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Archive for the ‘Curation methodology’ Category

PCCI’s 7th Annual Roundtable “Crowdfunding for Life Sciences: A Bridge Over Troubled Waters?” May 12 2014 Embassy Suites Hotel, Chesterbrook PA 6:00-9:30 PM

Posted in Curation, Curation methodology, Disease Biology, Small Molecules in Development of Therapeutic Drugs, Drug Delivery Platform Technology, Health Economics and Outcomes Research, Health Law & Patient Safety, HealthCare IT, Intellectual Property, Innovations, Commercialization, Investment in technological breakthrough, Interviews with Scientific Leaders, Medical Devices R&D Investment, Pharmaceutical Industry Competitive Intelligence, Scientific & Biotech Conferences: Press Coverage, tagged Aviva Lev-Ari, Content Curation, crowd-funding, crowdsourcing, Curation methodology, pharmaceutical consultation, Pharmaceutical industry, science funding, Social media, Social network on April 17, 2014| Leave a Comment »

PCCI’s 7th Annual Roundtable “Crowdfunding for Life Sciences: A Bridge Over Troubled Waters?”

Reporter: Stephen J. Williams, Ph.D.

Article ID #130: PCCI’s 7th Annual Roundtable “Crowdfunding for Life Sciences: A Bridge Over Troubled Waters?” May 12 2014 Embassy Suites Hotel, Chesterbrook PA 6:00-9:30 PM. Published on 4/17/2014

WordCloud Image Produced by Adam Tubman

 

http://www.rxpcci.com/meetings.htm

Monday, May 12 2014 Embassy Suites Hotel, Chesterbrook PA 6:00 -9:30 PM

Pharmaceutical Consulting Consortium International Inc. presents their 7^th annual Roundtable on Crowdfunding for the Life Sciences and how this funding mechanism applies to early stage life science companies and changes the funding landscape. The conference will examine the types of crowdfunding out there and attempts to answer many questions including:

• Which one is right for which new companies at which stage of the funding process?
• And how will choosing the right or wrong one influence follow-on funders and funding rounds?
• Will the advent of crowdfunding speed up the investment process?
• Will it really bridge the yawning “valley of death”?

The panel is made up of notables and practitioners who will be called upon to deal with the pros and cons of crowdfunding in real life and let them discuss how all this is likely to apply to life science entrepreneurs and investors.

The panel includes:

1. Mark Roderick, Attorney Flaster/Greenberg PC (Moderator)
2. Valerie Gaydos, President, Capital Growth (represents angel/venture community)
3. Samuel Wertheimer, Chief Investment Officer, Poliwogg Darrick Mix
4. Duane Morris, LLP (journalist who covers crowdfunding

Register by clicking on www.rxpcci.com and following directions The event will be webcast.

Leaders in Pharmaceutical Business Intelligence had recently launched a new, real-time based methodology for meeting coverage using social media as a platform to foster discussion and commentary.

This methodology is described in the following post REAL TIME Cancer Conference Coverage: A Novel Methodology for Authentic Reporting on Presentations and Discussions launched via Twitter.com @ The 2nd ANNUAL Sachs Cancer Bio Partnering & Investment Forum in Drug Development, 19th March 2014 • New York Academy of Sciences • USA

This new method was successfully used and curated at the 2^nd Annual Sachs Cancer Bio Partnering &Investment Forum at the New York Academy of Sciences and will be featured at the forthcoming Sachs Global Conferences in 2014 and 2015.

Related articles on this site include:

conceived: NEW Definition for Co-Curation in Medical Research

Cancer Biology and Genomics for Disease Diagnosis, Volume One Pre-ePub Announcement

Volatile Organic Compounds (VOCs) as Biomarkers in Cancer Detection: • Alnion Ranked #1 in “Top 10 Israeli medical advances to watch in 2014”.

Investing and inventing: Is the Tango of Mars and Venus Still on

SACHS Associates, London – Planning Forthcoming Conferences: 2014 – 2015

 

 

 

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Power of Analogy: Curation in Music, Music Critique as a Curation and Curation of Medical Research Findings – A Comparison

Posted in Curation, Curation methodology, De novo synthesis, Dialectic, Discovery process, Evolutionary cognition, Explanatory, Historical relevance, Theoretic convergence on February 11, 2014| Leave a Comment »

Power of Analogy: Curation in Music, Music Critique as a Curation and Curation of Medical Research Findings – A Comparison

Curator: Aviva Lev-Ari, PhD, RN

 

UPDATED on 8/19/2018

This is the best curation on Music I read to date

Aviva Lev-Ari, PhD, RN

LEONARD BERNSTEIN AT 100 Celebrating the legendary composerconductor’s string works and unbridled loyalty to the music By Thomas May

https://memeteria.files.wordpress.com/2018/07/august-2018-st280.pdf

 

On 2/11/2014 I read The Hub Review: Concert with a key by Thomas Gravey. I was inspired to develop an Analogy between his Review and the work we do.

This article has three parts:

Part 1: Six Components in the Analogy 

Part 2: Equivalence in the Analogy 

Part 3: Curation in Music (Component #1) and Music Review as a Curation (Component #2)

 

Part 1

Six Components in the Analogy

Component #1: Curation in Music

Component #1: Detailed, below

Work of Original Music Curation and Performance: The Celebrity Series Concert on 1/31/2014 in Boston, MA, which I attended.

#Boston premiere of ‘Old Friend’ tonight at New England Conservatory’s Jordan Hall at Kirill’s recital, which includes works by #Haydn, #Schumann (‘Carnaval’), and #Mussorgsky (‘Pictures at an Exhibition’).

