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India is developing fast in the lines of some of the greatest cities of the world. Graph from the last 20-25 years show that India has majorly borne a paradigm shift in development icons as such Its cities have surpassed even double to its initial infrastructure during this period. Most of these infrastructural icons have a lot to do with the IT industry boom in the country as such most of these cities (e.g. Delhi, Bombay, Bangalore, Hyderabad etc.) are further burdened with employable youth, who require transit accommodation in the same city as well. There are some other cities too who used to enjoy the tourist or the pilgrims’ inflow by virtue of some kind of religious, natural or heritage resource attached to it. But, as evident in History, India and the Indians are known to be cultural driven, Pilgrimage friendly people. As such, these Blessings to such cities are continuously turning out to be the sufferings in the light of the number of pilgrims/tourists (floating population) these cities bear on daily basis. Most of these cities lack the sustainable infrastructure to uphold these burdens and to meet the energy demands for the well-being of people and city. These infrastructural additions must contemplate the Energy demands of the built form, people and their activities. One of such vulnerable town due to Paradigm shift in its development priorities is KATRA town, which is continuously getting burdened with more and more buildings, people & loss of Rural Greens as such contemplation of energy requirements is the need of the hour. Katra town is world famous for the rich religious history attached to it as it forms the base town (Camp) of Trikuta Hills upon which (12 kms away from base town) the Holy Shrine of Goddess Maa Vaishno Devi is located. Every year millions of Pilgrims from around the globe visit the shrine & the Katra Town. The Katra town is the major contributor of J&K (Jammu & Kashmir State) economy & India at Large. Pertinently, its being projected as one of the smart cities of India in next few years in the lines of leading smart cities of the world. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) is a concept that refers to the deployment of Internet Protocol (IP) address sensors in health care systems to monitor patients' health. It has the ability to access the Internet and collect data from sensors. Automated decisions are made after evaluating the information of illness people records. Patients' health and well-being can be monitored through IoT medical devices. It is possible to trace the origins of biological, medical equipment and processes. Human reliability is a major concern in user activity and fitness trackers in day-to-day activities. The fundamental challenge is to measure the efficiency of the human system accurately. Aim to maintain tabs on the well-being of humans; this paper recommends the use of wireless body area networks (WBANs) and artificial neural networks (ANN) to create an IoT-based healthcare framework for hospital information systems (IoT-HF-HIS). Our evaluation system uses a server to estimate how much computing power is needed for modeling, and simulations of the framework have been done using data rate and latency requirements are implementing the energy-aware technology presented in this paper. The proposed framework implements several hospital information system case studies by building a time-saving simulation environment. As the world's population ages, more and more people suffer from physical and emotional ailments. Using the recommended strategy regularly has been proven user-friendly, reliable, and cost-effective, with an overall performance of 95.2%. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) is a concept that refers to the deployment of Internet Protocol (IP) address sensors in health care systems to monitor patients' health. It has the ability to access the Internet and collect data from sensors. Automated decisions are made after evaluating the information of illness people records. Patients' health and well-being can be monitored through IoT medical devices. It is possible to trace the origins of biological, medical equipment and processes. Human reliability is a major concern in user activity and fitness trackers in day-to-day activities. The fundamental challenge is to measure the efficiency of the human system accurately. Aim to maintain tabs on the well-being of humans; this paper recommends the use of wireless body area networks (WBANs) and artificial neural networks (ANN) to create an IoT-based healthcare framework for hospital information systems (IoT-HF-HIS). Our evaluation system uses a server to estimate how much computing power is needed for modeling, and simulations of the framework have been done using data rate and latency requirements are implementing the energy-aware technology presented in this paper. The proposed framework implements several hospital information system case studies by building a time-saving simulation environment. As the world's population ages, more and more people suffer from physical and emotional ailments. Using the recommended strategy regularly has been proven user-friendly, reliable, and cost-effective, with an overall performance of 95.2%. [ABSTRACT FROM AUTHOR]

