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The rational clinical exam

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https://www.readbyqxmd.com/read/29684831/dis-integrating-cultural-difference-in-practice-and-communication-a-qualitative-study-of-host-and-migrant-registered-nurse-perspectives-from-new-zealand
#1
Margaret Brunton, Catherine Cook
BACKGROUND: Several earlier studies have provided evidence of the difficulties nurses have had adapting to foreign workplaces, however few have considered wider perspectives of the workplace communication environment. OBJECTIVE: The aim of this study was to examine the viewpoints and experience of both New Zealand qualified nurses and internationally qualified nurses in managing communication within teams and the clinical practice context in an increasingly diverse healthcare workplace in New Zealand...
April 6, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29679500/a-unified-material-decomposition-framework-for-quantitative-dual-and-triple-energy-ct-imaging
#2
Wei Zhao, Don Vernekohl, Fei Han, Bin Han, Hao Peng, Yong Yang, Lei Xing, James K Min
PURPOSE: Many clinical applications depend critically on the accurate differentiation and classi-fication of different types of materials in patient anatomy. This work introduces a unified framework for accurate nonlinear material decomposition and applies it, for the first time, in the concept of triple-energy CT (TECT) for enhanced material differentiation and classification as well as dual-energy CT METHODS: We express polychromatic projection into a linear combination of line integrals of material-selective images...
April 21, 2018: Medical Physics
https://www.readbyqxmd.com/read/29676680/midline-central-fluid-percussion-model-of-traumatic-brain-injury-in-pediatric-and-adolescent-rats
#3
Rachel K Rowe, Jordan L Harrison, Timothy W Ellis, P David Adelson, Jonathan Lifshitz
OBJECTIVE Experimental traumatic brain injury (TBI) models hold significant validity to the human condition, with each model replicating a subset of clinical features and symptoms. TBI is the leading cause of mortality and morbidity in children and teenagers; thus, it is critical to develop preclinical models of these ages to test emerging treatments. Midline fluid percussion injury (FPI) might best represent mild and diffuse clinical brain injury because of the acute behavioral deficits, the late onset of behavioral morbidities, and the absence of gross histopathology...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29676679/principles-of-system-design-not-realized-for-pediatric-craniospinal-trauma-care-in-the-united-states
#4
Joseph Piatt
OBJECTIVE An implicit expectation of the pioneers of trauma system design was that high clinical volume at select centers could lead to superior outcomes. There has been little study of the regionalization of pediatric craniospinal trauma care, and whether it continues to trend in the direction of regionalization is unknown. The motivating hypothesis for this study was that trauma system design in the United States is proceeding on a rational basis, producing hospital caseloads that are increasing over time and, because of geographic siting appropriate to the needs of catchment areas, in an increasingly uniform manner...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29674774/-psychiatrist-burnout-or-psychiatric-assistance-burnout
#5
Vincenzo Manna, Francesca Dicuonzo
In recent years, mature industrial countries are rapidly changing from production economies to service economies. In this new socio-economic context, particular attention has been paid to mental health problems in the workplace. The risk of burnout is significantly higher for certain occupations, in particular for health workers. Doctors and psychiatrists, in particular, quite frequently have to make quick decisions by dealing with a huge amount of requests, which often require considerable assumptions of responsibility...
March 2018: Rivista di Psichiatria
https://www.readbyqxmd.com/read/29655699/scutellarin-protects-against-vascular-endothelial-dysfunction-and-prevents-atherosclerosis-via-antioxidation
#6
Jiao Mo, Renhua Yang, Fan Li, Xiaochao Zhang, Bo He, Yue Zhang, Peng Chen, Zhiqiang Shen
BACKGROUND: Scutellarin is the major constituent responsible for the clinical benefits of Erigeron breviscapus (Vant.) Hand.-Mazz which finds a long history of ethnopharmacological use in Traditional Chinese Medicine. Scutellarin as a pure compound is now under investigation for its protections against various tissue injuries. PURPOSE: This study aims to examine the effects of scutellarin on oxidative stress-induced vascular endothelial dysfunction and endothelial cell damage, and then to evaluate the therapeutic efficacy of scutellarin in preventing atherosclerosis in rats...
