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https://www.readbyqxmd.com/read/29166354/smoothing-the-transition-points-in-canadian-medical-education
#1
Nick Busing, Jay Rosenfield, Kamal Rungta, Matt Raegele, Andrew Warren, Bruce Wright, Mark Walton, Ivy Oandasan, Anthony Sanfilippo, Anurag Saxena
In 2010 the Association of Faculties of Medicine of Canada, Collège des médecins du Québec, College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada launched The Future of Medical Education in Canada Postgraduate (FMEC PG) Project to examine postgraduate medical education (PGME) in Canada and make recommendations for improvement. One recommendation that emerged concerns the transitions learners experience across the undergraduate medical education-PGME-practice continuum...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166260/the-development-and-content-validation-of-a-multidisciplinary-evidence-based-wound-infection-prevention-and-treatment-guideline
#2
Sammy A Zakhary, Chris Davey, Rebecca Bari, Jordan Bean, Tyler Reber, Kathy Gallagher, Kara Couch, Jennifer Hurlow, Karen Laforet, Corrine McIssac, Karen Napier, Diana Vilar-Compte, Emily Zakhary, Michel Hermans, Laura Bolton
Acute and chronic wound infections create clinical, economic, and patient-centered challenges best met by multidisciplinary wound care teams providing consistent, valid, clinically relevant, safe, evidence-based management across settings. To develop an evidence-based wound infection guideline, PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases were searched from inception through August 1, 2017 using the terms (or synonyms) wound infection and risk factor, significant, diagnosis, prevention, treatment, or surveillance...
November 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29166249/qualitative-exploration-of-cross-sector-perspectives-on-the-contributions-of-local-health-departments-in-land-use-and-transportation-policy
#3
Meera Sreedhara, Karin Valentine Goins, Semra A Aytur, Rodney Lyn, Jay E Maddock, Robin Riessman, Thomas L Schmid, Heather Wooten, Stephenie C Lemon
INTRODUCTION: Transportation and land-use policies can affect the physical activity of populations. Local health departments (LHDs) are encouraged to participate in built-environment policy processes, which are outside their traditional expertise. Cross-sector collaborations are needed, yet stakeholders' perceptions of LHD involvement are not well understood. The objective of this study was to describe the perceived value of LHD participation in transportation and land-use decision making and potential contributions to these processes among stakeholders...
November 22, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29165831/external-validation-of-the-ita-li-ca-prognostic-system-for-patients-with-hepatocellular-carcinoma-a-multicenter-cohort-study-hep-17-0903
#4
Mauro Borzio, Elena Dionigi, Angelo Rossini, Massimo Marignani, Rodolfo Sacco, Ilario De Sio, Emanuela Bertolini, Giampiero Francica, Anna Giacomin, Giancarlo Parisi, Susanna Vicari, Anna Toldi, Andrea Salmi, Sergio Boccia, Mario Mitra, Fabio Fornari
Several staging systems for HCC have been developed. BCLC is considered the best in predicting survival, although limitations have emerged. Recently the Italian-Liver-Cancer (ITA.LI.CA) prognostic system, integrating the ITA.LI.CA tumor-staging (stages 0, A, B1-3; C) with Child-Pugh score, ECOG-PST, and AFP with a strong ability to predict survival was proposed. Aim of our study was to provide an external validation of the ITA.LI.CA system in an independent real-life occidental cohort of HCCs. METHODS: From September 2008 to April 2016, 1508 cirrhotics with incident HCC were consecutively enrolled in 27 Italian institutions (EpaHCC multi-institutional cohort)...
November 22, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29165340/impacts-of-low-temperature-on-the-teleost-immune-system
#5
REVIEW
Quinn H Abram, Brian Dixon, Barbara A Katzenback
As poikilothermic vertebrates, fish can experience changes in water temperature, and hence body temperature, as a result of seasonal changes, migration, or efflux of large quantities of effluent into a body of water. Temperature shifts outside of the optimal temperature range for an individual fish species can have negative impacts on the physiology of the animal, including the immune system. As a result, acute or chronic exposure to suboptimal temperatures can impair an organisms' ability to defend against pathogens and thus compromise the overall health of the animal...
