Effective User Experience in Online Technical Communication Courses: Employing Multiple Methods within Organizational Contexts to Assess Usability

In teaching online technical communication courses, shaping an electronic interface requires extensive consideration of the user experience, both for students and for faculty members who design and teach the courses. Technical communication faculty members should provide strong examples of effective user experiences and should be leaders in making the interfaces of online learning management systems as usable as possible. Principles of usability designed for general web sites may or may not apply to learning management systems designed for educational purposes. In order to create effective online technical communication courses, one needs to consider both usability concerns and pedagogical concerns. To assess the usability and pedagogical effectiveness of online courses, faculty members may use indirect means such as heuristic analyses. In addition, they may use direct means such as usability testing, student feedback, and analytic tools. Each approach has advantages as well as limitations. Faculty members will gain the richest information through using multiple approaches. In assessing usability and pedagogical effectiveness, faculty members also need to consider the situational constraints and resources in their unique contexts. Understanding and adapting their approaches to use resources well and to work within constraints will benefit their abilities to enhance their student users' experiences with online courses

Evaluation of retinal nerve fibre layer thickness as a possible measure of diabetic retinal neurodegeneration in the EPIC-Norfolk Eye Study

Background/aims: Markers to clinically evaluate structural changes from diabetic retinal neurodegeneration (DRN) have not yet been established. To study the potential role of peripapillary retinal nerve fibre layer (pRNFL) thickness as a marker for DRN, we evaluated the relationship between diabetes, as well as glycaemic control irrespective of diabetes status and pRNFL thickness. Methods: Leveraging data from a population-based cohort, we used general linear mixed models (GLMMs) with a random intercept for patient and eye to assess the association between pRNFL thickness (measured using GDx) and demographic, systemic and ocular parameters after adjusting for typical scan score. GLMMs were also used to determine: (1) the relationship between: (A) glycated haemoglobin (HbA1c) irrespective of diabetes diagnosis and pRNFL thickness, (B) diabetes and pRNFL thickness and (2) which quadrants of pRNFL may be affected in participants with diabetes and in relation to HbA1c. Results: 7076 participants were included. After controlling for covariates, inferior pRNFL thickness was 0.94 µm lower (95% CI −1.28 µm to −0.60 µm), superior pRNFL thickness was 0.83 µm lower (95% CI −1.17 µm to −0.49 µm) and temporal pRNFL thickness was 1.33 µm higher (95% CI 0.99 µm to 1.67 µm) per unit increase in HbA1c. Nasal pRNFL thickness was not significantly associated with HbA1c (p=0.23). Similar trends were noted when diabetes was used as the predictor. Conclusion: Superior and inferior pRNFL was significantly thinner among those with higher HbA1c levels and/or diabetes, representing areas of the pRNFL that may be most affected by diabetes

Detecting retinal neurodegeneration in people with diabetes: Findings from the UK Biobank

