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https://www.readbyqxmd.com/read/28644919/signaling-and-epigenetic-mechanisms-of-intestinal-stem-cells-and-progenitors-insight-into-crypt-homeostasis-plasticity-and-niches
#1
REVIEW
Ryan J Smith, Abilasha Rao-Bhatia, Tae-Hee Kim
The rapid turnover of intestinal epithelial cells is maintained by a small number of stem cells located in pocket-like gland structures called crypts. While our understanding of the identity and function of intestinal stem cells (ISCs) has rapidly progressed, epigenetic and transcriptional regulation in crypt stem cell and progenitor pools remains an active field of investigation. Surrounded by various types of cells in the stroma, crypt progenitors display high levels of plasticity, harboring the ability to interconvert in the face of epithelial damage...
June 23, 2017: Wiley Interdisciplinary Reviews. Developmental Biology
https://www.readbyqxmd.com/read/28644890/drivers-of-coral-reef-marine-protected-area-performance
#2
Venetia Alexa Hargreaves-Allen, Susana Mourato, Eleanor Jane Milner-Gulland
Coral reefs are severely threatened and a principal strategy for their conservation is marine protected areas (MPAs). However the drivers of MPA performance are complex and there are likely to be trade-offs between different types of performance (e.g. conservation or welfare related outcomes). We compiled a global dataset from expert knowledge for 76 coral reef MPAs in 33 countries and identified a set of performance measures reflecting ecological and socio-economic outcomes, achievement of aims and reduction of threats, using spatial or temporal comparisons wherever possible...
2017: PloS One
https://www.readbyqxmd.com/read/28644835/physician-assessments-of-drug-seeking-behavior-a-mixed-methods-study
#3
Michael A Fischer, John B McKinlay, Jeffrey N Katz, Eric Gerstenberger, Felicia Trachtenberg, Lisa D Marceau, Lisa C Welch
BACKGROUND: Pain complaints are common, but clinicians are increasingly concerned about overuse of opioid pain medications. This may lead patients with actual pain to be stigmatized as "drug-seeking," or attempting to obtain medications they do not require medically. We assessed whether patient requests for specific opioid pain medication would lead physicians to classify them as drug-seeking and change management decisions. METHODS AND FINDINGS: Mixed-methods analysis of interviews with 192 office-based primary care physicians after viewing video vignettes depicting patients presenting with back pain...
2017: PloS One
https://www.readbyqxmd.com/read/28644786/antecedents-and-consequences-of-medical-students-moral-decision-making-during-professionalism-dilemmas
#4
Lynn Monrouxe, Malissa Shaw, Charlotte Rees
Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students' action (or inaction) runs counter to their perceived moral values-often due to organizational constraints or power hierarchies-they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance)...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#5
Noel Baxter
PURPOSE OF REVIEW: Breathlessness is a high-volume problem with 10% of adults experiencing the symptom daily placing a heavy burden on the health and wider economy. As it worsens, they enter the specialist and hospital-based symptom services where costs quickly escalate and people may find themselves in a place not of their choosing. For many, their care will be delivered by a disease or organ specialist and can find themselves passing between physicians without coordination for symptom support...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#6
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28644081/effects-of-added-lipids-on-digestibility-and-nitrogen-balance-in-oiled-common-murres-uria-aalge-and-western-grebes-aechmophorus-occidentalis-fed-four-formulations-of-a-critical-care-diet
#7
Rebecca S Duerr, Kirk C Klasing
Nutritional support is a primary therapy administered to oiled animals during responses to oil spills, but data informing nutritional decision-making during events are limited. In this study, 44 common murres ( Uria aalge ) and 6 Western grebes ( Aechmophorus occidentalis ), naturally oiled by oceanic seeps off the coast of Ventura and Santa Barbara Counties, CA, USA, were assigned to 1 of 4 groups fed diets with varying levels (6.8% [no added oil], 11%, and 20%) and types (salmon, corn) of oil added to a partially purified basal diet...
June 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/28643560/design-quality-in-the-context-of-healthcare-environments-a-scoping-review
#8
Anna Anåker, Ann Heylighen, Susanna Nordin, Marie Elf
OBJECTIVE: We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare. BACKGROUND: High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security...
