bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Kidney Disease: Implications for Progression Using Telehealth Monitoring
Authors: Mansur Abeera 
Published: May 2018

Background: Chronic Kidney Disease (CKD) is a complex and common medical condition requiring a multidisciplinary management approach, including control of multiple parameters to delay progression of the disease. Telehealth has been used for monitoring chronic conditions and can be used for managing chronic kidney disease.
Materials and Methods: Patients (N = 34) with CKD Stage II-V were studied for four months. Vital signs, weight, intake and output, blood glucose level, oxygen saturation, and edema were checked twice weekly by trained nurses, transmitted via WhatsApp, and incorporated into the electronic medical records of the patients. Monthly serum creatinine, hemoglobin, and electrolytes were obtained and reviewed by a nephrologist. Necessary intervention was conveyed to the patients.
Results: Patient satisfaction rate with telehealth management was high. Measured parameters were maintained in the recommended range in a higher percentage of the study group compared to the controls. Glomerular filtration rate was maintained in a significantly more patient in the study group (p<0.001).
Conclusions: Telehealth monitoring of patients with CKD (tele-nephrology) is a viable and effective option for management of this increasingly prevalent disease.
Chronic kidney disease (CKD) is a worldwide public health problem with increasing severity in renal dysfunction extending to dialysis.
TMT Interview: Robert Abel, MaineHealth Care at Home
Authors: Abel Robert 
Published: May 2018

No abstract available.
Editor’s note: On March 16th and 17th, 2017, Telehealth and Medicine Today convened a national conference of opinion leaders to discuss and debate “Technologies and Tactics Transforming Long-term Care.” What follows is an interview with Robert Abel, who is the Chief Nursing Officer and Director of Palliative Care for MaineHealth Care at Home, a member of the MaineHealth system.
Telehealth Vendor Selection: Get Intentional, Not Overwhelmed
Authors: Leslie Monica 
Published: May 2018

The term “vendor overwhelmed” in the telehealth market is alive and well. In a global market predicted to more than double in value over the next several years to an estimated $36.2B,1 the number of vendors that have flooded the market is not surprising. As a “vendor agnostic” telehealth consulting team, Schumacher Clinical Partners, Subsidium Healthcare, specializes in helping clients plan, design, select, and implement telehealth programs. What follows is information regarding solutions and key differentiators for successful vendor selection.
Caregivers & Technology: What They Want and Need A Guide for Innovators — Research from A Nationally Representative Sample of America’s 40 Million Family Caregivers
Authors: Editorial Team TMT 
Published: May 2018

No abstract available.
Editor’s note: What follows is an abridged, illustration-rich presentation of research conducted for Project Catalyst (charged with positioning the 50+ consumer the center of innovation) by HITLAB (a healthcare innovation lab dedicated to improving the quality and accessibility of healthcare worldwide). HITLAB helps stakeholders in the public and private sectors technology-based solutions from concept to development and evaluation to meet pressing healthcare challenges.
Grading Obamacare on the Fundamentals of Care Delivery
Authors: Gruber David , Urbanowicz Peter 
Published: May 2018

No abstract available.
Editor’s note: Changes (some predict repeal) in the Affordable Care Act is an immanent prospect that will affect all stakeholders in healthcare, including patients, providers, and innovators in telemedicine. In this article and three others included in this issue of Telehealth and Medicine Today, David Gruber and Peter Urbanowicz inform our readers and, hopefully, help prepare them for changes that may be every bit as impactful in 2017 as were the initiating events that occurred seven years ago on March 23rd, 2010. The authors address issues of special relevance to stakeholders in telehealth in this article.
Análisis primera etapa de proyectos de vinculación con la sociedad en algunas parroquias de Ambato.
Authors: Espinosas Pire Lina Neri , Estenoz. Maggy 
Published: May 2018

