Mayo Clinic Arizona SD experience compares to prior reports and reveals a female preponderance, onset in middle age, infrequent hereditary pattern, high co-occurrence of VT, and low co-occurrence of other dystonias. © The Author(s) 2015.

Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic.

PubMed

Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

2012-01-01

Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Temporal and geographical external validation study and extension of the Mayo Clinic prediction model to predict eGFR in the younger population of Swiss ADPKD patients.

PubMed

Girardat-Rotar, Laura; Braun, Julia; Puhan, Milo A; Abraham, Alison G; Serra, Andreas L

2017-07-17

Prediction models in autosomal dominant polycystic kidney disease (ADPKD) are useful in clinical settings to identify patients with greater risk of a rapid disease progression in whom a treatment may have more benefits than harms. Mayo Clinic investigators developed a risk prediction tool for ADPKD patients using a single kidney value. Our aim was to perform an independent geographical and temporal external validation as well as evaluate the potential for improving the predictive performance by including additional information on total kidney volume. We used data from the on-going Swiss ADPKD study from 2006 to 2016. The main analysis included a sample size of 214 patients with Typical ADPKD (Class 1). We evaluated the Mayo Clinic model performance calibration and discrimination in our external sample and assessed whether predictive performance could be improved through the addition of subsequent kidney volume measurements beyond the baseline assessment. The calibration of both versions of the Mayo Clinic prediction model using continuous Height adjusted total kidney volume (HtTKV) and using risk subclasses was good, with R 2 of 78% and 70%, respectively. Accuracy was also good with 91.5% and 88.7% of the predicted within 30% of the observed, respectively. Additional information regarding kidney volume did not substantially improve the model performance. The Mayo Clinic prediction models are generalizable to other clinical settings and provide an accurate tool based on available predictors to identify patients at high risk for rapid disease progression.

The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory.

PubMed

Malec, James F; Kean, Jacob; Monahan, Patrick O

To determine the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) as measures of response to intervention. Retrospective analysis of existing data. Both distribution- and anchor-based methods were used to triangulate on the MCID and to identify a moderate, that is, more robust, level of change (RCID) for the MPAI-4. These were further evaluated with respect to clinical provider ratings. Data for individuals with acquired brain injury in rehabilitation programs throughout the United States in the OutcomeInfo Database (n = 3087) with 2 MPAI-4 ratings. MPAI-4, Supervision Rating Scale, Clinician Rating of Global Clinical Improvement. Initial analyses suggested 5 T-score points (5T) as the MCID and 9T as the RCID. Eighty-one percent to 87% of clinical raters considered a 5T change and 99% considered a 9T change to indicate meaningful improvement. 5T represents the MCID for the MPAI-4 and 9T, the RCID. Both values are notably less than the Reliable Change Index (RCI). While the RCI indicates change with a high level of statistical confidence, it may be insensitive to change that is considered meaningful by providers and participants as indicated by the MCID.

Thrombotic Microangiopathy Care Pathway: A Consensus Statement for the Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy (CAP-TMA) Disease-Oriented Group.

PubMed

Go, Ronald S; Winters, Jeffrey L; Leung, Nelson; Murray, David L; Willrich, Maria A; Abraham, Roshini S; Amer, Hatem; Hogan, William J; Marshall, Ariela L; Sethi, Sanjeev; Tran, Cheryl L; Chen, Dong; Pruthi, Rajiv K; Ashrani, Aneel A; Fervenza, Fernando C; Cramer, Carl H; Rodriguez, Vilmarie; Wolanskyj, Alexandra P; Thomé, Stephan D; Hook, C Christopher

2016-09-01

Thrombotic microangiopathies (TMAs) comprise a heterogeneous set of conditions linked by a common histopathologic finding of endothelial damage resulting in microvascular thromboses and potentially serious complications. The typical clinical presentation is microangiopathic hemolytic anemia accompanied by thrombocytopenia with varying degrees of organ ischemia. The differential diagnoses are generally broad, while the workup is frequently complex and can be confusing. This statement represents the joint recommendations from a multidisciplinary team of Mayo Clinic physicians specializing in the management of TMA. It comprises a series of evidence- and consensus-based clinical pathways developed to allow a uniform approach to the spectrum of care including when to suspect TMA, what differential diagnoses to consider, which diagnostic tests to order, and how to provide initial empiric therapy, as well as some guidance on subsequent management. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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).

Hypertrophic obstructive cardiomyopathy: the Mayo Clinic experience.

PubMed

Kotkar, Kunal D; Said, Sameh M; Dearani, Joseph A; Schaff, Hartzell V

2017-07-01

Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease characterized by left ventricular hypertrophy in the absence of other etiologies. Clinical presentation may vary from asymptomatic to sudden cardiac death. Medical treatment is the first-line therapy for symptomatic patients. Extended left ventricular septal myectomy is the procedure of choice if medical treatment is unsuccessful or intolerable. More than 3,000 patients have had septal myectomy for HCM at the Mayo Clinic (MN, USA) from 1993 to 2016. Risk of hospital death after isolated septal myectomy for obstructive HCM is <1% and is similar to the risk of operation for elective mitral valve repair. Complications, such as complete heart block requiring permanent pacemaker, are uncommon (2%), although partial or complete left bundle branch block is a frequent finding on the postoperative ECG. Relief of left ventricular outflow tract (LVOT) obstruction with septal myectomy dramatically improves symptoms and exercise capacity in symptomatic patients with obstructive HCM. More than 90% of severely symptomatic patients have improvement by at least two functional classes, and reduction of outflow gradients by myectomy decreases or eliminates symptoms of dyspnea, angina and/or syncope. Basal obstruction with systolic anterior motion (SAM) is treated by transaortic myectomy. The transapical approach was applied in 115 patients with obstructive midventricular and apical variants of HCM between 1993 and 2012. All patients with midventricular obstruction had gradient relief and none developed an apical aneurysm or ventricular septal defect. Recurrent obstruction after satisfactory myectomy was rare. Septal myectomy effectively and definitively relieves LVOT obstruction and cardiac symptoms in patients with obstructive HCM. In experienced centers, early mortality for isolated septal myectomy is less than 1%, and overall results are excellent and continue to improve in the current era.

The Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project: program activities and participant reactions.

PubMed

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

1996-04-01

To determine the response of participants to the Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project. 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. 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. 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. These data suggest that a program of clinical consultation services, professional education, and patient education available by telemedicine might be viewed as beneficial.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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 28more » 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.« less

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,…

Enhancing the Clinical Reasoning Skills of Postgraduate Students in Internal Medicine Through Medical Nonfiction and Nonmedical Fiction Extracurricular Books.

PubMed

Kiran, H S; Chacko, Thomas V; Murthy, K A Sudharshana; Gowdappa, H Basavana

2016-12-01

To improve the clinical reasoning skills of postgraduate students in internal medicine through 2 kinds of extracurricular books: medical nonfiction and nonmedical fiction. Clinical reasoning is difficult to define, understand, observe, teach, and measure. This is an educational innovation under an experimental framework based on a cognitive intervention grounded in constructivist and cognitivist theories. This study was conducted from June 1, 2014, through May 31, 2015. It was a pre-post, randomized, controlled, prospective, mixed-methods, small-group study. The intervention was through medical nonfiction and nonmedical fiction books. The process was structured to ensure that the students would read the material in phases and reflect on them. Clinical reasoning (pretests and posttests) was quantitatively assessed using the Diagnostic Thinking Inventory (DTI) and clinical reasoning exercises (CREs) and their assessment using a rubric. A qualitative design was used, and face-to-face semistructured interviews were conducted. Posttest total scores (DTI=188.92; CREs=53.92) were higher for the study group after the intervention compared with its own pretest scores (DTI=165.25; CREs=41.17) and with the pretest (DTI=159.27; CRE=40.73) and posttest (DTI=166.91; CREs=41.18) scores of the control group. Interviews with the study group confirmed that the intervention was acceptable and useful in daily practice. We introduced, evaluated, and proved an approach to teaching-learning clinical reasoning based on the assumption that the clinical reasoning skills of postgraduate students in internal medicine can be enhanced through 2 kinds of extracurricular books and that fun as well as interest will enhance learning. This study is not only about teaching-learning clinical reasoning but also about the humanities in medical education. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Outcome of Whole Exome Sequencing for Diagnostic Odyssey Cases of an Individualized Medicine Clinic: The Mayo Clinic Experience.

PubMed

Lazaridis, Konstantinos N; Schahl, Kimberly A; Cousin, Margot A; Babovic-Vuksanovic, Dusica; Riegert-Johnson, Douglas L; Gavrilova, Ralitza H; McAllister, Tammy M; Lindor, Noralane M; Abraham, Roshini S; Ackerman, Michael J; Pichurin, Pavel N; Deyle, David R; Gavrilov, Dimitar K; Hand, Jennifer L; Klee, Eric W; Stephens, Michael C; Wick, Myra J; Atkinson, Elizabeth J; Linden, David R; Ferber, Matthew J; Wieben, Eric D; Farrugia, Gianrico

2016-03-01

To describe the experience and outcome of performing whole-exome sequencing (WES) for resolution of patients on a diagnostic odyssey in the first 18 months of an individualized medicine clinic (IMC). The IMC offered WES to physicians of Mayo Clinic practice for patients with suspected genetic disease. DNA specimens of the proband and relatives were submitted to WES laboratories. We developed the Genomic Odyssey Board with multidisciplinary expertise to determine the appropriateness for IMC services, review WES reports, and make the final decision about whether the exome findings explain the disease. This study took place from September 30, 2012, to March 30, 2014. In the first 18 consecutive months, the IMC received 82 consultation requests for patients on a diagnostic odyssey. The Genomic Odyssey Board deferred 7 cases and approved 75 cases to proceed with WES. Seventy-one patients met with an IMC genomic counselor. Fifty-one patients submitted specimens for WES testing, and the results have been received for all. There were 15 cases in which a diagnosis was made on the basis of WES findings; thus, the positive diagnostic yield of this practice was 29%. The mean cost per patient for this service was approximately $8000. Medicaid supported 27% of the patients, and 38% of patients received complete or partial insurance coverage. The significant diagnostic yield, moderate cost, and notable health marketplace acceptance for WES compared with conventional genetic testing make the former method a rational diagnostic approach for patients on a diagnostic odyssey. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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.

Direct booking colposcopy clinic -- the Portsmouth experience.

PubMed

Lukman, H; Bevan, J R; Greenwood, E

2004-08-01

We present 2 years data on direct booking in our colposcopy clinic. The new booking system has improved our efficiency and helped us to achieve the national quality standards on clinic waiting time. The non-attendance (DNA) rate has also improved.

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…

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

Emergency Video Telemedicine Consultation for Newborn Resuscitations: The Mayo Clinic Experience.

PubMed

Fang, Jennifer L; Collura, Christopher A; Johnson, Robert V; Asay, Garth F; Carey, William A; Derleth, Douglas P; Lang, Tara R; Kreofsky, Beth L; Colby, Christopher E

2016-12-01

To describe the Mayo Clinic experience with emergency video telemedicine consultations for high-risk newborn deliveries. From March 26, 2013, through December 31, 2015, the Division of Neonatal Medicine offered newborn telemedicine consultations to 6 health system sites. A wireless tablet running secure video conferencing software was used by the local care teams. Descriptive data were collected on all consultations. After each telemedicine consult, a survey was sent to the neonatologist and referring provider to assess the technology, teamwork, and user satisfaction. During the study, neonatologists conducted 84 telemedicine consultations, and 64 surveys were completed. Prematurity was the most frequent indication for consultation (n=32), followed by respiratory distress (n=15) and need for advanced resuscitation (n=14). After the consult, nearly one-third of the infants were able to remain in the local hospital. User assessment of the technology revealed that audio and video quality were poor or unusable in 16 (25%) and 12 (18.8%) of cases, respectively. Providers failed to establish a video connection in 8 consults (9.5%). Despite technical issues, providers responded positively to multiple questions assessing teamwork (86.0% [n=37 of 43] to 100.0% [n=17 of 17] positive responses per question). In 93.3% (n=14 of 15) of surveyed cases, the local provider agreed that the telemedicine consult improved patient safety, quality of care, or both. Telemedicine consultation for neonatal resuscitation improves patient access to neonatology expertise and prevents unnecessary transfers to a higher level of care. A highly reliable technology infrastructure that provides high-quality audio and video should be considered for any emergency telemedicine service. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

The conversion to electronic hospital notes at Mayo Clinic. Overcoming barriers and challenges.

PubMed

Andreen, Debra L; Dobie, Linda J; Jasperson, Jan C; Lucas, Thomas A; Wubbenhorst, Cathryn L

2010-01-01

This article describes the conversion to electronic hospital notes at a large, multi-specialty group practice: Mayo Clinic in Rochester, Minnesota. Because of the size of the institution and the barriers to the adoption of electronic notes, the process was a gradual one that took several years. Making a convincing case for change to institutional leaders and maintaining their support was crucial to success. Equally vital was the careful investigation of user requirements and the development of software features that allowed providers to complete their notes quickly in the fast-paced hospital environment. Care providers discovered the value of having immediate access to legible hospital notes throughout the campus and from remote locations.

Image acquisition unit for the Mayo/IBM PACS project

NASA Astrophysics Data System (ADS)

Reardon, Frank J.; Salutz, James R.

1991-07-01

The Mayo Clinic and IBM Rochester, Minnesota, have jointly developed a picture archiving, distribution and viewing system for use with Mayo's CT and MRI imaging modalities. Images are retrieved from the modalities and sent over the Mayo city-wide token ring network to optical storage subsystems for archiving, and to server subsystems for viewing on image review stations. Images may also be retrieved from archive and transmitted back to the modalities. The subsystems that interface to the modalities and communicate to the other components of the system are termed Image Acquisition Units (LAUs). The IAUs are IBM Personal System/2 (PS/2) computers with specially developed software. They operate independently in a network of cooperative subsystems and communicate with the modalities, archive subsystems, image review server subsystems, and a central subsystem that maintains information about the content and location of images. This paper provides a detailed description of the function and design of the Image Acquisition Units.

Bringing human resources to the table: utilization of an HR balanced scorecard at Mayo Clinic.

PubMed

Fottler, Myron D; Erickson, Eric; Rivers, Patrick A

2006-01-01

Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions. This article shows how Mayo Clinic uses the popular Balanced Scorecard approach to align its measures of HR performance to the organization's strategic plan.

Clinical implications of The Red Book.

PubMed

Culliford, Penny

2012-09-01

This presentation stresses the uniqueness of both the therapist's and patient's personal experience in clinical work and relates this to the significance of The Red Book as Jung's personal odyssey and for me personally as an analyst. I consider The Red Book's enduring relevance alongside recent psychological theories, neuroscience and early mystical writings, and conclude with a clinical vignette of a patient's response to a piece of choral music and subsequent use of active imagination. © 2012, The Society of Analytical Psychology.

Trends of radiopharmaceutical use at Mayo Clinic Rochester.

PubMed

Mroczenski, Ashley A; Berent, Stephanie M; Hall, Alice A; Hung, Joseph C; Herold, Thomas J; Mullan, Brian P

2007-09-01

The field of radiology is continuously changing. The purpose of this study was to identify the effect of technologic advances on nuclear medicine during the past 15 y. The number of radiopharmaceutical doses dispensed at Mayo Clinic (Rochester, Minnesota) from 1990 through 2004 was tracked. The number of doses was equivalent to the number of scans performed. Since 1990, the number of bone scans decreased by 38%. Brain scans using (99m)Tc have increased by 166%. The number of cardiac doses dispensed increased 184% from 1990 through 1999 but decreased 3% between 2000 and 2004. The number of lung scans decreased 52% from 1992 through 1999 and increased 66% from 1999 through 2004. The number of kidney scans decreased 67% since 1990. Since its introduction in 1993, the use of (111)In-pentetreotide has increased 16-fold. PET data showed a 602% increase in the number of procedures from 2001 through 2004. The number of bone, lung, and kidney scans has decreased because of advances in other imaging modalities. Although the number of cardiac imaging scans increased during most of the study period, the recent rate of growth has declined, possibly because of the availability of alternative procedures such as stress echocardiography. The number of brain and lung scans performed has increased, partially because of the development of new protocols. PET and tumor imaging have shown a substantial increase because of increasing numbers of approved indications and Medicare reimbursement.

Fetoscopic Therapy for Severe Pulmonary Hypoplasia in Congenital Diaphragmatic Hernia: A First in Prenatal Regenerative Medicine at Mayo Clinic.

PubMed

Ruano, Rodrigo; Klinkner, Denise B; Balakrishnan, Karthik; Novoa Y Novoa, Victoria A; Davies, Norman; Potter, Dean D; Carey, William A; Colby, Christopher E; Kolbe, Amy B; Arendt, Katherine W; Segura, Leal; Sviggum, Hans P; Lemens, Maureen A; Famuyide, Abimbola; Terzic, Andre

2018-05-15

To introduce the prenatal regenerative medicine service at Mayo Clinic for fetal endoscopic tracheal occlusion (FETO) care for severe congenital diaphragmatic hernia (CDH). Two cases of prenatal management of severe CDH with FETO between January and August 2017 are reported. Per protocol, FETO was offered for life-threatening severe CDH at between 26 and 29 weeks' gestation. Regenerative outcome end point was fetal lung growth. Gestational age at procedure and maternal and perinatal outcomes were additional monitored parameters. Diagnosis by ultrasonography of severe CDH was based on extremely reduced lung size (observed-to-expected lung area to head circumference ratio [o/e-LHR], eg, o/e-LHR of 20.3% for fetus 1 and 23.0% for fetus 2) along with greater than one-third of the liver herniated into the chest in both fetuses. Both patients underwent successful FETO at 28 weeks. At the time of intervention, no maternal or fetal complications were observed. Postintervention, fetal lung growth was observed in both fetuses, reaching an o/e-LHR of 62.7% at 36 weeks in fetus 1 and 52.4% at 32 weeks in fetus 2. The balloons were removed successfully at 35 weeks and 4 days by ultrasound-guided puncture in the first patient and at 32 weeks and 3 days by ex utero intrapartum therapy-to-airway procedure in the second patient. Postnatal management followed standard of care with patch CDH therapy. At discharge, one patient was breathing normally, whereas the other required minimal nasal cannula oxygen support. The successful launch of the first fetoscopic therapy for CDH at Mayo Clinic reveals its feasibility and safety, with early signs of benefit documented by fetal lung growth and reversal of severe pulmonary hypoplasia. clinicaltrials.gov Identifier: G170062. Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

HIPAA costs and patient perceptions privacy safeguards Mayo Clinic.

PubMed

Williams, Arthur R; Herman, David C; Moriarty, James P; Beebe, Timothy J; Bruggeman, Sandra K; Klavetter, Eric W; Steger, Paul H; Bartz, Janet K

2008-01-01

A study was conducted to assess the costs of implementation of the Health Insurance Portability and Accountability Act (HIPAA) and to report patient awareness of Notices of Privacy Practices (NPP) content and HIPAA privacy protections. All HIPAA start-up and implementation costs were collected prospectively. A random sample of 2,000 patients receiving services at the Mayo Clinic after HIPAA implementation (April 14, 2003) was surveyed about HIPAA knowledge, HIPAA content, and privacy concerns. Comprehensive measures of total HIPAA costs and costs related only to privacy practices were amortized over 7, 15, and 20 years. Patient knowledge of privacy protections and attitudes toward HIPAA were obtained from 1,309 (65.5%) respondents. The total HIPAA startup costs were $4,663,672. Fully amortized costs (annual plus start-up costs) were $1 per patient visit or $5 per patient per year. Costs for the privacy portion were $2,734,855. These costs were about $.90 per patient visit or about $4 per patient per year. Patients indicated high levels of awareness of HIPAA (71%), reading the NPP (79%), knowledge about HIPAA (80% with 6+ correct answers on a 10-item quiz), and improved feelings of privacy (44% versus 55% the same). Patients reported high levels of knowledge about HIPAA and confidence in privacy protections. HIPAA costs were modest per patient or per visit.

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. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Evaluation of the Risk of Relapse in Ulcerative Colitis According to the Degree of Mucosal Healing (Mayo 0 vs 1): A Longitudinal Cohort Study.

PubMed

Barreiro-de Acosta, Manuel; Vallejo, Nicolau; de la Iglesia, Daniel; Uribarri, Laura; Bastón, Iria; Ferreiro-Iglesias, Rocío; Lorenzo, Aurelio; Domínguez-Muñoz, J Enrique

2016-01-01

Mucosal healing in ulcerative colitis (UC) has become a common endpoint in most clinical trials and a relevant therapeutic goal in clinical practice. Despite important differences between endoscopic Mayo scores 0 and 1, both scores are considered as mucosal healing in most important trials. The aim of the present study was to evaluate the risk of relapse in UC patients according to the degree of mucosal healing (endoscopic Mayo scores of 0 and 1). A prospective longitudinal cohort study was designed. All UC patients who presented with mucosal healing at colonoscopy were consecutively included. Mucosal healing was defined as an endoscopic Mayo score of 0 or 1. Clinical relapse was defined as the need for therapy to induce remission, any treatment escalation, hospitalization or colectomy. All clinical relapses were evaluated at months 6 and 12 after study entry. Results were subjected to unconditional stepwise logistic and Kaplan-Meier regression analysis. One hundred and eighty-seven consecutive UC patients (126 [67.3%] with Mayo score 0 and 61 [32.7%] with Mayo score 1) were included. Of patients with Mayo scores 0 and 1, 9.4 and 36.6% respectively presented a relapse during the first 6 months of follow-up (p < 0.001). The only factor independently associated with UC relapses in the multivariate analysis was an endoscopic Mayo score of 1 (odds ratio 6.27, 95% confidence interval 2.73-14.40, p < 0.001). Patients with an endoscopic Mayo score of 1 have a higher risk of relapse than those with a score of 0. The concept of mucosal healing should be limited to patients with an endoscopic Mayo score of 0. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

The online outpatient booking system 'Choose and Book' improves attendance rates at an audiology clinic: a comparative audit.

PubMed

Parmar, Vijal; Large, Ann; Madden, Colm; Das, Vijay

2009-01-01

The 'Choose and Book' system provides an online booking service which primary care professionals can book in real time or soon after a patient's consultation. It aims to offer patients choice and improve outpatient clinic attendance rates. An audit comparing attendance rates of new patients booked into the Audiological Medicine Clinic using the 'Choose and Book' system with that of those whose bookings were made through the traditional booking system. Data accrued between 1 April 2008 and 31 October 2008 were retrospectively analysed for new patient attendance at the department, and the age and sex of the patients, method of appointment booking used and attendance record were collected. Patients were grouped according to booking system used - 'Choose and Book' or the traditional system. The mean ages of the groups were compared by a t test. The standard error of the difference between proportions was used to compare the data from the two groups. A P value of < or = 0.05 was considered to be significant. 'Choose and Book' patients had a significantly better rate of attendance than traditional appointment patients, P < 0.01 (95% CI 4.3, 20.5%). There was no significant difference between the two groups in terms of sex, P > 0.1 (95% CI-3.0, 16.2%). The 'Choose and Book' patients, however, were significantly older than the traditional appointment patients, P < 0.001 (95% CI 4.35, 12.95%). This audit suggests that when primary care agents book outpatient clinic appointments online it improves outpatient attendance.

Cortical Thickness and Anxiety Symptoms Among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging.

PubMed

Pink, Anna; Przybelski, Scott A; Krell-Roesch, Janina; Stokin, Gorazd B; Roberts, Rosebud O; Mielke, Michelle M; Spangehl, Kathleen A; Knopman, David S; Jack, Clifford R; Petersen, Ronald C; Geda, Yonas E

2017-01-01

The authors conducted a cross-sectional study to investigate the association between anxiety symptoms and cortical thickness, as well as amygdalar volume. A total of 1,505 cognitively normal participants, aged ≥70 years, were recruited from the Mayo Clinic Study of Aging in Olmsted County, Minnesota, on whom Beck Anxiety Inventory and 3T brain MRI data were available. Even though the effect sizes were small in this community-dwelling group of participants, anxiety symptoms were associated with reduced global cortical thickness and reduced thickness within the frontal and temporal cortex. However, after additionally adjusting for comorbid depressive symptoms, only the association between anxiety symptoms and reduced insular thickness remained significant.

Leptomeningeal Carcinomatosis in Colorectal Cancer: The Mayo Clinic Experience.

PubMed

Taylor, Gretchen; Karlin, Nina; Halfdanarson, Thorvardur R; Coppola, Kyle; Grothey, Axel

2018-06-01

Leptomeningeal metastasis (LM) is an uncommon form of metastatic disease in many cancers. There remains a paucity of literature with regard to the course and management of LM in colorectal cancers (CRCs). The aim of this study was to estimate the incidence of LM in patients with CRC seen at our institution over a 15-year period, and to describe the clinical course and outcome of these cases. LM in CRC primary cases between 2000 and 2014 were identified in the Mayo Clinic databases. The charts were retrospectively reviewed. Of 17,095 CRC primaries, we identified 10 patients with LM (0.058%) in this 15-year period. Nine cases were included in the analysis. Four had metastatic disease at the time of their initial CRC diagnosis. Median overall survival after CRC diagnosis was 25.7 months (range, 4.7-74.8 months). Median time to diagnosis of LM after CRC diagnosis was 25.3 months (range, 0-68.1 months). All patients had magnetic resonance imaging findings consistent with LM: 3 patients with spinal LM, 5 patients with intracranial LM, and 1 with both. Neurologic symptoms correlated with site of the lesions, with headache, cranial nerve palsy, lower extremity weakness, and gait disturbance among the most frequently reported. However, not all patients had neurologic findings, with LM lesions found incidentally in 2 cases. Seven patients (78%) had palliative radiotherapy for LM. Three patients continued to receive systemic chemotherapy after diagnosis of LM. Median survival after LM diagnosis was 7 weeks (range, 2-39 weeks). LM is an exceedingly rare development in the natural course of CRC. It confers a poor prognosis with limited treatment options. At our institution, most patients had their disease addressed by palliative means, with many receiving radiotherapy to control their neurologic symptoms. Based on our series, supportive care remains a sensible approach to the management of LM in CRC. Copyright © 2017 Elsevier Inc. All rights reserved.

Mohs micrographic surgery for the treatment of hidradenocarcinoma: the Mayo Clinic experience from 1993 to 2013.

PubMed

Tolkachjov, Stanislav N; Hocker, Thomas L; Hochwalt, Phillip C; Camilleri, Michael J; Arpey, Christopher J; Brewer, Jerry D; Otley, Clark C; Roenigk, Randall K; Baum, Christian L

2015-02-01

Hidradenocarcinoma (HAC) is a rare malignant adnexal neoplasm with reported metastatic potential and undefined optimal treatment. To review clinical characteristics and outcomes of patients with HAC treated with Mohs micrographic surgery (MMS). The authors performed a retrospective chart review of patients with HAC treated by MMS at Mayo Clinic from 1993 to 2013, recording patient demographics, tumor characteristics, MMS stages to clearance, follow-up, recurrence, metastasis, and mortality. Ten patients underwent MMS for HAC more than 20 years. The average age was 62.8 years, with 6 females and 4 males. Occipital scalp was the most common location (40%), followed by extremities (30%) and face (20%). In 5 of 7 cases (71%), "cyst" was the working clinical diagnosis. The average preoperative lesion area was 3.18 cm, with an average of 1.5 MMS stages required for clearance. Mean postoperative follow-up was 7 years (range, 5-205 months). No tumors treated with MMS recurred, metastasized, or led to disease-related mortality. Mohs micrographic surgery seems to be a useful treatment modality for HAC. This is the largest reported series of HAC treated with MMS with long-term follow-up.

Assessment of anosognosia in persons with frontal lobe damage: clinical utility of the Mayo-Portland Adaptability Inventory (MPAI).

PubMed

Murrey, G J; Hale, F M; Williams, J D

2005-08-10

To determine if the Mayo-Portland Adaptability Inventory (MPAI) demonstrates clinical utility in differentiating between persons with severe TBI and frontal lobe damage/anosognosia and persons with mild TBI and no frontal lobe damage. Forty-three persons with TBI and documented frontal lobe damage (mean age = 34; mean time since injury = 5.2 years) and 69 persons with mild TBI and no frontal lobe damage (mean age = 34.3; mean time since injury = 4.8 4.8 years). MPAI. Total inventory and select sub-category difference scores were significantly greater in the frontal lobe group than in the non-frontal lobe group. However, as expected, there was no significant difference between the two groups on the mobility sub-category difference scores. The MPAI appears to be potentially clinically useful in assessing for frontal lobe damage and associated anosognosia in patients with TBI.

Outcomes of Radiofrequency Ablation Therapy for Large Benign Thyroid Nodules: A Mayo Clinic Case Series.

PubMed

Hamidi, Oksana; Callstrom, Matthew R; Lee, Robert A; Dean, Diana; Castro, M Regina; Morris, John C; Stan, Marius N

2018-03-21

To assess the effectiveness, tolerability, and complications of radiofrequency ablation (RFA) in patients with benign large thyroid nodules (TNs). This is a retrospective review of 14 patients with predominantly solid TNs treated with RFA at Mayo Clinic in Rochester, Minnesota, from December 1, 2013, through October 30, 2016. All the patients declined surgery or were poor surgical candidates. The TNs were benign on fine-needle aspiration, enlarging or causing compressive symptoms, and 3 cm or larger in largest diameter. We evaluated TN volume, compressive symptoms, cosmetic concerns, and thyroid function. Median TN volume reduction induced by RFA was 44.6% (interquartile range [IQR], 42.1%-59.3%), from 24.2 mL (IQR, 17.7-42.5 mL) to 14.4 mL (IQR, 7.1-19.2 mL) (P<.001). Median follow-up was 8.6 months (IQR, 3.9-13.9 months). Maximum results were achieved by 6 months. Radiofrequency ablation did not affect thyroid function. In 1 patient with subclinical hyperthyroidism due to toxic adenoma, thyroid function normalized 4 months after ablation of the toxic nodule. Compressive symptoms resolved in 8 of 12 patients (67%) and improved in the other 4 (33%). Cosmetic concerns improved in all 8 patients. The procedure had no sustained complications. In this population, RFA of benign large TNs performed similarly to the reports from Europe and Asia. It induces a substantial volume reduction of predominantly solid TNs, improves compressive symptoms and cosmetic concerns, and does not affect normal thyroid function. Radiofrequency ablation has an acceptable safety profile and should be considered as a low-risk alternative to conventional treatment of symptomatic benign TNs. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Practice of Intubation of the Critically Ill at Mayo Clinic.

