Published on 02/16/2017
The ePHR (electronic Personal Health Record) is a self-service technology (SST) used in health care, which can serve as an electronic information source for patients, physician and the government. Based on the literature review, we found that there are some concerns and barriers during the ePHR implement in industry perspectives, physicians’ perspective, patients’ perspectives and technology perspectives. In the pilot study of ePHR implementation impact on physician workflow, we conduct a qualitative analysis using structured physician interviews, and a quantitative analysis for physician workflow observations. We try to create recommendations for ePHR implementation for a variety of physician practices, at the same time, discussed some other important ePHR implementation components: communication, training and measurement.
Published on 02/10/2017
Auxins are a class of phytohormones in plants which have an active role in growth and development. The Auxin hormone control pathway in maize meristem is not well studied and has significant scope for in-depth exploration. Previous studies have not shown much novel information about how Auxin is regulated. Weighted Gene co-expression analysis takes results from differentially expressed genes and organizes them into clusters and modules showing possible interactions and co-regulation. These clusters usually highlight unique interactions which cannot be seen by most other methods. We present our ongoing work in building gene co-regulatory networks using certain gene knockouts in the maize meristem Auxin network.
Published on 02/03/2017
Health communication is the process that coordinates health services such as specimen transaction, oral interactions, medical records, and more. Healthcare workflows are based on communication established historically through the practice of healthcare or by the leadership in health institutions. However, during healthcare practices communication doesn’t flow according to plan; interpersonal miscommunication, technical glitches, information overload, etc. risk inefficient healthcare services. We hypothesize that health records contain information related to communication and we can retrieve it in order to address issues of communication. We present an informatics pipeline to retrieve health communication episodes from unstructured health data. The method uses Resource Description Framework (RDF), ontological modeling, and description logic inference to uncover and quantify implicit communication episodes. Retrieved communication has the potential to optimize and improve health communication structures especially, in data-intensive to precision medicine settings.
Published on 01/24/2017
With the advent of next-generation sequencing technologies, a considerable effort has been put into sequencing the epigenome of different species. The efforts such as “Encode” and “Roadmap” epigenomics projects provide an opportunity to compare epigenomes across species (especially between human and mouse). This study is an effort to understand how different histone modifications vary/co-appear between orthologus regions of the two species. In this work, we have also used various measures of orthologus similarity between each pair of orthologus genes and explore how histone modifications are conserved with respect to changes in these similarity measures. These measures of similarity include “gene ontology semantic similarity” (GOSemsim), “codon usage frequency similarity” (CUFS), Ka/Ks ratio and gene expression similarity. Our simulations indicate that evolutionary selection pressure of an orthologus pair (Ka/Ks ratio) is more strongly correlated with its histone modification than any other similarity measure.
Published on 01/18/2017
Early childhood home visiting programs date back to the 1880s and deliver a vital public service of providing and connecting families with health, educational, and economic resources to support optimal development. Continuous quality improvement (CQI) consists of systematic and continuous actions that lead to measurable improvement in services for targeted groups. CQI initiatives (CQII) in home visiting programs have traditionally occurred within a local implementing agency (LIA), parent organization, or funding provision. LIA CQII are often lost to the benefit of external agencies facing similar challenges. We developed a web-based environment, the Gateway, to virtually connect and engage users within an environment aimed to balance CQII training and practice. The environment supports CQII activities which promote and support LIAs quality improvement initiatives while aligning stakeholders from seven Missouri home visiting LIAs. Gateway standardizes quality improvement training, collates overlapping resources, and supports knowledge translation, thus improving capacity for measurable change in organizational initiatives. Gateway allows LIA personnel to identify program activities in need of quality improvement, and guide the planning, implementation, and evaluation of CQII. Prior to site launch, pilot and usability testing was conducted to three defined groups with positive results and a combined System Usability Scale score of 71.63. After full launch, we examined performance relative to targets through the integration of data, dashboards, and reports. To our knowledge, a virtual environment aimed to create a culture of quality improvement and foster CQII for home visiting program LIAs has not been previously reported. Given broad focus on CQI priorities across disciplines, the Gateway offers endless potential with expansion of this site and deployment to programs and agencies beyond the build population.
