Unravelling the Influence of Online Social Context on Consumer Health Information Technology (CHIT) Implementations

While health information technology research has examined a variety of topics (e.g., adoption and assimilation of technology within healthcare organizations, critical success factors), it has remained unclear how the uniqueness of the online context (e.g., users connecting with strangers for social and emotional support) influences consumer health information technology (CHIT) implementations. Towards this goal, this dissertation examines the influence of online social context on CHIT implementations and outcomes. Using theories from social psychology, this dissertation encompasses two empirical research essays. The first essay draws on the environmental enrichment concept to examine the influential role of the online social context of a gamified CHIT on its success. By surveying existing fitness technology users, we demonstrate the influence of the social context enabled by CHITs on behavioral adherence to exercise. The second essay draws on construal level theory to examine the influence of textual information (such as race, geographic location) in online patient communities on a user’s trust of the community and the system as well as their intentions to participate in them. Using randomized experiments, we identify some of the propinquity-related factors that influence a user’s trust in online patient communities. The key contribution of this dissertation is the advancement of our understanding of the important role played by the social context enabled by the CHITs

Group Decision Making in OSS: A Dialectic Perspective on Herding

Herding behavior in group (collaborative) decision making has been studied purely as imitation of others and discounting own information. However, collaboration is a dynamic process and decision making should be viewed with this dynamic in mind. Drawing on the The Laws of Imitation from sociology, we offer a new perspective to understand herding behavior in group decision making. By acknowledging the tension between imitation (respectively counter-imitation) and invention, we conceptualize herd behavior as a dialectic process. This research-in-progress aims at offering a theoretical framework for explaining the dialectic relation between imitation (respectively counter-imitation) and invention. We describe the dialectic process of problem-solving using cases from GitHub. Our research contributes to existing literature by acknowledging that before convergence towards a solution i.e. herding as an outcome, there is a dialectic process. We are offering a research model for dialectic problem-solving within OSS context

Cangrelor - rising from the ashes: a phoenix story

Cangrelor is a novel intravenous antiplatelet agent that has been approved for usage in the setting of percutaneous coronary revascularization in patients with acute coronary syndrome. The drug was evaluated in three major trials namely Champion-Platform, Champion-PCI and Champion Phoenix with a total of 25,107 patients. Although there was a reduction in the incidence of ischemia driven revascularization, Q wave MI and stent thromboses in the first 48 hours among cangrelor users as compared to clopidogrel, there was no difference in the incidence of all-cause mortality or myocardial infarction. In terms of safety, cangrelor does not appear to have a higher bleeding risk. A distinct appeal with cangrelor is its unique pharmacokinetic property of having a rapid onset and offset of action. The drug would also have a niche role among patients with challenges to oral drug administration as in mechanically ventilated patients and those with severe vomiting. Although the drug managed to rise against odds in getting regulatory approval from the FDA, it remains to be seen if this could become a frontline agent among the current array of anti-platelet molecules

Prevalence of anemia among health science students of a university in South India

Background: Anemia due to iron deficiency continues to be the major public health problem in developing as well as developed countries affecting quality of life and work capacity of large population throughout the world. It is being observed that prevalence of anemia is more in students of both the genders due to several factors like improper nutrition intake, socio-economic background etc. The objective of our study was to determine the prevalence of anemia among health science students of a private university in South India.Methods: A total of 568 university students between 18-45 years participated in the study. Patients who underwent major surgery less than three months before and who had donated blood within the last three months were excluded. Baseline characteristics of all the patients were recorded. 1.5 ml of blood was collected from all the study patients for complete haemogram test. WHO criterions were taken for determining severity of anemia with determined hemoglobin (Hb) concentration.Results: Among the study subjects, 43% (n=237) had anaemia as per the WHO criteria. There was a significant preponderance of female students with anaemia as compared to males (97 vs. 68%, p=0.0001). Anaemic subjects had a higher risk of bleeding disorders as compared to non-anaemic subjects (16 vs. 12%, p=0.0001). When assessed by WHO criteria of anemia severity, majority of the anemic subjects had mild anemia and only less than two percent had severe anemia.Conclusions: Present study showed the prevalence of anemia among university health science students to be 43%. The need of the hour is to provide health education on the ill-effects of anemia and the life-style modification particularly with respect to eating habits along with nutritional supplementation

