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Amir S Steinberg, Anish B Parikh, Sara Kim, Damaris Peralta-Hernandez, Talaat Aggour, Luis Isola
OBJECTIVES: Antibiotic stewardship is an integral aspect of hospital care, limiting the potential for resistance while working to minimize waste. A similar system is needed in oncology, given the rapid proliferation of new therapies and the challenges of navigating a complicated reimbursement environment. A "cancer therapy stewardship program" has never been described in the literature. Here, we detail our efforts to design and implement such a program and share lessons learned to inform future projects...
March 2018: American Journal of Managed Care
Tammy Toscos, Maria Carpenter, Mindy Flanagan, Kislaya Kunjan, Bradley N Doebbeling
Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These "positive deviant" practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families...
January 2018: Health Services Research and Managerial Epidemiology
Matthias Stangl, Johannes Achtzehn, Karin Huber, Caroline Dietrich, Claus Tempelmann, Thomas Wolbers
A progressive loss of navigational abilities in old age has been observed in numerous studies, but we have only limited understanding of the neural mechanisms underlying this decline [1]. A central component of the brain's navigation circuit are grid cells in entorhinal cortex [2], largely thought to support intrinsic self-motion-related computations, such as path integration (i.e., keeping track of one's position by integrating self-motion cues) [3-6]. Given that entorhinal cortex is particularly vulnerable to neurodegenerative processes during aging and Alzheimer's disease [7-14], deficits in grid cell function could be a key mechanism to explain age-related navigational decline...
March 12, 2018: Current Biology: CB
Annette Peart, Virginia Lewis, Ted Brown, Grant Russell
OBJECTIVE: Patient navigators are a promising mechanism to link patients with primary care. While navigators have been used in population health promotion and prevention programmes, their impact on access to primary care is not clear. The aim of this scoping review was to examine the use of patient navigators to facilitate access to primary care and how they were defined and described, their components and the extent to which they were patient centred. SETTING AND PARTICIPANTS: We used the Arksey and O'Malley scoping review method...
March 17, 2018: BMJ Open
Noorulain Iqbal, Salman Sharif, Mehak Hafiz, Aman Ullah
No abstract text is available yet for this article.
March 14, 2018: World Neurosurgery
Giovanni Raffa, Maria C Quattropani, Antonino Scibilia, Alfredo Conti, Filippo Flavio Angileri, Felice Esposito, Carmela Sindorio, Salvatore Massimiliano Cardali, Antonino Germanò, Francesco Tomasello
OBJECTIVES: Awake surgery and intraoperative monitoring represent the gold standard for surgery of brain tumors located in the perisylvian region of the dominant hemisphere due to their ability to map and preserve the language network during surgery. Nevertheless, in some cases awake surgery is not feasible. This could increase the risk of postoperative language deficit. Navigated transcranial magnetic stimulation (nTMS) and nTMS-based DTI fiber tracking (DTI-FT) provide a preoperative mapping and reconstruction of the cortico-subcortical language network...
March 11, 2018: Clinical Neurology and Neurosurgery
Tuomo Kujala, Jakke Mäkelä
We present results from a naturalistic study that tracked how Finnish drivers use their smartphones while on the move. We monitored 30 heavy in-car smartphone users in Finland during June-September 2016, recording the times that they used their phones, the application used at the time of touch (calls excluded), the location and driving speed. Touches per time unit were used as a proxy for estimating visual-manual distraction due to visual-manual tasks. Our data set allows the determining of whether drivers use their phones differently on varying road types (highway, main road, local rural road, urban road)...
March 14, 2018: Accident; Analysis and Prevention
Florent Lalys, Ketty Favre, Alexandre Villena, Vincent Durrmann, Mathieu Colleaux, Antoine Lucas, Adrien Kaladji
PURPOSE: Interventional endovascular treatment has become the first line of management in the treatment of peripheral artery disease (PAD). However, contrast and radiation exposure continue to limit the feasibility of these procedures. This paper presents a novel hybrid image fusion system for endovascular intervention of PAD. We present two different roadmapping methods from intra- and pre-interventional imaging that can be used either simultaneously or independently, constituting the navigation system...
