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Value-based medicine

Yusuke Chigira, Ikuri Miyazaki, Masataka Izumi, Takahiro Oda
[Purpose] The present study examined the effects of expiratory muscle training on elderly day care service users, who had been classified into Care Grades 1 and 2 based on Japan's long-term care insurance system. [Subjects and Methods] Intervention was provided for 29 Care Grade 1 or 2 day care service users. During intervention, expiratory muscle training was performed by slowly expiring using the abdominal muscles and a device after maximal inspiration. Each intervention session lasted for approximately 10 minutes, and 2 sessions were held weekly for 3 months to compare respiratory function test values before and after intervention...
February 2018: Journal of Physical Therapy Science
Yi Zheng, Wei Shen, Jian Zhang, Bo Yang, Yao-Nan Liu, Huihui Qi, Xia Yu, Si-Yao Lu, Yun Chen, Yu-Zhou Xu, Yun Li, Fred H Gage, Shuangli Mi, Jun Yao
In the version of this article initially published, the affiliation for Jian Zhang and Shuangli Mi was incomplete. In addition to the Key Laboratory of Genomics and Precision Medicine, they are also affiliated with the University of Chinese Academy of Sciences, Beijing, China. In Supplementary Fig. 1h,l, the molecular mass marker accompanying Snap25 was labeled 58 kDa; the correct value is 25 kDa. In Supplementary Fig. 9b,c, the top panel was labeled Syt1, with molecular mass markers ranging from 46 to 100 kDa; it is actually Snap25, with molecular mass markers ranging from 17 to 46 kDa...
March 15, 2018: Nature Neuroscience
Sabine Salloch, Ina C Otte, Anke Reinacher-Schick, Jochen Vollmann
The impact of patient preferences in evidence-based medicine is a complex issue which touches on theoretical questions as well as medical practice in the clinical context. The interaction between evidence-based recommendations and value-related patient preferences in clinical practice is, however, highly complex and requires not only medical knowledge but social, psychological and communicative competencies on the side of the physician. The multi-layered process of oncology physicians' clinical decision-making was explored in 14 semi-structured interviews with respect to a first diagnosis of a pancreatic adenocarcinoma...
March 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
H A Alhazmi
Transferrin is iron (III)-binding protein that transports Fe (III) ion to cells in different parts of the body. At saturation level 70% of transferrin remains free from iron (apo-transferrin), suggesting a broader scope of binding capabilities with non-iron (III) metal ions. Our previous work demonstrated that transferrin can effectively coordinate with noble metal ions. Hence to improve our understanding of the in-vitro metal-interaction behavior of the protein and how it correlates with its functions invivo, the interactions between apo-transferrin and medicinally important noble metals, Au (I), Au (III), Os (III), Pt (IV), Ir (III) and Ru (III) were investigated in the mobility shift mode of affinity capillary electrophoresis...
March 5, 2018: Die Pharmazie
Beatriz Silva Lima, Mafalda Ascensão Videira
Since the human genome decoding, understanding and identification of genetic disturbances behind many diseases, including cancer, are intensively increasing. Scientific and technological advances in this area trigger the search for therapeutic (curative) approaches targeting the correction of gene disturbances. Gene therapy medicinal products (GTMPs) emerge in this context, bringing new challenges for their characterization. Compared to small molecules, biodistribution is fundamental to identifying target organs and anticipating safety and efficacy, may be integrated into safety and pharmacology studies, and may eventually be anticipated based on specificities of vectors and constructs...
March 16, 2018: Molecular Therapy. Methods & Clinical Development
Daeho Kim, Sanghyun Hong, Hongjun Na, Jihwan Chun, Robin B Guevarra, You-Tae Kim, Sangryeol Ryu, Hyeun Bum Kim, Ju-Hoon Lee
Bellflower root ( Platycodon grandiflorum ), which belongs to the Campanulaceae family, is a perennial grass that grows naturally in Korea, northeastern China, and Japan. Bellflower is widely consumed as both food and medicine due to its high nutritional value and potential therapeutic effects. Since foodborne disease outbreaks often come from vegetables, understanding the public health risk of microorganisms on fresh vegetables is pivotal to predict and prevent foodborne disease outbreaks.We investigated the microbial communities on the bellflower root (n=10)...