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This paper offers a future scenario to expose the potential engagement of tourism in the year 2200. Taking a socio-constructionist approach to research and through the analysis of secondary data, it explores current issues and debates concerned with the environment, disasters and depletion of natural resources; social context including movies and entertainment, the media and technology, the evolution of the theme park and cultural transmission; and economical realities, covering poverty vs. world elite and global culture, all of which are seen as drivers of the potential future tourism market. In so doing, it presents a narrative (scenario), provoking the notion that in the year 2200 death and hunting humans will form part of the tourism entertainment industry and a practice carried out by the wealthy-elite, a view backed with substance. It argues, that as a result of past and current engagements with murder, death and human atrocities, and significantly our relationship with death, humans will gradually become more accustomed to death as a form of spectacle, influenced by current entertainment, movies and the media. Death as entertainment by form of detachment (emotionally and physically) will further influence the future fun aspect of hunting humans. Significantly, changes in our natural environment will lead to great challenges, lack of water, depleted food resources and greater disparity between the wealthy and impoverished; all of which will drive the change in our humanly existence. This papers aims to provide a provocative account of the ‘potential future meaning of tourism’, through the application of current knowledge, and significantly, it is our relationship with death and violence that are central, death and violence are becoming diluted and thus, will be a source of future entertainment and a tourism activity – in less humans can reach a level of transcendence that has never been present, to transcend the culture they have created, one that has always witnessed violence as a means to survival. If violence can be detached then we will be presented with a ‘wild card’, a future that is truly out of this world. [ABSTRACT FROM AUTHOR]

Nanoplastics have attracted increasing attention in recent years due to their widespread existence in the environment and the potential adverse effects on living organisms. In this paper, the toxic effects of nanoplastics on organisms were systematically reviewed. The translocation and absorption of nanoplastics, as well as the release of additives and contaminants adsorbed on nanoplastics in the organism body were discussed, and the potential adverse effects of nanoplastics on human health were evaluated. Nanoplastics can be ingested by organisms, be accumulated in their body and be transferred along the food chains. Nanoplastics showed effects on the growth, development and reproduction of organisms, and disturbing the normal metabolism. The toxic effects on living organisms mainly depended on the surface chemical properties and the particle size of nanoplastics. Positively charged nanoplastics showed more significant effects on the normal physiological activity of cells than negatively charged nanoplastics, and smaller particle sized nanoplastics could more easily penetrate the cell membranes, hence, accumulated in tissues and cells. Additionally, the release of additives and contaminants adsorbed on nanoplastics in organism body poses more significant threats to organisms than nanoplastics themselves. However, there are still knowledge gaps in the determination and quantification of nanoplastics, as well as their contaminant release mechanisms, degradation rates and process from large plastics to nanoplastics, and the transportation of nanoplastics along food chains. These challenges would hinder the risk assessment of nanoplastics in the environment. It is necessary to further develop the risk assessment of nanoplastics and deeply investigate its toxicological effects. Image 1 • Recent advances in toxicological research of nanoplastics have been reviewed. • Potential toxic effects of nanoplastics on ecosystems and human health are discussed. • Using environmental concentrations of nanoplastics to test is necessary. [ABSTRACT FROM AUTHOR]

The complex relationships between humans and dogs (Canis lupus familiaris) have a very deep and unique history. Dogs have accompanied humans as they colonised much of the world, and were introduced via human agency into the insular Caribbean where they became widespread throughout the Ceramic Age. It is likely that the dynamic interactions between humans, dogs, and their environments in the Caribbean were spatially, chronologically, and socially variable. However, almost no research has specifically addressed the nature, or potential variability, of human/dog interactions in this region. This study presents isotopic (strontium and carbon) evidence bearing on human and dog paleomobility and paleodietary patterns in the pre-colonial Caribbean. The isotope results illustrate a generally high degree of correspondence between human and dog dietary practices at all analysed sites but also slight differences in the relative importance of different dietary inputs. Striking parallels are also observed between the human and dog mobility patterns and shed light on broader networks of social interaction and exchange. Lastly, the paper addresses the possible utility and relevance of canine isotope data as proxies for inferring past human behaviours. [ABSTRACT FROM AUTHOR]