July 2017: HERD
https://www.readbyqxmd.com/read/28642353/when-sanctity-of-life-and-self-determination-clash-briggs-versus-briggs-2016-ewcop-53-implications-for-policy-and-practice
#9
Jenny Kitzinger, Celia Kitzinger, Jakki Cowley
In a landmark judgment in the English Court of Protection, the judge (Charles J) found it to be in the best interests of a minimally conscious patient for clinically assisted nutrition and hydration (CANH) to be withdrawn, with the inevitable consequence that the patient would die. In making this judgment, it was accepted that the patient's level of consciousness - if CANH were continued and rehabilitation provided - might improve, and that he might become capable of expressing emotions and making simple choices...
June 22, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28642287/genetic-screening-in-sporadic-als-and-ftd
#10
EDITORIAL
Martin R Turner, Ammar Al-Chalabi, Adriano Chio, Orla Hardiman, Matthew C Kiernan, Jonathan D Rohrer, James Rowe, William Seeley, Kevin Talbot
The increasing complexity of the genetic landscape in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) presents a significant resource and physician training challenge. At least 10% of those diagnosed with ALS or FTD are known to carry an autosomal dominant genetic mutation. There is no consensus on what constitutes a positive family history, and ascertainment is unreliable for many reasons. However, symptomatic individuals often wish to understand as much as possible about the cause of their disease, and to share this knowledge with their family...
June 22, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28642218/the-effectiveness-of-information-technology-supported-shared-care-for-patients-with-chronic-disease-a-systematic-review
#11
Laura Kooij, Wim G Groen, Wim H van Harten
BACKGROUND: In patients with chronic disease, many health care professionals are involved during treatment and follow-up. This leads to fragmentation that in turn may lead to suboptimal care. Shared care is a means to improve the integration of care delivered by various providers, specifically primary care physicians (PCPs) and specialty care professionals, for patients with chronic disease. The use of information technology (IT) in this field seems promising. OBJECTIVE: Our aim was to systematically review the literature regarding the effectiveness of IT-supported shared care interventions in chronic disease in terms of provider or professional, process, health or clinical and financial outcomes...
June 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28642211/the-integrating-depression-and-diabetes-treatment-independent-study-design-and-methods-to-address-mental-healthcare-gaps-in-india
#12
A J Kowalski, S Poongothai, L Chwastiak, M Hutcheson, N Tandon, R Khadgawat, G R Sridhar, S R Aravind, B Sosale, R M Anjana, D Rao, R Sagar, N Mehta, K M V Narayan, J Unutzer, W Katon, V Mohan, M K Ali
INTRODUCTION: Depression and diabetes are highly prevalent worldwide and often co-exist, worsening outcomes for each condition. Barriers to diagnosis and treatment are exacerbated in low and middle-income countries with limited health infrastructure and access to mental health treatment. The INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) study tests the sustained effectiveness and cost-effectiveness of a multi-component care model for individuals with poorly-controlled diabetes and depression in diabetes clinics in India...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28642108/investing-in-new-technology-in-pulmonary-medicine-navigating-the-tortuous-path-to-success
#13
REVIEW
Robert Kruklitis, Kim French, Michael Joseph Cangelosi, Kevin L Kovitz
The introduction of new technologies offer the promise to advance medicine. This occurs alongside improved efforts to control costs of healthcare by hospital administrators, Center for Medicare and Medicaid Services' (CMS) pivot to value programs, and commercial payers' efforts to reduce reimbursement. These trends present a challenge for the pulmonologist, among others, who must navigate increasingly complex and highly scrutinized evaluation processes used to secure new technologies. Healthcare providers are turning toward value assessments, while simultaneously tasked with a mission of offering state-of-the art technologies and services...
