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Haymart M.R.,Endocrinology and Diabetes | Haymart M.R.,University of Michigan | Haymart M.R.,North Campus Research Complex | Banerjee M.,University of Michigan | And 4 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013

Context: Little is known about practice patterns in thyroid cancer, a cancer that is increasing in incidence. Objective: Wesought to identify aspects of thyroid cancer management that have the greatest variation. Design/Setting/Participants: We surveyed 944 physicians involved in thyroid cancer care from 251 hospitals affiliated with the US National Cancer Database. Physicians were asked questions in the following four domains: thyroid surgery, radioactive iodine use, thyroid hormone replacement postsurgery, and long-term thyroid cancer management. We calculated the ratio of observed variation to hypothetical maximum variation under the assumed distribution of the response. Ratios closer to 1 indicate greater variation. Results: We had a 66% response rate. We found variation in multiple aspects of thyroid cancer management, including the role of central lymph node dissections (variation, 0.99; 95% confidence interval [CI], 0.98-1.00), the role of pretreatment scans before radioactive iodine treatment (variation, 1.00; 95% CI, 0.98-1.00), and all aspects of long-term thyroid cancer management, including applications of ultrasound (variation, 0.97; 95% CI, 0.93-0.99) and radioactive iodine scans (variation, 0.99; 95% CI, 0.97-1.00). For the management of small thyroid cancers, variation exists in all domains, including optimal extent of surgery (variation, 0.91; 95% CI, 0.88-0.94) and the role of both radioactive iodine treatment (variation, 0.91; 95% CI, 0.89-0.93) and suppressive doses of thyroid hormone replacement (variation, 1.00; 95% CI, 0.99-1.00). Conclusion: We identified areas of variation in thyroid cancer management. To reduce the variation and improve the management of thyroid cancer, there is a need for more research and more research dissemination. Copyright © 2013 by The Endocrine Society.


News Article | November 13, 2015
Site: www.greencarcongress.com

Ford is the first automaker to test autonomous vehicles at Mcity—the full-scale simulated real-world urban environment at the University of Michigan. (Earlier post.) The 32-acre facility is part of the university’s Mobility Transformation Center. Ford has been testing autonomous vehicles for more than 10 years and is now expanding testing on the diversity of roads and realistic neighborhoods of Mcity near the North Campus Research Complex to accelerate research of advanced sensing technologies. The Ford Fusion Hybrid Autonomous Research Vehicle merges today’s driver-assist technologies, such as front-facing cameras, radar and ultrasonic sensors, and adds four Velodyne LiDAR sensors to generate a real-time 3D map of the vehicle’s surrounding environment. Mcity opened in July. The full-scale urban environment provides real-world road scenarios—such as running a red light—that can’t be replicated on public roads. There are street lights, crosswalks, lane delineators, curb cuts, bike lanes, trees, hydrants, sidewalks, signs, traffic control devices—even construction barriers. Here, Ford Fusion Hybrid Autonomous Research Vehicle is tested over a range of surfaces—concrete, asphalt, simulated brick and dirt—and maneuvers two-, three- and four-lane roads, as well as ramps, roundabouts and tunnels. The goal of Mcity is that we get a scaling factor. Every mile driven there can represent 10, 100 or 1,000 miles of on-road driving in terms of our ability to pack in the occurrences of difficult events. —Ryan Eustice, University of Michigan associate professor and principal investigator in Ford’s research collaboration with the university Ford revealed its Fusion Hybrid Autonomous Research Vehicle with University of Michigan and State Farm Insurance in 2013 in an effort to advance sensing systems so these technologies could be integrated into Ford’s next-generation vehicles. (Earlier post.) Earlier this year, Ford announced it moved its research efforts in autonomous vehicle technology to the next step in development, to the advanced engineering phase. The team is working to make sensing and computing technologies feasible for production while continuing to test and refine algorithms. Along with testing at Mcity and on public roads, Ford’s autonomous fleet has been put through the paces at the company’s vehicle development facilities in Dearborn and Romeo, Michigan.


