The Institute of Medicine's To Err Is Human, published in 1999, represented a watershed moment for the US health care system. The report dramatically raised the profile of patient safety and ...stimulated dedicated research funding to this essential aspect of patient care. Highly effective interventions have since been developed and adopted for hospital-acquired infections and medication safety, although the impact of these interventions varies because of their inconsistent implementation and practice. Progress in addressing other hospital-acquired adverse events has been variable. In the past two decades additional areas of safety risk have been identified and targeted for intervention, such as outpatient care, diagnostic errors, and the use of health information technology. In sum, the frequency of preventable harm remains high, and new scientific and policy approaches to address both prior and emerging risk areas are imperative. With the increasing availability of electronic data, investments must now be made in developing and testing methods to routinely and continuously measure the frequency and types of patient harm and even predict risk of harm for specific patients. This progress could lead us from a Bronze Age of rudimentary tool development to a Golden Era of vast improvement in patient safety.
Vascular endothelial growth factors (VEGFs) are key regulators of permeability. The principal evidence behind how they increase vascular permeability in vivo and in vitro and the consequences of that ...increase are addressed here. Detailed analysis of the published literature has shown that in vivo and in vitro VEGF-mediated permeability differs in its time course, but has common involvement of many specific signalling pathways, in particular VEGF receptor-2 activation, calcium influx through transient receptor potential channels, activation of phospholipase C gamma and downstream activation of nitric oxide synthase. Pathways downstream of endothelial nitric oxide synthase appear to involve the guanylyl cyclase-mediated activation of the Rho–Rac pathway and subsequent involvement of junctional signalling proteins such as vascular endothelial cadherin and the tight junctional proteins zona occludens and occludin linked to the actin cytoskeleton. The signalling appears to be co-ordinated through spatial organization of the cascade into a signalplex, and arguments for why this may be important are considered. Many proteins have been identified to be involved in the regulation of vascular permeability by VEGF, but still the mechanisms through which these are thought to interact to control permeability are dependent on the experimental system, and a synthesis of existing data reveals that in intact vessels the co-ordination of the pathways is still not understood.
The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data that are available electronically. Simultaneously, rapid ...progress has been made in clinical analytics--techniques for analyzing large quantities of data and gleaning new insights from that analysis--which is part of what is known as big data. As a result, there are unprecedented opportunities to use big data to reduce the costs of health care in the United States. We present six use cases--that is, key examples--where some of the clearest opportunities exist to reduce costs through the use of big data: high-cost patients, readmissions, triage, decompensation (when a patient's condition worsens), adverse events, and treatment optimization for diseases affecting multiple organ systems. We discuss the types of insights that are likely to emerge from clinical analytics, the types of data needed to obtain such insights, and the infrastructure--analytics, algorithms, registries, assessment scores, monitoring devices, and so forth--that organizations will need to perform the necessary analyses and to implement changes that will improve care while reducing costs. Our findings have policy implications for regulatory oversight, ways to address privacy concerns, and the support of research on analytics.
Cervical cancer is a malignant tumour that occurs in the cervix and is classified into two histological types, adenocarcinoma and squamous cell carcinoma (SCC); SCC is more common and accounts for ...70% of all cases. In 2018 there were ~569,000 new cases of cervical cancer diagnosed worldwide and ~311,000 deaths were attributed to cervical cancer. Of these, between 84 and 90% occurred in low- and middle-income countries (LMICs) such as South Africa, India, China and Brazil. The most common cause of cervical cancer is persistent infection caused by the sexually transmitted human papilloma virus. Other factors that contribute to the incidence of cervical cancer include geography, traditional practices and beliefs, the screening levels, socioeconomic status, healthcare access, public awareness, use of oral contraceptives, smoking and co-infection with HIV. An estimated 11 million women from LMICs will be diagnosed with cervical cancer in the next 10-20 years. The aim of this review was to explore various types of genetic and epigenetic factors that influence the development, progression or suppression of cervical cancer. Key words: cervical cancer, South Africa, India, Brazil, Tanzania, miRNA
Introduction
As computational capabilities have advanced, radiologists and their collaborators have looked for novel ways to analyze diagnostic images. This has resulted in the development of ...radiomics and radiogenomics as new fields in medical imaging. Radiomics and radiogenomics may change the practice of medicine, particularly for patients with colorectal cancer. Radiomics corresponds to the extraction and analysis of numerous quantitative imaging features from conventional imaging modalities in correlation with several endpoints, including the prediction of pathology, genomics, therapeutic response, and clinical outcome. In radiogenomics, qualitative and/or quantitative imaging features are extracted and correlated with genetic profiles of the imaged tissue. Thus far, several studies have evaluated the use of radiomics and radiogenomics in patients with colorectal cancer; however, there are challenges to be overcome before its routine implementation including challenges related to sample size, model design and interpretability, and the lack of robust multicenter validation set.
Material and methods
In this article, we will review the concepts of radiomics and radiogenomics and their potential applications in rectal cancer.
Conclusion
Radiologists should be aware of the basic concepts, benefits, pitfalls, and limitations of new radiomic and radiogenomics techniques to achieve a balanced interpretation of the results.
This paper critically examines how senior figures in the UK Labour Party and wider labour movement discussed the topic of immigration in the immediate aftermath of the UK's vote to leave the European ...Union in 2016. Influenced by the Discourse Historical Approach, the paper is based on an analysis of 86 public interventions by Labour figures, over a 6-month period, delivered in speeches, articles and essays. The paper examines argumentative strategies adopted by Labour figures - including Members of Parliament, advisors and trade union leaders - who called for stronger immigration controls from an avowedly 'left-wing' perspective. Foregrounding their commitment to progressive politics, Labour politicians argued that restricting the number of migrants entering Britain was democratic, anti-racist and an expression of the Labour Party's commitment to the interests of working-class people. Nevertheless, it is the contention of this paper that the Labour Party's rhetoric tapped into right-wing populist discourses which constructed immigration as a threat to the racialised privileges of a 'white' working class.
This paper explores whether affine models with volatility jumps estimated on intradaily S&P 500 futures data over 1983 to 2008 can capture major daily outliers such as the 1987 stock market crash. ...Intradaily jumps in futures prices are typically small; self-exciting but short-lived volatility spikes capture intradaily and daily returns better. Multifactor models of the evolution of diffusive variance and jump intensities improve fits substantially, including out-of-sample over 2009 to 2016. The models capture reasonably well the conditional distributions of daily returns and realized variance outliers, but underpredict realized variance inliers. I also examine option pricing implications.
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