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Search Results: 1 - 10 of 487174 matches for " John A House "
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Lost in the Present: Anterograde Amnesia and Medical Decision Making Capacity  [PDF]
John McKelvie, Christopher A. Pierce, Thomas M. Dunn, Philippe Weintraub, Robert M. House
Open Journal of Medical Psychology (OJMP) , 2014, DOI: 10.4236/ojmp.2014.31007
Abstract: Although there have been a limited number of case reports of human bilateral hippocampal injury, none of these have addressed the impact of such injuries on medical decision making capacity. The authors present a case of an elderly man with discrete bilateral hippocampal injury. As a result of his injury, the patient was hopelessly “lost in the present” and only retained the basic cognitive functions necessary to have decision making capacity for a limited period of time. He was unable to appreciate the nature of his injury, the potential risks involved in his decisions, and the recommended course of treatment longer than a few minutes. The patient’s resultant neurocognitive deficits left him lacking medical decision making capacity, a likely outcome for patients with persistent anterograde amnesia.
Testing the performance of the ENRICHD Social Support Instrument in cardiac patients
Joseph Vaglio, Mark Conard, Walker S Poston, James O'Keefe, C Keith Haddock, John House, John A Spertus
Health and Quality of Life Outcomes , 2004, DOI: 10.1186/1477-7525-2-24
Abstract: The ESSI, along with the Short Form-36 (SF-36), was sequentially administered to a cohort of 271 patients undergoing PCI. The test-retest reliability was examined with an intra-class correlation coefficient by comparing scores among 174 patients who completed both instruments 5 and 6 months after their procedure. Internal reliability was assessed using Cronbach's alpha at the time of patients' baseline procedure. The concurrent validity of the ESSI was assessed by comparing scores between depressed (MHI-5 score < 44) vs. non-depressed patients. The correlation between the ESSI and the SF-36 Social Functioning sub-scale, an accepted measure of social functioning, was also examined.Test-retest reliability showed no significant differences in mean scores among ESSI questionnaires administered 1 month apart (27.8+/-1.4 vs 27.8+/-1.5, p = 0.98). The intra-class correlation coefficient was 0.94 and Cronbach's alpha was 0.88. Mean ESSI scores were significantly lower among depressed vs. non-depressed patients (24.6+/-1.7 vs 27+/-1.4, p < 0.018) and a positive albeit modest correlation with social functioning was seen (r = 0.19, p = 0.002).The ESSI appears to be a valid and reliable measure of social support in patients undergoing treatment for coronary artery disease. It may prove to be a valuable method of controlling for patient variability in outcomes studies where the outcomes are related to patients' social support.Social support is broadly defined as the existence or availability of people on whom one can rely; people who let one know that they are cared about, valued, and loved [1]. Lack of social support is associated with increased morbidity and mortality in patients with ischemic heart disease [2,3]. Growing awareness of the importance of social support on cardiovascular outcomes has necessitated the development of instruments to measure social support. The ENRICHD Social Support Instrument (ESSI) is one such measure derived from questions on the Medical Outcomes
Diagnostic Performance of a Rapid Magnetic Resonance Imaging Method of Measuring Hepatic Steatosis
Michael J. House, Eng K. Gan, Leon A. Adams, Oyekoya T. Ayonrinde, Sander J. Bangma, Prithi S. Bhathal, John K. Olynyk, Tim G. St. Pierre
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0059287
Abstract: Objectives Hepatic steatosis is associated with an increased risk of developing serious liver disease and other clinical sequelae of the metabolic syndrome. However, visual estimates of steatosis from histological sections of biopsy samples are subjective and reliant on an invasive procedure with associated risks. The aim of this study was to test the ability of a rapid, routinely available, magnetic resonance imaging (MRI) method to diagnose clinically relevant grades of hepatic steatosis in a cohort of patients with diverse liver diseases. Materials and Methods Fifty-nine patients with a range of liver diseases underwent liver biopsy and MRI. Hepatic steatosis was quantified firstly using an opposed-phase, in-phase gradient echo, single breath-hold MRI methodology and secondly, using liver biopsy with visual estimation by a histopathologist and by computer-assisted morphometric image analysis. The area under the receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of the MRI method against the biopsy observations. Results The MRI approach had high sensitivity and specificity at all hepatic steatosis thresholds. Areas under ROC curves were 0.962, 0.993, and 0.972 at thresholds of 5%, 33%, and 66% liver fat, respectively. MRI measurements were strongly associated with visual (r2 = 0.83) and computer-assisted morphometric (r2 = 0.84) estimates of hepatic steatosis from histological specimens. Conclusions This MRI approach, using a conventional, rapid, gradient echo method, has high sensitivity and specificity for diagnosing liver fat at all grades of steatosis in a cohort with a range of liver diseases.
