Search

The California Hospital Outcomes Project is an initiative mandated by the State of California and conducted by the Office of Statewide Health Planning and Development (OSHPD), to develop public reports comparing hospital outcomes for selected medical conditions and surgical procedures for patients treated in hospitals throughout California. Over the last decade, CHOP has reported risk-adjusted hospital mortality rates for heart attack and community-acquired pneumonia. In 2005, OSHPD is releasing its first report on obstetric care.Delivery was selected as an important topic for public reporting because it is the most frequent single reason for hospitalization in California, and because complications of delivery are associated with substantial health care costs and impairment of function. In 2003, for example, there were 170,465 repairs of obstetric lacerations and 147,084 cesarean deliveries performed in California hospitals – more than any other surgical procedure. Although most women who require these procedures have excellent outcomes, a small minority experience complications that cause pain, weakness, impaired bonding with their new child, bowel or bladder problems, sexual dysfunction, rehospitalization, and even death.This technical report, prepared for OSHPD, summarizes the validation of multiple potential measures of inpatient obstetric quality of care. These measures include two that have been endorsed by OSHPD for public reporting: risk-adjusted postpartum maternal readmission rates and risk-adjusted perineal laceration rates. Other measures were also evaluated in this validation study, but are not recommended for public reporting, including risk-adjusted rates of endometritis, wound infection, hemorrhage, and urinary tract infection. This validation study was designed by the UC Davis research team in collaboration with OSHPD staff and the AB 524 Technical Advisory Committee. It was designed to address a variety of concerns, specified in detail later in this report, about the validity of using hospital-reported ICD-9-CM codes in the California Patient Discharge Data Set to report publicly on hospital performance.The original methodology for estimating and analyzing risk-adjusted postpartum maternal readmission rates was developed in 1996, using data on deliveries performed in 1992-1993. This developmental work is fully described in a report that was published by the OSHPD in December 1996 (Section 2, citation 19). We were subsequently asked by the OSHPD to validate the data and methodology used in this 1996 report. To simplify the task, we selected a subsample of the same records for this validation study. As described in detail in later sections of this report, we collected records from hospitals in 1998, recoded and abstracted them in 1999, and performed analyses in 2000-2001. Although some results from these analyses have already appeared in print elsewhere, this report compiles all relevant findings in a single document. We believe that the findings are still informative, despite their age, because there is no evidence of statewide improvement in the coding of obstetric records over the past decade. In addition, the mean postpartum length of stay and readmission rate have remained relatively stable over time (after some decrease in length of stay during the 1990s), suggesting that the clinical factors driving readmissions have also been relatively stable. This study remains the most comprehensive published analysis of the accuracy of ICD-9-CM coded inpatient obstetric data. However, if the OSHPD continues to use the same datasets in the same manner, it would be prudent to repeat this validation study in the future.

Summary: Functional precision oncology—a strategy based on perturbing primary tumor cells from cancer patients—could provide a road forward for personalized treatment. Here, we present a comprehensive protocol covering generation and culture of patient-derived colorectal organoids, isolation and expansion of tumor-infiltrating lymphocytes (TILs), and isolation and culture of peripheral blood mononuclear cells (PBMCs). With this protocol, samples fulfilling the demands for performing multi-omics analysis, e.g., RNA sequencing (RNA-seq), whole-exome sequencing (WES), single-cell RNA sequencing (scRNA-seq), and (phospho-)proteomics, can be generated.For complete details on the use and execution of this protocol, please refer to Plattner et al. (2023).1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Abstract Eliciting regulated cell death, like necroptosis, is a potential cancer treatment. However, pathways eliciting necroptosis are poorly understood. It has been reported that prolonged activation of acid-sensing ion channel 1a (ASIC1a) induces necroptosis in mouse neurons. Glioblastoma stem cells (GSCs) also express functional ASIC1a, but whether prolonged activation of ASIC1a induces necroptosis in GSCs is unknown. Here we used a tumorsphere formation assay to show that slight acidosis (pH 6.6) induces necrotic cell death in a manner that was sensitive to the necroptosis inhibitor Nec-1 and to the ASIC1a antagonist PcTx1. In addition, genetic knockout of ASIC1a rendered GSCs resistant to acid-induced reduction in tumorsphere formation, while the ASIC1 agonist MitTx1 reduced tumorsphere formation also at neutral pH. Finally, a 20 amino acid fragment of the ASIC1 C-terminus, thought to interact with the necroptosis kinase RIPK1, was sufficient to reduce the formation of tumorspheres. Meanwhile, the genetic knockout of MLKL, the executive protein in the necroptosis cascade, did not prevent a reduction in tumor sphere formation, suggesting that ASIC1a induced an alternative cell death pathway. These findings demonstrate that ASIC1a is a death receptor on GSCs that induces cell death during prolonged acidosis. We propose that this pathway shapes the evolution of a tumor in its acidic microenvironment and that pharmacological activation of ASIC1a might be a potential new strategy in tumor therapy.

Algorithms for a rapid analysis of hyperspectral data are becoming more and more important with planned next generation spaceborne hyperspectral missions such as the Environmental Mapping and Analysis Program (EnMAP) and the Japanese Hyperspectral Imager Suite (HISUI), together with an ever growing pool of hyperspectral airborne data. The here presented EnGeoMAP 2.0 algorithm is an automated system for material characterization from imaging spectroscopy data, which builds on the theoretical framework of the Tetracorder and MICA (Material Identification and Characterization Algorithm) of the United States Geological Survey and of EnGeoMAP 1.0 from 2013. EnGeoMAP 2.0 includes automated absorption feature extraction, spatio-spectral gradient calculation and mineral anomaly detection. The usage of EnGeoMAP 2.0 is demonstrated at the mineral deposit sites of Rodalquilar (SE-Spain) and Haib River (S-Namibia) using HyMAP and simulated EnMAP data. Results from Hyperion data are presented as supplementary information.