Component #2: Music Review and Critique as a Curation

Component #2: Detailed, below

Music Review and Critique as a Curation it represents a very fine example of Music Critique as a Curation written by Thomas Garvey on 2/8/2014 for the 1/31/2014, Celebrity Series concert in Jordan Hall by Kirill Gerstein, Component #1, above

http://hubreview.blogspot.com/2014/02/concert-with-key.html#links

Component #3, #4, #5, #6 – Curations in Medical Research

Component #3: Detailed, here

Work of Original Expression what is the methodology of Curation in the context of Medical Research Findings Exposition of Synthesis and Interpretation of the significance of the results to Clinical Care

Dr. A. Lev-Ari‘s definition of the Methodology of Curation

conceived: NEW Definition for Co-Curation in Medical Research

Component #4: Detailed, here

Work of Original Expression of the function and use of Curation methodology for Medical Research Findings Exposition of Synthesis and Interpretation of the significance of the results to Clinical Care

Dr. JD Pearlman‘s metaphoric expression of the Curation Methodology

In the Summary to Volume Two 

Cardiovascular Original Research: Cases in Methodology Design for Content Co-Curation – The Art of Scientific & Medical Curation

Dr. Pearlman writes:

This volume introduces a fresh look at keeping abreast of cardiovascular disease. In particular it explains and exemplifies the how and why of curation as a methodology for discourse. Curation is designed to edify and facilitate awareness and cohesive access to biomedical knowledge otherwise buried in subspecialty scientific journals in the Life Sciences and Medicine. Particular themes of focus include discovery, innovation and translation to clinical care, including linkages and underpinnings that might otherwise be mislabeled as esoteric. Key components of curation include expert identification of data, ideas and innovations of interest, expert interpretation of the original research results, integration with context, digesting, highlighting, correlating and presenting in novel light.

The superstructure of curations includes multiple additional creative elements:

• eTOCs stands for electronic Table of Contents: fresh thought-provoking organizing themes link a path to a diverse trail of publications (analogous to creating a path in the forest)
• Extracts highlighting notable elements of publications that mark a path
• Voice of Expert commentary providing context and direction

The Electronic Table of Contents (eTOCs) serves several functions:

• eTOCs collates information from multiple sources into coherent themes
• eTOCs enables multiple pathways to information, including both Longitudinal and cross-sectional organizational themes.
• eTOCs presents nested pathways through the forest, including nesting of topics by overreaching theme, chapters, Curations, reports and references.
• eTOCs assemblies of thought provide fresh vistas that promote innovation and rethinking

In ekistics (urban design) Francis Bacon emphasized the importance of pathways linked to purpose, recommending a landmark magnet as an attractor for pursuits along a created path. Analogously, if the continually expanding collective knowledge embodied in subspecialty publications represents a forest of data and ideas, then Curation creates pathways in that forest that serve not only to keep the reader from getting lost, but also, as recommended by Francis Bacon, creates pathways that serve attractive purposes, with special vistas, highlights, themes, coherence, motivations and purposes.

CONTEXT (for each, Causes, Risks, Biomarkers and Therapeutics): See Volumes 1,2,3,4,5,6 

Component #5: Detailed, here

Work of Original Expression of two examples for the Writing Tatent and the Curation Talent applied in Medical writings by a Surgeon and by a Pathologist

Dr. A. Lev-Ari’s Curation of an article that demonstrates the Art of Praise for the Physician as a Author and Writer of proze of high literary merit on subjects in Science and Medicine:

The Young Surgeon and The Retired Pathologist: On Science, Medicine and HealthCare Policy – The Best Writers Among the WRITERS

Component #6: Detailed, here

Music in the Service of Clinical Care

Dr. A. Lev-Ari’s Curation of an article on the Function of Music in Restoration of Wellness from a Disease Stage

The Role of the Harp and of Music in Medical Recovery

More Harp Music

http://www.youtube.com/watch?v=Tiye0BqxJS4 

Part 2

Equivalence in the Analogy

Analogy Defined

(from Greek ἀναλογία, analogia, “proportion”^[1][2]) is a cognitive process of transferring information or meaning from a particular subject (the analogue or source) to another particular subject (the target), or a linguistic expression corresponding to such a process. In a narrower sense, analogy is an inference or anargument from one particular to another particular, as opposed to deduction, induction, and abduction, where at least one of the premises or the conclusion is general. The word analogy can also refer to the relation between the source and the target themselves, which is often, though not necessarily, a similarity, as in the biological notion of analogy.

Analogy has been studied and discussed since classical antiquity by philosophers, scientists and lawyers. The last few decades have shown a renewed interest in analogy, most notably in cognitive science.

SOURCE of the definition

http://en.wikipedia.org/wiki/Analogy

Equivalence in the Analogy

[Component #1] is analogous to [Component #6] = [Component #6] is analogous to [Component #1]

[Component #2] is analogous to [Component #4] = [Component #4] is analogous to [Component #2]

[Components #3, #5] are analogous to [Components #1, #4] and [Component #2]

 

Component #1: Work of Original Music Curation and Performance:

Component #2: Music Review and Critique as a Curation

Component #3: Work of Original Expression what is the methodology of Curation

Component #4: Work of Original Expression of the function and use of Curation methodology for Medical Research

Component #5:  Work of Original Expression of two examples for the Writing Tatent and the Curation Talent applied in Medical writings by a Surgeon and by a Pathologist

Component #6: Music in the Service of Clinical Care

 

Part 3

Curation in Music (Component #1) and

Music Review as  a Curation (Component #2)

Component #1: Curation in Music

Work of Original Music Curation and Performance: The Celebrity Series Concert on 1/31/2014 in Boston, MA, which I attended.

#Boston premiere of ‘Old Friend’ tonight at New England Conservatory’s Jordan Hall at Kirill’s recital, which includes works by #Haydn, #Schumann (‘Carnaval’), and #Mussorgsky (‘Pictures at an Exhibition’).

