Falling Through The Digital Cracks: An EHR-Focused Approach to Promote Social History and Mental Health in the Outpatient Setting

Although they may not call prevention centers, people considering suicide usually do seek help; for example, 64% of people who attempt suicide visit a doctor in the month before their attempt, and 38% in the week before. Given the recent suicide of a father in Newtown, CT whose daughter was killed in the Sandy Hook Massacre, it needs to be asked if his suicide could have been prevented by having his physician discuss his mental health with him at his most recent check-up. Of equal importance, it must be asked if there are flaws within the EHR platform that make it more difficult for physicians to access or document a recent major life event while reviewing a patient’s chart. This project\u27s goal was to remind providers about a recent stressful life event for a patient by implementing a specific problem list entry on the EHR titled “History of Recent Stressful Life Event .https://scholarworks.uvm.edu/fmclerk/1539/thumbnail.jp

Diseño de investigación diseño para la aplicación de un modelo de madurez de capacidades e integración (CMMI) en el área administrativa de una empresa de desarrollo de software en la ciudad de Guatemala

Proponer un diseño para la aplicación del Modelo de Madurez de Capacidades e Integración (CMMI) en el área administrativa de una empresa de desarrollo de software en la ciudad de Guatemala. Identificar los procesos con deficiencia en el área administrativa de una empresa de desarrollo de software

Reinforced silica-carbon nanotube monolithic aerogels synthesised by rapid controlled gelation

This work introduces a new synthesis procedure for obtaining homogeneous silica hybrid aerogels with carbon nanotube contents up to 2.50 wt.%. The inclusion of nanotubes in the highly porous silica matrix was performed by a two-step sol–gel process, resulting in samples with densities below 80 mg/cm3. The structural analyses (N2 physisorption and SEM) revealed the hierarchical structure of the porous matrix formed by nanoparticles arranged in clusters of 100 and 300 nm in size, specific surface areas around 600 m2/g and porous volumes above 4.0 cm3/g. In addition, a relevant increase on the mechanical performance was found, and an increment of 50% for the compressive strength and 90% for the maximum deformation were measured by uniaxial compression. This reinforcement was possible thanks to the outstanding dispersion of the CNT within the silica matrix and the formation of Si–O–C bridges between nanotubes and silica matrix, as suggested by FTIR. Therefore, the original synthesis procedure introduced in this work allows the fabrication of highly porous hybrid materials loaded with carbon nanotubes homogeneously distributed in the space, which remain available for a variety of technological applications

Influence of Titanium Oxide Pillar Array Nanometric Structures and Ultraviolet Irradiation on the Properties of the Surface of Dental Implants: A Pilot Study

Aim: Titanium implants are commonly used as replacement therapy for lost teeth and much current research is focusing on the improvement of the chemical and physical properties of their surfaces in order to improve the osseointegration process. TiO2, when it is deposited in the form of pillar array nanometric structures, has photocatalytic properties and wet surface control, which, together with UV irradiation, provide it with superhydrophilic surfaces, which may be of interest for improving cell adhesion on the peri-implant surface. In this article, we address the influence of this type of surface treatment on type IV and type V titanium discs on their surface energy and cell growth on them. Materials and methods: Samples from titanium rods used for making dental implants were used. There were two types of samples: grade IV and grade V. In turn, within each grade, two types of samples were differentiated: untreated and treated with sand blasting and subjected to double acid etching. Synthesis of the film consisting of titanium oxide pillar array structures was carried out using plasma-enhanced chemical vapor deposition equipment. The plasma was generated in a quartz vessel by an external SLAN-1 microwave source with a frequency of 2.45 GHz. Five specimens from each group were used (40 discs in total). On the surfaces to be studied, the following determinations were carried out: (a) X-ray photoelectron spectroscopy, (b) scanning electron microscopy, (c) energy dispersive X-ray spectroscopy, (d) profilometry, (e) contact angle measurement or surface wettability, (f) progression of contact angle on applying ultraviolet irradiation, and (g) a biocompatibility test and cytotoxicity with cell cultures. Results: The application of ultraviolet light decreased the hydrophobicity of all the surfaces studied, although it did so to a greater extent on the surfaces with the studied modification applied, this being more evident in samples manufactured in grade V titanium. In samples made in grade IV titanium, this difference was less evident, and even in the sample manufactured with grade IV and SLA treatment, the application of the nanometric modification of the surface made the surface optically less active. Regarding cell growth, all the surfaces studied, grouped in relation to the presence or not of the nanometric treatment, showed similar growth. Conclusions. Treatment of titanium oxide surfaces with ultraviolet irradiation made them change temporarily into superhydrophilic ones, which confirms that their biocompatibility could be improved in this way, or at least be maintained

