Improving Resulted Hemoglobin A1c Rates: A Feasibility Study for Point-of-Care Hemoglobin A1c Testing at an Urban Family Medicine Office

Study Aims: Our practice’s goal is to increase the number of up to date hemoglobin A1c for diabetic patients seen at JFMA in order to help improve glycemic control The aim of this study is to see if point of care (POC) hemoglobin A1C is a feasible way to increase the number of up to date hemoglobin A1C. We looked at various factors including timing, training, and flow.https://jdc.jefferson.edu/patientsafetyposters/1037/thumbnail.jp

On-Site Test Collection Intervention Improves Lead Screening Rates at an Urban Family Medicine Practice

Study Aims: Examine the effect of on-site lead screening collection on resulted lead screening rates.https://jdc.jefferson.edu/patientsafetyposters/1018/thumbnail.jp

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ABSTRACT. Objective. To investigate by high frequency grey-scale ultrasonography (US) and power Doppler sonography (PDS) the modality and frequency of involvement of the Achilles tendon and plantar fascia in chondrocalcinosis (CC), and to correlate these findings with clinical complaints and radiographic evidence. Methods. The heels of 57 consecutive patients with CC were evaluated by US, PDS, and radiography. One control group of 50 consecutive patients with osteoarthritis (OA) without signs of CC was studied in the same way. A second control group of 50 healthy subjects underwent only US/PDS examination. All subjects also underwent clinical assessment. Results. US revealed Achilles tendon calcifications in 57.9% of those with CC, but none in the control groups. Plantar fascia calcifications were observed in 15.8% of CC and in 2% of OA cases, but not in healthy controls. US showed no significant difference in postero-inferior and inferior calcaneal enthesophytosis between subjects with CC (59.6% and 61.4%, respectively) and those with OA (46% and 44%, respectively). Such alterations were also present, in lower percentages, in the healthy controls. Posterior and inferior calcaneal erosions were absent in all groups. Achilles enthesopathy was found in 22.8% of patients with CC (14.9% of heels, with vascular signals in 11.4% of heels on PDS). Deep retrocalcaneal bursitis was found in 10.5% of patients with CC (7% of heels, with vascular signals in 5.2% of heels on PDS). Plantar fasciitis was found in 40.3% of patients with CC (36% of heels, with vascular signals in 2.6% of heels on PDS) and in 14% of OA patients, but not in healthy controls. No significant correlation was found between talalgia or sex of patients and presence of calcifications. A significant correlation was observed between talalgia and Achilles enthesopathy (r = 0.78, p < 0.0001), deep retrocalcaneal bursitis (r = 0.7, p < 0.0001), and plantar fasciitis (r = 0.31, p < 0.001). A significant correlation between talalgia and vascular signals on PDS was observed in Achilles enthesopathy (r = 0.91, p < 0.0001) and deep retrocalcaneal bursitis (r = 0.65, p < 0.0001). The presence of vascular signals on PDS was significantly associated with the presence of tendinous and bursal grey-scale US alterations. Achilles tendon calcifications were 39% sensitive, 100% specific, and 77% accurate for the presence of CC, whereas plantar fascia calcifications were 15% sensitive, 98% specific, and 54% accurate. Excellent agreement was found between US and radiography in detecting Achilles tendon calcifications (k = 0.86), plantar fascia calcifications (k = 0.77), postero-inferior enthesophytosis (k = 0.90), and inferior enthesophytosis (k = 0.83). Chondrocalcinosis (CC) is an arthropathy generally caused by deposit of calcium pyrophosphate-dihydrate (CPPD) microcrystals in the joints and in the tendons 1,2 . In CPPD crystal deposition disease typical linear calcifications can be found in fibrocartilage, especially in the knee menisci, carpus triangular ligament, symphysis pubis, and in hyaline articular cartilage, especially in the knee 1,2 . Calcifications in tendons have been described in previous radiological reports 3-9 : Achilles tendon, gastrocnemius tendon, hip adductors, and quadriceps tendon were the sites primarily involved. Conclusio

Spillover events of rabbit haemorrhagic disease virus 2 (recombinant GI.4P-GI.2) from Lagomorpha to Eurasian badger

Rabbit haemorrhagic disease (RHD) is a major threat to domestic and wild European rabbits. Presently, in Europe, the disease is caused mainly by Rabbit haemorrhagic disease virus 2 (RHDV2/b or Lagovirus europaeus GI.2), the origin of which is still unclear, as no RHDV2 reservoir hosts were identified. After the RHDV2 emergence in 2010, viral RNA was detected in a few rodent species. Furthermore, RHDV2 was found to cause disease in some hare species resembling the disease in rabbits, evidencing the ability of the virus to cross the species barrier. In this study, through molecular, histopathologic, antigenic and morphological evidences, we demonstrate the presence and replication of RHDV2 in Eurasian badgers (Meles meles) found dead in the district of Santarém, Portugal, between March 2017 and January 2020. In two of these seven animals, we further classify the RHDV2 as a Lagovirus europaeus recombinant GI.4P‐GI.2. Our results indicate that Meles meles is susceptible to RHDV2, developing systemic infection, and excreting the virus in the faeces. Given the high viral loads seen in several organs and matrices, we believe that transmission to the wild rabbit is likely. Furthermore, transmission electron microscopy data shows the presence of Calicivirus compatible virions in the nucleus of hepatocytes, which has not been demonstrated before and constitutes a paradigm shift for caliciviruses’s replication cycle