Ford researchers are slated to be embedded at the University of Michigan in a new partnership focused on autonomous driving technology development, in what the company claims is the first ever such arrangement. The partnership will see Ford researchers working directly with, and alongside of, University of Michigan researchers in the same academic building — the North Campus Research Complex (NCRC). Eventually, they will work in a state-of-the-art robotics laboratory on the University of Michigan’s Ann Arbor campus slated to open in 2020. As a reminder, Ford is currently aiming to have “fully autonomous SAE-defined level 4-capable vehicles available for high-volume commercial use in 2021.” The new partnership is part of the effort to achieve that. “Ford engineers and researchers will begin working shoulder-to-shoulder with U-M faculty and students to test and learn about autonomous vehicle technology and innovation,” stated Mark Fields, Ford president and CEO. “We are aiming to show the world what we can achieve when leaders in business and academia work together to make people’s lives better.” The press release provides more: “Ten years into the Ford–University of Michigan Innovation Alliance, the two parties have agreed Ford will lease the fourth floor of the new robotics laboratory. It is an approximately 140,000-square-foot building on Hayward Street, east of the university’s Space Research Building. The planned robotics laboratory will have space where machines walk, fly, drive, and swim. The building will house labs, offices, and classrooms, continuing a tradition of robotics leadership at U-M that includes the creation of MABEL, the world’s fastest-running robot with knees.” It certainly seems like one of the top universities for Ford to partner with in order to be on the cutting edge of autonomous driving. Continuing: “By locating a team of more than 100 employees on campus, Ford benefits from being close to technical leaders as well as facilities, such as Mcity — a one-of-a-kind urban simulation test environment in Ann Arbor. … Today, Ford and U-M also announce professors Matthew Johnson-Roberson and Ram Vasudevan will serve as leaders of a new autonomous vehicle research team comprising graduate students, postdoctoral fellows, and researchers. Both professors, who began collaborating with Ford earlier this summer, bring a wealth of autonomous vehicle research experience. Dr Johnson-Roberson is an assistant professor of Naval Architecture and Marine Engineering, and has worked in autonomous vehicles since the first DARPA Grand Challenge in 2004. His research focuses on robotic systems perception. Dr Vasudevan is an assistant professor of Mechanical Engineering with a background in robotics and next-generation automotive technologies.” Sounds like a serious research team. You can tell that Ford is serious about autonomous driving technology. Too bad it doesn’t seem to be putting the same resources into the development of a long-range electric vehicle. Or maybe it is secretly doing so behind the scenes. Buy a cool T-shirt or mug in the CleanTechnica store!   Keep up to date with all the hottest cleantech news by subscribing to our (free) cleantech daily newsletter or weekly newsletter, or keep an eye on sector-specific news by getting our (also free) solar energy newsletter, electric vehicle newsletter, or wind energy newsletter.


News Article | September 16, 2016
Site: www.greencarcongress.com

« Volkswagen teases release of EV concept at Paris; production version to be 1st MEB vehicle | Main | 24M and partners awarded $3.5M from ARPA-E to develop ultra-high-energy density batteries with new lithium-metal anodes » Ford and the University of Michigan are teaming up to accelerate autonomous vehicle research and development with a first-time arrangement that embeds Ford researchers and engineers into a new state-of-the-art robotics laboratory on U-M’s Ann Arbor campus. While the new robotics laboratory opens in 2020, by the end of this year Ford will move a dozen researchers into the North Campus Research Complex (NCRC), kicking off the first phase of expanded presence. The announcement is the latest in a series of actions by Ford as it moves toward having fully autonomous SAE-defined level 4-capable vehicles available for high-volume commercial use in 2021. Autonomous vehicles are part of Ford’s expansion to be an auto and a mobility company. Ford will lease the fourth floor of the new robotics laboratory. It is an approximately 140,000-square-foot building on Hayward Street, east of the university’s Space Research Building. The planned robotics laboratory will have space where machines walk, fly, drive and swim. The building will house labs, offices and classrooms, continuing a tradition of robotics leadership at U-M that includes the creation of MABEL, the world’s fastest-running robot with knees. By locating a team of more than 100 employees on campus, Ford benefits from being close to technical leaders as well as facilities, such as Mcity—the urban simulation test environment in Ann Arbor. Ford has been testing autonomous vehicles for more than 10 years, last fall becoming the first automaker to begin testing at Mcity. It also is tripling its fleet of autonomous research vehicles this year—making Ford’s fully autonomous vehicle fleet the largest of all automakers. Ford and U-M also announced that professors Matthew Johnson-Roberson and Ram Vasudevan will serve as leaders of a new autonomous vehicle research team comprising graduate students, postdoctoral fellows and researchers. Both professors, who began collaborating with Ford earlier this summer, bring a wealth of autonomous vehicle research experience. Dr. Johnson-Roberson is an assistant professor of Naval Architecture and Marine Engineering, and has worked in autonomous vehicles since the first DARPA Grand Challenge in 2004. His research focuses on robotic systems perception. Dr. Vasudevan is an assistant professor of Mechanical Engineering with a background in robotics and next-generation automotive technologies. U-M’s College of Engineering also named Professor Jessy Grizzle as Director of Robotics. Dr. Grizzle also serves as the key liaison between Ford’s autonomous vehicle research program and the College of Engineering. Grizzle’s familiarity with Ford will be of great value as the college and Ford strengthen their bonds. A U-M professor of engineering since 1987, Grizzle has spent nearly two decades as a Ford consultant working on programs such as environmentally friendly emissions, enhanced fuel economy and hybrid-electric vehicles. U-M is one of only a handful of universities to offer master’s and doctoral degrees in robotics, with the Ph.D. program now in its third year. More than 35 faculty members work in the field.


