• Richards Stilling posted an update 5 months, 4 weeks ago

    We conclude that knowledge about the characteristics of an embodied avatar can modify the subject’s level of mentally represented physical activity.Background Several clinical practice guidelines exist for the management of respiratory syncytial virus (RSV) infection, but the use and overuse of medications and medical tests with insufficient evidence of effectiveness remains substantial. Objective This study aimed to evaluate the medical costs associated with bronchiolitis hospitalizations caused by RSV infection among infants aged less then 2 years in Colombia. Methods This was a prevalence-based cost-of-illness multicentric study performed from the societal perspective during 2016-2017. A case was defined as a laboratory-confirmed RSV infection with hospitalization. All costs and use of resources were collected directly from medical invoices and health records. Results This study included 193 patients with a diagnosis of RSV. The average hospital stay duration was 5.55 days. The major contributors to hospitalization costs were room costs (31.5%), drugs (21.8%), and indirect costs (14.9%). Medications with the highest costs were nebulization with a hypertonic solution and systemic antibiotics. In total, 96% of β-lactam antibiotics, 90% of bronchodilators, and 86% of corticosteroids and epinephrine were classified as inappropriate. Conclusion RSV infection in Colombia places a high economic burden on the health system. Generating comprehensive data on healthcare resource use and costs associated with RSV will help to provide valuable information for the development of cost-effectiveness models and to guide RSV-prevention strategies.Successful pregnancies rely on sufficient energy and nutrient supply which requires the mother to metabolically adapt to support fetal needs. The placenta has a critical role in this process, as this specialized organ produces hormones and peptides that regulate fetal and maternal metabolism. The ability for the mother to metabolically adapt to support the fetus depends on maternal pre-pregnancy health. Two thirds of pregnancies in the United States involve obese or overweight women at the time of conception. This poses significant risks for the infant and mother by disrupting metabolic changes that would normally occur during pregnancy. selleck compound Despite well characterized functions of placental hormones, there is scarce knowledge surrounding placental endocrine regulation of maternal metabolic trends in pathological pregnancies. In this review, we discuss current efforts to close this gap of knowledge and highlight areas where more research is needed. As the intrauterine environment predetermines the health and wellbeing of the offspring in later life, adequate metabolic control is essential for successful pregnancy outcome. Understanding how placental hormones contribute to aberrant metabolic adaptations in pathological pregnancies, may unveil disease mechanisms and provide methods for better identification and treatment. Search methods Studies discussed in this review were identified through PubMed searches between the years of 1966 to present. We interrogated studies of normal pregnancy and metabolic disorders in pregnancy that focused on energy requirements during pregnancy, endocrine regulation of glucose metabolism and insulin resistance, cholesterol and lipid metabolism, and placental hormone regulation.Throughout March 2020, cases of COVID-19 grew exponentially, and New York emerged as an epicenter of the crisis. Social distancing, shortages of personal protective equipment, and clinical care needs necessitated that students be removed from the clinical setting. A group of students, faculty members, and administrators formed to identify ways in which students could be involved in supporting the health system.This study aims to identify post-operative recurrence patterns of pancreatic cancer with different molecular profiles, which provides evidence for personalized target volumes of adjuvant radiotherapy. Patients with pathologically confirmed resectable pancreatic ductal adenocarcinoma were included. Recurrences were treated with SBRT. Immunohistochemical staining of Ki-67, P53 and PD-L1 was performed. Both of the intensities of Ki-67 and P53 were classified as ≤10%, 11%-49% and ≥50%. Eighty-nine patients had PD-L1 tested, stratified as TC0 and IC0 and TC1/2 or IC1/2. Distances with significant differences among different levels or beyond 10mm were of interest. With the increasing intensity of Ki-67, the distance from the superior and posterior border of 80% recurrences to the CA ranged from 10.1-13.8mm and 9.2-11.0mm. While the distance from the inferior and posterior border of 80% recurrences to the SMA ranged from 9.4-9.9mm and 9.4-11.0mm. Similarly, with the increasing intensity of P53, the distance from the superior and posterior border of 80% recurrences to the CA ranged from 9.7-13.2mm and 10.1-10.6mm. While the distance from the inferior and anterior border of 80% recurrences to the SMA ranged from 9.5-9.9mm and 8.6-9.4mm. Regarding the increasing level of PD-L1, the distance from the superior border of 80% recurrences to the CA ranged from 10.9-13.5mm. BED>65Gy to local recurrences was predictive of favorable outcomes in all levels of Ki-67, P53 and PD-L1. Non-uniform expansions of regions of interest based on different levels of molecular profiles to form target volumes could cover most recurrences, which may be feasible for adjuvant radiotherapy.Clinical dashboards summarize indicators of high-volume patient data in a concise, user-friendly visual format. There are few studies of the use of dashboards to improve professional practice in anesthesiology. The objective of the present study was to describe the user-centered development, implementation and preliminary evaluation of clinical dashboards dealing with anesthesia unit management and quality assessment in a French university medical center. User needs and technical requirements were identified in end user interviews and then synthesized. Several representations were then developed (according to good visualization practice) and submitted to end users for appraisal. Lastly, dashboards were implemented and made accessible for everyday use via the medical center’s network. After a period of use, end user feedback on the dashboard platform was collected as a system usability score (range 0 to 100). Seventeen themes (corresponding to 29 questions and 42 indicators) were identified. After prioritization and feasibility assessment, 10 dashboards were ultimately implemented and deployed.

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