Take a deeper look into all the publications produced by researchers at The Dartmouth Institute.

Miranda ER, Fuller KNZ, Perkins RK, Beisswenger PJ, Farabi SS, Quinn L, Haus JM

2019 Feb 13;11(2)pii: E386. doi: 10.3390/nu11020386

Advanced glycation end products (AGEs) promote the development of diabetic complications through activation of their receptor (RAGE). Isoforms of soluble RAGE (sRAGE) sequester AGEs and protect against RAGE-mediated diabetic complications. We investigated the effect of an overnight fast on circulating metabolic substrates, hormones, AGEs, and sRAGE isoforms in 26 individuals with type 1 diabetes (T1DM). Blood was collected from 26 young (18⁻30 years) T1DM patients on insulin pumps before and after an overnight fast. Circulating AGEs were measured via LC-MS/MS and sRAGE isoforms were analyzed via ELISA. Glucose, insulin, glucagon, and eGFR decreased while cortisol increased following the overnight fast ( 0.05). AGEs (CML, CEL, 3DG-H, MG-H1, and G-H1) decreased (21⁻58%, < 0.0001) while total sRAGE, cleaved RAGE (cRAGE), and endogenous secretory RAGE (esRAGE) increased (22⁻24%, < 0.0001) following the overnight fast. The changes in sRAGE isoforms were inversely related to MG-H1 ( = -0.493 to -0.589, < 0.05) and the change in esRAGE was inversely related to the change in G-H1 ( = -0.474, < 0.05). Multiple regression analyses revealed a 1 pg/mL increase in total sRAGE, cRAGE, or esRAGE independently predicted a 0.42⁻0.52 nmol/L decrease in MG-H1. Short-term energy restriction via an overnight fast resulted in increased sRAGE isoforms and may be protective against AGE accumulation.

Nutrients|2019 Feb 13

Gitajn IL, Titus A, Mastrangelo S, Ali S, Sparks M, Jevsevar D

2019 Mar;33(3):149-154doi: 10.1097/BOT.0000000000001371

To (1) describe the prevalence of psychiatric illness in fracture patients ≥70 years of age and (2) investigate the association between psychiatric illness and complications requiring unplanned readmission in elderly patients.

J Orthop Trauma|2019 Mar

Pinney SJ, Page AE, Jevsevar DS, Bozic KJ

2016;8:1-11doi: 10.2147/ORR.S92216

Multiple health care stakeholders are increasingly scrutinizing musculoskeletal care to optimize quality and cost efficiency. This has led to greater emphasis on quality and process improvement. There is a robust set of business strategies that are increasingly being applied to health care delivery. These quality and process improvement tools (QPITs) have specific applications to segments of, or the entire episode of, patient care. In the rapidly changing health care world, it will behoove all orthopedic surgeons to have an understanding of the manner in which care delivery processes can be evaluated and improved. Many of the commonly used QPITs, including checklist initiatives, standardized clinical care pathways, lean methodology, six sigma strategies, and total quality management, embrace basic principles of quality improvement. These principles include focusing on outcomes, optimizing communication among health care team members, increasing process standardization, and decreasing process variation. This review summarizes the common QPITs, including how and when they might be employed to improve care delivery.

Orthop Res Rev|2016

North WG, Liu F, Dragnev KH, Demidenko E

2019;11:15-23doi: 10.2147/CPAA.S183885

Small-cell lung cancer (SCLC) has a poor prognosis since there is currently no effective therapy for commonly recurring disease. In our previous study, both primary and recurrent human tumors have been shown to express functional -methyl-D-aspartate (NMDA) receptors, and blockade of these receptors with GluN1 and GluN2B antagonists decreased tumor cell viability in vitro, and growth of tumor xenografts in nu/nu mice.

Clin Pharmacol|2019

Adler J, Toy D, Anderson JC, Robertson DJ, Pohl H

2019 Feb 12;pii: S1542-3565(19)30152-1. doi: 10.1016/j.cgh.2019.01.047

Incomplete resection of polyps could be an important cause of post-colonoscopy colorectal cancer. However, it is difficult to study progression of incompletely removed polyps or their clinical importance. We aimed to estimate incomplete polyp resection using risk of metachronous neoplasia per colon segment.