In this paper, we examine a case of scientific controversy over the evolving role of the paranasal sinuses, comparing Neanderthals and humans by analyzing two rival hypotheses. The first hypothesis states th a t the paranasal sinuses do not represent an adaptation to extreme cold, while the second claims the contrary. The two articles partially use the same database and employ identical methodologies and evolutionary theoretical assumptions. This example is interesting because, in terms of Nudler's concepts of controversial and non-controversial spaces, the problem lies in the latter, i.e., the biases of the two articles and their mistakes. Our paper highlights the misunderstandings that can arise when an attempt is made to analyze a complex structure from an evolutionary perspective using two-dimensional analytical techniques, that is to say, explaining a trait in isolation and, consequently, losing an integrated approach to the organism and its multiple interactions with the environment. [ABSTRACT FROM AUTHOR]

Arsenic (As) is a toxic metalloid exist ubiquitously in environment. Epidemiological studies and laboratory animal studies have verified that As damages multiple organs or tissues in the body and is associated with a variety of diseases. Changes in metabolites usually indicate disturbances in metabolic pathways and specific metabolites are considered as biomarkers of diseases or drugs/toxins or environmental effects. Metabolomics is the quantitative measurement of the dynamic multi-parameter metabolic responses of biological systems due to pathophysiological or genetic changes. Current years, some metabolomic studies on the hazardous effect of environmental As on humans have been reported. In this paper, we first overviewed the metabolomics studies of environmental As exposure in humans since 2011, emphasizing on the data mining process of metabolic characteristics related to the hazardous effects of environmental As on humans. Then, the relationship between metabolic characteristics and the toxic mechanism of environmental As exposure in humans were discussed, and finally, the prospects of metabolomics studies on populations exposed to environmental As were put forward. Our paper may shed light on the study of mechanisms, prevention and individualized treatment of As poisoning. [Display omitted] • Metabolomics was used in study of the hazardous effect of environmental As on humans. • The data mining of metabolic characteristics adopts many statistical strategies. • Methionine and one carbon metabolism are associated with As biotransformation. • Metabolic changes are related to toxic mechanisms, such as oxidative stress, apoptosis, etc. • There are limitations and perspectives in experimental design, samples, methodology and technology. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Finding reliable prognostic factors for osteosarcoma remains problematic. A systematic review [Davis AM, Bell RS, Goodwin PJ. Prognostic factors in osteosarcoma: a critical review. Journal of Clinical Oncology 1994; 12(2): 423–431.] showed chemotherapy response as only independent factor. We tried to identify evidence-based prognostic factors in the literature since 1992 and to establish pooled relative risks of factors. Methods: MEDLINE and Embase search (1992–August 2006). Two reviewers independently selected papers addressing prognostic factors in localized extremity osteosarcoma, which were studied for methodological quality, and valuable new factors. An attempt was made to pool results. Results: Of 1777 “hits”, 93 papers were studied in depth. Several “new” prognostic factors were found. Only 7 papers were of sufficient quality to analyze. Chemotherapy response, tumor size and site, alkaline phosphatase level and p-glycoprotein expression seemed to be independent factors. Some new factors looked promising. Conclusions: Although the literature is abundant, it is disappointing that only few papers are of sufficient quality to allow hard conclusions. Because of heterogeneity of the studies pooling results is hardly possible. There is a need for standardization of studies and reports. [Copyright &y& Elsevier]

