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Health care does not always take place in a setting of peace, prosperity, and social order, a point that is often overlooked in quotidian medical practice. This has become most evident with the current COVID-19 pandemic by the new coronavirus that is wreaking havoc across the planet. Health care providers are facing unprecedented challenges to intervene on numerous nonlinear uncertainties in science and society as the pandemic evolves. In Afghanistan, health care delivery is already a major crosscutting challenge. Although efforts to rebuild the health care systems in Afghanistan have been made (Acerra et al.), both acute and chronic illnesses remain as major medical and critical governance gaps to be remedied. In addition, health care facilities and medical equipment are not adequate in the country. There is a need for medical and scientific expertise to clinically and sociologically contextualize and interpret diagnostic tests as well as drugs and vaccines that will be deployed in the coming months as part of the planetary collective response to the COVID-19 pandemic. In a time of pandemic and facing a novel infectious pathogen, health care workers are in need of planetary scale consultation and support. Even creating a small consultation network using mobile applications might offer improved health outcomes. The Internet of Things and digital health ought to be considered in concert with telemedicine as part of an effective pandemic response.Purpose The purpose of this study was to document whether mean length of utteranceSUGAR (MLUS), total number of words (TNW), clauses per sentence (CPS), and/or words per sentence (WPS) demonstrated age-related changes in children with typically developing language, aged 7;0-10;11 (years;months). MK-0752 Method Participants were 132 typically developing children (aged 7;0-10;11), with a final sample size of 112 participants (57 boys and 55 girls). Fifty utterance conversational language samples were collected using a language sampling protocol. Four language sample analysis metrics (i.e., MLUS, TNW, CPS, and WPS) were calculated from the samples. Results Results indicated statistically significant age-related increases in three (MLUS, TNW, and WPS) of the four metrics. Conclusions MLUS, TNW, CPS, and WPS may be used with other assessment data to document age-related language changes in children aged 7;0-10;11. When combined with previous data from younger (aged 3;0-7;11) children (Pavelko & Owens, 2017), the data suggest that these metrics offer a set of measures that can be used to assess children's conversational language skills from preschool through late elementary school.Introduction The Lake Louise Score (LLS) has low specificity for diagnosing acute mountain sickness (AMS). As this tool is used for research and clinical decision making, it is important to understand the origins of this poor specificity. We reviewed AMS diagnoses in a population trekking at low altitude ("false positives") to critically assess LLS specificity. Method We retrospectively analyzed data from a sample of 123 adolescents trekking at low altitude to establish the predominant causes of false-positive AMS diagnoses (1993 LLS criteria), separately removing each LLS component to assess its contribution to the final score. Exploratory factor analysis (EFA) was applied to the data to establish component patterns. Results Removal of LLS components individually showed fatigue contributed slightly more to false-positive AMS diagnoses than sleep quality in this group. An EFA from morning data highlighted sleep quality as a stand-alone factor in the measurement of AMS. Although of smaller significance, an EFA of the evening data highlighted fatigue and headache as the stand-alone factor. Conclusion Our findings not only supported the recent removal of sleep quality from the LLS, but also demonstrated that fatigue had an equal part to play in the misdiagnosis of AMS in this population. These data highlighted the poor specificity of the LLS and suggest that the measurement of illness at altitude undergo further review.PURPOSE Zero-footprint Web architecture enables imaging applications to be deployed on premise or in the cloud without requiring installation of custom software on the user's computer. Benefits include decreased costs and information technology support requirements, as well as improved accessibility across sites. The Open Health Imaging Foundation (OHIF) Viewer is an extensible platform developed to leverage these benefits and address the demand for open-source Web-based imaging applications. The platform can be modified to support site-specific workflows and accommodate evolving research requirements. MATERIALS AND METHODS The OHIF Viewer provides basic image review functionality (eg, image manipulation and measurement) as well as advanced visualization (eg, multiplanar reformatting). It is written as a client-only, single-page Web application that can easily be embedded into third-party applications or hosted as a standalone Web site. The platform provides extension points for software developers to includeantitative Imaging Network.PURPOSE Tumor boards, clinical practice guidelines, and cancer registries are intertwined cancer care quality instruments. Standardized structured reporting has been proposed as a solution to improve clinical documentation, while facilitating data reuse for secondary purposes. This study describes the implementation and evaluation of a national standard for tumor board reporting for breast cancer on the basis of the clinical practice guideline and the potential for reusing clinical data for the Netherlands Cancer Registry (NCR). METHODS Previously, a national information standard for breast cancer was derived from the corresponding Dutch clinical practice guideline. Using data items from the information standard, we developed three different tumor board forms preoperative, postoperative, and postneoadjuvant-postoperative. The forms were implemented in Amphia Hospital's electronic health record. Quality of clinical documentation and workload before and after implementation were compared. RESULTS Both draft and final tumor board reports were collected from 27 and 31 patients in baseline and effect measurements, respectively.

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