La realidad encontrada en los colegios de las Parroquias Huachi Chico, Huachi Grande, Picaihua, Patate, Pelileo, Sigualo, Santa Rosa, Salasaca, Huambaló, de la Provincia Tungurahua fue; alto nivel de conocimiento sobre la existencia de métodos anticonceptivos sin embargo el uso de los mismo es minino debido que no existe conocimiento de un método adecuado para su edad y características morfo funcionales del mismo. La población estudiada tiene ideas erróneas sobre las consecuencias que puede conllevar un embarazo adolescente, identificando como principal causa la falta de acceso a educación sexual y comunicación con la familia. Esta falta de comunicación conlleva a que no exista temor de presentar un embarazo precoz. En la intervención se trabajó sobre la prevención del embarazo adolescente, los factores de riesgo a los que están expuestos, el uso adecuado de los anticonceptivos, y las posibles consecuencias que conlleva un embarazo adolescente. Se trabajó con un club adolescente vinculado a los Subcentros de Salud para despejar dudas acerca de los temas planteados.
Recibido: 05-01-2017 / Aceptado: 25-01-2017
Hipotiroidismo, enfoque actual.
Authors: Leiva Suero Lizette Elena , Morales Solís Jorge , Villacís Valencia Sandra , Quishpe Jara Graciela , Acosta Acosta Josué 
Published: May 2018

El hipotiroidismo tiene una elevada prevalencia en nuestra población, la inespecificidad de sus manifestaciones clínicas ocasiona sub diagnóstico y su descontrol genera temibles complicaciones fácilmente corregibles con un tratamiento sustitutivo adecuado, lo cual cobra mayor significación cuando se trata de una mujer embarazada. Con el objetivo de resumir información actualizada y disponer de la mejor evidencia médica desarrollamos un artículo de revisión cualitativo descriptivo sobre el tema, abordando generalidades, etiología, manifestaciones clínicas, enfermedades asociadas, diagnóstico y tratamiento. Para lo cual se realizó una revisión sistemática a través de búsqueda en bases de datos electrónicas (MEDLINE, CUIDEN plus). Resultados 45 artículos fueron incluidos para esta revisión, de ellos tres metas análisis que trataban directamente de Hipotiroidismo. Empleamos dos modelos para combinar estadísticamente los resultados: el modelo de efectos fijos y el modelo de efectos aleatorios. Se obtuvo una concordancia del 82,5 % en cuanto a la etiología del síndrome, 94,5% para las manifestaciones clínicas, 98,6 % en el diagnóstico y 96,1 % en el tratamiento. Todo lo cual permitió resumir los elementos fundamentales del diagnóstico clínico y el tratamiento de manera sintética que permita a nuestros profesionales apropiarse de las competencias necesarias para diagnosticar y tratar esta enfermedad, evitar el subdiagnóstico, prevenir las complicaciones y motivar el desarrollo de estrategias de prevención y diagnóstico precoz de esta patología altamente prevalente.
Recibido: 10-08-2017 / Aceptado: 12-09-2017
Association of copeptin, a surrogate marker of arginine vasopressin, with cerebral vasospasm and delayed ischemic neurologic deficit after aneurysmal subarachnoid hemorrhage
Authors: Fernandez Sandra J. , Barakat Ibraham , Ziogas James , Frugier Tony , Stylli Stanley S. , Laidlaw John D. , Kaye Andrew H. , Adamides Alexios A. 
Published: May 2018

OBJECTIVEDelayed ischemic neurological deficit (DIND) is a leading cause of mortality and morbidity after aneurysmal subarachnoid hemorrhage (aSAH). Arginine vasopressin (AVP) is a hormone released by the posterior pituitary. It is known to cause cerebral vasoconstriction and has been implicated in hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion. Direct measurement of AVP is limited by its short half-life. Copeptin, a cleavage product of the AVP precursor protein, was therefore used as a surrogate marker for AVP. This study aimed to investigate the temporal relationship between changes in copeptin concentrations and episodes of DIND and hyponatremia.METHODSCopeptin concentrations in cerebrospinal fluid were quantified using enzyme-linked immunosorbent assay in 19 patients: 10 patients with DIND, 6 patients without DIND (no-DIND), and 3 controls.RESULTSCopeptin concentrations were higher in DIND and no-DIND patients than in controls. In hyponatremic DIND patients, copeptin concentrations were higher compared with hyponatremic no-DIND patients. DIND was associated with a combination of decreasing sodium levels and increasing copeptin concentrations.CONCLUSIONSIncreased AVP may be the unifying factor explaining the co-occurrence of hyponatremia and DIND. Future studies are indicated to investigate this relationship and the therapeutic utility of AVP antagonists in the clinical setting.
MGMT promoter methylation in patients with glioblastoma: is methylation-sensitive high-resolution melting superior to methylation-sensitive polymerase chain reaction assay?
Authors: Yamashita Shinji , Yokogami Kiyotaka , Matsumoto Fumitaka , Saito Kiyotaka , Mizuguchi Asako , Ohta Hajime , Takeshima Hideo 
Published: May 2018

