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OBJECTIVE: Flexible sigmoidoscopy has been recommended for diagnosis of patients with bright red rectal bleeding. The purpose of this study was to determine whether lesions associated with bright red hematochezia are located in the distal 60 cm of the colorectum and, therefore, in reach of a flexible sigmoidoscope. METHODS: Three hundred-twelve consecutive patients presenting with hematochezia were shown a card containing three shades of red and asked to choose the color most representative of their fecal blood. Patients then underwent colonoscopy. The colonoscopist noted the length of the scope inserted when bleeding lesions were found. RESULTS: Of 217 patients with bright red hematochezia, 181 bled from the distal 60 cm of the colon. 20 had more proximal lesions (including eight with cancer), and 16 had no lesion found. However, 140 patients with rectosigmoid neoplasms or nonbleeding nonneoplastic lesions (e.g., hemorrhoids, diverticula, vascular anomalies, and fissures) if found by sigmoidoscopy would have subsequently required full colonoscopic surveillance, it was calculated that the average per patient medical charges employing an initial colonoscopic approach would save $12 or $116 over one beginning with sigmoidoscopy (depending on whether sigmoidoscopy is performed in an office setting or endoscopy suite, respectively), and would reduce the probability of perforation slightly. CONCLUSION: A diagnostic approach to hematochezia beginning with colonoscopy should be more effective, safer, and less costly than one beginning with flexible sigmoidoscopy, even when the blood is bright red. [ABSTRACT FROM AUTHOR]

Background: Health disparities are pervasive and are linked to economic losses in the United States of up to $135 billion per year. The Flint Center for Health Equity Solutions (FCHES) is a Transdisciplinary Collaborative Center for health disparities research funded by the National Institute of Minority Health and Health Disparities (NIMHD). The purpose of this study was to estimate the economic impact of the 5-year investment in FCHES in Genesee County, Michigan., Methods: The estimated impacts of FCHES were calculated using a U.S.-specific input/output (I/O) model, IMPLAN, from IMPLAN Group, LLC., which provides a software system to access geographic specific data regarding economic sector interactions from a variety of sources. This allowed us to model the cross-sector economic activity that occurred throughout Genesee County, Michigan, as a result of the FCHES investment. The overall economic impacts were estimated as the sum of three impact types: 1. Direct (the specific expenditures impact of FCHES and the Scientific Research and Development Services sector); 2. Indirect (the impact on suppliers to FCHES and the Scientific Research and Development Services sector); and 3. Induced (the additional economic impact of the spending of these suppliers and employees in the county economy)., Results: The total FCHES investment amounted to approximately $11 million between 2016 and 2020. Overall, combined direct, indirect, and induced impacts of the total FCHES federal investment in Genesee County included over 161 job-years, over $7.6 million in personal income, and more than $19.2 million in economic output. In addition, this combined economic activity generated close to $2.3 million in state/local and federal tax revenue. The impact multipliers show the ripple effect of the FCHES investment. For example, the overall output of over $19.2 million led to an impact multiplier of 1.75 - every $1 of federal FCHES investment led to an additional $.75 of economic output in Genesee County., Conclusions: The FCHES research funding yields significant direct economic impacts above and beyond the direct NIH investment of $11 million. The economic impact estimation method may be relevant and generalizable to other large research centers such as FCHES., (© 2021. The Author(s).)

The organizational importance for interactions between frontline employees and customers has been examined in relation to dimensions such as climate or culture. In this article, we highlight the importance of pricing strategies - typically studied in relation to consumer preferences - for frontline employees. To do this, we apply an evolutionary perspective and present two complementary studies that focus on the relevance of price discipline in relation to employee attitudes and preferences. Focusing on the industry of new automobile sales since there is important firm-level pricing variation, Study 1 finds a faintly positive relationship among employee prosociality, customer satisfaction, and fixed or "no-haggle" pricing strategies. In Study 2, participants indicated a preference for working in environments that offered the same, non-disparate prices to all customers. While previous research has examined the relationships between employee and customer attitudes in relation to firm performance, our studies emphasize the role that pricing strategies can play as a mechanism in those relationships. Our studies illustrate the value of evolutionary frameworks for contemporary business problems.

The focus of this Research Experience for Undergraduates (REU) project was on RNA secondary structure prediction by using a lattice walk approach. The lattice walk approach is a combinatorial and computational biology method used to enumerate possible secondary structures and predict RNA secondary structure from RNA sequences. The method uses discrete mathematical techniques and identifies specified base pairs as parameters. The goal of the REU was to introduce upper-level undergraduate students to the principles and challenges of interdisciplinary research in molecular biology and discrete mathematics. At the beginning of the project, students from the biology and mathematics departments of a mid-sized university received instruction on the role of secondary structure in the function of eukaryotic RNAs and RNA viruses, RNA related to combinatorics, and the National Center for Biotechnology Information resources. The student research projects focused on RNA secondary structure prediction on a regulatory region of the yellow fever virus RNA genome and on an untranslated region of an mRNA of a gene associated with the neurological disorder epilepsy. At the end of the project, the REU students gave poster and oral presentations, and they submitted written final project reports to the program director. The outcome of the REU was that the students gained transferable knowledge and skills in bioinformatics and an awareness of the applications of discrete mathematics to biological research problems.

Learning-impaired children can present with a clinical history suggesting additional problems, including attention deficit disorder and absence seizures. Physicians use clinical judgment in diagnosing the former, but rely heavily on the electroencephalogram (EEG) to diagnose the latter. Most clinicians are reluctant to treat patients with anticonvulsants without seeing 3 Hz spike-and-wave discharges in an EEG. We studied 21 learning-impaired and 7 control children, ages 5 through 12 years, with normal baseline EEGs. All had an additional EEG recorded after 24 hour sleep deprivation. Nine learning-impaired children had a history compatible with absence seizures; 8 of them showed spike-and-wave discharges after sleep deprivation. Of the 12 learning-impaired children with no history of absence seizures, 2 showed spike-and-wave discharges after sleep deprivation. These results are significant (p less than 0.001). Of the 7 controls, none had epileptiform activity following sleep deprivation. Our results show that routine EEGs may be falsely negative in patients with absence seizures, and that sleep deprivation is a potent activator.