PubMed

Smischney, Nathan J; Seisa, Mohamed O; Heise, Katherine J; Busack, Kyle D; Loftsgard, Theodore O; Schroeder, Darrell R; Diedrich, Daniel A

2017-01-01

To describe the practice of intubation of the critically ill at a single academic institution, Mayo Clinic's campus in Rochester, Minnesota, and to report the incidence of immediate postintubation complications. Critically ill adult (≥18 years) patients admitted to a medical-surgical intensive care unit from January 1, 2013, to December 31, 2014, who required endotracheal intubation included. The final cohort included 420 patients. The mean age at intubation was 62.9 ± 16.3 years, with 58% (244) of the cohort as male. The most common reason for intubation was respiratory failure (282 [67%]). The most common airway device used was video laryngoscopy (204 [49%]). Paralysis was used in 264 (63%) patients, with ketamine as the most common sedative (194 [46%]). The most common complication was hypotension (170 [41%]; 95% confidence interval [CI]: 35.7-45.3) followed by hypoxemia (74 [17.6%]; 95% CI: 14.1-21.6), with difficult intubation occurring in 20 (5%; 95% CI: 2.9-7.3). We found a high success rate of first-pass intubation in critically ill patients (89.8%), despite the procedure being done primarily by trainees 92.6% of the time; video was the preferred method of laryngoscopy (48.6%). Although our difficult intubation (4.8%) and complication rates typically associated with the act of intubation such as aspiration (1.2%; 95% CI: 0.4-2.8) and esophageal intubation (0.2%; 95% CI: 0.01-1.3) are very low compared to other published rates (8.09%), postintubation hypotension (40.5%) and hypoxemia (17.6%) higher.

Highlights From the Third Annual Mayo Clinic Conference on Systems Engineering and Operations Research in Health Care

PubMed Central

Kamath, Janine R. A.; Osborn, John B.; Roger, Véronique L.; Rohleder, Thomas R.

2011-01-01

In August 2010, the Third Annual Mayo Clinic Conference on Systems Engineering and Operations Research in Health Care was held. The continuing mission of the conference is to gather a multidisciplinary group of systems engineers, clinicians, administrators, and academic professors to discuss the translation of systems engineering methods to more effective health care delivery. Education, research, and practice were enhanced via a mix of formal presentations, tutorials, and informal gatherings of participants with diverse backgrounds. Although the conference promotes a diversity of perspectives and methods, participants are united in their desire to find ways in which systems engineering can transform health care, especially in the context of health care reform and other significant changes affecting the delivery of health care. PMID:21803959

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.

Clinical profiles and outcomes in idiopathic duct-centric chronic pancreatitis (type 2 autoimmune pancreatitis): the Mayo Clinic experience.

PubMed

Hart, Phil A; Levy, Michael J; Smyrk, Thomas C; Takahashi, Naoki; Abu Dayyeh, Barham K; Clain, Jonathan E; Gleeson, Ferga C; Pearson, Randall K; Petersen, Bret T; Topazian, Mark D; Vege, Santhi S; Zhang, Lizhi; Chari, Suresh T

2016-10-01

Idiopathic duct-centric chronic pancreatitis (IDCP), also known as type 2 autoimmune pancreatitis (AIP), is an uncommon subtype of AIP. International Consensus Diagnostic Criteria for IDCP propose that the diagnosis requires pancreatic histology and/or concurrent IBD. We examined our experience with IDCP (type 2 AIP) to assess the appropriateness of these criteria, and identify unique characteristics in patients presenting with acute pancreatitis. We reviewed the Mayo Clinic AIP database through May 2014 to identify subjects with either definitive (n=31) or probable (n=12) IDCP. We compared demographic and clinical factors based on strength of diagnostic confidence (definitive versus probable), presence of IBD, and acute pancreatitis as the presenting manifestation. Relapse-free survival was determined using the Kaplan-Meier method. The clinical profiles were similar irrespective of the diagnostic criteria fulfilled. Common clinical presentations included acute pancreatitis (n=25, 58.1%, 12 of whom (27.9%) had recurrent pancreatitis) and pancreatic mass/obstructive jaundice (n=15, 34.9%). The cumulative relapse rate was 10.6% at 3 years (median follow-up 2.9 years). Relapse-free survival was similar for the different diagnostic categories, but was decreased in those initially presenting with acute pancreatitis (p=0.047) or treated with steroids (vs surgery, p=0.049). The current diagnostic classification of probable IDCP and the inclusion of IBD as a supportive criterion appear valid, because patients have similar clinical profiles and disease-related outcomes to those with definitive IDCP. Concurrent IBD, especially in young patients, may suggest when IDCP is the underlying cause of recurrent acute pancreatitis, but additional studies are needed for validation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Lichen planus affecting the female genitalia: A retrospective review of patients at Mayo Clinic.

PubMed

Fahy, Caoimhe M R; Torgerson, Rochelle R; Davis, Mark D P

2017-12-01

Genital or vulval lichen planus (VLP) may have a disabling effect on a patient's quality of life. Evidence-based management guidelines are lacking for VLP. We sought to review clinical presentation and treatment of patients who received a diagnosis of VLP. The 100 consecutive patients who received a diagnosis of VLP at Mayo Clinic between January 1, 1997, and December 31, 2015, were reviewed retrospectively. Descriptive statistics were used for data analysis. Fisher's exact test and the Wilcoxon rank sum test were used for analysis of categorical and continuous variables, respectively. All statistical tests were 2 sided, with the α level set at .05 for statistical significance. The time to diagnosis for 49% of patients was more than 1 year. Three patients (3%) had vulval dysplasia, including invasive squamous cell carcinoma. Sixty-eight patients (68%) had multisite lichen planus disease. Eleven patients (11%) had disease remission. Dermatology was the lead specialty for 9 of these cases of remission. This was a retrospective, small-cohort study. A low frequency of disease remission was seen in patients with VLP. Patients with lichen planus benefit considerably from dermatology consultation. Further research is warranted to establish high-quality, evidence-based guidelines for multidisciplinary management of this challenging disease. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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)

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

HLA Genes in Mayos Population from Northeast Mexico

PubMed Central

Arnaiz-Villena, A; Moscoso, J; Granados, J; Serrano-Vela, J.I; de la Peña, A.; Reguera, R; Ferri, A; Seclen, E; Izaguirre, R; Perez-Hernandez, N; Vargas-Alarcon, G

2007-01-01

HLA class I and class II alleles have been studied in 60 unrelated people belonging to Mayos ethnic group, which lives in the Mexican Pacific Sinaloa State. Mayos HLA profile was compared to other Amerindians and worldwide populations’ profile. A total of 14,896 chromosomes were used for comparisons. Genetic distances between populations, Neigbour-Joining dendrograms and correspondence analyses were performed to determine the genetic relationship among population. The new specific Mayo HLA haplotypes found are: HLA-A*02-B*35-DRB1*1406-DQB1*0301; HLA-A*02-B*48-DRB1*0404-DQB1*0302; HLA-A*24-B*51-DRB1*0407-DQB1*0302 and HLA-A*02-B*08-DRB1*0407-DQB1*0302. However, the typical Meso American HLADRB1*0407 represents a 40% of all DRB1 alleles. While common HLA characteristics are found in Amerindian distant ethnic groups, still new group specific HLA haplotypes are being found, suggesting that a common founder effect (i.e. high DRB1*0407) is noticed. Moreover, new HLA haplotypes are almost certainly appearing along time probably due to specific pathogen (?) selection for diversity. Mayo language is close to the Tarahumara one (another geographically close group); notwithstanding both groups are not genetically close according to our results, showing again the different evolution of genes and languages, which do not correlate. Finally, Sinaloa is one of the Mexican States in which more European genes are found. However, the results presented in this paper, where no European HLA genes are seen in Mayos, should have a bearing in establishing transplant programs and in HLA and disease studies. PMID:19412332

Validation of the Mayo Hip Score: construct validity, reliability and responsiveness to change.

PubMed

Singh, Jasvinder A; Schleck, Cathy; Harmsen, W Scott; Lewallen, David G

2016-01-19

Previous studies have provided the initial evidence for construct validity and test-retest reliability of the Mayo Hip Score. Instruments used for Total Hip Arthroplasty (THA) outcomes assessment should be valid, reliable and responsive to change. Our main objective was to examine the responsiveness to change, association with subsequent revision and the construct validity of the Mayo hip score. Discriminant ability was assessed by calculating effect size (ES), standardized response mean (SRM) and Guyatt's responsiveness index (GRI). Minimal clinically important difference (MCII) and moderate improvement thresholds were calculated. We assessed construct validity by examining association of scores with preoperative patient characteristics and correlation with Harris hip score, and assessed association of scores with the risk of subsequent revision. Five thousand three hundred seven provided baseline data; of those with baseline data, 2,278 and 2,089 (39%) provided 2- and 5-year data, respectively. Large ES, SRM and GRI ranging 2.66-2.78, 2.42-2.61 and 1.67-1.88 were noted for Mayo hip scores with THA, respectively. The MCII and moderate improvement thresholds were 22.4-22.7 and 39.4-40.5 respectively. Hazard ratios of revision surgery were higher with lower final score or less improvement in Mayo hip score at 2-years and borderline significant/non-significant at 5-years, respectively: (1) score ≤55 with hazard ratios of 2.24 (95% CI, 1.45, 3.46; p = 0.0003) and 1.70 (95% CI, 1.00, 2.92; p = 0.05) of implant revision subsequently, compared to 72-80 points; (2) no improvement or worsening score with hazard ratios 3.94 (95% CI, 1.50, 10.30; p = 0.005) and 2.72 (95% CI, 0.85,8.70; p = 0.09), compared to improvement >50-points. Mayo hip score had significant positive correlation with younger age, male gender, lower BMI, lower ASA class and lower Deyo-Charlson index (p ≤ 0.003 for each) and with Harris hip scores (p < 0.001). Mayo Hip Score is

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…

Sarcomatoid Carcinoma of the Lung: The Mayo Clinic Experience in 127 Patients.

PubMed

Maneenil, Kunlatida; Xue, Zhiqiang; Liu, Ming; Boland, Jennifer; Wu, Fengying; Stoddard, Shawn M; Molina, Julian; Yang, Ping

2018-05-01

Pulmonary sarcomatoid carcinoma (PSC) is an unusual form of non-small-cell lung cancer (NSCLC). Because of its rarity and heterogeneity, the treatment and prognosis of PSC have not been clearly described. We retrospectively evaluated all patients with a diagnosis of PSC from 1997 to 2015 at the Mayo Clinic (Rochester, MN). The clinical characteristics, treatment details, and outcomes were collected. The survival rates of the PSC patients were compared with those for other subtypes of NSCLC. We used propensity score matching to minimize the bias resulting from to imbalanced comparison groups. The study included 127 PSC patients. The median age at diagnosis was 68 years (range, 32-89 years), most of whom were men (61%) and smokers (82%). The clinical stage was I, II, III, and IV in 15.9%, 20.6%, 22.2%, and 41.3%, respectively. The median survival time was 9.9 months (95% confidence interval [CI], 7.6-12.6 months). The 1-, 2-, and 5-year survival rates were 42%, 23%, and 15%, respectively. Most patients received multimodality treatment. Of the 3 patients who received neoadjuvant chemotherapy, a partial response was demonstrated in 2. Twenty-five patients who underwent palliative chemotherapy were evaluated for tumor response: 52% experienced progression, 40% stable disease, 8.0% a partial response, and 0% a complete response. Multivariate analysis showed T stage, M stage, and treatment with surgery plus neoadjuvant chemotherapy or surgery plus adjuvant therapy were independent prognostic factors (P < .05). In matched analysis, multivariate models revealed worse overall survival for PSC compared with adenocarcinoma (hazard ratio, 2.38; 95% CI, 1.61-2.53) and squamous cell carcinoma (hazard ratio, 2.20; 95% CI, 1.44-2.34). We found the outcome of PSC to be significantly worse than that of adenocarcinoma and squamous cell carcinoma. Neoadjuvant or adjuvant chemotherapy, in addition to surgical resection, should be considered. Copyright © 2017 Elsevier Inc. All rights

The comparative importance of books: clinical psychology in the health sciences library.

PubMed Central

Wehmeyer, J M; Wehmeyer, S

1999-01-01

Clinical psychology has received little attention as a subject in health sciences library collections. This study seeks to demonstrate the relative importance of the monographic literature to clinical psychology through the examination of citations in graduate student theses and dissertations at the Fordham Health Sciences Library, Wright State University. Dissertations and theses were sampled randomly; citations were classified by format, counted, and subjected to statistical analysis. Books and book chapters together account for 35% of the citations in clinical psychology dissertations, 25% in nursing theses, and 8% in biomedical sciences theses and dissertations. Analysis of variance indicates that the citations in dissertations and theses in the three areas differ significantly (F = 162.2 with 2 and 253 degrees of freedom, P = 0.0001). Dissertations and theses in biomedical sciences and nursing theses both cite significantly more journals per book than the dissertations in clinical psychology. These results support the hypothesis that users of clinical psychology literature rely more heavily on books than many other users of a health sciences library. Problems with using citation analyses in a single subject to determine a serials to monographs ratio for a health sciences library are pointed out. PMID:10219478

The Red Book and clinical practice.

PubMed

Bygott, Catherine

2012-09-01

Jung's work is fundamentally an experience, not an idea. From this perspective, I attempt to bridge conference, consulting room and living psyche by considering the influence of the 'Red Book' on clinical practice through the subtle and imaginal. Jung's journey as a man broadens out to have relevance for women. His story is individual but its archetypal foundation finds parallel expression in analytic practice today. © 2012, The Society of Analytical Psychology.

Harmonizing and consolidating the measurement of patient-reported information at health care institutions: a position statement of the Mayo Clinic

PubMed Central

Eton, David T; Beebe, Timothy J; Hagen, Philip T; Halyard, Michele Y; Montori, Victor M; Naessens, James M; Sloan, Jeff A; Thompson, Carrie A; Wood, Douglas L

2014-01-01

Patient-reported outcomes (PROs) capture how patients perceive their health and their health care; their use in clinical research is longstanding. Today, however, PROs increasingly are being used to inform the care of individual patients, and document the performance of health care entities. We recently wrote and internally distributed an institutional position statement titled “Harmonizing and Consolidating the Measurement of Patient-Reported Outcomes at Mayo Clinic: A Position Statement for the Center for the Science of Health Care Delivery”. The statement is meant to educate clinicians, clinical teams, and institutional administrators about the merits of using PROs in a systematic manner for clinical care and quality measurement throughout the institution. The present article summarizes the most important messages from the statement, describing PROs and their use, identifying practical considerations for implementing them in routine practice, elucidating potential barriers to their use, and formulating strategies to overcome these barriers. The lessons learned from our experience – including pitfalls, challenges, and successes – may inform other health care institutions that are interested in systematically using PROs in health care delivery science and practice. PMID:24550683

Cortical Thickness and Depressive Symptoms in Cognitively Normal Individuals: The Mayo Clinic Study of Aging.

PubMed

Pink, Anna; Przybelski, Scott A; Krell-Roesch, Janina; Stokin, Gorazd B; Roberts, Rosebud O; Mielke, Michelle M; Knopman, David S; Jack, Clifford R; Petersen, Ronald C; Geda, Yonas E

2017-01-01

Altered cortical thickness has been observed in aging and various neurodegenerative disorders. Furthermore, reduced hippocampal volume has been reported in late-life depression. Even mild depressive symptoms are common in the elderly. However, little is known about the structural MRI measures of depressive symptoms in normal cognitive aging. Thus we sought to examine the association between depressive symptoms with cortical thickness and hippocampal volume as measured by brain MRI among community-dwelling participants. We conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging, involving cognitively normal participants (N = 1,507) aged≥70 years. We observed that depressive symptoms were associated with lower global cortical thickness and lower thickness in specific prefrontal and temporal cortical regions, labeled by FreeSurfer software, version 5.3. As expected, the strength of correlation was very small, given that participants were community-dwelling with only mild depressive symptoms. We did not observe associations between hippocampal volume and depressive symptoms. These findings may provide insight into the structural correlates of mild depressive symptoms in elderly participants.

Acute generalized exanthematous pustulosis: clinical characteristics, etiologic associations, treatments, and outcomes in a series of 28 patients at Mayo Clinic, 1996-2013.

PubMed

Alniemi, Dema T; Wetter, David A; Bridges, Alina G; El-Azhary, Rokea A; Davis, Mark D P; Camilleri, Michael J; McEvoy, Marian T

2017-04-01

Acute generalized exanthematous pustulosis (AGEP) is a rare skin condition typically caused by medications. The objective of this study was to examine the clinical features, causes, and outcomes of AGEP at a sole tertiary care center. A retrospective review of patients with AGEP (European Study of Severe Cutaneous Adverse Reactions score of ≥ 5) seen at Mayo Clinic (Rochester, MN, USA) between January 1, 1996, and December 31, 2013, was conducted. Of 28 patients (mean age at onset: 56 years), 17 (61%) were women. The development of AGEP was attributed to medications in 25 patients (89%), with clindamycin the most common culprit (six patients). Three patients (11%) had mucous membrane involvement, and 21 (75%) showed systemic involvement. Ten patients (36%) received systemic corticosteroids for treatment of AGEP. Skin findings resolved within 15 days in 26 patients (93%) (mean time to resolution: 7.6 days). In three patients (11%), generalized skin eruptions or dermatitis developed weeks to months after the resolution of AGEP. Twenty-four patients (86%) had a personal history of drug reactions before the development of AGEP. A previous history of drug reactions and clindamycin causation were more common in the present cohort than in prior reports. A small subset of patients experienced new-onset non-AGEP skin eruptions within a few months of the resolution of AGEP. © 2017 The International Society of Dermatology.

Outcomes of hospitalization in adults with Fontan palliation: The Mayo Clinic experience.

PubMed

Egbe, Alexander; Khan, Arooj R; Al-Otaibi, Mohamad; Said, Sameh M; Connolly, Heidi M

2018-04-01

The outcomes of hospitalization in the Fontan population have not been specifically studied. The purpose of this study was to describe outcomes of hospitalization (frequency and indications for hospitalization, and in-hospital mortality) in this population and to determine how these outcomes differ from those of other adults with congenital heart disease (CHD). This was a retrospective study of adult Fontan patients hospitalized at Mayo Clinic Rochester in 1990-2015. We selected age- and gender-matched control group of patients with repaired CHD and biventricular circulation hospitalized within the study period. A total of 367 Fontan patients (age 31±7 years and 259 [71%] with atriopulmonary Fontan) had 853 hospital admissions in 4 years (58 hospitalizations per 100 patient-years). The most common indications were arrhythmia (n=188, 22%), heart failure (n=169, 20%), and cardiac surgery (n=133, 16%). Overall in-hospital mortality was 4% (n=38), and the highest in-hospital mortality occurred in patients hospitalized for cardiac surgery (n=15, 11%) and heart failure (n=13, 8%). In comparison to the repaired CHD and biventricular circulation group, the Fontan group had more frequent hospitalizations (22 vs 58 per 100 patient-years, P<.001) and higher overall in-hospital mortality (1% vs 5%, P<.001), mortality after cardiac surgery (2% vs 11%, P=.01), and mortality for heart failure-related hospitalizations (2% vs 8%, P=.04). Adults with Fontan palliation had more frequent hospitalization and in-hospital mortality compared to the rest of the CHD population. Arrhythmia and heart failure were the most common indications for hospitalization. Perhaps optimal management of heart failure and arrhythmia may improve outcomes in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

Brief Report: Cancer Immunotherapy in Patients With Preexisting Rheumatic Disease: The Mayo Clinic Experience.

PubMed

Richter, Michael D; Pinkston, Olga; Kottschade, Lisa A; Finnes, Heidi D; Markovic, Svetomir N; Thanarajasingam, Uma

2018-03-01

To determine the risk of rheumatic disease flare and adverse effects in patients with preexisting rheumatic disease who were receiving immune checkpoint inhibitor (ICI) therapy. A retrospective medical record review was performed to identify all patients who received ICI therapy at Mayo Clinic in Rochester, Minnesota between 2011 and 2016 (~700 patients). Those with a preexisting rheumatic disease were identified using specific diagnostic codes. Sixteen patients were identified (81% female, median age 68.5 years). The most common rheumatic diseases were rheumatoid arthritis (n = 5), polymyalgia rheumatica (n = 5), Sjögren's syndrome (n = 2), and systemic lupus erythematosus (n = 2). Seven patients were receiving immunosuppressive therapy or glucocorticoids for their rheumatic disease at the time of initiation of the ICI. The primary malignancies were melanoma (n = 10), pulmonary (n = 4), or hematologic (n = 2). In most cases, ICIs were offered only after failure of several other therapies. Immune-related adverse effects (IRAEs) occurred in 6 patients, and all were treated successfully with glucocorticoids and discontinuation of the ICI therapy. There were no significant differences in time from cancer diagnosis to immunotherapy, duration of immunotherapy, age, or sex between the patients with and those without IRAEs. To our knowledge, this represents the largest single-center cohort of patients with rheumatic diseases who were exposed to modern cancer immunotherapy. Only a minority of these patients experienced a flare of their preexisting rheumatic disease or any other IRAE. © 2017, American College of Rheumatology.

Leisure-Time Physical Activity and the Risk of Incident Dementia: The Mayo Clinic Study of Aging.

PubMed

Krell-Roesch, Janina; Feder, Nathanael T; Roberts, Rosebud O; Mielke, Michelle M; Christianson, Teresa J; Knopman, David S; Petersen, Ronald C; Geda, Yonas E

2018-01-01

We conducted a prospective cohort study derived from the population-based Mayo Clinic Study of Aging. We investigated if leisure-time physical activity among individuals with mild cognitive impairment (MCI) was associated with a decreased risk of developing dementia. 280 persons aged≥70 years (median 81 years, 165 males) with MCI and available data from neurologic evaluation, neuropsychological testing, and questionnaire-based physical activity assessment, were followed for a median of 3 years to the outcomes of incident dementia or censoring variables. We conducted Cox proportional hazards regression analyses with age as a time scale and adjusted for sex, education, medical comorbidity, depression, and APOE ɛ4 status. Moderate intensity midlife physical activity among MCI participants was significantly associated with a decreased risk of incident dementia (HR = 0.64; 95% CI, 0.41-0.98). There was a non-significant trend for a decreased risk of dementia for light and vigorous intensity midlife physical activity, as well as light and moderate intensity late-life physical activity. In conclusion, we observed that physical activity may be associated with a reduced risk of dementia among individuals with MCI. Furthermore, intensity and timing of physical activity may be important factors when investigating this association.

Mayo Clinic employees responded to new requirements for cost sharing by reducing possibly unneeded health services use.

PubMed

Shah, Nilay D; Naessens, James M; Wood, Douglas L; Stroebel, Robert J; Litchy, William; Wagie, Amy; Fan, Jiaquan; Nesse, Robert

2011-11-01

Some health plans have experimented with increasing consumer cost sharing, on the theory that consumers will use less unnecessary health care if they are expected to bear some of the financial responsibility for it. However, it is unclear whether the resulting decrease in use is sustained beyond one or two years. In 2004 Mayo Clinic's self-funded health plan increased cost sharing for its employees and their dependents for specialty care visits (adding a $25 copayment to the high-premium option) and other services such as imaging, testing, and outpatient procedures (adding 10 or 20 percent coinsurance, depending on the option). The plan also removed all cost sharing for visits to primary care providers and for preventive services such as colorectal screening and mammography. The result was large decreases in the use of diagnostic testing and outpatient procedures that were sustained for four years, and an immediate decrease in the use of imaging that later rebounded (possibly to levels below the expected trend). Beneficiaries decreased visits to specialists but did not make greater use of primary care services. These results suggest that implementing relatively low levels of cost sharing can lead to a long-term decrease in utilization.

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

Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic.

PubMed

Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S

2014-01-01

Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

The prevalence of cardiovascular disease risk factors and the Framingham Risk Score in patients undergoing percutaneous intervention over the last 17 years by gender: time-trend analysis from the Mayo Clinic PCI Registry.

PubMed

Lee, Moo-Sik; Flammer, Andreas J; Kim, Hyun-Soo; Hong, Jee-Young; Li, Jing; Lennon, Ryan J; Lerman, Amir

2014-07-01

This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for β-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends. This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender

Clinical and academic use of electronic and print books: the Health Sciences Library System e-book study at the University of Pittsburgh.

PubMed

Folb, Barbara L; Wessel, Charles B; Czechowski, Leslie J

2011-07-01

The purpose of the Health Sciences Library System (HSLS) electronic book (e-book) study was to assess use, and factors affecting use, of e-books by all patron groups of an academic health sciences library serving both university and health system-affiliated patrons. A web-based survey was distributed to a random sample (n=5,292) of holders of library remote access passwords. A total of 871 completed and 108 partially completed surveys were received, for an approximate response rate of 16.5%-18.5%, with all user groups represented. Descriptive and chi-square analysis was done using SPSS 17. Library e-books were used by 55.4% of respondents. Use by role varied: 21.3% of faculty reported having assigned all or part of an e-book for class readings, while 86% of interns, residents, and fellows reported using an e-book to support clinical care. Respondents preferred print for textbooks and manuals and electronic format for research protocols, pharmaceutical, and reference books, but indicated high flexibility about format choice. They rated printing and saving e-book content as more important than annotation, highlighting, and bookmarking features. Respondents' willingness to use alternate formats, if convenient, suggests that libraries can selectively reduce title duplication between print and e-books and still support library user information needs, especially if publishers provide features that users want. Marketing and user education may increase use of e-book collections.

Clinical and academic use of electronic and print books: the Health Sciences Library System e-book study at the University of Pittsburgh

PubMed Central

Wessel, Charles B; Czechowski, Leslie J

2011-01-01

Objectives: The purpose of the Health Sciences Library System (HSLS) electronic book (e-book) study was to assess use, and factors affecting use, of e-books by all patron groups of an academic health sciences library serving both university and health system–affiliated patrons. Methods: A web-based survey was distributed to a random sample (n = 5,292) of holders of library remote access passwords. A total of 871 completed and 108 partially completed surveys were received, for an approximate response rate of 16.5%–18.5%, with all user groups represented. Descriptive and chi-square analysis was done using SPSS 17. Results: Library e-books were used by 55.4% of respondents. Use by role varied: 21.3% of faculty reported having assigned all or part of an e-book for class readings, while 86% of interns, residents, and fellows reported using an e-book to support clinical care. Respondents preferred print for textbooks and manuals and electronic format for research protocols, pharmaceutical, and reference books, but indicated high flexibility about format choice. They rated printing and saving e-book content as more important than annotation, highlighting, and bookmarking features. Conclusions: Respondents' willingness to use alternate formats, if convenient, suggests that libraries can selectively reduce title duplication between print and e-books and still support library user information needs, especially if publishers provide features that users want. Marketing and user education may increase use of e-book collections. PMID:21753914

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

Diagnostic report acquisition unit for the Mayo/IBM PACS project

NASA Astrophysics Data System (ADS)

Brooks, Everett G.; Rothman, Melvyn L.

1991-07-01

The Mayo Clinic and IBM Rochester have jointly developed a picture archive and control system (PACS) for use with Mayo's MRI and Neuro-CT imaging modalities. One of the challenges of developing a useful PACS involves integrating the diagnostic reports with the electronic images so they can be displayed simultaneously. By the time a diagnostic report is generated for a particular case, its images have already been captured and archived by the PACS. To integrate the report with the images, the authors have developed an IBM Personal System/2 computer (PS/2) based diagnostic report acquisition unit (RAU). A typed copy of the report is transmitted via facsimile to the RAU where it is stacked electronically with other reports that have been sent previously but not yet processed. By processing these reports at the RAU, the information they contain is integrated with the image database and a copy of the report is archived electronically on an IBM Application System/400 computer (AS/400). When a user requests a set of images for viewing, the report is automatically integrated with the image data. By using a hot key, the user can toggle on/off the report on the display screen. This report describes process, hardware, and software employed to integrate the diagnostic report information into the PACS, including how the report images are captured, transmitted, and entered into the AS/400 database. Also described is how the archived reports and their associated medical images are located and merged for retrieval and display. The methods used to detect and process error conditions are also discussed.

Assessment of human long saphenous vein function with minimally invasive harvesting with the Mayo stripper.

PubMed

O'Regan, D J; Borland, J A; Chester, A H; Pennell, D J; Yacoub, M; Pepper, J R

1997-09-01

The use of the Mayo Stripper to harvest the long saphenous vein has been shown to improve morbidity from leg wound incisions. It has not been universally accepted because of a perceived increase in injury to the venous conduit. To compare the function of undistended autologous long saphenous vein harvested by a Mayo stripper with the traditional 'open' technique in the same patient (n = 12) appearance. Vascular reactivity was assessed in isolated organ baths. Contractile function was measured in response to increasing concentrations (10(-9)-10(-5) mol) of 5-hydroxytryptamine and noradrenaline. This was calculated as a percentage of the maximum contractile response to 90 mM KCl measured in millinewtons (mN) (control 41.4 +/- 12.1, (n = 11), open technique 35.8 +/- 11.1, (n = 11), Mayo stripper 33.7 +/- 15.9, (n = 11)). The endothelial dependent and independent function was assessed with acetylcholine and sodium nitroprusside, respectively. There was no significant difference in response to both constrictors and dilators between vein taken with the Mayo stripper compared with the traditional open technique (n = 6 for each observation; P > 0.05 by ANOVA). Histological examination by light microscopy of the vessel segments removed with the Mayo stripper was unable to show any significant damage to the vessel wall. Both functional and morphological studies were conducted by 'blinded' observers. One-year follow-up with magnetic resonance angiography (MRA) and stress thallium tomography demonstrated a patency rate with lower and upper estimates of 80 and 94%. We have shown that harvesting the long saphenous vein with a Mayo stripper does not compromise vascular reactivity of the long saphenous vein or long-term patency.