November 22, 2017: Biology
https://www.readbyqxmd.com/read/29165139/analysis-of-the-evidence-practice-gap-to-facilitate-proper-medical-care-for-the-elderly-investigation-using-databases-of-utilization-measures-for-national-database-of-health-insurance-claims-and-specific-health-checkups-of-japan-ndb
#6
Takeo Nakayama, Yuichi Imanaka, Yasushi Okuno, Genta Kato, Tomohiro Kuroda, Rei Goto, Shiro Tanaka, Hiroshi Tamura, Shunichi Fukuhara, Shingo Fukuma, Manabu Muto, Motoko Yanagita, Yosuke Yamamoto
As Japan becomes a super-aging society, presentation of the best ways to provide medical care for the elderly, and the direction of that care, are important national issues. Elderly people have multi-morbidity with numerous medical conditions and use many medical resources for complex treatment patterns. This increases the likelihood of inappropriate medical practices and an evidence-practice gap. The present study aimed to: derive findings that are applicable to policy from an elucidation of the actual state of medical care for the elderly; establish a foundation for the utilization of National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), and present measures for the utilization of existing databases in parallel with NDB validation...
June 6, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29165094/potential-risks-and-mitigation-strategies-during-the-conduct-of-a-clinical-trial-an-industry-perspective
#7
Seema Bhagat, Vaibhavi Kapatkar, Sagar Katare, Ashish Mane, Colette Pinto, Kedar Pawar, Agam Shah, Hanmant Barkate
BACKGROUND: Every phase of a clinical trial should be designed in compliance with good clinical practices by following all relevant regulatory guidelines. Patient safety, data integrity and ethics are an integral part of a successful clinical trial which must be considered. Therefore risk monitoring is an essential tool to identify the risks associated with conduct of any trial. This article is a result of extensive research conducted by a reputed pharmaceutical company to identify the potential stages of risks associated with the conduct phase of trial that could impact the overall quality and safety of a trial...
November 19, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29164593/immune-correlates-of-clinical-outcome-in-melanoma
#8
REVIEW
Graham Pawelec
Melanoma has long been recognized as a potentially immunogenic tumour, but only recently has it become clear that the reason for this resides in its many UV-induced mutations and expression of multiple autoantigens which can be targeted by the immune system. The first successful applications of immune-based treatments included passive immunotherapy using high-dose IL-2 and/or adoptive transfer of NK-cells, as well as active immunotherapy using whole cell-derived or peptide vaccines. In the intervening decades, it has become clear that these approaches can lead to durable responses in stage III/IV melanoma, and even to functional cures - but only in a vanishingly small fraction of patients...
November 21, 2017: Immunology
https://www.readbyqxmd.com/read/29164536/particle-size-distribution-predicts-particulate-phosphorus-removal
#9
Mark River, Curtis J Richardson
Particulate phosphorus (PP) is often the largest component of the total phosphorus (P) load in stormwater. Fine-resolution measurement of particle sizes allows us to investigate the mechanisms behind the removal of PP in stormwater wetlands, since the diameter of particles influences the settling velocity and the amount of sorbed P on a particle. In this paper, we present a novel method to estimate PP, where we measure and count individual particles in stormwater and use the total surface area as a proxy for PP...
November 21, 2017: Ambio
https://www.readbyqxmd.com/read/29164210/high-efficiency-near-infrared-enabled-planar-perovskite-solar-cells-by-embedding-upconversion-nanocrystals
#10
Fan-Li Meng, Jiao-Jiao Wu, Er-Fei Zhao, Yan-Zhen Zheng, Mei-Lan Huang, Li-Ming Dai, Xia Tao, Jian-Feng Chen
Integration of the upconversion effect in perovskite solar cells (PSCs) is a facile approach towards extending the spectral absorption from the visible to the near infrared (NIR) range and reducing the non-absorption loss of solar photons. However, the big challenge for practical application of UCNCs in planar PSCs is the poor compatibility between UCNCs and the perovskite precursor. Herein, we have subtly overcome the tough compatibility issue using a ligand-exchange strategy. For the first time, β-NaYF4:Yb,Er UCNCs have been embedded in situ into a CH3NH3PbI3 layer to fabricate NIR-enabled planar PSCs...