Patient Perspectives of the Doctor-at-Home Service

Introduction. Home health care has been established as an effective model for reducing mortality in the elderly. The Doctor-at-Home Service at the Community Health Centers of Burlington (CHCB) has offered home health care to Burlington residents since January 2015. Dr. Karen Sokol, MD, alone provides care to 176 patients at their homes, including at-home palliative care. CHCB hope to expand this program by hiring more providers. Objective. To understand the impact of the Doctor-at-Home Service from the pa- tients’ perspective. Methods. A survey was administered to a cohort of eighteen patients over an 8- week period and addressed topics such as barriers to healthcare, benefits, and costs associated with doctor-at-home programs. A theme analysis on the responses was then conducted to reflect patient opinions. Available summary data describing the pa- tient population was also analyzed. Results. The Doctor- at- Home program serves patients ranging from 26 to 100 years old, with the majority of the patient population comprised of senior citizens. Prior to at home care, patients faced barriers such as lack of transportation, negative past experi- ences, anxiety, and distance from relatives. Four main themes from patient responses were physician-patient relationship, convenience, quality of care, and environment of care. Discussion. Evidence is compelling that there is a desire and need for an exten- sion of the Doctor-at-Home program to reach additional patients. Doctor-at-Home pro- grams could eliminate identified barriers and provide quality care to patients, especially those with specific barriers to access.https://scholarworks.uvm.edu/comphp_gallery/1256/thumbnail.jp

Editorial : Foot-and-mouth disease epidemiology, vaccines and vaccination : moving forward

Vaccination has played a major role in foot-and-mouth disease (FMD) control. There are different approaches to the design and implementation of vaccination campaigns, and epidemiological information is paramount in influencing the vaccine and vaccination strategy that best suit each geographic location. FMD-endemic regions typically organize vaccination campaigns as a routine preventive control policy or to mitigate the impact of the disease. The majority of currently used vaccines are formulated with chemically inactivated whole-viral particles and suitable adjuvants such as single and double oil emulsions. The most recent strains circulating in a particular region are typically selected as antigens based on the results of vaccine-matching data and in vitro experiments, however, predictions based on vaccine-matching approaches are usually uncertain without a live virus challenge in natural hosts combined with reliable field data. Vaccine selection and successful vaccination campaigns rely on a deep knowledge of the epidemiology of the region where these vaccines will be used, as well as access to the appropriate diagnostic tools to underpin these campaigns.Instituto de VirologíaFil: Capozzo, Alejandra. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología e Innovaciones Tecnológicas; ArgentinaFil: Capozzo, Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Vosloo, Wilna. Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity. Transboundary Disease Mitigation. Australian Centre for Disease Preparedness; AustraliaFil: de los Santos, Teresa. United States Department of Agriculture. Agricultural Research Service. Plum Island Animal Disease Center; Estados UnidosFil: Pérez, Andrés M. University of Minnesota. Department of Veterinary Population Medicine; Estados UnidosFil: Perez Filgueira, Daniel Mariano. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología e Innovaciones Tecnológicas; ArgentinaFil: Perez Filgueira, Daniel Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Different HCV exposure drives specific miRNA profile in PBMCS of HIV patients

"Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAM"Micro RNAs (miRNAs) are essential players in HIV and HCV infections, as both viruses modulate cellular miRNAs and interact with the miRNA-mediated host response. We aim to analyze the miRNA profile of HIV patients with different exposure to HCV to explore specific signatures in the miRNA profile of PBMCs for each type of infection. We massively sequenced small RNAs of PBMCs from 117 HIV+ infected patients: 45 HIV+ patients chronically infected with HCV (HIV/HCV+), 36 HIV+ that spontaneously clarified HCV after acute infection (HIV/HCV-) and 36 HIV+ patients without previous HCV infection (HIV). Thirty-two healthy patients were used as healthy controls (HC). Differential expression analysis showed significantly differentially expressed (SDE) miRNAs in HIV/HCV+ (n = 153), HIV/HCV-(n = 169) and HIV (n = 153) patients. We found putative dysregulated pathways, such as infectious-related and PI3K signaling pathways, common in all contrasts. Specifically, putatively targeted genes involved in antifolate resistance (HIV/HV+), cancer-related pathways (HIV/HCV-) and HIF-signaling (HIV) were identified, among others. Our findings revealed that HCV strongly influences the expression profile of PBMCs from HIV patients through the disruption of its miRNome. Thus, different HCV exposure can be identified by specific miRNA signatures in PBMCs.This work has been supported by grants from Institute of Health Carlos III, [PI15CIII/00031 and PI18CIII/00020/ to AFR and VB] and the Foundation Universidad Alfonso X el Sabio-Santander [grant number 1.010.932 to AFR] and the Spanish AIDS Research Network (RD16CIII/0002/0002), and Centro de Investigación Biomédica en Red (CIBER) en Enfermedades Infecciosas (CB21/13/00044). AFR is supported by the Miguel Servet programme from Fondo de Investigación Sanitaria (ISCIII) [CP14/CIII/00010 and CPII20CIII/0001]

Effect of the drying procedure on hybrid sono-aereogels for organic solvent remediation

Hybrid organic–inorganic aerogels are highly hydrophobic porous solids that avoid the brittleness and moisture adsorption of the standard silica aerogels. Superhydrophobic porous materials have attracted great interest because of their ability for selective absorption of organic solvents while repelling water, as excellent candidates for remediation techniques. This work shows a comparative of three drying procedures of DEDMS/TEOS (diethoxydimethylsilane/tetraethylorthosilicate) gels, namely, by supercritical CO2, by supercritical ethanol, and dried at ambient conditions. Supercritical CO2 and ambient drying produced superhydrophobic aerogels (θ > 150°), while supercritical ethanol drying produces denser aerogels with smaller both porous volume and specific surface area. Regarding the absorption of organic liquids, swelling is observed in all cases. Hexane had faster diffusion that obeyed Fick's law (∝t0.5) whereas liquid polydimethylsiloxane exhibited slower non-Fickian diffusion process (∝tn, n < 0.5

Hydroxyl Groups Induce Bioactivity in Silica/Chitosan Aerogels Designed for Bone Tissue Engineering. In Vitro Model for the Assessment of Osteoblasts Behavior

Silica (SiO2)/chitosan (CS) composite aerogels are bioactive when they are submerged in simulated body fluid (SBF), causing the formation of bone-like hydroxyapatite (HAp) layer. Silica-based hybrid aerogels improve the elastic behavior, and the combined CS modifies the network entanglement as a crosslinking biopolymer. Tetraethoxysilane (TEOS)/CS is used as network precursors by employing a sol-gel method assisted with high power ultrasound (600 W). Upon gelation and aging, gels are dried in supercritical CO2 to obtain monoliths. Thermograms provide information about the condensation of the remaining hydroxyl groups (400-700 degrees C). This step permits the evaluation of the hydroxyl group's content of 2 to 5 OH nm(-2). The formed Si-OH groups act as the inductor of apatite crystal nucleation in SBF. The N-2 physisorption isotherms show a hysteresis loop of type H3, characteristic to good interconnected porosity, which facilitates both the bioactivity and the adhesion of osteoblasts cells. After two weeks of immersion in SBF, a layer of HAp microcrystals develops on the surface with a stoichiometric Ca/P molar ratio of 1.67 with spherulite morphology and uniform sizes of 6 mu m. This fact asserts the bioactive behavior of these hybrid aerogels. Osteoblasts are cultured on the selected samples and immunolabeled for cytoskeletal and focal adhesion expression related to scaffold nanostructure and composition. The initial osteoconductive response observes points to a great potential of tissue engineering for the designed composite aerogels