IMPORTANCE: Efforts are underway to incorporate retinal neurodegeneration in the diabetic retinopathy severity scale. However, there is no established measure to quantify diabetic retinal neurodegeneration (DRN). OBJECTIVE: We compared total retinal, macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness among participants with and without diabetes (DM) in a population-based cohort. DESIGN/SETTING/PARTICIPANTS: Cross-sectional analysis, using the UK Biobank data resource. Separate general linear mixed models (GLMM) were created using DM and glycated hemoglobin as predictor variables for retinal thickness. Sub-analyses included comparing thickness measurements for patients with no/mild diabetic retinopathy (DR) and evaluating factors associated with retinal thickness in participants with and without diabetes. Factors found to be significantly associated with DM or thickness were included in a multiple GLMM. EXPOSURE: Diagnosis of DM was determined via self-report of diagnosis, medication use, DM-related complications or glycated hemoglobin level of ≥ 6.5%. MAIN OUTCOMES AND MEASURES: Total retinal, mRNFL and GC-IPL thickness. RESULTS: 74,422 participants (69,985 with no DM; 4,437 with DM) were included. Median age was 59 years, 46% were men and 92% were white. Participants with DM had lower total retinal thickness (-4.57 μm, 95% CI: -5.00, -4.14; p<0.001), GC-IPL thickness (-1.73 μm, 95% CI: -1.86, -1.59; p<0.001) and mRNFL thickness (-0.68 μm, 95% CI: -0.81, -0.54; p<0.001) compared to those without DM. After adjusting for co-variates, in the GLMM, total retinal thickness was 1.99 um lower (95% CI: -2.47, -1.50; p<0.001) and GC-IPL was 1.02 μm lower (95% CI: -1.18, -0.87; p<0.001) among those with DM compared to without. mRNFL was no longer significantly different (p = 0.369). GC-IPL remained significantly lower, after adjusting for co-variates, among those with DM compared to those without DM when including only participants with no/mild DR (-0.80 μm, 95% CI: -0.98, -0.62; p<0.001). Total retinal thickness decreased 0.40 μm (95% CI: -0.61, -0.20; p<0.001), mRNFL thickness increased 0.20 μm (95% CI: 0.14, 0.27; p<0.001) and GC-IPL decreased 0.26 μm (95% CI: -0.33, -0.20; p<0.001) per unit increase in A1c after adjusting for co-variates. Among participants with diabetes, age, DR grade, ethnicity, body mass index, glaucoma, spherical equivalent, and visual acuity were significantly associated with GC-IPL thickness. CONCLUSION: GC-IPL was thinner among participants with DM, compared to without DM. This difference persisted after adjusting for confounding variables and when considering only those with no/mild DR. This confirms that GC-IPL thinning occurs early in DM and can serve as a useful marker of DRN

Design of a graphical and interactive interface for facilitating access to drug contraindications, cautions for use, interactions and adverse effects

<p>Abstract</p> <p>Background</p> <p>Drug iatrogeny is important but could be decreased if contraindications, cautions for use, drug interactions and adverse effects of drugs described in drug monographs were taken into account. However, the physician's time is limited during consultations, and this information is often not consulted. We describe here the design of "Mister VCM", a graphical interface based on the VCM graphical language, facilitating access to drug monographs. We also provide an assessment of the usability of this interface.</p> <p>Methods</p> <p>The "Mister VCM" interface was designed by dividing the screen into two parts: a graphical interactive one including VCM icons and synthetizing drug properties, a textual one presenting on demand drug monograph excerpts. The interface was evaluated over 11 volunteer general practitioners, trained in the use of "Mister VCM". They were asked to answer clinical questions related to fictitious randomly generated drug monographs, using a textual interface or "Mister VCM". When answering the questions, correctness of the responses and response time were recorded.</p> <p>Results</p> <p>"Mister VCM" is an interactive interface that displays VCM icons organized around an anatomical diagram of the human body with additional mental, etiological and physiological areas. Textual excerpts of the drug monograph can be displayed by clicking on the VCM icons. The interface can explicitly represent information implicit in the drug monograph, such as the absence of a given contraindication. Physicians made fewer errors with "Mister VCM" than with text (factor of 1.7; <it>p </it>= 0.034) and responded to questions 2.2 times faster (<it>p </it>< 0.001). The time gain with "Mister VCM" was greater for long monographs and questions with implicit replies.</p> <p>Conclusion</p> <p>"Mister VCM" seems to be a promising interface for accessing drug monographs. Similar interfaces could be developed for other medical domains, such as electronic patient records.</p

A top-down systems biology view of microbiome-mammalian metabolic interactions in a mouse model

