The competition of ecological resonances in the quantum metabolic model of cancer: Potential energetic interventions.

Cancer (a) represents an atavistic reversion to attempted asexual reproduction; (b) metastasizes to absorber "soil" tissues based upon temporal, ontogenetic commonalities; (c) cycles/precesses with competitive immunological surveillance and self-competition within the ecological environment of the body; and (d) is potentially manageable via quantum information qubit phase transitions and universal principles of thermodynamic hysteresis and resonant driving forces . We use retro-recognition of evidence-based cancer anomalies to make these arguments, which in sum position cancer as an ecological quantum information problem. The findings reposition the quantum metabolic model of cancer and presents a research approach aimed at applied treatments: Tertiary Lymphoid Structure ecological competition with cellular transmembrane quantum energy boosting using VDAC and other voltage gated ion channels.

Allostatic Load, Mobility Disability, and Viral Effects in Cancer: A Structural Equation Model.

A growing number of cancers have been linked to specific oncogenic viruses and physiological stress. Recently, two separate studies linked mobility limitations to allostatic load and four major cancer types. The objective of this study was to determine if cancer occurrence regresses on three latent domains of Allostatic Load, Level of Physical Functioning (i.e., Mobility Disability), and Viral Exposure. We compared several structural equation models using adult participant (n = 17,969) data from three National Health and Nutrition Examination Survey (NHANES) periods. The primary two-level model with three exogenous latent factors and a single Cancer endogenous latent factor demonstrated a strong fit (GFI = 0.948, RMSEA = 0.024), and the model had a non-significant Chi-Square indicative of a strong model.What is already known on this subjectAllostatic load represents how the body responds to physiological stress and is associated with increased morbidity/mortality, including cancers.Viruses are the causative agents of 15-20% of cancers and can be stress activated.People with mobility limitations experience significantly higher allostatic loads and secondary health conditions, and one recent study indicates a heightened risk for certain cancers.What this study addsThis study is original in its testing of a conceptual model that links together cancer outcomes with latent factors/variables including disability/mobility limitations, allostatic load, and viral exposure.The study indicates that there might be important associations between allostatic load, disability burden, and viral exposure/activation on the occurrence of cancer.The research suggests the need for stress reduction, preventative health interventions, and additional supports for people with disabilities and their caregivers.

Disability and health outcomes in geospatial analyses of Southeastern U.S. county health data.

BACKGROUND: People with disabilities tend to be at risk for secondary conditions. There is a need for comprehensive disability and health databases, including geographic information systems to evaluate trends in health, functioning, and employment. OBJECTIVE: We evaluated county levels in morbidity and mortality across the Southeastern United States using spatial regression, examining 2015 trends in accordance with Healthy People 2020 objectives. METHODS: We merged 2015 National County Health Rankings and the 2015 Social Security Administration's Report on SSDI Beneficiaries, all for n = 1387 Southeastern U.S. county units. We used GeoDa to regress health and disability multivariable models for the dependent variable, age-adjusted Years of Potential Life Lost (YPLL) per 100,000 population. RESULTS: The principal Health/Demographic multivariable model of factors impacting YPLL yielded an adjusted R2 = 0.743 (F = 188.3, p < 0.001) with percentage physically inactive, preventable hospital stays, percentage diabetics, and low college attendance figuring prominently. A Socioeconomic/Demographic multivariable model impacting YPLL yielded R2 = 0.631 (F = 156.0, p < 0.001), with disability and percentage unemployment being major associated variables. CONCLUSIONS: For the Southeastern U.S., counties with higher prevalence of SSDI disability workers correlated with significantly higher YPLL and poorer health outcomes. The research augments CDC Disability and Health GIS systems to measure Healthy People 2020 outcomes for persons with disabilities nationwide. Spatial regression represents a robust approach for improved analysis of geographic data for population health measures.

Biomarkers of chondriome topology and function: implications for the extension of healthy aging.

Multiple theories of aging (e.g., free radical, error catastrophe, mitochondrial) are complementary but fail to provide adequate models that comprehensively predict lifelong aging processes and that are valid across species. Hayflick (PLoS Genet 3(12):2351-2354, 2007) described six universal characteristics of aging that focus upon post-reproductive molecular entropy. Here we present a thermodynamic potential model of aging in which the energetic and topological properties of the mitochondrion drive functional and structural stabilities within living systems. Using multivariate regressions of physiological assessments from the National Health and Nutrition Examination Survey, VO2 max consistently declined with age regardless of gender or race, although it had a significantly greater decline for African American females. Percent fat (negative), hematocrit (negative), and urine creatinine (negative) were strongly and significantly associated with VO2 max and male aging, although cholesterol (positive) was an additional factor for African American males. Bioenergetic measures such as VO2 max can be useful for physical assessments to promote healthy aging.

Heart age differentials and general cardiovascular risk profiles for persons with varying disabilities: NHANES 2001-2010.

