bluuebunny/crossref_metadata_2025 huggingface dataset:
Vertical migrations in two hygrophilous species of micro‐snails in relation to time of the year and habitat type
Authors: Książkiewicz‐Parulska Zofia
Published: June 2019

The aim of this study was to investigate vertical migration behaviors in two species of hygrophilous micro‐snails, Vertigo moulinsiana and Vertigo angustior, in relation to the time of the year (spring and summer) at two sites that differ in ground water level (periodically inundated site and non‐inundated site). The study shows different patterns of vertical migrations in the studied species. Vertigo angustior demonstrated a strong affinity to the litter layer (a weak tendency for vertical movements), independent of the time of year and site studied. By contrast, V. moulinsiana showed a clear tendency for vertical migrations, which differed depending on the time of year and site. These differences may be related to the spatial segregation of microhabitats used by these two species at the sites studied and to differences in the ability to resist inundation. Vertigo angustior is associated with microhabitats which are not subjected to prolonged inundation and tolerates a brief submersion. The periodic character of vertical migrations may suggest the effect of endogenous factors related to reproduction in V. moulinsiana. Some plasticity of this behavior in relation to habitat conditions demonstrated by this species may be an adaptation to live in unpredictably flooded environments.
On the hydrogen production of geopolymer wasteforms under irradiation
Authors: Cantarel Vincent , Arisaka Makoto , Yamagishi Isao
Published: June 2019

The hydrogen gas (H2) production of wasteforms is a major safety concern for encapsulating nuclear wastes. For geopolymers, the H2 produced by radiolytic processes is a key factor because of the large amount of water present in their porous structure. Herein, the hydrogen production was measured under 60Co gamma irradiation. The effect of water saturation and sample size were studied for pure geopolymers, or using zeolites as an example waste. To interpret results, a simple model was used, considering only hydrogen production, a potential recombination and its diffusion in the geopolymer matrix. When geopolymer monolithic samples were large and saturated by water, the hydrogen released was measured up to two orders of magnitude lower with a 40‐cm long cylinder samples (1.9 × 10−10 mol/J) than a sample in powder form (2.2 × 10−8 mol/J). Knowing the diffusion constant of the matrix, the model was able to reproduce the evolution of the hydrogen release as a function of the water saturation level and predict accurately the evolution when sample size is increased up to 40 cm.
Outcome measurement instruments for erythema associated with incontinence‐associated dermatitis: Systematic review
Authors: De Meyer Dorien , Gabriel Sabrina , Kottner Jan , Van Damme Nele , Van den Bussche Karen , Verhaeghe Sofie , Van Hecke Ann , Beeckman Dimitri
Published: June 2019

Aim

To: (a) examine which outcome measurement instruments for erythema associated with incontinence‐associated dermatitis (IAD) with supporting evidence about measurement properties are available; (b) evaluate the methodological quality of the studies and the quality of the measurement properties; and (c) identify eligible instruments to measure erythema in incontinence‐associated dermatitis research.

Design

Systematic review.

Data sources

MEDLINE, EMBASE, CINAHL and CENTRAL were systematically searched until July 2018 (update December 2018). Additional input was gathered from 151 incontinence‐associated dermatitis experts. Cited and citing references of included studies were screened.

Review Methods

The COSMIN Risk of Bias checklist was applied to evaluate the methodological quality of the studies. Reported measurement properties were rated against criteria for good measurement properties.

Results

Fourteen studies, describing 10 measurement instruments, were included. In five instruments, erythema was captured as a separate concept, two studies provided empirical evidence about the measurement properties. The most studied measurement properties were reliability (9 studies), measurement error (4 studies) and criterion validity (4 studies). In one study, internal consistency was examined.

Conclusion

No instrument measuring exclusively erythema associated with incontinence‐associated dermatitis exists. There is no single composite incontinence‐associated dermatitis measurement instrument that outperforms others. Development or adaption of an instrument to measure erythema associated with incontinence‐associated dermatitis is one option to solve this challenge.

Impact

The evidence about measurement properties of instruments measuring erythema associated with incontinence‐associated dermatitis has not been summarized to date. The lack of an instrument should trigger activities to measure this domain accurately in future clinical trials.
Electrophysiologic effects and outcomes of sympatholysis in patients with recurrent ventricular arrhythmia and structural heart disease
Authors: Cai Cheng , Dai Ming‐Yan , Tian Ying , Zhang Pei , Wittwer Erica D. , Rho Richard H. , Kapa Suraj , McLeod Christopher J. , Mulpuru Siva K. , Lee Hon‐Chi , Ackerman Michael J. , Asirvatham Samuel J. , Munger Thomas M. , Chen Ming‐Long , Friedman Paul A. , Cha Yong‐Mei
Published: June 2019

Introduction

Autonomic modulation has been used as a therapy to control recurrent ventricular arrhythmia (VA). This study was to explore stellate ganglion block (SGB) effect on cardiac electrophysiologic properties and evaluate the long‐term outcome of cardiac sympathetic denervation (CSD) for patients with recurrent VA and structural heart disease (SHD).

Materials and Methods

Patients who had recurrent VA due to SHD were enrolled prospectively. Electrophysiologic study and ventricular tachycardia (VT) induction were performed before and after left and right SGB. VA burden and long‐term outcomes were assessed for a separate patient group who underwent left or bilateral CSD for drug‐refractory VA due to SHD.