NASA/DARPA advanced communications technology satellite project for evaluation of telemedicine outreach using next-generation communications satellite technology: Mayo Foundation participation.

PubMed

Gilbert, B K; Mitchell, M P; Bengali, A R; Khandheria, B K

1999-08-01

To describe the development of telemedicine capabilities-application of remote consultation and diagnostic techniques-and to evaluate the feasibility and practicality of such clinical outreach to rural and underserved communities with limited telecommunications infrastructures. In 1992, Mayo Foundation (Rochester, Minn, Jacksonville, Fla, and Scottsdale, Ariz), the National Aeronautics and Space Administration, and the Defense Advanced Research Projects Agency collaborated to create a complex network of fiberoptic landlines, video recording systems, satellite terminals, and specially developed data translators linking Mayo sites with other locations in the continental United States on an on-demand basis. The purpose was to transmit data via the asynchronous transfer mode (ATM) digital communications protocol over the Advanced Communications Technology Satellite. The links were intended to provide a conduit for transmission of data for patient-specific consultations between physicians, evaluation of medical imagery, and medical education for clinical staffs at remote sites. Low-data-rate (LDR) experiments went live late in 1993. Mayo Clinic Rochester successfully provided medical consultation and services to 2 small regional medical facilities. High-data-rate (HDR) experiments included studies of remote digital echocardiography, store-and-forward telemedicine, cardiac catheterization, and teleconsultation for congenital heart disease. These studies combined landline data transmission with use of the satellite. The complexity of the routing paths and network components, immaturity of available software, and inexperience with existing telecommunications caused significant study delays. These experiments demonstrated that next-generation satellite technology can provide batch and real-time imagery for telemedicine. The first-generation of the ATM and satellite network technology used in these experiments created several technical problems and inconveniences that should

A selective annotated bibliography for clinical audiology (1989-2009): books.

PubMed

Ferrer-Vinent, Susan T; Ferrer-Vinent, Ignacio J

2010-12-01

This is the 2nd in a series of 3 planned companion articles that present a selected, annotated, and indexed bibliography of clinical audiology publications from 1989 through 2009. Research and preparation of the bibliography were based on published guidelines, professional audiology experience, and professional librarian experience. The first article in the series covered reference works. This article focuses on other books. The planned third companion article will present periodicals and online resources. Audiologists and librarians can use this bibliography to help them identify relevant clinical audiology literature.

Mammographic breast density and risk of breast cancer in women with atypical hyperplasia: an observational cohort study from the Mayo Clinic Benign Breast Disease (BBD) cohort.

PubMed

Vierkant, Robert A; Degnim, Amy C; Radisky, Derek C; Visscher, Daniel W; Heinzen, Ethan P; Frank, Ryan D; Winham, Stacey J; Frost, Marlene H; Scott, Christopher G; Jensen, Matthew R; Ghosh, Karthik; Manduca, Armando; Brandt, Kathleen R; Whaley, Dana H; Hartmann, Lynn C; Vachon, Celine M

2017-01-31

Atypical hyperplasia (AH) and mammographic breast density (MBD) are established risk factors for breast cancer (BC), but their joint contributions are not well understood. We examine associations of MBD and BC by histologic impression, including AH, in a subcohort of women from the Mayo Clinic Benign Breast Disease Cohort. Women with a diagnosis of BBD and mammogram between 1985 and 2001 were eligible. Histologic impression was assessed via pathology review and coded as non-proliferative disease (NP), proliferative disease without atypia (PDWA) and AH. MBD was assessed clinically using parenchymal pattern (PP) or BI-RADS criteria and categorized as low, moderate or high. Percent density (PD) was also available for a subset of women. BC and clinical information were obtained by questionnaires, medical records and the Mayo Clinic Tumor Registry. Women were followed from date of benign biopsy to BC, death or last contact. Standardized incidence ratios (SIRs) compared the observed number of BCs to expected counts. Cox regression estimated multivariate-adjusted MBD hazard ratios. Of the 6271 women included in the study, 1132 (18.0%) had low MBD, 2921 (46.6%) had moderate MBD, and 2218 (35.4%) had high MBD. A total of 3532 women (56.3%) had NP, 2269 (36.2%) had PDWA and 470 (7.5%) had AH. Over a median follow-up of 14.3 years, 528 BCs were observed. The association of MBD and BC risk differed by histologic impression (p-interaction = 0.03), such that there was a strong MBD and BC association among NP (p < 0.001) but non-significant associations for PDWA (p = 0.27) and AH (p = 0.96). MBD and BC associations for AH women were not significant within subsets defined by type of MBD measure (PP vs. BI-RADS), age at biopsy, number of foci of AH, type of AH (lobular vs. ductal) and body mass index, and after adjustment for potential confounding variables. Women with atypia who also had high PD (>50%) demonstrated marginal evidence of increased BC risk (SIR 4

Prognostic factors and benefits of adjuvant therapy after pancreatoduodenectomy for ampullary adenocarcinoma: Mayo Clinic experience.

PubMed

Jin, Zhaohui; Hartgers, Mindy L; Sanhueza, Cristobal T; Shubert, Christopher R; Alberts, Steven R; Truty, Mark J; Muppa, Prasuna; Nagorney, David M; Smyrk, Thomas C; Hassan, Mohamed; Mahipal, Amit

2018-05-01

Ampullary adenocarcinoma is a rare entity with limited data on prognostic factors. The aim of this study is to identify prognostic factors and assess the benefit of adjuvant therapy in patients with ampullary adenocarcinoma who underwent pancreatoduodenectomy. A cohort of 121 consecutive patients underwent pancreatoduodenectomy for ampullary adenocarcinoma from 2006 to 2016 at Mayo Clinic in Rochester, MN. All patients were confirmed by independent pathologic review to have ampullary carcinoma. Patient survival and its correlation with patient and tumor variables were evaluated by univariate and multivariate analysis. Fifty three patients (45%) received adjuvant therapy (34 patients had chemotherapy alone, while 19 patients received both chemotherapy and radiation therapy). Fifty seven percent of the patients were diagnosed with advanced stage disease (Stage IIB or higher). Nearly all patients (98.3%) had negative surgical margins. Median overall survival (OS) was 91.8 months (95% CI:52.6 months-not reached). In multivariate analysis, excellent performance status (ECOG: 0), adjuvant therapy, and advanced stage remained statistically significant. Adjuvant therapy was independently associated with improved disease free survival (Hazard ratio [HR]:0.52, P = 0.04) and overall survival (HR:0.45, P = 0.03) in patients with advanced disease. Adjuvant therapy was associated with improved survival in patients with resected ampullary cancer, especially with advanced stage disease. A multi-institutional randomized trial is needed to further assess the role of adjuvant therapy in ampullary adenocarcinoma. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Clinical use of the Mayo-Portland Adaptability Inventory in rehabilitation after paediatric acquired brain injury.

PubMed

Oddson, Bruce; Rumney, Peter; Johnson, Patricia; Thomas-Stonell, Nancy

2006-11-01

The Mayo-Portland Adaptability Inventory (MPAI; designed to be administered by clinicians) is a popular measure of disability following head injury in adults. Its acceptability, validity, and reliability were assessed for use with children. There were 335 children and adolescents (215 males, 120 females) aged between 1 and 19 years at injury (median age 9y 8mo [SD 5y]) in our sample. The test was acceptable to respondents, rapidly and easily administered, and required only small modifications. It demonstrated validity against client and parent reports of major symptoms. It demonstrated test-retest reliability within the limitations of our data and excellent interrater accord. Consequently, the MPAI is recommended for paediatric use for evaluating rehabilitation needs and therapy outcome.

Flat epithelial atypia and risk of breast cancer: A Mayo cohort study.

PubMed

Said, Samar M; Visscher, Daniel W; Nassar, Aziza; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene H; Ghosh, Karthik; Radisky, Derek C; Hartmann, Lynn C; Degnim, Amy C

2015-05-15

Based on its cytologic features, and its co-occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an "atypical" or high-risk lesion. However, to the authors' knowledge, the long-term risk of breast cancer in women with FEA is undefined. Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry. FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow-up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17-6.81) versus 4.23 (95% CI, 3.44-5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23-3.19) versus 1.90 (95% CI, 1.72-2.09) for patients with PDWA without FEA (P = .76). FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH. © 2015 American Cancer Society.

Adrenocortical Carcinoma in Children: A Clinicopathological Analysis of 41 Patients at the Mayo Clinic from 1950 to 2017.

PubMed

Gupta, Nidhi; Rivera, Michael; Novotny, Paul; Rodriguez, Vilmarie; Bancos, Irina; Lteif, Aida

2018-05-25

Adrenocortical carcinoma (ACC) is an aggressive childhood cancer. Limited evidence exists on a definite histopathological criterion to differentiate ACC from adrenocortical adenoma. The aim of this study was to investigate the clinicopathological data of children with ACC, identify prognostic factors, and validate a histopathological criterion to differentiate ACC from adrenocortical adenoma. This retrospective cohort included 41 children, followed at the Mayo Clinic from 1950 to 2017 (onset of symptoms ≤21 years). Outcomes of interest were: alive with no evidence of disease, alive with evidence of disease, and dead of disease. Median age at onset of symptoms was 15.7 years (n = 41; range, 0.2-21 years). Female:male ratio was 3.6: 1. Mixed symptomatology (> 1 hormone abnormality) was the most common presentation (54%, n = 22). Sixty-six percent of patients (n = 27 out of 41) underwent total adrenalectomy. Metastatic disease was more common in children aged > 12 years (p = 0.002 compared to < 4 years). The most common sites of metastases were the liver and lungs. Overall 2-year and 5-year survival rates were 61% (95% CI 45-77) and 46% (95% CI 30-62), respectively. Metastasis at the time of diagnosis was independently associated with poor prognosis (risk ratio 13.7%; 95% CI 3.9-87.7). Weiss criteria (29%) and modified Weiss criteria (33%) were less accurate in younger patients (< 12 years), compared to the Wieneke index (100%). The presence of metastases was an independent prognostic factor. The Wieneke index was the most accurate in predicting clinical outcomes in younger children. © 2018 S. Karger AG, Basel.

Primary hyperparathyroidism surgical management since the introduction of minimally invasive parathyroidectomy: Mayo Clinic experience.

PubMed

Grant, Clive S; Thompson, Geoffrey; Farley, David; van Heerden, Jon

2005-05-01

Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (HPT) has equal cure and recurrence rates as standard cervical exploration. Changes in the management of primary HPT have occurred since introducing MIP including localization, anesthesia, intraoperative parathyroid hormone monitoring, and indications for parathyroidectomy. Cohort analysis of 1361 consecutive patients with primary HPT operated on at the Mayo Clinic, Rochester, Minn, from June 1998 through March 2004. Mean follow-up, 25 months. Tertiary referral center. One thousand three hundred sixty-one patients operated on for primary HPT, excluding 160 patients who were reoperated on. Standard cervical exploration MIP. Cure, recurrence, localization, anesthesia, hospitalization, intraoperative parathyroid hormone level monitoring, contraindications to MIP, surgical indications, assessment of osteoporosis and osteopenia, postoperative patient assessment of general patient health, and operative satisfaction. Cure of primary HPT for both conventional exploration and MIP was 97%; only 1 patient who underwent MIP had a potential recurrence. Imaging sensitivity and positive predictive values were as follows: sestamibi scintigraphy, 86% and 93%; ultrasonography, 61% and 87%, respectively. Usage of general vs local anesthesia with intravenous sedation was 46% and 49%, respectively, in patients w ho underwent MIP; 46% were dismissed as outpatients, 49% had single-night stays. The accuracy of intraoperative parathyroid hormone level monitoring was as follows: 98% (8% had true-negative results); the frequency of multiple gland disease was 13%. Accounting for causes precluding MIP, an estimated 60% to 70% of all patients would be eligible for MIP. By preoperative assessment, 79% had osteoporosis-osteopenia; 58% with postoperative bone mineral density measurements were improved. More than 85% were satisfied with the results of their operation. With high-quality localization and intraoperative

Clinical Audit of Dengue Related Deaths in 2011-Mayo Hospital Lahore Pakistan

PubMed Central

Iqtadar, Somia; Akbar, Nabeel; Mehmood, Mehreen; Abaidullah, Sajid

2017-01-01

Background and Objective: Dengue infection has evolved into an epidemic during last few years in Pakistan and has been associated with poor outcomes. Literature with respect to mortality risk factors in Dengue infection is not sufficient. This compelled us to conduct this study to find out major contributory factors to death in patients with dengue viral infection at one of Asia’s ancient hospital setting with an aim to recognize complications at earliest and improve case management in future. Methods: A retrospective observational study of 95 adult dengue deaths was performed at Mayo Hospital Lahore from July 1st 2011 to 31st December 2011 during a major dengue epidemic. Patients who tested positive by dengue IgM in the presence of acute fever fulfilling the World Health Organization criteria for Dengue Fever, Dengue Hemorrhagic Fever or Dengue Shock Syndrome and died within same setting, were included. Data regarding demographic profile, clinical and laboratory parameters along with treatment details were obtained and analysed. All records examined were anonymized. Results: Median age was 36 years (range13-80 years) among 95 deaths due to Dengue. Male gender comprised 60 (63.1%). Co-morbidities existed in 74 (77.9%) with hypertension in 21 (22.1%) diabetes in 11 (11.58%), liver disease in 9 (9.47%) and ischemic heart disease in 8(8.4%) cases. Patients presented at second day of fever for admission (range 1-8 days) and death occurred at a median of 4 days (range 30 minutes to 23 days). Hospital stay was for less than a week for seventy nine (83.2%) patients and 16 (16.8%) were admitted for more than 7 days. Critical care was required in 67(71%). Severe hepatitis occurred in 41 (43.1%), acute renal impairment occurred in 32 (33.7%) and disseminated intravascular coagulation in 16 (16.8%). Deaths were due to prolonged shock 49 (51.5%) fluid overload 46 (48.4%) and massive bleeding 18(19%) leading to organ failure. Conclusion: Decompensated shock complicated by

Clinical Audit of Dengue Related Deaths in 2011-Mayo Hospital Lahore Pakistan.

PubMed

Iqtadar, Somia; Akbar, Nabeel; Mehmood, Mehreen; Abaidullah, Sajid

2017-01-01

Dengue infection has evolved into an epidemic during last few years in Pakistan and has been associated with poor outcomes. Literature with respect to mortality risk factors in Dengue infection is not sufficient. This compelled us to conduct this study to find out major contributory factors to death in patients with dengue viral infection at one of Asia's ancient hospital setting with an aim to recognize complications at earliest and improve case management in future. A retrospective observational study of 95 adult dengue deaths was performed at Mayo Hospital Lahore from July 1st 2011 to 31st December 2011 during a major dengue epidemic. Patients who tested positive by dengue IgM in the presence of acute fever fulfilling the World Health Organization criteria for Dengue Fever, Dengue Hemorrhagic Fever or Dengue Shock Syndrome and died within same setting, were included. Data regarding demographic profile, clinical and laboratory parameters along with treatment details were obtained and analysed. All records examined were anonymized. Median age was 36 years (range13-80 years) among 95 deaths due to Dengue. Male gender comprised 60 (63.1%). Co-morbidities existed in 74 (77.9%) with hypertension in 21 (22.1%) diabetes in 11 (11.58%), liver disease in 9 (9.47%) and ischemic heart disease in 8(8.4%) cases. Patients presented at second day of fever for admission (range 1-8 days) and death occurred at a median of 4 days (range 30 minutes to 23 days). Hospital stay was for less than a week for seventy nine (83.2%) patients and 16 (16.8%) were admitted for more than 7 days. Critical care was required in 67(71%). Severe hepatitis occurred in 41 (43.1%), acute renal impairment occurred in 32 (33.7%) and disseminated intravascular coagulation in 16 (16.8%). Deaths were due to prolonged shock 49 (51.5%) fluid overload 46 (48.4%) and massive bleeding 18(19%) leading to organ failure. Decompensated shock complicated by either massive plasma leakage, frank bleeding, multi organ

Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging

PubMed Central

Alhurani, Rabe E.; Vassilaki, Maria; Aakre, Jeremiah; Mielke, Michelle M.; Kremers, Walter K.; Machulda, Mary M.; Geda, Yonas E.; Knopman, David S.; Peterson, Ronald C.; Roberts, Rosebud O.

2016-01-01

IMPORTANCE Unintentional weight loss has been associated with risk of dementia. Since mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI. OBJECTIVE To investigate the association of change in weight and BMI with risk of MCI. DESIGN, SETTING, AND PARTICIPANTS A population-based, prospective study of participants aged 70 years and older from the Mayo Clinic Study of Aging. Maximum weight and height in midlife (aged 40 to 65 years old) were retrospectively ascertained from the medical records of participants using a medical records linkage system. MAIN OUTCOMES MEASURES Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and body mass index with risk of MCI was investigated using proportional hazards models. RESULTS Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI. The mean (standard deviation) rate of weight change per decade from midlife to study entry was greater for individuals who developed incident MCI vs. those who remained cognitively normal (−2.0 (5.1) vs. −1.2 (4.9) kg; p = 0.006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR] 95% confidence interval [CI], 1.04 [1.02, 1.06], p < 0.001) after adjusting for sex, education and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg/decade corresponds to a 24% increase in risk of MCI (HR=1.24). Higher decline in BMI per decade was also associated with incident MCI (HR, 1.08, 95% CI = [1.03, 1.13], p = 0.003). CONCLUSIONS AND RELEVANCE These findings suggest that declining weight from midlife to late-life is a marker for MCI and may help identify persons at increased risk for MCI. PMID:26831542

Books and babies: clinical-based literacy programs.

PubMed

Fortman, Kristine K; Fisch, Robert O; Phinney, Margaret Y; Defor, Terese A

2003-01-01

The purpose of this study was to assess parental response to a clinic-based literacy program at a health maintenance organization. It was hypothesized that participation would be associated with increased literacy orientation by children. This randomized community trial took place at a Midwestern health maintenance organization. Six clinics were paired and randomly assigned to participate or not participate in Project Read. The main outcome variable was literacy orientation (book use). The target population was parents of children younger than 12 months (N = 165). After 6 months of participation, parents were surveyed by telephone. Seventy-five percent and 77% of the treatment and control groups, respectively, had positive literacy orientation; this difference was not significant. Persons receiving a videotape were more likely to have a positive literacy orientation (82.9% vs 69.2%; P <.05). The multivariate regression analyses also showed that receiving the free videotape was a significant intervention exposure. The members of the population in this study are reading to their children. Parents who receive a videotape on the importance of reading are likely to read more to their children.

Utility of the Mayo-Portland adaptability inventory-4 for self-reported outcomes in a military sample with traumatic brain injury.

PubMed

Kean, Jacob; Malec, James F; Cooper, Douglas B; Bowles, Amy O

2013-12-01

To investigate the psychometric properties of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) obtained by self-report in a large sample of active duty military personnel with traumatic brain injury (TBI). Consecutive cohort who completed the MPAI-4 as a part of a larger battery of clinical outcome measures at the time of intake to an outpatient brain injury clinic. Medical center. Consecutively referred sample of active duty military personnel (N=404) who suffered predominantly mild (n=355), but also moderate (n=37) and severe (n=12), TBI. Not applicable. MPAI-4 RESULTS: Initial factor analysis suggested 2 salient dimensions. In subsequent analysis, the ratio of the first and second eigenvalues (6.84:1) and parallel analysis indicated sufficient unidimensionality in 26 retained items. Iterative Rasch analysis resulted in the rescaling of the measure and the removal of 5 additional items for poor fit. The items of the final 21-item Mayo-Portland Adaptability Inventory-military were locally independent, demonstrated monotonically increasing responses, adequately fit the item response model, and permitted the identification of nearly 5 statistically distinct levels of disability in the study population. Slight mistargeting of the population resulted in the global outcome, as measured by the Mayo-Portland Adaptability Inventory-military, tending to be less reflective of very mild levels of disability. These data collected in a relatively large sample of active duty service members with TBI provide insight into the ability of patients to self-report functional impairment and the distinct effects of military deployment on outcome, providing important guidance for the meaningful measurement of outcome in this population. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Outcomes and patterns of failure of sarcomatoid carcinoma of the larynx: The Mayo Clinic experience.

PubMed

Gamez, Mauricio E; Jeans, Elizabeth; Hinni, Michael L; Moore, Eric; Young, Geoffrey; Ma, Daniel; McGee, Lisa; Buras, Matthew R; Patel, Samir H

2018-02-01

Sarcomatoid carcinoma is a rare variant of squamous cell carcinoma of the head and neck. No consensus exists on its management. Our aim was to present our outcomes. Retrospective study. Median follow-up 45 months. There were 38 patients with pathologically confirmed sarcomatoid carcinoma of the larynx treated at the Mayo Clinic from 1990 to 2014. Statistical analysis of overall survival (OS), progression-free survival (PFS), and local control (LC) were conducted using the Kaplan-Meier method. The majority of patients were elderly males (92%) with a smoking history (74%) presenting with early-stage disease (71%). Surgery alone was the primary treatment in 27 patients (71%). Nine patients (25%) were treated with adjuvant radiation due to initial stage or high-risk pathologic features. Median radiation dose to the primary/surgical bed was 65 Gy (range, 60.3-75.0 Gy). A total of 15 patients (39%) had tumor recurrence, majority being local (n = 12). Sixty percent (n = 9) had multiple local recurrences. Five-year OS, PFS, and LC were 63%, 46%, and 72%, respectively. Subgroup analysis by stage I versus higher stages (II-IV) showed an OS of 80% versus 43% (P = .030), PFS of 65% versus 18% (P = .003), and LC of 84% versus 57% (P = .039). Sarcomatoid carcinoma of the larynx is rare, and frequently presents at an early stage in older men with history of smoking. Based on our outcomes and patterns of failure, it appears early-stage tumors are treated appropriately with single-modality therapy, whereas more advanced tumors require multimodality therapy. Validation in a larger cohort is warranted. 4. Laryngoscope, 128:373-377, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Presbyopia

MedlinePlus

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Comparison of the EZ-Cap recapper with the Mayo recapper for the prevention of needlesticks.

PubMed

Dewhirst, Chad A; Hung, Joseph C

2008-09-01

The purpose of this project was the development of a device that improves the design of our current capping block, the Mayo recapper. The major challenges for design and improvement included creating a device that is simple to use and can be applied throughout our department. We wanted a recapper device that increased safety and minimized the potential for needlesticks. Simplicity was another important factor, along with versatility and low cost. A new recapper, called EZ-Cap, was developed, and a comparison study was conducted to evaluate the pros and cons of the EZ-Cap recapper and the Mayo recapper. Nuclear medicine technologists (n = 10) in our department used each device when administering patient injections. At the conclusion of their patient injection rotation, they recorded on a survey sheet the pros and cons of each device. The results of this survey were used to evaluate the effectiveness, comfort level during use, and safety of each recapping device. We used a 2-level scoring system to help determine which device was more favorable. The first level focused on comfort and convenience and was given a score of +1 or -1. The second level focused on safety and was given a score of +2 or -2. Because we believed that safety was a high priority for our capping blocks, this level received a higher score than the first level. The Mayo recapper was the device preferred by 9 of 10 technologists surveyed. The EZ-Cap recapper had several technical issues that made it difficult to use and that could potentially lead to safety concerns. According to our scoring system, the Mayo recapper received a score of +9 for its pros and -4 for its cons. By comparison, the EZ-Cap recapper received a score of +7 for its pros and -16 for its cons. Our results show that the Mayo recapper was the device of choice because its pros outweighed its cons. However, we will continually improve the effectiveness of the Mayo recapper to prevent needlesticks.

Evaluation of DNA Repair Function as a Predictor of Response in a Clinical Trial of PARP Inhibitor Monotherapy for Recurrent Ovarian Carcinoma

DTIC Science & Technology

2015-10-01

Monotherapy for Recurrent Ovarian Carcinoma PRINCIPAL INVESTIGATOR: Scott H. Kaufmann CONTRACTING ORGANIZATION: Mayo Clinic Rochester, MN 55905...UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Mayo Clinic and Foundation AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT...NUMBER 200 First St., S.W. Rochester, MN 55905 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) Mayo Clinic Rochester, MN 55905 10. SPONSOR

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

A New Library for Galway-Mayo Institute of Technology

ERIC Educational Resources Information Center

Kelly, Hugh

2004-01-01

The newly-built library at Ireland's Galway-Mayo Institute of Technology (GMIT) is innovative in design, responds to environmental conditions and identifies the campus with its location. The library is part of the Learning Resource Centre recently constructed to meet the institute's objective for a new landmark frontage. This article presents the…

Flat Epithelial Atypia and Risk of Breast Cancer: A Mayo Cohort Study

PubMed Central

Said, Samar M.; Visscher, Daniel W.; Nassar, Aziza; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene H.; Ghosh, Karthik; Radisky, Derek C.; Hartmann, Lynn C.; Degnim, Amy C.

2014-01-01

Background Based on its cytologic features, and its co-occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to breast cancer development. It is often referred to as an “atypical” or high-risk lesion. However, the long term risk of breast cancer in women with FEA is undefined. Methods Biopsies with FEA were identified in excisional breast biopsies in the Mayo Clinic Benign Breast Disease (BBD) Cohort, which includes 11,591 women who had benign biopsies at Mayo-Rochester 1967–2001. Breast cancer risk of FEA, non-proliferative, proliferative and atypical hyperplasia (AH) subsets was assessed using standardized incidence ratios (SIRs), relative to the Iowa Surveillance, Epidemiology, and End Results registry. Results FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as proliferative disease without atypia (PDWA). With median follow-up of 16.8 years, the SIR for breast cancer in AH + FEA was 4.74 (95% CI: 3.17–6.81) versus 4.23 (3.44–5.13) for AH without FEA (p=0.59). The SIR for PDWA + FEA was 2.04 (95% CI: 1.23–3.19) versus 1.90 (1.72–2.09) for PDWA without FEA (p=0.76). Conclusions FEA is an uncommon finding in women with BBD. FEA does not convey independent risk of breast cancer beyond that of the associated PDWA or AH. PMID:25639678

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.

Book Review:

NASA Astrophysics Data System (ADS)

Fallone, B. G.

2004-01-01

This book represents the proceedings of the five day programme on IMRT techniques presented at the 2003 American Association of Physicists in Medicine (AAPM) Summer School held in Colorado Springs, Colorado. The book is essentially an overview of IMRT techniques, discussing the history, the mathematical processes involved in the planning stages, the biological indices for evaluations, the off-line and on-line medical imaging that is required, the various IMRT delivery techniques available, positioning and motion verification, shielding and QA issues, and some clinical applications. There is some additional discussion on modulated electron and proton therapy, views on the clinical and financial impact of IMRT, as well as some speculation on the future uses of IMRT. The fact that the book is an `overview' must be emphasized. Medical physicists who are well-read in IMRT, or have implemented IMRT, even partially, may be a little disappointed with the book. Although specific details were purposely omitted, the well-read physicist would have preferred to go right to the `heart of the matter', something this book fails to do. As is typical of many proceedings-type books, there is a certain level of inconsistency of writing styles, as well as some redundancy between the different chapters. It is unfortunate that such a large volume does not have an index to allow a reader to explore a particular subject pertaining to IMRT. The reader would have to guide himself/herself by the table of contents before each chapter which could be a problem if the reader requires some information quickly. It is interesting to note that the book lends itself to a variety of professionals interested in IMRT, including administrators. It may be a source of help for medical physicists who wish to discuss IMRT issues with higher level administration, for example. Some clinical applications are also reviewed. The lack of details concerning the advantages of IMRT with respect to clinical outcome is

Using a silver-coated polymeric substrate for the management of chronic ulcerations: the initial Mayo Clinic experience.

PubMed

Moore, Rusty A; Liedl, David A; Jenkins, Sarah; Andrews, Karen L

2008-11-01

This retrospective observational study was designed to review the use of a silver-coated polymeric substrate on various types of chronic wounds at the Mayo Clinic in Rochester, Minnesota. The study was set in a community and referral multidisciplinary vascular wound clinic. The authors identified the first 112 patients treated with a silver dressing in the center. Of these, 15 were lost to follow-up or had incomplete data. Ninety-seven patients were included in the study. Thirty-seven of these 97 patients had multiple wounds; however, 1 wound per person was randomly chosen for analysis. The median age of these patients was 69 years. A wound was considered healed when the wound was completely epithelialized. Of the 97 wounds evaluated, the primary etiologies were as follows: 20 (20.6%) were neurotrophic, 24 (24.7%) were ischemic (arterial, arteriolar, or vasculitic), 20 (20.6%) were venous, 7 (7.2%) were traumatic, and 16 (16.5%) were multifactorial. The silver dressing was the primary wound care product on all wounds. Silverlon (Argentum LLC, Chicago, Illinois) was the silver dressing used for this study. The frequency of dressing changes and use of secondary dressings, to keep the wound moist, were based on the amount of drainage, debris, and slough on the wound. Data pertaining to patient demographics, risk factors, wound etiology, noninvasive arterial vascular studies, frequency of dressing changes, wound discomfort, wound size, and wound duration were collected by retrospective chart review. Thirty-five of the 97 wounds (36.1%) healed. The 62 nonhealed wounds (63.9%) decreased in size by a median of 55.2%. Among the 68 patients who had reported discomfort before the study, 77.9% reported no change in discomfort, 17.7% reported increased pain, and 4.4% reported decreased pain. A silver-coated polymeric substrate (Silverlon) can be used as an effective primary wound care dressing in patients with active wounds.