March 16, 2018: International Journal of Computer Assisted Radiology and Surgery
Zhihui Zhao, Zhen Liu, Zongshan Hu, Changchun Tseng, Jie Li, Wei Pan, Yong Qiu, Zezhang Zhu
PURPOSE: The purpose of this study was to analyze the occurrence of PE after intra-operative O-arm navigation-assisted surgery and determine whether the post-operative PE incidence could be decreased by using O-arm navigation as compared to conventional free-hand technique. METHODS: A cohort of 27 patients with spinal deformity who were operated upon with an O-arm navigated system (group A) between 2013 and 2016 were enrolled in the study. A total of 27 curve-matched patients treated by conventional free-hand technique were included as the control group (group B)...
March 16, 2018: International Orthopaedics
Jaclyn Hirschey, Sunetra Bane, Moussa Mansour, Jodi Sperber, Stephen Agboola, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Atrial fibrillation (AFib) is the most common form of heart arrhythmia and a potent risk factor for stroke. Nonvitamin K antagonist oral anticoagulants (NOACs) are routinely prescribed to manage AFib stroke risk; however, nonadherence to treatment is a concern. Additional tools that support self-care and medication adherence may benefit patients with AFib. OBJECTIVE: The aim of this study was to evaluate the perceived usability and usefulness of a mobile app designed to support self-care and treatment adherence for AFib patients who are prescribed NOACs...
March 15, 2018: JMIR Human Factors
Xiaotian Lian, Jun Guo, Wei Zeng, Hai Qing, Rui Ju, Wei Tang
PURPOSE: The purpose of this study was to explore new landmark-independent methods suitable for determining the midsagittal plane (MSP) in patients with craniomaxillofacial trauma and its clinical application. MATERIALS AND METHODS: Preoperative computed tomography data of 25 patients with craniomaxillofacial trauma were imported into Mimics software (Materialise, Leuven, Belgium) to reconstruct 3-dimensional skull models. In the experimental group, the MSP was determined by different landmarks that were clear, were scattered, and did not have displacement according to the types of fractures...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Jesper Jansen, Ruud Schreurs, Leander Dubois, Thomas J J Maal, Peter J J Gooris, Alfred G Becking
OBJECTIVE: Advanced three-dimensional (3D) diagnostics and preoperative planning are the first steps in computer-assisted surgery (CAS). They are an integral part of the workflow, and allow the surgeon to adequately assess the fracture and to perform virtual surgery to find the optimal implant position. The goal of this study was to evaluate the accuracy and predictability of 3D diagnostics and preoperative virtual planning without intraoperative navigation in orbital reconstruction. METHODS: In 10 cadaveric heads, 19 complex orbital fractures were created...
February 26, 2018: Journal of Cranio-maxillo-facial Surgery
Peijuan Li, Guoliang Sheng, Xiaofei Zhang, Jingqiu Wu, Baochun Xu, Xing Liu, Yao Zhang
Considering that the terrain-aided navigation (TAN) system based on iterated closest contour point (ICCP) algorithm diverges easily when the indicative track of strapdown inertial navigation system (SINS) is large, Kalman filter is adopted in the traditional ICCP algorithm, difference between matching result and SINS output is used as the measurement of Kalman filter, then the cumulative error of the SINS is corrected in time by filter feedback correction, and the indicative track used in ICCP is improved. The mathematic model of the autonomous underwater vehicle (AUV) integrated into the navigation system and the observation model of TAN is built...
March 13, 2018: ISA Transactions
Malgorzata A Gazda, Pedro Andrade, Sandra Afonso, Jolita Dilyte, John P Archer, Ricardo J Lopes, Rui Faria, Miguel Carneiro
Racing pigeons have been selectively bred to find their way home quickly over what are often extremely long distances. This breed is of substantial commercial value and is also an excellent avian model to gain empirical insights into the evolution of traits associated with flying performance and spatial orientation. Here, we investigate the molecular basis of the superior athletic and navigational capabilities of racing pigeons using whole-genome and RNA sequencing data. We inferred multiple signatures of positive selection distributed across the genome of racing pigeons...