Kirill Gerstein shared a link.

https://vine.co/v/MzmbQ2FT7Jv

January 31, 2014

The Boston Globe tells the tale of how ‘Old Friend’, a piece Kirill commissioned from composer Timo Andres, came into fruition.You can hear the #Boston premiere of ‘Old Friend’ tonight at New England Conservatory’s Jordan Hall at Kirill’s recital, which includes works by #Haydn, #Schumann (‘Carnaval’), and #Mussorgsky (‘Pictures at an Exhibition’).Tickets: http://www.celebrityseries.org/CS_performers_2013_14/gerstein.htm

‘Old Friend’ is formed over a piano and some coffee – The Boston Globe

http://www.bostonglobe.com

As Kirill Gerstein remembers it, it was over coffee early in 2011 that he asked composer Timothy Andres to write a…

SOURCE

https://www.facebook.com/pages/Kirill-Gerstein/101570384501

Component #2: Music Review as a Curation

Music Review and Critique which represents a very fine example of a Curation in Music Critique written by Thomas Garvey for the 1/31/2014, Celebrity Series concert in Jordan Hall by Kirill Gerstein, Component #1, above

http://hubreview.blogspot.com/2014/02/concert-with-key.html#links

Saturday, February 8, 2014

Concert with a key

Kirill Gerstein

Rarely has a performance been curated with such subtle thematic skill as Kirill Gerstein’s at Celebrity Series last weekend.

Its calling card was the Boston premiere of current wunderkind Timo Andres’ “Old Friend,” a kind of millennial fantasia on Chopin’s Third Scherzo.  You know the Chopin – it’s a dazzler split between two apparent emotional poles, one grumbling at the bottom of the keyboard, the other chiming at the top; the piece is perhaps most memorable for the sparkling arpeggios that rain over the conflicted theme that sounds at the point where the two modes meet in the middle.

Andres teases that opposition into a vast structure in “Old Friend” – but more on that later. The point I want to make now is that Andres’ title unlocks the design of Gerstein’s whole concert – or concert à clef, if you will. For the pianist had clearly taken Andres’ insight into Chopin’s scherzo as the key to his entire program, and had thought long and hard not only about the theme of “friendship” (particularly lost friendship) in life and art, but about the musical values that undergird its expression.Hence the opening choice of Haydn’s familiar Variations in F Minor. It too, of course, is a double variation: an initial melancholy voice in F minor is slowly entwined by a lighter song in F major; two “friends,” if you will, of opposed temperaments. The voices dance in ever more elaborate patterns until the second is abruptly cut off, and a coda of poignant force rings down the curtain on the piece. Legend has it that this shock was inspired by the unexpected death of Haydn’s friend Maria Anna von Genzinger, with whom he had struck up a passionate correspondence. And the Variations do have a sweetly epistolary quality; one voice seems to “reply” to the other almost by post. But Gerstein took that sense of distance a bit far; he played with a measured precision that came off as slightly dry – although the outpouring of emotion at the end of the affair, if you will, was genuine, and genuinely moving.In the next offering, Schumann’s Carnaval, the theme of friendship evoked in music was even more overt. For the program of Carnaval – now worked out by scholars from Schumann’s notes and titles – is a cavalcade of the composer’s friends, both real and imaginary, through which move two lovers, Ernestine von Fricken and Schumann’s eventual wife, Clara (along with real-life musical idols like Paganini). The piece seems structureless to the uninitiated (and, well, it is!) – but there is clearly some sort of romantic showdown at its core; many believe Schumann’s eventual rejection of Ernestine in favor of Clara is prefigured in its variations. But then Chopin shows up, and the party grinds on. I admit Carnaval never quite sustains my interest throughout its meandering length; but I also admit that Gerstein’s version was among the most compelling I’ve heard.  From its opening flourish, the pianist seemed in superb control of its many voices, and even the sense of their overlapping interpenetration, and the musical haze that surrounds them.  And Gerstein carried off the finale, in which the whole artsy crowd marches out to confront the Philistines, in very high style indeed.After intermission came the premiere from Andres, who delivered the most musically abstracted vision of friendship yet. Of course, this time the friend was itself a piece of music – Chopin’s scherzo (rather than the composer himself) – and music about music is almost always inherently abstract. Andres basically took the most famous feature of the scherzo – those cascades of arpeggios – and doubled them, so that “Old Friend” rippled up from the bottom of the keyboard as well as down from its top, in a series of interlocking minimalist cells drawn from Chopin’s harmonic material. The cells moved in and out of phase, and various points of intersection or inversion were constantly shifting – still, Andres seemed unable to transcend the limits of his schema, and the eventual emergence of the scherzo’s own phrases seemed like a slight anticlimax (as we could see them coming from so very far away).

Hartmann’s “Catacombs of Paris”

Thus “Old Friend” at times felt like pianism for pianists, a kind of giant tinkertoy – still, its construction was virtuosic, and its technical demands challenging indeed (the composer himself is an astonishingly facile pianist, and he clearly intended this as his own exploration of the grand manner – a kind of maximal minimalism!). For his part, Gerstein played its rumbling, chiming cadences for all they were worth; Andres wrote the piece for him, and he had to have been pleased with this performance.

Finally, galloping after the premiere came one of the great keyboard warhorses – Mussorgsky’sPictures at an Exhibition. If you’re wondering at the friendship connection here, recall that the paintings in question were by a close friend and artistic associate of the composer – the architect/artist Viktor Hartmann. And in keeping with the slightly funereal theme of much of the concert, these famous tone poems were intended as both valedictory and obituary; for the exhibition that Mussorgsky evokes (and which included works from his own collection) was, tragically, a posthumous one, as the artist died of an aneurysm at the early age of 39.

Hartmann’s “Great Gate” of Kiev was never realized.

I always make it a point to recommend that concertgoers who are only familiar with Ravel’s celebrated orchestration seek out a performance of the original score (preferably in its first form – as here – rather than Rimsky-Korsakov’s corrected edition). It’s not often heard, as its demands are punishing, particularly in the final two “pictures,” but it is an eye-opener. Perhaps inevitably, the dazzling color of the Ravel somehow spectacularizes, and perhaps even slightly de-personalizes, everything inPictures; certainly on the keyboard, for instance, it is far easier to limn the shifting response of the “Promenade” theme as it moves from vignette to vignette.

Although of course the viewer of these pictures eventually seems to step right into them; his voice first materializes deep within “Catacombs” – where perhaps he is calling to Hartmann himself – before later opening out into its own apotheosis in “The Great Gate of Kiev” (the artist’s sketch for the project, at left) – which in a way is both a gate to Heaven, through which we can imagine the artist’s spirit soaring, and a portal into the deeply Russian artistic consciousness that Mussorgsky and Hartmann dreamed of together.

To be honest, I felt that Gerstein was finally tiring a bit as the bells chimed their welcome in “Great Gate,” but it hardly mattered, as so much of his performance had proved so very exciting (perhaps it’s worth noting at this point the pianist’s own Russian roots). Just a few highlights were the subtly singing line of “The Old Castle,” the note of tragedy sounding beneath “Goldenberg and Schmuyle,” and the haunted murmur of “Con Mortuis in Lingua Mortua.” This was truly a masterly performance of a masterpiece, so no wonder the crowd called the pianist back for an encore. Gerstein chose Rachmaninoff’s Op. 3, No. 3, “Mélodie,” – a last nostalgic bouquet, simple and sweet – and perhaps meant for yet another friend cut down too soon.

Posted by Thomas Garvey at 3:54 PM 

Labels: Carnaval, Celebrity Series, Haydn, Kirill Gerstein, Old Friend, Pictures at an Exhibition,Schumann, Timo Andres, Variations in F Minor

Thomas Garvey – A local reviewer for several years, I was cast from my perch at the Boston Globesome time ago, but quickly learned I could write about my hometown’s culture with more freedom and accuracy on the Web than I ever could at the Globe. And as local reviews grow ever more watered-down (as the press becomes more and more desperate to hang onto advertising – and readers), it has become obvious this town needs an independent, unfettered critic who’s not interested in tossing softballs to the suburbs (or the academy), And I guess I’m just dumb enough to take the job. You can reach me with invites, praise, screeds, etc., at hubreview@hotmail.com.

SOURCE

http://hubreview.blogspot.com/2014/02/concert-with-key.html#links

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Pathophysiological Effects of Diabetes on Ischemic-Cardiovascular Disease and on Chronic Obstructive Pulmonary Disease (COPD)

Posted in Atherogenic Processes & Pathology, Best evidence, Biomarkers & Medical Diagnostics, Biomedical Measurement Science, Cardiovascular Research, Curation, Curation methodology, Diabetes Mellitus, Discovery process, Evidence-based decision-making, Evolutionary cognition, Experimental validation, Explanatory, Frontiers in Cardiology and Cardiovascular Disorders, Health Economics and Outcomes Research, Human Immune System in Health and in Disease, Indigent Nutrition, Innovation in Immunology Diagnostics, International Global Work in Pharmaceutical, Interviews with Scientific Leaders, Medicare and Medicaid, Metabolomics, Nephrology, Neurohumoral Transmission, Nitric Oxide in Health and Disease, Nutrition, Nutritional Supplements: Atherogenesis, lipid metabolism, Origins of Cardiovascular Disease, Pharmacotherapy of Cardiovascular Disease, Population Health Management, Genetics & Pharmaceutical, Population Health Management, Nutrition and Phytochemistry, Proteomics, Systemic Inflammatory Response Related Disorders, Theoretic convergence, Translational Effectiveness, Translational Research, Translational Science, Uninsured and Underinsured, tagged AMI, Arterial stiffness, comorbidities - type 2 DM, COPD, coronary vascular disease, Diabetes management, Diabetes mellitus type 2, hs-CPR, Nutrition and Metabolism Disorders, Nutritional Supplements, prediabetes, proinflammatory, statins, waist circumference on January 15, 2014| Leave a Comment »

Pathophysiological Effects of Diabetes on Ischemic-Cardiovascular Disease and on Chronic Obstructive Pulmonary Disease (COPD)

Curator:  Larry H. Bernstein, MD, FCAP

Article ID #106: Pathophysiological Effects of Diabetes on Ischemic-Cardiovascular Disease and on Chronic Obstructive Pulmonary Disease (COPD). Published 1/15/2014

WordCloud Image Produced by Adam Tubman

This is a multipart article that develops the pathological effects of type-2 diabetes in the progression of a systemic inflammatory disease with a development of neuropathy, and fully developing into cardiovascular disease.  It also identifies a systemic relationship to the development of chronic obstructive pulmonary disease (COPD).

The more we learn about diabetes, we learn about its generalized systemic effects.

This article has the following SIX Parts:

Part 1. Role of Autonomic Cardiovascular Neuropathy in Pathogenesis of ischemic heart disease in patients with diabetes mellitus

Part 2. A Longitudinal Cohort Study of the Cardiovascular Experience of Individuals at High Risk for Diabetes

Part 3.  Clinical significance of cardiovascular dysmetabolic syndrome

Part 4.   Waist circumference a good indicator of future risk for type 2 diabetes and cardiovascular disease

Part 5.   How to use C-reactive protein in acute coronary care

Part 6.  Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony

INTRODUCTION

Type 2 diabetes mellitus is a common chronic disease which develops insidiously over time, and is associated with obesity, nutritional imbalance (high fructose beverages, high starch and processed foods, carbohydrate excess intake, and an imbalance of proinflammatory to anti-inflammatory polyunsaturated  fatty acids), which makes it an acquired and manageable disease.  The long term effects of T2DM is played out on cardiovascular disease and stroke-risk, obstructive sleep apnea, progressive renal insufficiency, development of neuropathy, congestive heart failure and chronic obstructive pulmonary disease, all of which are occuring related to an systemic inflammatory condition that proceeds for some time prior to the identification of overt diabetes.
A detailed story of a significant part of these associations continues in the SIX Part series.