November 22, 2017: Nanoscale
https://www.readbyqxmd.com/read/29164037/guidelines-for-the-management-of-degenerative-cervical-myelopathy-and-acute-spinal-cord-injury-development-process-and-methodology
#11
Lindsay A Tetreault, Andrea C Skelly, Joseph R Dettori, Jefferson R Wilson, Allan R Martin, Michael G Fehlings
The Institute of Medicine defines clinical practice guidelines as "statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options." Guidelines help clinicians implement best evidence into practice and encourage informed shared decision making with patients. Guidelines are intended to enhance the quality of patient care by discouraging ineffective and potentially harmful interventions and standardizing practice...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164036/a-clinical-practice-guideline-for-the-management-of-acute-spinal-cord-injury-introduction-rationale-and-scope
#12
Michael G Fehlings, Lindsay A Tetreault, Jefferson R Wilson, Brian K Kwon, Anthony S Burns, Allan R Martin, Gregory Hawryluk, James S Harrop
Acute spinal cord injury (SCI) is a traumatic event that results in disturbances to normal sensory, motor, or autonomic function and ultimately affects a patient's physical, psychological, and social well-being. The management of patients with SCI has drastically evolved over the past century as a result of increasing knowledge on injury mechanisms, disease pathophysiology, and the role of surgery. There still, however, remain controversial areas surrounding available management strategies for the treatment of SCI, including the use of corticosteroids such as methylprednisolone sodium succinate, the optimal timing of surgical intervention, the type and timing of anticoagulation prophylaxis, the role of magnetic resonance imaging, and the type and timing of rehabilitation...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164035/a-clinical-practice-guideline-for-the-management-of-patients-with-degenerative-cervical-myelopathy-recommendations-for-patients-with-mild-moderate-and-severe-disease-and-nonmyelopathic-patients-with-evidence-of-cord-compression
#13
Michael G Fehlings, Lindsay A Tetreault, K Daniel Riew, James W Middleton, Bizhan Aarabi, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Simon Carette, Robert Chen, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, James S Harrop, Langston T Holly, Sukhvinder Kalsi-Ryan, Mark Kotter, Brian K Kwon, Allan R Martin, James Milligan, Hiroaki Nakashima, Narihito Nagoshi, John Rhee, Anoushka Singh, Andrea C Skelly, Sumeet Sodhi, Jefferson R Wilson, Albert Yee, Jeffrey C Wang
Study Design: Guideline development. Objectives: The objective of this study is to develop guidelines that outline how to best manage (1) patients with mild, moderate, and severe myelopathy and (2) nonmyelopathic patients with evidence of cord compression with or without clinical symptoms of radiculopathy. Methods: Five systematic reviews of the literature were conducted to synthesize evidence on disease natural history; risk factors of disease progression; the efficacy, effectiveness, and safety of nonoperative and surgical management; the impact of preoperative duration of symptoms and myelopathy severity on treatment outcomes; and the frequency, timing, and predictors of symptom development...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164034/guidelines-for-the-management-of-degenerative-cervical-myelopathy-and-spinal-cord-injury-an-introduction-to-a-focus-issue
#14
Michael G Fehlings, Brian K Kwon, Lindsay A Tetreault
Study Design: Introduction to a guidelines project. Objectives: The objective of this focus issue is to present guidelines that outline how to best manage patients with degenerative cervical myelopathy (DCM) and spinal cord injury (SCI). Topics addressed in this focus issue include: 1) management strategies for patients with mild, moderate and severe DCM; and 2a) timing of surgical decompression; b) the use of methylprednisolone sodium succinate; c) the type and timing of anticoagulation strategies; d) the role of magnetic resonance imaging in clinical decision making and outcome prediction; and e) the type and timing of rehabilitation in patients with SCI...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164027/a-clinical-practice-guideline-for-the-management-of-degenerative-cervical-myelopathy-introduction-rationale-and-scope
#15
Michael G Fehlings, Lindsay A Tetreault, K Daniel Riew, James W Middleton, Jeffrey C Wang