March 15, 2018: Journal of Microbiology and Biotechnology
Marion Semmler, Michael Döllinger, Rita R Patel, Anke Ziethe, Anne Schützenberger
OBJECTIVE/HYPOTHESIS: Laser-based three-dimensional (3D) imaging allows realistic visualization and absolute measurement of the vocal folds for comprehensive characterization of the oscillation pattern. STUDY DESIGN: Exploratory study with descriptive data analysis in healthy cohort. METHODS: The custom-developed miniaturized measuring device is an endoscopic camera-laser setup for stereo triangulation and suitable for in vivo application...
March 14, 2018: Laryngoscope
Mona Dawood, Sami Hamdoun, Thomas Efferth
Arsenic trioxide is a traditional remedy in Chinese Medicine since ages. Nowadays, it is clinically used to treat acute promyelocytic leukemia (APL) by targeting PML/RARA. However, the drug's activity is broader and the mechanisms of action in other tumor types remain unclear. In this study, we investigated molecular modes of action by classical and network pharmacological approaches. CEM/ADR5000 resistance leukemic cells were similar sensitive to As2 O3 as their wild-type counterpart CCRF-CEM (resistance ratio: 1...
2018: Frontiers in Pharmacology
Hongxiang Zhang, Fan Wu, Wenli Guo, Rong Bai, Zhuanzhuan Yan, Blaise Pascal Muvunyi, Qi Yan, Yufei Zhang, Xianfeng Yi, Jiyu Zhang
Melilotus is an important genus of legume plants and an herbage with excellent nitrogen fixation; it can tolerate extreme environmental conditions and possesses important medicinal value. However, there is limited genetic information about the genus; thus, we analysed four chloroplast loci (rbcL, matK, psbA-trnH and trnL-F) and one nuclear region (ITS) to determine the genetic diversity of 199 accessions from 18 Melilotus species. The rbcL and matK sequences were highly conserved, whereas the trnL-F and ITS sequences contained variable and parsimony-informative sites...
2018: PloS One
Zsolt J Nagykaldi, Huibert Tange, Jan De Maeseneer
Electronic health records (EHRs) have been in place for decades; however, most existing systems were designed in the prevailing disease- and payment-focused care paradigm that often loses sight of the goals, needs, and values of patients and clinicians. The goal-directed health care model was proposed more than 20 years ago, but no design principles have been developed for corresponding electronic record systems. Newly designed EHRs are needed to facilitate health care that is anchored by patient life and health goals...
March 2018: Annals of Family Medicine
Yemisi Takwoingi, Terence J Quinn
Diagnostic Test Accuracy (DTA) describes a field of research that aims to assess how well a test is able to detect or exclude a condition of interest. Although geriatric medicine is not as reliant on investigations as other medical disciplines, almost all patient encounters with older adults will involve some form of diagnostic assessment. Thus, understanding the terminology and methods of DTA is essential for any clinician. In this review we use examples based around the diagnosis of dementia to highlight issues in DTA research...
March 8, 2018: Age and Ageing
Shi-Jun Liu, Zhi-Shu Tang, Zhi-Xin Liao, Chun-Li Cui, Hong-Bo Liu, Yan-Ni Liang, Yu Zhang, Hong-Bo Xu, Dong-Bo Zhang, Ya-Ting Zheng, Huan-Xian Shi, Shi-Ying Li
ETHNOPHARMACOLOGICAL RELEVANCE: Ligularia przewalskii (Maxim.) Diels (LP) (called zhangyetuowu in Chinese), is generally found in moist forest areas in the western regions of China. The root, leaves and flower of LP are utilized as a common traditional medicine in China. It has been utilized conventionally in herbal remedies for the remedy of haemoptysis, asthma, pulmonary phthisis, jaundice hepatitis, food poisoning, bronchitis, cough, fever, wound healing, measles, carbuncle, swelling and phlegm diseases...
March 8, 2018: Journal of Ethnopharmacology
Jun He, Xinchi Feng, Kai Wang, Changxiao Liu, Feng Qiu
BACKGROUND: Quality control of Chinese medicine (CM) is an effective measure to ensure the safety and efficacy of CM in clinical practice, which is also a key factor to restrict the modernization process of CM. Various chemical components exist in CM and the determination of several chemical components is the main approach for quality control of vast majority of CM in the present. However, many components determined lack not only specificity, but also biological activities. This is bound to greatly reduce the actual value of quality standard of CM...