March 15, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/29623825/functional-neuroimaging-biomarkers-in-migraine-diagnostic-prognostic-and-therapeutic-implications
#7
Antonio Russo, Marcello Silvestro, Alessandro Tessitore, Gioacchino Tedeschi
INTRODUCTION: in current migraine clinical practice conventional neuroimaging examinations are often sought to exclude possible causes of secondary headaches or migraine-associated disorders. Contrariwise, although advanced magnetic resonance imaging (MRI) has improved tremendously our understanding of human brain processes in migraine patients, to the state of the art they have not superseded the conventional neuroimaging techniques in the migraine clinical setting. METHODS: a comprehensive review was conducted of PubMed citations by entering the key word "marker" AND/OR "biomarker" combined with "migraine" AND/OR "headache...
April 5, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29609582/ex-met-study-exercise-in-prevention-on-of-metabolic-syndrome-a-randomized-multicenter-trial-rational-and-design
#8
Arnt Erik Tjønna, Joyce S Ramos, Axel Pressler, Martin Halle, Klaus Jungbluth, Erika Ermacora, Øyvind Salvesen, Jhennyfer Rodrigues, Carlos Roberto Bueno, Peter Scott Munk, Jeff Coombes, Ulrik Wisløff
BACKGROUND: Metabolic syndrome substantially increases risk of cardiovascular events. It is therefore imperative to develop or optimize ways to prevent or attenuate this condition. Exercise training has been long recognized as a corner-stone therapy for reducing individual cardiovascular risk factors constituting the metabolic syndrome. However, the optimal exercise dose and its feasibility in a real world setting has yet to be established. The primary objective of this randomized trial is to investigate the effects of different volumes of aerobic interval training (AIT) compared to the current exercise guideline of moderate-intensity continuous training (MICT) on the composite number of cardiovascular disease risk factors constituting the metabolic syndrome after a 16 week, 1-year, and 3-year follow-up...
April 2, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29603837/treatment-with-the-gsk3-beta-inhibitor-tideglusib-improves-hippocampal-development-and-memory-performance-in-juvenile-but-not-adult-cdkl5-knockout-mice
#9
Claudia Fuchs, Norma Fustini, Stefania Trazzi, Laura Gennaccaro, Roberto Rimondini, Elisabetta Ciani
Cyclin-dependent kinase-like 5 (CDKL5) disorder is a severe neurodevelopmental disorder characterized by early-onset epileptic seizures, severe developmental delay, and intellectual disability. To date, no effective pharmacological treatments are available to improve the neurological phenotype that is due to mutations in the CDKL5 gene. Murine models of CDKL5 disorder have recently been generated, making the preclinical testing of pharmacological interventions possible. Using a Cdkl5 knockout (KO) mouse model, we recently demonstrated that deficiency of Cdkl5 causes defects in postnatal hippocampal development and hippocampus-dependent learning and memory...
March 30, 2018: European Journal of Neuroscience
https://www.readbyqxmd.com/read/29568159/exploring-the-relationship-balance-assessment
#10
Thomas B Luttrell, Brian Distelberg, Colwick Wilson, Carmen Knudson-Martin, Mary Moline
Assessments of power in couples' relationships often only survey one partner, but they do not take into consideration both partners' perceptions. Thus, many assumptions about power and equality in relationships have not been quantitatively tested due to a lack of dyadic measures of power. Therefore, the purpose of the Gender and Relationships Study was to develop and test a new scale of equality and relative power for couples, the Relationship Balance Assessment (RBA). The RBA may be useful for research and for clinical work with couples to help raise awareness of the balance of power in their relationship...
