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LncRNA SNHG8 sponges miR-449c-5p as well as manages the SIRT1/FoxO1 pathway to have an effect on microglia account activation and blood-brain buffer leaks in the structure within ischemic cerebrovascular event.
ental offloading in surgical shoes. These devices could provide an alternative way for physicians to offload plantar wounds and expedite closure for patients that cannot tolerate a TCC or other restrictive devices.Maggot debridement therapy is the real-time placement of maggots into a wound by health professionals for the treatment of diabetic ulcers or hard-to-heal wounds infected with antibiotic-resistant bacteria. Maggot debridement therapy shortens healing and disinfects wounds. This paper is a literature review of maggot debridement therapy in the clinical setting today and addresses the costs and benefits of this therapy. It includes recommendations to engage healthcare providers and increase awareness of this therapeutic treatment. A case study is presented on the use of maggot therapy for full debridement of a necrotic wound and clearing of a meticillin-resistant Staphylococcus aureus infection. There is also discussion on how to engage healthcare workers and reduce anxieties about the use of maggots as a treatment for hard-to-heal wounds. Education and awareness are the key factors in changing healthcare workers attitudes to maggot debridement therapy.The objective of this article is to explain the biophysical principles underlying the design of the subepidermal moisture (SEM) scanner, commercially known as the 'SEM scanner'. We also describe the mode of operation of the SEM scanner in monitoring tissue health and detecting subtle abnormal changes in tissue physiology in patients and anatomical sites at a risk of a pressure ulcer (PU also known as a pressure injury). The technology of the SEM scanner was approved last year for sales in the US by the Food and Drug Administration (FDA). The SEM scanner detects changes in fluid contents of human skin and subdermal tissues, to a tissue depth of several millimetres, by measuring 'capacitance', an electrical property of the locally examined tissue site to store electric charge. The capacitance of tissues, called 'biocapacitance', is strongly affected by the amount of fluid (water) in the tissue. When the first cells die in a forming PU, inflammatory signalling causes the permeability of blood vessel walls to increase and oedema to develop. Simply, the scanner detects the early appearance of oedema, which is called 'micro-oedema.' Calculation of a 'SEM-delta' value, which compares biocapacitance measurements, acquired across several tissue sites, some of which are healthy and others where the PU may evolve, eliminates potential effects of systemic changes in tissue fluid contents and provides a consistent quantitative measure of the tissue health conditions at the monitored anatomical site. Here, we describe SEM scanner technology, how it operates and has been laboratory tested (in computer simulations, in silico) before commercial launch. We explain why targeting the physical biomarker of oedema leads to the documented success of the SEM scanner in the multiple published clinical trials, proving its ability to early detect PUs that form under intact skin.CT myelography is an important imaging modality that combines the advantages of myelography and the high resolution of CT. It provides a detailed delineation of pathologic spine conditions, especially those involving the thecal sac and its contents. However, the role of CT myelography has dramatically and appropriately decreased with the advent of MRI, which provides a noninvasive method to demonstrate pathologic spine conditions with high signal intensity in soft tissues. At the present time, CT myelography is often performed in patients who require evaluation of the thecal sac but have a contraindication to undergoing MRI. However, there remain many situations in which CT myelography is indicated and plays a critical role in patient treatment. The authors review common and uncommon indications for CT myelography and demonstrate various pathologic conditions in which CT myelography plays a vital role in patient treatment in this modern era of MRI.©RSNA, 2020.Diagnostic and interventional radiology residency programs must educate trainees on quality and patient safety topics to meet board requirements and prepare residents to become effective physician leaders. A quality curriculum should encompass process improvement methodology as well as instruction about crucial patient safety subjects. The authors have developed a standardized and structured approach to fulfill this need using didactic and experiential learning. The educational format includes short lectures, peer-to-peer instruction, and self-study, with the value of presented information reinforced by physician leaders and process improvement specialists. Equally important is a structured experience in departmental quality improvement wherein trainees learn the collaborative nature of effective durable process change in areas of interest to them. This curriculum is implemented during the 3rd year of radiology residency to leverage residents' knowledge and experience with radiology workflows and proximity to the American Board of Radiology Core Exam. Feedback from educators and trainees as well as objective examination data support this approach. This article shares guidance and lessons learned from the authors' radiology residency educational efforts and offers a framework for successful implementation of a comprehensive quality curriculum at any residency training program. This curriculum serves the dual purpose of developing skilled future physician leaders and promoting value for patients. ©RSNA, 2020.Background Technological advances have given rise to virtual health care services, resulting in a shift in how traditional health care services are being delivered. Consumers are increasingly demanding efficient access to health care information and services irrespective of time and distance, which is further driving the digitization of health care. This digital economy has created new opportunities for innovative new business