The Added Value of Log File Analyses of the Use of a Personal Health Record for Patients With Type 2 Diabetes Mellitus: Preliminary Results

The electronic personal health record (PHR) is a promising technology for improving the quality of chronic disease management. Until now, evaluations of such systems have provided only little insight into why a particular outcome occurred. The aim of this study is to gain insight into the navigation process (what functionalities are used, and in what sequence) of e-Vita, a PHR for patients with type 2 diabetes mellitus (T2DM), to increase the efficiency of the system and improve the long-term adherence. Log data of the first visits in the first 6 weeks after the release of a renewed version of e-Vita were analyzed to identify the usage patterns that emerge when users explore a new application. After receiving the invitation, 28% of all registered users visited e-Vita. In total, 70 unique usage patterns could be identified. When users visited the education service first, 93% of all users ended their session. Most users visited either 1 or 5 or more services during their first session, but the distribution of the routes was diffuse. In conclusion, log file analyses can provide valuable prompts for improving the system design of a PHR. In this way, the match between the system and its users and the long-term adherence has the potential to increase.     

Getting ready for user involvement in a systematic review

Objective  This paper aims to support the critical development of user involvement in systematic reviews by explaining some of the theoretical, ethical and practical issues entailed in 'getting ready' for user involvement.
Background  Relatively few health or social care systematic reviews have actively involved service users. Evidence from other research contexts shows that user involvement can have benefits in terms of improved quality and outcomes, hence there is a need to test out different approaches in order to realize the benefits of user involvement and gain a greater understanding of any negative outcomes.
Design  Setting up a service-user reference group for a review of user involvement in nursing, midwifery and health visiting research involved conceptualizing user involvement, developing a representation framework, identifying and targeting service users and creating a sense of mutuality and reciprocity.
Setting and participants  Recruitment was undertaken across England by two researchers. Members from 24 national consumer organizations were selected to participate in the review.
Main variables studied  Learning was gained about finding ways of navigating consumer networks and organizations, how best to communicate our goals and intentions and how to manage selection and 'rejection' in circumstances where we had stimulated enthusiasm.
Results and conclusions  Involving service users helped us to access information, locate the findings in issues that are important to service users and to disseminate findings. User involvement is about relationships in social contexts: decisions made at the early conceptual level of research design affect service users and researchers in complex and personal ways.     

Bowel migration in the normal fetus: US detection

Ten fetuses underwent ultrasound scanning at 7-10 weeks gestational (postmenstrual) age. In all cases, an echogenic mass measuring 0.5-1.0 cm was demonstrated within the base of the umbilical cord at its insertion into the fetal abdomen. No area with echogenicity characteristic of the small bowel was identified within the lower part of the fetal abdomen. All fetuses were reexamined 4-12 weeks later, at which time the mass in the umbilical cord was no longer seen, and normal fetal bowel was visualized in the lower abdominal cavity of the fetus. This sequence of findings appears to represent the sonographic demonstration of normal fetal bowel migration early in gestation and should not be confused with defects of the abdominal wall such as omphalocele or gastroschisis.     

新吩嗪化合物K3-Ye的分离和结构鉴定

自一株基因工程链霉菌K₃的发酵液中分离得到一吩嗪类新化合物,经光谱数据(UL,IR,¹HNMR,¹³CNMR,DEPT)分析,确定其结构为1-吩嗪氧基乙酸甲酯,代号K₃-Ye。经初步测定它有较强的抗核苷转运活性。     

Pancreatic insufficiency: role of CT evaluation

The medical records of all patients discharged over a 3-year period with a diagnosis of pancreatic insufficiency were reviewed. In some patients, abdominal radiographs or sonograms provided adequate information. However, computed tomography (CT) was a key diagnostic tool in understanding the cause of pancreatic insufficiency in 11 of the 13 patients in whom it was performed. CT study detected previously undiagnosed carcinoma in one patient, enabled diagnosis of chronic pancreatitis in five, confirmed complete surgical removal of the pancreas in two, and--despite optimal use of contrast material and 5-mm contiguous sections--was unable to detect any pancreatic tissue in three patients, suggesting complete idiopathic atrophy. Pancreatic insufficiency is a difficult clinical diagnostic problem. CT scanning should be employed early if abdominal radiographs or sonograms do not detect an abnormality.     

