Diffusion of Computer Applications Among Physicians: A Quasi-Experimental Study

An experimental program involving the use of a hospital information system was implemented and evaluated on four services at Methodist Hospital of Indiana, a 1120-bed, private teaching hospital. Ten other hospital services were assigned to a control group. The program utilized educationally influential physicians to disseminate information concerning the advantages of using predesigned computer-stored personal order sets for the entry of medical orders into a hospital information system. Data from the hospital information system\u27s tapes were collected at three times in order to evaluate the effectiveness of the intervention. A multivariate analysis of variance indicated that the program resulted in a significant increase in personal order set use by physicians, physician assistants, and unit secretaries on the experimental services. The results of the study suggest that the identification and use of educationally influential physicians is an effective means of introducing medical innovations into clinical settings

Influencing Test Ordering In Primary Care Using Influential Physicians

The purpose of this study was to evaluate the use of influential physicians to influencetest ordering in a primary care setting. Structured order forms for three commonly orderedtests were developed in conjunction with the chief residents in internal medicineand family practice at Methodist Hospital of Indiana, a 1120 bed private teachinghospital. After data were collected for a nine month baseline period, the forms wereintroduced by the chief residents to the house staff in the Adult Ambulatory Care Centerand the Family Practice Center. After two months, the study was discontinued. Thedata were analyzed using a multivariate analysis of variance with repeated measuresand paired t-tests. Test ordering rates for complete blood counts were significantlyreduced in both centers. Urinalysis rates were significantly reduced in the FamilyPractice Center. There was no significant effect of the intervention on ordering ratesfor the chemistry-23 test. The findings suggest that the use of influential physicians isan effective way to change physician behavior in primary care settings

Grip Force Control Using Prosthetic and Anatomical Limbs

Introduction Skillful object manipulation in various activities of daily living requires accurate and economical modulation of grip force, yet experimental studies investigating grip force using a prosthesis are lacking. The purpose of this study was to compare grip force output between two types of upper-limb prosthetic prehensors. We hypothesized a relationship between grip force output and the muscular tension needed to control the prehensor. Materials and Methods Ten able-bodied participants attempted to produce a static target grip force using a voluntary opening and voluntary closing prosthetic simulator and their anatomical hand. The target forces were 0.49 N, 4 N, and 10.5 N. Each target force was produced three times, with and without augmented visual feedback. Performance was evaluated for error and variability. Results Using the voluntary closing device resulted in more accuracy and less variability for two of the three grip forces and followed the same trends as the anatomical hand, both of which performed inversely to the voluntary opening device. Conclusions Compared with the voluntary opening prosthesis, there may exist a more intuitive compatibility between the muscle tension used to control cable tension of a voluntary closing prosthesis and the resulting grip force of the prehensor that may benefit performance on some tasks

Monomers, dimers, and trimers of [Au(CN)2]− in a Ba(diaza-18-crown-6)2+ coordination polymer

The structure of the title compound, poly[triaquatetra-μ-cyanido-tetracyanidobis­(1,4,10,13-tetra­oxa-7,16-diaza­cyclo­octa­deca­ne)di­barium(II)tetra­gold(I)], [Au4Ba2(CN)8(C12H26N2O4)2(H2O)3]n, displays O—H⋯N hydrogen bonding between water molecules and cyano ligands and an unusual pattern of aurophilic inter­actions that yields a monomer, dimer, and trimer of [Au(CN)2]− within the same crystal structure. In two of the five Au positions, the atom resides on a center of inversion. The overall arrangement is that of a coordination polymer assisted by aurophilic and hydrogen-bonded inter­actions

Plant Defensins NaD1 and NaD2 Induce Different Stress Response Pathways in Fungi

Nicotiana alata defensins 1 and 2 (NaD1 and NaD2) are plant defensins from the ornamental tobacco that have antifungal activity against a variety of fungal pathogens. Some plant defensins interact with fungal cell wall O-glycosylated proteins. Therefore, we investigated if this was the case for NaD1 and NaD2, by assessing the sensitivity of the three Aspergillus nidulans (An) O-mannosyltransferase (pmt) knockout (KO) mutants (AnDpmtA, AnDpmtB, and AnDpmtC). AnDpmtA was resistant to both defensins, while AnDpmtC was resistant to NaD2 only, suggesting NaD1 and NaD2 are unlikely to have a general interaction with O-linked side chains. Further evidence of this difference in the antifungal mechanism was provided by the dissimilarity of the NaD1 and NaD2 sensitivities of the Fusarium oxysporum f. sp. lycopersici (Fol) signalling knockout mutants from the cell wall integrity (CWI) and high osmolarity glycerol (HOG) mitogen-activated protein kinase (MAPK) pathways. HOG pathway mutants were sensitive to both NaD1 and NaD2, while CWI pathway mutants only displayed sensitivity to NaD