OBJECTIVEThe methylation status of the O6-methylguanine-DNA methyltransferase (MGMT) gene promoter is a prognostic factor in adults with glioblastoma (GBM); it also yields information that is useful for clinical decision-making in elderly GBM patients. While pyrosequencing is the gold standard for the evaluation of the methylation status of MGMT, methylation-sensitive polymerase chain reaction (MS-PCR) assay continues to be used widely. Although MS-PCR results exhibited a good correlation with the prognosis of patients with GBM treated under the Stupp protocol, interpretation of the bands is based on subjective judgment, and the assay cannot be used to analyze heterogeneously methylated samples. We assessed whether methylation-sensitive high-resolution melting (MS-HRM) is an alternative to MS-PCR.METHODSThe authors prepared 3 primer sets that covered CpG 72–89 for MS-HRM analysis to determine the methylation levels of 6 human glioma cell lines. The results were validated by bisulfite sequencing of cloned alleles. The authors also subjected surgical samples from 75 GBM patients treated with temozolomide (TMZ) to MS-HRM to assess the MGMT methylation status and compared the findings with MS-PCR results using receiver operating characteristic (ROC), univariate, and multivariate analyses.RESULTSThere was a strong correlation between the methylation levels of the 6 glioma cell lines evaluated by MS-HRM and by bisulfite sequencing; with primers 1 and 2, the correlation was significant (r = 0.959 and r = 0.960, respectively, p < 0.01). Based on log-rank analysis, MS-HRM was significantly better than MS-PCR for predicting progression-free survival (PFS) and overall survival (OS) based on the methylation status of the MGMT promoter (PFS predicted by MS-HRM and MS-PCR = 0.00023 and 0.0035, respectively; OS = 0.00019 and 0.00028, respectively). ROC analysis showed that the area under the curve was larger with MS-HRM than with MS-PCR (PFS: 0.723 vs 0.635; OS: 0.716 vs 0.695). Based on multivariate Cox regression analysis, MS-HRM was significantly better than MS-PCR for predicting the treatment outcome (MS-HRM vs MS-PCR: PFS, p = 0.001 vs 0.207; OS, p = 0.013 vs 0.135).CONCLUSIONSThe authors’ findings show that MS-HRM is superior to MS-PCR for the detection of MGMT promoter methylation. They suggest MS-HRM as an alternative to MS-PCR for assessing the prognosis of patients with GBM.
Reduction in surgical site infection with suprafascial intrawound application of vancomycin powder in instrumented posterior spinal fusion: a retrospective case-control study
Authors: Haimoto Shoichi , Schär Ralph T. , Nishimura Yusuke , Hara Masahito , Wakabayashi Toshihiko , Ginsberg Howard J. 
Published: May 2018

OBJECTIVERecent studies have demonstrated the efficacy of subfascial intrawound application of vancomycin powder in spine surgery in reducing the rate of surgical site infections (SSIs). However, to date no study has evaluated the efficacy and safety of suprafascial application of vancomycin powder in spine surgery. The purpose of this study was to quantify the rate of SSIs after open instrumented posterior spinal fusion with and without application of suprafascial vancomycin powder and to evaluate the rate of vancomycin powder–related local adverse effects.METHODSThe authors conducted a single-center retrospective case-control study of adult patients undergoing open instrumented posterior fusion of the cervical, thoracic, or lumbar spine performed by a single surgeon from January 2010 through December 2016. In March 2013, routine application of 1 g of suprafascial vancomycin powder was started for all cases in addition to standard systemic antibiotic prophylaxis. Baseline demographics and operative data as well as the SSI rates were compared between the study groups. The incidence of vancomycin powder–related adverse effects was analyzed.RESULTSA total of 515 patients (268 in the untreated group and 247 in the treated group) were included in the study. The mean age was significantly higher in the treated group than in the untreated group (58.4 vs 54.4 years, p < 0.01). Operative variables were similar between the study groups. Patients receiving vancomycin powder had a significantly lower infection rate (5.6% in the untreated group vs 0% in the treated group, p < 0.001). No vancomycin powder–related adverse effects were identified in the treated group.CONCLUSIONSRoutine application of suprafascial intrawound vancomycin powder in addition to systemic antibiotic prophylaxis is an easy-to-use, safe, and effective strategy for preventing SSIs after instrumented posterior spinal fusion. Suprafascial application of vancomycin powder could be a valuable alternative to previously reported subfascial distribution, minimizing the risk of local adverse drug reactions.
Duality and the Kami: The Ritual Iconography and Visual Constructions of Medieval Shintō
Authors: Dolce Lucia 
Published: May 2018