Published on 11/30/2016
The Neosho madtom (Noturus placidus) is a small catfish, generally less than 3 inches in length, unique to the Neosho-Spring River system within the Arkansas River Basin. It was federally listed as threatened in 1990, largely due to habitat loss. As part of conservation efforts, we generated whole genome Illumina paired-end sequence data from ten Neosho madtom (average 39X coverage) originating from three geographically separated subpopulations to evaluate genetic diversity and population structure. One slender madtom (Noturus exilis) was also sequenced as an outgroup. Although over 1 million variants were found between Neosho and slender madtom, only 86,155 SNPs were variable across the Neosho madtoms sequenced, indicating overall low level genetic diversity. In addition, principal component analysis based on these genotypes indicated weak population structure, suggesting these subpopulations are genetically compatible for reintroduction among the locations. Using only 50X coverage of paired-end and mate pair data, we assembled the Neosho madtom genome into 68,147 scaffolds with a scaffold N50 of 120 kb, demonstrating the value in assembling a genome from a population that is closely related to a species of economic interest (i.e., channel catfish, Ictalurus punctatus) but has lower genetic diversity and is easier to assemble. Ongoing efforts aim to improve the assembly and develop demographic models and genomic resources to investigate the basic biology of why such a low-diversity species can subsist and to assist in future conservation efforts.
Published on 11/08/2016
Polyploidy is an important mechanism in plant evolution. We are interested in studying how selective pressures change after a lineage experiences whole genome duplication (WGD) or triplication (WGT). Alpha duplication is the most recent WGD event in Arabidopsis. Then a WGT event occurred in genus Brassica when they diverged from Arabidopsis thaliana. We examined selection at both the population and the species level, by calculating the ratio of non-synonymous to synonymous polymorphisms (pN/pS) and computing Ka/Ks between species. In both lineages of Arabidopsis and Brassica, pN/pS values are larger than Ka/Ks, in accord with the expectation that most populations include individuals possessing mildly deleterious mutations that will eventually be removed by purifying selection. Naïve models of evolution after gene duplication would suggest that duplicates should experience some period of relaxed purifying selection as a result of the genetic redundancy. However, we found that alpha duplicates are actually under stronger constraint compared to other genes. Similarly, triplicated Brassica rapa genes have smaller pN/pS and Ka/Ks when compared to single copy genes. This indicates that the special classes of genes surviving after polyploidy are still under relatively strong selective pressure. Next, we mapped pN/pS and Ka/Ks onto the Arabidopsis thaliana metabolic network and looked for correlations between selection and network statistics. We found pN/pS and Ka/Ks are more variable for nodes with lower degree, while nodes with higher degree are more likely to have smaller pN/pS and Ka/Ks. These results suggest that more “important” nodes in network are generally more constrained selectively.
Published on 11/02/2016
Objective: To develop a systematic and reproducible way to identify patients at increased risk for higher healthcare costs. Methods: Medical records were analyzed for 9,581 adults who were primary care patients in the University of Missouri Health System and who were enrolled in Medicare or Medicaid. Patients were categorized into one of four risk tiers as of October 1, 2013, and the four tiers were compared on demographic characteristics, number of healthcare episodes, and healthcare charges in the year before and the year after cohort formation. Results: The mean number of healthcare episodes and the sum of healthcare charges in the year following cohort formation were higher for patients in the higher-risk tiers. Conclusions: Retrospective information that is easily extracted from medical records can be used to create risk tiers that provide highly useful information about the prospective risk of healthcare utilization and costs.
Published on 10/11/2016
A Metagenomic Analysis of the Effect of Residual Feed Intake on Rumen Metabolism
Ruminant animals have a symbiotic relationship with gastrointestinal microorganisms in the rumen where microbes degrade compounds that can be used in the host animal’s metabolism. Currently, changes in the diet or feed efficiency of the sheep results in differences to the rumen’s microbiota population. By using a metabolic approach, the effects of differing residual feed intake (RFI) on the rumen’s microbiome are analyzed to determine the network interface between the host’s metabolism and rumen microbiome. These findings demonstrate important network structure differences between low and high RFI animals providing a greater understanding of the complexities in the rumen ecosystem.
Published on 09/12/2016
The number of mobile diabetes self-management (DSM) apps has risen. However, it is not certain whether these apps provide effective DSM for elderly diabetic patients. The purpose of this study was to identify barriers in functionality and usability related to needs of elderly diabetic patients for DSM apps. We conducted two focus groups with 10 older diabetic patients. Participants completed a set of DSM tasks using nine representative DSM apps on iPads. They answered a questionnaire which included basic information, System Usability Scale (SUS), app specific questions, and open-ended questions. We found DSM apps did not adhere to diabetes guidelines. Usability was their primary concern about DSM apps. However, average SUS score measured usability was considered not acceptable. This study suggests current DSM apps do not provide evidence-based and usable features for DSM. New DSM app following user-centered design process and evidence–based guidelines are needed for growing diabetic population..