Meddings J.A.,North Campus Research Complex | Reichert H.,North Campus Research Complex | Rogers M.A.M.,North Campus Research Complex | Saint S.,North Campus Research Complex | And 2 more authors.
Annals of Internal Medicine | Year: 2012

Background: Most (59% to 86%) hospital-acquired urinary tract infections (UTIs) are catheter-associated urinary tract infections (CAUTIs). As of 2008, claims data are used to deny payment for certain hospital-acquired conditions, including CAUTIs, and publicly report hospital performance. Objective: To examine rates of UTIs in adults that are coded in claims data as hospital-acquired and catheter-associated events and evaluate how often nonpayment for CAUTI lowers hospital payment. Design: Before-and-after study of all-payer cross-sectional claims data. Setting: 96 nonfederal acute care Michigan hospitals. Patients: Nonobstetric adults discharged in 2007 (n = 767 531) and 2009 (n = 781 343). Measurements: Hospital rates of UTIs (categorized as catheterassociated or hospital-acquired) and frequency of reduced payment for hospital-acquired CAUTIs. Results: Hospitals frequently requested payment for non-CAUTIs as secondary diagnoses: 10.0% (95% CI, 9.5% to 10.5%) of discharges in 2007 and 10.3% (CI, 9.8% to 10.9%) in 2009. Hospital rates of CAUTI were very low: 0.09% (CI, 0.06% to 0.12%) in 2007 and 0.14% (CI, 0.11% to 0.17%) in 2009. In 2009, 2.6% (CI, 1.6% to 3.6%) of hospital-acquired UTIs were described as CAUTIs. Nonpayment for hospital-acquired CAUTIs reduced payment for 25 of 781 343 (0.003%) hospitalizations in 2009. Limitations: Data are from only 1 state and involved only 1 year before and after nonpayment for complications. Hospital prevention practices were not examined. Conclusion: Catheter-associated UTI rates determined by claims data seem to be inaccurate and are much lower than expected from epidemiologic surveillance data. The financial impact of current nonpayment policy for hospital-acquired CAUTI is low. Claims data are currently not valid data sets for comparing hospitalacquired CAUTI rates for the purpose of public reporting or imposing financial incentives or penalties. Primary Funding Source: Blue Cross Blue Shield of Michigan Foundation. © 2012 American College of Physicians.


Harrod M.,VA Ann Arbor Healthcare System | Kowalski C.P.,VA Ann Arbor Healthcare System | Saint S.,VA Ann Arbor Healthcare System | Saint S.,North Campus Research Complex | And 3 more authors.
BMC Health Services Research | Year: 2013

Background: Catheter associated urinary tract infection (CAUTI) is one of the most commonly acquired health care associated infections within the United States. We examined the implementation of an initiative to prevent CAUTI, to better understand how health care providers' perceptions of risk influenced their use of prevention practices and the potential impact these risk perceptions have on patient care decisions. Understanding such perceptions are critical for developing more effective approaches to ensure the successful uptake of key patient safety practices and thus safer care for hospitalized patients. Methods. We conducted semi-structured phone and in-person interviews with staff from 12 hospitals. A total of 42 interviews were analyzed using open coding and a constant comparative approach. This analysis identified "risk" as a central theme and a "risk explanatory framework" was identified for its sensitizing constructs to organize and explain our findings. Results: We found that multiple perceptions of risk, some non-evidence based, were used by healthcare providers to determine if use of the indwelling urethral catheter was necessary. These risks included normative work where staff deal with competing priorities and must decide which ones to attend too; loosely coupled errors where negative outcomes and the use of urinary catheters were not clearly linked; process weaknesses where risk seemed to be related to both the existing organizational processes and the new initiative being implemented and; workarounds that consisted of health care workers developing workarounds in order to bypass some of the organizational processes created to dissuade catheter use. Conclusions: Hospitals that are implementing patient safety initiatives aimed at reducing indwelling urethral catheters should be aware that the risk to the patient is not the only risk of perceived importance; implementation plans should be formulated accordingly. © 2013 Harrod et al.; licensee BioMed Central Ltd.


