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Independent practice

Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Meisser Vidal Madera Anaya, Juan Victor Franco, Ángela María Merchán-Galvis, Carmen R Gallardo, Xavier Bonfill Cosp
BACKGROUND: The applicability of clinical practice guidelines (CPGs) on treatments for oral cancer remains unknown since there are no systematic assessments of their quality. Thus, the objective of this study is to identify and assess the quality of them. METHODS: We conducted a systematic search to identify CPGs that provided recommendations on treatments for oral cancer. The quality of each included CPG was determined using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, by four appraisers independently...
March 10, 2018: Cancer Treatment Reviews
S Sengottuvel, Pathan Fayaz Khan, N Mariyappa, Rajesh Patel, S Saipriya, K Gireesan
Cutaneous measurements of electrogastrogram (EGG) signals are heavily contaminated by artifacts due to cardiac activity, breathing, motion artifacts, and electrode drifts whose effective elimination remains an open problem. A common methodology is proposed by combining independent component analysis (ICA) and ensemble empirical mode decomposition (EEMD) to denoise gastric slow-wave signals in multichannel EGG data. Sixteen electrodes are fixed over the upper abdomen to measure the EGG signals under three gastric conditions, namely, preprandial, postprandial immediately, and postprandial 2 h after food for three healthy subjects and a subject with a gastric disorder...
March 1, 2018: SLAS Technology
Diyuan Zong, Zhen Yang, Yuanyuan Duan
The wetting kinetics of droplets on lyophilic pillar-arrayed substrates is the driving mechanism of several natural phenomena (e.g., insect capturing by Nepenthes) and many industrial technologies (e.g., gas-liquid separation). For a lyophilic pillar-arrayed surface, a fringe film is formed ahead of the contact line, resulting in distinct wetting kinetics, which needs further investigation. In this study, Si(100) substrates with square micropillars were used to investigate the early spreading of droplets on lyophilic pillar-arrayed surfaces through the droplet-spreading method...
March 16, 2018: Langmuir: the ACS Journal of Surfaces and Colloids
Zachary Predmore, Jean Pannikottu, Ritu Sharma, Monica Tung, Stephanie Nothelle, Jodi B Segal
This systematic review examined factors associated with overuse of colorectal cancer (CRC) screening. The authors searched MEDLINE and EMBASE from January 1998 to March 2017. Studies were included if they were written in English, contained original data, involved a US population, and examined factors potentially associated with overuse of CRC screening. Paired reviewers independently screened abstracts, assessed quality, and extracted data. In 8 studies, the associations between patient factors, including age, sex, race, and number of comorbidities, were tested and were inconsistently associated with CRC screening overuse...
March 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Alberto Pilotto, Raffaella Boi, Jean Petermans
Recently, the interest of industry, government agencies and healthcare professionals in technology for aging people has increased. The challenge is whether technology may play a role in enhancing independence and quality of life and in reducing individual and societal costs of caring. Information and communication technologies, i.e. tools aimed at communicating and informing, assistive technologies designed to maintain older peoples' independence and increasing safety, and human-computer interaction technologies for supporting older people with motility and cognitive impairments as humanoid robots, exoskeletons, rehabilitation robots, service robots and companion-type are interdisciplinary topics both in research and in clinical practice...
March 13, 2018: Age and Ageing
Andras Inotai, Marcell Csanadi, Guenka Petrova, Maria Dimitrova, Tomasz Bochenek, Tomas Tesar, Kristina York, Leos Fuksa, Alexander Kostyuk, Laszlo Lorenzovici, Vitaly Omelyanovskiy, Katalin Egyed, Zoltan Kalo
This policy research aims to map patient access barriers to biologic treatments, to explore how increased uptake of biosimilars may lower these hurdles and to identify factors limiting the increased utilisation of biosimilars. A policy survey was developed to review these questions in 10 Central and Eastern European (CEE) and Commonwealth of Independent States (CIS) countries. Two experts (one public and one private sector representative) from each country completed the survey. Questions were related to patient access, purchasing, clinical practice, and real-world data collection on both original biologics and biosimilars...