Clin Gastroenterol Hepatol|2019 Feb 12

Wasson JH

2019 Feb 13;doi: 10.1097/JAC.0000000000000273

During college and medical school, the author's summer employment acquainted him with members of organized crime families. After a full career as a primary care clinician and geriatrician with research on improving health care delivery, the author opines that several insights from organized crime should be of interest to health care professionals: (1) don't damage the host; (2) protect the brand; and (3) lead necessary adaption. From these insights, the author presents symptoms of failure evidenced by the US health care system, followed by several adaptations that would reduce the system's costs, improve its image, and address future challenges.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

J Ambul Care Manage|2019 Feb 13

Mott SH, Morse RP, Burroughs SA, Buckley AW, Farmer CA, Thurm AE, Swedo SE, Krag AL, Holmes GL

2019 Feb 15;doi: 10.1684/epd.2019.1027

Electrical status epilepticus in sleep (ESES) is an age-related, self-limited epileptic encephalopathy. The syndrome is characterized by cognitive and behavioral abnormalities and a specific EEG pattern of continuous spikes and waves during slow-wave sleep. While spikes and sharp waves are known to result in transient cognitive impairment during learning and memory tasks performed during the waking state, the effect of epileptiform discharges during sleep on cognition and behavior is unclear. There is increasing evidence that abnormalities of coherence, a measure of the consistency of the phase difference between two EEG signals when compared over time, is an important feature of brain oscillations and plays a role in cognition and behavior. The objective of this study was to determine whether coherence of EEG activity is altered during slow-wave sleep in children with ESES when compared to typically developing children. We examined coherence during epochs of ESES versus epochs when ESES was not present. In addition, we compared coherence during slow-wave sleep between typically developing children and children with ESES. ESES was associated with remarkably high coherences at all bandwidths and most electrode pairs. While the high coherence was largely attributed to the spikes and spike-and-wave discharge, activity between spikes and spike-and-wave discharge also demonstrated high coherence. This study indicates that EEG coherence during ESES is relatively high. Whether these increases in coherence correlate with the cognitive and behavioral abnormalities seen in children with this EEG pattern remains to be determined.

Epileptic Disord|2019 Feb 15

Singh SB, Madan J, Coker M, Hoen A, Baker ER, Karagas MR, Mueller NT

2019 Feb 14;doi: 10.1038/s41366-018-0273-0

Mother-to-newborn transmission of obesity-associated microbiota may be modified by birth mode (vaginal vs. Cesarean delivery). Prospective data to test this hypothesis are still sparse.

Int J Obes (Lond)|2019 Feb 14

Stief JD, Haase M, Lüdemann L, Theilig D, Schmelzle M, Hamm B, Denecke T, Geisel D

2019 Feb 14;9(1):2083doi: 10.1038/s41598-018-37689-y

Noninvasive early detection of liver cirrhosis and fibrosis is essential for management and therapy. The aim was to investigated whether a combination of the functional parameter relative enhancement (RE) on Gadoxetic Acid magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) and the fibrosis parameter T1ρ distinguishes cirrhosis and healthy liver. We analyzed patients with Gd-EOB-DTPA-enhanced MRI and T1ρ mapping. Signal intensity was measured before and after contrast; RE was calculated. T1ρ was measured with circular regions of interest (T1ρ-cROI). A quotient of RE and T1ρ-cROI was calculated: the fibrosis function quotient (FFQ). Cirrhosis was evaluated based on morphology and secondary changes. 213 datasets were included. The difference between cirrhotic and noncirrhotic liver was 51.11 ms vs. 47.56 ms for T1ρ-cROI (p < 0.001), 0.59 vs. 0.70 for RE (p < 0.001), and 89.53 vs. 70.83 for FFQ (p < 0.001). T1ρ-cROI correlated with RE, r = -0.14 (p < 0.05). RE had an AUC of 0.73. The largest AUC had the FFQ with 0.79. The best cutoff value was 48.34 ms for T1ρ-cROI, 0.70 for RE and 78.59 ms for FFQ. In conclusion T1ρ and RE can distinguish between cirrhotic and noncirrhotic liver. The FFQ, which is the combination of the two, improves diagnostic performance.

Sci Rep|2019 Feb 14

den Dekker HT, Burrows K, Felix JF, Salas LA, Nedeljkovic I, Yao J, Rifas-Shiman SL, Ruiz-Arenas C, Amin N, Bustamante M, DeMeo DL, John Henderson A, Howe CG, Hivert MF, Arfan Ikram M, de Jongste JC, Lahousse L, Mandaviya PR, van Meurs JB, Pinart M, Sharp GC, Stolk L, Uitterlinden AG, Anto JM, Liton...

2019 Feb 14;pii: 1801795. doi: 10.1183/13993003.01795-2018

We aimed to identify differentially methylated regions (DMRs) in cord blood DNA associated with childhood lung function, asthma and chronic obstructive pulmonary disease (COPD) across the life course.

Eur Respir J|2019 Feb 14


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