Usefulness and Usability of a Personal Health Record and Survivorship Care Plan for Colorectal Cancer Survivors: Survey Study

Background: As a result of improvements in cancer screening, treatment, and supportive care, nearly two-thirds of individuals diagnosed with colorectal cancer (CRC) live for 5 years after diagnosis. An ever-increasing population of CRC survivors creates a need for effective survivorship care to help manage and mitigate the impact of CRC and its treatment. Personal health records (PHRs) and survivorship care plans provide a means of supporting the long-term care of cancer survivors. Objective: The purpose of this study is to characterize the usefulness of a CRC PHR and survivorship care plan and to describe the usability of these technologies in a population of CRC survivors. To our knowledge, this is the first study to assess a PHR and survivorship care plan specifically targeting CRC survivors. Methods: Twenty-two patients with CRC were recruited from surgery clinics of an academic medical center and Veterans Affairs hospital in Indianapolis and provided access to an online Colorectal Cancer Survivor’s Personal Health Record (CRCS-PHR). Survey data were collected to characterize the usefulness of the CRCS-PHR and describe its usability in a population of CRC survivors. CRC survivors were surveyed 6 months after being provided online access. Means and proportions were used to describe the usefulness and ease of using the CRC website. Open-ended questions were qualitatively coded using the constant comparative method. Results: CRC survivors perceived features related to their health care (ie, summary of cancer treatment history, follow-up care schedule, description of side effects, and list of community resources) to be more useful than communication features (ie, creating online relationships with family members or caregivers, communicating with doctor, and secure messages). CRC survivors typically described utilizing traditional channels (eg, via telephone or in person) to communicate with their health care provider. Participants had overall positive perceptions with respect to ease of use and overall satisfaction. Major challenges experienced by participants included barriers to system log-in, lack of computer literacy or experience, and difficulty entering their patient information. Conclusions: For CRC, survivors may find the greater value in a PHR’s medical content than the communication functions, which they have available elsewhere. These findings regarding the usefulness and usability of a PHR for the management of CRC survivorship provide valuable insights into how best to tailor these technologies to patients’ needs. These findings can inform future design and development of PHRs for purposes of both cancer and chronic disease management

Serum Vitamin D Levels and Polycystic Ovary syndrome: A Systematic Review and Meta-Analysis

Citation: He, C. L., Lin, Z., Robb, S. W., & Ezeamama, A. E. (2015). Serum Vitamin D Levels and Polycystic Ovary syndrome: A Systematic Review and Meta-Analysis. Nutrients, 7(6), 4555-4577. doi:10.3390/nu7064555Vitamin D deficiency (VDD) is common in women with and without polycystic ovary syndrome (PCOS) and may be associated with metabolic and endocrine disorders in PCOS. The aim of this meta-analysis is to assess the associations of serum vitamin D levels with metabolic and endocrine dysregulations in women with PCOS, and to determine effects of vitamin D supplementation on metabolic and hormonal functions in PCOS patients. The literature search was undertaken through five databases until 16 January 2015 for both observational and experimental studies concerning relationships between vitamin D and PCOS. A total of 366 citations were identified, of which 30 were selected (n = 3182). We found that lower serum vitamin D levels were related to metabolic and hormonal disorders in women with PCOS. Specifically, PCOS patients with VDD were more likely to have dysglycemia (e.g., increased levels of fasting glucose and homeostatic model assessment-insulin resistance index (HOMA-IR)) compared to those without VDD. This meta-analysis found no evidence that vitamin D supplementation reduced or mitigated metabolic and hormonal dysregulations in PCOS. VDD may be a comorbid manifestation of PCOS or a minor pathway in PCOS associated metabolic and hormonal dysregulation. Future prospective observational studies and randomized controlled trials with repeated VDD assessment and better characterization of PCOS disease severity at enrollment are needed to clarify whether VDD is a co-determinant of hormonal and metabolic dysregulations in PCOS, represents a consequence of hormonal and metabolic dysregulations in PCOS or both

Optical pattern formation with a 2-level nonlinearity

We present an experimental and theoretical investigation of spontaneous pattern formation in the transverse section of a single retro-reflected laser beam passing through a cloud of cold Rubidium atoms. In contrast to previously investigated systems, the nonlinearity at work here is that of a 2-level atom, which realizes the paradigmatic situation considered in many theoretical studies of optical pattern formation. In particular, we are able to observe the disappearance of the patterns at high intensity due to the intrinsic saturable character of 2-level atomic transitions.Comment: 5 pages, 4 figure

Substituição da torta de algodão por feno de leguminosas em rações baseadas em restolho da cultura do milho para ovinos em confinamento.

Resumo: Dois experimentos usando ovinos deslanados testaram a substituiçao da torta de algodao por feno de Ieguminosas em rações corn restolho da cultura do milho. No primeiro experimento, foi usada uma raçao-base de 51% restolho do milho, 28% torta de algodao, 20% milho e 1% sal, na quaI a torta de algodao foi substituîda por 5%, 10%, e 15% de feno de mata-pasto (Cassia sericea), enquanto um Iote-testemunha era mantido em pastoreio. Os animais confinados ganharam 95, 106, 103 e 93 gramas/cabeça/dia (P > 0,05), para as rações com 0%, 5%, 10% e 15% de mata-pasto, respectivamente. Os animais em pastoreio perderam 11 gramas/cabeça/dia (P 0.05) for tho rations with 0%, 5%, 10% and 15% of "mata-pasto", respective-ly. The grazing animais iost 11 grams/head/day , (P <0.05). in the second experiment, the cottonseed calce was either partiaiiy (50%) or totaily repiacod by "mata-pasto" or "cunha" (ditaria terl7atee) hays, whiie the grazing sheep received a suppiementation of 200 grams of corn grain/headldayWith the exception of the treatment In which the eottonseed cake was totaily repiaced by "mata-pasto" hay, the other treatments with coniined animais showed gains above 100 grams/head/day, which were hi -,er than (P <0.01) the 42 grams/head/day for the grazing animais. The resuits indicate that it is possibie to substituto "mata-pasto" hay for cottonseed calce ar leveis up to 50%, while the total substitution Lan be made "cunhâ" Is used