Le discours médiéval sur les kami a produit de riches représentations iconographiques des divinités. Ces images mettent non seulement au défi l'idée reçue, moderne, selon laquelle le shintō serait une tradition sans images, mais elles témoignent également du fait que de nombreuses manières de visualiser les kami ont été expérimentées au Moyen Âge. De plus, elles mettent au premier plan la variété des performances rituelles relatives aux kami, auxquelles la production de l'imagerie religieuse était liée.
Le présent article explore l'iconographie du shintō médiéval en rapport avec le développement du discours visuel de l'ésotérisme, et sa signification épistémologique et sotériologique. Il introduit une énigmatique triade « shintō », dans laquelle Amaterasu est mise au centre, flanquée par les deux Rois de Science (myōō) Fudō et Aizen. Amaterasu est représentée comme une déesse à cheval et elle est identifiée au Bodhisattva Mvaghosa (Memyō). Les deux myōō sont représentés comme ses acolytes, mais ils jouent un rôle crucial dans la construction symbolique de la triade. Cette imagerie se retrouve dans nombre d'ouvrages appartenant au courant tardif de ce qu'on appelle le Ryōbu Shintō, et dans le contexte des rituels du Miwaryù Shintō. C'est une imagerie comportant plusieurs couches d'interprétation, où sont encastrés des mythes, des doctrines ésotériques et des exégèses du Yijing : elle est en fait informée par les idées du yin et du yang et par la notion classique de l'interface entre l'externe et l'interne exprimée dans le Yijing, en même temps qu'elle cristallise des segments de pratiques méditatives de l'ésotérisme. Une analyse détaillée de divers documents traitant de cette triade suggère que cette iconographie shintō était étroitement influencée par les tentatives de l'ésotérisme contemporain pour visualiser les différents stades et les fruits des pratiques rituelles sous forme anthropomorphique. De plus, cette triade pouvait être le point de départ d'un discours sur une « bouddhéité embryologique », qui s'était développé et répandu dans toutes sortes de lignées au cours du Moyen Âge tardif. Les matériaux du Miwaryû montrent que ce discours s'est même prolongé jusqu'à l'époque Edo.
Do Kami Ever Overlook Pollution? Honji suijaku and the Problem of Death Defilement
Authors: Stone Jacqueline I. 
Published: May 2018

Les XIIe et XIIIe siècles ont vu la diffusion de la pensée du honji suijaku, qui maintient que les buddhas et les bodhisattvas s'étaient manifestés sous des formes appropriées au milieu local en tant que kami japonais. L'idée de considérer les kami comme des avatars des divinités bouddhiques a-t-elle mené à un affaiblissement dans la rigueur de l'action menée contre la pollution (imi), et en particulier la pollution de la mort, traditionnellement observée dans le culte des sanctuaires ? Telle est l'impression que l'on pourrait retirer des contes didactiques de l'époque Kamakura (1185-1333) qui présentent de manière récurrente le cas d'un moine qui encourt inopinément la souillure de la mort mais à qui on permet toujours de s'approcher du sanctuaire et d'en vénérer le kami. D'autres sources, cependant, suggèrent que l'on a continué à observer la prohibition concernant la pollution de la mort, non seulement dans les sanctuaires des kami, mais également dans bien des temples bouddhiques ; et que l'on a adapté les idées du honji suijaku de façons diverses, soit pour affirmer la nécessité de continuer à observer les tabous sur la pollution, soit pour suggérer qu'ils sont inapplicables du point de vue sotériologique. Les histoires de kami ne tenant pas compte de la pollution, elles indiquent moins un relâchement des prohibitions concernant la souillure qu'une concurrence de définitions de la pureté soutenues par différentes écoles bouddhiques. Les clercs qui occupaient des postes officiels, responsables des prières visant à protéger la nation et les rites des kami durent maintenir la pureté rituelle, alors que les moines reclus ou ascétiques pratiquant en dehors de l'organisation officielle des temples n'étaient pas liés par de telles restrictions et considéraient que la pureté consistait non pas à éviter la souillure mais à abandonner tout attachement au monde. Les pratiquants de cette dernière tendance pouvaient ainsi avoir affaire à la pollution de la mort et ils en vinrent à se spécialiser dans les rites centrés sur le lit de mort et les rites funéraires.
Savoirs sur la langue et étayages des activités de langage écrit au cycle 2
Authors: Rilliard Jacques , Delbrayelle Anne 
Published: May 2018