Results

Electrophysiologic study of nine patients showed that baseline mean (SD) corrected sinus node recovery time (cSNRT) increased from 320.4 (73.3) ms to 402.9 (114.2) ms after left and 482.4 (95.7) ms after bilateral SGB (P = .03). SGB did not significantly change P‐R, QRS, and Q‐T intervals and ventricular effective refractory period, nor did the inducibility of VA. Nineteen patients underwent left (n = 14) or bilateral (n = 5) CSD. CSD reduced VA burden and appropriate ICD therapies from a median (interquartile range) of 2.5 (0.4‐11.6) episodes weekly to 0.1 (0.0‐2.4) episodes weekly at 6‐month follow‐up (P = .002). Three‐year freedom from orthotopic heart transplant (OHT) and death was 52.6%. New York Heart Association functional class III/IV and VT rate less than 160 beats per minute were predictors of recurrent VA, OHT, and death.

Conclusion

SGB increased cSNRT without changing heart rate. CSD was more beneficial for patients with mild‐to‐moderate heart failure and faster VA.
MicroRNA‐551b‐3p inhibits tumour growth of human cholangiocarcinoma by targeting Cyclin D1
Authors: Chang Weiping , Wang Yuan , Li WenZhi , Shi Lei , Geng Zhimin
Published: June 2019

MicroRNAs (miRNAs) are powerful regulators in the tumorigenesis of cholangiocarcinoma (CCA). Previous studies report that miR‐551b‐3p acts as an oncogenic factor in ovarian cancer, but plays a tumour suppressive role in gastric cancer. However, the expression pattern and potential function of miR‐551b‐3p were still unclear in CCA. Therefore, this study aimed to explore the expression of miR‐551b‐3p and its role as well as molecular mechanism in CCA. Analysis of TCGA dataset suggested that miR‐551b‐3p was under‐expressed in CCA tissues compared to normal bile duct tissues. Furthermore, our data confirmed the decreased levels of miR‐551b‐3p in CCA samples and cell lines. Interestingly, TCGA data suggested that low miR‐551b‐3p level indicated reduced overall survival of CCA patients. Gain‐ and loss‐of‐function experiments found that miR‐551b‐3p inhibited the proliferation, G1‐S phase transition and induced apoptosis of CCA cells. In vivo experiments revealed that ectopic expression of miR‐551b‐3p inhibited tumour growth of CCA in mice. Further investigation demonstrated that miR‐551b‐3p directly bond to the 3′‐UTR of Cyclin D1 (CCND1) mRNA and negatively regulated the abundance of CCND1 in CCA cells. An inverse correlation between miR‐551b‐3p expression and the level of CCND1 mRNA was detected in CCA tissues from TCGA dataset. Notably, CCND1 knockdown showed similar effects to miR‐551b‐3p overexpression in HuCCT‐1 cells. CCND1 restoration rescued miR‐551b‐3p‐induced inhibition of proliferation, G1 phase arrest and apoptosis in HuCCT‐1 cells. In summary, miR‐551b‐3p inhibits the expression of CCND1 to suppress CCA cell proliferation and induce apoptosis, which may provide a theoretical basis for improving CCA treatment.
Diabetes Care Providers’ Manual for Disaster Diabetes Care
Authors: Satoh Jo , Yokono Koichi , Ando Rie , Asakura Toshinari , Hanzawa Kazuhiko , Ishigaki Yasushi , Kadowaki Takashi , Kasuga Masato , Katagiri Hideki , Kato Yasuhisa , Kurosawa Koreyuki , Miura Masanobu , Nakamura Jiro , Nishitsuka Koichi , Ogawa Susumu , Okamoto Tomoko , Sakuma Sadanori , Sakurai Shigeru , Satoh Hiroaki , Shimauchi Hidetoshi , Shimokawa Hiroaki , Shoji Wataru , Sugiyama Takashi , Suwabe Akira , Tachi Masahiro , Takahashi Kazuma , Takahashi Susumu , Terayama Yasuo , Tomita Hiroaki , Tsuchiya Yoko , Waki Hironori , Watanabe Tsuyoshi , Yahata Kazuaki , Yamashita Hidetoshi
Published: June 2019

To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the “Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake” under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata‐Chuetsu Earthquakes, the current “Manual for Disaster Diabetes Care” has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world's first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.
Protective potential of klotho protein on diabetic retinopathy: Evidence from clinical and in vitro studies
Authors: Ji Baolan , Wei Huili , Ding Yao , Liang Huimin , Yao Lu , Wang Hang , Qu Hua , Deng Huacong
Published: June 2019

Aims/Introduction

The purpose of the present study was to observe the relationship between serum α‐klotho (KL) protein level and diabetic retinopathy (DR), and to further examine the effects of KL protein on apoptosis induced by palmitic acid (PA) in human retinal endothelial cells.

Materials and Methods

A total of 17 healthy people and 60 type 2 diabetes patients were included. According to the results from fundus fluorescein angiography, the diabetes patients were divided into three subgroups: without DR, non‐proliferative DR and proliferative DR. Serum KL level was measured by enzyme‐linked immunosorbent assay. In vitro, human retinal endothelial cells were exposed to PA with or without KL protein. Apoptosis rates were analyzed by flow cytometry analysis. Apoptotic‐related protein expressions were detected by western blotting analysis.

