Characterization of oral leukoplakia. Justo Ortelio Pestana Lorenzo Provincial Teaching Stomatology Clinic. 2019

Introducción: la leucoplasia bucal es una lesión premaligna que se manifiestan como una mancha blanca, no suelen ser dolorosas y pueden pasar desapercibidas.Objetivo: caracterizar la leucoplasia bucal en pacientes de la Clínica Estomatológica Docente Provincial “Justo Ortelio Pestana Lorenzo” durante el año 2019Métodos: se realizó un estudio observacional descriptivo transversal de enero a diciembre de 2019 en la clínica estomatológica provincial “Dr. Justo Ortelio Pestana Lorenzo”. Se seleccionaron 21 pacientes portadores de leucoplasiabucal que cumplieron criterios de inclusión. Las variables estudiadas fueron edad, sexo, color de la piel, factores de riesgo y localización de la lesión.Resultados: el 57,1 % de los pacientes con leucoplasia tenían entre 45 y 59 años de edad, el 61,9 % pertenecía al sexo masculino y el 47,6 % de color de la piel blanco. La zona mayormente afectada fue la mucosa del carrillo en el 42,8 %. De los pacientes examinados, el 57,1 % fueron fumadores y el 28,8 % presentó prótesis desajustadas e higiene bucal deficiente.Conclusiones: predominaron los pacientes del grupo entre 45 y 59 años de edad, con sexo masculino y color de la piel blanca, la mayor localización en la mucosa del carrillo y los factores de riesgo hábito de fumar, la deficiente higiene bucal y las prótesis desajustadas.Introduction: oral leukoplakia is a premalignant lesion that usually manifests as a white spot, but it is not usually painful and can go unnoticed.Objective: to characterize oral leukoplakia in patients of the "Justo Ortelio Pestana Lorenzo" Provincial Teaching Stomatology Clinic during 2019.Methods: a cross-sectional descriptive observational study was conducted from January to December 2019 at the "Dr. Justo Ortelio Pestana Lorenzo" Provincial Stomatological Clinic. Twenty-one patients with oral leukoplakia who met inclusion criteria were selected. The variables studied were age, sex, skin color, risk factors and location of the lesion.Results: 57,1 % of the patients with leukoplakia were between 45 and 59 years of age, 61,9 % were male and 47,6 % were of white skin color. 42,8 % of the area most affected was the mucosa of the cheek. Of the patients examined, 57,1 % were smokers and 28,8 % presented maladjusted prosthesis and deficient oral hygiene.Conclusions: patients between 45 and 59 years of age were predominant, with male sex and white skin color, the greatest localization in the mucosa of the cheek and the risk factors were smoking, poor oral hygiene and maladjusted prostheses

SUN-131 Improving the Glycemic Control of Women Veterans with Poorly Controlled Diabetes with a Telephone Encounter

Introduction : Despite having a broad range of services available at the Veterans Affairs Healthcare System (VAHS), veterans struggle to control their chronic diseases. At the Miami VAHS, 30% of veterans have diabetes, and of those, 30% are poorly controlled. Women represent a growing number of veterans at the Miami VAHS who face many of the challenges posed by having a diabetes diagnosis. Objective: To improve HbA1c measurements in women veterans (WV) with poorly controlled diabetes following a phone encounter with an endocrinologist addressing diabetes management. Method: This was a prospective intervention study of WV with HbA1c levels ≥ 9%. An endocrinologist attempted up to three telephone calls to reach WV. The phone intervention involved a chart review of co-morbidities to establish a HbA1c target, and management included lifestyle modification counseling, insulin dose adjustment, introduction and/or discontinuation of diabetes medications, and a plan for follow-up. During the following 3-4 months, results of follow-up HbA1c were collected regardless of having had an initial telephone encounter. WV who did not have follow-up HbA1c were excluded from the study. The remaining WV were further divided into 1) those that answered the phone and participated in the assessment (intervention group) and 2) those who did not answer the phone to have an initial encounter (control group). Other variables included BMI, eGFR, type of diabetes, diabetes medication, presence of hypertension, dyslipidemia, coronary artery disease (CAD), smoking, and psychiatric illness. Results: Of 77 WV who were called, 36 WV were assessed by the endocrinologist; 41 did not answer the phone and were regarded as the control. 8 WV from the intervention group and 16 WV from the control group did not have a follow-up HbA1c, and were excluded. 28 intervention and 25 control WV were included in the final analysis. In the intervention group: mean age 55.0 ± 10.3 years, BMI 29.8 ± 5.5, eGFR 57.9 ± 4.5, 86% type 2 diabetes, 61% on basal bolus insulin therapy, 68% HTN, 93% dyslipidemia, 71% smokers, 4% CAD, and 68% psychiatric diagnosis. In the control group: mean age 55.6 ± 9.9 years, BMI 32.5 ± 6.1, eGFR 58.9 ± 4.5, 96% type 2 diabetes, 44% on basal bolus insulin therapy, 80% HTN, 84% dyslipidemia, 16% smokers, 4% CAD, and 68% psychiatric diagnosis. Mean baseline HbA1c was 10.9 ± 1.5 for the intervention and 10.8 ± 1.8 for the control group. After 3-4 months, mean HbA1c was 9.9 ± 2.3 in the intervention group, and 10.6 ± 1.7 in the control group. HbA1c decrease in the intervention group was statistically significant (p = 0.03). Conclusion: This preliminary study demonstrates that a telephone intervention from a diabetes specialist has a positive impact on decreasing HbA1c in WV with poorly controlled diabetes. Findings from this study suggest that this approach should be considered in management of other chronic diseases