La recherche INRP PROGCODE «Maitrise progressive du système de l'écrit de la GS au CEI » se donne comme objectif d' étudier les moyens didactiques permettant à tous les élèves de traiter avec une compétence de plus en plus assurée les activités de compréhension, de production de langage écrit et les connaissances sur l'écrit sans jamais les séparer.
Nous montrons d'abord qu'il est possible d'articuler la construction de connaissances sur le système de l'écrit avec les progrès de chaque enfant en compréhension et production de langage écrit au cours du cycle 2 grâce à des apprentissages progressifs, c'est-à-dire qui prennent appui sur les acquis du cycle 1 et accompagnent les élèves par des étayages différenciés au cours du cycle 2.
Nous présentons ensuite un tableau des apprentissages des élèves susceptible de guider le maitre dans son action d'enseignement : lors des activités langagières, les remarques des élèves prennent la forme de scandales qui traduisent leur découverte progressive du système de l'écrit. Ce tableau indique comment, à partir des réflexions, des difficultés qu'ils rencontrent dans les textes, le maitre peut les aider à comprendre les principes de fonctionnement de l'écrit pour devenir lecteurs et producteurs d'écrits.
L'article se consacre enfin aux modalités de l'association entre les apprentis¬ sages d'une élève et ceux de la classe. Pour permettre à chaque élève d'atteindre les visées de fin de cycle 2, il est nécessaire de redéfinir les appuis permettant les progrès de chacun. Un essai de théorisation didactique des écrits de référence et des outils analogiques permet d'esquisser une recomposition des savoirs lorsqu'ils sont construits à partir des activités de langage écrit.
Plurilinguisme et approche interculturelle. Quelques réflexions à propos d’expérimentations de type «Éveil aux langues ou aux langages» à l’école primaire
Authors: Dreyfus Martine 
Published: May 2018

The topic of this article will be the place and relevance of approaches such as awareness of language and cultures in Primary school, based on the presentation and analysis of differents projects. The main data used as a basis for this article come essentially from the EVLANG research in which a team of teachers of Montpellier has taken part and also from a Group of Study and Research on the learning of language in an Educational Priority Network by children and teenagers for whom the French language, i. e. the school language is either a language very far from their linguistic and social practices or a second and foreign language. Among other objectives, this research meant to produce and mutualize some aids to train teachers, out of the observation and analysis of the teaching practices
in use. I have, within this Group, worked more specifically with Linguistic Initiation Classgroup teachers.
Les annotations, indicateurs des fonctions de la rédaction : parcours historique
Authors: Bishop Marie-France 
Published: May 2018

Teachers’ annotations, indicators of the functions of writing : a historical survey,
Marie-France Bishop, IUFM de Versailles, équipe Théodile, université Charlesde-Gaulle, Lille 3 This contribution aims to rediscover, from a historical point of view, the different functions of the writing activities in the school, through the ways they are assesssed. It consists more particularly in reading the annotations which go with the pupils’ assignments as illustrations of what the different eras have set up as models of the learning of writing... The first examples which have been selected date back to the beginning of the century, they show the diversity of the educational project which uses the writing activity with varied objectives outgoing widely the mere framework of the school topic. As far as this traditional model is concerned, the assessment of written assignments is part of a project aiming at the moral and intellectual education of the citizen-to-be. A second set of examples concerns the current model, whose stakes are mainly centered on the knowledge of the texts and how they work. Writing aims mainly at acquiring a practice of textual structures. But this approach of evaluation based on precise linguistic criteria is brought into question by supporters of a position more centered on the learner who try to take account of the individual approach to writing.