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Laurie Lovett Novak Jonathan Wanderer David A. Owens Daniel Fabbri Julian Z. Genkins Thomas A. Lasko 《Applied clinical informatics》2021,12(1):164
Background The data visualization literature asserts that the details of the optimal data display must be tailored to the specific task, the background of the user, and the characteristics of the data. The general organizing principle of a concept-oriented display is known to be useful for many tasks and data types. Objectives In this project, we used general principles of data visualization and a co-design process to produce a clinical display tailored to a specific cognitive task, chosen from the anesthesia domain, but with clear generalizability to other clinical tasks. To support the work of the anesthesia-in-charge (AIC) our task was, for a given day, to depict the acuity level and complexity of each patient in the collection of those that will be operated on the following day. The AIC uses this information to optimally allocate anesthesia staff and providers across operating rooms. Methods We used a co-design process to collaborate with participants who work in the AIC role. We conducted two in-depth interviews with AICs and engaged them in subsequent input on iterative design solutions. Results Through a co-design process, we found (1) the need to carefully match the level of detail in the display to the level required by the clinical task, (2) the impedance caused by irrelevant information on the screen such as icons relevant only to other tasks, and (3) the desire for a specific but optional trajectory of increasingly detailed textual summaries. Conclusion This study reports a real-world clinical informatics development project that engaged users as co-designers. Our process led to the user-preferred design of a single binary flag to identify the subset of patients needing further investigation, and then a trajectory of increasingly detailed, text-based abstractions for each patient that can be displayed when more information is needed. 相似文献
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Salvatore Greco Beatrice Bonsi Nicol Fabbri 《World Journal of Experimental Medicine》2022,12(5):104-107
Even if the relationships between nutrition and inflammatory bowel disease (IBD) remain underexplored, the current literature is providing, day by day, much more evidence on the effects of various diets in both prevention and treatment of such illnesses. Wrong dietary habits, together with other environmental factors such as pollution, breastfeeding, smoke, and/or antibiotics, are among the theoretical pathogenetic causes of IBD, whose multifactorial aetiology has been already confirmed. While some of these risk factors are potentially reversible, some others cannot be avoided, and efficient treatments become necessary to prevent IBD spread or recurrence. Furthermore, the drugs currently available for treatment of such disease provide low-to-no effect against the symptoms, making the illnesses still strongly disabling. Whether nutrition and specific diets will prove to effectively interrupt the course of IBD has still to be clarified and, in this sense, further research concerning the applications of such dietary interventions is still needed. 相似文献
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Core-Shell Arginine-Containing Chitosan Microparticles for Enhanced Transcorneal Permeation of Drugs
Nicolò Mauro Giulia Di Prima Paola Varvarà Mariano Licciardi Gennara Cavallaro Gaetano Giammona 《Journal of pharmaceutical sciences》2019,108(2):960-969
Chitosan oligosaccharide (C) was functionalized with l-arginine (A) and short hydrocarbon chains (C8) to design an amphiphilic copolymer, henceforth CAC8, leading to microparticles (MPs) consisting of an arginine-decorated hydrophilic shell and inner hydrophobic domains allowing the encapsulation of high amount hydrophobic drugs such as sorafenib tosylate (>10% w/w). l-arginine side chains were selected in order to impart the final MPs enhanced transcorneal penetration properties, thus overcoming the typical biological barriers which hamper the absorption of drugs upon topical ocular administration. The mucoadhesive properties and drug release profile of the CAC8 MPs (CAC8-MPs) were studied, showing that CAC8-MPs can strongly interact with mucin, and thus gradually release their payload in situ to potentially improve the bioavailability of the drug after topical administration. In vitro transcorneal studies also showed that CAC8-MPs are endowed with effective permeation enhancer ability combined with negligible toxicity. 相似文献
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Carmen Freire Esperanza Amaya Fernando Gil Mario Murcia Sabrina LLop Maribel Casas Martine Vrijheid Aitana Lertxundi Amaia Irizar Guillermo Fernández-Tardón Rafael Vicente Castro-Delgado Nicolás Olea Mariana F. Fernández 《International journal of hygiene and environmental health》2019,222(3):468-478
Objective
To examine the association of placental levels of arsenic (As), cadmium (Cd), mercury (Hg), lead (Pb), manganese (Mn), and chromium (Cr) with birth outcomes (birth weight, length, and head circumference, low birth weight [LBW], gestational age, preterm delivery, and small for gestational age [SGA]) in mother-child pairs from the Environment and Childhood (INMA) Project in Spain.Methods
Metal concentrations were measured in placenta tissue samples randomly selected from five INMA cohorts. Data on birth outcomes were obtained from medical records. Associations were assessed in a sub-sample of 327 mother-infant pairs by regression models adjusted for confounding factors and for all metals simultaneously. Effect modification by sex was also evaluated.Results
Elevated placental Cd levels (>5.79 vs. <3.30?ng/g) were associated with reduced birth weight (?111.8?g, 95%CI?=??215.6; ?8.06, p-trend?=?0.01) and length (?0.62?cm, 95%CI?=??1.20; ?0.04, p-trend?=?0.02), while a 10% increase in Cd was associated with 1.21-fold increased odds (95%CI?=?1.01; 1.43) of LBW in the global sample but with 14% lower odds (95%CI?=?0.78; 0.96) of preterm delivery in males (Pinteraction?=?0.10). Detected (vs. undetected) Hg was associated with reduced head circumference (?0.49?cm, 95%CI?=??1.00; 0.03) in females (Pinteraction?=?0.03). A 10% increase in placental Mn was associated with slight increases in gestational age (0.04 weeks, 95%CI?=?0.01; 0.07) in the global sample and in head circumference (0.05?cm, 95%CI?=??0.01; 0.10) in females (Pinteraction?=?0.03). Elevated Cr levels (>99.6 vs. <56.1?ng/g) were associated with reduced birth length (?0.68?cm, 95%CI?=??1.33; ?0.04, p-trend?=?0.02) and slightly increased gestational age (0.35 weeks, 95%CI?=??0.07; 0.77, p-trend?=?0.08) in the global sample. As and Pb were detected in few placentas (27% and 13%, respectively) and were not associated with any studied birth outcome.Conclusions
Data suggest that in utero exposure to Cd, Hg, and Cr could adversely affect fetal growth, whereas Mn and Cr appear to have a positive effect on gestational age. Given the relatively small number of subjects, sex-specific associations should be interpreted with caution. 相似文献7.
Nicolás Menéndez Granados Manuel Vaquero Abellán Manuel Toledano Estepa Manuel Modesto Pérez Díaz Rosa Redondo Pedraza 《Gaceta sanitaria / S.E.S.P.A.S》2019,33(1):38-44
Objective
To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain).Methods
An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural).Results
The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics.Conclusions
A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. 相似文献8.
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Nicolás García MD Julio Rosales MD Cristóbal Greene MD Guillermo Droppelmann MSc PhD Marco A. Verdugo MD 《Journal of ultrasound in medicine》2020,39(1):165-168
The aim of this study was to describe a perineural ultrasound-guided infiltration technique for management of radial tunnel syndrome and to report its preliminary results in 54 patients. A mixture of a saline solution, a local anesthetic, and a corticosteroid solution was infiltrated in the perineural region at the arcade of Frohse. Pain was reported in 100% of patients before the procedure versus 1.9% after the procedure. Scratch collapse and Cozen test results were positive in 98.1% and 66.7% of patients before infiltration, respectively, versus 5.6% and 9.2% after infiltration. All variables had statistically significant differences between preprocedure and postprocedure evaluations (P < .01). 相似文献