299 results match your criteria initially encounters


Magnetic Confinement of an Ultracold Neutral Plasma.

Phys Rev Lett 2021 Feb;126(8):085002

Department of Physics and Astronomy, Rice University, Houston, Texas 77005, USA.

We demonstrate magnetic confinement of an ultracold neutral plasma (UCNP) created at the null of a biconic cusp, or quadrupole magnetic field. Initially, the UCNP expands due to electron thermal pressure. As the plasma encounters stronger fields, expansion slows and the density distribution molds to the field. Read More

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February 2021

"Like a doctor, like a brother": Achieving competence amongst lay health workers delivering community-based rehabilitation for people with schizophrenia in Ethiopia.

PLoS One 2021 25;16(2):e0246158. Epub 2021 Feb 25.

Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.

Background: There are gaps in our understanding of how non-specialists, such as lay health workers, can achieve core competencies to deliver psychosocial interventions in low- and middle-income countries.

Methods: We conducted a 12-month mixed-methods study alongside the Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE) pilot study. We rated a total of 30 role-plays and 55 clinical encounters of ten community-based rehabilitation (CBR) lay workers using an Ethiopian adaptation of the ENhancing Assessment of Common Therapeutic factors (ENACT) structured observational rating scale. Read More

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February 2021

Using Virtual Visits to Care for Primary Care Patients With COVID-19 Symptoms.

J Am Board Fam Med 2021 Feb;34(Suppl):S147-S151

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT, EMH, MAB); Division of Sports Medicine, Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA (CH, SPS).

Purpose: Examine use of office resources by primary care patients who were initially evaluated through telehealth, telephone, or in-person encounters.

Methods: Retrospective electronic health record review on patients seen in March 2020 for evaluation of potential COVID-19 symptoms, to assess the total number of interactions with physicians and office staff.

Results: Of 202 patients, 89 (44%) had initial telehealth, 55 (27%) telephone, and 52 (26%) in-person encounters. Read More

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February 2021

Coupled Effect of Electronic Medical Record Modifications and Lean Six Sigma Methodology on Rheumatoid Arthritis Disease Activity Measurement and Treat-to-Target Outcomes.

ACR Open Rheumatol 2021 Mar 11;3(3):164-172. Epub 2021 Feb 11.

University of Texas Southwestern Medical Center, Dallas.

Objective: Rheumatoid arthritis (RA) disease activity assessment is critical for treatment decisions and treat to target (T2T) outcomes. Utilization of the electronic medical record (EMR) and techniques to improve the routine capture of disease activity measures in clinical practice are not well described. We leveraged a Lean Six Sigma (LSS) approach, a data-driven five-step process improvement and problem-solving methodology, coupled with EMR modifications to evaluate improvement in disease activity documentation and patient outcomes. Read More

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Implementing the MAMAACT intervention in Danish antenatal care: a qualitative study of non-Western immigrant women's and midwives' attitudes and experiences.

Midwifery 2021 Apr 29;95:102935. Epub 2021 Jan 29.

Department of Public Health, Section of Social Medicine, Copenhagen University, Gothersgade 160, 1123, Copenhagen K., Denmark. Electronic address:

Introduction: Immigrant women have an increased risk of negative pregnancy and birth outcomes compared to women from European host populations. Similar trends are seen in Denmark, where especially some groups of non-Western immigrant women have an increased risk of stillbirth and infant mortality. This study reports on an implementation analysis of The MAMAACT Intervention, which was developed to increase midwives' and women's responses to pregnancy complications (trial registration number: NCT03751774). Read More

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Community Pharmacist Telephonic Medication Reviews with Uncontrolled Asthma Patients: A Pilot Study.

Pharmacy (Basel) 2021 Jan 22;9(1). Epub 2021 Jan 22.

School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA.

This study reports the process of telephonic medication reviews conducted by community pharmacists for patients with asthma. The study occurred at an independent community chain in association with a Missouri Medicaid consulting group. Participants were identified utilizing claims data and met the National Quality Forum criteria for uncontrolled moderate-to-severe persistent asthma. Read More

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January 2021

Factors associated with waiting time to breast cancer diagnosis among symptomatic breast cancer patients: a population-based study from Ontario, Canada.

Breast Cancer Res Treat 2021 Jan 24. Epub 2021 Jan 24.

Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, ON, Canada.

Purpose: A prolonged time from first presentation to cancer diagnosis has been associated with worse disease-related outcomes. This study evaluated potential determinants of a long diagnostic interval among symptomatic breast cancer patients.