[Clinical laboratory medicine: continuous amelioration with a book of objectives and satisfaction survey].

PubMed

Reix, Nathalie; Agin, Arnaud; Bahram, Seiamak; Dali-Youcef, Nassim; Grucker, Daniel; Jaulhac, Benoît; Lepiller, Quentin; Lessinger, Jean-Marc; Mauvieux, Laurent; Monier, Laurie; Schramm, Frédéric; Stoll-Keller, Françoise; Vallat, Laurent; Ludes, Bertrand; Candolfi, Ermanno; Filisetti, Denis

2015-01-01

We report in this publication the use of two educational tools, a questionnaire of satisfaction and a training book, to improve the training of students during their internship in clinical laboratory at the "Pôle de biologie des Hôpitaux universitaires de Strasbourg" in France. First, the ongoing training was assessed by the interns with a questionnaire measuring satisfaction. The analysis of this questionnaire identified four key points to improve: 1) define the teaching objectives, 2) organize the training with a schedule, 3) revise certain teaching methods and 4) ensure better integration of the students in the team of medical biologists. After this assessment, we implemented a training book to answer these four points. Indeed, the training book presents the objectives, the schedule of training, and how to validate the educational objectives. A new assessment was performed again using the same methodology. Results showed an improvement in student satisfaction from 74 to 88 %. The questionnaire of satisfaction and the training book are presented in this article. The aim of the assessment of training combined with the training book is to incite the actors of the training (students and teachers) to continually improve the training. The objectives of the Pôle de Biologie are to obtain an 80 % satisfaction rate during the 6 months trainings and to reduce or eliminate dissatisfaction, and finally to ensure the validation by students of 80 to 100 % of their predetermined objectives.

Antimycobacterial activity of medicinal plants used by the Mayo people of Sonora, Mexico.

PubMed

Coronado-Aceves, Enrique Wenceslao; Sánchez-Escalante, José Jesús; López-Cervantes, Jaime; Robles-Zepeda, Ramón Enrique; Velázquez, Carlos; Sánchez-Machado, Dalia Isabel; Garibay-Escobar, Adriana

2016-08-22

Tuberculosis (TB) is an infectious disease mainly caused by Mycobacterium tuberculosis (Mtb), which generates 9 million new cases worldwide each year. The Mayo ethnicity of southern Sonora, Mexico is more than 2000 years old, and the Mayos possess extensive knowledge of traditional medicine. To evaluate the antimycobacterial activity levels of extracts of medicinal plants used by the Mayos against Mtb and Mycobacterium smegmatis (Msm) in the treatment of TB, respiratory diseases and related symptoms. A total of 34 plant species were collected, and 191 extracts were created with n-hexane, dichloromethane, ethyl acetate (EtOAc), methanol and water. Their minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined against Mtb H37Rv using the microplate alamar blue assay (MABA) and against Msm using the resazurin microplate assay (REMA) at 6 and 2 days of exposure, respectively, and at concentrations of 250-1.9µg/mL (n-hexane extracts) and 1000-7.81µg/mL (extracts obtained with dichloromethane, EtOAc, methanol and water). Rhynchosia precatoria (Willd.) DC. (n-hexane root extract), Euphorbia albomarginata Torr. and A. Gray. (EtOAc shoot extract) and Helianthus annuus L. (n-hexane stem extract) were the most active plants against Mtb H37Rv, with MICs of 15.6, 250, 250µg/mL and MBCs of 31.25, 250, 250µg/mL, respectively. R. precatoria (root) was the only active plant against Msm, with MIC and MBC values of ≥250µg/mL. None of the aqueous extracts were active. This study validates the medicinal use of certain plants used by the Mayo people in the treatment of TB and related symptoms. R. precatoria, E. albomarginata and H. annuus are promising plant sources of active compounds that act against Mtb H37Rv. To our knowledge, this is the first time that their antimycobacterial activity has been reported. Crude extracts obtained with n-hexane, EtOAc and dichloromethane were the most active against Mtb H37Rv. Copyright © 2016

Pessimistic, Anxious, and Depressive Personality Traits Predict All-Cause Mortality: The Mayo Clinic Cohort Study of Personality and Aging

PubMed Central

Grossardt, Brandon R.; Bower, James H.; Geda, Yonas E.; Colligan, Robert C.; Rocca, Walter A.

2011-01-01

Objective To study the association between several personality traits and all-cause mortality. Methods We established a historical cohort of 7216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 to 1965, and who resided within a 120-mile radius centered in Rochester, MN. A total of 7080 subjects (98.1%) were followed over four decades either actively (via a direct or proxy telephone interview) or passively (via review of medical records or by obtaining their death certificates). We examined the association of pessimistic, anxious, and depressive personality traits (as measured using MMPI scales) with all-cause mortality. Results A total of 4634 subjects (65.5%) died during follow-up. Pessimistic, anxious, and depressive personality traits were associated with increased all-cause mortality in both men and women. In addition, we observed a linear trend of increasing risk from the first to the fourth quartile for all three scales. Results were similar in additional analyses considering the personality scores as continuous variables, in analyses combining the three personality traits into a composite neuroticism score, and in several sets of sensitivity analyses. These associations remained significant even when personality was measured early in life (ages 20 to 39 years). Conclusions Our findings suggest that personality traits related to neuroticism are associated with an increased risk of all-cause mortality even when they are measured early in life. PMID:19321849

The development and implementation of a strategic and tactical planning framework at Mayo Clinic Arizona.

PubMed

Frey, Keith; Cranmer, John Jack; Kirby, Lani J; Lenko, Paul H; Vrabel, Amy Z

2005-01-01

This article describes the Mayo Arizona process for developing an information technology strategic plan. The background of organizational events that gave rise to this strategic planning process is presented. A cross-functional team of key IT stakeholders was convened; the team used a facilitated process to derive a pro forma set of IT strategic objectives from the larger organization's emerging strategic plan. A broad set of leadership interviews was conducted to further identify detailed objectives that would confirm, complement, or conflict with the "strawperson." The IT strategic objectives then were refined and published by the organization. The article also describes the annual process of reviewing the IT strategic plan and translating it to a set of tactical objectives. This includes the committee structure for project prioritization, which is guided by the IT strategic plan. The outcome of the prioritization process is a five-year IT tactical plan, which is used to communicate the IT action plan for achievement of the strategic objectives. The strategic and tactical plans have resulted in stronger ownership and advocacy of IT activities by organizational leadership and a clearer view of the impact of technology on the organization's strategic plan.

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

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.

The Arabic version of the Mayo-Portland Adaptability Inventory 4: a validation study.

PubMed

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

2012-09-01

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 translate the tool into Arabic and to examine its validity and reliability with multiple sclerosis and stroke patients. A total of 128 participants were enrolled in this study: 49 with multiple sclerosis, 17 with stroke, and 62 healthy adults. The psychometric properties of discriminative and convergent construct validity as well as test-retest reliability were tested. The translated tool, the Arabic-MPAI-4 (A-MPAI-4), significantly discriminated among the three subgroups (F=50.93, P<0.001), correlated moderately but significantly with the Arabic version of the Performance Assessment of Self-Care Skills Self-Report as a measure of functional independence in daily activities (r=-0.35, P<0.001), and showed good stability over time (r=0.73, P<0.001). The A-MPAI-4 is a valid and reliable tool for clinical use with multiple sclerosis and stroke patients who speak Arabic.

Mayo's Older Americans Normative Studies (MOANS): Factor Structure of a Core Battery.

ERIC Educational Resources Information Center

Smith, Glenn E.; And Others

1992-01-01

Using the Mayo Older Americans Normative Studies (MOANS) group (526 55-to 97-year-old adults), factor models were examined for the Wechsler Adult Intelligence Scale-Revised (WAIS-R); the Wechsler Memory Scale (WMS); and a core battery of the WAIS-R, the WMS, and the Rey Auditory-Verbal Learning Test. (SLD)

Textbooks on tap: using electronic books housed in handheld devices in nursing clinical courses.

PubMed

Williams, Margaret G; Dittmer, Arlis

2009-01-01

Changing technology is creating new ways to approach nursing education and practice. Beginning in 2003, using a quasi-experimental design, this project introduced personal digital assistants (PDAs) as a clinical tool to five experimental and control groups of students and faculty. The handheld device, or PDA, was loaded with e-books for clinical practice. Differences in learning styles and preferences emerged during the different phases of the study. Students were quickly able to master the technology and use the device effectively, reporting that they liked the concise nature of the information obtained. No students expressed dissatisfaction or regret at being in the experimental group. Results and implications for clinical practice, education, and library resources are discussed.

Implementation of a care management model for depression at two primary care clinics.

PubMed

Williams, Mark; Angstman, Kurt; Johnson, Isaac; Katzelnick, David

2011-01-01

The Mayo clinic participated in the Depression Improvement Across Minnesota, Offering a New Direction model at two Mayo Family Clinics, that is, the Rochester Northwest and Northeast sites. Although the Northwest and Northeast clinics demonstrated the best 6-month remission rates in the state during the first year of implementation, they were retrospectively found to differ on several process issues and on measures related to the populations served. Six-month remission rates were significantly better at Northwest clinic; yet, Northeast clinic had more patient contacts. Differences in rates of activation into care management, care management accessibility, and differences in maintaining contact with patients at 6 months may explain some of these results.

Trajectories of plasma IGF-1, IGFBP-3, and their ratio in the Mayo Clinic Study of Aging.

PubMed

Wennberg, Alexandra M V; Hagen, Clinton E; Petersen, Ronald C; Mielke, Michelle M

2018-06-01

Insulin-like growth factor 1 (IGF-1) has been associated with osteoporosis, cardiovascular disease, cancer, neurodegenerative diseases, and mortality in middle and older aged adults. Cross-sectionally, IGF-1 decreases with age and levels of IGF-1 are markedly different between individuals. However, little is known about intra-individual trajectories of IGF-1. We examined baseline and serial measures of plasma total IGF-1, IGF binding protein (IGFBP)-3, and their ratio, which is a proxy for bioavailable IGF-1, among 1618 adults, aged 50-95, enrolled in the Mayo Clinic Study of Aging. At baseline, IGF-1 and IGFBP-3 were strongly correlated (r = 0.62, p < 0.001). Total IGF-1 and IGFBP-3 decreased across age, while the ratio of IGF-1/IGFBP-3 increased across age. This pattern was consistent across ages at baseline and intra-individually over an average 2.3 years follow-up (range = 10 months-5.6 years). In age-adjusted linear regression models, baseline levels of total IGF-1, IGFBP-3, and IGF-1/IGFBP-3 varied by participant characteristics (sex, BMI, gait speed), medical comorbidities (Charlson comorbidity index score, hypertension, diabetes, and cardiovascular disease), and hormone replacement therapy use in women. High interclass correlation coefficients (ICCs) suggest little intra-individual variability in levels of total IGF-1 (ICC = 0.84), IGFBP-3 (ICC = 0.88), and IGF-1/IGFBP-3 (ICC = 0.81) over time. In mixed effects models that specified age as a time scale, men showed greater decreases in total IGF-1 and IGFBP-3 with age, while more comorbidities and decreasing gait speed were associated with increasing IGFBP-3. In sex-stratified models, trajectories of total IGF-1, IGFBP-3, and IGF-1/IGFBP-3, as a function of participant demographics, health characteristics, and medical conditions, differed between men and women. These results suggest that change in levels of plasma total IGF-1, IGFBP-3, and IGF-1/IGFBP-3 are associated with

Feasibility, Acceptability and Findings from a Pilot Randomized Controlled Intervention Study on the Impact of a Book Designed to Inform Patients about Cancer Clinical Trials

PubMed Central

Carney, Patricia A.; Tucker, Erin K.; Newby, Timothy A.; Beer, Tomasz M.

2014-01-01

Objective To assess the feasibility, acceptability and changes in knowledge among cancer patients assigned to receive a 160 page book on experimental cancer therapies and clinical trials. Methods We enrolled 20 patients with cancer who had never participated in a clinical trial, and randomly assigned them to receive the book either during Week 1or Week 4 of the study. We collected baseline patient demographic and cancer related information as well as knowledge about cancer clinical trials at Week 0. Follow-up surveys were administered at Weeks 3 and 6 for both study groups. Comparisons were made within and between groups randomized to receive the book Early (at Week 1) to those who received it Later (at Week 4). Results One hundred percent of data were captured in both groups at baseline, which decreased to 77.8% by Week 6. The vast majority of participants found the book moderately or very useful (89% in the Early Group at Week 3 and 95.5% in the Late Group at Week 6). Within group pair-wise comparisons found significant difference between baseline and Week 6 in content-specific knowledge scores among participants in the Late Group (79% vs. 92.1%, p=0.01). Global knowledge scores increased significantly for variables reflecting knowledge that promotes decisions to participate in clinical trials. Conclusions Providing published reading material to patients with cancer is both feasible and acceptable. Offering information to patients about cancer clinical trials, using a book designed for patients with cancer may influence knowledge related to decision to participate in clinical trials. PMID:24127249

Feasibility, acceptability and findings from a pilot randomized controlled intervention study on the impact of a book designed to inform patients about cancer clinical trials.

PubMed

Carney, Patricia A; Tucker, Erin K; Newby, Timothy A; Beer, Tomasz M

2014-03-01

This study was conducted to assess the feasibility, acceptability, and changes in knowledge among cancer patients assigned to receive a 160-page book on experimental cancer therapies and clinical trials. We enrolled 20 patients with cancer who had never participated in a clinical trial and randomly assigned them to receive the book either during week 1 or week 4 of the study. We collected baseline patient demographic and cancer-related information as well as knowledge about cancer clinical trials at week 0. Follow-up surveys were administered at weeks 3 and 6 for both study groups. Comparisons were made within and between groups randomized to receive the book early (at week 1) to those who received it later (at week 4). One hundred percent of data were captured in both groups at baseline, which decreased to 77.8% by week 6. The vast majority of participants found the book moderately or very useful (89% in the Early Group at week 3 and 95.5% in the Late Group at week 6). Within group pairwise comparisons found significant difference between baseline and week 6 in content-specific knowledge scores among participants in the Late Group [79% versus 92.1%, p = 0.01). Global knowledge scores increased significantly for variables reflecting knowledge that promotes decisions to participate in clinical trials. Providing published reading material to patients with cancer is both feasible and acceptable. Offering information to patients about cancer clinical trials, using a book designed for patients with cancer may influence knowledge related to decision to participate in clinical trials.

Factor analysis of the Mayo-Portland Adaptability Inventory: structure and validity.

PubMed

Bohac, D L; Malec, J F; Moessner, A M

1997-07-01

Principal-components (PC) factor analysis of the Mayo-Portland Adaptability Inventory (MPAI) was conducted using a sample of outpatients (n = 189) with acquired brain injury (ABI) to evaluate whether outcome after ABI is multifactorial or unifactorial in nature. An eight-factor model was derived which explained 64-4% of the total variance. The eight factors were interpreted as representing Activities of Daily Living, Social Initiation, Cognition, Impaired-Self-awareness/Distress, Social Skills/ Support, Independence, Visuoperceptual, and Psychiatric, respectively. Validation of the Cognition factor was supported when factor scores were correlated with various neuropsychological measures. In addition, 117 patient self-rating total scores were used to evaluate the Impaired Self-awareness/Distress factor. An inverse relationship was observed, supporting this factor's ability to capture the two-dimensional phenomena of diminished self-awareness or enhanced emotional distress. A new subscale structure is suggested, that may allow greater clinical utility in understanding how ABI manifests in patients, and may provide clinicians with a better structure for implementing treatment strategies to address specific areas of impairment and disability for specific patients. Additionally, more precise measurement of treatment outcomes may be afforded by this reorganization.

Mayo's Older American Normative Studies: Separate Norms for WMS-R Logical Memory Stories.

ERIC Educational Resources Information Center

Smith, Glenn E.; Wong, Jennifer S.; Ivnik, Robert J.; Malec, James F.

1997-01-01

Norms are presented for persons ages 56 to 93 years for each story from the Logical Memory subtests of the revised edition of the Wechsler Memory Scale following the methods used for other Mayo's Older American Normative Studies. Means and standard deviations are presented for 3-year interval age groups from age 61 to 88. (SLD)

Children's E-Book Technology: Devices, Books, and Book Builder

ERIC Educational Resources Information Center

Shiratuddin, Norshuhada; Landoni, Monica

2003-01-01

This article describes a study of children's electronic books (e-books) technology. In particular, the focus is on devices used to access children's e-books, current available e-books and an e-book builder specifically for children. Three small case studies were conducted: two to evaluate how children accept the devices and one to test the ease of…

Thirty years of the Paediatric Standard Treatment Book.

PubMed

Vince, John D; Mokela, David

2006-01-01

The publication of the 8th edition of the Paediatric Standard Treatment Book 30 years after the first edition was introduced in 1975 provided an opportunity to examine the changes in the book's content and composition that have occurred over time. A detailed analysis of all editions of the book was made. The 8th edition is bigger, contains more clinical and guidance topics, and is undoubtedly more complex than the first. Health workers of different levels of training undoubtedly value the book, but there is evidence that it is frequently not used appropriately. The books form an important historical record of the changes in treatment of various clinical conditions that have been driven by alterations in antimicrobial susceptibility and by the emergence of evidence for efficacy. The current book is intricately linked with the Integrated Management of Childhood Illness and the treatments it contains are based on best evidence and practicality. Whilst there are challenges in ensuring that the information in the standard treatment book is accessible, practical and up to date, the book will continue to provide the basis for treatment of the common conditions presenting in children in the future.

The association between peripheral total IGF-1, IGFBP-3, and IGF-1/IGFBP-3 and functional and cognitive outcomes in the Mayo Clinic Study of Aging.

PubMed

Wennberg, Alexandra M V; Hagen, Clinton E; Machulda, Mary M; Hollman, John H; Roberts, Rosebud O; Knopman, David S; Petersen, Ronald C; Mielke, Michelle M

2018-06-01

Levels of insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, and their ratio in the blood may be useful for monitoring those at risk of cognitive and functional decline. However, the association between IGF measures and functional and cognitive outcomes has been mixed, and the associations may vary by sex. The present study investigated the cross-sectional, sex-specific associations between serum measures total IGF-1, IGFBP-3, and the IGF-1/IGFBP-3 ratio, gait speed, and cognition in 1320 cognitively unimpaired participants aged 50-95 years enrolled in the Mayo Clinic Study of Aging. We used multivariable linear regression models to determine the association between IGF measures and gait speed or cognitive test performance by sex. IGF measures were not associated with cognitive or functional performance among men. Among women, higher levels of log total IGF-1 and IGFBP-3 were associated with better performance in attention, visuospatial, and global cognitive domains, independent of the gait speed. These findings suggest that among women, IGF measures are associated with cognition, and these associations are independent of function. Copyright © 2018 Elsevier Inc. All rights reserved.

Clinical documentation variations and NLP system portability: a case study in asthma birth cohorts across institutions.

PubMed

Sohn, Sunghwan; Wang, Yanshan; Wi, Chung-Il; Krusemark, Elizabeth A; Ryu, Euijung; Ali, Mir H; Juhn, Young J; Liu, Hongfang

2017-11-30

To assess clinical documentation variations across health care institutions using different electronic medical record systems and investigate how they affect natural language processing (NLP) system portability. Birth cohorts from Mayo Clinic and Sanford Children's Hospital (SCH) were used in this study (n = 298 for each). Documentation variations regarding asthma between the 2 cohorts were examined in various aspects: (1) overall corpus at the word level (ie, lexical variation), (2) topics and asthma-related concepts (ie, semantic variation), and (3) clinical note types (ie, process variation). We compared those statistics and explored NLP system portability for asthma ascertainment in 2 stages: prototype and refinement. There exist notable lexical variations (word-level similarity = 0.669) and process variations (differences in major note types containing asthma-related concepts). However, semantic-level corpora were relatively homogeneous (topic similarity = 0.944, asthma-related concept similarity = 0.971). The NLP system for asthma ascertainment had an F-score of 0.937 at Mayo, and produced 0.813 (prototype) and 0.908 (refinement) when applied at SCH. The criteria for asthma ascertainment are largely dependent on asthma-related concepts. Therefore, we believe that semantic similarity is important to estimate NLP system portability. As the Mayo Clinic and SCH corpora were relatively homogeneous at a semantic level, the NLP system, developed at Mayo Clinic, was imported to SCH successfully with proper adjustments to deal with the intrinsic corpus heterogeneity. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Representations of the veterinary profession in nonfiction children's books.

PubMed

Amass, Sandra F

2011-05-01

To evaluate how the veterinary profession is represented in nonfiction children's books and determine whether representations reflect the current veterinary profession or the demographics of the United States. Survey. Covers of 46 nonfiction children's books and contents of 45 nonfiction children's books. Book covers and book contents (images and text) were evaluated for representations of veterinarians and to identify settings, clients, technology and equipment, and animals portrayed. Book contents were additionally evaluated to identify specialties and career opportunities specifically mentioned in the text. Book covers predominantly portrayed veterinarians as Caucasian women who wore examination coats, worked alone in veterinary clinics, and cared for dogs without a client present. Book contents predominantly portrayed veterinarians as a Caucasian man or woman who wore an examination coat, worked as part of a team in a veterinary clinic, and helped clients care for dogs, cats, and exotic animals. Specialties and career opportunities in the veterinary profession were mentioned in the text of 29 of 45 (64.4%) books. Nonfiction children's book covers that focused on the veterinary profession portrayed a greater percentage of women than is currently found in the profession. Similarly, books portrayed a greater percentage of Caucasians than in the current or predicted US population. With the exception of Asians, books collectively represented lower or similar percentages of underrepresented minorities, compared with the US population. Veterinarians are encouraged to select books for individual children that portray veterinarians with whom the children can identify.

Congenital malformations and genetic diseases in comic books.

PubMed

Mégarbané, A; Adib, S M

2003-01-01

Medical syndromes have often been represented in fine arts, but rarely have clinical diagnoses been discussed in comic book characters. Since their first appearance in Europe in the middle of the 19th century and in America in 1895, comic books have been considered as "the 9th art". In many comic books, the appearance and/or the behavior of central or support characters are suggestive of already well-defined medical disorders. The representation of five particular groups or clinical features: mental retardation, abnormal stature, abnormal hair, obesity, and cranial malformations is discussed from mostly European comic series. Whether comic authors intended to describe specific clinical entities while drawing their characters or whether such situations appeared by mere luck, is open to debate. In many series from the first half of the 20th century characters with remarkable clinical features were also painted as psycho-social deviants. Such stereotypes are found much less frequently nowadays. Writers of comic books, realizing the major impact of their work especially in adolescent age groups, have increasingly been using their series to actually promote issues of equity and well being for physically or mentally impaired people.

A Tale of Smoking Cessation Promotion: The Utilization of a Children's Book to Increase Screening and Counseling in the Pediatric Clinic.

PubMed

Thomas, Katharine E H; Kisely, Steve; Urrego, Fernando

2017-10-01

The rate at which pediatricians promote smoking cessation in clinical settings is low. The literature demonstrates that interventions paired with tangible health promotion materials may significantly increase screening rates to the pediatric office. The aim of this study was to investigate whether the addition of a children's book in the pediatric clinic could result in an increase in the rate in which pediatricians screened for secondhand smoke exposure (SHSe) and counseled caregivers to stop smoking. This randomized controlled study was performed at 7 pediatric clinics. Seven pediatric clinic sites were randomly assigned to either an intervention or control group. Pediatricians in the intervention group were given children's books about SHSe to distribute to their patients while the control group did not receive any materials. At baseline, there was no difference between the control group and intervention group in rates at which pediatricians screened for SHSe ( P = .8728) and counseled caregivers to stop smoking ( P = .29). After the intervention, screening for SHSe and counseling caregivers to stop smoking were statistically significantly greater in the intervention group, when compared to controls ( P < .01 and P < .001, respectively). The use of a health promotion children's book in the pediatric setting can increase the rate at which pediatricians screen for SHSe and counsel caregivers to stop smoking. Future research should examine the effect of the storybook on various parameters of smoking cessation and future smoking behaviors.

Melorheostosis: A Retrospective Clinical Analysis of 24 Patients at the Mayo Clinic.

PubMed

Smith, Gabriel C; Pingree, Matthew J; Freeman, Laura A; Matsumoto, Jane M; Howe, Benjamin M; Kannas, Stephanie N; Pyfferoen, Mary D; Struss, Leah T; Wenger, Doris E; Amrami, Kimberly K; Matsumoto, Martha; Jurisson, Mary L

2017-03-01

Current understanding of the clinical features of persons with melorheostosis is restricted primarily to individual case reports and small case series. To assess the clinical features of patients with melorheostosis treated at our institution from 1972 through 2010. Chart review. Tertiary academic medical center. Twenty-three patients with "definite" and one patient with "probable" melorheostosis based on radiographic criteria. The eligible study cohort was identified through the Rochester Medical Index database. Further diagnostic confirmation of patients with melorheostosis was performed by radiographic review. We evaluated age at first visit to our institution, gender, affected body area, number of bones affected, presenting symptoms, surgical evaluation, and therapies provided. The average age at first evaluation at our clinic was 36.5 years (median 41.5 years, range 3-68 years). The female to male ratio was 4:1. The lower extremity was most commonly affected (66.6%), followed by upper extremity (33.3%), spine (16.6%), and head (8.3%). One-third of patients had involvement of a single bone; two-thirds had multiple bone involvement. Pain was the most common presenting concern (83.3%), followed by deformity (54.1%), limitation of movement (45.8%), numbness (37.5%), and weakness (25.0%). Most patients had a physician evaluation (87.5%); patients also underwent orthopedic surgery (45.8%), physical therapy (33.3%), and occupational therapy (12.5%). Melorheostosis is a rare sclerotic bone disease resulting in pain, deformity, and dysfunction. An interdisciplinary approach to care should include nonoperative and operative evaluation, as well as appropriate therapies. A prospective approach to evaluation, including imaging and physical examinations, would provide valuable longitudinal data. IV. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Diabetes is Associated with Worse Executive Function in Both Eastern and Western Populations: Shanghai Aging Study and Mayo Clinic Study of Aging.

PubMed

Zhao, Qianhua; Roberts, Rosebud O; Ding, Ding; Cha, Ruth; Guo, Qihao; Meng, Haijiao; Luo, Jianfeng; Machulda, Mary M; Shane Pankratz, V; Wang, Bei; Christianson, Teresa J H; Aakre, Jeremiah A; Knopman, David S; Boeve, Bradley F; Hong, Zhen; Petersen, Ronald C

2015-01-01

It remains unknown whether the association between diabetes mellitus (DM) and cognitive function differs in Eastern and Western populations. This study aimed to elucidate whether DM is associated with worse cognitive performance in both populations. The Shanghai Aging Study (SAS) and the Mayo Clinic Study of Aging (MCSA) are two population-based studies with similar design and methodology in Shanghai, China and Rochester, MN, USA. Non-demented participants underwent cognitive testing, and DM was assessed from the medical record. Separate analyses were performed in SAS and MCSA regarding the association between DM and cognitive performance. A total of 3,348 Chinese participants in the SAS and 3,734 American subjects in the MCSA were included. Compared with MCSA subjects, SAS participants were younger, less educated, and had lower frequency of vascular disease, APOE ɛ4 carriers and obesity. Participants with DM (compared to non-DM participants) performed significantly worse on all the cognitive domains in both the SAS and MCSA. After adjustment for age, gender, education, and vascular covariates, DM was associated with worse performance in executive function (β=-0.15, p = 0.001 for SAS, and β=-0.10, p = 0.008 for MCSA) in the total sample and in the cognitively normal sub-sample. Furthermore, DM was associated with poor performance in visuospatial skills, language, and memory in the SAS, but not in the MCSA. Diabetes is associated with cognitive dysfunction and, in particular, exerts a negative impact on executive function regardless of race, age, and prevalence of vascular risk factors.

Demographic and clinical variables influencing gestational age at booking among South African pregnant women.

PubMed

Basu, J K; Basu, D; Jeketera, C M

2011-11-01

A retrospective record review was made of 758 women who delivered over a 2-month period at the Charlottee Maxeke Johannesburg Academic Hospital. Women booking early (up to 14 weeks) were compared with women booking late (from 15 weeks onwards). A total of 45 (6%) and 713 (94%) women booked in the early and late groups, respectively. Women of white ethnicity and women who experienced previous fetal loss booked significantly early. Primigravidae booked significantly late.

Understanding the 'Silver Book' - An important reference for standardised nomenclature in clinical laboratory sciences.

PubMed

Flatman, Robert; Férard, Georges; Dybkaer, René

2017-04-01

Clinical laboratories perform a wide menu of testing (examinations). Successful requesting, examination, and ordering in this environment requires clear standardised nomenclature. The Silver Book (SB) is an IUPAC (International Union of Pure and Applied Chemistry) publication, produced with the support of both IUPAC and the IFCC (International Federation of Clinical Chemistry and Laboratory Medicine), that makes recommendations on logical standardised nomenclature, symbols, properties, and units in many disciplines of the clinical laboratory sciences. These recommendations are founded on and in agreement with the principles and work of the International Organization for Standardization (ISO), Bureau International des Poids et Mesures (BIPM), IUPAC, and the IFCC. Practical applications described are based on those scientific principles. The SB recommendations apply to all types of examination, not only to measurement of quantities but also examination of nominal properties where no magnitude is involved. The SB is applicable not only to clinical chemistry, but to many other clinical laboratory disciplines. For examples, reports regarding haemostasis, toxicology, clinical microbiology, reproduction and fertility, clinical pharmacology, clinical allergology, clinical molecular biology, and clinical immunohaematology have been published by the IUPAC and the IFCC. Peak scientific bodies such as the IUPAC and the IFCC have important roles in the development of sound international standards for nomenclature of examinations. Such standards support safe and effective representation of patient health information, foster portability, and empower future decision support systems. Copyright © 2016. Published by Elsevier B.V.

Nursing Home Use Across The Spectrum of Cognitive Decline: Merging Mayo Clinic Study of Aging With CMS MDS Assessments.