March 13, 2018: Molecular Biology and Evolution
Junbo Tie, Juliang Cao, Lubing Chang, Shaokun Cai, Meiping Wu, Junxiang Lian
Compensation of gravity disturbance can improve the precision of inertial navigation, but the effect of compensation will decrease due to the accelerometer bias, and estimation of the accelerometer bias is a crucial issue in gravity disturbance compensation. This paper first investigates the effect of accelerometer bias on gravity disturbance compensation, and the situation in which the accelerometer bias should be estimated is established. The accelerometer bias is estimated from the gravity vector measurement, and a model of measurement noise in gravity vector measurement is built...
March 16, 2018: Sensors
Matthew J Murray, Nicholas E Peters, Matthew B Reeves
The host cell represents a hostile environment that viruses must counter in order to establish infection. Human cytomegalovirus (HCMV) is no different and encodes a multitude of functions aimed at disabling, re-directing or hijacking cellular functions to promulgate infection. However, during the very early stages of infection the virus relies on the outcome of interactions between virion components, cell surface receptors and host signalling pathways to promote an environment that supports infection. In the context of latent infection-where the virus establishes an infection in an absence of many gene products specific for lytic infection-these initial interactions are crucial events...
March 16, 2018: Pathogens
Xu Zhao, Lihua Dou, Zhong Su, Ning Liu
A snake robot is a type of highly redundant mobile robot that significantly differs from a tracked robot, wheeled robot and legged robot. To address the issue of a snake robot performing self-localization in the application environment without assistant orientation, an autonomous navigation method is proposed based on the snake robot's motion characteristic constraints. The method realized the autonomous navigation of the snake robot with non-nodes and an external assistant using its own Micro-Electromechanical-Systems (MEMS) Inertial-Measurement-Unit (IMU)...
March 16, 2018: Sensors
J J Brudvig, J T Cain, G G Schmidt-Grimminger, D J Stumpo, K J Roux, P J Blackshear, J M Weimer
Axons of the corpus callosum (CC), the white matter tract that connects the left and right hemispheres of the brain, receive instruction from a number of chemoattractant and chemorepulsant cues during their initial navigation towards and across the midline. While it has long been known that the CC is malformed in the absence of Myristoylated alanine-rich C-kinase substrate (MARCKS), evidence for a direct role of MARCKS in axon navigation has been lacking. Here, we show that MARCKS is necessary for Netrin-1 (NTN1) signaling through the DCC receptor, which is critical for axon guidance decisions...
March 15, 2018: Molecular Neurobiology
Andrew R Christiansen, Rami M Shorti, Cory D Smith, William C Prows, Jay T Bishoff
PURPOSE: Despite the increasing use of advanced 3D imaging techniques and 3D printing, these techniques have not yet been comprehensively compared in a surgical setting. The purpose of this study is to explore the effectiveness of five different advanced imaging modalities during a complex renal surgical procedure. METHODS: A patient with a horseshoe kidney and multiple large, symptomatic stones that had failed Extracorporeal Shock Wave Lithotripsy (ESWL) and ureteroscopy treatment was used for this evaluation...
March 15, 2018: World Journal of Urology
A G Ramos, V J García-Garrido, A M Mancho, S Wiggins, J Coca, S Glenn, O Schofield, J Kohut, D Aragon, J Kerfoot, T Haskins, T Miles, C Haldeman, N Strandskov, B Allsup, C Jones, J Shapiro
Transoceanic Gliders are Autonomous Underwater Vehicles (AUVs) for which there is a developing and expanding range of applications in open-seas research, technology and underwater clean transport. Mature glider autonomy, operating depth (0-1000 meters) and low energy consumption without a CO2 footprint enable evolutionary access across ocean basins. Pursuant to the first successful transatlantic glider crossing in December 2009, the Challenger Mission has opened the door to long-term, long-distance routine transoceanic AUV missions...
March 15, 2018: Scientific Reports
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