Methods: This was a population-based, cross-sectional study of symptomatic breast cancer patients diagnosed in Ontario, Canada from 2007 to 2015 using administrative health data. Read More

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January 2021

Identifying and Characterizing a Chronic Cough Cohort Through Electronic Health Records.

Chest 2020 Dec 17. Epub 2020 Dec 17.

Merck & Co., Inc., Kenilworth, NJ.

Background: Chronic cough (CC) of 8 weeks or more affects about 10% of adults and may lead to expensive treatments and reduced quality of life. Incomplete diagnostic coding complicates identifying CC in electronic health records (EHRs). Natural language processing (NLP) of EHR text could improve detection. Read More

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December 2020

Herpes simplex virus 1 targets IRF7 via ICP0 to limit type I IFN induction.

Sci Rep 2020 12 17;10(1):22216. Epub 2020 Dec 17.

Department of Ophthalmology, Royal College of Surgeons in Ireland, Dublin 2, Ireland.

Herpes simplex keratitis (HSK), caused by herpes simplex virus type 1 (HSV-1) infection, is the commonest cause of infectious blindness in the developed world. Following infection the virus is initially suspended in the tear film, where it encounters a multi-pronged immune response comprising enzymes, complement, immunoglobulins and crucially, a range of anti-viral and pro-inflammatory cytokines. However, given that HSV-1 can overcome innate immune responses to establish lifelong latency throughout a susceptible individual's lifetime, there is significant interest in understanding the mechanisms employed by HSV-1 to downregulate the anti-viral type I interferon (IFN) mediated immune responses. Read More

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December 2020

Deprescribing in the Home Palliative Setting.

J Palliat Med 2020 Dec 16. Epub 2020 Dec 16.

Temmy Latner Centre for Palliative Care Lunenfeld Tanenbaum Research Institute, Sinai Health Division of Palliative Care, University of Toronto, Toronto, Ontario, Canada.

When patients' goals of care have shifted toward comfort, treatment should focus on alleviating symptoms rather than prolonging life at the expense of comfort. To determine whether the number of noncomfort medications is associated with deprescribing in patients seen by a home-visiting palliative care physician. Single-centre retrospective chart review of patients cared for in the home setting by a specialty palliative care program to determine factors associated with deprescribing. Read More

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December 2020

Increased competency of registered dietitian nutritionists in physical examination skills after simulation-based education in the United States.

J Educ Eval Health Prof 2020 14;17:40. Epub 2020 Dec 14.

Department of Allied Health Sciences, College of Health Professions, Grand Valley State University, Allendale, MI, USA.

Purpose: This study aimed to translate simulation-based dietitian nutritionist education to clinical competency attainment in a group of practicing registered dietitian nutritionists (RDNs). Using a standardized instrument to measure performance on a newly-required clinical skill, the nutrition-focused physical exam (NFPE), competence was measured both before and after a simulation-based education (SBE) session.

Methods: Eighteen practicing RDNs were recruited by their employer, Spectrum Health. Read More

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December 2020

Time trends and predictors of laboratory-confirmed recurrent and severe infections in Manitoba: a population-based study.

CMAJ Open 2020 Oct-Dec;8(4):E737-E746. Epub 2020 Nov 16.

Internal Medicine (Shaffer, Nugent, Walkty, Bernstein, Singh), University of Manitoba, Winnipeg, Man.; Inflammatory Bowel Disease Centre (Shaffer), University of Chicago Medicine, Chicago, Ill.; CancerCare Manitoba, Research Institute (Nugent, Singh); Community Health Sciences (Yu, Lix, Singh), University of Manitoba, Winnipeg, Man.; Division of Epidemiology and Population Health (Yu), BC Centre for Excellence in HIV/AIDS, Vancouver, BC; Division of Gastroenterology (Targownik), Mount Sinai Hospital, University of Toronto, Toronto, Ont.

Background: Many previous studies of infection (CDI) epidemiology have used hospital discharge data codes, which can have limited accuracy. We used a data set of laboratory-confirmed cases of CDI in the province of Manitoba, Canada, to describe the epidemiology of CDI over a decade.

Methods: We conducted a population-based historical cohort study using Manitoba Health's population-wide laboratory-based CDI data set linked to administrative health databases. Read More

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November 2020

β-Glucan-Induced Trained Immunity in Dogs.

Front Immunol 2020 9;11:566893. Epub 2020 Oct 9.

Boehringer Ingelheim Animal Health, R&D, Lyon, France.