Benefits of Blockchain Initiatives for Value-Based Care: Proposed Framework

Background The potential of blockchain technology to achieve strategic goals, such as value-based care, is increasingly being recognized by both researchers and practitioners. However, current research and practices lack comprehensive approaches for evaluating the benefits of blockchain applications. Objective The goal of this study was to develop a framework for holistically assessing the performance of blockchain initiatives in providing value-based care by extending the existing balanced scorecard (BSC) evaluation framework. Methods Based on a review of the literature on value-based health care, blockchain technology, and methods for evaluating initiatives in disruptive technologies, we propose an extended BSC method for holistically evaluating blockchain applications in the provision of value-based health care. The proposed method extends the BSC framework, which has been extensively used to measure both financial and nonfinancial performance of organizations. The usefulness of our proposed framework is further demonstrated via a case study. Results We describe the extended BSC framework, which includes five perspectives (both financial and nonfinancial) from which to assess the appropriateness and performance of blockchain initiatives in the health care domain. Conclusions The proposed framework moves us toward a holistic evaluation of both the financial and nonfinancial benefits of blockchain initiatives in the context of value-based care and its provision

Evaluation of soluble ST2 as a novel cardiovascular biomarker in patients with acute myocardial infarction

Background: Soluble ST-2 has considerable prognostic value and is used as an aid for risk stratification in identifying patients who are at high risk of cardiovascular disease. The main objective of the study was to analyze the level of soluble ST-2 biomarker in patients with acute myocardial infarction and chronic stable angina patients and secondly to evaluate the cardiovascular outcomes after 30 days.Methods: A total of 71 patients were enrolled into the study, patients were divided into two groups of which 50 patients were in test group (AMI patients) and the remaining 21 patients were in the control group (chronic stable angina). Then, 5ml of blood was collected from the patients and plasma soluble ST-2 was estimated from the sample using ELISA technique. Patients were then followed up to 30 days to ascertain the development of major adverse cardiovascular outcomes.Results: The median concentration of soluble ST-2 in test group was found to be 213.46pg/ml and in control group was found to be 124.53 pg/ml. Soluble ST-2 correlated significantly with left ventricular ejection fraction (LVEF) between the two groups (P value=0.01). Measurement of soluble ST-2 early after MI assists in the prediction of adverse cardiovascular events. In this study, soluble ST-2 was found to be higher in patients with acute myocardial infarction and also in patients with poor ejection fraction.Conclusions: Soluble ST-2 is a novel cardiovascular biomarker that is elevated in patients with acute myocardial infarction

Second Primary Malignancies after Autologous Hematopoietic Cell Transplantation for Multiple Myeloma

AbstractRecent studies demonstrate an increased risk of second primary malignancies (SPMs) in patients with multiple myeloma (MM) receiving maintenance lenalidomide after autologous stem cell transplantation (ASCT). We explored the possibility of other risk factors driving post-ASCT SPMs in patients with MM through analysis of our large transplantation database in conjunction with our Long-Term Follow-Up Program. We conducted a retrospective cohort study of 841 consecutive patients with MM who underwent ASCT at City of Hope between 1989 and 2009, as well as a nested case-control analysis evaluating the role of all therapeutic exposures before, during, and after ASCT. Median duration of follow-up for the entire cohort was 3.4 years (range, 0.3-19.9 years). Sixty cases with a total of 70 SPMs were identified. The overall cumulative incidence of SPMs was 7.4% at 5 years and 15.9% at 10 years when nonmelanoma skin cancers (NMSCs) were included and 5.3% at 5 years and 11.2% at 10 years when NMSCs were excluded. Multivariate analysis of the entire cohort revealed associations of both older age (≥55 years; relative risk, 2.3; P < .004) and race (non-Hispanic white; relative risk, 2.4; P = .01) with an increased risk of SPM. Furthermore, thalidomide exposure demonstrated a trend toward increased risk (odds ratio, 3.5; P = .15); however, an insufficient number of patients were treated with lenalidomide to allow us to accurately assess the risk of this agent. Exclusion of NMSCs retained the association with these variables but was accompanied by loss of statistical significance. This large single-institution analysis identified associations between race and older age and increased risk of developing SPM. The trend toward increased risk with thalidomide exposure suggests a class effect from immunomodulatory drugs that might not be restricted to lenalidomide