2018: BioMed Research International
Jae Hong Lee, Dong Ki Min, Han Seong Choe, Jin Hwan Lee, So Hong Shin
[Purpose] The purpose of this study was to evaluate the influence of arm and leg posture elements on symmetrical weight bearing during Sit to Stand tasks in chronic stroke patients. [Subjects and Methods] The subjects were diagnosed with stroke and 22 patients (15 males and 7 females) participated in this study. All participants performed Sit to Stand tasks on three foot postures and two arm postures. Two force plates were used to measure peak of vertical ground reaction force and symmetrical ratio to peak Fz...
February 2018: Journal of Physical Therapy Science
Kednapa Thavorn, Howsikan Kugathasan, Darrell H S Tan, Nasheed Moqueet, Stefan D Baral, Becky Skidmore, Derek MacFadden, Anna Simkin, Sharmistha Mishra
BACKGROUND: Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations...
March 15, 2018: Systematic Reviews
Claire M Lawlor, Charles A Riley, John M Carter, Kimsey H Rodriguez
Importance: The 1996 Tonsillectomy and Adenoidectomy Inpatient Guidelines of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Pediatric Otolaryngology Committee recommended that children younger than 3 years be admitted following tonsillectomy. Recommendations for hospital observation were not included as a key action statement in the 2011 AAO-HNS Clinical Practice Guidelines for Tonsillectomy in Children. Objective: To examine the association between posttonsillectomy complication rate and the age and weight of the child at the time of surgery...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Lawrence Mj Best, Yemisi Takwoingi, Sulman Siddique, Abiram Selladurai, Akash Gandhi, Benjamin Low, Mohammad Yaghoobi, Kurinchi Selvan Gurusamy
BACKGROUND: Helicobacter pylori (H pylori) infection has been implicated in a number of malignancies and non-malignant conditions including peptic ulcers, non-ulcer dyspepsia, recurrent peptic ulcer bleeding, unexplained iron deficiency anaemia, idiopathic thrombocytopaenia purpura, and colorectal adenomas. The confirmatory diagnosis of H pylori is by endoscopic biopsy, followed by histopathological examination using haemotoxylin and eosin (H & E) stain or special stains such as Giemsa stain and Warthin-Starry stain...
March 15, 2018: Cochrane Database of Systematic Reviews
Lone Baandrup, Bjørn H Ebdrup, Jesper Ø Rasmussen, Jane Lindschou, Christian Gluud, Birte Y Glenthøj
BACKGROUND: Prolonged treatment with benzodiazepines is common practice despite clinical recommendations of short-term use. Benzodiazepines are used by approximately 4% of the general population, with increased prevalence in psychiatric populations and the elderly. After long-term use it is often difficult to discontinue benzodiazepines due to psychological and physiological dependence. This review investigated if pharmacological interventions can facilitate benzodiazepine tapering. OBJECTIVES: To assess the benefits and harms of pharmacological interventions to facilitate discontinuation of chronic benzodiazepine use...
March 15, 2018: Cochrane Database of Systematic Reviews
A V Kalinovskiy, D A Rzaev, K Yoshimitsu
INTRODUCTION: Modern neurosurgical practice is impossible without access to various information sources. The use of MRI and MSCT data during surgery is an integral part of the neurosurgeon's daily practice. Devices capable of managing an image viewer system without direct contact with equipment simplify working in the operating room. AIM AND OBJECTIVES: To test operation of a non-contact MRI and MSCT image viewer system in the operating room and to evaluate the system effectiveness...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
M Cadeddu, C Giunti, Y F Li, Y Y Zhang
Using the coherent elastic neutrino-nucleus scattering data of the COHERENT experiment, we determine for the first time the average neutron rms radius of ^{133}Cs and ^{127}I. We obtain the practically model-independent value R_{n}=5.5_{-1.1}^{+0.9}  fm using the symmetrized Fermi and Helm form factors. We also point out that the COHERENT data show a 2.3σ evidence of the nuclear structure suppression of the full coherence.
February 16, 2018: Physical Review Letters
Alexander Buchholz, Laura Ueberham, Kaja Gorczynska, Borislav Dinov, Sebastian Hilbert, Nikolaos Dagres, Daniela Husser, Gerhard Hindricks, Andreas Bollmann
BACKGROUND: Apixaban is a non-vitamin K oral anticoagulant and has been approved for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF). Current labelling recommends dose reduction based on patients age, weight and renal function. OBJECTIVES: The aim of this study was to analyze adherence to current labeling instructions concerning initial apixaban dosing in clinical practice and to identify factors associated with inappropriate dose reduction...