Results

Serum KL level was lower in diabetes patients than that in healthy participants (P = 0.007), and was gradually decreased among the without DR, non‐proliferative DR and proliferative DR subgroups (P = 0.045). A logistic regression analysis showed that after adjusting for the other confounding factors, serum KL level was independently and negatively related with DR (P = 0.049). Furthermore, the increased apoptosis rates induced by PA were inhibited with the addition of KL protein. Consistently, KL protein reversed the expression levels of the increased pro‐apoptotic protein Bax and the decreased anti‐apoptotic protein Bcl‐2 induced by PA. However, the anti‐apoptotic effect of KL protein was attenuated by LY294002 through the phosphatidylinositol 3 kinase‐serine∕threonine kinase pathway.

Conclusions

The data suggested that KL protein was probably a potential protective factor against retinopathy in type 2 diabetes patients.
Response to ‘Letter to the editor’ by Wienholtz et al. entitled ‘The many faces of rosacea: liberal diagnostic criteria have ramifications on disease prevalence and accuracy’
Authors: Tizek L. , Schielein M.C. , Seifert F. , Biedermann T. , Böhner A. , Zink A.
Published: June 2019

Linked article: N. Wienholtz J Eur Acad Dermatol Venereol 2019; 33: e426–e427. https://doi.org/10.1111/jdv.15748.
An intervention model with self‐assessment and subsequent multi‐professional review might be effective and feasible to improve drug safety in primary healthcare. A survey‐based evaluation of SÄKLÄK2
Authors: Skoog Jessica , Lenander Cecilia , Modig Sara
Published: June 2019

Rationale, aims, and objectives

Drug‐related morbidity is common, which results in suffering for the patients and a high cost to society. SÄKLÄK2 is a multi‐professional intervention model aiming at improving drug safety in primary health care. The objective of this study was to elucidate the perceptions of the participants' regarding the efficiency of the intervention and the feasibility to introduce this model widely.

Method

SÄKLÄK2 is a multi‐professional intervention model in primary health care in Sweden that consisted of self‐assessment, peer‐review, written feedback, and agreements for change. Web‐based surveys were sent to both the management of participating primary health care centres (PHC) and to reviewers. The participating PHCs were fairly well‐staffed and had a high interest in improvement work. Descriptive analysis and content analysis was used.

Results

For the PHC management, the following categories were formed: Comprehensive project, Time‐consuming, Multi‐professional character, Relevant action agreements, and Feasible to implement. For the reviewers, the following categories were formed: Multi‐professional character, Relevant action agreements, Feasible to implement, Useful self‐assessment questionnaire, and Valuable visit at the PHC. There was a high degree of consistency between the PHC management and the reviewers' answers, especially regarding the efficiency of the model to improve drug safety and the feasibility to implement it on a broad front.

Conclusion

SÄKLÄK2, a model with self‐assessment, peer review, written feedback, and the formation of action agreements was considered by both the participating heads of the PHC centres and the reviewers to be effective to improve drug safety in primary health care. Though time‐consuming, this multi‐professional model was considered to be feasible to implement on a broad front and might thereby be one way of working with quality improvement regarding drug safety.
Lifestyle interventions for cancer prevention in primary care: Differences between family physicians and nursing professionals
Authors: Esteban‐Vasallo María D. , García‐Riolobos Carmen , Domínguez‐Berjón M. Felicitas , Zoni Ana Clara
Published: June 2019

Rationale, aims, and objectives

Prevention offers the most cost‐effective long‐term strategy for cancer control. The objective of this study was to ascertain opinions, attitudes, and professional practices towards cancer prevention among primary care professionals and to assess differences between family physicians (FP) and nursing professionals (NP).

Method

A cross‐sectional study was performed in 2012 in the Community of Madrid. A random sample of 3586 professionals received an online questionnaire about opinions/attitudes, training, and interventions in cancer prevention. The chi‐square test was used to analyse the association of the profession with all the variables. Factors associated with the usual practice of individual, group, and community interventions were analysed using multivariate logistic regression, with separate models for FP and NP.

Results

The response rate was 39.4% (N = 1413). Approximately 90% of the participants attributed “sufficient/high” utility to individualized counselling. NP attributed higher utility to group and community interventions than FP (70.1% vs 60.1% and 64.9% vs 57.7%, respectively, P‐value < 0.01). The usual practice of group and community interventions was more frequent among NP. The practice of group and community interventions was associated with knowledge of resources for prevention, specific training in group interventions, and the utility attributed to these methods. Among FP, the ability to dispense effective health advice and the utility attributed to this advice were associated with the usual practice of the three interventions.

Conclusions

Group and community interventions are rarely practised, especially among FP. Actions targeting improved ability and knowledge could lead to higher involvement in the promotion of health. It would also be necessary to intervene in the examination of the utility of such interventions.
The Cingulate Island Sign on FDG‐PET vs. IMP‐SPECT to Assess Mild Cognitive Impairment in Alzheimer's Disease vs. Dementia with Lewy Bodies
Authors: Chiba Yuhei , Fujishiro Hiroshige , Iseki Eizo , Kasanuki Koji , Sato Kiyoshi
Published: June 2019

BACKGROUND AND PURPOSE

The cingulate island sign (CIS) on 18F‐fluorodeoxyglucose positron emission tomography (FDG‐PET); ie, the relative preservation of mid‐posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). However, limited information is currently available on the diagnostic value of the CIS on FDG‐PET or 123I‐iodoamphetamine single‐photon emission computed tomography (IMP‐SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI‐AD) and MCI due to DLB (MCI‐DLB).