Time-Dependent Effects of CX3CR1 in a Mouse Model of Mild Traumatic Brain Injury

BACKGROUND: Neuroinflammation is an important secondary mechanism that is a key mediator of the long-term consequences of neuronal injury that occur in traumatic brain injury (TBI). Microglia are highly plastic cells with dual roles in neuronal injury and recovery. Recent studies suggest that the chemokine fractalkine (CX3CL1, FKN) mediates neural/microglial interactions via its sole receptor CX3CR1. CX3CL1/CX3CR1 signaling modulates microglia activation, and depending upon the type and time of injury, either protects or exacerbates neurological diseases. METHODS: In this study, mice deficient in CX3CR1 were subjected to mild controlled cortical impact injury (CCI), a model of TBI. We evaluated the effects of genetic deletion of CX3CR1 on histopathology, cell death/survival, microglia activation, and cognitive function for 30 days post-injury. RESULTS: During the acute post-injury period (24 h-15 days), motor deficits, cell death, and neuronal cell loss were more profound in injured wild-type than in CX3CR1-/- mice. In contrast, during the chronic period of 30 days post-TBI, injured CX3CR1-/- mice exhibited greater cognitive dysfunction and increased neuronal death than wild-type mice. The protective and deleterious effects of CX3CR1 were associated with changes in microglia phenotypes; during the acute phase CX3CR1-/- mice showed a predominant anti-inflammatory M2 microglial response, with increased expression of Ym1, CD206, and TGFβ. In contrast, increased M1 phenotypic microglia markers, Marco, and CD68 were predominant at 30 days post-TBI. CONCLUSION: Collectively, these novel data demonstrate a time-dependent role for CX3CL1/CX3CR1 signaling after TBI and suggest that the acute and chronic responses to mild TBI are modulated in part by distinct microglia phenotypes

Comparative genomics of ST5 and ST30 methicillin-resistant Staphylococcus aureus sequential isolates recovered from paediatric patients with cystic fibrosis

Staphylococcus aureus chronic airway infection in patients with cystic fibrosis (CF) allows this pathogen to adapt over time in response to different selection pressures. We have previously shown that the main sequence types related to community-acquired methicillin-resistant S. aureus (MRSA) infections in Argentina - ST5 and ST30 - are also frequently isolated from the sputum of patients with CF, but in these patients they usually display multi-drug antimicrobial resistance. In this study, we sequenced the genomes of MRSA from four paediatric CF patients with the goal of identifying mutations among sequential isolates, especially those possibly related to antimicrobial resistance and virulence, which might contribute to the adaptation of the pathogen in the airways of patients with CF. Our results revealed genetic differences in sequential MRSA strains isolated from patients with CF in both their core and accessory genomes. Although the genetic adaptation of S. aureus was distinct in different hosts, we detected independent mutations in thyA, htrA, rpsJ and gyrA - which are known to have crucial roles in S. aureus virulence and antimicrobial resistance - in isolates recovered from multiple patients. Moreover, we identified allelic variants that were detected in all of the isolates recovered after a certain time point; these non-synonymous mutations were in genes associated with antimicrobial resistance, virulence, iron scavenging and oxidative stress resistance. In conclusion, our results provide evidence of genetic variability among sequential MRSA isolates that could be implicated in the adaptation of these strains during chronic CF airway infection.Fil: Haim, Maria Sol. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Zaheer, Rahat. No especifíca;Fil: Bharat, Amrita. No especifíca;Fil: Di Gregorio, Sabrina Noelia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Di Conza, José Alejandro. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Galanternik, Laura Irene. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Departamento de Medicina; ArgentinaFil: Lubovich, Silvina Laura. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Departamento de Medicina; ArgentinaFil: Golding, George R.. No especifíca;Fil: Graham, Morag R.. No especifíca;Fil: Van Domselaar, Gary. No especifíca;Fil: Cardona, Silvia T.. University of Manitoba; CanadáFil: Mollerach, Marta Eugenia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquimica. Instituto de Investigaciones En Bacteriologia y Virologia Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentin