Clineconway3087

With the onset of the coronavirus pandemic, clinicians, public officials, and citizens alike struggled to stay abreast of the constant and evolving stream of information about the clinical manifestations of illness, epidemiology of the disease, and the public health response. In this paper, we adapted (i.e., added and modified elements) Beasley and colleagues' information chaos framework to understand the context of citizens' experiences with information during the COVID-19 pandemic. We will show how our adapted framework can be used to characterize information associated challenges observed during this time and the possible impact of information chaos on peoples' cognition and behaviours. Ultimately, we believe that research will benefit by adopting a more holistic perspective using the information chaos framework than strictly studying the independent factors in isolation.Under pandemic conditions, it is important to communicate local infection risks to better enable the general population to adjust their behaviors accordingly. In Japan, our team operates a popular non-government and not-for-profit dashboard project - "Japan LIVE Dashboard" - which allows the public to easily grasp the evolution of the pandemic on the internet. We presented the Dashboard design concept with a generic framework integrating socio-technical theories, disease epidemiology and related contexts, and evidence-based approaches. Through synthesizing multiple types of reliable and real-time local data sources from all prefectures across the country, the Dashboard allows the public access to user-friendly and intuitive disease visualization in real time and has gained an extensive online followership. To date, it has attracted c.30 million visits (98% domestic access) testifying to the reputation it has acquired as a user-friendly portal for understanding the progression of the pandemic. Designed as an open-source solution, the Dashboard can also be adopted by other countries as well as made applicable for other emerging outbreaks in the future. Furthermore, the conceptual design framework may prove applicable into other ehealth scaled for global pandemics.Many organizations created COVID-19 dashboards to communicate epidemiologic statistics or community health capabilities with the public. In this paper we used dashboard heuristics to identify common violations observed in COVID-19 dashboards targeted to citizens. Many of the faults we identified likely stem from failing to include users in the design of these dashboards. We urge health information dashboard designers to implement design principles and test dashboards with representative users to ensure that their tools are satisfying user needs.Law and regulation have not received much attention as part of the context shaping and being shaped by health informatics. Telemedicine, data, devices and software, and electronic health records (EHRs) are examples of how technologies are affected by privacy, intellectual property protections, and other law and regulation.The COVID-19 pandemic has disrupted many global industries and shifted the digital health landscape by stimulating and accelerating the delivery of digital care. It has emphasized the need for a system level informatics implementation that supports the healthcare management of populations at a macro level while also providing the necessary support for front line care delivery at a micro level. From data dashboard to Telemedicine, this crisis has necessitated the need for health informatics transformation that can bridge time and space to provide timely care. However, heath transformation cannot solely rely on Health Information Technology (HIT) for progress, but rather success must be an outcome of system design focus on the contextual complexity of the health system where HIT is used. D-Luciferin inhibitor This conference highlights the important roles context plays for health informatics in global pandemics and aims to answer critical questions in four main areas 1) health information management in the covid-19 context, 2) implementation of new practices and technologies in healthcare, 3) sociotechnical analysis of task performance and workload in healthcare, and 4) innovations in design and evaluation methods of health technologies. We deem this as a call to action to understand the importance of context while solving the last mile problem in delivering the informatics solutions that are needed to support our public health response.The dose rate distributions delivered to 55 prostate and head & neck (H&N) cancer patients treated with a helical TomoTherapy (HT) system were resolved and assessed with regard to pitch and field width defined during treatment planning. Statistical analysis of the studied cases showed that the median treatment delivery time was 4.4 min and 6.3 min for the prostate and H&N cases, respectively. Dose rate volume histogram data for the studied cases showed that the 25% and 12% of the volume of the planning target volumes of the prostate and H&N cases are irradiated with a dose rate of greater or equal to 1 Gy/min. Quartile dose rate (QDR) data confirmed that in HT, where the target is irradiated in slices, most of the dose is delivered to each voxel of the target when it travels within the beam. Analysis of the planning data from all cases showed that this lasts for 68 s (median value). QDRs results showed that using the 2.5 cm field width, 75% of the prescribed dose is delivered to target voxels with a median dose rate of at least 3.2 Gy/min and 4.5 Gy/min, for the prostate and H&N cases, respectively. Systematically higher dose rates were observed for the H&N cases due to the shallower depths of the lesions in this anatomical site. Delivered dose rates were also found to increase with field width and pitch setting, due to the higher output of the system which, in general, results in accordingly decreased total treatment time. The biological effect of the dose rate findings of this work needs to be further investigated using in-vitro studies and clinical treatment data.We review the current knowledge of pancreas pathology in type 1 diabetes. During the last two decades dedicated efforts towards the recovery of pancreas from deceased patients with type 1 diabetes have promoted significant advances in the characterization of the pathological changes associated with this condition. The implementation autoantibody screening among organ donors has also allowed examining pancreas pathology in the absence of clinical disease, but in the presence of serological markers of autoimmunity. The assessment of key features of pancreas pathology across various disease stages allows driving parallels with clinical disease stages. The main pathological abnormalities observed in the pancreas with type 1 diabetes are beta cell loss, insulitis, and more recently hyperexpression of HLA class I and class II molecules have been reproduced and validated. Additionally, there are changes affecting extracellular matrix components, evidence of viral infections, inflammation, and ER stress, which could contribute to beta cell dysfunction and the stimulation of apoptosis and autoimmunity. The increasing appreciation that beta cell loss can be less severe at diagnosis than previously estimated, the coexistence of beta cell dysfunction, and the persistence of key features of pancreas pathology for years after diagnosis impact the perception of the dynamics of this chronic process. The emerging information is helping identifying novel therapeutic targets and have implications for the design of clinical trials.Primary aldosteronism (PA) is caused by autonomous overproduction of aldosterone, which induces organ damage directly via activation of the mineralocorticoid receptor (MR); however, no specific or sensitive biomarkers are able to reflect MR activity. Recently, it is found that urinary extracellular vesicles (uEVs) are secreted by multiple cell types in the kidney and are an enriched source of kidney-specific proteins. Here, we evaluate sodium transporters in uEVs as candidates of biomarkers of MR activity in the clinical setting. Sixteen patients were examined to determine their plasma aldosterone concentration (PAC) and renin activity, and their morning urine was collected. The protein levels of two sodium transporters in uEVs, γ-epithelial sodium channel (γENaC) and thiazide-sensitive sodium chloride cotransporter (NCC), were quantified by Western blot analysis, and their clinical correlation with PAC was determined. Consequently, we found PAC was significantly correlated with the γENaC protein level adjusted by the CD9 protein level in uEVs (correlation coefficient = 0.71). PAC was also correlated with the NCC protein level adjusted by the CD9 protein level in uEVs (correlation coefficient = 0.61). In two PA patients, treatment with an MR antagonist or adrenalectomy reduced γENaC/CD9 in uEVs. In conclusion, γENaC/CD9 in uEVs is a valuable biomarker of MR activity in PA patients and may be a useful biomarker for other MR-associated diseases.