Part 1. Role of Autonomic Cardiovascular Neuropathy in Pathogenesis of ischemic heart disease in patients with diabetes mellitus

This article is an abstract only of a related publication of the pathogenesis of autonomic neuropathy in diabetics leading to ischemic heart disease.

Subjects: Medicine (General), Medicine, Medicine (General),
Health Sciences Authors: Popović-Pejičić Snježana, Todorović-Đilas Ljiljana, Pantelinac Pavle
Publisher: Društvo lekara Vojvodine Srpskog lekarskog društva
Publication: Medicinski Pregled 2006; 59(3-4): Pp 118-123 (2006) ISSN(s): 0025-8105  Added to DOAJ: 2010-11-11
http://dx.doi.org/10.2298/MPNS0604118P  http://www.doiserbia.nb.rs/img/doi/0025-8105/2006/0025-81050604118P.pdf

Keywords: diabetes mellitus, autonomic nervous system diseases, heart diseases, myocardial ischemia, comorbidity

Introduction.

Diabetes is strongly associated with macrovascular complications, among which

• ischemic heart disease is the major cause of mortality.

Autonomic neuropathy increases the risk of complications, which calls for an early diagnosis. The aim of this study was to determine

• both presence and extent of cardiac autonomic neuropathy,

in regard to the type of diabetes mellitus, as well as

• its correlation with coronary disease and
• major cardiovascular risk factors.

Material and methods. We have examined 90 subjects, classified into three groups, with 30 patients each: those with type 1 diabetes, type 2 diabetes and control group of healthy subjects. All patients underwent

• cardiovascular tests (Valsalva maneuver, deep breathing test, response to standing, blood pressure response to standing sustained, handgrip test),
• electrocardiogram,
• treadmill exercise test and
• filled out a questionnaire referring to major cardiovascular risk factors: smoking, obesity, hypertension, and dyslipidemia.

Results. Our results showed that cardiovascular autonomic neuropathy was

• more frequent in type 2 diabetes,
• manifesting as autonomic neuropathy.

In patients with autonomic neuropathy, regardless of the type of diabetes,

• the treadmill test was positive, i.e. strongly correlating with coronary disease.

In regard to coronary disease risk factors,

• the most frequent correlation was found for obesity and hypertension.

Discussion

Cardiovascular autonomic neuropathy is considered to be the principal cause of arteriosclerosis and coronary disease. Our results showed that the occurrence of cardiovascular autonomic neuropathy increases the risk of coronary disease due to dysfunction of autonomic nervous system.

Conclusions

Cardiovascular autonomic neuropathy is a common complication of diabetes that significantly correlates with coronary disease. Early diagnosis of cardiovascular autonomic neuropathy points to increased cardiovascular risk, providing a basis for preventive and therapeutic measures.

Part 2. A Longitudinal Cohort Study of the Cardiovascular Experience of Individuals at High Risk for Diabetes

This second part is a description of a longitudinal cohort study of individuals at high-risk for diabetes.  Unlike the SSA study, the study is not focused on protein-energy malnutrition.

Protocol for ADDITION-PRO: a longitudinal cohort study of the cardiovascular experience of individuals at high risk for diabetes recruited from Danish primary care

Subjects: Public aspects of medicine, Medicine, Public Health, Health Sciences
Authors: Johansen NB, Hansen Anne-Louise S, Jensen TM, Philipsen A, Rasmussen SS, Jørgensen ME, Simmons RK, Lauritzen T, Sandbæk A, Witte DR
Publisher: BioMed Central    Date of publication: 2012 Dec Published in: BMC Public Health 2012; 12(1): 1078    ISSN(s): 1471-2458   Added to DOAJ: 2013-03-12 http://dx.doi.org/10.1186/1471-2458-12-1078       http://www.biomedcentral.com/1471-2458/12/1078

Keywords: Diabetes, Cardiovascular disease, Primary care, Complications, Microvascular, Impaired fasting glucose, Impaired glucose intolerance, Aortic stiffness, Physical activity, Body composition

Background

Screening programmes for type 2 diabetes inevitably find more individuals at high risk for diabetes than people with undiagnosed prevalent disease. While well established guidelines for the treatment of diabetes exist, less is known about treatment or prevention strategies for individuals found at high risk following screening. In order to make better use of the opportunities for primary prevention of diabetes and its complications among this high risk group, it is important to

• quantify diabetes progression rates and to examine
• the development of early markers of cardiovascular disease and
• microvascular diabetic complications.

We also require a better understanding of the

• mechanisms that underlie and drive early changes in cardiometabolic physiology.

The ADDITION-PRO study was designed to address these issues among individuals at different levels of diabetes risk recruited from Danish primary care.

Methods/Design

ADDITION-PRO is a population-based, longitudinal cohort study of individuals at high risk for diabetes. 16,136 eligible individuals were identified at high risk following participation in a stepwise screening programme in Danish general practice between 2001 and 2006.

• All individuals with impaired glucose regulation at screening,
• those who developed diabetes following screening, and
• a random sub-sample of those at lower levels of diabetes risk

were invited to attend a follow-up health assessment in 2009–2011 (n = 4,188), of whom 2,082 (50%) attended. The health assessment included

• detailed measurement of anthropometry,
• body composition,
• biochemistry,
• physical activity and
• cardiovascular risk factors including aortic stiffness and central blood pressure.