METHODS

We examined the CIS ratio in 9 AD patients, 9 DLB patients, 8 patients with MCI‐AD, and 9 patients with MCI‐DLB using FDG‐PET and IMP‐SPECT. The CIS ratio was calculated using NEUROSTAT software.

RESULTS

In the dementia groups, a receiver operating characteristic analysis of the CIS ratio showed significant accuracy for differentiating between AD and DLB on FDG‐PET and IMP‐SPECT. In the MCI groups, only the FDG‐PET derived CIS ratio displayed significant accuracy for differentiating between AD and DLB.

CONCLUSIONS

The FDG‐PET and IMP‐SPECT derived CIS ratios are both useful for differentiating between AD and DLB. The FDG‐PET derived CIS ratio is more valuable than the IMP‐SPECT derived CIS ratio for differential diagnosis in patients with MCI. A larger study is needed to confirm these results.
Genetic relationships and diversity patterns within the invasive range of the Mediterranean Painted Frog
Authors: Pujol‐Buxó E. , Garcia‐Cisneros A. , Miaud C. , Llorente G. A.
Published: June 2019

Range expansions are an intrinsic part of the biogeography of most species. Among them, some invasive species represent a paradigmatic case in which local introductions are followed by rapid expansions in several directions. Theoretically, this creates a recursive founder effect, leading to sustained losses of genetic diversity and – through stochastic changes in allele frequency – to a population structure that mirrors invasion history. Here, we use restriction site‐associated DNA (RAD) markers to detect these patterns in the invasive range of the Mediterranean Painted Frog (Discoglossus pictus) in Europe. We identify and genotype a large panel of loci using genotyping‐by‐sequencing in several sites along its two main directions of invasion – northwards and southwards. Although the frog has a few translocated isolated populations, most of the invasive range is contiguous, allegedly corresponding to a self‐sustained expansion from a single introduction point in Banyuls de la Marenda (Southern France) more than a century ago. As expected, the highest genetic diversity was found in this location, with progressive losses of genetic diversity north‐ and southwards. Genetic similarities among sampling sites also coincided with predictions according to the documented process of expansion, showing a latitudinal population structure matching predictions according to geographic distance among locations. This poses the two opposite expansion directions as independent processes of loss of genetic diversity and creation of population structure, that is, two different cases of range expansion which are ready for further examinations.
Making change in medical education
Authors: Sherbino Jonathan
Published: June 2019

Sherbino promotes engaging learners in the design of education innovations by promoting the adoption of platforms that allow rich discussion, including social media, and authentic conversation about why change is necessary.
Discontinuation of Chronic Opiate Therapy After Successful Spinal Cord Stimulation Is Highly Dependent Upon the Daily Opioid Dose
Authors: Simopoulos Thomas , Sharma Sanjiv , Wootton Raymond Joshua , Orhurhu Vwaire , Aner Moris , Gill Jatinder S
Published: June 2019

Objectives

The aim of this study was to determine if any of the factors recorded on a standard clinical history of a patient considered for spinal cord stimulation (SCS) would be associated with reduction or cessation of opioids following implantation.

Design

Retrospective, single academic center.

Methods

Patients included in the chart analysis underwent implantation of percutaneous SCS devices from 1999 to 2015 with follow‐up until the end of September 2018. Patients who achieved at least an average of 50% pain reduction were included for analysis of daily opioid intake. Patients were then divided into 4 groups that included no opioid use, stable opioid daily dose, weaned opioid dose, and complete cessation of opioids. Statistical methods were used to analyze for associations between opioid intake after SCS insertion and usual elements of a clinical history, including adjuvant medications, numeric pain rating, past medical history, psychiatric illness, substance abuse, employment, and smoking history.

Results

In a group of 261 patients who had undergone implantation, 214 met the criteria for analysis and had a median age of 50 years, with majority having the diagnoses of failed back surgery syndrome and complex regional pain syndrome. The only factor that was associated with complete cessation of opioid use was a median dose of 30 mg of morphine per day (P < 0.01) and was observed in 15% of subjects who used opioids preoperatively.