Background: The HIV epidemic in Eastern and Southern Africa is characterized by a high incidence and prevalence of HIV infection among adolescent girls and young women (AGYW) aged 15-24 years. For instance, in some countries, HIV prevalence in AGYW aged 20-24 years exceeds that in AGYW aged 15-19 years by 2:1. Sauti (meaning voices), a project supported by the United States Agency for International Development, is providing HIV combination prevention interventions to AGYW in the Shinyanga region, Tanzania. Objective: The aim of this study is to determine the impact of cash transfer on risky sexual behavior among AGYW receiving cash transfer and HIV combination prevention interventions. This paper describes the research methods and general protocol of the study. Risky sexual behavior will be assessed by herpes simplex virus type 2 (HSV-2) incidence, compensated sex (defined as sexual encounters motivated by exchange for money, material support, or other benefits), and intergenerational sex (defined as a sexual partnership between AGYW and a man 10 or more years older). Through a qualitative study, the study seeks to understand how the intervention affects the structural and behavioral drivers of the HIV epidemic. Methods: The trial employs audio computer-assisted self-interviewing, participatory group discussions (PGDs), and case studies to collect data. A total of 30 matched villages (15 intervention and 15 control clusters) were randomized to either receive cash transfer delivered over 18 months in addition to other HIV interventions (intervention arm) or to receive other HIV interventions without cash transfer (control arm). Study participants are interviewed at baseline and 6, 12, and 18 months to collect data on demographics, factors related to HIV vulnerabilities, family planning, sexual risk behavior, gender-based violence, and HSV-2 and HIV infections. A total of 6 PGDs (3 intervention, 3 control) were conducted at baseline to describe perceptions and preferences of different intervention packages, whereas 20 case studies are used to monitor and unearth the dynamics involved in delivery and uptake of cash transfer. Results: The study was funded in June 2017; enrollment took place in December 2017. A total of two rounds of the follow-up survey are complete, and one round has yet to be conducted. The results are expected in December 2019 and will be disseminated through conferences and peer-reviewed publications. Conclusions: This study will document the synergetic impact of cash transfer in the presence of HIV combination prevention interventions on risky sexual behavior among out-of-school AGYW. The results will strengthen the evidence of cash transfer in the reduction of risky sexual behavior and provide feasible HIV prevention strategies for AGYW. Trial Registration: Clinicaltrials.gov NCT03597243; https://clinicaltrials.gov/ct2/show/NCT03597243. International Registered Report Identifier (IRRID): DERR1-10.2196/14696 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]

Alcohol is often cited to be a common cause of cardiomyopathy and heart failure. However, in most available population-based studies, a modest-to-moderate alcohol consumption has been associated with favorable effects on the cardiovascular system, including a lowered risk of heart failure, compared with no alcohol consumption. Available genetic epidemiological data have not supported a causal association between alcohol consumption and heart failure risk, suggesting that alcohol may not be a common cause of heart failure in the community. Data linking alcohol intake with cardiomyopathy risk are sparse, and the concept of alcoholic cardiomyopathy stems mainly from case series of selected patients with dilated cardiomyopathy, where a large proportion reported a history of excessive alcohol intake. This state-of-the-art paper addresses the current knowledge of the epidemiology of alcoholic cardiomyopathy and the role of alcohol intake in patients with non–alcohol-related heart failure. It also offers directions to future research in the area. The review questions the validity of current clinical teaching in the area. It is not well known how much alcohol is needed to cause disease, and the epidemiological pathways linking alcohol consumption to cardiomyopathy and heart failure are not well understood. Until more evidence becomes available, caution is warranted before labeling patients as having alcoholic cardiomyopathy due to a risk of neglecting other contributors, such as genetic causes of cardiomyopathy. In non–alcohol-related heart failure, it is unknown whether total abstinence is improving outcomes (compared with moderate drinking). Ideally, randomized clinical trials are needed to answer this question. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The paper deals with the anthropological-ethical problems as articulated in the sketches of the Slovak philosopher Teodor Münz published in the 1990s in the jour-nal Filozofia. Its focus is on Münz's radical approach to human reason, his demys-tification of its capacities and consequently his innovative understanding of human condition. In addition to that Münz's insufficiently justified views are critically re-viewed as possible subjects of further debates. [ABSTRACT FROM AUTHOR]