All ADDITION-PRO participants are being followed for incident cardiovascular disease and death.

Discussion

The ADDITION-PRO study is designed to increase

• understanding of cardiovascular risk and
• its underlying mechanisms among individuals at high risk of diabetes.

Key features of this study include

• (i) a carefully characterised cohort at different levels of diabetes risk;
• (ii) detailed measurement of cardiovascular and metabolic risk factors;
• (iii) objective measurement of physical activity behaviour; and
• (iv) long-term follow-up of hard clinical outcomes including mortality and cardiovascular disease.

Results will inform policy recommendations concerning cardiovascular risk reduction and treatment among individuals at high risk for diabetes. The detailed phenotyping of this cohort will also allow a number of research questions concerning early changes in cardiometabolic physiology to be addressed.

Part 3.  Clinical significance of cardiovascular dysmetabolic syndrome

This study also addresses the issue of diabetes insulin resistance leading to cardiovascular dysmetabolic syndrome.

Subjects: Diseases of the circulatory (Cardiovascular) system,
Specialties of internal medicine, Internal medicine, Medicine, Cardiovascular, Medicine (General), Health Sciences
Authors: Deedwania Prakash C Publisher: BioMed Central            Date of publication: 2002 Jan
Published in: Trials 2002; 3: 1(2)   ISSN(s): 1468-6708  Added to DOAJ: 2004-06-03
http://dx.doi.org/10.1186/1468-6708-3-2   http://cvm.controlled-trials.com/content/3/1/2

Keywords: cardiovascular dysmetabolic syndrome, coronary heart disease, diabetes mellitus, hyperinsulinemia, insulin resistance

Although diabetes mellitus is predominantly a metabolic disorder,

• recent data suggest that it is as much a vascular disorder.
• Cardiovascular complications are the leading cause
  • of death and disability in patients with diabetes mellitus.

A number of recent reports have emphasized that

• many patients already have atherosclerosis in progression
• at the time they are diagnosed with clinical evidence of diabetes mellitus.

The increased risk of atherosclerosis and cardiovascular complications in diabetic patients is related to

• the frequently associated dyslipidemia, hypertension, hyperglycemia, hyperinsulinemia, and endothelial dysfunction.

The evolving knowledge regarding the variety of

• metabolic,
• hormonal, and
• hemodynamic abnormalities in patients with diabetes mellitus

has led to efforts designed for early identification of individuals at risk of subsequent disease. It has been suggested that

• insulin resistance, the key abnormality in type II diabetes,
• often precedes clinical features of diabetes by 5–6 years.

Careful attention to the criteria described for the cardiovascular dysmetabolic syndrome

• should help identify those at risk at an early stage.

The application of nonpharmacologic as well as newer emerging pharmacologic therapies can have beneficial effects

• in individuals with cardiovascular dysmetabolic syndrome and/or diabetes mellitus
• by improving insulin sensitivity and related abnormalities.

Early identification and implementation of appropriate therapeutic strategies would be necessary

• to contain the emerging new epidemic of cardiovascular disease related to diabetes.

Part 4.   Waist circumference a good indicator of future risk for type 2 diabetes and cardiovascular disease

Subjects: Public aspects of medicine, Medicine, Public Health, Health Sciences
Authors: Siren Reijo, Eriksson Johan G, Vanhanen Hannu
Publisher: BioMed Central      Date of publication: 2012 Aug
Published in: BMC Public Health 2012; 12: 1(631)    ISSN(s): 1471-2458   Added to DOAJ: 2013-03-12
http://dx.doi.org/10.1186/1471-2458-12-631    http://www.biomedcentral.com/1471-2458/12/631

Keywords: Waist circumference, Type 2 diabetes, Cardiovascular disease, Middle-aged men

Background

Abdominal obesity is a more important risk factor than overall obesity in

• predicting the development of type 2 diabetes and cardiovascular disease.

From a preventive and public health point of view it is crucial that

• risk factors are identified at an early stage,
• in order to change and modify behaviour and lifestyle in high risk individuals.

Methods

Data from a community based study was used to assess

• the risk for type 2 diabetes,
• cardiovascular disease and
• prevalence of metabolic syndrome in middle-aged men.

In order to identify those with increased risk for type 2 diabetes and/or cardiovascular disease

• sensitivity and specificity analysis were performed, including
• calculation of positive and negative predictive values, and
• corresponding 95% CI for eleven different cut-off points,
  • with 1 cm intervals (92 to 102 cm), for waist circumference.

Results

A waist circumference ≥94 cm in middle-aged men,

• identified those with increased risk for type 2 diabetes
• and/or for cardiovascular disease

with a sensitivity of 84.4% (95% CI 76.4% to 90.0%), and a specificity of 78.2% (95% CI 68.4% to 85.5%). The positive predictive value was 82.9% (95% CI 74.8% to 88.8%), and negative predictive value 80.0% (95% CI 70.3% to 87.1%), respectively .

Conclusions

Measurement of waist circumference in middle-aged men

• is a reliable test to identify individuals at increased risk for type 2 diabetes and cardiovascular disease.

This measurement should be used more frequently in daily practice in primary care

• in order to identify individuals at risk and when planning health counselling and interventions.

Part 5.  How to use C-reactive protein in acute coronary care

Luigi M. Biasucci, Wolfgang Koenig, Johannes Mair, Christian Mueller, Mario Plebani, Bertil Lindahl, Nader Rifai,Per Venge,Christian Hamm, and the Study Group on Biomarkers in Cardiology of the Acute Cardiovascular Care Association of the European Society of Cardiology
Department of Cardiology B, Aarhus University Hospital, Tage Hansens Gade2, Aarhus DK-8000,Denmark; Germany, U.K., U.S., Italy
European Heart Journal Advance Access published Nov 7, 2013.  Current Opinion.  http://dx.doi.org/10.1093/eurheartj/eht435

Introduction

 C-reactive protein (CRP) is an acute phase protein and an established marker for detection, risk stratification, and monitoring of infections, and inflammatory and necrotic processes.. Because C-reactive protein is sensitive but not specific, its values must be nterpreted  in the clinical context. Inpatients with acute myocardial infarction (AMI), CRP increases within 4–6h of symptoms, peaks 2–4 days later,and returns to baseline after 7–10 days.