Conclusion

The elimination of opioid dependence following initiation of SCS therapy is highly dependent on the daily dose.
A xylem‐produced peptide PtrCLE20 inhibits vascular cambium activity in Populus
Authors: Zhu Yingying , Song Dongliang , Zhang Rui , Luo Laifu , Cao Shumin , Huang Cheng , Sun Jiayan , Gui Jinshan , Li Laigeng
Published: June 2019

In trees, lateral growth of the stem occurs through cell divisions in the vascular cambium. Vascular cambium activity is regulated by endogenous developmental programmes and environmental cues. However, the underlying mechanisms that regulate cambium activity are largely unknown. Genomic, biochemical and genetic approaches were used here to elucidate the role of PtrCLE20, a CLAVATA3 (CLV3)/embryo surrounding region (ESR)‐related peptide gene, in the regulation of lateral growth in Populus. Fifty‐two peptides encoded by CLE genes were identified in the genome of Populus trichocarpa. Among them PtrCLE20 transcripts were detected in developing xylem while the PtrCLE20 peptide was mainly localized in vascular cambium cells. PtrCLE20 acted in repressing vascular cambium activity indicated by that upregulation of PtrCLE20 resulted in fewer layers of vascular cambium cells with repressed expression of the genes related to cell dividing activity. PtrCLE20 peptide also showed a repression effect on the root growth of Populus and Arabidopsis, likely through inhibiting meristematic cell dividing activity. Together, the results suggest that PtrCLE20 peptide, produced from developing xylem cells, plays a role in regulating lateral growth by repression of cambium activity in trees.
Optimal timing of video‐assisted thoracoscopic surgery for patent ductus arteriosus in preterm infants born at ≤ 28 weeks of gestation
Authors: Kemmochi Manabu , Senzaki Hideaki , Miyaji Kagami , Hashimoto Megumi , Yamaguchi Ayano , Ooka Mari , Yokozeki Yuuichirou , Ishii Masahiro
Published: June 2019

Background

Video‐assisted thoracoscopic surgery for patent ductus arteriosus (VATS‐PDA) is an alternative surgical procedure to open chest surgery, even in premature infants. This study investigated whether the timing of VATS‐PDA has a prognostic impact in premature infants whose operative indication was determined according to the symptomatic PDA and the ineffectiveness of or contraindication to indomethacine therapy.

Methods

We studied 49 infants born at or before 28 weeks of gestation who were admitted to the neonatal intensive care unit between January 2004 and June 2016, and who underwent VATS‐PDA. The patients were divided into two groups according to median age at the time of surgery (early group, 24 infants who underwent surgery at ≤ 24 days of life; late group, 25 infants who underwent surgery at ≥ 25 days of life).

Results

No significant differences were found in bodyweight at 30 days of age and 40 weeks of corrected gestational age between the groups. The timing of surgery did not affect the operative procedure or postoperative complications. In addition, no differences were observed between the early and late groups in terms of complications associated with prematurity, including intraventricular hemorrhage, incidence and severity of bronchopulmonary dysplasia, and necrotizing enteropathy.

Conclusion

Video‐assisted thoracoscopic surgery for patent ductus arteriosus can be safely performed in premature infants without a preferential timing for the intervention, suggesting that this procedure allows for an elective basis approach after heart failure management with conservative and/or drug therapy in premature infants with PDA.
Detection of an HLA‐A*33 variant, HLA‐A*33:176N, in a Taiwanese individual
Authors: Yang Kuo‐Liang , Lin Py‐Yu
Published: June 2019

Nucleotide deletions from residue 472 to 485 of HLA‐A*33:03:01:01 result in a novel allele HLA‐A*33:176N.
Desigualdades en salud y opinión pública. Un análisis de las preferencias redistributivas en la provincia de Córdoba, Argentina
Authors: Nazareno Marcelo , Santillán Pizarro María Marta
Published: June 2019

América Latina muestra elevadas desigualdades en salud. Su reducción solo es posible a través de políticas públicas redistributivas, cuya viabilidad depende de una opinión pública que reconozca estas desigualdades y que apoye las acciones redistributivas del Estado. A pesar de la relevancia, son escasos los trabajos en América Latina sobre percepciones de desigualdad y preferencias redistributivas en salud. A partir del análisis de una encuesta poblacional en la provincia de Córdoba, Argentina, hacemos un aporte en este sentido. Nuestros principales hallazgos muestran: (i) más del 50 % de la población percibe alta o muy alta desigualdad en salud; (ii) más del 90 % tiene preferencias redistributivas; (iii) para casi la mitad estas preferencias son muy intensas; (iv) las posibilidades de tener preferencias muy intensas dependen inversamente del ingreso y directamente de ser mujer, del temer que la desigualdad genere problemas al entorno familiar y de la pertenencia a organizaciones voluntarias.
Validación de un cuestionario de clima organizacional para organizaciones de salud
Authors: Bustamante U Miguel A , Álvarez H Alejandra
Published: June 2019

This work presents a redesign of the organizational climate questionnaire for high-complexity hospitals, by evaluating the hospital dimensions and reaction processes in the Primary Health Care (PHC) units. Two sample groups were used: 389 cases in Chile and 583 in Ecuador. The reaction processes were made sensitive according to an analysis of factor loads and commonalities and were then validated with a modelling based on structural equations. Four dimensions summarize the 27 reaction processes validated herein. Direct and inverse relations between the factors match the assumptions provided in the theory. The variance and covariance of the matrices confirmed that it is a homoscedastic model. The measures of goodness of fit validated the model. It is then confirmed that both the internal tension and the professional development influence significantly and inversely the internal management factors as well as the organization and performance. The adjustments done to the model and the goodness of fit measures confirmed that the model represents appropriately the reality.
Hallazgos neuropsicológicos de una muestra de niños con epilepsias focales de etiología genética y desconocida
Authors: Garnica Agudelo David , Izquierdo-Bello Álvaro , Zuluaga Gómez Jairo
Published: June 2019