Degenerative cervical myelopathy (DCM) is a progressive spine disease and the most common cause of spinal cord dysfunction in adults worldwide. Patients with DCM may present with common signs and symptoms of neurological dysfunction, such as paresthesia, abnormal gait, decreased hand dexterity, hyperreflexia, increased tone, and sensory dysfunction. Clinicians across several specialties encounter patients with DCM, including primary care physicians, rehabilitation specialists, therapists, rheumatologists, neurologists, and spinal surgeons...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164016/insights-in-public-health-ambulatory-blood-pressure-monitoring-underuse-in-clinical-practice-in-hawai-i
#16
Deborah Taira, Tetine Sentell, Cheryl Albright, Doug Lansidell, Kazuma Nakagawa, Todd Seto, Joel Mark Stevens
Hypertension is one of the leading causes of death and disability worldwide. Blood pressure reduction and control are associated with reduced risk of stroke and cardiovascular disease. To achieve optimal reduction and control, reliable and valid methods for blood pressure measurement are needed. Office based measurements can result in 'white coat' hypertension, which is when a patient's blood pressure in a clinical setting is higher than in other settings, or 'masked' hypertension, which occurs when a patient's blood pressure is normal in a clinical setting, but elevated outside the clinical setting...
November 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/29164005/study-of-systemic-disease-igg4-usefulness-of-2-18f-fluoro-2-deoxy-d-glucose-positron-emission-tomography-computed-tomography-for-staging-selection-of-biopsy-site-evaluation-of-treatment-response-and-follow-up
#17
Guillermo Martinez-Pimienta, Edel Noriega-Álvarez, Marc Simó-Perdigó
Immunoglobulin G4-related systemic disease (IgG4-RSD) is a recently emerging disorder characterized by swelling lesions with storiform fibrosis and lymphoplasmacytic infiltration enriched with IgG4-positive plasma cells. IgG4-RSD has been found in multiple organs/tissues. The diagnosis requires the integration of clinical, serological, imaging, histopathological, and immunohistological features. The 2-[18F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (18F-FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity...
September 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/29163946/vertebral-body-segmentation-with-growcut-initial-experience-workflow-and-practical-application
#18
Jan Egger, Christopher Nimsky, Xiaojun Chen
Objectives: Spinal diseases are very common; for example, the risk of osteoporotic fracture is 40% for White women and 13% for White men in the United States during their lifetime. Hence, the total number of surgical spinal treatments is on the rise with the aging population, and accurate diagnosis is of great importance to avoid complications and a reappearance of the symptoms. Imaging and analysis of a vertebral column is an exhausting task that can lead to wrong interpretations. The overall goal of this contribution is to study a cellular automata-based approach for the segmentation of vertebral bodies between the compacta and surrounding structures yielding to time savings and reducing interpretation errors...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29163939/infection-prevention-and-control-measures-and-tools-for-the-prevention-of-entry-of-carbapenem-resistant-enterobacteriaceae-into-healthcare-settings-guidance-from-the-european-centre-for-disease-prevention-and-control
#19
A P Magiorakos, K Burns, J Rodríguez Baño, M Borg, G Daikos, U Dumpis, J C Lucet, M L Moro, E Tacconelli, G Skov Simonsen, E Szilágyi, A Voss, J T Weber
Background: Infections with carbapenem-resistant Enterobacteriaceae (CRE) are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are "at-risk" may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E).The purpose of this guidance is to raise awareness and identify the "at-risk" patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29163293/adaptation-and-validation-of-the-ados-2-polish-version
#20
Izabela Chojnicka, Ewa Pisula
Autism Diagnostic Observation Schedule (ADOS) is one of the most popular instruments used world-widely in the diagnosis of autism spectrum disorders (ASD). Unfortunately, there are only a few studies of the psychometric properties of non-English language versions of this instrument and none of the adaptation of its second edition (ADOS-2). The objective of this study was to verify the psychometric properties of the Polish version of the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2-PL). The authors recruited 401 participants: 193 with ASDs (ASD group) and 78 with non-spectrum disorders, plus 130 typically developing participants (control group)...
2017: Frontiers in Psychology
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