BACKGROUND: Persons with disabilities are at risk for secondary conditions, including allostatic load contributing to cardiovascular disease. The General Cardiovascular Risk Profile (GCRP) estimates cardiovascular disease risk for individuals. The GCRP variables are present in the National Health and Nutrition Examination Survey (NHANES) for the Healthy People 2010 decade. OBJECTIVE/HYPOTHESIS: The objective of this study was to compare persons with varying disabilities versus persons without disabilities on GCRP cardiovascular disease risk estimates across the Healthy People 2010 decade. METHODS: Weighted cross-sectional one-way Analyses of Variance (ANOVA) and non-parametric Kruskal-Wallis analyses compared persons with each of eight disability types versus persons without disabilities for point estimate GCRP heart vascular age differential and Cox regression model ten-year risk estimate in each NHANES survey year for 2001-2010. RESULTS: Persons with mobility or vision disabilities had significantly (p < .025) greater ten-year percent risks for cardiovascular disease and negative heart vascular age differentials (with respect to actual age, therefore "older" hearts) than persons without disabilities. The GCRP dual models conflict for certain disabilities (e.g., hearing, physical/mental/emotional) but are consistently reliable measures of GCRP for persons with mobility limitations and vision disabilities. CONCLUSIONS: With higher CVD risk among persons with disabilities, there is a clear need for increased interventions to benefit the health of persons with disabilities. The GCRP represents a valuable, simple measurement that uses routinely collected examination data. Physicians and nurses can use the GCRP to make immediate CVD assessments and to provide point-of-contact counseling to patients with and without disabilities.

Creating a multi-institutional family medicine clerkship examination: lessons learned.

BACKGROUND AND OBJECTIVES: Multiple choice examinations assess learners' attainment of medical knowledge. Developing multiple choice examinations that discriminate among learners is difficult and time-consuming. Many institutions avoid this effort by using the National Board of Medical Examiners (NBME) subject examinations, which can also provide comparisons to a national norm. The family medicine subject examination has been criticized, however, because the test's content does not reflect the learning expected during the clerkship. Additionally, the test results cannot guide clerkship directors sufficiently to help students study or to improve the curriculum. METHODS: Family medicine clerkships at three different institutions used a common 75-item examination based on the textbook Essentials of Family Medicine, Fifth Edition, for one academic year. Data were pooled and analyzed. The Raush Item Response Theory assessed student and item performance. RESULTS: A total of 451 students took the examination. Across the three schools: (1) item separations (Rasch) were high (8.64), indicating good spread in item difficulty, (2) person separations were lower (1.65), indicating that medical students are likely a relatively homogeneous group, (3) Rasch item reliabilities were strong (ranging from .96-.99), and (4) Rasch person reliabilities (.54-.73) were lower. True internal consistencies across items as measured by the Kuder-Richardson 20 (KR-20) reliabilities were just adequate at .71-.77. CONCLUSIONS: By pooling resources, clerkship directors can share the creation and implementation of a written examination that has acceptable reliability and greater face validity than the NBME subject examination. They also have more control over examination content and can guide students' learning and curriculum improvements more accurately.

Risk for intentional violent death associated with HLA genotypes: a preliminary survey of deceased American organ donors.

This study investigates the different Human Leukocyte Antigen (HLA) genotypes and their possible associations with both disease and behavior, specifically by describing significant associations between particular HLA genotypes and occurrence of intentional violent death. A de-identified dataset of n = 216,426 deceased American organ donors was analyzed for all possible genotypes by comparing the Independent Variable (Each specific HLA genotype vs. remainder of sample, non-genotype) on the Dependent Variable (Intentional Violent vs. Non-violent death). For HLA-A, 17 heterozygotes were significantly associated with increased occurrence of intentional violent death, with heightened prevalence for HLA-A2, HLA-A23, HLA-A30, HLA-A68, and HLA-A74 alleles. For HLA-B, 32 heterozygotes were significant, 25 of which (e.g., HLA-B7, HLA-B8, HLA-B35, HLA-B44, and HLA-B53) exhibited heightened prevalence of violent death. For HLA-BW, homozygotes had significantly increased odds ratios for intentional violent death. For HLA-DRB1, 19 heterozygotes were significant, with heightened prevalence only for the HLA-DRB1-4 allele. There were no racial differences in risk for the significant HLA-A and HLA-B genotypes. These exploratory, not necessarily causal, results provide the first indications of possible HLA-aggression associations in humans, supporting animal models.

Progress along developmental tracks for electronic health records implementation in the United States.

The development and implementation of electronic health records (EHR) have occurred slowly in the United States. To date, these approaches have, for the most part, followed four developmental tracks: (a) Enhancement of immunization registries and linkage with other health records to produce Child Health Profiles (CHP), (b) Regional Health Information Organization (RHIO) demonstration projects to link together patient medical records, (c) Insurance company projects linked to ICD-9 codes and patient records for cost-benefit assessments, and (d) Consortia of EHR developers collaborating to model systems requirements and standards for data linkage. Until recently, these separate efforts have been conducted in the very silos that they had intended to eliminate, and there is still considerable debate concerning health professionals access to as well as commitment to using EHR if these systems are provided. This paper will describe these four developmental tracks, patient rights and the legal environment for EHR, international comparisons, and future projections for EHR expansion across health networks in the United States.

Griev_Ing: death notification skills and applications for fourth-year medical students.

BACKGROUND AND PURPOSE: Our study examined whether GRIEV_ING improved death notification skills of medical students, whether pretesting with simulated survivors primed learners and improved results of the intervention, and whether feedback on the simulated encounter improved student performance. METHODS: GRIEV_ING training was given to 138 fourth-year medical students divided into three groups: exposure to simulated survivor (SS) with written feedback, exposure to SS but no feedback, and no exposure to SS before the training. Students were tested on self-confidence before and after the intervention and were rated by SSs on interpersonal communication and death notification skills. ANCOVA was performed, with gender and race covariates. RESULTS: All groups improved on death notification competence and confidence at about the same rate. Competence significantly (p =.037) improved for the feedback group. Interpersonal communication scores declined for all groups. CONCLUSIONS: GRIEV_ING provides an effective model medical educators can use to train medical students to provide competent death notifications. Senior medical students are primed to learn death notification and do not require a preexposure.