Objetivo. Caracterizar el perfil cognitivo de un grupo de niños con epilepsias focales de etiología genética y desconocida y control de crisis epilépticas. Método. Se realizó una evaluación neuropsicológica con subpruebas de la batería Evaluación Neuropsicológica Infantil (ENI), a 35 niños entre los 7 y los 15 años de edad, con diagnóstico de epilepsias focales de etiología genética o desconocida, tratamiento farmacológico y coeficiente intelectual ≥ 80. Resultados. El grupo de pacientes evidenció déficit significativo en atención auditiva, al comparar su desempeño con los datos normativos de la ENI para población colombiana. No se encontraron diferencias significativas en el desempeño de pacientes con o sin crisis epilépticas durante el último año, etiología genética o desconocida, foco epiléptico en región cerebral frontal o centro-temporal, con o sin diagnóstico previo de trastorno por déficit con o sin hiperactividad (TDAH/TDA). Conclusión. La dificultad atencional observada puede requerir mayor manejo terapéutico, al plantearles una mayor susceptibilidad para desatender a los contenidos de clase que requieren una focalización rápida y efectiva, implicando también tareas de conteo numérico auditivo (como dictados y operaciones matemáticas sencillas), que dependen del adecuado funcionamiento de la atención auditiva.
Moduladores de la ventaja del bilingüismo en la inhibición, atención y tareas de cambio
Authors: Sarli Leticia , Justel Nadia
Published: June 2019

Objetivo. Revisar la literatura para identificar si existen diferencias en el desempeño ejecutivo de la atención, inhibición y tareas de cambio entre personas bilingües y monolingües. Método. Se realizó una búsqueda bibliográfica utilizando las palabras clave: bilingüismo, funciones ejecutivas y atención; 36 artículos cumplieron los criterios de inclusión. Estos se dividieron en tres grupos, según la edad de las muestras estudiadas: en niños, adultos jóvenes y adultos mayores. Resultados. Los factores principales que modelaron los resultados comportamentales fueron la edad de adquisición y el contexto de uso del segundo idioma. Además, se encontraron diferentes perfiles de desempeño en las tareas de funciones ejecutivas, según el grupo etario. Conclusión. Los mejores desempeños ejecutivos se observaron en aquellas personas bilingües que adquirieron su segundo idioma en contextos naturales, de uso frecuente para el hablante y a edades tempranas. Estos aportes son importantes para el ámbito escolar y de salud.
Disaster Reconnaissance Using Multiple Small Unmanned Aerial Vehicles
Authors: Derricott Jeffrey C. , Willis Jacob B. , Peterson Cameron K. , Franke Kevin W. , Hedengren John D.
Published: June 2019

Small rotorcraft unmanned air vehicles (sUAVs) are valuable tools in solving geospatial inspection challenges. One area where this is being widely explored is disaster reconnaissance [1]. Using sUAVs to collect images provides engineers and government officials critical information about the conditions before and after a disaster [2]. This is accomplished by creating high- fidelity 3D models from the sUAV’s imagery. However, using an sUAV to perform inspections is a challenging task due to constraints on the vehicle’s flight time, computational power, and data storage capabilities [3]. The approach presented in this article illustrates a method for utilizing multiple sUAVs to inspect a disaster region and merge the separate data into a single high-resolution 3D model.
Impact of hydrostatic pressure on phase-change contrast agent activation by pulsed ultrasound
Authors: Raut Saurabh , Khairalseed Mawia , Honari Arvin , Sirsi Shashank R. , Hoyt Kenneth
Published: June 2019

A phase-change contrast agent (PCCA) can be activated from a liquid (nanodroplet) state using pulsed ultrasound (US) energy to form a larger highly echogenic microbubble (MB). PCCA activation is dependent on the ambient pressure of the surrounding media, so any increase in hydrostatic pressure demands higher US energies to phase transition. In this paper, the authors explore this basic relationship as a potential direction for noninvasive pressure measurement and foundation of a unique technology the authors are developing termed tumor interstitial pressure estimation using ultrasound (TIPE-US). TIPE-US was developed using a programmable US research scanner. A custom scan sequence interleaved pulsed US transmissions for both PCCA activation and detection. An automated US pressure sweep was applied, and US images were acquired at each increment. Various hydrostatic pressures were applied to PCCA samples. Pressurized samples were imaged using the TIPE-US system. The activation threshold required to convert PCCA from the liquid to gaseous state was recorded for various US and PCCA conditions. Given the relationship between the hydrostatic pressure applied to the PCCA and US energy needed for activation, phase transition can be used as a surrogate of hydrostatic pressure. Consistent with theoretical predictions, the PCCA activation threshold was lowered with increasing sample temperature and by decreasing the frequency of US exposure, but it was not impacted by PCCA concentration.
A Case Study of Factors Influencing Performance in the Practice Environment
Authors: Smith Steve M. , Cotterill Stewart T. , Brown Hazel
Published: June 2019