The rate of convergence to early asymptotic behaviour in age-structured epidemic models
Christopher A. Rhodes,Thomas House
Quantitative Biology , 2013, DOI: 10.1016/j.tpb.2013.02.003
Abstract: Age structure is incorporated in many types of epidemic model. Often it is convenient to assume that such models converge to early asymptotic behaviour quickly, before the susceptible population has been appreciably depleted. We make use of dynamical systems theory to show that for some reasonable parameter values, this convergence can be slow. Such a possibility should therefore be considered when parameterising age-structured epidemic models.
Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
Ngan Lam,Gurbir Sekhon,Andrew A. House
Case Reports in Nephrology , 2012, DOI: 10.1155/2012/671595
Abstract: A 43-year-old woman was brought to the hospital with severe metabolic acidosis (pH 6.56, bicarbonate 3 mmol/L, and lactate 18.4 mmol/L) and a serum creatinine of 162 μmol/L with a serum potassium of 7.8 mmol/L. A delayed diagnosis of metformin-associated lactic acidosis was made, and she was treated with tris-hydroxymethyl aminomethane (THAM) and renal replacement therapy (RRT). Following a complete recovery, she admitted to ingesting 180 tablets (90 grams) of metformin. Her peak serum metformin concentration was 170 μg/mL (therapeutic range 1-2 μg/mL). Our case demonstrates an intentional metformin overdose resulting in lactic acidosis in a nondiabetic patient who was successfully treated with THAM and RRT.
Theoretical and Perceptual Market Values for Fresh Squeezed Orange Juice
Hyeyoung Kim,Lisa A. House,Zhifeng Gao
International Journal of Marketing Studies , 2012, DOI: 10.5539/ijms.v4n2p45
Abstract: This study measures product differentiation effects from observing the fresh orange juice being squeezed on the willingness to pay for a glass of fresh juice. Both the Westendorp price sensitivity meter and a hypothetical choice experiment are used to estimate consumer willingness to pay. Results from the hypothetical choice model indicated when participants observed the process of squeezing fresh oranges to make juice, they were statistically willing to pay higher values not only for the fresh squeezed orange juice, but other types of orange juices as well. The van Westendorp method failed to pick up significant differences in willingness to pay for fresh, or other, juices. This may be due to the lack of theoretical grounding and incentive compatibility, leading to underestimating the value of the fresh squeezed orange juice.
Metformin-Associated Lactic Acidosis following Intentional Overdose Successfully Treated with Tris-Hydroxymethyl Aminomethane and Renal Replacement Therapy
Ngan Lam,Gurbir Sekhon,Andrew A. House
Case Reports in Nephrology , 2012, DOI: 10.1155/2012/671595
Abstract: A 43-year-old woman was brought to the hospital with severe metabolic acidosis (pH 6.56, bicarbonate 3?mmol/L, and lactate 18.4?mmol/L) and a serum creatinine of 162?μmol/L with a serum potassium of 7.8?mmol/L. A delayed diagnosis of metformin-associated lactic acidosis was made, and she was treated with tris-hydroxymethyl aminomethane (THAM) and renal replacement therapy (RRT). Following a complete recovery, she admitted to ingesting 180 tablets (90 grams) of metformin. Her peak serum metformin concentration was 170?μg/mL (therapeutic range 1-2?μg/mL). Our case demonstrates an intentional metformin overdose resulting in lactic acidosis in a nondiabetic patient who was successfully treated with THAM and RRT. 1. Background Metformin is an oral antihyperglycemic agent that is the first-line therapy for noninsulin-dependent diabetes mellitus [1]. Although the adverse event rate is 20–30%, the majority of these are gastrointestinal symptoms such as abdominal pain and nausea [2]. Metformin has been associated with an increased risk of lactic acidosis through the inhibition of hepatic gluconeogenesis causing an increased level of lactate, pyruvate, and alanine. The incidence of metformin-associated lactic acidosis (MALA) is reported to be 3 per 100,000 person-years [3]. The symptoms of severe MALA can be nonspecific, such as tachycardia, hypotension, tachypnea, and mental status changes, potentially misleading the diagnosis and delaying treatment. 2. Case Report A 43-year-old woman was brought to the emergency room complaining of chest pain for 20hours radiating to her back. Her medical history was significant for hypertension for which she was on atenolol 50?mg daily and anxiety for which she was on mirtazapine 30 mg daily and lorazepam 2 mg three times a day. Her temperature was 32.3°C (axilla), blood pressure 66/45?mmHg, heart rate 57 beats per minute, and oxygen saturation 97% on 3 liters. Her respiratory, cardiac, and abdominal exams were unremarkable. In addition to normal cardiac enzymes, her initial laboratory values revealed the following: serum creatinine 162?μmol/L, potassium 5.3?mmol/L, bicarbonate 4?mmol/L, anion gap 31?mmol/L, lactate 18.4?mmol/L, osmolar gap 18.3?mOsm/kg, venous blood gas: pH 6.56, pCO2 35?mmHg, bicarbonate 3?mmol/L (Table 1). Four hours after she first arrived, her condition rapidly deteriorated, and she became obtunded requiring intubation and transfer to the intensive care unit (ICU). Table 1: Laboratory investigations. Prior to intubation, the patient adamantly denied any toxic ingestion. She was treated with levofloxacin