Problematic smartphone use and academic achievement: a systematic review and meta-analysis

Background and aims: The present study aimed to synthesize existing quantitative evidence on the relationship between problematic smartphone use (PSU) and academic achievement with a focus on quantifying its magnitude and examining its potential moderators. Methods: Eligible studies were searched for up to February 10, 2023 in six different databases (i.e., MEDLINE, Current Contents Connect, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global). Studies were considered eligible if they provided information derived from self-report instruments that allowed statistical calculation of the relationship between PSU and academic achievement. Pooled effect sizes (r) were computed using a random-effects model. Meta-regressions were conducted to test the influence of study-level moderators on the relationship of interest. Influence analyses and a three-parameter selection model (3PSM) were conducted to examine the robustness of the results and publication bias, respectively. Results: A total of 33 effect sizes from 29 studies (n = 48,490) were retrieved. Results showed a small effect size (r = −0.110), which tended to be larger in samples consisting of students from elementary and middle schools. Discussion and Conclusions: Findings from the present study contribute to the understanding of a potential determinant of decreased academic achievement by providing evidence that PSU may be one of them

Can robotic-based top-down rehabilitation therapies improve motor control in children with cerebral palsy? A perspective on the CPWalker project

[EN] Cerebral Palsy (CP) is one of the most severe disabilities in childhood, and it demands important costs in health, education, and social services. CP is caused by damage to or abnormalities inside the developing brain that disrupt the brain's ability to control movement and maintain posture. Furthermore, CP is often associated with sensory deficits, cognition impairments, communication and motor disabilities, behavior issues, seizure disorder, pain, and secondary musculoskeletal problems. According to the literature, motor modules are peripheral measurements related to automatic motor control. There is a lack of evidence of change in motor modules in children with CP when different treatment approaches have been evaluated. Thus, new strategies are needed to improve motor control in this population. Robotic-based therapies are emerging as an effective intervention for gait rehabilitation in motor disorders such as stroke, spinal cord injury, and CP. There is vast clinical evidence that neural plasticity is the central core of motor recovery and development, and on-going studies suggest that robot-mediated intensive therapy could be beneficial for improved functional recovery. However, current robotic strategies are focused on the peripheral neural system (PNS) facilitating the performance of repetitive movements (a bottom-up approach). Since CP affects primarily brain structures, both the PNS and the central nervous system (CNS) should to be integrated in a physical and cognitive rehabilitation therapy (a top-down approach). This paper discusses perspectives of the top-down approach based on a novel robot-assisted rehabilitative system. Accordingly, the CPWalker robotic platform was developed to support novel therapies for CP rehabilitation. This robotic platform (Smart Walker + exoskeleton) is controlled by a multimodal interface enabling the interaction of CP infants with robot-based therapies. The aim of these therapies is to improve the physical skills of infants with CP using a top-down approach, in which motor related brain activity is used to drive robotic physical rehabilitation therapies. Our hypothesis is that the CPWalker concept will promote motor learning and this improvement will lead to significant improvements in automatic motor control.Lerma Lara, S.; Martínez Caballero, I.; Bayón, C.; Del Castillo, M.; Serrano, I.; Raya, R.; Belda Lois, JM.... (2016). Can robotic-based top-down rehabilitation therapies improve motor control in children with cerebral palsy? A perspective on the CPWalker project. Biomedical Research and Clinical Practice. 22-26. doi:10.15761/BRCP.1000106S222

Effects of testicular microlithiasis on Doppler parameters: report of three cases

BACKGROUND: Testicular microlithiasis is a rare, usually asymptomatic, non-progressive disease of the testes associated with various genetic anomalies, infertility and testicular tumors. According to our literature search, there is no specific data about Doppler findings in this disease. CASE PRESENTATION: Doppler findings of three cases of testicular microlithiasis during last two years in our institution are presented. CONCLUSIONS: Although our hypothesis was to find increased Doppler parameters due to intratesticular arterial compression, our findings suggest that there are no Doppler findings specific to testicular microlithiasis

Estimating Genetic Ancestry Proportions from Faces

Ethnicity can be a means by which people identify themselves and others. This type of identification mediates many kinds of social interactions and may reflect adaptations to a long history of group living in humans. Recent admixture in the US between groups from different continents, and the historically strong emphasis on phenotypic differences between members of these groups, presents an opportunity to examine the degree of concordance between estimates of group membership based on genetic markers and on visually-based estimates of facial features. We first measured the degree of Native American, European, African and East Asian genetic admixture in a sample of 14 self-identified Hispanic individuals, chosen to cover a broad range of Native American and European genetic admixture proportions. We showed frontal and side-view photographs of the 14 individuals to 241 subjects living in New Mexico, and asked them to estimate the degree of NA admixture for each individual. We assess the overall concordance for each observer based on an aggregated measure of the difference between the observer and the genetic estimates. We find that observers reach a significantly higher degree of concordance than expected by chance, and that the degree of concordance as well as the direction of the discrepancy in estimates differs based on the ethnicity of the observer, but not on the observers' age or sex. This study highlights the potentially high degree of discordance between physical appearance and genetic measures of ethnicity, as well as how perceptions of ethnic affiliation are context-specific. We compare our findings to those of previous studies and discuss their implications