February 28, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Walter A Boyle, David J Murray, Mary Beth Beyatte, Justin G Knittel, Paul W Kerby, Julie Woodhouse, John R Boulet
OBJECTIVES: Develop a standardized simulation method to assess clinical skills of ICU providers. DESIGN: Simulation assessment. SETTING: Simulation laboratory. SUBJECTS: Residents, Critical Care Medicine fellows, acute care nurse practitioner students. INTERVENTIONS: Performance scoring in scenarios from multiple Critical Care Medicine competency domains. MEASUREMENTS AND MAIN RESULTS: Three-hundred eighty-four performances by 48 participants were scored using checklists (% correct) and holistic "global" ratings (1 [unprepared] to 9 [expert])...
March 7, 2018: Critical Care Medicine
John D Cramer, David H Chi, Barry M Schaitkin, David E Eibling, Jonas T Johnson
OBJECTIVES/HYPOTHESIS: Fellowship is the capstone of academic training and serves as preparation for an academic career. Fellows are expected to educate medical students and residents during and long after fellowship. However, little time is typically spent teaching fellows to become effective educators. We investigate a formal curriculum addressing teaching skills among fellows in otolaryngology-head and neck surgery (OHNS). STUDY DESIGN: E-mail survey. METHODS: We developed and implemented an educational program called Teach the Teacher to build skills as educators for fellows in OHNS...
March 9, 2018: Laryngoscope
Kai Feng, Zhi-Sheng Xu, Jie-Xia Liu, Jing-Wen Li, Feng Wang, Ai-Sheng Xiong
This study showed that a galactosyltransferase, AgUCGalT1, is involved in anthocyanin galactosylation in purple celery. Celery is a well-known vegetable because of its rich nutrients, low calories, and medicinal values. Its petioles and leaf blades are the main organs acting as nutrient sources. UDP-galactose: cyanidin 3-O-galactosyltransferase can transfer the galactosyl moiety from UDP-galactose to the 3-O-position of cyanidin through glycosylation. This process enhances the stability and water solubility of anthocyanins...
March 8, 2018: Planta
Jessica M Goldonowicz, Michael S Runyon, Mark J Bullard
BACKGROUND: To investigate the value of a novel simulation-based palliative care educational intervention within an emergency medicine (EM) residency curriculum. METHODS: A palliative care scenario was designed and implemented in the simulation program at an urban academic emergency department (ED) with a 3-year EM residency program. EM residents attended one of eight high-fidelity simulation sessions, in groups of 5-6. A standardized participant portrayed the patient's family member...
March 7, 2018: BMC Palliative Care
J Knez, E Saridogan, T Van Den Bosch, D Mavrelos, G Ambler, D Jurkovic
STUDY QUESTION: What would be a potential impact of implementing the new ESHRE/European Society of Gynaecological Endoscopy (ESGE) female genital anomalies classification system on the management of women with previous diagnosis of arcuate uteri based on the modified American Society for Reproductive Medicine (ASRM) criteria? SUMMARY ANSWER: A significant number of women with previous diagnosis of arcuate uteri are reclassified as having partial septate uteri according to the new ESHRE/ESGE classification system which may increase the number of remedial surgical procedures...
March 5, 2018: Human Reproduction
Xuegui Liu, Yixing Gao, Danqi Li, Changfeng Liu, Mei Jin, Jun Bian, Mengchao Lv, Yuqiu Sun, Lixin Zhang, Pinyi Gao
Rosa laevigata fruit has been known as a functional foodstuff for a long time. Recently, increasing attention has been given to polysaccharides from R. laevigata fruit due to their numerous medicinal and nutritional properties. In this study, a rapid and effective approach for the extraction and separation of polysaccharides from the title fruit was developed using microwave-assisted aqueous two-phase extraction (MA-ATPE) with a PEG/ammonium sulfate system. After analysis of the response surface methodology (RSM) data based on a Box-Behnken design (BBD), a model was proposed and was found to predict an optimum yield value of 258...
March 7, 2018: Food & Function
Dongmei Lin, Aihua Zhang, Jason Gu, Xiaolei Chen, Qi Wang, Liming Yang, Yongxin Chou, Gongcai Liu, Jingyang Wang
BACKGROUND AND OBJECTIVE: Pulse signals contain a wealth of human physiological and pathological information. How to get full pulse information is especially challenging, and most of the traditional pulse sensors can only get the pulse wave of a single point. This study is aimed at developing a binocular pulse detection system and method to obtain multipoint pulse waves and dynamic three-dimensional pulse shape of the radial artery. METHODS: The proposed pulse detection approach is image-based and implemented by two steps...
March 2018: Computer Methods and Programs in Biomedicine
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