Investigation of 95 variants identified in a genome-wide study for association with mortality after acute coronary syndrome
Thomas M Morgan, John A House, Sharon Cresci, Philip Jones, Hooman Allayee, Stanley L Hazen, Yesha Patel, Riyaz S Patel, Danny J Eapen, Salina P Waddy, Arshed A Quyyumi, Marcus E Kleber, Winfried M?rz, Bernhard R Winkelmann, Bernhard O Boehm, Harlan M Krumholz, John A Spertus
BMC Medical Genetics , 2011, DOI: 10.1186/1471-2350-12-127
Abstract: We examined 95 polymorphisms in 69 distinct gene regions identified in a GWAS for premature myocardial infarction for their association with post-ACS mortality among 811 whites recruited from university-affiliated hospitals in Kansas City, Missouri. We then sought replication of a positive genetic association in a large, racially diverse cohort of myocardial infarction patients (N = 2284) using Kaplan-Meier survival analyses and Cox regression to adjust for relevant covariates. Finally, we investigated the apparent association further in 6086 additional coronary artery disease patients.After Cox adjustment for other ACS risk factors, of 95 SNPs tested in 811 whites only the association with the rs6922269 in MTHFD1L was statistically significant, with a 2.6-fold mortality hazard (P = 0.007). The recessive A/A genotype was of borderline significance in an age- and race-adjusted analysis of the entire combined cohort (N = 3095; P = 0.052), but this finding was not confirmed in independent cohorts (N = 6086).We found no support for the hypothesis that the GWAS-identified variants in this study substantially alter the probability of post-ACS survival. Large-scale, collaborative, genome-wide studies may be required in order to detect genetic variants that are robustly associated with survival in patients with coronary artery disease.Genome-wide association studies (GWAS) have identified robust genetic associations in a variety of common diseases [1], including myocardial infarction (MI) [2-6]. The GWAS approach, with its emphasis on large sample sizes and inclusion of hundreds of thousands of genetic markers, has produced a degree of reproducibility that was generally lacking in earlier candidate gene studies of MI [7]. However, nine GWAS-identified genetic susceptibility markers, all meeting criteria for genome-wide statistical significance, collectively account for only 3% of the estimated heritability of early-onset myocardial infarction (MI), raising questions about t
A Secure Approach to Educating a Mobile World-Class Military —A Mobile Secure Concept for Accessing the Classroom from Around the World  [PDF]
Terry C. House
Communications and Network (CN) , 2013, DOI: 10.4236/cn.2013.53B2087
Abstract:

The “Mobile Secure Role Base Access Control Device” (MS-Ro-BAC) Device and database is a single unit system with the ability to instantly connect to secure databases around the world through Low Earth Orbit Satellite (LEO) using VPN wired communications. The capabilities provided by the MS-Ro-BAC device would support the“Global War on Terrorism” and increase the security of US force and Department of Defense Personnel around the world. Information dissemination in an austere environment is the focus of this seminal research; combat forces and DoD personnel depend on timely strategic information before making life threatening decisions on the battle field. This manuscript provides the framework and a prototype to improve the information dissemination process in the modern day information scenario.

Bayesian nonparametric models for peak identification in MALDI-TOF mass spectroscopy
Leanna L. House,Merlise A. Clyde,Robert L. Wolpert
Statistics , 2011, DOI: 10.1214/10-AOAS450
Abstract: We present a novel nonparametric Bayesian approach based on L\'{e}vy Adaptive Regression Kernels (LARK) to model spectral data arising from MALDI-TOF (Matrix Assisted Laser Desorption Ionization Time-of-Flight) mass spectrometry. This model-based approach provides identification and quantification of proteins through model parameters that are directly interpretable as the number of proteins, mass and abundance of proteins and peak resolution, while having the ability to adapt to unknown smoothness as in wavelet based methods. Informative prior distributions on resolution are key to distinguishing true peaks from background noise and resolving broad peaks into individual peaks for multiple protein species. Posterior distributions are obtained using a reversible jump Markov chain Monte Carlo algorithm and provide inference about the number of peaks (proteins), their masses and abundance. We show through simulation studies that the procedure has desirable true-positive and false-discovery rates. Finally, we illustrate the method on five example spectra: a blank spectrum, a spectrum with only the matrix of a low-molecular-weight substance used to embed target proteins, a spectrum with known proteins, and a single spectrum and average of ten spectra from an individual lung cancer patient.
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