June 19, 2017: Chest
https://www.readbyqxmd.com/read/28641354/-acute-liver-failure-acute-on-chronic-liver-failure-hepatorenal-syndrome-hepatopulmonary-syndrome-and-portopulmonary-hypertension-artificial-liver-support-on-the-icu
#14
Uwe Lodes, David Jacob, Frank Meyer
Background Acute hepatic dysfunction in the form of acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) is a disease with a high risk of mortality and requires interdisciplinary intensive care. Aim This article explains the nomenclature, pathophysiology, prognosis and possible treatment options of ALF and ACLF, including the possibilities of extracorporeal liver support therapy at the point of liver transplantation (LTx). Method Narrative review with a selective literature review and representative case studies...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28641264/a-single-channel-eog-based-speller
#15
Shenghong He, Yuanqing Li
Electrooculography (EOG) signals, which can be used to infer the intentions of a user based on eye movements, are widely used in human-computer interface (HCI) systems. Most existing EOG-based HCI systems incorporate a limited number of commands because they generally associate different commands with a few different types of eye movements, such as looking up, down, left, or right. This paper presents a novel single-channel EOG-based HCI that allows users to spell asynchronously by only blinking. Forty buttons corresponding to 40 characters displayed to the user via a graphical user interface (GUI) are intensified in a random order...
June 15, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28641244/computerized-lung-sound-screening-for-pediatric-auscultation-in-noisy-field-environments
#16
Dimitra Emmanouilidou, Eric D McCollum, Daniel E Park, Mounya Elhilali
GOAL: Chest auscultations offer a non-invasive and low-cost tool for monitoring lung disease. However, they present many shortcomings including inter-listener variability, subjectivity, and vulnerability to noise and distortions. The current work proposes a computer-aided approach to process lung signals acquired in the field under adverse noisy conditions, by improving the signal quality and offering automated iden- tification of abnormal auscultations indicative of respiratory pathologies...
June 19, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28641213/measurement-properties-of-screening-and-diagnostic-tools-for-autism-spectrum-adults-of-mean-normal-intelligence-a-systematic-review
#17
A Baghdadli, F Russet, L Mottron
BACKGROUND: The autism spectrum (AS) is a multifaceted neurodevelopmental variant associated with lifelong challenges. Despite the relevant importance of identifying AS in adults for epidemiological, public health, and quality of life issues, the measurement properties of the tools currently used to screen and diagnose adults without intellectual disabilities (ID) have not been assessed. OBJECTIVES: This systematic review addresses the accuracy, reliability, and validity of the reported AS screening and diagnostic tools used in adults without ID...
May 17, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28641187/multi-criteria-decision-support-system-dss-for-optimal-locations-of-soil-aquifer-treatment-sat-facilities
#18
P Tsangaratos, A Kallioras, Th Pizpikis, E Vasileiou, I Ilia, F Pliakas
Managed Aquifer Recharge is a wide-spread well-established groundwater engineering method which is largely seen as sound and sustainable solution to water scarcity hydrologically sensitive areas, such as the Circum Mediterranean. The process of site selection for the installation of a MAR facility is of paramount importance for the feasibility and effectiveness of the project itself, especially when the facility will include the use of waters of impaired quality as a recharge source, as in the case of Soil-Aquifer-Treatment systems...
June 19, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28641049/a-study-of-physicians-experiences-with-recommending-hpv-vaccines-to-adolescent-boys
#19
Li Ping Wong, Zobaida Edib, Haridah Alias, Sharina M Mohamad Shakir, Raja N A Raja Muhammad Yusoff, I-Ching Sam, Gregory D Zimet
Assessing physicians' experiences in HPV vaccine recommendation and delivery to adolescent boys is essential to providing an understanding of the issues of vaccine acceptance and an insight for policymakers to enhance HPV vaccinations among adolescent boys. Between January and April 2014 a mail survey was conducted using physicians in Malaysia known to provide either one or both HPV vaccine (Gardasil and Cervarix) immunisation services. A total of 357 completed questionnaires were received (response rate 22...
June 22, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28640720/fungating-wounds-management-and-treatment-options
#20
Suzanne Tandler, Jackie Stephen-Haynes
This article defines fungating wounds and considers the underlying cause, location and presentation. The clinical challenges presented by fungating wounds are discussed, with reference to evidence-based care delivery. This includes wound assessment, cleansing, debridement and management of malodour, infection, bleeding and exudate. Guidance on the use of wound management dressings is considered in relation to symptom management. The importance of clinical decision-making and educational preparation in the delivery of evidenced-based care for those with fungating wounds is emphasised...
June 22, 2017: British Journal of Nursing: BJN
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