CRP has gained interest recently as a marker for risk stratification in acute coronary syndrome (ACS) when measured by high-sensitivity CRP assays. These assays have greater analytical sensitivity and reliably measure CRP concentrations within the reference range with low imprecision (5–10%). Because of evidence that atherosclerosis is an inflammatory disease, high-sensitivity CRP can be used as a biomarker of risk
in primary prevention and in patients with known cardiovascular disease. The aim of this review is to evaluate the use of CRP in patients with acute coronary disease.

The in-vitro stability of high-sensitivity C-reactive protein is excellent. Specific blood sampling conditions aren’t necessary.  However, retesting may be necessary with some assays if there is marked lipaemia.  Baseline and subsequent measures are in good for agreement for risk stratification despite biological variability of 30–60%.

The upper reference limit is method-dependent but usually 8mg/L for standard assays. The distribution of high-sensitivity CRP concentrations is skewed in both genders with a 50th percentile of_1.5mg/L (excluding women on hormone replacement therapy). Race differences have been reported. Most studies have reported no relationship with age,  but to circadian and seasonal variation. CRP concentrations are increased by smoking, obesity, and hormone replacement therapy and reduced by exercise, moderate alcohol drinking, and statin use. Correction for these factors is essential in reference range studies. CRP assays are not standardized. We recommend  the use of third-generation high-sensitivity CRP assays that combine features of standard and high-sensitivity CRP assays.  Required assay precision should be < 10% in the range of 3 and 10 mg/L.

Biochemical and analytical issues

Critical clinical concepts

(1) CRP concentrations are reported in mg/L
(2) CRP test results are method-dependent

•  classification of patients into risk categories is usually comparable

(3) Third generation CRP assay are recommended
(4) No specific patient preparation before blood sampling is necessary
(5) The in-vitro stability of CRP is high

This is only a portion of the published concensus document. What is relevant to this discussion is that the hs-CRP is an extremely valuable marker for inflammatory disease.  It is not ordered often enough because of the broad range of values that we have become accustomed to for years, and it is elevated in rheumatologic conditions, but even then, it is widely used in pediatrics because children may present with rapidly emergent sepsis with very minimal sympoms.
The hs-CRP has opened a window to subliminal inflammatory disease that is diabetes, with accompanied arteriolar endothelial inflammation.

Part 6.  Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony

Subjects: Diseases of the circulatory (Cardiovascular) system,
Specialties of internal medicine, Internal medicine, Medicine, Cardiovascular, Medicine (General), Health Sciences
Authors: Mirrakhimov Aibek E
Publisher: BioMed Central      Date of publication: Oct 2012   ISSN(s): 1475-2840
Published in: Cardiovascular Diabetology 2012; 11(1):132   Added to DOAJ: 2013-03-12
http://dx.doi.org/10.1186/1475-2840-11-132      http://www.cardiab.com/content/11/1/132

Keywords: COPD, Dysglycemia, Insulin resistance, Obesity, Metabolic syndrome, Diabetes mellitus endothelial dysfunction, Vasculopathy

Chronic obstructive pulmonary disease, metabolic syndrome and diabetes mellitus

• are common and underdiagnosed medical conditions.

It was predicted that chronic obstructive pulmonary disease

• will be the third leading cause of death worldwide by 2020.

The healthcare burden of this disease is even greater

• if we consider the significant impact of chronic obstructive pulmonary disease on
  • the cardiovascular morbidity and mortality.

Chronic obstructive pulmonary disease

• may be considered as a novel risk factor for new onset type 2 diabetes mellitus via

multiple pathophysiological alterations such as:

1. inflammation and oxidative stress,
2. insulin resistance,
3. weight gain and
4. alterations in metabolism of adipokines.

On the other hand, diabetes may act as an independent factor,

• negatively affecting pulmonary structure and function.

Diabetes is associated with an increased risk of

1. pulmonary infections,
2. disease exacerbations and
3. worsened COPD outcomes.

On the top of that, coexistent OSA

• may increase the risk for type 2 DM in some individuals.

The current scientific data necessitate a greater outlook on chronic obstructive pulmonary disease and

• chronic obstructive pulmonary disease may be viewed as a risk factor for
• the new onset type 2 diabetes mellitus.

Conversely, both types of diabetes mellitus should be viewed as

• strong contributing factors for the development of obstructive lung disease.

Such approach can potentially improve the outcomes and medical control for both conditions,

• and, thus, decrease the healthcare burden of these major medical problems.

CONCLUSIONS

This discussion  presents a spectrum of cardiovascular risk associated with type 2 diabetes mellitus, with high risk for CVD, stroke, endothelial dysfunction, and an association with obesity, measured by waist circumference, and an underlying proinflammatory state that can be measured by CRP.