Sampling locality is more detectable than taxonomy or ecology in the gut microbiota of the brood-parasitic Brown-headed Cowbird (Molothrus ater)

Brown-headed Cowbirds (Molothrus ater) are the most widespread avian brood parasite in North America, laying their eggs in the nests of approximately 250 host species that raise the cowbird nestlings as their own. It is currently unknown how these heterospecific hosts influence the cowbird gut microbiota relative to other factors, such as the local environment and genetics. We test a Nature Hypothesis (positing the importance of cowbird genetics) and a Nurture Hypothesis (where the host parents are most influential to cowbird gut microbiota) using the V6 region of 16S rRNA as a microbial fingerprint of the gut from 32 cowbird samples and 16 potential hosts from nine species. We test additional hypotheses regarding the influence of the local environment and age of the birds.We found no evidence for the Nature Hypothesis and little support for the Nurture Hypothesis. Cowbird gut microbiota did not forma clade, but neither did members of the host species. Rather, the physical location, diet and age of the bird, whether cowbird or host, were the most significant categorical variables. Thus, passerine gut microbiota may be most strongly influenced by environmental factors. To put this variation in a broader context, we compared the bird data to a fecal microbiota dataset of 38 mammal species and 22 insect species. Insects were always the most variable; on some axes, we found more variation within cowbirds than across all mammals. Taken together, passerine gut microbiota may be more variable and environmentally determined than other taxonomic groups examined to date. © 2014 Hird et al

Quantum threshold for optomechanical self-structuring in a Bose-Einstein condensate

Theoretical analysis of the optomechanics of degenerate bosonic atoms with a single feedback mirror shows that self-structuring occurs only above an input threshold that is quantum mechanical in origin. This threshold also implies a lower limit to the size (period) of patterns that can be produced in a condensate for a given pump intensity. These thresholds are interpreted as due to the quantum rigidity of Bose-Einstein condensates, which has no classical counterpart. Above the threshold, the condensate self-organizes into an ordered supersolid state with a spatial period self-selected by optical diffraction

Design and Validation of a General Purpose Robotic Testing System for Musculoskeletal Applications

Orthopaedic research on in vitro forces applied to bones, tendons, and ligaments during joint loading has been difficult to perform because of limitations with existing robotic simulators in applying full-physiological loading to the joint under investigation in real time. The objectives of the current work are as follows: (1) describe the design of a musculoskeletal simulator developed to support in vitro testing of cadaveric joint systems, (2) provide component and system-level validation results, and (3) demonstrate the simulator’s usefulness for specific applications of the foot-ankle complex and knee. The musculoskeletal simulator allows researchers to simulate a variety of loading conditions on cadaver joints via motorized actuators that simulate muscle forces while simultaneously contacting the joint with an external load applied by a specialized robot. Multiple foot and knee studies have been completed at the Cleveland Clinic to demonstrate the simulator’s capabilities. Using a variety of general-use components, experiments can be designed to test other musculoskeletal joints as well (e.g., hip, shoulder, facet joints of the spine). The accuracy of the tendon actuators to generate a target force profile during simulated walking was found to be highly variable and dependent on stance position. Repeatability (the ability of the system to generate the same tendon forces when the same experimental conditions are repeated) results showed that repeat forces were within the measurement accuracy of the system. It was determined that synchronization system accuracy was 6.7±2.0 ms and was based on timing measurements from the robot and tendon actuators. The positioning error of the robot ranged from 10 μm to 359 μm, depending on measurement condition (e.g., loaded or unloaded, quasistatic or dynamic motion, centralized movements or extremes of travel, maximum value, or root-mean-square, and x-, y- or z-axis motion). Algorithms and methods for controlling specimen interactions with the robot (with and without muscle forces) to duplicate physiological loading of the joints through iterative pseudo-fuzzy logic and real-time hybrid control are described. Results from the tests of the musculoskeletal simulator have demonstrated that the speed and accuracy of the components, the synchronization timing, the force and position control methods, and the system software can adequately replicate the biomechanics of human motion required to conduct meaningful cadaveric joint investigations

Opto-Mechanical Pattern Formation in Cold Atoms

Transverse pattern formation in an optical cavity containing a cloud of cold two-level atoms is discussed. We show that density modulation becomes the dominant mechanism as the atomic temperature is reduced. Indeed, for low but achievable temperatures the internal degrees of freedom of the atoms can be neglected, and the system is well described by treating them as mobile dielectric particles. A linear stability analysis predicts the instability threshold and the spatial scale of the emergent pattern. Numerical simulations in one and two transverse dimensions confirm the instability and predict honeycomb and hexagonal density structures, respectively, for the blue and red detuned cases.Comment: submitted to Physical Review Letter