Several observations in the world of comparative immunology in plants, insects, fish and eventually mammals lead to the discovery of trained immunity in the early 2010's. The first demonstrations provided evidence that innate immune cells were capable of developing memory after a first encounter with some pathogens. Trained immunity in mammals was initially described in monocytes with the Bacille Calmette-Guerin vaccine (BCG) or prototypical agonists like β-glucans. Read More

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October 2020

Rapid Implementation of Telecritical Care Support During a Pandemic: Lessons Learned During the Coronavirus Disease 2020 Surge in New York City.

Crit Care Explor 2020 Nov 23;2(11):e0271. Epub 2020 Oct 23.

Department of Medicine, Division of Cardiology, NYC Health + Hospitals/Jacobi Medical Center, Bronx, NY.

Objectives: We describe the key elements for a New York City health system to rapidly implement telecritical care consultative services to a newly created ICU during the coronavirus disease 2020 patient surge.

Design: This was a rapid quality-improvement initiative using public health decrees, a HIPAA-compliant and device-agnostic telemedicine patform, and a group of out-of-state intensivist volunteers to enhance critical care support. Telecritical care volunteers initially provided on-demand consults but then shifted to round twice daily with housestaff in a 12-bed newly created ICU. Read More

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November 2020

Artery of Percheron infarction with persistent amnesia: a case report of bilateral paramedian thalamic syndrome.

BMC Neurol 2020 Oct 8;20(1):370. Epub 2020 Oct 8.

Regional Rehabilitation Centre, Hamilton Health Sciences, Hamilton, Canada.

Background: The artery of Percheron is an uncommon anatomic variant which supplies the bilateral paramedian thalami and rostral midbrain. While infarction of its vascular territory can result in a wide range of symptoms, paramedian thalamic syndrome is classically described as a triad of symptoms including vertical gaze disturbances, fluctuating level of consciousness, and amnesia. There is minimal evidence to date to characterize the long-term cognitive consequences of infarction of the artery of Percheron utilizing neuropsychological assessment. Read More

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October 2020

Interdisciplinary Telemedicine Services for Huntington's Disease: A 20-Year Experience.

Telemed J E Health 2020 Oct 6. Epub 2020 Oct 6.

Department of Neurology, University of Virginia, Charlottesville, Virginia, USA.

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October 2020

Evaluation of a clinical pharmacist team-based telehealth intervention in a rural clinic setting: a pilot study of feasibility, organizational perceptions, and return on investment.

Pilot Feasibility Stud 2020 10;6:127. Epub 2020 Sep 10.

College of Pharmacy, The University of Iowa, 180 S. Grand Ave, Iowa City, IA 52242 USA.

Background: Remote, centralized clinical pharmacist services provided by board-certified clinical pharmacists have been shown to effectively assist in chronic disease management. We assess the feasibility of implementing a pharmacist-led, remote, centralized pharmacy service to improve A1c levels in patient with diabetes in a rural clinic setting.

Methods: This was a non-randomized pilot and feasibility study. Read More

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September 2020

Hospital Ward Adaptation During the COVID-19 Pandemic: A National Survey of Academic Medical Centers.

J Hosp Med 2020 08;15(8):483-488

Brigham and Women's Hospital, Boston, Massachusetts.

Importance: Although intensive care unit (ICU) adaptations to the coronavirus disease of 2019 (COVID-19) pandemic have received substantial attention , most patients hospitalized with COVID-19 have been in general medical units.

Objective: To characterize inpatient adaptations to care for non-ICU COVID-19 patients.

Design: Cross-sectional survey. Read More

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Species coexist more easily if reinforcement is based on habitat preferences than on species recognition.

J Anim Ecol 2020 11 6;89(11):2605-2616. Epub 2020 Sep 6.

Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zurich, Switzerland.

Maladaptive hybridization selects for prezygotic isolation, a process known as reinforcement. Reinforcement reduces gene flow and contributes to the final stage of speciation. Ecologically, however, coexistence of the incipient species is difficult if they initially use identical resources. Read More

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November 2020

Rib Somatic Dysfunction Among General Surgical Patients.

J Am Osteopath Assoc 2020 Aug 7. Epub 2020 Aug 7.

Context: Upper abdominal or chest pain, tenderness, or sensation of the presence of a mass may lead to general surgery (GS) service referral. These symptoms may be related to rib somatic dysfunction (SD).

Objective: To describe rib SD in the GS setting and help build a foundation for additional osteopathic manipulative treatment (OMT) research in surgical care. Read More

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Effects of the COVID-19 Pandemic on Cancer-Related Patient Encounters.

JCO Clin Cancer Inform 2020 07;4:657-665

Department of Cancer Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA.