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The Cost to Value Conundrum in Cardiovascular Healthcare Provision

Posted in Accountable Care Organizations, Affordable Care Act, Anemia, Atherogenic Processes & Pathology, Best evidence, Bio Instrumentation in Experimental Life Sciences Research, Biomarkers & Medical Diagnostics, Biomedical Measurement Science, Ca2+ triggered activation, Ca2+ triggered activation, Calcium Signaling, Cardiac & Vascular Repair Tools Subsegment, Cardiac and Cardiovascular Surgical Procedures, Cardiac muscle regeneration, Cardiomyopathy, Cardiovascular Pharmacogenomics, Coagulation Therapy and Internal Bleeding, Computational Biology/Systems and Bioinformatics, Curation, Curation methodology, Cytoskeleton, Diabetes Mellitus, Electrophysiology, Evidence-based decision-making, Experimental validation, Federal Budget Appropriations, Frontiers in Cardiology and Cardiovascular Disorders, Health Economics and Outcomes Research, Health Law & Patient Safety, Healthcare costs and reimbursement, Healthcare Reform, Historical relevance, HTN, HTN in Youth, Indigent Nutrition, Interviews with Scientific Leaders, Ionic Transporters Na+, K, Medical Devices R&D and Inventions, Medical Imaging Technology, Image Processing/Computing, MRI, CT, Nuclear Medicine, Ultra Sound, Medicare and Medicaid, Na-K transport, Na-K-ATPase, Nephrology, Nitric Oxide in Health and Disease, Nutrition, Nutritional Supplements: Atherogenesis, lipid metabolism, Origins of Cardiovascular Disease, Pharmaceutical Analytics, Pharmacogenomics, Pharmacologic toxicities, Pharmacotherapy of Cardiovascular Disease, Population Health Management, Genetics & Pharmaceutical, Population Health Management, Nutrition and Phytochemistry, Prescription Drugs Costs, Regenerative Biology and Medicine, Resident-cell-based, Skilled Nursing Facilities, Stem Cells for Regenerative Medicine, Stents & Tools, Synaptic vesicle, Systematic Error (Bias), Systemic Inflammatory Response Related Disorders, Technology Advance Assessment of, Technology Capital Expenses, Technology Transfer: Biotech and Pharmaceutical, Translational Effectiveness, Translational Science, Uninsured and Underinsured, Valves & Tools, tagged acute myocardial infarct, American College of Cardiology ACC, Antiarrhythmic drugs, arrythmias, Artificial Biosensor, Artificial cardiac pacemaker, Artificial heart, Bare-metal stent, Cardiac & Vascular Repair, cardiac myocyte regeneration, Cardiogenic Shock, Cardiology, Cardiometabolic Syndrome, CHF, Content Curation, Coronary artery disease, Coronary stent, Curation methodology, Drug-eluting stents, gene expression, Hypertension, myocardial hypertrophy, nitric oxide, Nitric oxide synthase, RNA, Stem cell on January 1, 2014| Leave a Comment »

The Cost to Value Conundrum in Cardiovascular Healthcare Provision

Author: Larry H. Bernstein, MD, FCAP

Article ID #98: The Cost to Value Conundrum in Cardiovascular Healthcare Provision. Published on 1/1/2014

WordCloud Image Produced by Adam Tubman

I write this introduction to Volume 2 of the e-series on Cardiovascular Diseases, which curates the basic structure and physiology of the heart, the vasculature, and related structures, e.g., the kidney, with respect to:

1. Pathogenesis
2. Diagnosis
3. Treatment

Curation is an introductory portion to Volume Two, which is necessary to introduce the methodological design used to create the following articles. More needs not to be discussed about the methodology, which will become clear, if only that the content curated is changing based on success or failure of both diagnostic and treatment technology availability, as well as the systems needed to support the ongoing advances.  Curation requires:

• meaningful selection,
• enrichment, and
• sharing combining sources and
• creation of new synnthesis

Curators have to create a new perspective or idea on top of the existing media which supports the content in the original. The curator has to select from the myriad upon myriad options available, to re-share and critically view the work. A search can be overwhelming in size of the output, but the curator has to successfully pluck the best material straight out of that noise.

Part 1 is a highly important treatment that is not technological, but about the system now outdated to support our healthcare system, the most technolog-ically advanced in the world, with major problems in the availability of care related to economic disparities.  It is not about technology, per se, but about how we allocate healthcare resources, about individuals’ roles in a not full list of lifestyle maintenance options for self-care, and about the important advances emerging out of the Affordable Care Act (ACA), impacting enormously on Medicaid, which depends on state-level acceptance, on community hospital, ambulatory, and home-care or hospice restructuring, which includes the reduction of management overhead by the formation of regional healthcare alliances, the incorporation of physicians into hospital-based practices (with the hospital collecting and distributing the Part B reimbursement to the physician, with “performance-based” targets for privileges and payment – essential to the success of an Accountable Care Organization (AC)).  One problem that ACA has definitively address is the elimination of the exclusion of patients based on preconditions.  One problem that has been left unresolved is the continuing existence of private policies that meet financial capabilities of the contract to provide, but which provide little value to the “purchaser” of care.  This is a holdout that persists in for-profit managed care as an option.  A physician response to the new system of care, largely fostered by a refusal to accept Medicaid, is the formation of direct physician-patient contracted care without an intermediary.

In this respect, the problem is not simple, but is resolvable.  A proposal for improved economic stability has been prepared by Edward Ingram. A concern for American families and businesses is substantially addressed in a macroeconomic design concept, so that financial services like housing, government, and business finance, savings and pensions, boosting confidence at every level giving everyone a better chance of success in planning their personal savings and lifetime and business finances.

http://macro-economic-design.blogspot.com/p/book.html

Part 2 is a collection of scientific articles on the current advances in cardiac care by the best trained physicians the world has known, with mastery of the most advanced vascular instrumentation for medical or surgical interventions, the latest diagnostic ultrasound and imaging tools that are becoming outdated before the useful lifetime of the capital investment has been completed.  If we tie together Part 1 and Part 2, there is ample room for considering  clinical outcomes based on individual and organizational factors for best performance. This can really only be realized with considerable improvement in information infrastructure, which has miles to go.  Why should this be?  Because for generations of IT support systems, they are historically focused on billing and have made insignificant inroads into the front-end needs of the clinical staff.

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