2018: Contemporary Family Therapy
https://www.readbyqxmd.com/read/29566364/the-immunogenicity-and-anti-tumor-efficacy-of-a-rationally-designed-egfr-vaccine
#11
Chao Cheng, Li Deng, Rongxiu Li
BACKGROUND/AIMS: The abnormally activated EGFR promotes tumor growth, invasion and metastasis. Current therapeutics targeting EGFR have markedly improved the clinical outcome, but they are limited in use due to transient efficacy, frequent administration, high cost and significant toxicity. METHODS: We rationally designed a multiepitope immunogen against EGFR, named as DEGFRm. The immunogen is composed of an epitope peptide (EGFR265-283) and the extracellular domain III (EGFR334-505) of mouse EGFR...
March 20, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29561461/a-randomized-controlled-study-to-evaluate-the-effect-of-pharmacist-led-educational-intervention-on-glycemic-control-self-care-activities-and-disease-knowledge-among-type-2-diabetes-patients-a-consort-compliant-study-protocol
#12
Allah Bukhsh, Muhammad Sarfraz Nawaz, Hafiz Sajjad Ahmed, Tahir Mehmood Khan
BACKGROUND: Diabetes self-care activities, like, healthy diet, regular exercise, self-monitoring of blood glucose, and rational use of medicines are considered to play a vital role in establishing euglycemia. Health literacy among type 2 diabetes mellitus (T2DM) patients in Pakistan is very low, which is the most likely cause for poor clinical outcomes. This study is designed to investigate the impact of pharmacist-led educational intervention on glycemic control, self-care activities and disease knowledge among T2DM patients in Pakistan...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29560356/development-and-application-of-the-lincoln-adherence-instrument-record-for-assessing-client-adherence-to-advice-in-dog-behavior-consultations-and-success
#13
Lisanna Lamb, Nadja Affenzeller, Lynn Hewison, Kevin James McPeake, Helen Zulch, Daniel S Mills
Adherence to the advice of medical practitioners is critical to successful treatment outcomes and has been much researched in human health, but is less well studied in the veterinary and clinical animal behavior fields. Given that the management of behavior problems often requires substantial change in established client behavior, it is likely that adherence is a substantive issue affecting success. However, little is known about the relationships between relevant factors, and there is no established way of assessing these...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29535763/genetic-markers-are-associated-with-the-ruminal-microbiome-and-metabolome-in-grain-and-sugar-challenged-dairy-heifers
#14
Helen M Golder, Jennifer M Thomson, Stuart E Denman, Chris S McSweeney, Ian J Lean
Dairy heifers were subjected to a non-life-threatening challenge designed to induce ruminal acidosis by feeding grain and sugar. Large among animal variation in clinical signs of acidosis, rumen metabolite concentrations, and the rumen microbiome occurred. This exploratory study investigates sources of the variation by examining associations between the genome, metabolome, and microbiome, albeit with a limited population. The broader objective is to provide a rationale for a larger field study to identify markers for susceptibility to ruminal acidosis...
2018: Frontiers in Genetics
https://www.readbyqxmd.com/read/29513124/a-rational-approach-to-identifying-newborns-with-hearing-loss-caused-by-congenital-cytomegalovirus-infection-by-dried-blood-spot-screening
#15
Hideaki Moteki, Yuichi Isaka, Yuji Inaba, Mitsuo Motobayashi, Shin-Ya Nishio, Satoshi Ohira, Takuya Yano, Satoshi Iwasaki, Tanri Shiozawa, Kenichi Koike, Shin-Ichi Usami
OBJECTIVE: Congenital cytomegalovirus (cCMV) infection is the most common congenital infection, with the majority of infected newborns having no detectable signs. The aim of this study was to examine the accuracy of our newly developed DBS-based assay as an appropriate mass screening method for cCMV infection. METHODS: Between May 2011 and October 2016, newborns delivered at six hospitals in Nagano Prefecture, Japan were enrolled prospectively. We employed dried blood spot (DBS)-based assays with real-time quantitative PCR (qPCR)...