Purpose: While there are studies under way to characterize the direct effects of the COVID-19 pandemic on the care of patients with cancer, there have been few quantitative reports of the impact that efforts to control the pandemic have had on the normal course of cancer diagnosis and treatment encounters.

Methods: We used the TriNetX platform to analyze 20 health care institutions that have relevant, up-to-date encounter data. Using this COVID and Cancer Research Network (CCRN), we compared cancer cohorts identified by querying encounter data pre-COVID (January 2019-April 2019) and current (January 2020-April 2020). Read More

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Orthopedic telemedicine encounter during the COVID-19 pandemic: A cautionary tale.

Trauma Case Rep 2020 Aug 27;28:100323. Epub 2020 Jun 27.

Dept. of Orthopedic Surgery, Brigham Health, 75 Francis St., Boston, MA, United States of America.

The COVID-19 pandemic has necessitated increased use of telemedicine for diagnosis and management of musculoskeletal disorders. We describe the virtual/telemedicine encounter and management of a patient with knee pain initially diagnosed as gonarthrosis but that actually resulted from an impending pathologic fracture of the femur. Definitive diagnosis and treatment occurred only after completion of the impending fracture. Read More

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Are Virtual Fracture Clinics During the COVID-19 Pandemic a Potential Alternative for Delivering Fracture Care? A Systematic Review.

Clin Orthop Relat Res 2020 11;478(11):2610-2621

E. P. Murphy, M. D. O'Sullivan, D. P. Moore, Department of Orthopaedic Surgery, Children's Health Ireland at Crumlin, Dublin, Ireland.

Background: Virtual fracture clinics are an alternative to the traditional model of fracture care. Since their introduction in 2011, they have become increasingly used in the United Kingdom and Ireland. The coronavirus disease 2019 (COVID-19) health crisis has driven institutions to examine such innovative solutions to manage patient care. Read More

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November 2020

Elderly Medication Adherence Intervention Using the My Interventional Drug-Eluting Stent Educational App: Multisite Randomized Feasibility Trial.

JMIR Mhealth Uhealth 2020 06 24;8(6):e15900. Epub 2020 Jun 24.

Biobehavioral Nursing Science, University of Florida, Gainesville, FL, United States.

Background: A lifesaving treatment for myocardial infarction is the placement of a stent in a closed or obstructed coronary artery. The largest modifiable risk factor after receiving a stent is medication adherence to Dual AntiPlatelet Therapy, a combination of P2Y12 inhibitors and aspirin.

Objective: This study aimed to determine the acceptability of a protocol and an intervention using the My Interventional Drug-Eluting Stent Educational App (MyIDEA) and to evaluate medication adherence using the proportion of days covered (PDC) and platelet activation tests in a multisite randomized controlled trial. Read More

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Modeling navigation by weaver ants in an unfamiliar, featureless environment.

Phys Rev E 2020 May;101(5-1):052404

School of Physics, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand and NANOTEC-SUT Center of Excellence on Advanced Functional Nanomaterials, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand.

The motion of individual weaver ants from Oecophylla smaragdina was tracked within a small arena to study the algorithm that these ants use for navigation. The arena, a floor tile, was either clean or partly covered by a mild chemical repellent. Statistical properties of the observed motion of the ant can be described by a model that is analogous to the Langevin theory of the motion of Brownian particles. Read More

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Patient pathways of tuberculosis care-seeking and treatment: an individual-level analysis of National Health Insurance data in Taiwan.

BMJ Glob Health 2020 06;5(6)

School of Health and Related Research, The University of Sheffield, Sheffield, UK.

Introduction: Patients with tuberculosis (TB) often experience difficulties in accessing diagnosis and treatment. Patient pathway analysis identifies mismatches between TB patient care-seeking patterns and service coverage, but to date, studies have only employed cross-sectional aggregate data.

Methods: We developed an algorithmic approach to analyse and interpret patient-level routine data on healthcare use and to construct patients' pathways from initial care-seeking to treatment outcome. Read More

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Reimbursement patterns and user experiences in pediatric allergy home telehealth.

Ann Allergy Asthma Immunol 2020 12 9;125(6):693-698.e1. Epub 2020 Jun 9.

Keck School of Medicine, University of Southern California, Los Angeles, California; Division of General Pediatrics, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California. Electronic address:

Background: Telehealth use has been increasing during the last decade. Studies have found that patients have a positive attitude toward incorporating telehealth into their health care. Substantial uncertainty remains regarding reimbursement policies that vary widely between states and by payer. Read More

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December 2020