Abstract: INTRODUCTION: There is much controversy regarding the current indications and contraindications for digital replantation. PRESENTATION OF CASE: Three patients with absolute contraindications for digital replantation according to classical criteria are presented (Case 1: multilevel amputation of the hand and fingers; Case 3: avulsion of the thumb; Case 4: index amputation proximal to the insertion of the flexor digitorum superficialis). In addition a patient with a very distal digital amputation (Case 2), whose indication for replantation is controversial is also presented. In all cases, the patients were replanted and showed good functional and aesthetical results. DISCUSSION: Most authors advocate that the classical indications for replantation have been validated by experience, are predicated on the potential for long-term function, and should be followed in most if not all cases. However, some surgeons have been adopting a more liberal attitude with good results. CONCLUSION: The clinical cases presented in this paper suggest that the standard criteria for digital replantation should not be followed rigidly but instead should be regarded as a general guide. [Copyright &y& Elsevier]

Abstract: The paper gives an overview of recent studies investigating the health value of organic foods and presents a framework for estimating the scientific impact of these studies. Furthermore, the problems connected with the different research approaches are being discussed. A number of comparative studies showed lower nitrate contents and less pesticide residues, but usually higher levels of vitamin C and phenolic compounds in organic plant products, as well as higher levels of omega-3 fatty acids and conjugated linoleic acid in milk from organically raised animals. However, the variation in outcomes of comparative studies is very high, depending on plant fertilization, ripening stage and plant age at harvest, and weather conditions. Moreover, there appeared no simple relationship between nutritional value and health effects. It is difficult therefore to draw conclusions from analytical data about the health effects of organic foods. Some in vitro studies comparing health-related properties of organic vs conventional foods showed higher antioxidative and antimutagenic activity as well as better inhibition of cancer cell proliferation of organically produced food. If ‘health effects’ are defined as effects on defined diseases in humans, evidence for such effects is presently lacking. Animal studies carried out so far have demonstrated positive effects of an organic diet on weight, growth, fertility indices and immune system. Recent human epidemiological studies associated consumption of organic foods with lower risks of allergies, whereas findings of human intervention studies were still ambiguous. The hypothesis might be that organic food increases the capacity of living organisms towards resilience. To confirm this, effect studies on specific markers for health are necessary. [Copyright &y& Elsevier]

Abstract: Objective: While in previous studies heterozygosity for an Insulin-Like Growth Factor 1 (IGF1) defect only modestly decreased height and head circumference, we recently reported on two siblings with severe short stature with a maternally transmitted heterozygous duplication of 4 nucleotides, resulting in a frame shift and a premature termination codon in the IGF1 gene. In this paper we describe the structural and functional characteristics of the putative truncated IGF-I protein. Design: Two children, their mother and maternal grandfather carried the mutation. In addition, two family members who were not affected were included in the study. Mutant (MT) IGF-I was synthesized in oxidized and reduced form using two methods. Neutral gel filtration studies were carried out with wild-type (WT) and synthetic MT IGF-I. Binding analysis of synthetic MT IGF-I to the IGF1R and insulin receptors were performed with EBNA-293 cells, stably transfected with the IGF-I receptor, and IM9 cells. L6 cells were used to examine the mitogenic potency and the potential antagonizing effect of synthetic MT IGF-I by [3H]-thymidine incorporation assays. Results: In the sera of both the carriers and non-carriers the proportion of 125I-IGF-I that was associated with the 150kDa complex was somewhat less (varying between ~37 and ~52%) than in normal pooled serum (~53−~63%) and, instead, slightly increased amounts of radioactivity were eluted in the 40−50kDa fraction (consisting of binary IGF–IGFBP complexes) or remained unbound. Synthetic MT IGF-I did not bind to the IGF-I receptor, nor antagonize the growth-promoting effect of IGF-I. It did bind to IGFBPs, but was barely incorporated into 150kDa complexes. Because in all cases WT IGF-I immunoreactivity was recovered in one peak, corresponding to the MW of WT IGF-I, i.e. ~7.6kDa, an interaction of circulating truncated mutant peptide with WT IGF-I is very unlikely. Conclusions: There is no evidence that the severe short stature associated with heterozygosity for this novel IGF1 mutation in children born from a mother with the same mutation is caused by a dominant negative effect of the truncated protein. We speculate that the growth failure is caused by a combination of partial IGF-I deficiency, placental IGF-I insufficiency, and other genetic factors. [Copyright &y& Elsevier]