March 7, 2018: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/29508476/-strangers-in-the-er-quality-indicators-and-third-party-interference-in-dutch-emergency-care
#16
Floortje B Moes, Eddy S Houwaart, Diana M J Delnoij, Klasien Horstman
RATIONALE, AIMS, AND OBJECTIVES: This paper examines a remarkable dispute between Dutch insurers, hospitals, doctors, and patients about a set of quality indicators. In 2013, private insurers planned to drastically reform Dutch emergency care using quality indicators they had formulated drawing from clinical guidelines, RCTs, and systematic reviews. Insurers' plans caused much debate in the field of emergency care. As quality indicators have come to play a more central role in health care governance, the questions what constitutes good evidence for them, how they ought to be used, and who controls them have become politically and morally charged...
March 6, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29497278/abemaciclib-a-cdk4-6-inhibitor-for-the-treatment-of-hr-her2-advanced-breast-cancer
#17
REVIEW
Silvia Paola Corona, Daniele Generali
Although early breast cancer (BC) is highly curable, advanced or metastatic disease poses numerous challenges in terms of medical management and treatment decisions and is associated with significantly worse prognosis. Among the new targeted agents, anticancer drugs exploiting the cell-cycle machinery have shown great potential in preclinical studies. CDK4/6 inhibitors target the cyclin D/CDK/retinoblastoma signaling pathway, inducing cell-cycle arrest, reduced cell viability and tumor shrinking. As the cyclin D/CDK complex is activated downstream of estrogen signaling, the combination of CDK4/6 inhibitors with standard endocrine therapies represents a rational approach to elicit synergic antitumor activity in hormone receptor-positive BC...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29466877/behavior-and-health-beliefs-as-predictors-of-hiv-testing-among-women-a-prospective-study-of-observed-hiv-testing
#18
Hao Fan, Kenneth H Fife, Dena Cox, Anthony D Cox, Gregory D Zimet
Much of the research examining predictors of HIV testing has used retrospective self-report to assess HIV testing. FINDINGS: therefore, may be subject to recall bias and to difficulties determining the direction of associations. In this prospective study, we administered surveys to women in community clinics to identify predictors of subsequent observed HIV testing, overcoming these limitations. Eighty-three percent were tested. In the adjusted multivariable model, being born in the U...
February 22, 2018: AIDS Care
https://www.readbyqxmd.com/read/29462206/cell-free-synthesis-of-functional-antibody-fragments-to-provide-a-structural-basis-for-antibody-antigen-interaction
#19
Takayoshi Matsuda, Takuhiro Ito, Chie Takemoto, Kazushige Katsura, Mariko Ikeda, Motoaki Wakiyama, Mutsuko Kukimoto-Niino, Shigeyuki Yokoyama, Yoshikazu Kurosawa, Mikako Shirouzu
Growing numbers of therapeutic antibodies offer excellent treatment strategies for many diseases. Elucidation of the interaction between a potential therapeutic antibody and its target protein by structural analysis reveals the mechanism of action and offers useful information for developing rational antibody designs for improved affinity. Here, we developed a rapid, high-yield cell-free system using dialysis mode to synthesize antibody fragments for the structural analysis of antibody-antigen complexes. Optimal synthesis conditions of fragments (Fv and Fab) of the anti-EGFR antibody 059-152 were rapidly determined in a day by using a 30-μl-scale unit...
2018: PloS One
https://www.readbyqxmd.com/read/29458294/the-impact-of-implementing-an-intensivist-model-with-nighttime-in-hospital-nocturnist-and-effect-on-icu-outcomes
#20
Maged A Tanios, Daniel Teres, Hyunsoon Park, Antonio Beltran, Arunpal Sehgal, James D Leo
BACKGROUND: Various intensivist staffing models have been suggested, but the long-term sustainability and outcomes vary and may not be sustained. We examined the impact of implementing a high-intensity intensivist coverage model with a nighttime in-house nocturnist (non-intensivist) and its effect on intensive care unit (ICU) outcomes. METHODS: We obtained historical control baseline data from 2007 to 2011 and compared the same data from 2011 to 2015. The Acute Physiological and Chronic Health Evaluation outcomes system was utilized to collect clinical, physiological, and outcome data on all adult patients in the medical ICU and to provide severity-adjusted outcome predictions...
January 1, 2018: Journal of Intensive Care Medicine
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