Podcast Listening and Informal Learning

Listening to podcasts is a popular way adults learn outside of formal school settings. Examining podcast listening through the lens of informal learning is an important and underexplored area of inquiry. This is especially important considering the growth of the adult population in the United States and the new opportunities for learning and recreation. In this research, we interviewed 31 adult podcast listeners from across the United States about their experiences listening to and learning from podcasts. We open coded and refined the analysis to three themes. There was a strong connection between listening, learning, and personal growth among the participants. The participants experienced meaningful changes in their perspectives and behaviors from what they learned in podcasts. Finally, the unique features of the medium of podcasting such as its convenience and ease of production were integral to this learning

A Survey of Software-Defined Networks-on-Chip: Motivations, Challenges and Opportunities

Current computing platforms encourage the integration of thousands of processing cores, and their interconnections, into a single chip. Mobile smartphones, IoT, embedded devices, desktops, and data centers use Many-Core Systems-on-Chip (SoCs) to exploit their compute power and parallelism to meet the dynamic workload requirements. Networks-on-Chip (NoCs) lead to scalable connectivity for diverse applications with distinct traffic patterns and data dependencies. However, when the system executes various applications in traditional NoCs—optimized and fixed at synthesis time—the interconnection nonconformity with the different applications’ requirements generates limitations in the performance. In the literature, NoC designs embraced the Software-Defined Networking (SDN) strategy to evolve into an adaptable interconnection solution for future chips. However, the works surveyed implement a partial Software-Defined Network-on-Chip (SDNoC) approach, leaving aside the SDN layered architecture that brings interoperability in conventional networking. This paper explores the SDNoC literature and classifies it regarding the desired SDN features that each work presents. Then, we described the challenges and opportunities detected from the literature survey. Moreover, we explain the motivation for an SDNoC approach, and we expose both SDN and SDNoC concepts and architectures. We observe that works in the literature employed an uncomplete layered SDNoC approach. This fact creates various fertile areas in the SDNoC architecture where researchers may contribute to Many-Core SoCs designs

Evaluating an Electronic Health Record Intervention for Management of Heart Failure Among Veterans

Background: We studied the feasibility of using the Veteran Health Administration's electronic health record (EHR), My Health e Vet, as an educational and monitoring tool for veterans with heart failure (HF). Methods: We enrolled 120 HF patients with a mean age (±standard deviation): 64.8 ± 9.6, range: 41–91 years. There were 105 (87.5%) non-Hispanics, 15 (12.5%) Hispanics, 91 (75.8%) whites, and 20 (16.5%) blacks, and 62 (51.7%) were married. Study participants received educational material on managing their HF and were monitored on their weight and HF symptoms weekly. Surveys on My Health e Vet use and secondary outcomes including knowledge of their illness, quality of life (QoL), and self-efficacy were conducted at baseline and 26 weeks after enrollment. Results: Among the participants, 55 (45.8%) had used My Health e Vet. The number of weeks each user responded to the weekly messages by the care coordinator ranged from 1 (4%) to 26 (100%) with a median of 8. Secondary outcome data were available for 54 patients (24 users and 30 nonusers) who participated in both baseline and 26-week surveys. There was a significant improvement in QoL ( p < 0.01) among users of My Health e Vet compared with nonusers. There were no significant differences with respect to self-efficacy or HF knowledge. Use of My Health e Vet and ease in using the Health e Vet portal increased from baseline to follow-up. Conclusions: EHR-based interventions have potential for HF monitoring and case management, and may be feasible in improving QoL for patients

Women veterans and menopause: Knowledge and preferences

The increasing number and older age of women Veterans receiving care at Veterans Health Administration (VHA) requires health-care providers to adjust to their changing patient population. We explored women Veterans' self-reported knowledge of menopause, current/preferred sources of menopausal health information, and perceptions/barriers regarding treatment of menopausal symptoms. Three focus groups were conducted at two South Florida VHA facilities in 2014, which included 30 women Veterans (aged 45-60 years) who visited VHA primary care clinics at least once in the past year. Participants reported using various sources to obtain general and menopausal health information, particularly family, friends, and the internet. Some women also had discussions with their health-care providers, but believed not all VHA providers were knowledgeable about menopause. Most preferred older female providers, thinking they were better informed about menopausal issues. Women favored complementary/alternative therapies and were against using hormone therapy (HT) for symptom relief, although they felt they were insufficiently informed about HT. Menopausal-age women are the fastest growing group at VHA. To provide better care and enhance their experiences, the VHA must educate all primary care providers about menopausal care and strive to address women Veterans' menopausal concerns and preferences

Communicating global cardiovascular risk: Are icon arrays better than numerical estimates in improving understanding, recall and perception of risk?

Experts recommend that adults have their global cardiovascular risk assessed. We investigated whether icon arrays increase understanding, recall, perception of CVR, and behavioral intent as compared with numerical information. Male outpatient veterans, at an intermediate to high cardiovascular risk participated in a randomized controlled trial of a computer tutorial presenting individualized risk. Message format was presented in 3 formats: percentages, frequencies, and frequencies with icon arrays. We assessed understanding immediately (T1) and recall at 20min (T2) and 2 weeks (T3) after the intervention. We assessed perceptions of importance/seriousness, intent to adhere, and self-efficacy at T1. Self-reported adherence was assessed at T3. One-hundred and twenty male veterans participated. Age, education, race, health literacy and numeracy were comparable at baseline. There were no differences in understanding at T1 [p=.31] and recall at T3 [p=.10]. Accuracy was inferior with frequencies with icon arrays than percentages or frequencies at T2 [p≤.001]. There were no differences in perception of seriousness and importance for heart disease, behavioral intent, self-efficacy, actual adherence and satisfaction. Icon arrays may impair short-term recall of CVR. Icon arrays will not necessarily result in better understanding and recall of medical risk in all patients