Athletes’ practice environment can influence their competitive performance. The influencing performance factors present in practice are understudied, and the aim of this study was to explore these factors. Using a case-study approach, the authors investigated a basketball practice environment to reveal influencing performance factors. Participants were 15 members of a U.K. Elite Academy Basketball League team based in a sixth-form college (equivalent to American high school age) that included 10 players, 2 coaches, 1 strength and conditioning coach, 1 academic teacher, and the head of sport (mean age 21.8 yr). A case-study approach was adopted to collect data from interviews, focus groups, and direct observations to provide a holistic assessment of the practice environment. Data were analyzed using inductive thematic analysis, which revealed 6 overarching themes: effort, status, individuality, preparation, team drive, and practice vision. Data analysis exposed several themes of influencing performance factors unreported in previous literature, suggesting that practice environments should be viewed as a stand-alone field of investigative enquiry. The results from this study provide a much-needed foray into the psychological influences of practice and give practitioners the opportunity to reflect on the results against their own practice environments.
Verapamil Improves the Activity of Bedaquiline against Mycobacterium abscessusIn Vitro and in Macrophages
Authors: Viljoen Albertus , Raynaud Clément , Johansen Matt D. , Roquet-Banères Françoise , Herrmann Jean-Louis , Daher Wassim , Kremer Laurent
Published: June 2019

Due to intrinsic multidrug resistance, pulmonary infections with
Mycobacterium abscessus
are extremely difficult to treat. Previously, we demonstrated that bedaquiline is highly effective against
Mycobacterium abscessus
both
in vitro
and
in vivo
. Here, we report that verapamil improves the efficacy of bedaquiline activity against
M. abscessus
clinical isolates and low-level resistant strains, both
in vitro
and in macrophages.
Neuron-specific enolase is correlated with lesion topology, relative infarct volume and outcome of symptomatic NAIS
Authors: Arca Gemma , Arnaez Juan , Agut Thais , Núñez Christian , Stephan-Otto Christian , Valls Anna , García-Alix Alfredo
Published: June 2019

Objective

To correlate neuron-specific enolase (NSE) levels in cerebrospinal fluid (CSF) in neonate infants with symptomatic neonatal arterial ischaemic stroke (NAIS) with the arterial distribution of infarct, infarct volume and outcome.

Design

Prospective observational multicentre cohort.

Setting

Three paediatric university hospitals in Spain.

Subjects

Thirty-eight neonates with more than 35 weeks’ gestational age between 2006 and 2016 were studied. They were diagnosed with NAIS by MRI. They underwent a lumbar puncture to measure CSF-NSE concentrations within 96 hours after the onset of symptoms. Sixty-seven neonates admitted with suspected infections served as controls. We used a classification based on the arterial distribution, and the lesions were segmented with ITK-Snap software to determine their volume. Neurodevelopment was assessed at 24 months using the Bayley-III, Gross Motor Function Classification System and Bimanual Fine Motor Function.

Results

CSF-NSE levels were higher in patients with symptomatic NAIS when compared with controls. Neonates with multifocal NAIS and with NAIS located in middle cerebral artery (MCA)-M1 arterial territory showed higher CSF-NSE levels when compared with cases with MCA-M2-M3-M4 territories (p<0.001). A significant correlation was found between CSF-NSE and relative infarction volume (rs=0.597; p<0.001). CSF-NSE values were higher in those infants with symptomatic NAIS with adverse outcome compared with infants with good development (p=0.020). Infants with CSF-NSE values above 55 ng/mL had an OR of adverse outcome of 6.48 (95% CI 1.48 to 28.33).

Conclusions

CSF-NSE is a potential early prognostic biomarker after an NAIS due to the relation between volume, topology and neurodevelopment at 2 years of age.
Effect of trabeculectomy on corneal endothelial cell loss
Authors: Hirooka Kazuyuki , Nitta Eri , Ukegawa Kaori , Sato Shino , Kiuchi Yoshiaki
Published: June 2019

Aim

To investigate changes in corneal endothelial cell density (CECD) after trabeculectomy.

Methods

This prospective, observational study followed 117 eyes of 117 patients for 2 years after trabeculectomy. The central cornea was examined by corneal specular microscopy prior to and at every 6 months after the surgery. Survival analysis of patients who exhibited a 10% or less reduction of the postoperative CECD compared with preoperative levels was assessed using the Kaplan-Meier survival curve. A Cox proportional hazards model was used to evaluate prognostic factors for decreasing CECD.

Results

At baseline, the mean CECD was 2420±357 cells/mm2, while at 6, 12, 18 and 24 months after surgery, the mean CECD was 2324±373 cells/mm2 (p<0.001), 2276±400 cells/mm2 (p<0.001), 2290±398 cells/mm2 (p<0.001) and 2267±446 cells/mm2 (p<0.001), respectively. At 6, 12, 18 and 24 months after surgery, the results of the Kaplan-Meier survival analysis of the 10% loss of CECD from baseline were 91%, 85%, 83% and 77%, respectively. Uveitic glaucoma was a significant prognostic factor for decreasing CECD (p=0.041).

Conclusions

CECD significantly and continuously decreased after trabeculectomy.
Potential impact of data source and interoperability messaging on health information technology (HIT) users: a study series from the United States Department of Veterans Affairs
Authors: Herout Jennifer , Baggetta Donna , Cournoyer Amanda , Dietz Aaron S , Robbins Jane , Maddox Kyle , Dobre Jolie
Published: June 2019

Background

The promise of Health Information Exchange (HIE) systems rests in their potential to provide clinicians and administrative staff rapid access to relevant patient data to support judgement and decision-making. However, HIE systems can have usability and technical issues, as well as fail to support user workflow.