Chronically obstructed sinonasal secretions: observations on T1 and T2 shortening

Clinically assessed chronic proteinacious sinonasal secretions usually have long T1 and T2 relaxation times reflecting their high water content. However, in some cases variable combinations of short and long T1 and T2 relaxation times are found. To study the causes of these findings, the magnetic resonance (MR) images of 41 patients with surgically proved, chronically obstructed sinonasal secretions were studied. The relative signal intensities on both T1- and T2-weighted sequences of the sinus specimens were correlated with the gross viscosity of the specimens at surgery. Ten specimens were collected that were not contaminated with either blood or saline. UV spectrophotometric analysis of four of these samples excluded the presence of methemoglobin. Total protein content was determined in five samples, and in vitro T1 and T2 values were measured in one sample. These T1 and T2 relaxation times were accurately predicted with use of a standard pure lysozyme protein solution with the same concentration as the specimen. In addition, the observed T1- and T2-weighted signal intensities on the 41 MR images were predicted from an analysis of pure protein solutions. This study concludes that the primary causes of the variable T1 and T2 relaxation times of chronic sinonasal secretions are the macromolecular protein concentration, the amount of free water, and the specimen viscosity. Furthermore, an orderly and predictable transition of these signal intensities occurs over time.     

速激肽NK-1受体拮抗剂SR-140333对抗原引起致敏大鼠气道高反应性的影响

为观察速激肽ＮＫ１受体拮抗剂ＳＲ１４０３３３对抗原攻击引起的致敏大鼠气道高反应性的影响，测定了致敏大鼠在抗原攻击前后的基础呼吸频率，对ＭＣｈ的反应性及支气管肺泡灌洗液中的白细胞数量。实验结果显示，致敏大鼠吸入ＯＡ后６ｈ基础呼吸频率增加，并显著增加乙酰甲胆碱（ＭＣｈ）的反应性、ＭＣｈ的－ｌｏｇＰＣ３０值和支气管肺泡灌洗液中的白细胞数量。ｉｐ速激肽ＮＫ１受体拮抗剂ＳＲ１４０３３３（０１ｍｇ·ｋｇ－１）或地塞米松（０５ｍｇ·ｋｇ－１），可明显抑制上述反应，小剂量ＳＲ１４０３３３（００１ｍｇ·ｋｇ－１）仅有部分抑制作用。结果提示抗原攻击可引起致敏大鼠气道高反应性和气道炎症，速激肽ＮＫ１受体拮抗剂可抑制这些反应     

Traumatic intratendinous flexor digitorum profundus rupture: A case report

Intratendinous ruptures of a flexor digitorum profundus tendon are rare in patients who do not have rheumatoid arthritis. A case of a patient with no history of autoimmune disease who suffered a traumatic rupture of the flexor digitorum profundus tendon to the ring finger in the mid-palm is reported.     

速激肽NK-1受体拮抗剂SR-140333对抗原引起致敏大鼠气道高反应性的影响

为观察速激肽NK-1受体拮抗剂SR-140333对抗原攻击引起的致敏大鼠气道高反应性的影响,测定了致敏大鼠在抗原攻击前后的基础呼吸频率,对MCh的反应性及支气管-肺泡灌洗液中的白细胞数量。实验结果显示,致敏大鼠吸入OA后6h基础呼吸频率增加,并显著增加乙酰甲胆碱(MCh)的反应性、MCh的-logPC₃₀值和支气管-肺泡灌洗液中的白细胞数量。ip速激肽NK-1受体拮抗剂SR-140333(0.1mg·kg^-1)或地塞米松(0.5mg·kg^-1),可明显抑制上述反应,小剂量SR-140333(0.01mg·kg^-1)仅有部分抑制作用。结果提示抗原攻击可引起致敏大鼠气道高反应性和气道炎症,速激肽NK-1受体拮抗剂可抑制这些反应。