PubMed

Emerson, Jane A; Smith, Carin Y; Long, Kirsten H; Ransom, Jeanine E; Roberts, Rosebud O; Hass, Steven L; Duhig, Amy M; Petersen, Ronald C; Leibson, Cynthia L

2017-10-01

Objective, complete estimates of nursing home (NH) use across the spectrum of cognitive decline are needed to help predict future care needs and inform economic models constructed to assess interventions to reduce care needs. Retrospective longitudinal study. Olmsted County, MN. Mayo Clinic Study of Aging participants assessed as cognitively normal (CN), mild cognitive impairment (MCI), previously unrecognized dementia, or prevalent dementia (age = 70-89 years; N = 3,545). Participants were followed in Centers for Medicare and Medicaid Services (CMS) Minimum Data Set (MDS) NH records and in Rochester Epidemiology Project provider-linked medical records for 1-year after assessment of cognition for days of observation, NH use (yes/no), NH days, NH days/days of observation, and mortality. In the year after cognition was assessed, for persons categorized as CN, MCI, previously unrecognized dementia, and prevalent dementia respectively, the percentages who died were 1.0%, 2.6%, 4.2%, 21%; the percentages with any NH use were 3.8%, 8.7%, 19%, 40%; for persons with any NH use, median NH days were 27, 38, 120, 305, and median percentages of NH days/days of observation were 7.8%, 12%, 33%, 100%. The year after assessment, among persons with prevalent dementia and any NH use, >50% were a NH resident all days of observation. Pairwise comparisons revealed that each increase in cognitive impairment category exhibited significantly higher proportions with any NH use. One-year mortality was especially high for persons with prevalent dementia and any NH use (30% vs 13% for those with no NH use); 58% of all deaths among persons with prevalent dementia occurred while a NH resident. Findings suggest reductions in NH use could result from quality alternatives to NH admission, both among persons with MCI and persons with dementia, together with suitable options for end-of-life care among persons with prevalent dementia. © 2017, Copyright the Authors Journal compilation © 2017, The

The Significance of A Neglected Romanian Book - "The Methods of the Clinical Laboratory", by Ioan Manta and Alexandru Ciplea.

PubMed

Barsu, Cristian

2017-04-06

"The Methods of Clinical Laboratory" was the first comprehensive Romanian book in the medical laboratory field, having utility in clinical practice. It was written by Prof. Ioan Manta (1900-1979) and Alexandru Ciplea (1912-1988), both from the Cluj Faculty of Medicine. The volume was published for the first time in 1944, during the refuge of this Faculty in Sibiu, and for the second time in 1947, in Cluj. Our aim is to make a brief analysis of its structure and to put into evidence the importance of this book for the Romanian laboratory medicine, some techniques (e.g. microscopic techniques) keeping their validity until today. The authors made over 800 detailed presentations about: laboratory sampling and preservation techniques, different types of tests and methods for qualitative and quantitative determinations, techniques to prepare various solutions, microbiological culture media, laboratory stains and reagents, as well as maneuvering of some laboratory equipments. For each method, Manta and Ciplea presented: the principle of working method, reagents required, the working technique, mode of calculation, the result and its interpretation. It also includes some laboratory apparatus descriptions, as well as their mode of working. With regard to the scientific value and to the practical utility of this book, it remains a very important milestone in the Romanian medical literature of the XX-th century.

Book Review: Book review

NASA Astrophysics Data System (ADS)

Manohar, C. S.

2015-02-01

The subject of the theory of vibrations has carried an aesthetic appeal to generations of engineering students for its richness of ideas, and for the intellectual challenges it offers. Also, the diverse range of its applications (covering civil, mechanical, automotive, and aerospace structures) has provided obvious motivations for its study. For most students, the subject provides, perhaps, the first encounter in substantial application of mathematical tools (differential equations, calculus of variations, Fourier/Laplace transforms, and matrix algebra) to engineering problems. The intimate relationship that the subject of mechanics has with mathematics strikes home probably for the first time. While teaching this subject, the instructor is spoilt for choice in selecting a text book and so are the students who wish to pursue a self-study of the subject. Many luminaries in the field have offered their own exposition of the subject: starting from the classics of Rayleigh, Timoshenko, Den Hartog, Bishop and Johnson, and the works of more recent vintage (e.g., the books by Meirovich, Clough, and Penzien, and works with computational flavour, such as, those by Bathe and Petyt), several works easily come to one's mind. Given this milieu, it requires a distinctive conviction to write a new book on this subject. And, here we have a book, written by a practitioner, which aims to deal with fundamental aspects of vibrations of engineering systems. The scepticism that this reviewer had on the need for having one more such book vanished as he browsed through the book and read selectively a few sections. The author's gift for elegant explanations is immediately noticeable even in such a preliminary reading. After a more careful reading, the reviewer has found this book to be insightful and he considers the book to be a welcome addition to the family of books on vibration engineering. The author has struck a fine balance between physical explanations, mathematical niceties

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. Copyright © 2015 Mayo Clinic. Published by Elsevier Inc. All rights reserved.

A basic list of recommended books and journals for support of clinical dentistry in a nondental library.

PubMed Central

Johnson, R C; Mason, F O; Sims, R H

1997-01-01

A basic list of 133 book and journal titles in dentistry is presented. The list is intended as a bibliographic selection tool for those libraries and health institutions that support clinical dentistry programs and services in the nondental school environment in the United States and Canada. The book and journal titles were selected by the membership of the Dental Section of the Medical Library Association (MLA). The Dental Section membership represents dental and other health sciences libraries and dental research institutions from the United States and Canada, as well as from other countries. The list was compiled and edited by the Ad Hoc Publications Committee of the Dental Section of MLA. The final list was reviewed and subsequently was approved for publication and distribution by the Dental Section of MLA during the section's 1996 annual meeting in Kansas City, Missouri. PMID:9285122

Adult-onset systemic Langerhans cell histiocytosis mimicking inflammatory bowel disease: the value of skin biopsy and review of cases of Langerhans cell histiocytosis with cutaneous involvement seen at the Mayo Clinic.

PubMed

Podjasek, Joshua O; Loftus, Conor G; Smyrk, Thomas C; Wieland, Carilyn N

2014-03-01

Langerhans cell histiocytosis (LCH) is frequently known to involve multiple organ systems. However, gastrointestinal involvement by LCH is rare. We describe a 68-year-old woman with a 3-year history of intermittent diarrhea initially diagnosed as inflammatory bowel disease. She was subsequently found to have systemic LCH with involvement of the gastrointestinal tract, lungs, liver, and skin after skin biopsy was performed. A retrospective review of patients with cutaneous involvement of LCH seen at the Mayo Clinic over the past 15 years was conducted. The presence of systemic disease as well as specific organ system involvement was reviewed. Twenty-four patients with cutaneous LCH were identified. Besides our case, one other patient with both gastrointestinal and cutaneous involvement was identified. This patient died at six months of age. No other adult-onset cases were identified. Gastrointestinal involvement with LCH is rare, can be easily misdiagnosed, and likely portends a poor prognosis. In patients with ill-defined systemic symptoms, cutaneous exam and biopsy have the potential to diagnose systemic disease. © 2013 The International Society of Dermatology.

Clinician time used for decision making: a best case workflow study using cardiovascular risk assessments and Ask Mayo Expert algorithmic care process models.

PubMed

North, Frederick; Fox, Samuel; Chaudhry, Rajeev

2016-07-20

Risk calculation is increasingly used in lipid management, congestive heart failure, and atrial fibrillation. The risk scores are then used for decisions about statin use, anticoagulation, and implantable defibrillator use. Calculating risks for patients and making decisions based on these risks is often done at the point of care and is an additional time burden for clinicians that can be decreased by automating the tasks and using clinical decision-making support. Using Morae Recorder software, we timed 30 healthcare providers tasked with calculating the overall risk of cardiovascular events, sudden death in heart failure, and thrombotic event risk in atrial fibrillation. Risk calculators used were the American College of Cardiology Atherosclerotic Cardiovascular Disease risk calculator (AHA-ASCVD risk), Seattle Heart Failure Model (SHFM risk), and CHA2DS2VASc. We also timed the 30 providers using Ask Mayo Expert care process models for lipid management, heart failure management, and atrial fibrillation management based on the calculated risk scores. We used the Mayo Clinic primary care panel to estimate time for calculating an entire panel risk. Mean provider times to complete the CHA2DS2VASc, AHA-ASCVD risk, and SHFM were 36, 45, and 171 s respectively. For decision making about atrial fibrillation, lipids, and heart failure, the mean times (including risk calculations) were 85, 110, and 347 s respectively. Even under best case circumstances, providers take a significant amount of time to complete risk assessments. For a complete panel of patients this can lead to hours of time required to make decisions about prescribing statins, use of anticoagulation, and medications for heart failure. Informatics solutions are needed to capture data in the medical record and serve up automatically calculated risk assessments to physicians and other providers at the point of care.

Selected list of books and journals for the small medical library.

PubMed

Brandon, A N

1967-04-01

This updated list of 388 books and 140 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing.

SELECTED LIST OF BOOKS AND JOURNALS FOR THE SMALL MEDICAL LIBRARY.

PubMed

BRANDON, A N

1965-07-01

This list of 358 books and 123 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing.

Chilkat Ceremonial Dancing Blanket - Circa 1870s.

PubMed

Wentz, Margaret R

2017-05-01

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 interpreted by the author. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Madonna della Pietá by Michelangelo.

PubMed

Wentz, Margaret R

2018-05-01

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 interpreted by the author. Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Selected List of Books and Journals for the Small Medical Library *

PubMed Central

Brandon, Alfred N.

1967-01-01

This updated list of 388 books and 140 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. PMID:6041826

Selected List of Books and Journals for the Small Medical Library

PubMed Central

Brandon, Alfred N.

1965-01-01

This list of 358 books and 123 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. PMID:14308899

Selected List of Books and Journals for the Small Medical Library

PubMed Central

Brandon, Alfred N.

2012-01-01

This list of 358 books and 123 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. PMID:23509428

Rasch Measurement Analysis of the Mayo-Portland Adaptability Inventory (MPAI-4) in a Community-Based Rehabilitation Sample

PubMed Central

Malec, James F.; Altman, Irwin M.; Swick, Shannon

2011-01-01

Abstract The precise measurement of patient outcomes depends upon clearly articulated constructs and refined clinical assessment instruments that work equally well for all subgroups within a population. This is a challenging task in those with acquired brain injury (ABI) because of the marked heterogeneity of the disorder and subsequent outcomes. Alhough essential, the iterative process of instrument refinement is often neglected. This present study was undertaken to examine validity, reliability, dimensionality and item estimate invariance of the Mayo-Portland Adaptability Inventory – 4 (MPAI-4), an outcome measure for persons with ABI. The sampled population included 603 persons with traumatic ABI participating in a home- and community-based rehabilitation program. Results indicated that the MPAI-4 is a valid, reliable measure of outcome following traumatic ABI, which measures a broad but unitary core construct of outcome after ABI. Further, the MPAI-4 is composed of items that are unbiased toward selected subgroups except where differences could be expected [e.g., more chronic traumatic brain injury (TBI) patients are better able to negotiate demands of transportation than more acute TBI patients]. We address the trade-offs between strict unidimensionality and clinical applicability in measuring outcome, and illustrate the advantages and disadvantages of applying single-parameter measurement models to broad constructs. PMID:21332409

Rasch measurement analysis of the Mayo-Portland Adaptability Inventory (MPAI-4) in a community-based rehabilitation sample.

PubMed

Kean, Jacob; Malec, James F; Altman, Irwin M; Swick, Shannon

2011-05-01

The precise measurement of patient outcomes depends upon clearly articulated constructs and refined clinical assessment instruments that work equally well for all subgroups within a population. This is a challenging task in those with acquired brain injury (ABI) because of the marked heterogeneity of the disorder and subsequent outcomes. Although essential, the iterative process of instrument refinement is often neglected. This present study was undertaken to examine validity, reliability, dimensionality and item estimate invariance of the Mayo-Portland Adaptability Inventory - 4 (MPAI-4), an outcome measure for persons with ABI. The sampled population included 603 persons with traumatic ABI participating in a home- and community-based rehabilitation program. Results indicated that the MPAI-4 is a valid, reliable measure of outcome following traumatic ABI, which measures a broad but unitary core construct of outcome after ABI. Further, the MPAI-4 is composed of items that are unbiased toward selected subgroups except where differences could be expected [e.g., more chronic traumatic brain injury (TBI) patients are better able to negotiate demands of transportation than more acute TBI patients]. We address the trade-offs between strict unidimensionality and clinical applicability in measuring outcome, and illustrate the advantages and disadvantages of applying single-parameter measurement models to broad constructs.

The Red Book through the ages.

PubMed

Pickering, Larry K; Peter, Georges; Shulman, Stanford T

2013-11-01

The first edition of the Red Book was published in 1938. Since then, there have been numerous advances in the fields of infectious diseases and public health that have decreased morbidity and mortality of infants, children, and adolescents. Over the years, emerging pathogens and disease complexes have been described, sophisticated diagnostic techniques developed, advances in antimicrobial therapy have occurred, and immunizations have been implemented to prevent previously deadly diseases. Of the 18 diseases or organisms in the 1938 edition, 13 are now vaccine-preventable. Since inception of the Red Book, the aims of the editors have been to keep pace with these innovations and to continue to inform the medical community. These goals have made the Red Book a fundamental resource for pediatricians and other health care professionals in terms of guiding diagnosis, therapy, and prevention of infectious diseases. The list of 18 diseases or organisms originally described in the 1938 Red Book has expanded to include over 160 diseases or organisms in the 2012 edition. The pace of biomedical discovery, as well as the amount of information available and the number of methods for its delivery, will continue to accelerate in the future. Integration of information into future editions of the Red Book will ensure that practitioners continue to rely on the Red Book in its various electronic formats for clinical guidance and support.

Seeing into Books: Lessons from Rare Book School

ERIC Educational Resources Information Center

Hendrickson, Lois G.

2012-01-01

Recently, the author spent a week at Rare Book School (RBS) immersed in a course entitled "Teaching the History of the Book;" an investigation into different ways of thinking about, designing, and conducting a course on the history of the book. The goal was to learn how to convert teaching and outreach experiences in rare book collections from a…

Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank.

PubMed

Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A

2015-07-03

Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the

Selected List of Books and Journals for the Small Medical Library *

PubMed Central

Brandon, Alfred N.

1969-01-01

This updated list of 398 books and 141 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. Items suggested for first purchase by smaller libraries are noted by an asterisk. PMID:4888285

Selected List of Books and Journals for the Small Medical Library *

PubMed Central

Brandon, Alfred N.

1971-01-01

This updated list of 389 books and 135 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. Items suggested for first purchase by smaller libraries are noted by an asterisk. PMID:5582092

Selected list of books and journals for the small medical library.

PubMed

Brandon, A N

1971-04-01

This updated list of 389 books and 135 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. Items suggested for first purchase by smaller libraries are noted by an asterisk.

Selected list of books and journals for the small medical library.

PubMed

Brandon, A N

1969-04-01

This updated list of 398 books and 141 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. Items suggested for first purchase by smaller libraries are noted by an asterisk.

Exploring a National Book-Gifting Scheme: Parents' and Children's Reactions

ERIC Educational Resources Information Center

Wray, David; Medwell, Jane

2015-01-01

Several early learning programmes have targeted children's reading, particularly their relationships with books. One, Bookstart, provided free books to babies attending their eighth-month health check at local clinics. Study of this programme suggested that it led to an improvement in language performance upon school entry. Booktime continues from…

The field of affectiveology at the new millennium: clinically relevant advances as reflected in books (1998-2007).

PubMed

Akiskal, Hagop

2008-04-01

This brief review summarizes what in the view of the writer represent 10 illustrative authored monographs (as contrasted to edited texts) reflecting the transition of the field of affectiveology into the new millennium. The choice of these books is meant to emphasize the breadth of our field, embracing among others normal emotional life, the clinical descriptive approach, evolutionary biology, genetics, neurobiology, and therapeutics. I may have had some penchant for the unusual--and in this sense this is a very personal list--but my intention was to highlight new developments which are shaping our field.

Teaching with Children's Books--Bi the Book

ERIC Educational Resources Information Center

Von Drasek, Lisa

2005-01-01

In this article, the author presents the bilingual books suggested by Pistu Downey, a bilingual teacher that teaches Spanish to kids ages three to six at the Bank Street College School for Children. Downey claims that reading bilingual books--books that contain words in languages other than English--gives children a very good opportunity of…

Relatively High Complication and Revision Rates of the Mayo® Metaphysical Conservative Femoral Stem in Young Patients.

PubMed

Rutenberg, Tal Frenkel; Warshevski, Yaniv; Gold, Aviram; Shasha, Nadav; Snir, Nimrod; Chechik, Ofir; Dolkart, Oleg; Eilig, Dynai; Herman, Amir; Rath, Ehud; Kramer, Moti; Drexler, Michael

2018-05-08

The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013. All patients underwent clinical assessment, radiological evaluation for the presence and development of radiolucent lines, and functional assessment (numerical analog scale, Harris hip score, and Short Form-12 questionnaire). Ninety-five hips (79 patients) were available for analysis. The patients' mean age was 43 years (range, 18-64 years), and the mean follow-up was 97 months (range, 26.9-166 months). The postoperative clinical assessments and functional assessments revealed significant improvements. Sixteen patients (20.3%) had 18 orthopedic complications, the most common of which were an intraoperative femoral fracture and implant dislocation requiring revision surgeries in 10 hips (10.5%). Radiological analysis revealed evidence of femoral remodeling in 64 (67.4%) implants, spot welds (neocortex) in 35 (36.8%), and osteolysis in 3 (3.2%). These results suggest that the conservative hip femoral implant has an unacceptable complication rate for non-elderly patients. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.

Design and validity of a clinic-based case-control study on the molecular epidemiology of lymphoma

PubMed Central

Cerhan, James R; Fredericksen, Zachary S; Wang, Alice H; Habermann, Thomas M; Kay, Neil E; Macon, William R; Cunningham, Julie M; Shanafelt, Tait D; Ansell, Stephen M; Call, Timothy G; Witzig, Thomas E; Slager, Susan L; Liebow, Mark

2011-01-01

We present the design features and implementation of a clinic-based case-control study on the molecular epidemiology of lymphoma conducted at the Mayo Clinic (Rochester, Minnesota, USA), and then assess the internal and external validity of the study. Cases were newly diagnosed lymphoma patients from Minnesota, Iowa and Wisconsin seen at Mayo and controls were patients from the same region without lymphoma who had a pre-scheduled general medical examination, frequency matched on age, sex and residence. Overall response rates were 67% for cases and 70% for controls; response rates were lower for cases and controls over age 70 years, cases with more aggressive disease, and controls from the local area, although absolute differences were modest. Cases and controls were well-balanced on age, sex, and residence characteristics. Demographic and disease characteristics of NHL cases were similar to population-based cancer registry data. Control distributions were similar to population-based data on lifestyle factors and minor allele frequencies of over 500 SNPs, although smoking rates were slightly lower. Associations with NHL in the Mayo study for smoking, alcohol use, family history of lymphoma, autoimmune disease, asthma, eczema, body mass index, and single nucleotide polymorphisms in TNF (rs1800629), LTA (rs909253), and IL10 (rs1800896) were at a magnitude consistent with estimates from pooled studies in InterLymph, with history of any allergy the only directly discordant result in the Mayo study. These data suggest that this study should have strong internal and external validity. This framework may be useful to others who are designing a similar study. PMID:21686124

Book It!

ERIC Educational Resources Information Center

Baird, Diane; Vesper, Virginia

On the Internet, one can not only buy books but also obtain information about publishers and vendors, book reviews, authors, and other book-related information. Even electronic texts are available for downloading or browsing online. The paper discusses World Wide Web sites for many book-related information needs, whether a person is searching for…

Book Repair Manual.

ERIC Educational Resources Information Center

Milevski, Robert J.

1995-01-01

This book repair manual developed for the Illinois Cooperative Conservation Program includes book structure and book problems, book repair procedures for 4 specific problems, a description of adhesive bindings, a glossary, an annotated list of 11 additional readings, book repair supplies and suppliers, and specifications for book repair kits. (LRW)

Association between an individual housing-based socioeconomic index and inconsistent self-reporting of health conditions: a prospective cohort study in the Mayo Clinic Biobank.

PubMed

Ryu, Euijung; Olson, Janet E; Juhn, Young J; Hathcock, Matthew A; Wi, Chung-Il; Cerhan, James R; Yost, Kathleen J; Takahashi, Paul Y

2018-05-14

Using surveys to collect self-reported information on health and disease is commonly used in clinical practice and epidemiological research. However, the inconsistency of self-reported information collected longitudinally in repeated surveys is not well investigated. We aimed to investigate whether a socioeconomic status based on current housing characteristics, HOUsing-based SocioEconomic Status (HOUSES) index linking current address information to real estate property data, is associated with inconsistent self-reporting. We performed a prospective cohort study using the Mayo Clinic Biobank (MCB) participants who resided in Olmsted County, Minnesota, USA, at the time of enrolment between 2009 and 2013, and were invited for a 4-year follow-up survey (n=11 717). Using repeated survey data collected at the baseline and 4 years later, the primary outcome was the inconsistency in survey results when reporting prevalent diseases, defined by reporting to have 'ever' been diagnosed with a given disease in the baseline survey but reported 'never' in the follow-up survey. Secondary outcome was the response rate for the 4-year follow-up survey. Among the MCB participants invited for the 4-year follow-up survey, 8508/11 717 (73%) responded to the survey. Forty-three per cent had at least one inconsistent self-reported disease. Lower HOUSES was associated with higher inconsistency rates, and the association remained significant after pertinent characteristics such as age and perceived general health (OR=1.46; 95% CI 1.17 to 1.84 for the lowest compared with the highest HOUSES decile). HOUSES was also associated with lower response rate for the follow-up survey (56% vs 77% for the lowest vs the highest HOUSES decile). This study demonstrates the importance of using the HOUSES index that reflects current SES when using self-reporting through repeated surveys, as the HOUSES index at baseline survey was inversely associated with inconsistent self-report and the response rate

Eight Years of the Mayo International Health Program: What an International Elective Adds to Resident Education

PubMed Central

Sawatsky, Adam P.; Rosenman, David J.; Merry, Stephen P.; McDonald, Furman S.

2010-01-01

OBJECTIVE: To examine the educational benefits of international elective rotations during graduate medical education. PARTICIPANTS AND METHODS: We studied Mayo International Health Program (MIHP) participants from April 1, 2001, through July 31, 2008. Data from the 162 resident postrotation reports were reviewed and used to quantitatively and qualitatively analyze MIHP elective experiences. Qualitative analysis of the narrative data was performed using NVivo7 (QRS International, Melbourne, Australia), a qualitative research program, and passages were coded and analyzed for trends and themes. RESULTS: During the study period, 162 residents representing 20 different specialties were awarded scholarships through the MIHP. Residents rotated in 43 countries, serving over 40,000 patients worldwide. Their reports indicated multiple educational and personal benefits, including gaining experience with a wide variety of pathology, learning to work with limited resources, developing clinical and surgical skills, participating in resident education, and experiencing new peoples and cultures. CONCLUSION: The MIHP provides the structure and funding to enable residents from a variety of specialties to participate in international electives and obtain an identifiable set of unique, valuable educational experiences likely to shape them into better physicians. Such international health electives should be encouraged in graduate medical education. PMID:20675512

Delusional infestation: clinical presentation in 147 patients seen at Mayo Clinic.

PubMed

Foster, Ashley A; Hylwa, Sara A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

2012-10-01

Delusional infestation is the conviction that one's skin is infested with foreign organisms or materials despite contradictory objective evidence. To delineate clinical characteristics of patients presenting with delusional infestation. We performed a retrospective study of patients meeting delusional infestation criteria who were seen for diagnosis and treatment in our tertiary care academic medical center (2001-2007). Medical records were reviewed to abstract demographic, historical, and physical findings and treatment. Over 7 years, 147 patients presented with delusional infestation; 87% (123/142) for another opinion. Mean age was 57 years; female-to-male ratio was 2.89 to 1; 82 (56%) were married. Mean duration of symptoms was 31 months. Employment data were available for 145 patients: 48 (33%) were self-described as disabled, 16 of whom cited delusions as their disability; 41 (28%) were retired; and 38 (26%) were employed. Reported infestations included multiple materials (45% [64/143]), not limited to insects (79% [113/143]), worms (27% [39/143]), and fibers (20% [29/143]). Most patients presented initially to dermatology or other specialties; only 3 presented to psychiatry. A high proportion (81%) had prior psychiatric conditions. Thirty-eight (26%) of the 147 patients had a shared psychotic disorder. The retrospective nature of the study and the incompleteness of some data because not all the characteristics that were analyzed were documented for every patient. Patients were predominantly female, had a long history of symptoms, and had been seen previously at many medical centers. A large proportion were disabled or retired. Patients reported skin infestation with both animate and inanimate objects. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Book a Book Fair Today! It's a Celebration!

ERIC Educational Resources Information Center

Brodie, Carolyn S.

2001-01-01

Discusses the value of book fairs to encourage reading and offers suggestions for planning them. Considers sponsorship, location and timing, sources to get books from, how to select books, marketing, library programs connected with the fair, volunteers, and who receives the profits. (LRW)

Urinary Tract Infection

MedlinePlus

... contribute to bacterial growth. By Mayo Clinic Staff . Mayo Clinic Footer Legal Conditions and Terms Any use of ... Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization and proceeds ...

The December 2012 Mayo River debris flow triggered by Super Typhoon Bopha in Mindanao, Philippines: lessons learned and questions raised

NASA Astrophysics Data System (ADS)

Rodolfo, Kelvin S.; Lagmay, A. Mahar F.; Eco, Rodrigo C.; Herrero, Tatum Miko L.; Mendoza, Jerico E.; Minimo, Likha G.; Santiago, Joy T.

2016-12-01

Category 5 Super Typhoon Bopha, the world's worst storm of 2012, formed abnormally close to the Equator, and its landfall on Mindanao set the record proximity to the Equator for its category. Its torrential rains generated an enormous debris flow in the Mayo River watershed that swept away much of the village Andap in the New Bataan municipality, burying areas under rubble as thick as 9 m and killing 566 people. Established in 1968, New Bataan had never experienced super typhoons and debris flows. This unfamiliarity compounded the death and damage. We describe Bopha's history, debris flows and the Mayo River disaster, and then we discuss how population growth contributed to the catastrophe, as well as the possibility that climate change may render other near-Equatorial areas vulnerable to hazards brought on by similar typhoons. Finally, we recommend measures to minimize the loss of life and damage to property from similar future events.

Further psychometric evaluation and revision of the Mayo-Portland Adaptability Inventory in a national sample.

PubMed

Malec, James F; Kragness, Miriam; Evans, Randall W; Finlay, Karen L; Kent, Ann; Lezak, Muriel D

2003-01-01

To evaluate the internal consistency of the Mayo-Portland Adaptability Inventory (MPAI), further refine the instrument, and provide reference data based on a large, geographically diverse sample of persons with acquired brain injury (ABI). 386 persons, most with moderate to severe ABI. Outpatient, community-based, and residential rehabilitation facilities for persons with ABI located in the United States: West, Midwest, and Southeast. Rasch, item cluster, principal components, and traditional psychometric analyses for internal consistency of MPAI data and subscales. With rescoring of rating scales for 4 items, a 29-item version of the MPAI showed satisfactory internal consistency by Rasch (Person Reliability=.88; Item Reliability=.99) and traditional psychometric indicators (Cronbach's alpha=.89). Three rationally derived subscales for Ability, Activity, and Participation demonstrated psychometric properties that were equivalent to subscales derived empirically through item cluster and factor analyses. For the 3 subscales, Person Reliability ranged from.78 to.79; Item Reliability, from.98 to.99; and Cronbach's alpha, from.76 to.83. Subscales correlated moderately (Pearson r =.49-.65) with each other and strongly with the overall scale (Pearson r=.82-.86). Outcome after ABI is represented by the unitary dimension described by the MPAI. MPAI subscales further define regions of this dimension that may be useful for evaluation of clinical cases and program evaluation.

Central Sleep Apnea - Mayo Clinic

MedlinePlus

... up Difficulty staying asleep (insomnia) Excessive daytime sleepiness (hypersomnia) Chest pain at night Difficulty concentrating Mood changes ... chronically fatigued, sleepy and irritable. Excessive daytime drowsiness (hypersomnia) may be due to other disorders, such as ...

Mayo clinic NLP system for patient smoking status identification.

PubMed

Savova, Guergana K; Ogren, Philip V; Duffy, Patrick H; Buntrock, James D; Chute, Christopher G

2008-01-01

This article describes our system entry for the 2006 I2B2 contest "Challenges in Natural Language Processing for Clinical Data" for the task of identifying the smoking status of patients. Our system makes the simplifying assumption that patient-level smoking status determination can be achieved by accurately classifying individual sentences from a patient's record. We created our system with reusable text analysis components built on the Unstructured Information Management Architecture and Weka. This reuse of code minimized the development effort related specifically to our smoking status classifier. We report precision, recall, F-score, and 95% exact confidence intervals for each metric. Recasting the classification task for the sentence level and reusing code from other text analysis projects allowed us to quickly build a classification system that performs with a system F-score of 92.64 based on held-out data tests and of 85.57 on the formal evaluation data. Our general medical natural language engine is easily adaptable to a real-world medical informatics application. Some of the limitations as applied to the use-case are negation detection and temporal resolution.

Designing Electronic Books.

ERIC Educational Resources Information Center

Barker, Philip; Manji, Karim

1991-01-01

Discussion of the design of interactive environments focuses on three types of electronic book metaphors that use optical discs and can facilitate computer-based learning: (1) static picture books, (2) moving picture books, and (3) multimedia books. Guidelines for designing electronic books are presented, and future directions are discussed. (17…

Coordinating clinic and surgery appointments to meet access service levels for elective surgery.

