Arnon D. Cohen

Bio: Arnon D. Cohen is an academic researcher from Clalit Health Services. The author has contributed to research in topics: Population & Odds ratio. The author has an hindex of 41, co-authored 374 publications receiving 7913 citations. Previous affiliations of Arnon D. Cohen include University of Milan & University of Connecticut.

Health provider determinants of nonattendance in pediatric otolaryngology patients.

Abstract: Introduction: Nonattendance for otolaryngology appointments disrupts the management of medical care and leads to ineffective use of resources. The determinants of nonattendance in pediatric otolaryngology patients have not been well documented. Objectives: To investigate health provider determinants of nonattendance in pediatric otolaryngology patients. Study Design: We assessed the effects of waiting time for an appointment and the timing of the appointment (during the day, week, and year) on nonattendance proportions during a 1 year period. Chi square tests were used to analyze statistically significant differences of categorical variables. Logistic regression was used for multivariate analyses. Results: A total of 2,628 pediatric visits were included in the study. The overall proportion of nonattendance at the pediatric otolaryngology clinic was 33.0%. Nonattendance proportions were 32.7% between 7 AM and 9 AM; 28.3% between 9 AM and 2 PM, and 36.5% between 2 PM and 8 PM (P < .001). The proportion of nonattendance was 24.1% when there was a short waiting time for an appointment (0–7 days), and 36.3% when there was an intermediate waiting time (7–15 days), and 36.6% when there was a long waiting time (15 days and above)(P < .001, P < .012, respectively). Conclusive: Health provider determinants of nonattendance in pediatric otolaryngology clinic appointments include the waiting time for an appointment and the hour of the appointment within the day.

Detection of K-complexes in sleep EEG using CD-HMM

Abstract: In the current paper a new approach for K-complex detection using a continuous density hidden Markov model (CD-HMM) is presented. The system performance was evaluated in two manners. First using three seconds long segments of K-complexes and of background EEG (classification problem). Second using a whole night record and detecting the K complexes (detection problem). The fist test achieved an equal error rate of 7%. In the second test the system performance was compared to four trained scores that scored the signal independently. The performance of the algorithm was within the variance of the human scorers.

Cutaneous angiosarcoma of breast after lumpectomy, axillary lymph node dissection, and radiotherapy for primary breast carcinoma: case report and review of the literature.

Abstract: Malignant neoplasms known to develop after external beam radiation include angiosarcoma. Although angiosarcoma developing in a lymphedematous arm after radical mastectomy is a well-known phenomenon, cutaneous angiosarcoma after radiotherapy for breast carcinoma has been rarely documented. Herein we present a case with cutaneous angiosarcoma that developed in a 69-year-old woman's breast 5 years after she underwent conservative treatment to the breast: lumpectomy, axillary lymph node dissection, and radiation therapy to the breast. The possible relation of the angiosarcoma to the initial radiotherapy, early diagnosis, and treatment is discussed.

Association between time to colonoscopy after a positive guaiac fecal test result and risk of colorectal cancer and advanced stage disease at diagnosis

Abstract: We evaluated time to colonoscopy after a positive guaiac-based fecal occult blood test (gFOBT) result and its association with the risk of overall colorectal cancer (CRC) and advanced-stage disease at diagnosis. We conducted a retrospective cohort study (2011-2013) within the Clalit Health Services, Israel. Participants were patients between 50 and 74 years old with a positive gFOBT result who had follow-up colonoscopies within 24 months. The exposure was time to colonoscopy, and the main outcome measure was a risk for overall and advanced CRC (defined as Stages III-IV). Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for patient demographics and baseline risk factors. Of the 17,958 patients with positive gFOBT results (median age, 61 years [interquartile range, 56-67 years]; women, 52.2%), there were 685 cases of CRC and 156 cases of an advanced-stage disease diagnosed. The rate of cancer diagnosis at 0-3, 4-6, 7-9, 10-12 and 13-24 months was 3.9%, 2.5%, 3.5%, 4.2% and 7.3%, respectively (p < 0.001). Compared to colonoscopy follow-up within 0-3 months, risks for any CRC and advanced stage disease were higher for a follow-up of 12-24 months: OR, 1.97 (95% CI, 1.51-2.56) and 1.88 (95% CI, 1.43-2.46), respectively. For right-sided cancer (n = 194), an increased risk starts at 10 months, OR, 1.91 (95% CI 1.03-3.56). A result of 3-6 positive fields was significantly associated diagnosis of cancer (OR, 5.52; 95% CI, 4.71-6.46) and advanced stage disease (OR, 8.07; 95% CI, 5.74-11.36). Encouraging an early uptake of colonoscopy and targeting those with 10-24 months delay and a 3-6 positive fields is warranted.

Harrison's Principles of Internal Medicine

Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

The Self-Organizing Map

Abstract: An overview of the self-organizing map algorithm, on which the papers in this issue are based, is presented in this article.

The Geometry of Algorithms with Orthogonality Constraints

Abstract: In this paper we develop new Newton and conjugate gradient algorithms on the Grassmann and Stiefel manifolds. These manifolds represent the constraints that arise in such areas as the symmetric eigenvalue problem, nonlinear eigenvalue problems, electronic structures computations, and signal processing. In addition to the new algorithms, we show how the geometrical framework gives penetrating new insights allowing us to create, understand, and compare algorithms. The theory proposed here provides a taxonomy for numerical linear algebra algorithms that provide a top level mathematical view of previously unrelated algorithms. It is our hope that developers of new algorithms and perturbation theories will benefit from the theory, methods, and examples in this paper.

Sarcoidosis

Abstract: 结节病易误诊,据王洪武等~([1])收集国内18篇关于此病误诊的文献,误诊率高达63.2%,当然有误诊就会有误治,如孙永昌等~([2])报道26例结节病在影像学检查诊断的第一印象中拟诊结核5例,其中就有2例完成规范的抗结核治疗,为此应引起临床对本病诊治的重视。

Type 2 diabetes mellitus.

Abstract: Type 2 diabetes mellitus (T2DM) is an expanding global health problem, closely linked to the epidemic of obesity. Individuals with T2DM are at high risk for both microvascular complications (including retinopathy, nephropathy and neuropathy) and macrovascular complications (such as cardiovascular comorbidities), owing to hyperglycaemia and individual components of the insulin resistance (metabolic) syndrome. Environmental factors (for example, obesity, an unhealthy diet and physical inactivity) and genetic factors contribute to the multiple pathophysiological disturbances that are responsible for impaired glucose homeostasis in T2DM. Insulin resistance and impaired insulin secretion remain the core defects in T2DM, but at least six other pathophysiological abnormalities contribute to the dysregulation of glucose metabolism. The multiple pathogenetic disturbances present in T2DM dictate that multiple antidiabetic agents, used in combination, will be required to maintain normoglycaemia. The treatment must not only be effective and safe but also improve the quality of life. Several novel medications are in development, but the greatest need is for agents that enhance insulin sensitivity, halt the progressive pancreatic β-cell failure that is characteristic of T2DM and prevent or reverse the microvascular complications. For an illustrated summary of this Primer, visit: http://go.nature.com/V2eGfN.