Objective

Share the findings from a series of studies that address HIE system deficiencies for an Electronic Health Record (EHR) viewer which accesses multiple data sources.

Methods

A variety of methods were used, in a series of studies, to gain a better understanding of issues and their mitigation through use of promising EHR viewer features.

Results

The study series results are presented by the themes that underscore the importance for users to distinguish between data that are available but missing due to connection or system errors, data that are omitted entirely because they are not available and data that are excluded due to filtered search criteria.

Conclusions

The principal findings from this study series led to improvement recommendations for the EHR viewer, as well as citing areas that are ripe for further investigation and analysis.
Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study
Authors: Trinkley Katy E , Blakeslee Weston W , Matlock Daniel D , Kao David P , Van Matre Amanda G , Harrison Robert , Larson Cynthia L , Kostman Nic , Nelson Jennifer A , Lin Chen-Tan , Malone Daniel C
Published: June 2019

Background

To improve user-centred design efforts and efficiency; there is a need to disseminate information on modern day clinician preferences for technologies such as computerised clinical decision support (CDS).

Objective

To describe clinician perceptions regarding beneficial features of CDS for chronic medications in primary care.

Methods

This study included focus groups and clinicians individually describing their ideal CDS. Three focus groups were conducted including prescribing clinicians from a variety of disciplines. Outcome measures included identification of favourable features and unintended consequences of CDS for chronic medication management in primary care. We transcribed recordings, performed thematic qualitative analysis and generated counts when possible.

Results

There were 21 participants who identified four categories of beneficial CDS features during the group discussion: non-interruptive alerts, clinically relevant and customisable support, presentation of pertinent clinical information and optimises workflow. Non-interruptive alerts were broadly defined as passive alerts that a user chooses to review, whereas interruptive were active or disruptive alerts that interrupted workflow and one is forced to review before completing a task. The CDS features identified in the individual descriptions were consistent with the focus group discussion, with the exception of non-interruptive alerts. In the individual descriptions, 12 clinicians preferred interruptive CDS compared with seven clinicians describing non-interruptive CDS.

Conclusion

Clinicians identified CDS for chronic medications beneficial when they are clinically relevant and customisable, present pertinent clinical information (eg, labs, vitals) and improve their workflow. Although clinicians preferred passive, non-interruptive alerts, most acknowledged that these may not be widely seen and may be less effective. These features align with literature describing best practices in CDS design and emphasise those features clinicians prioritise, which should be considered when designing CDS for medication management in primary care. These findings highlight the disparity between the current state of CDS design and clinician-stated design features associated with beneficial CDS.
Conformity of Diabetes Mobile apps with the Chronic Care Model
Authors: Salari Raheleh , R Niakan Kalhori Sharareh , Ghazisaeidi Marjan , Fatehi Farhad
Published: June 2019

Background

Despite the growing use of mobile applications (apps) for chronic disease management, the evidence on the effectiveness of this technology on clinical and behavioural outcomes of the patients is scant. Many studies highlight the importance of the theoretical foundations of mobile-based interventions. One of the most widely accepted models for the management of chronic diseases, such as diabetes, is the Chronic Care Model (CCM). In this study, we investigated the conformity of the selected diabetes mobile apps with CCM.

Method

We searched online journal databases related to diabetes mobile apps to find common features. Then considering the components of the CCM as a reference model, features of some popular and top-ranking apps were compared with CCM.

Results

Among 23 studied apps, 34 per cent of them had medium conformity and 66 per cent of these apps were in weak conformity. The self-management support component is covered by 100 per cent of them. Ninety-five per cent of apps have covered the proactive follow-up component.

Conclusions

App conformance with CCM is generally weak. App developers are recommended to give greater consideration to established theoretical models in their design and implementation.
Digital innovation evaluation: user perceptions of innovation readiness, digital confidence, innovation adoption, user experience and behaviour change
Authors: Benson Tim
Published: June 2019

Background

Innovation spread is a key policy objective for health systems world-wide, but adoption success varies enormously. We have developed a set of short generic user-reported measures to help understand how and why healthcare innovations spread. This work builds on the literature and on practical experience in developing and using patient-reported outcome measures.

Measures

TheInnovation Readiness Scoremeasures user perceptions of how much they are open to and up-to-date with new ideas, and whether their organisations are receptive to and capable of innovation. It is based on Rogers’ classification of innovativeness (innovator, early adopter, early majority, etc).

TheDigital Confidence Scorerates users’ digital literacy and confidence to use digital products, with dimensions of familiarity, social pressure, support and digital self-efficacy.

TheInnovation Adoption Scorerates the adoption process in terms of coherence and reflective thought before, during and after implementation. It is based on Normalisation Process Theory.

TheUser Satisfactionmeasure assesses a digital product in terms of usefulness, ease of use, support and satisfaction.

TheBehaviour Changemeasure covers user perceptions of their capability, opportunity and motivation to change behaviour, based on the COM-B model.

These measures have been mapped onto Greenhalgh’s NASSS Framework (non-adoption, abandonment and challenges to scale-up, spread and sustainability of health and care technologies).

Conclusion

These tools measure different aspects of digital health innovations and may help predict the success of innovation dissemination, diffusion and spread programmes.