PubMed

Kazemian, Pooyan; Sir, Mustafa Y; Van Oyen, Mark P; Lovely, Jenna K; Larson, David W; Pasupathy, Kalyan S

2017-02-01

Providing timely access to surgery is crucial for patients with high acuity diseases like cancer. We present a methodological framework to make efficient use of scarce resources including surgeons, operating rooms, and clinic appointment slots with a goal of coordinating clinic and surgery appointments so that patients with different acuity levels can see a surgeon in the clinic and schedule their surgery within a maximum wait time target that is clinically safe for them. We propose six heuristic scheduling policies with two underlying ideas behind them: (1) proactively book a tentative surgery day along with the clinic appointment at the time an appointment request is received, and (2) intelligently space out clinic and surgery appointments such that if the patient does not need his/her surgery appointment there is sufficient time to offer it to another patient. A 2-stage stochastic discrete-event simulation approach is employed to evaluate the six scheduling policies. In the first stage of the simulation, the heuristic policies are compared in terms of the average operating room (OR) overtime per day. The second stage involves fine-tuning the most-effective policy. A case study of the division of colorectal surgery (CRS) at the Mayo Clinic confirms that all six policies outperform the current scheduling protocol by a large margin. Numerical results demonstrate that the final policy, which we refer to as Coordinated Appointment Scheduling Policy considering Indication and Resources (CASPIR), performs 52% better than the current scheduling policy in terms of the average OR overtime per day under the same access service level. In conclusion, surgical divisions desiring stratified patient urgency classes should consider using scheduling policies that take the surgical availability of surgeons, patients' demographics and indication of disease into consideration when scheduling a clinic consultation appointment. Copyright © 2016 Elsevier Inc. All rights reserved.

The white book of radiation oncology in Spain.

PubMed

Herruzo, Ismael; Romero, Jesús; Palacios, Amalia; Mañas, Ana; Samper, Pilar; Bayo, Eloísa; Guedea, Ferran

2011-06-01

The White Book of Radiation Oncology provides a comprehensive overview of the current state of the speciality of radiation oncology in Spain and is intended to be used as a reference for physicians, health care administrators and hospital managers. The present paper summarises the most relevant aspects of the book's 13 chapters in order to bring the message to a wider audience. Among the topics discussed are the epidemiology of cancer in Spain, the role of the radiation oncologist in cancer care, human and material resource needs, new technologies, training of specialists, clinical and cost management, clinical practice, quality control, radiological protection, ethics, relevant legislation, research & development, the history of radiation oncology in Spain and the origins of the Spanish Society of Radiation Oncology (SEOR).

Development of Assays for Detecting Significant Prostate Cancer Based on Molecular Alterations Associated with Cancer in Non-Neoplastic Prostate Tissue

DTIC Science & Technology

2015-10-01

with Cancer in Non-Neoplastic Prostate Tissue PRINCIPAL INVESTIGATOR: Farhad Kosari, Ph.D. CONTRACTING ORGANIZATION: Mayo Clinic Rochester, MN...E-Mail: kosari.farhad@mayo.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Mayo Clinic Rochester, MN 55905-0002 8...with the Tissue Request Acquisition Group (TRAG) at the Mayo Clinic , a process was implemented for the collection of resected prostates from

A comprehensive information technology system to support physician learning at the point of care.

PubMed

Cook, David A; Sorensen, Kristi J; Nishimura, Rick A; Ommen, Steve R; Lloyd, Farrell J

2015-01-01

MayoExpert is a multifaceted information system integrated with the electronic medical record (EMR) across Mayo Clinic's multisite health system. It was developed as a technology-based solution to manage information, standardize clinical practice, and promote and document learning in clinical contexts. Features include urgent test result notifications; models illustrating expert-approved care processes; concise, expert-approved answers to frequently asked questions (FAQs); a directory of topic-specific experts; and a portfolio for provider licensure and credentialing. The authors evaluate MayoExpert's reach, effectiveness, adoption, implementation, and maintenance. Evaluation data sources included usage statistics, user surveys, and pilot studies.As of October 2013, MayoExpert was available at 94 clinical sites in 12 states and contained 1,368 clinical topics, answers to 7,640 FAQs, and 92 care process models. In 2012, MayoExpert was accessed at least once by 2,578/3,643 (71%) staff physicians, 900/1,374 (66%) midlevel providers, and 1,728/2,291 (75%) residents and fellows. In a 2013 survey of MayoExpert users with 536 respondents, all features were highly rated (≥67% favorable). More providers reported using MayoExpert to answer questions before/after than during patient visits (68% versus 36%). During November 2012 to April 2013, MayoExpert sent 1,660 notifications of new-onset atrial fibrillation and 1,590 notifications of prolonged QT. MayoExpert has become part of routine clinical and educational operations, and its care process models now define Mayo Clinic best practices. MayoExpert's infrastructure and content will continue to expand with improved templates and content organization, new care process models, additional notifications, better EMR integration, and improved support for credentialing activities.

Book Review: Book review

NASA Astrophysics Data System (ADS)

Mishchenko, Michael I.

2017-07-01

This fundamental (and in many respects encyclopedic) 755-page monograph was published as part of the "Mario Boella Series on Electromagnetism in Information and Communication" edited by P. L. E. Uslenghi. The main purpose of the book is systematic exposition of several important aspects of the electromagnetic scattering theory along with the presentation of the requisite mathematical apparatus and illustrative numerical results. What distinguishes this volume from the vast majority of related books is the extensive treatment of the time-domain scattering theory.

Hyper-Book: A Formal Model for Electronic Books.

ERIC Educational Resources Information Center

Catenazzi, Nadia; Sommaruga, Lorenzo

1994-01-01

Presents a model for electronic books based on the paper book metaphor. Discussion includes how the book evolves under the effects of its functional components; the use and impact of the model for organizing and presenting electronic documents in the context of electronic publishing; and the possible applications of a system based on the model.…

Top-selling childbirth advice books: a discourse analysis.

PubMed

Kennedy, Holly Powell; Nardini, Katrina; McLeod-Waldo, Rebecca; Ennis, Linda

2009-12-01

Recent evidence suggests that one-third of women receive information about pregnancy and childbirth through books. Messages about what characteristics are normal (or expected) in childbirth are disseminated in a variety of ways, including popular childbirth education books, but little study of them has been conducted. The purpose of this investigation is to address that gap by examining the discussions about childbirth in the 10 top-selling books in the United States. Discourse analysis (relating to the public, personal, and political discussions about a specific phenomenon) was used to study 10 best-selling United States childbirth advice books marketed to childbearing women during the first week of November 2007. Book styles ranged from clinical descriptions of pregnancy and birth primarily offering reassurance, self-help information, and danger signs to more folksy and humorous commentaries. Presentation of scientific evidence to support recommendations was uneven and at times inaccurate. Five focal areas of discourse included body image, labor and birth, pain, power and control, and life preparation for motherhood. Top-selling books shine an interesting light on the current state of United States maternity practices. Women and health professionals should assess them carefully and engage with each other about their recommendations and implications for childbirth.

E-Books and E-Book Apps: Considerations for Beginning Readers

ERIC Educational Resources Information Center

Bates, Celeste C.; Klein, Adria; Schubert, Barbara; McGee, Lea; Anderson, Nancy; Dorn, Linda; McClure, Erin; Ross, Rachael Huber

2017-01-01

This article highlights considerations for teachers when selecting and using e-books and e-book applications (apps) with beginning readers during guided and independent reading. A framework for examining e-books and e-book apps is suggested, and several apps and related digital features are described. The article also includes an overview of…

Book Review:

NASA Astrophysics Data System (ADS)

Gregory, Ruth

2007-06-01

The study of braneworlds has been an area of intense activity over the past decade, with thousands of papers being written, and many important technical advances being made. This book focuses on a particular aspect of braneworlds, namely perturbative gravity in one specific model: the Randall-Sundrum model. The book starts with an overview of the Randall-Sundrum model, discussing anti-de Sitter (AdS) space and the Israel equations in some detail. It then moves on to discuss cosmological branes, focusing on branes with constant curvature. The book then turns to brane gravity, i.e. what do we, as brane observers, perceive the gravitational interaction to be on the brane as derived from the actual five-dimensional gravitational physics? After a derivation of the general brane equations from the Israel equations, the remainder of the book deals with perturbative gravity. This part of the book is extremely detailed, with calculations given explicitly. Overall, the book is quite pedagogical in style, with the aim being to explain in detail the topics it chooses to cover. While it is not unusual to have books written on current and extremely popular research areas, it is unusual to have calculations written so explicitly. This is both a strength and a weakness of this book. It is a strength because the calculations are presented in a detail that students learning the topic will definitely appreciate; however, the narrow focus of the book also means that it lacks perspective and fails to present the broader context. In choosing to focus on one particular aspect of Randall-Sundrum branes, the book has not managed to communicate why a large number of theorists have worked so intensively on this model. In its early stages, the explicit detail of the Randall-Sundrum model would be extremely useful for a student starting out in this research area. In addition, the calculational detail later in the computation of the graviton propagator on the brane would also be welcome not

A Review of Two Distance Learning Books [book review].

ERIC Educational Resources Information Center

Koszalka, Tiffany A.; Spector, J. Michael

2003-01-01

Reviews two books that are representative of the substantive books aimed at those who wish to design effective distance learning. Together these books provide a reasonably complete perspective on how to design effective distance learning. They have many strengths, and few weaknesses. (SLD)

Selected List of Books and Journals for the Small Medical Library *

PubMed Central

Brandon, Alfred N.

1973-01-01

This updated list of 410 books and 136 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. Items suggested for first purchase by smaller libraries are noted by an asterisk. To purchase the entire collection of books and to pay for the annual subscription costs of all the journals would require an expenditure of about $12,000. To acquire only those items suggested for first purchase, approximately $3,250 would be needed. PMID:4702804

Selected list of books and journals for the small medical library.

PubMed

Brandon, A N

1973-04-01

This updated list of 410 books and 136 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. Items suggested for first purchase by smaller libraries are noted by an asterisk. To purchase the entire collection of books and to pay for the annual subscription costs of all the journals would require an expenditure of about $12,000. To acquire only those items suggested for first purchase, approximately $3,250 would be needed.

Best Books 1982.

ERIC Educational Resources Information Center

School Library Journal, 1982

1982-01-01

This annotated bibliography lists 45 children's books and 29 young adult books selected by School Library Journal's Book Review staff and Young Adult Review committee, respectively. Arrangement is alphabetical by author with the grade level indicated for children's books. (EJS)

Media Type Influences Preschooler's Literacy Development: E-Book versus Printed Book Reading

ERIC Educational Resources Information Center

Kozminsky, Ely; Asher-Sadon, Revital

2013-01-01

Traditionally, children's books are in a printed format and shared book reading is done with an adult. In recent years, interactive E-books have become a common medium for children's books and shared book reading is diminishing. This study compared the contribution of book format to the development of literacy in kindergarten children. We…

Breast Biopsy

MedlinePlus

... time If your biopsy will be done using magnetic resonance imaging (MRI), tell your doctor if you ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Mini-Stroke vs. Regular Stroke: What's the Difference?

MedlinePlus

... may need various diagnostic tests, such as a magnetic resonance imaging (MRI) scan or a computerized tomography ( ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Tailbone Pain: How Can I Relieve It?

MedlinePlus

... any other conditions. Your doctor might recommend using magnetic resonance imaging (MRI) to find out if you ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Vagus Nerve Stimulation

MedlinePlus

... before you have any medical tests, such as magnetic resonance imaging (MRI), which might interfere with your ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Breast Lump: Early Evaluation Is Essential

MedlinePlus

... is solid or filled with fluid. MRI. A magnetic field and radio waves create detailed images of ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

MRI: Is Gadolinium Safe for People with Kidney Problems?

MedlinePlus

... M.D. It depends on the type of magnetic resonance imaging (MRI) scan you're scheduled to ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Biopsy: Types of Biopsy Procedures Used to Diagnose Cancer

MedlinePlus

... procedure — such as X-ray, computerized tomography (CT), magnetic resonance imaging (MRI) or ultrasound — with a needle ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Phantom Pain

MedlinePlus

... cord and brain. During imaging scans — such as magnetic resonance imaging (MRI) or positron emission tomography (PET) — ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Medication Errors: Cut Your Risk with These Tips

MedlinePlus

... program. Reporting to MedWatch is easy, confidential and secure — and it can help save others from being ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Legibility difference between e-books and paper books by using an eye tracker.

PubMed

Kim, Jung-Yong; Min, Seung-Nam; Subramaniyam, Murali; Cho, Young-Jin

2014-01-01

The aim of the study was to evaluate the difference in legibility between e-books and paper books by using an eye tracker. Eight male and eight female subjects free of eye disease participated in the experiment. The experiment was conducted using a 2 × 3 within-subject design. The book type (e-book, paper book) and font size (8 pt, 10 pt, 12 pt) were independent variables, and fixation duration time, saccade length, blink rate and subjective discomfort were dependent variables. In the results, all dependent variables showed that reading paper books provided a better experience than reading e-books did. These results indicate that the legibility of e-books needs further improvement, considering fixation duration time, saccade movement, eye fatigue, device and so on. This study evaluated the legibility difference between e-books and paper books from the viewpoint of readability, eye fatigue and subjective discomfort by using an eye tracker. The results showed that paper books provided a better experience than e-books. This indicates that the readability of e-books needs further improvement in relation to paper books.

Book Review: Book review

NASA Astrophysics Data System (ADS)

Wegener, Daan

Writing a biography of a complex personality and mastermind like Albert Einstein is a daunting task for any historian of science. Yet the sheer temptation of writing his biography has apparently helped to overcome scholarly scruples, as biographies of Einstein have appeared quite regularly on the market. One of them is Einstein: his Life and Universe by journalist Walter Isaacson. It is a best-seller, which is one of the reasons the book deserves a critical evaluation. Isaacson is a man of considerable repute: he has been the chairman of CNN and managing editor of Time magazine. Isaacson's Einstein is written in a style that is accessible to a wide audience. Scholars who are already familiar with Einstein's physics may still enjoy the parts of the book that deal with the relation between Einstein and the press. Indeed, the breadth of its scope is the book's major merit, as it connects the personal, scientific, public and political dimensions of Einstein's life. In this review, I discuss Isaacson's treatment of these dimensions one-by-one.

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.

From the Popcorn Book to Popcorn!: Multigenre Children's Books

ERIC Educational Resources Information Center

Danielson, Kathy Everts; Harrington, Jeanne

2005-01-01

Multigenre texts are a recent trend in children's books. These types of books can enhance students' comprehension and provide models of various types of writing genres. They can be used in differentiating instruction and increasing fluency when transformed into readers' theater texts. Many examples of multigenre books are provided in this article.

Book Review: Book review

NASA Astrophysics Data System (ADS)

Clevers, Jan G. P. W.

2016-09-01

For many years a good introductory book for undergraduate and postgraduate students on remote sensing of the Earth's land surface, which was not starting with an emphasis on traditional photographic techniques, was missing. In 2010 the first edition of the book Fundamentals of Satellite Remote Sensing by Emilio Chuvieco and Alfredo Huete was published by CRC Press and it was filling this gap. Now the second edition by Emilio Chuvieco was published by CRC Press. This second edition is made more attractive by the use of colour and including colour illustrations instead of the black-and-white ones in the first edition.

Write-Headed Books.

ERIC Educational Resources Information Center

Ohanian, Susan

1998-01-01

Notes that emphasis on the writing process has produced books on the subject of students as authors. Discusses several recent books with that theme. Suggests that teachers can encourage kids to become writers by finding books that will "knock their socks off" instead of books that promote propaganda about writing as a process. Provides…

Mayo-Portland adaptability inventory: comparing psychometrics in cerebrovascular accident to traumatic brain injury.

PubMed

Malec, James F; Kean, Jacob; Altman, Irwin M; Swick, Shannon

2012-12-01

(1) To evaluate the measurement reliability and construct validity of the Mayo-Portland Adaptability Inventory, 4th revision (MPAI-4) in a sample consisting exclusively of patients with cerebrovascular accident (CVA) using single parameter (Rasch) item-response methods; (2) to examine the differential item functioning (DIF) by sex within the CVA population; and (3) to examine DIF and differential test functioning (DTF) across traumatic brain injury (TBI) and CVA samples. Retrospective psychometric analysis of rating scale data. Home- and community-based brain injury rehabilitation program. Individuals post-CVA (n=861) and individuals with TBI (n=603). Not applicable. MPAI-4. Item data on admission to community-based rehabilitation were submitted to Rasch, DIF, and DTF analyses. The final calibration in the CVA sample revealed satisfactory reliability/separation for persons (.91/3.16) and items (1.00/23.64). DIF showed that items for pain, anger, audition, and memory were associated with higher levels of disability for CVA than TBI patients; whereas, self-care, mobility, and use of hands indicated greater overall disability for TBI patients. DTF analyses showed a high degree of association between the 2 sets of items (R=.92; R(2)=.85) and, at most, a 3.7 point difference in raw scores. The MPAI-4 demonstrates satisfactory psychometric properties for use with individuals with CVA applying for interdisciplinary posthospital rehabilitation. DIF reveals clinically meaningful differences between CVA and TBI groups that should be considered in results at the item and subscale level. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Vedolizumab induction therapy for inflammatory bowel disease in clinical practice--a nationwide consecutive German cohort study.

PubMed

Baumgart, D C; Bokemeyer, B; Drabik, A; Stallmach, A; Schreiber, S

2016-05-01

Vedolizumab (VDZ) is a humanised monoclonal IgG1 antibody targeting α4 β7 integrin. To investigate the real-world efficacy of vedolizumab for the treatment of Crohn's disease (CD) and ulcerative colitis (UC). A consecutive cohort of 212 adult IBD patients with active disease (HBI >7/partial Mayo >4) newly receiving VDZ was prospectively recruited from 7 academic and 17 community centres. The primary endpoint was clinical remission (CRM) (CD HBI ≤4, UC pMayo ≤1) in week 14. Secondary endpoints included steroid-free remission (SFCRM), clinical response (CRS) (HBI/pMayo score drop ≥3), vedolizumab impact on CRP, calprotectin and haemoglobin. Data of 97 CD (71.1% female, HBI 11) and 115 UC (42.6% female, pMayo 6) patients were analysed. Only 5.2% CD and 24.3% UC were anti-TNFα naïve. Most had extensive mucosal involvement (Montreal L3 69.1%/E3 53.9%). At week 14, 23.7% vs. 23.5% of CD vs. UC patients achieved CRM, 19.6% vs. 19.1% SFCRM and 60.8% vs. 57.4% CRS, respectively (all based on NRI). Week 14 CRM in CD was significantly associated with no history of extraintestinal manifestations (P = 0.019), no prior adalimumab use (P = 0.011), no hospitalisation in the past 12 months (P = 0.015) and low HBI score (P = 0.02) and in UC with active or previous smoking (P = 0.044/0.028) and no anti-TNFα (P = 0.023) use. Low HBI (P = 0.019) and no hospitalisation in the past 12 months (P = 0.01) predict CD CRM. The three most common AE were joint pain, acne and nasopharyngitis. Vedolizumab is effective in routine use. © 2016 John Wiley & Sons Ltd.

Astronomical Book Trek: Astronomy Books of 1983.

ERIC Educational Resources Information Center

Fraknoi, Andrew

1984-01-01

Presents an annotated list of technical and non-technical astronomy books. Topic areas of non-technical books include general astronomy, amateur astronomy, computers and astronomy, history of astronomy, pseudoscience, space exploration, physics and astronomy, and textbooks. Each entry includes author, title, description, source, and current cost.…

Books from the Past: An E-Books Project at Culturenet Cymru

ERIC Educational Resources Information Center

Haarhoff, Leith

2005-01-01

Purpose: To describe the open-source solution developed by Culturenet Cymru, for the Welsh Books Council, for presenting digitised books and other printed material online. Design/methodology/approach: The challenges faced in the implementation of a pilot e-book collection of nine out-of-print books is described. Findings: The adoption of a number…

Results of intraoperative electron beam radiotherapy containing multimodality treatment for locally unresectable T4 rectal cancer: a pooled analysis of the Mayo Clinic Rochester and Catharina Hospital Eindhoven

PubMed Central

Holman, Fabian A.; Haddock, Michael G.; Gunderson, Leonard L.; Kusters, Miranda; Nieuwenhuijzen, Grard A. P.; van den Berg, Hetty A.; Nelson, Heidi

2016-01-01

Background The aim of this study is to analyse the pooled results of intraoperative electron beam radiotherapy (IOERT) containing multimodality treatment of locally advanced T4 rectal cancer, initially unresectable for cure, from the Mayo Clinic, Rochester, USA (MCR) and Catharina Hospital, Eindhoven, The Netherlands (CHE), both major referral centers for locally advanced rectal cancer. A rectal tumor is called locally unresectable for cure if after full clinical work-up infiltration into the surrounding structures or organs has been demonstrated, which would result in positive surgical margins if resection was the initial component of treatment. This was the reason to refer these patients to the IOERT program of one of the centers. Methods In the period from 1981 to 2010, 417 patients with locally unresectable T4 rectal carcinomas at initial presentation were treated with multimodality treatment including IOERT at either one of the two centres. The preferred treatment approach was preoperative (chemo) radiation and intended radical surgery combined with IOERT. Risk factors for local recurrence (LR), cancer specific survival, disease free survival and distant metastases (DM) were assessed. Results A total of 306 patients (73%) underwent a R0 resection. LRs and metastases occurred more frequently after an R1-2 resection (P<0.001 and P<0.001 respectively). Preoperative chemoradiation (preop CRT) was associated with a higher probability of having a R0 resection. Waiting time after preoperative treatment was inversely related with the chance of developing a LR, especially after R+ resection. In 16% of all cases a LR developed. Five-year disease free survival and overall survival (OS) were 55% and 56% respectively. Conclusions An acceptable survival can be achieved in treatment of patients with initially unresectable T4 rectal cancer with combined modality therapy that includes preop CRT and IOERT. Completeness of the resection is the most important predictive and

Making Books Irresistible: Ways to Bring Kids, Books, and Teacher Together.

ERIC Educational Resources Information Center

Kenney, Donald J.

The major way teachers can motivate students to read is to be avid readers themselves. They need to read current young adult books to keep up with frequently changing trends. Preparing short book lists and giving book talks are other effective ways of encouraging students to read. Teachers might use a number of activities in place of book reports…

Book Review: Book review

NASA Astrophysics Data System (ADS)

Wang, Christina Yan

2017-02-01

The world class Ni-Cu-PGE sulfide deposits associated with the Sudbury Igneous Complex (SIC) are quite unique on earth in the sense that the energy source and origin were triggered by a large meteorite impact event. The ore deposits in the SIC make up one of the largest Ni-Cu-PGE sulfide deposit camps in the world and have now been mined for over 100 years. This is the first complete reference book that focuses entirely on the SIC and covers the fields of economic geology, petrology, geochemistry and geophysics. The purpose of this book is to explore the linkage between sulfide and silicate magmas generated by the 1.85 Ga Sudbury impact event and to unite an understanding of the process of crustal melt sheet evolution with the formation of the magmatic sulfide mineralization. The author, Peter Lightfoot, has been based in Sudbury for 25 years. As a top scientist on magmatic Ni-Cu-PGE sulfide deposits and a Chief Geologist with the Brownfield Exploration group at Vale Base Metals, Peter has been positioned to develop and assemble the ideas presented in this book, which are perfectly balanced between industry and academia.

Expectancy of an open-book test decreases performance on a delayed closed-book test.

PubMed

Agarwal, Pooja K; Roediger, Henry L

2011-11-01

Two experiments examined the influence of practice with, and the expectancy of, open-book tests (students viewed studied material while taking the test) versus closed-book tests (students completed the test without viewing the studied material) on delayed retention and transfer. Using GRE materials specifically designed for open-book testing, participants studied passages and then took initial open- or closed-book tests. Open-book testing led to better initial performance than closed-book testing, but on a delayed criterial (closed-book) test both types of testing produced similar retention after a two-day delay in Experiment 1. In Experiment 2 participants were informed in advance about the type of delayed criterial test to expect (open- or closed-book). Expecting an open-book test (relative to a closed-book test) decreased participants' time spent studying and their delayed test performance on closed-book comprehension and transfer tests, demonstrating that test expectancy can influence long-term learning. Expectancy of open-book tests may impair long-term retention and transfer compared to closed-book tests, despite superior initial performance on open-book tests and students' preference for open-book tests.

Discis Books: Interactive Computer Books for Children.

ERIC Educational Resources Information Center

TechTrends, 1990

1990-01-01

Describes children's books available on CD-ROM that can be read using Apple Macintosh computers. Literacy problems with adults and children are discussed, the use of Discis books to encourage reading and improve understanding is described, first- and second-language learning is discussed, and a list of currently available titles is provided. (LRW)

Comparison of MMPI Scores of Drug Abusers and Mayo Clinic Normative Groups.

ERIC Educational Resources Information Center

Patalano, Frank

1980-01-01

Compared MMPIs of 80 male and 80 female drug abusers with MMPIs of 550 male and 695 female medical patients. Male drug abusers obtained significantly higher scores than male medical patients on all clinical scales. Female drug abusers obtained significantly higher scores than female medical patients on seven scales. (Author)

Best Books of 1977

ERIC Educational Resources Information Center

Gerhardt, Lillian N.; And Others

1977-01-01

School Library Journal book review editors have selected and annotated their choices for the best children's and young adults' books from those books that were submitted for review during 1977 by general book trade book publishers. Included in the annotations are: author, title, publisher, price, and recommended reading and interest levels. (JPF)

Swiss cheese striatum: clinical implications.

PubMed

Burnett, Melinda S; Witte, Robert J; Ahlskog, J Eric

2014-06-01

Markedly enlarged Virchow-Robin spaces throughout the striatum appear occasionally on magnetic resonance imaging (MRI) scans of the elderly, and this type of striatum is known as the Swiss cheese striatum (SCS); however, its clinical impact is unknown. To determine the clinical features associated with SCS detected on MRI scans. A blinded, retrospective case-control study using medical records from 2000 to 2007 obtained from an MRI database at the Mayo Clinic in Rochester, Minnesota, of residents 40 years of age or older of Olmsted County, Minnesota, who had extensive Mayo Clinic medical records and MRI reports suggestive of SCS. Cases with a severe form of SCS (n = 27) were randomly selected for comparison with age-, sex-, and examination year-matched controls (n = 52) with a minimal form of SCS or no SCS. Magnetic resonance imaging. Associations of clinical and imaging features with the presence of a severe form of SCS. Medical records were reviewed for clinical features such as parkinsonism, dementia, and vascular risk factors. The MRI scans were visually scored for degree of leukoaraiosis, central atrophy, and cortical atrophy. No significant differences were found between those with a severe form of SCS and controls in rates of parkinsonism (19% vs 17%; odds ratio, 1.09 [95% CI, 0.28-4.16]) or dementia of any type (30% vs 21%; odds ratio, 1.57 [95% CI, 0.48-5.13]). Vascular risk factors were not significantly different between groups. Swiss cheese striatum correlated with degree of leukoaraiosis (P < .001). Potential associations with visualized cortical atrophy (P = .01), nonobstructive urinary incontinence (18.5% vs 3.9%; P = .04), and syncope (37% vs 9.6%; P = .01) did not hold up after correction for the false discovery rate. Our study suggests that marked cribriform change in the striatum was not associated with the development of extrapyramidal clinical disorders, including parkinsonism. The association of SCS with leukoaraiosis

Books as Culture/Books as Commerce: An Analysis of the Text and Format of the "New York Times Book Review."

ERIC Educational Resources Information Center

Haugland, Ann

The oldest of the mass communication technologies, books, needs to be examined in mass communication research. Accordingly a study analyzed the structure and format of the "New York Times Book Review" to identify its dual roles: evaluating books and providing information crucial to book marketing. Also explored was how the text of the…

Comparing Safari Tech Books Online and Books24x7 E-Book Collections: A Case Study from the University of British Columbia Library

ERIC Educational Resources Information Center

Barsky, Eugene; Schattman, Lisa; Greenwood, Aleteia

2009-01-01

Most academic libraries are seeking to provide electronic access to the very dynamic and changing field of technology related material. "Safari Tech Books Online" and "Books24x7" are the major e-book collections in this area. We compared the "Safari Tech Books Online" and "Books24x7" e-book packages as to…

By the Book: An Annotated Bibliography of Music-Based Picture Books.

ERIC Educational Resources Information Center

Sotherden, Emily

2002-01-01

Provides an annotated bibliography of music related picture books that can be used in the music classroom. Discusses the benefits of using picture books for all ages. Includes books in ten categories, such as instruments, ensembles, and styles of music. (CMK)

Libros Bilingues, Traducciones y Libros Recomendables. (Bilingual Books, Translations and Recommended Books in Spanish.)

ERIC Educational Resources Information Center

Taylor, Jose G., Comp.

Citing 123 books published between 1960 and 1977, this bibliography is divided into 3 main categories: (1) books with Spanish and English text, (2) translations of books also available in English, and (3) recommended books in Spanish. The first two sections concentrate on books for use in grades K-3. The final section includes books for older…

Outstanding Science Trade Books for Students K-12 (Books Published in 2009)

ERIC Educational Resources Information Center

Science Teacher, 2010

2010-01-01

What makes an outstanding book for a young reader? Although it would be hard to create a rubric for every book, experienced teachers recognize them quickly. They fascinate and captivate with both their content and style. Award-winning trade books inspire young readers to want more... more information, more books, more inquiry, more science. The…

Idiopathic Systemic Capillary Leak Syndrome (Clarkson's Disease): The Mayo Clinic Experience

PubMed Central

Kapoor, Prashant; Greipp, Patricia T.; Schaefer, Eric W.; Mandrekar, Sumithra J.; Kamal, Arif H.; Gonzalez-Paz, Natalia C.; Kumar, Shaji; Greipp, Philip R.