March 15, 2018: Clinical Cardiology
Takeshi Takamatsu, Marouane Baslam, Takuya Inomata, Kazusato Oikawa, Kimiko Itoh, Takayuki Ohnishi, Tetsu Kinoshita, Toshiaki Mitsui
Chloroplasts, which perform photosynthesis, are one of the most important organelles in green plants and algae. Chloroplasts maintain an independent genome that includes important genes encoding their photosynthetic machinery and various housekeeping functions. Owing to its non-recombinant nature, low mutation rates, and uniparental inheritance, the chloroplast genome (plastome) can give insights into plant evolution and ecology and in the development of biotechnological and breeding applications. However, efficient methods to obtain high-quality chloroplast DNA (cpDNA) are currently not available, impeding powerful sequencing and further functional genomics research...
2018: Frontiers in Plant Science
John Connolly, Maria-Teresa Sebastià, Laura Kirwan, John Anthony Finn, Rosa Llurba, Matthias Suter, Rosemary P Collins, Claudio Porqueddu, Áslaug Helgadóttir, Ole H Baadshaug, Gilles Bélanger, Alistair Black, Caroline Brophy, Jure Čop, Sigridur Dalmannsdóttir, Ignacio Delgado, Anjo Elgersma, Michael Fothergill, Bodil E Frankow-Lindberg, An Ghesquiere, Piotr Golinski, Philippe Grieu, Anne-Maj Gustavsson, Mats Höglind, Olivier Huguenin-Elie, Marit Jørgensen, Zydre Kadziuliene, Tor Lunnan, Paivi Nykanen-Kurki, Angela Ribas, Friedhelm Taube, Ulrich Thumm, Alex De Vliegher, Andreas Lüscher
Grassland diversity can support sustainable intensification of grassland production through increased yields, reduced inputs and limited weed invasion. We report the effects of diversity on weed suppression from 3 years of a 31-site continental-scale field experiment.At each site, 15 grassland communities comprising four monocultures and 11 four-species mixtures based on a wide range of species' proportions were sown at two densities and managed by cutting. Forage species were selected according to two crossed functional traits, "method of nitrogen acquisition" and "pattern of temporal development"...
March 2018: Journal of Applied Ecology
Matthew Dankner, April A N Rose, Shivshankari Rajkumar, Peter M Siegel, Ian R Watson
The RAS-RAF-MEK-ERK signaling cascade is among the most frequently mutated pathways in human cancer. Approximately 50% of melanoma patients possess a druggable hotspot V600E/K mutation in the BRAF protein kinase. FDA-approved combination therapies of BRAF and MEK inhibitors are available that provide survival benefits to patients with a BRAF V600 mutation. Non-V600 BRAF mutants are found in many cancers, and are more prevalent than V600 mutations in certain tumor types. For example, between 50-80% of BRAF mutations in non-small cell lung cancer and 22-30% in colorectal cancer encode for non-V600 mutants...
March 15, 2018: Oncogene
Yefei Jiang, Shuangge Ma, Ben-Chang Shia, Tian-Shyug Lee
In "classic" biomedical research, diseases have usually been studied individually. The pioneering human disease network (HDN) studies jointly consider a large number of diseases, analyse their interconnections, and provide a more comprehensive description of diseases. However, most of the existing HDN studies are based on molecular information and can only partially describe disease interconnections. Building on the unique Taiwan National Health Insurance Research Database (NHIRD), in this study, we construct the epidemiological HDN (eHDN), where two diseases are concluded as interconnected if their observed probability of co-occurrence deviating that expected under independence...
March 14, 2018: Scientific Reports
Cynthia M Rand, Stanley J Schaffer, Nui Dhepyasuwan, Aaron Blumkin, Christina Albertin, Janet R Serwint, Paul M Darden, Sharon G Humiston, Keith J Mann, William Stratbucker, Peter G Szilagyi
BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. METHODS: Staff and providers in 8 resident clinics participated in a 12-month QI study...
March 14, 2018: Pediatrics
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