Symbiotic gut microorganisms (microbiome) interact closely with the mammalian host's metabolism and are important determinants of human health. Here, we decipher the complex metabolic effects of microbial manipulation, by comparing germfree mice colonized by a human baby flora (HBF) or a normal flora to conventional mice. We perform parallel microbiological profiling, metabolic profiling by 1H nuclear magnetic resonance of liver, plasma, urine and ileal flushes, and targeted profiling of bile acids by ultra performance liquid chromatography–mass spectrometry and short-chain fatty acids in cecum by GC-FID. Top-down multivariate analysis of metabolic profiles reveals a significant association of specific metabotypes with the resident microbiome. We derive a transgenomic graph model showing that HBF flora has a remarkably simple microbiome/metabolome correlation network, impacting directly on the host's ability to metabolize lipids: HBF mice present higher ileal concentrations of tauro-conjugated bile acids, reduced plasma levels of lipoproteins but higher hepatic triglyceride content associated with depletion of glutathione. These data indicate that the microbiome modulates absorption, storage and the energy harvest from the diet at the systems level

Enterocolitis necrotizante en recién nacidos ingresados en el Servicio de Neonatología del Hospital Escuela "Carlos Roberto Huembes" en el período comprendido de Enero 2011 a Diciembre 2013

La enterocolitis necrotizante en el recién nacido presenta un amplio espectro de manifestaciones clínicas, caracterizándose principalmente por la tríada de distensión abdominal, sangramiento gastrointestinal y neumatosis intestinal. A pesar del avance en el cuidado intensivo neonatal, persiste como una enfermedad grave, que afecta habitualmente al recién nacido pretérmino, especialmente de muy bajo peso

Interactions of bile salts with a dietary fibre, methylcellulose, and impact on lipolysis

Methylcellulose (MC) has a demonstrated capacity to reduce fat absorption, hypothetically through bile salt (BS) activity inhibition. We investigated MC cholesterol-lowering mechanism, and compared the influence of two BS, sodium taurocholate (NaTC) and sodium taurodeoxycholate (NaTDC), which differ slightly by their architecture and exhibit contrasting functions during lipolysis. BS/MC bulk interactions were investigated by rheology, and BS behaviour at the MC/water interface studied with surface pressure and ellipsometry measurements. In vitro lipolysis studies were performed to evaluate the effect of BS on MC-stabilised emulsion droplets microstructure, with confocal microscopy, and free fatty acids release, with the pH-stat method. Our results demonstrate that BS structure dictates their interactions with MC, which, in turn, impact lipolysis. Compared to NaTC, NaTDC alters MC viscoelasticity more significantly, which may correlate with its weaker ability to promote lipolysis, and desorbs from the interface at lower concentrations, which may explain its higher propensity to destabilise emulsions

A Mini-Open, Dorsal Approach for Scaphoid Fracture Fixation With a Ligament Sparing Arthrotomy

There are several surgical approaches that are currently used to address nondisplaced scaphoid waist fractures, including percutaneous fixation, limited exposure fixation, and traditional open techniques through a volar or dorsal approach. Although percutaneous fixation has some theoretical advantages, it is much more difficult to achieve an accurate starting point for a headless compression screw. The purpose of this paper is to describe a simple, dorsal, mini-open approach to the scaphoid that minimizes incision size, extensor tendon dissection, capsular trauma, and vascular disruption, while still allowing for direct visualization of the proximal pole and optimal exposure for accurate screw placement. As a case report, we retrospectively evaluated 80 consecutive patients with closed scaphoid fractures. There were 2 groups, with 44 patients (age: 24±10 y) receiving a percutaneous dorsal approach and 36 patients (age: 30±16 y) treated with a mini-open approach. All scaphoid fractures were acute or fibrous nonunions (<6 mo from injury, except for one) treated with cannulated headless compression screws. Intraoperative and postoperative complications were measured and evaluated for each group to assess for differences between the percutaneous approach and the mini-open technique. We found no significant difference in complication rate with the mini-open dorsal technique compared with the dorsal percutaneous approach (8.3% vs. 4.5%, respectively). Therefore, we suggest consideration of this mini-open dorsal approach for scaphoid fracture fixation as a useful and safe technique