2010-01-01

OBJECTIVE: To determine clinical features, natural history, and outcome of a well-defined cohort of 25 consecutive patients with idiopathic systemic capillary leak syndrome (SCLS) evaluated at a tertiary care center. PATIENTS AND METHODS: Records of patients diagnosed as having SCLS from November 1, 1981, through April 30, 2008, were reviewed. Descriptive statistics were used to analyze patient demographics, clinical features, complications, and therapeutic interventions. RESULTS: Of the 34 patients whose records were reviewed, 25 fulfilled all diagnostic criteria for SCLS. The median age at diagnosis of SCLS was 44 years. Median follow-up of surviving patients was 4.9 years, and median time to diagnosis from symptom onset was 1.1 years (interquartile range, 0.5-4.1 years). Flulike illness or myalgia was reported by 14 patients (56%) at onset of an acute attack of SCLS, and rhabdomyolysis developed in 9 patients (36%). Patients with a greater decrease in albumin level had a higher likelihood of developing rhabdomyolysis (p=.03). Monoclonal gammopathy, predominantly of the IgG-κ type, was found in 19 patients (76%). The progression rate to multiple myeloma was 0.7% per person-year of follow-up. The overall response rate to the different therapies was 76%, and 24% of patients sustained durable (>2 years) complete remission. The estimated 5-year overall survival rate was 76% (95% confidence interval, 59%-97%). CONCLUSION: Systemic capillary leak syndrome, a rare disease that occurs in those of middle age, is usually diagnosed after a considerable delay from onset of symptoms. The degree of albumin decrement during an attack correlates with development of rhabdomyolysis. A reduction in the frequency and/or the severity of attacks was seen in nearly three-fourths of patients who were offered empirical therapies. The rate of progression to multiple myeloma appears to be comparable to that of monoclonal gammopathy of undetermined significance. PMID:20634497

Mothers' Complex Talk When Sharing Books with Their Toddlers: Book Genre Matters

ERIC Educational Resources Information Center

Nyhout, Angela; O'Neill, Daniela K.

2013-01-01

This study investigated the influence of book genre (narrative or didactic) on mothers' language use during a book sharing interaction with their 18- to 25-month-olds. Mother-child dyads were videotaped sharing both a narrative and a didactic book, adapted from two commercially available books, and matched in terms of length, quantity of text, and…

Books on acoustics

NASA Astrophysics Data System (ADS)

Shaw, Neil A.

2004-05-01

The legacy of a man is not limited to just his projects. His writings in many cases are a more lasting, and a definitely more accessible, monument. For 60 years, Leo L. Beranek has produced books on acoustics, acoustic measurements, sound control, music and architecture, noise and vibration control, concert halls, and opera houses in addition to teaching and consulting. His books are standard references and still cited in other books and in technical and professional articles. Many of his books were among, if not, the first comprehensive modern treatment of the subject and many are still foremost. A review of Dr. Beranek's many books as well as some anecdotes about the circumstances and consequences of same will be presented.

Book Preservation

NASA Technical Reports Server (NTRS)

1980-01-01

Books produced since 1850, held in the Library of Congress, have a very high acid content, hence a shorter life expectancy than prior-published volumes. A means of "deacidifying" books on a large, economically-viable scale is of great interest, particularly to the research library community, which stores millions of valuable, often irreplaceable documents. The General Electric vacuum chamber used in deacidification tests serves a dual purpose. It creates an environment in which DEZ can do its job without presence of oxygen and also dries the books. After the drying phase, DEZ is introduced to the chamber as a paper-penetrating vapor. The complete process typically takes eight days, four days for vacuum drying and four days of book exposure to DEZ. Accelerated aging tests showed that the process can extend paper life almost fourfold, even on color illustrations.

Give a Book, Take a Book | Poster

Cancer.gov

Collection has begun for the 15th Annual Book & Media Swap sponsored by the Scientific Library. NCI at Frederick staff can use this opportunity to clear out personal book and DVD shelves of unwanted materials, donate them to the swap, and then receive “new” materials in return. The library staff will collect materials through Tuesday, Oct. 27. Kick-off day for the event is

Book Trade Research and Statistics.

ERIC Educational Resources Information Center

Sullivan, Sharon G.; Ink, Gary; Grabois, Andrew; Barr, Catherine

2001-01-01

Includes six articles that discuss research and statistics relating to the book trade. Topics include prices of U.S. and foreign materials; book title output and average prices; book sales statistics; book exports and imports; book outlets in the U.S. and Canada; and books and other media reviewed. (LRW)

Patient-Reported Outcome Measures for Use in Clinical Trials and Clinical Practice in Inflammatory Bowel Diseases: A Systematic Review.

PubMed

de Jong, Marin J; Huibregtse, Roxanne; Masclee, Ad A M; Jonkers, Daisy M A E; Pierik, Marie J

2018-05-01

Mucosal inflammation must be carefully monitored to improve the long-term outcomes of patients with inflammatory bowel diseases (IBD). Patient-reported outcome measures (PROMs) are used increasingly to monitor disease activity in clinical practice and as endpoints in clinical trials. We performed a systematic review to provide an overview of the available PROMs on IBD activity and to evaluate their diagnostic value. A systematic search of the PubMed, Medline, Cochrane library, and Embase databases using defined keywords, identified 973 articles. These were screened by 2 independent reviewers, and 37 articles on development or validation of PROMs to assess IBD activity were identified for further analysis. Based on the recommendations of the Food and Drug Administration (FDA), the following measurement properties were evaluated: content, construct, and criterion validity; reliability; and responsiveness to change. In addition, data on ease of use in clinical practice were collected. Seventeen articles presenting 20 different PROMs were included the final analysis, although none met all the FDA-recommended criteria. Only 2 PROMs (patient-reported Harvey Bradshaw Index and Simple Clinical Colitis Activity Index scores) reported patient involvement during its development. Only 6 PROMs (patient-reported global assessment, patient assessment of disease activity, mobile health index for Crohn's disease, mobile health index for ulcerative colitis, patient-reported outcome derived from the Mayo score, and the 6-point Mayo score) were validated as markers of IBD activity, using findings from endoscopy as the reference standard; these PROMs identified patients with mucosal inflammation with area under the curve values of 0.63-0.82. The mobile health index for CD and UC scores had the best measurement properties for use in clinical practice and in clinical trials. In a systematic review, we identified more than 20 PROMS that have been developed and tested for their ability to

The Aztec, Frida Kahlo, and Cinco de Mayo: Mexico in Children's Literature

ERIC Educational Resources Information Center

Bauml, Michelle; Field, Sherry L.

2012-01-01

The authors provide an overview of children's books published in the United States during the last decade (2000-2010) that deal with Mexico and Mexican people. Suggested guidelines for selecting quality books and a list of award-winning titles are included as resources for teaching about Mexico. (Contains 2 tables and 4 figures.)

A Comprehensive Book on Autism Spectrum Disorders

ERIC Educational Resources Information Center

Mohammadi, Mohammad-Reza, Ed.

2011-01-01

The aim of the book is to serve for clinical, practical, basic and scholarly practices. In twentyfive chapters it covers the most important topics related to Autism Spectrum Disorders in the efficient way and aims to be useful for health professionals in training or clinicians seeking an update. Different people with autism can have very different…

Writing a book review.

PubMed

Bryson, David; Hudson, Robert

2017-04-01

Book reviews are a good way to get started with writing for a journal and this Learning and CPD activity takes you through the process of understanding the aims of book review, undertaking practice pieces through to reviewing a book and advice on the dos and don'ts of book reviewing.

Book Review: Book review

NASA Astrophysics Data System (ADS)

Martínez, Alberto A.

The title Einstein's Generation immediately suggests names such as Ehrenfest, Ritz, Kaufmann, Born, Laue, and Laub. Staley's book discusses these individuals, but it actually has a broader scope. Both the title and the subtitle are not quite appropriate. A much more fitting title would be Michelson, Electrons, and the Rise of "Modern" Physics. The emphasis on Albert Michelson is evident in the Index: almost four columns on him, compared to just one and a half on Einstein. Likewise, "Einstein's generation" includes, for Staley, many other physicists who were quite older than Einstein, such as Lorentz, Planck, Poincaré, and Minkowski. The book exhibits a composite character because it includes and expands upon four articles that Staley had published earlier on Michelson, relativity, and the co-creation of modern and classical physics. Hence the book is partly a bridging work; it ambitiously connects areas in the history of physics, from the 1880s until 1911. Staley identifies how diverse interests produced crossfertilization, and how various disciplinary boundaries were crossed. He wants to discuss material culture, experiment, and theory, all on the same footing. Every page of the introduction seems to quadruple the scope; he writes about individuals and communities, consolidation and diversification, power and weakness, memory and neglect, the cultural and the material, the classical and the modern, and the absolute and the relative.

Scan This Book!

ERIC Educational Resources Information Center

Albanese, Andrew Richard

2007-01-01

In this article, the author presents an interview with Brewster Kahle, leader of the Open Content Alliance (OCA). OCA book scan program is an alternative to Google's library project that aims to make books accessible online. In this interview, Kahle discusses his views on the challenges of getting books on the Web, on Google's library…

Animation Augmented Reality Book Model (AAR Book Model) to Enhance Teamwork

ERIC Educational Resources Information Center

Chujitarom, Wannaporn; Piriyasurawong, Pallop

2017-01-01

This study aims to synthesize an Animation Augmented Reality Book Model (AAR Book Model) to enhance teamwork and to assess the AAR Book Model to enhance teamwork. Samples are five specialists that consist of one animation specialist, two communication and information technology specialists, and two teaching model design specialists, selected by…

Electronic Books.

ERIC Educational Resources Information Center

Barker, Philip; Giller, Susan

1992-01-01

Classifies types of electronic books: archival, informational, instructional, and interrogational; evaluates five commercially, available examples and two in-house examples; and describes software tools for creating and delivering electronic books. Identifies crucial design considerations: interactive end-user interfaces; use of hypermedia;…

Design reflowable digital book template

NASA Astrophysics Data System (ADS)

Prasetya, Didik Dwi; Widiyaningtyas, Triyanna; Arifin, M. Zainal; Wahyu Sakti G., I.

2017-09-01

Electronic books (e-books or digital books) increasingly in demand and continue to grow in the form of future books. One of the standard format electronic books that potential is EPUB (electronic publication) published by the International Digital Publishing Forum (IDPF). This digital book has major advantages are able to provide interactive and reflowable content, which are not found in another book format, such as PDF. Reflowable content allows the book can be accessed through a variety of reader device, like desktop and mobile with a fit and comfort view. However, because the generating process of an EPUB digital book is not as easy a PDF, so this format is less popular. Therefore, in order to help overcome the existing problems, this paper develops digital reflowable text book templates to support electronic learning, especially in Indonesia. This template can be used by anyone to produce a standard digital book quickly and easily without requiring additional specialized knowledge.

Writing Children's Books.

ERIC Educational Resources Information Center

Children's Book Council, New York, NY.

This pamphlet briefly answers some of the questions concerning the writing and publishing of children's books. What the writer needs to know, special techniques, how to submit a manuscript, what happens to a manuscript at a publishing house, and a listing of our books that may be useful for writers of children's books are discussed. (DB)

Food Production, Management, and Services. Reference Book [and] Student Activity Book.

ERIC Educational Resources Information Center

Texas Tech Univ., Lubbock. Curriculum Center for Family and Consumer Sciences.

This student activity book and reference book, which are part of a family and consumer sciences education series focusing on a broad range of employment opportunities, are intended for use in one- and two-year food production, management, and services programs for Texas high school students. The reference book provides information needed by…

[Clinical features of idiopathic restless legs syndrome in Japanese patients].

PubMed

Kume, Akito; Kume, Hideaki

2010-06-01

Little is known about the diagnosis and management of restless legs syndrome (RLS) in Japanese neurology clinics. To validate the diagnostic criteria of the International RLS Study Group (IRLSSG) and the treatment algorithm of the Mayo Clinic in a Japanese neurology clinic setting and to clarify the features of Japanese patients with idiopathic RLS. Patients with RLS symptoms were examined by a neurologist and the assessment included neurological examination, tests for periodic limb movements (PLM) and dopaminergic response, and the clinical diagnosis was made according to IRLSSG diagnostic criteria. Patients diagnosed with idiopathic RLS were treated with dopaminergic agents and the efficacy was evaluated. The study subjects were 151 Japanese patients who presented with RLS symptoms. Idiopathic RLS was diagnosed in 113 patients, secondary RLS in 16 and RLS mimics in 22. The cause of RLS mimics was either myelopathy, radiculopathy or neuropathy in 11 patients. The mean age of patients with idiopathic RLS was 50.1 (SD 20.0) years, 63% were woman, 97% had daily RLS, 31% had family history (40% of the early-onset subgroup), 86% reported unpleasant sensations in the lower legs, 43% had PLM in the daytime suggested immobilization test, 81% suffered from insomnia, 49% had limitations of work and activities, 71% reported impaired mood, 27% had consulted physicians about their symptoms, 4% had been diagnosed with RLS, 73% improved after dopaminergic treatments, and 33% experienced complete remission. The clinical features of Japanese patients with idiopathic RLS were identical to those reported in western countries, which suggests that IRLSSG diagnostic criteria and Mayo Clinic treatment algorism are valid in Japanese neurology clinics. Both patients and physicians were not fully aware of RLS in this country. Neurological examination was important in excluding RLS mimics and making a diagnosis of RLS.

[Version and compilation of Harikyuuhousouyou of Vietnamese medical book].

PubMed

Du, Fengjuan; Xiao, Yongzhi

2018-02-12

Harikyuuhousouyou （《》）was written in 1827 and the author is unknown. The book has only one version which is collected by the National Library of Vietnam. The book contains one volume and includes contraindication of acupuncture and moxibustion, meridian points, point locations, indications and the therapeutic methods at extraordinary points. They are mainly cited from Zhen Jiu Da Quan (《》 Great Compendium on Acupuncture and Moxibustion ) by XU Feng , Yi Xue Ru Men (《》 Elementary Medicine ) by LI Chan and Shou Shi Bao Yuan (《》 Longevity and Health Preservation ) by GONG Tingxian in the Ming Dynasty. In the paper, in view of the characteristics of version and compilation, the hand-coped book was introduced. It was explored that Vietnam acupuncture absorbed Chinese medicine and emphasized clinical practice rather than theoretic statement.

Mayo Clinic Approach to Minority Achievement.

ERIC Educational Resources Information Center

Sang, Herb A.

1987-01-01

Describes Duval County Public Schools' (Jacksonville, Florida) approach to addressing causes and symptoms of academic underachievement by Blacks and disadvantaged students. The project involved establishing a baseline testing program, observing symptoms, and treating underachievement problems by prescribing lifestyle changes and establishing a…

Children's Books in Review: Books on Strengthening Family Ties.

ERIC Educational Resources Information Center

Winfield, Evelyn T.

1991-01-01

Reviews children's books that emphasize the strengthening of family ties. Characters in the books realize the importance and influence of family relationships as they struggle with sibling rivalry, self-discovery, peer relationships, a search for heritage, adoption, and death. (SM)

Animals, Kids & Books: A Guide for Putting Humane Books into the Hands of Children.

ERIC Educational Resources Information Center

Freedman, Barbara

This guide for choosing humane children's books (i.e., books in which animals are not eaten, expolited, or treated with cruelty) presents reviews of over 100 books for children up to age 7. Both subtle and blatant examples of animal exploitation portrayed in children's picture books are examined. Reviews are grouped into 3 categories: kind books,…

Book Trade Research and Statistics.

ERIC Educational Resources Information Center

Bosch, Stephen; Ink, Gary; Greco, Albert N.

1999-01-01

Presents: "Prices of United States and Foreign Published Materials"; "Book Title Output and Average Prices"; "Book Sales Statistics, 1998"; "United States Book Exports and Imports: 1998"; "International Book Title Output: 1990-96"; "Number of Book Outlets in the United States and Canada";…

The Role of Book Familiarity and Book Type on Mothers' Reading Strategies and Toddlers' Responsiveness

ERIC Educational Resources Information Center

Fletcher, Kathryn L.; Finch, W. Holmes

2015-01-01

The purpose of the current study was to examine how maternal reading strategies and book type would impact on toddlers' responsiveness as they became familiar with three books. Eleven mothers and their 2- to 3-year-olds were recorded reading the same set of three different books (i.e. word book, narrative book and no narrative book) on four…

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.

Children's Books in Review. Books That Give Cultural Insights.

ERIC Educational Resources Information Center

Winfield, Evelyn T.

1992-01-01

Presents a selection of children's books that feature a variety of topics and literary representations with insight into other cultures. The books focus on foods, historical events, reliance on the environment, folktales, family experiences, community heritage, words and phrases, and linguistic eccentricities. (SM)

Building the Foundation of Acceptance Book by Book: Lesbian, Gay, Bisexual, and/or Transgender-Themed Books for Grades K-5 Multicultural Libraries

ERIC Educational Resources Information Center

Knoblauch, Dee

2016-01-01

This article is an analysis of picture books and chapter books involving lesbian, gay, bisexual, and/or transgender characters. Over 30 picture and chapter books were reviewed, each of which would be appropriate for use in elementary classrooms. For grades K-2, several picture books highlight different types of families, including families that…

Book Trade Research and Statistics.

ERIC Educational Resources Information Center

Alexander, Adrian W.; And Others

1994-01-01

The six articles in this section examine prices of U.S. and foreign materials; book title output and average prices; book sales statistics; U.S. book exports and imports; number of book outlets in the United States and Canada; and book review media statistics. (LRW)

Book Reviews.

ERIC Educational Resources Information Center

Powicke, J. C.; And Others

1986-01-01

Reviews of 10 recent books and one new journal ("Catalyst: A Journal of Policy Debate") are provided. Topics of the books reviewed include: economics in modern Britain, world economics, the mixed economy, Milton Friedman's thought, British industry, economic issues, and London as a financial center. (JDH)

Cassette Books.

ERIC Educational Resources Information Center

Library of Congress, Washington, DC. National Library Service for the Blind and Physically Handicapped.

This catalog lists cassette books produced by the National Library Service for the Blind and Physically Handicapped during 1989. Books are listed alphabetically within subject categories under nonfiction and fiction headings. Nonfiction categories include: animals and wildlife, the arts, bestsellers, biography, blindness and physical handicaps,…

The Continuous Quality Improvement Book Club: Developing a Book Club to Promote Praxis

ERIC Educational Resources Information Center

Lyons, Becky; Ray, Chris

2014-01-01

This article poses a model for developing a book club to promote praxis. This model is built upon a basic four step framework for developing book clubs and includes specific recommendations to focus the book club on reflection of theory and how to incorporate it into practice. This model will be used to start a book club examining Continuous…

Comparability of Mayo-Portland Adaptability Inventory ratings by staff, significant others and people with acquired brain injury.

PubMed

Malec, James F

2004-06-01

To determine the internal consistency, reliability and comparability of the Mayo-Portland Adaptability Inventory (MPAI-4) and sub-scales completed by people with acquired brain injury (ABI), family and significant others (SO) and rehabilitation staff. 134 people with ABI consecutively seen for outpatient rehabilitation evaluation. MPAI-4 protocols based on independent ratings by the people with ABI undergoing evaluation, SO and rehabilitation staff were submitted to Rasch Facets analysis to determine the internal consistency of the overall measure and sub-scales (Ability, Adjustment and Participation indices) for each rater group and for a composite measure based on all rater groups. Rater agreement for individual items was also examined. Rasch indicators of internal consistency were entirely within acceptable limits for 3-rater composite full scale and sub-scale measures; these indicators were generally within acceptable limits for measures based on a single rater group. Item agreement was generally acceptable; disagreements suggested various sources of bias for specific rater groups. The MPAI-4 possesses satisfactory internal consistency regardless of rating source. A composite measure based on ratings made independently by people with ABI, SO and staff may serve as a 'gold standard' for research purposes. In the clinical setting, assessment of varying perspectives and biases may not only best represent outcome as evaluated by all parties involved but be essential to developing effective rehabilitation plans.

The Impact of Myriad and Mayo: Will Advancements in the Biological Sciences Be Spurred or Disincentivized? (Or Was Biotech Patenting Not Complicated Enough?)

PubMed Central

Gordon, Jennifer

2015-01-01

For years, purified and isolated naturally occurring biological substances of great medical importance—including genes—have been the subject of U.S. patents. Similarly, methods in which the detection of a biological substance (e.g., in a blood sample) dictates subsequent actions, as in disease diagnostics and treatment, have long enjoyed patent protection. However, two recent Supreme Court cases, Association for Molecular Pathology v. Myriad Genetics, Inc. (133 S. Ct. 2107) (2013) and Mayo Collaborative Services v. Prometheus Laboratories, Inc. (132 S. Ct. 1289) (2012), have shaken up the status quo of biotech patenting. The highest court in our land unanimously agreed with patent challengers that much of what we took for granted as patentable subject matter is not, as a matter of law, eligible for patenting after all. This review discusses the Myriad and Mayo cases, their impact on which biology-based innovations we may or may not continue to patent, and whether the altered status quo is benignly corrective or gravely disruptive. Is what happened here a good thing or not? PMID:25502748

Progressive supranuclear palsy: neuropathologically based diagnostic clinical criteria.

PubMed Central

Collins, S J; Ahlskog, J E; Parisi, J E; Maraganore, D M

1995-01-01

All cases examined postmortem at the Mayo Clinic that met the classic neuropathological criteria for progressive supranuclear palsy (PSP) were identified for retrospective clinical analyses. The necropsy material was re-examined by a second neuropathologist to confirm the pathological diagnosis of PSP, yielding 12 cases. A range of clinical signs were documented in these patients, with numerous findings beyond those noted in the original descriptions of this disorder. Atypical clinical findings included absence of supranuclear gaze palsy (two cases), prominent asymmetry (two), arm dystonia (two), upper limb apraxia (two), myoclonus (two), chorea (one), eyelid opening apraxia (one), and respiratory disturbance (one). A definite clinical diagnosis of PSP had been made during life in only eight of the 12 patients. From the retrospective analysis of these 12 cases, a set of clinical criteria were developed for the premortem diagnosis of PSP emphasising differences from other akinetic-rigid disorders. PMID:7876846

The Comic Book Project

ERIC Educational Resources Information Center

Lopate, Phillip

1976-01-01

Describes the work and preparation--as well as the student response-- that went into the Comic Book Club in an elementary school which resulted in a student developed comic book and comic book fair. (HOD)

Professional Books.

ERIC Educational Resources Information Center

Gilstrap, Robert L.

1994-01-01

Reviews five books: "Garbage Pizza, Patchwork Quilts and Math Magic" (Ohanian), about elementary math instruction; "Ready for What?" (Graue), on school readiness; "The Braid of Literature: Children's Worlds of Reading" (Wolf and Heath); "The Best Years of Their Lives" (Zvirin), a book of resources for teenagers; and "Teaching and Learning in the…

Libraries, Patrons, and E-Books

ERIC Educational Resources Information Center

Zickuhr, Kathryn; Rainie, Lee; Purcell, Kristen; Madden, Mary; Brenner, Joanna

2012-01-01

This report explores the world of e-books and libraries, where libraries fit into these book-consumption patterns of Americans, when people choose to borrow their books and when they choose to buy books. It examines the potential frustrations e-book borrowers can encounter when checking out digital titles, such as long wait lists and compatibility…

Literacy through the Book Arts.

ERIC Educational Resources Information Center

Johnson, Paul

This book, a guide for adults to help children create their own original and creative books, demonstrates how constructing (writing and editing) their own books can be an engaging and highly educational experience for children. The book uses simple, easy-to-follow instructions to demonstrate how scores of different book forms can be made from a…

Outstanding Science Trade Books for Children for 1999: Books Published in 1998.

ERIC Educational Resources Information Center

Science and Children, 1999

1999-01-01

Presents those books that were selected as outstanding children's science trade books published in 1998 for elementary (K-8) students. Annotated bibliography entries list publication information, a brief description of the work, and the National Science Education Standards to which the book relates. Entries are classified under the categories of…

Book Longevity. Reports of the Committee on Production Guidelines for Book Longevity.

ERIC Educational Resources Information Center

Bailey, Herbert S., Jr.; And Others

In 1979, a Committee on Production Guidelines for Book Longevity was formed to study some aspects of the book preservation problem. Composed of representatives from libraries, publishing, and the paper industry, the committee set two primary objectives: to increase knowledge about the durability of books and other materials, and to encourage…

Book Development in Bangladesh.

ERIC Educational Resources Information Center

Rabbi, Fazle

1982-01-01

Describes the historical development of book production in Bangladesh and discusses the situation in Bangladesh with regard to the economics of publishing, the relationship between publishing and library development, book distribution, copyright and translation, and book experts. (Author/JL)

A Banquet of Books. An Assortment of Engrossing Books for All Ages and Reading Levels.

ERIC Educational Resources Information Center

Manitoba Dept. of Education, Winnipeg.

The books listed in this annotated bibligraphy have been selected to assist teachers, librarians, and other interested persons in choosing books for reluctant readers. The books present a wide range of high interest material which is not always at a low reading level. Books are listed in three categories: picture books, intended mostly for use…

Books on biotechnology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The books selected for this review could serve to establish or strengthen the background of the chemical engineer who seeks to enter the field of biotechnology, which is described as a field linking three different branches of science - microbiology, biochemistry and engineering. Nineteen books on biotechnology under the headings Science, Genetic Engineering, Biochemical Engineering, Biomass Energy, Directories and sourcebook are reviewed and titles of five other books received too late for comment given.

Views on Science Books.

ERIC Educational Resources Information Center

Stubbs, Harry C.

1979-01-01

Reviews six new children's science books. Five of the reviewed books deal separately with the topics of the space shuttle project, cosmology and stellar evolution, space, forest fires, and the electromagnetic spectrum; one is a book of geography puzzles. (GT)

A Different Kind of Book Club.

ERIC Educational Resources Information Center

Lesperance, Gerald

2002-01-01

Describes one teacher's experiences developing a book group for students in his suburban New York high school. Rather than attending required meetings, students read any book they chose and submitted book reviews on a book club bulletin board. For each book completed, students received a free book and eligibility to attend book club sponsored…

Platelet-rich plasma versus corticosteroid injection for recalcitrant lateral epicondylitis: clinical and ultrasonographic evaluation.

PubMed

Gautam, V K; Verma, Saurabh; Batra, Sahil; Bhatnagar, Nidhi; Arora, Sumit

2015-04-01

To evaluate the clinical and ultrasonographic changes in the morphology and vascularity of the common extensor tendon after injecting platelet-rich plasma (PRP) or corticosteroid (CS) for recalcitrant lateral epicondylitis (LE). 30 patients aged 18 to 60 years with recalcitrant (>6 months) LE not responsive to oral medication or non-invasive treatment were randomised to receive PRP (n=15) or CS (n=15) injection. Patients were assessed using the visual analogue scale (VAS) for pain, Disabilities of the Arm, Shoulder and Hand Scale (DASH) score, Oxford Elbow Score, modified Mayo Clinic performance index for the elbow (modified Mayo score), and hand grip strength. Ultrasonography was performed by a musculoskeletal ultrasonologist to evaluate for tear at the common extensor origin, oedema at the common extensor origin, cortical erosion, probe-induced tenderness, and thickness of the tendon. The VAS for pain, DASH score, Oxford Elbow Score, modified Mayo score, and hand grip strength all improved significantly from pre-injection to the 6-month follow-up in the PRP and CS groups. However, in the CS group, the scores generally peaked at 3 months and then deteriorated slightly at 6 months indicating recurrence of symptoms, which involved 46.7% of the CS patients. At 6 months, the number of patients positive for various ulrasonographic findings generally decreased. However, in the CS group, the number of patients with reduced thickness of the common extensor tendon increased from 2 to 12, and the number of patients with cortical erosion at the lateral epicondyle increased from 9 to 11. PRP appeared to enable biological healing of the lesion, whereas CS appeared to provide short-term, symptomatic relief but resulted in tendon degeneration.

Which Book and Why: Using Book Bands and Book Levels for Guided Reading in Key Stage 1 [Includes CD-ROM

ERIC Educational Resources Information Center

Bodman, Sue, Ed.; Franklin, Glen, Ed.

2014-01-01

We want all children to love reading, and Which Book and Why demonstrates how effective guided reading for children in Foundation Stage and Key Stage 1 can help teachers make this happen. Balancing theory and practice, this book explores how schools and teachers can implement guided reading more confidently and more effectively. Which Book and Why…

What clinical information resources are available in family physicians' offices?

PubMed

Ely, J W; Levy, B T; Hartz, A

1999-02-01

When faced with questions about patient care, family physicians usually turn to books in their personal libraries for the answers. The resources in these libraries have not been adequately characterized. We recorded the titles of all medical books in the personal libraries of 103 randomly selected family physicians in eastern Iowa. We also noted all clinical information that was posted on walls, bulletin boards, refrigerators, and so forth. Participants were asked to describe their use of other resources such as computers, MEDLINE, reprint files, and "peripheral brains" (personal notebooks of clinical information). For each physician, we recorded how often the resources were used to answer clinical questions during 2 half-day observation periods. The 103 participants owned a total of 5794 medical books, with 2836 different titles. Each physician kept an average of 56 books in the office. Prescribing references (especially the Physicians' Desk Reference) were most common (owned by 100% of the participants), followed by books on general internal medicine (99%), adult infectious disease (89%), and general pediatrics (83%). Books used to answer clinical questions were more likely to be up to date (copyright date within 5 years) than unused books (74% vs 27%, P <.001). Items posted on walls included drug dosage charts and pediatric immunization schedules. Only 26% of the physicians had computers in their offices. Drug-prescribing textbooks were the most common type of book in family physicians' offices, followed by books on general internal medicine and adult infectious diseases. Although many books were relatively old, those used to answer clinical questions were generally current.