To investigate the role of G-protein coupled receptor Smoothened (Smo) in regulating proliferation and migration of adult neural stem cells (ANSCs) and explore the underlying mechanism.

Cultured ANSCs were treated with purmorphamine (PM, an agonist of Smo) or cyclopamine (CPM, an inhibitor of Smo), and the changes in cell proliferation migration abilities were assessed using cell counting kit-8 (CCK8) assay and wound healing assay, respectively. The mRNA expressions of membrane receptor Patched 1 (Ptch1), Smo, glioma-associated oncogene homolog 1 (Gli1), axon guidance cue slit1 (Slit1) and brain-derived neurotrophic factor (BDNF) in the treated cells were detected using real-time quantitative PCR (RT-PCR).

PM significantly promoted the proliferation (

< 0.01) and migration of ANSCs (

< 0.01), and up-regulated the mRNA expressions of Ptch1, Smo, Gli1, Slit1 and BDNF. Treatment with CPM significantly inhibited the proliferation and migration of ANSCs.

Modulating Smo activity can positively regulate the proliferation and migration of ANSCs possibly by regulating the expressions of BDNF and Slit1.

Modulating Smo activity can positively regulate the proliferation and migration of ANSCs possibly by regulating the expressions of BDNF and Slit1.

To explore the feasibility of diffusion-weighted magnetic resonance imaging (DWI) instead of contrast-enhanced (CE) imaging for evaluation of the immediate therapeutic efficacy of high-intensity focused ultrasound (HIFU) ablation for treatment of adenomyosis.

We retrospectively analyzed the data of 29 patients aged 40.5 ± 5.4 years under going HIFU treatment for adenomyosis in our hospital between December, 2017 and July, 2020. The patients received MRI examination both before and within 24 h after the operation. Two observers analyzed the morphology of the ablation area on DWI and classified the lesions into type 1 (spot-like or no obvious signal intensity changes), type 2 (patchy signal intensity changes) and type 3 (ring-like signal intensity changes). The inter- and intra-observer reliability of morphological assessment was assessed using kappa test. The volume of necrotic tissues following the ablation was measured with both DWI and CE imaging, and the consistency of the measurements and the inter- and intra-observer reliability of DWI-based measurements were evaluated using Bland-Altman plot tests.