Carlozzi N.E.,North Campus Research Complex | Miciura A.,North Campus Research Complex | Migliore N.,North Campus Research Complex | Dayalu P.,University of Michigan
Journal of Huntington's Disease | Year: 2014

Background: The identification of the gene mutation causing Huntington disease has raised hopes for new treatments to ease symptoms and slow functional decline. As such, there has been a push towards designing efficient pharmacological trials (i.e., drug trials), especially with regard to selecting outcomes measures that are both brief and sensitive to changes across the course of the disease, from subtle prodromal changes, to more severe end-stage changes.Objectives: Recently, to aid in efficient development of new HD research studies, the National Institute of Neurological Disorders and Stroke (NINDS) published recommendations for measurement selection in HD. While these recommendations are helpful, many of the recommended measures have little published data in HD. As such, we conducted a systematic review of the literature to identify the most common outcomes measures used in HD clinical trials.Methods: Major medical databases, including PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, were used to identify peer-reviewed journal articles in English from 2001 through April 2013; 151 pharmacological trials were identified.Results: The majority of HD clinical trials employed clinician-reported outcomes measures (93%); patient reported outcome measures (11%) and observer reported outcome measures (3%) were used with much less frequency.Conclusions: We provide a review of the most commonly used measures across these trials, compare these measures to the clinical recommendations made by the NINDS working groups, and provide recommendations for selecting measures for future clinical trials that meet the Food and Drug Administration standards.


PubMed | North Campus Research Complex and Harvard University
Type: | Journal: Health services research | Year: 2016

Extensive evidence documents geographic variation in spending, but limited research assesses geographic variation in quality, particularly among commercially insured enrollees.To measure geographic variation in quality measures, correlation among measures, and correlation between measures and spending for commercially insured enrollees.Administrative claims from the 2007-2009 Truven MarketScan database.We calculated variation in, and correlations among, 10 quality measures across 306 Hospital Referral Regions (HRRs), adjusting for beneficiary traits and sample size differences. Further, we created a quality index and correlated it with spending.The coefficient of variation of HRR-level performance ranged from 0.04 to 0.38. Correlations among quality measures generally ranged from 0.2 to 0.5. Quality was modestly positively related to spending.Quality varied across HRRs and there was only a modest geographic quality footprint.


Herron T.J.,North Campus Research Complex
Cell Calcium | Year: 2016

The advent of induced pluripotent stem cell derived cardiomyocytes (hiPSC-CMs) has revolutionized the cardiovascular research field. Now it is possible to generate a virtually unlimited supply of patient specific pluripotent stem cells and cardiomyocytes that can be used for research purposes, drug toxicity testing and/or regenerative medicine therapies. The most immediate application for this technology is in vitro disease modeling and in vitro drug toxicity testing. To date the majority of disease modeling and drug toxicity testing has been performed on single hiPSC-CMs in culture. However, the study of complex cardiac arrhythmia mechanisms requires a more physiological model system of electrically and mechanically connected hiPSC-CMs that function as a syncytium-like the cardiomyocytes of the adult heart. This review focuses on the work that has been performed recently using hiPSC-CM 2D monolayers for the study of cardiac electrical impulse propagation. © 2016 Elsevier Ltd.


Sakshaug J.W.,North Campus Research Complex | Miller D.C.,North Campus Research Complex | Hollenbeck B.K.,North Campus Research Complex | Wei J.T.,North Campus Research Complex | Hollingsworth J.M.,North Campus Research Complex
Journal of Urology | Year: 2013

Purpose Hopes are high that the delivery system reforms embodied in the patient centered medical home will improve the quality of care for patients with chronic diseases. While primary care physicians, given their training, will likely be the locus of care under this model, there are certain conditions for which urologists are well suited to provide the continuous and comprehensive care called for by the patient centered medical home. To assess the feasibility of the urology based patient centered medical home, we analyzed national survey data. Materials and Methods For our measure of medical home infrastructure, we mapped items from the 2007 and 2008 NAMCS (National Ambulatory Medical Care Survey) to the NCQA (National Committee on Quality Assurance) standards for patient centered medical home recognition. We determined the proportion of urology practices in the United States that would achieve patient centered medical home recognition. Finally, we used NAMCS data to estimate the impact of consolidating genitourinary cancer (ie prostate, bladder, kidney and testis) followup care among the current supply of urologists. Results Nearly three-quarters of urology practices meet NCQA standards for patient centered medical home recognition. At present, primary care physicians spend 9,295 cumulative workweeks providing direct and indirect care to survivors of genitourinary cancers. Off-loading half of this care to urology practices, in the context of the patient centered medical home, would generate an average of 0.73 additional workweeks for each practicing urologist. Conclusions Urology practices may possess the capacity needed to direct medical homes for their patients with genitourinary cancers. Successful implementation of this model would likely require a willingness to manage some nonurological conditions. © 2013 by American Urological Association Education and Research, Inc.

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