Book Review: Book review

NASA Astrophysics Data System (ADS)

van der Linden, Sebastian

2016-05-01

Compiling a good book on urban remote sensing is probably as hard as the research in this disciplinary field itself. Urban areas comprise various environments and show high heterogeneity in many respects, they are highly dynamic in time and space and at the same time of greatest influence on connected and even tele-connected regions due to their great economic importance. Urban remote sensing is therefore of great importance, yet as manifold as its study area: mapping urban areas (or sub-categories thereof) plays an important (and challenging) role in land use and land cover (change) monitoring; the analysis of urban green and forests is by itself a specialization of ecological remote sensing; urban climatology asks for spatially and temporally highly resolved remote sensing products; the detection of artificial objects is not only a common and important remote sensing application but also a typical benchmark for image analysis techniques, etc. Urban analyses are performed with all available spaceborne sensor types and at the same time they are one of the most relevant fields for airborne remote sensing. Several books on urban remote sensing have been published during the past 10 years, each taking a different perspective. The book Global Urban Monitoring and Assessment through Earth Observation is motivated by the objectives of the Global Urban Observation and Information Task (SB-04) in the GEOSS (Global Earth Observation System of Systems) 2012-2015 workplan (compare Chapter 2) and wants to highlight the global aspects of state-of-the-art urban remote sensing.

The Book of Luck.

ERIC Educational Resources Information Center

Young, Carol

2002-01-01

Describes an art project that focused on the supernatural in which students create their own "Book Of Luck" using plastic videocassette containers. Discusses how each student created a book and the types of things that were included in the book. Includes examples. (CMK)

A Study on Reading Printed Books or E-Books: Reasons for Student-Teachers Preferences

ERIC Educational Resources Information Center

Tosun, Nilgun

2014-01-01

This study tried to determine the preferences of student-teachers on reading printed books or e-books and the reasons for these preferences. Reading printed books and e-books preferences of students are discussed in terms of gender and department variables. 258 student-teachers who are studying in Computer Education and Instructional Technologies…

Give a Book, Take a Book | Poster

Cancer.gov

Collection has begun for the 15th Annual Book & Media Swap sponsored by the Scientific Library. NCI at Frederick staff can use this opportunity to clear out personal book and DVD shelves of unwanted materials, donate them to the swap, and then receive “new” materials in return. The library staff will collect materials through Tuesday, Oct. 27. Kick-off day for the event is Wednesday, Oct. 28, 10 a.m. to 2 p.m., in the lobby of the Conference Center in Building 549.

Expanding the Boundaries of Shared Book Reading: E-Books and Printed Books in Parent-Child Reading as Support for Children's Language

ERIC Educational Resources Information Center

Korat, Ofra; Shamir, Adina; Heibal, Shani

2013-01-01

Early shared book reading activities are considered to be a promising context for supporting young children's language development. Ninety low socioeconomic status preschoolers and their mothers were randomly assigned to one of three groups: (1) e-book reading; (2) printed book reading; (3) regular kindergarten literacy program (control). Mothers…

The Comic Book as Course Book: Why and How.

ERIC Educational Resources Information Center

Williams, Neil

This paper describes how comic books are used as instructional materials in an intensive English-as-a-Second-Language (ESL) course and discusses the rationale for using them. The students in the course have low-intermediate English language skills with limited discourse and interactive competence. Comic books are used because they are authentic,…

Diabetes Prevention: 5 Tips for Taking Control

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Infant Reflux: Diagnosis and Treatment

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Bone Metastasis

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Pubic Lice (Crabs)

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Milia

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Byetta, Victoza, Bydureon: Diabetes Drugs and Weight Loss

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Epiglottitis

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Antidepressants: Another Weapon Against Chronic Pain

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Premenstrual Syndrome (PMS)

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Orchitis

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Crying Baby? How to Keep Your Cool

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Fibromyalgia Symptoms or Not? Understand the Fibromyalgia Diagnosis Process

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Motion Sickness: First Aid

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Bladder Outlet Obstruction: Causes in Men?

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Fallopian Tubes: Is Pregnancy Possible with Only One?

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Bent Penis

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Abortions: Does It Affect Subsequent Pregnancies?

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Fainting: First Aid

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Shift Work: Improving Daytime Sleep

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Pneumothorax

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Cancer Diagnosis: 11 Tips for Coping

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Canker Sore

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First-Aid Kits: Stock Supplies That Can Save Lives

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Lipoma

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Non-Hodgkin's Lymphoma

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Cold Sore

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Nail Fungus

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Cough

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Sick Baby? When to Seek Medical Attention

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Ruptured Spleen

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Croup

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Hodgkin's Lymphoma

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Cardiac Asthma: What Causes It?

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Toothache: First Aid

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Sty

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Infant Choking: How to Keep Your Baby Safe

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Enlarged Spleen (Splenomegaly)

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Fetal Macrosomia

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Female Condom

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Erectile Dysfunction: Viagra and Other Oral Medications

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Cervical Cerclage

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Limited Scleroderma (CREST Syndrome)

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Forceps Delivery

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Livedo Reticularis: When Is It a Concern?

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Addison's Disease: Treatment

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Hypothyroidism: Can It Cause Peripheral Neuropathy?

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Rh Factor Blood Test

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Adult Health: Worried About Empty Nest Syndrome?

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Teen Eating Disorders: Tips to Protect Your Teen

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Essure

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Parenting Tips: How to Improve Toddler Behavior

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Prostate Biopsy

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Pap Smear: Do I Need One If I'm a Virgin?

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Mindfulness Exercises: How to Get Started

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PSA Test: What's It for?

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Children's Nutrition: Tips for Picky Eaters

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Percent Daily Value: What Does It Mean?

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Is Ear Candling a Safe Way to Remove Earwax?

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Hand Swelling during Exercise: A Concern?

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Zinc for Colds: The Final Word?

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Yeast Infection during Pregnancy

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Abdominal Pain

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Otoplasty (Cosmetic Ear Surgery)

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Split Fingernails: Can They Be Prevented?

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Hypochondria

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Addison's Disease: Symptoms and Causes

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Intracranial hematoma

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Getting Past a Weight-Loss Plateau

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Broken Arm

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Migraine Medications and Antidepressants: A Risky Mix?

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Wrist Blood Pressure Monitors: Are They Accurate?

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Heat Rash (Prickly Heat or Miliaria)

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Acute Myelogenous Leukemia (AML)

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Managing Diabetes: Looking Beyond Carbs

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Water Breaking: Understand This Sign of Labor

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Contraceptive Sponge

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Sudden Infant Death Syndrome (SIDS)

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Mouth Sores Caused by Cancer Treatment: How to Cope

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Diverticulitis Diet: Can Certain Foods Trigger an Attack?

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Fasting Diet: Can It Improve My Heart Health?

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Diet After Gallbladder Removal

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Can Weight Loss Reduce the Need for Blood Pressure Medication?

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Pregnancy Acne: What's the Best Treatment?

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Tubal Ligation Reversal

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Thumb Sucking: Help Your Child Break the Habit

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Breast Lift (Mastopexy)

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Nail Biting: Does It Cause Long-Term Damage?

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Hypoxemia (Low Blood Oxygen)

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Biophysical Profile

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Bipolar Treatment: Are Bipolar I and Bipolar II Treated Differently?

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What's the Difference Between Vocal Cord Dysfunction and Asthma?

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Infant Reflux: Symptoms and Causes

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Antidepressants: Can They Lose Effectiveness?

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Atkins Diet: What's Behind the Claims?

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Electrical Shock: First Aid

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STD Testing: What's Right for You

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Antidepressants: Get Tips to Cope with Side Effects

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Tubal Ligation

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Blood Pressure: Is It Affected by Cold Weather?

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Fear of Public Speaking: How Can I Overcome It?

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What Causes a Pseudoaneurysm? Should a Pseudoaneurysm Always be Treated?

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Cervical Cap

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Exercising with Osteoporosis: Stay Active the Safe Way

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Are Chicken Eggs Good or Bad for My Cholesterol?

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Dermatographia

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Low White Blood Cell Count

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Lichen Sclerosus

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Women's Health: The Biggest Threats to Women's Health are often Preventable.

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Men's Health: Prevent the Top Threats

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MAOIs and Diet: Is It Necessary to Restrict Tyramine?

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Gas and Gas Pains

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Alcoholic Hepatitis

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Blood Pressure Test

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Alcohol: Does It Affect Blood Pressure?

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Monoamine Oxidase Inhibitors (MAOIs)

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Cancer Fatigue: Why It Occurs and How to Cope

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Beta Blockers

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Alpha Blockers

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Krabbe Disease

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Mitral Valve Stenosis

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Peanut Allergy

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Achilles Tendinitis

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Coenzyme Q10: Can It Prevent Statin Side Effects?

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Shortness of Breath

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Fainting during Urination (Micturition Syncope): What Causes It?

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Sore Throat: Diagnosis and Treatment

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Throat Cancer

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Kidney Cancer

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Cancer Survivors: Managing Your Emotions After Cancer Treatment

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Caring for the Elderly: Dealing with Resistance

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Bee Stings

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Is Acute Bronchitis Contagious?

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Vaccines for Adults: Which Do You Need?

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Nighttime Headaches: How Can I Get Relief?

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Thunderclap Headaches

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Brain AVM (Arteriovenous Malformation)

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Norovirus Infection

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Snoring

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Asthma Attack

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Factitious Disorder

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Post-Concussion Syndrome

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Limit Asthma Attacks Caused by Colds or Flu

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Prenatal Yoga: What You Need to Know

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Foot Swelling during Air Travel: A Concern?

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Nonulcer Stomach Pain

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Appendicitis

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Gallbladder Cleanse: A "Natural" Remedy for Gallstones?

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Pregorexia: A Legitimate Problem during Pregnancy?

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End of Life (Caring for a Dying Loved One)

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Foreign Object in the Ear: First Aid

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Spinal Headaches

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Oral Lichen Planus

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Earwax Blockage

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Cosmetic Surgery: What to Know Beforehand

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Recurrent Breast Cancer

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Left Ventricular Hypertrophy

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Cutting Edge Books: The Impact of Digital Books on Public Library Acquisitions

ERIC Educational Resources Information Center

Taylor, Lisa

2008-01-01

The book has made the transition to the digital age; that much is certain. However, the jury is still out on what form or forms the book of the future will take and how libraries will adapt. This article is a look at the impact of digital books on public library acquisitions, including available formats, purchasing considerations, functional…

Psychometric properties of the Mayo Elbow Performance Score.

PubMed

Celik, Derya

2015-06-01

To translate and culturally adapt the Mayo Elbow Performance Score (MEPS), a widely used instrument for evaluating disability associated with elbow injuries, into Turkish (MEPS-T) and to determine psychometric properties of the translated version. The MEPS was translated into Turkish using published methodological guidelines. The measurement properties of the MEPS-T (construct validity and floor and ceiling effects) were tested in 91 patients with elbow pathology. The reproducibility of the MEPS-T was tested in 59 patients over 7-14 days. The responsiveness of the MEPS-T was tested in a subgroup of 46 patients diagnosed with lateral epicondylitis and who received conservative treatment for 6 weeks. The interclass correlation coefficient (ICC) was used to estimate the test-retest reliability. The construct validity was analyzed with the disabilities of the arm, shoulder and hand (DASH), Visual Analog Scale (VAS) and the Short Form 36 (SF-36). Effect size (ES) was used to assess the responsiveness. The distribution of floor and ceiling effects was determined. The MEPS-T showed very good test-retest reliability (ICC 0.89). The correlation coefficients between the MEPS-T and DASH and VAS were -0.61 and -0.53, respectively (p < 0.001). The highest correlations were between the MEPS-T and the mental component summary (r = 0.47, p = 0.001) and role emotional (r = 0.45, p = 0.001). The MEPS-T ES, 0.50, was moderate (95% CI 0.33-0.62). We observed no ceiling or floor effects. The MEPS-T represents a valid, reliable and moderately responsive instrument for evaluating patients with elbow disease.

Book Review

NASA Astrophysics Data System (ADS)

Bokulich, Alisa

In recent years, there has been a growing resurgence of interest in the philosophical views of the founders of quantum mechanics. Kristian Camilleri's book on Werner Heisenberg's philosophy of quantum mechanics is a welcome addition to this literature. It takes Heisenberg seriously as a philosopher of science, traces the various philosophical influences on his view, and carefully distinguishes his interpretation of quantum mechanics from that of his contemporaries. It is a fine example of the new insights that can emerge when one takes an integrated approach to the history and philosophy of science. After summarizing some of the main themes of the book, I will turn to two moderate criticisms of the book-one stylistic, and the other, regarding its content.

Mayo's Older African Americans Normative Studies: norms for Boston Naming Test, Controlled Oral Word Association, Category Fluency, Animal Naming, Token Test, WRAT-3 Reading, Trail Making Test, Stroop Test, and Judgment of Line Orientation.

PubMed

Lucas, John A; Ivnik, Robert J; Smith, Glenn E; Ferman, Tanis J; Willis, Floyd B; Petersen, Ronald C; Graff-Radford, Neill R

2005-06-01

Normative data for older African Americans are presented for several clinical neuropsychological measures, including Boston Naming Test, Controlled Oral Word Association, Category Fluency, Token Test, WRAT-3 Reading, Trail Making Test, Stroop Color and Word Test, and Judgment of Line Orientation. Age-adjusted norms were derived from a sample of 309 cognitively normal, community-dwelling individuals, aged 56 through 94, participating in Mayo's Older African Americans Normative Studies (MOAANS). Years of education were modelled on age-scaled scores to derive regression Equations that may be applied for further demographic correction. These data should enhance interpretation of individual test performances and facilitate analysis of neuropsychological profile patterns in older African American patients who present for dementia evaluations.

Current Status of Biomedical Book Reviewing: Part IV. Major American and British Biomedical Book Publishers

PubMed Central

Chen, Ching-chih

1974-01-01

This is the fourth part of a comprehensive, quantitative study of biomedical book reviews. The data base of the total project was built from statistics of 3,347 reviews of 2,067 biomedical books taken from all 1970 issues of fifty-four reviewing journals. This part of the study identifies the major American and British biomedical book publishers in terms of their quantitative production of book titles reviewed, and determines the relationships among these publishers. It is found that Williams & Wilkins, Charles C Thomas, Academic Press, and Springer Verlag are the most productive biomedical book publishers in terms of books reviewed in 1970. These four publishers accounted for 32% of the 1,674 books available in the United States and reviewed in the reviewing media in 1970. Williams & Wilkins is especially significant by virtue of reprint activity. The present study also explores the price trend of biomedical books. It is found that the mean price for 1,077 books studied was $16.20 per volume, with a standard deviation of $9.42. PMID:4466508

Responding book banning in indonesia

NASA Astrophysics Data System (ADS)

Aji, RNB; Artono; Liana, C.

2018-01-01

The prohibition of books conducted by the government through its apparatus without any due process of law is unfortunate. The Constitutional Court of the Republic of Indonesia (MKRI) in 2010 was decided that book banning is contradictory to the 1945 Constitution (UUD 1945). The purpose of this paper is to know Indonesia, according to the Constitutional Court must absolutely carry out the function of due process of law that is law enforcement in a judicial system when it wants to prohibit printed material which is a book, whether it is a book that is considered criticism and books that teach radicalism. It would be wise for anyone who disagrees with a book, and then responds by writing through a book. The result of this article is to support and suggest that the government and its apparatus in the state of the law should not arbitrarily impose a book ban. Likewise, people should not take violence action to respond this issue. In historical records, the prohibition of books without due process of law is always followed by the withdrawal of books and make people unable to deal with differences, especially in knowledge. That’s why, the government and its apparatus must create a conducive situation and support the creation of various perspectives in the framework of the progress of science through a book. It would implicate that people can respect in any perspective and thought.

The Mayo Dysphagia Questionnaire-30: documentation of reliability and validity of a tool for interventional trials in adults with esophageal disease.

PubMed

McElhiney, Judith; Lohse, Matthew R; Arora, Amindra S; Peloquin, Joanna M; Geno, Debra M; Kuntz, Melissa M; Enders, Felicity B; Fredericksen, Mary; Abdalla, Adil A; Khan, Yulia; Talley, Nicholas J; Diehl, Nancy N; Beebe, Timothy J; Harris, Ann M; Farrugia, Gianrico; Graner, Darlene E; Murray, Joseph A; Locke, G Richard; Grothe, Rayna M; Crowell, Michael D; Francis, Dawn L; Grudell, April M B; Dabade, Tushar; Ramirez, Angelica; Alkhatib, MhdMaan; Alexander, Jeffrey A; Kimber, Jessica; Prasad, Ganapathy; Zinsmeister, Alan R; Romero, Yvonne

2010-09-01

The aim of this study was to develop the Mayo Dysphagia Questionnaire-30 Day (MDQ-30), a tool to measure esophageal dysphagia, by adapting items from validated instruments for use in clinical trials, and assess its feasibility, reproducibility, and concurrent validity. Outpatients referred to endoscopy for dysphagia or seen in a specialty clinic were recruited. Feasibility testing was done to identify problematic items. Reproducibility was measured by test-retest format. Concurrent validity reflects agreement between information gathered in a structured interview versus the patients' written responses. The MDQ-30, a 28-item instrument, took 10 min (range = 5-30 min) to complete. Four hundred thirty-one outpatients [210 (49%) men; mean age = 61 years] participated. Overall, most concurrent validity kappa values for dysphagia were very good to excellent with a median of 0.78 (min 0.28, max 0.95). The majority of reproducibility kappa values for dysphagia were moderate to excellent with a median kappa value of 0.66 (min 0.07, max 1.0). Overall, concurrent validity and reproducibility kappa values for gastroesophageal reflux disease (GERD) symptoms were 0.81 (95% CI = 0.72, 0.91) and 0.66 (95% CI = 0.55, 0.77), respectively. Individual item percent agreement was generally very good to excellent. Internal consistency was excellent. We conclude that the MDQ-30 is an easy-to-complete tool to evaluate reliably dysphagia symptoms over the last 30 days.

Children's Books about Religion.

ERIC Educational Resources Information Center

Dole, Patricia Pearl

Created to promote a mutual understanding and acceptance among various faiths and cultures throughout the world, this book is an annotated bibliography of religious children's books. It has almost 700 critical evaluations of books with distinct religious themes for children from preschool to middle school. Chapters are: (1) "Religion";…

The Real E-books.

ERIC Educational Resources Information Center

Ditlea, Steve

2000-01-01

Focuses on the "real" e-books. Discusses Stephen King's novella released exclusively for electronic publication, and discusses experiences of another author writing on a specialized subject. Presents a brief background of e-books. Examines the differences between Portable Document Format (PDF) technology and the new Open eBook (OEB)…

Granulomatosis with Polyangiitis (GPA): Symptoms and Causes

MedlinePlus

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The Children's Book Showcase 1975.

ERIC Educational Resources Information Center

Children's Book Council, New York, NY.

The 1975 Children's Book Showcase committee selected 27 children's books for their excellent quality and design. Each of these books is given a two-page spread in the Showcase catalog. Information about the books, which are arranged alphabetically by title, includes author, title, publisher, artist, editor, art director, designer, production…

Mayo clinical Text Analysis and Knowledge Extraction System (cTAKES): architecture, component evaluation and applications

PubMed Central

Masanz, James J; Ogren, Philip V; Zheng, Jiaping; Sohn, Sunghwan; Kipper-Schuler, Karin C; Chute, Christopher G

2010-01-01

We aim to build and evaluate an open-source natural language processing system for information extraction from electronic medical record clinical free-text. We describe and evaluate our system, the clinical Text Analysis and Knowledge Extraction System (cTAKES), released open-source at http://www.ohnlp.org. The cTAKES builds on existing open-source technologies—the Unstructured Information Management Architecture framework and OpenNLP natural language processing toolkit. Its components, specifically trained for the clinical domain, create rich linguistic and semantic annotations. Performance of individual components: sentence boundary detector accuracy=0.949; tokenizer accuracy=0.949; part-of-speech tagger accuracy=0.936; shallow parser F-score=0.924; named entity recognizer and system-level evaluation F-score=0.715 for exact and 0.824 for overlapping spans, and accuracy for concept mapping, negation, and status attributes for exact and overlapping spans of 0.957, 0.943, 0.859, and 0.580, 0.939, and 0.839, respectively. Overall performance is discussed against five applications. The cTAKES annotations are the foundation for methods and modules for higher-level semantic processing of clinical free-text. PMID:20819853

Paperback Books for Children.

ERIC Educational Resources Information Center

Simmons, Beatrice, Ed.

Nearly 700 titles are included in "Paperback Books for Children," a guide for librarians and teachers published by the American Association of School Librarians. It is divided into the following sections: Picture Books; Fiction; Nonfiction; Myths, Folklore, and Fairy Tales; and Poetry, Rhymes, Riddles and Jokes. The book also contains an adult…

Political Discovery Resource Book.

ERIC Educational Resources Information Center

Political Discovery Education Collaborative for Greater Boston, MA.

This resource book for secondary students describes various aspects of federal, state, and local political processes. Originally written for use in the magnet education program "Political Discovery" in Boston, Massachusetts, the book can easily be used or adapted by teachers in any state. The first part of the book deals with the federal…

[Published books on pain and its treatment in Spain. Analysis with the ISBN database].

PubMed

Guardiola, E; Baños, J E

1995-04-01

Although analyses have been done on the publishing of scientific articles on pain in Spanish, book publications in the field have not been studied. This article fills that gap. A bibliography of books with pain approached from a medical standpoint was compiled from ISBN CD-ROM database (updated for 1993). Books going into more than one edition were considered single titles. Multi-volume collections were considered single books. We analyzed type of book, subject, ISBN classification, year, language (of publication and original), publisher and place of publication. Two hundred books were studied. Over 60% had been published within the previous 10 years. The year that showed the most books published was 1990 (19) followed by 1989 (16) and 1988 (16). Output has been rising steadily. One hundred ninety-eight books were published in Spanish and 2 in Catalan. The original language was Spanish in 114 cases, English in 51 cases, French in 21 and German in 7. By ISBN classification, most (146) covered pathology, disease and medical/therapeutic clinical practice. By topic, 51 books were general, 41 treated lumbalgia, sciatica or back pain and 35 covered headaches in general or migraine. Most of the books were issued by trade publishers. The cities most often involved were Barcelona and Madrid. An increased number of books about pain are being published in Spain, coinciding with a rise in the publication of scientific articles on the subject.

Children's Book Awards Annual 1998.

ERIC Educational Resources Information Center

Berman, Matt; Dupuy, Marigny J.

This publication reviews the books from the major national children's book awards and lists. The following awards are covered: John Newberry Awards, Randolph Caldecott Awards, Coretta Scott King Awards, Mildred L. Batchelder Awards, Pura Belpre, Boston Globe-Horn Book Award, and the National Book Award for Young People's Literature. The lists are…

Association of antidiabetic medication use, cognitive decline, and risk of cognitive impairment in older people with type 2 diabetes: Results from the population-based Mayo Clinic Study of Aging.

PubMed

Wennberg, Alexandra M V; Hagen, Clinton E; Edwards, Kelly; Roberts, Rosebud O; Machulda, Mary M; Knopman, David S; Petersen, Ronald C; Mielke, Michelle M

2018-06-05

To determine the cross-sectional and longitudinal associations between diabetes treatment type and cognitive outcomes among type II diabetics. We examined the association between metformin use, as compared to other diabetic treatment (ie, insulin, other oral medications, and diet/exercise) and cognitive test performance and mild cognitive impairment (MCI) diagnosis among 508 cognitively unimpaired at baseline type II diabetics enrolled in the Mayo Clinic Study of Aging. We created propensity scores to adjust for treatment effects. We used multivariate linear and logistic regression models to investigate the cross-sectional association between treatment type and cognitive test z scores, respectively. Mixed effects models and competing risk regression models were used to determine the longitudinal association between treatment type and change in cognitive test z scores and risk of developing incident MCI. In linear regression analyses adjusted for age, sex, education, body mass index, APOE ε4, insulin treatment, medical comorbidities, number of medications, duration of diabetes, and propensity score, we did not observe an association between metformin use and cognitive test performance. Additionally, we did not observe an association between metformin use and cognitive test performance over time (median = 3.7-year follow-up). Metformin was associated with an increased risk of MCI (subhazard ratio (SHR) = 2.75; 95% CI = 1.64, 4.63, P < .001). Similarly, other oral medications (SHR = 1.96; 95% CI = 1.19, 3.25; P = .009) and insulin (SHR = 3.17; 95% CI = 1.27, 7.92; P = .014) use were also associated with risk of MCI diagnosis. These findings suggest that metformin use, as compared to management of diabetes with other treatments, is not associated with cognitive test performance. However, metformin was associated with incident MCI diagnosis. Copyright © 2018 John Wiley & Sons, Ltd.

When Do Children Read Books?

ERIC Educational Resources Information Center

van Ours, Jan C.

2008-01-01

This paper investigates the reading of fiction books by 15 year olds in 18 OECD countries. It appears that girls read fiction books more often than boys, whereas boys read comic books more often than girls. Parental education, family structure, and the number of books and televisions at home influence the intensity with which children read fiction…

A pilot study using children's books to understand caregiver perceptions of parenting practices.

PubMed

Bauer, Nerissa S; Hus, Anna M; Sullivan, Paula D; Szczepaniak, Dorota; Carroll, Aaron E; Downs, Stephen M

2012-06-01

To conduct a pilot study to test the feasibility and acceptability of using children's books to understand caregiver perceptions of parenting practices around common behavior challenges. A prospective 1-month pilot study was conducted in 3 community-based pediatric clinics serving lower income families living in central Indianapolis. One hundred caregivers of 4- to 7-year-old children presenting for a well-child visit chose 1 of 3 available children's books that dealt with a behavioral concern the caregiver reported having with the child. The book was read aloud to the child in the caregiver's presence by a trained research assistant and given to the families to take home. Outcomes measured were caregiver intent to change their interaction with their child after the book reading, as well as caregiver reports of changes in caregiver-child interactions at 1 month. Reading the book took an average of 3 minutes. Most (71%) caregivers reported intent to change after the book reading; two-thirds (47/71) were able to identify a specific technique or example illustrated in the story. One month later, all caregivers remembered receiving the book, and 91% reported reading the book to their child and/or sharing it with someone else. Three-fourths of caregivers (60/80) reported a change in caregiver-child interactions. The distribution of children's books with positive parenting content is a feasible and promising tool, and further study is warranted to see whether these books can serve as an effective brief intervention in pediatric primary care practice.

Textile and Apparel Production, Management, and Services. Reference Book [and] Student Activity Book.

ERIC Educational Resources Information Center

Texas Tech Univ., Lubbock. Curriculum Center for Family and Consumer Sciences.

This student activity book and reference book, which are part of a family and consumer sciences education series focusing on a broad range of employment opportunities, are intended for use in 1- and 2-year textile and apparel production, management, and services programs for Texas high school students. The reference book provides information…

Astronomy books in Spanish

NASA Astrophysics Data System (ADS)

Fierro, Julieta

Great cultures have created language. They have discovered its strength among other reasons for education. For a long time the Bible was one of the few books available in western culture, its influence is beyond any doubt. Many developing nations have no science books in their mother tongue. They might carry a few translations but these do not convey the local culture so it is harder for students to grasp the concepts and to build on what they know. Books, even if they are extremely simple, should be written in local languages because that will facilitate the conveying of knowledge and the creation of scientific culture. In the books examples that pertain to every day local life must be given, in particular examples that have to do with women. Women play a central role in developing nations by child bearing; if they become literate they will influence enormously the quality of their children's education, in particular their science comprehension. In Mexico a collection that includes astronomy books has recently been edited by the National Council for Culture and Arts. The books are small and light, which encourages middle-school students to carry them around and read them while traveling in public transportation, such as the subway. Every other page is a new subject, that carries illustrations, abstracts and conclusions. The astronomy books are on search for extraterrestrial life, the stars and the universe. These books are distributed nation-wide and are inexpensive. They have been written by Mexican astronomers.

Epilepsy Surgery

MedlinePlus

... monitor the brain's activity and detect abnormalities. Single-photon emission computerized tomography (SPECT). The scan image varies ... off anti-seizure drugs after a year or two. By Mayo Clinic Staff . Mayo Clinic Footer Legal ...

Books Matter: The Place of Traditional Books in Tomorrow's Library

ERIC Educational Resources Information Center

Megarrity, Lyndon

2010-01-01

People who love books can find entering an Australian library in the so-called "cyber-age" to be an unsettling experience. The first thing you notice is the reduced emphasis on book shelves in favour of empty but architecturally pleasing "public spaces", comfortable cushions, computer terminals, sometimes even new cafes and…

Book Review

NASA Astrophysics Data System (ADS)

Clevers, Jan G. P. W.

2018-05-01

This book provides a comprehensive and timely overview on all aspects of hyperspectral remote sensing combined with various applications. As such, it is an excellent book of reference for both students and professionals active in the field of optical remote sensing. It deals with all aspects of retrieving quantitative information on biophysical properties of the Earth's surface, the data corrections needed and the range of analysis approaches available.

Children's Books. Book Reviews.

ERIC Educational Resources Information Center

Moulton, Kate

1994-01-01

Reviews 10 children's books, published or reissued 1988-93, about daily life, traditional culture, and schooling among Taos Pueblo, Zuni Pueblo, Navajo, Inuit, Guatemalan, and other Native peoples, as well as tales from Native American oral tradition, the life of a buffalo, and Cherokee and Athapascan historical fiction. Includes grade range and…

Technical books and monographs. 1979 compilation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This booklet lists technical books and monographs published since the issuance of Technical Books and Monographs, 1978 Catalog, a bibliography of books and monographs sponsored by the US Department of Energy (DOE) or by one of the earlier organizations that were brought together to form DOE. In general, information for each published book, and for each book in press when known, includes title, author and author affiliation, publisher and publication date, page count, size of book, price, availability information if the book is not available from the publisher, Library of Congress card number, International Standard Book Number (ISBN), a briefmore » descriptive statement concerning the book, and a list or a description of the contents. The books and monographs are grouped under twelve subject categories: general reference, biology and medicine, chemistry, computers and mathematics, energy, engineering and instrumentation, environment, health and safety, isotope separation, metallurgy and materials, physics, and reactors. (RWR)« less