models to meet the needs of these new markets. This study explores several in-use business models of virtual health care service platforms that incorporate mobile teledermoscopy (MTD) technologies. By comparing the different building blocks of these commercial ventures, we provide insights on business model choices and discuss the elements that contribute to economically sustainable and viable service offerings incorporating MTD applications. Materials and Methods We searched the literature on teledermatology, complemented by searches using Google and other mobile app store platforms, and identified seven commercial ventures using teledermoscopy. We analyzed the building blocks of each business model by using an adapted version of Ash Maurya's Lean Canvas and Alexander Osterwalder's Business Model Canvas. Results We identified three business elements that support the viability, sustainability, and growth of online dermatology services developing key partnerships, clinician involvement in the design and implementation process, and managing the medico-legal risks and liabilities that are relevant for each country. Conclusions Leveraging mobile technologies to deliver virtual health care present new business opportunities for health care providers. A better understanding of the business features associated with existing commercial ventures may increase uptake and improve financial viability of MTD applications as a complementary tool to traditional patient care models.We describe the development and initial validity assessment of the 20-item BioCalculus Assessment (BCA), with the objective of comparing undergraduate life science students' understanding of calculus concepts in different courses with alternative emphases (with and without focus on biological applications). The development process of the BCA included obtaining input from a large network of scientists and educators as well as students in calculus and biocalculus courses to accumulate evidential support of the instrument's content validity and response processes of test takers. We used the Rasch model to examine the internal structure of scores from students who have experienced calculus instruction in the two methods. The analysis involved three populations (Calculus 1, Calculus 2, and Biocalculus) for which the Calc 1 and Calc 2 students were not exposed to calculus concepts in a life science setting, while the Biocalculus students were presented concepts explicitly with a life science emphasis. Overall, our findings indicate that the BCA has reasonable validity properties, providing a diagnostic tool to assess the relative learning success and calculus comprehension of undergraduate biology majors from alternative methods of instruction that do or do not emphasize life science examples.Group activities as part of active-learning pedagogies are thought to be effective in promoting student learning in part because of the quality of discussion they engender in student teams. Not much is known, however, about which instructional factors are most important in achieving productive conversation or how these factors may differ among different collaborative pedagogies. We explored what provokes meaningful group discussions in a university physiology course taught using team-based learning (TBL). We were most interested in discussions that evoke explanations that go beyond statements of basic facts and into disciplinary reasoning. Using transcribed conversations of four randomly selected teams three times throughout the semester, we analyzed three distinct discursive phenomena-conceptual explanations, re-evaluations, and co-construction-that occurred in productive conversations. In this paper, we provide examples from student discussions showing the role of each of these elements in moving students toward conceptual understanding. These phenomena were more likely to occur in response to higher-order questions in Bloom's taxonomy. GW3965 Preclass preparation and student accountability as part of TBL may be important factors in this finding. We share implications for practice based on our results.Purpose To describe the results of tocilizumab treatment in children with refractory non-anterior uveitis.Methods A case series of seven children with refractory non-anterior uveitis (onset ≤16 years) with leakage on fluorescein angiogram (FA) were treated with tocilizumab intravenously every 4 weeks (eight mg/kg). Minimum follow-up was 6 months. Reported outcomes are changes in BCVA, central macular thickness (CMT) on OCT image, FA scores, dose of systemic steroids, complications and side effects.Results In all patients, there was an improvement of macular edema and capillary leakage on FA. The median FA score decreased from 14 (10-18) at baseline to 8 (2-9) after 6 months of treatment (p = .018). The CMT decreased from 321 (314-384) to 295 (255-312) (p = .043). BCVA improved in five eyes and worsened in one eye due to cataract. No systemic or ocular complications were reported.Conclusion Tocilizumab is an effective therapeutic option for reducing disease activity in children with refractory non-anterior uveitis.Introduction Uveitic macular edema (UME) is a significant cause of visual impairment in all uveitis types.Methods Reports that were cited in the MEDLINE database, that analyzed the effectiveness of biologics for UME in at least five patients, with a minimum follow-up of 3 months, published prior to April 1, 2019 were included. Reports that did not compare UME findings before and after the therapy, using either OCT or fluorescein angiography, were excluded.Results Case series that analyzed the efficacy of intravitreal anti-VEGF agents showed modest, short-term benefit. Studies that investigated systemic anti-TNF agents in patients with noninfectious uveitis reported a therapeutic effect on UME. Anti-IL-6 antibodies have shown promising results for most severe cases of noninfectious UME. Interferon represents an option for patients with persistent UME in infectious and noninfectious uveitis.Conclusion Multicenter, randomized controlled trials are needed to assess the effectiveness of each group of biologic agents in sufficient number of patients.
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