Anonymized Video Analysis Methods and Systems

Methods and systems for anonymized video analysis are described. In one embodiment, a first silhouette image of a person in a living unit may be accessed. The first silhouette image may be based on a first video signal recorded by a first video camera. A second silhouette image of the person in the living unit may be accessed. The second silhouette image may be of a different view of the person than the first silhouette image. The second silhouette image may be based on a second video signal recorded by a second video camera. A three-dimensional model of the person in voxel space may be generated based on the first silhouette image, the second silhouette image, and viewing conditions of the first video camera and the second video camera. In some embodiments, information on falls, gait parameters, and other movements of the person living unit are determined. Additional methods and systems are disclosed

The effect of socio-demographic factors on mental health and addiction high-cost use : a retrospective, population-based study in Saskatchewan

Objective: A small proportion of the population accounts for the majority of healthcare costs. Mental health and addiction (MHA) patients are consistently high-cost. We aimed to delineate factors amenable to public health action that may reduce high-cost use among a cohort of MHA clients in Saskatoon, Saskatchewan. Methods: We conducted a population-based retrospective cohort study. Administrative health data from fiscal years (FY) 2009–2015, linked at the individual level, were analyzed (n = 129,932). The outcome of interest was ≥ 90th percentile of costs for each year under study (‘persistent high-cost use’). Descriptive analyses were followed by logistic regression modelling; the latter excluded long-term care residents. Results: The average healthcare cost among study cohort members in FY 2009 was ~ $2300; for high-cost users it was ~$19,000. Individuals with unstable housing and hospitalization(s) had increased risk of persistent high-cost use; both of these effects were more pronounced as comorbidities increased. Patients with schizophrenia, particularly those under 50 years old, had increased probability of persistent high-cost use. The probability of persistent high-cost use decreased with good connection to a primary care provider; this effect was more pronounced as the number of mental health conditions increased. Conclusion: Despite constituting only 5% of the study cohort, persistent high-cost MHA clients (n = 6455) accounted for ~ 35% of total costs. Efforts to reduce high-cost use should focus on reduction of multimorbidity, connection to a primary care provider (particularly for those with more than one MHA), young patients with schizophrenia, and adequately addressing housing stability

The health of women and girls determines the health and well-being of our modern world: A White Paper From the International Council on Women's Health Issues

The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally

Extracellular Vesicles from Fusarium graminearum Contain Protein Effectors Expressed during Infection of Corn.

Fusarium graminearum (Fgr) is a devastating filamentous fungal pathogen that causes diseases in cereals, while producing mycotoxins that are toxic for humans and animals, and render grains unusable. Low efficiency in managing Fgr poses a constant need for identifying novel control mechanisms. Evidence that fungal extracellular vesicles (EVs) from pathogenic yeast have a role in human disease led us to question whether this is also true for fungal plant pathogens. We separated EVs from Fgr and performed a proteomic analysis to determine if EVs carry proteins with potential roles in pathogenesis. We revealed that protein effectors, which are crucial for fungal virulence, were detected in EV preparations and some of them did not contain predicted secretion signals. Furthermore, a transcriptomic analysis of corn (Zea mays) plants infected by Fgr revealed that the genes of some of the effectors were highly expressed in vivo, suggesting that the Fgr EVs are a mechanism for the unconventional secretion of effectors and virulence factors. Our results expand the knowledge on fungal EVs in plant pathogenesis and cross-kingdom communication, and may contribute to the discovery of new antifungals

Nicotiana alata defensin chimeras reveal differences in the mechanism of fungal and tumor cell killing and an enhanced antifungal variant

The plant defensin NaD1 is a potent antifungal molecule that also targets tumor cells with a high efficiency. We examined the features of NaD1 that contribute to these two activities by producing a series of chimeras with NaD2, a defensin that has relatively poor activity against fungi and no activity against tumor cells. All plant defensins have a common tertiary structure known as a cysteine-stabilized alpha-beta motif which consists of an alpha helix and a triple-stranded beta-sheet stabilized by four disulfide bonds. The chimeras were produced by replacing loops 1 to 7, the sequences between each of the conserved cysteine residues on NaD1, with the corresponding loops from NaD2. The loop 5 swap replaced the sequence motif (SKILRR) that mediates tight binding with phosphatidylinositol 4,5-bisphosphate [PI(4,5)P-2] and is essential for the potent cytotoxic effect of NaD1 on tumor cells. Consistent with previous reports, there was a strong correlation between PI(4,5)P-2 binding and the tumor cell killing activity of all of the chimeras. However, this correlation did not extend to antifungal activity. Some of the loop swap chimeras were efficient antifungal molecules, even though they bound poorly to PI(4,5)P-2, suggesting that additional mechanisms operate against fungal cells. Unexpectedly, the loop 1B swap chimera was 10 times more active than NaD1 against filamentous fungi. This led to the conclusion that defensin loops have evolved as modular components that combine to make antifungal molecules with variable mechanisms of action and that artificial combinations of loops can increase antifungal activity compared to that of the natural variants