Copyright of Socijalna Ekologija is the property of Croatian Sociological Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The adoption and use of an electronic health record (EHR) can facilitate real-time access to key health information and support improved outcomes. Many Canadian provinces use interoperable EHRs (iEHRs) to facilitate health information exchange, but the clinical use and utility of iEHRs has not been well described. Objective: The aim of this study was to describe the use of a provincial iEHR known as the Alberta Netcare Portal (ANP) in 4 urban Alberta emergency departments. The secondary objectives were to characterize the time spent using the respective electronic tools and identify the aspects that were perceived as most useful by emergency department physicians. Methods: In this study, we have included 4 emergency departments, 2 using paper-based ordering (University of Alberta Hospital [UAH] and Grey Nuns Community Hospital [GNCH]) and 2 using a commercial vendor clinical information system (Peter Lougheed Centre [PLC] and Foothills Medical Centre [FMC]). Structured clinical observations of ANP use and system audit logs analysis were compared at the 4 sites from October 2014 to March 2016. Results: Observers followed 142 physicians for a total of 566 hours over 376 occasions. The median percentage of observed time spent using ANP was 8.5% at UAH (interquartile range, IQR, 3.7%-13.3%), 4.4% at GNCH (IQR 2.4%-4.4%), 4.6% at FMC (IQR 2.4%-7.6%), and 5.1% at PLC (IQR 3.0%-7.7%). By combining administrative and access audit data, the median number of ANP screens (ie, results and reports displayed on a screen) accessed per patient visit were 20 at UAH (IQR 6-67), 9 at GNCH (IQR 4-29), 7 at FMC (IQR 2-18), and 5 at PLC (IQR 2-14). When compared with the structured clinical observations, the statistical analysis of screen access data showed that ANP was used more at UAH than the other sites. Conclusions: This study shows that the iEHR is well utilized at the 4 sites studied, and the usage patterns implied clinical value. Use of the ANP was highest in a paper-based academic center and lower in the centers using a commercial emergency department clinical information system. More study about the clinical impacts of using iEHRs in the Canadian context including longer term impacts on quality of practice and safety are required. [ABSTRACT FROM AUTHOR]

Extracellular matrix molecules (ECMM) expression during tertiary dentinogenesis provides useful information for regenerative applications and efficacy of pulp capping materials. To identify and review the expression and roles of non-collagenous ECMM after successful direct pulp capping (DPC), following mechanical pulp exposures, via immunohistochemistry (IHC). The study addressed the question of where will successful DPC impact the IHC expression of these molecules. In vivo animal and human original clinical studies reporting on ECMM in relation to different follow-up periods were screened and evaluated via descriptive analysis. The electronic literature search was carried out in three databases (MEDLINE/PubMed, Web of Science, Scopus), followed by manual screening of relevant journals and cross-referencing, up to December 2018. Randomized and non-randomized controlled trials, conducted in humans and animals, were selected. Histological evidence for tertiary dentine formation was a prerequisite for IHC evaluation. The methodological quality of the included articles was independently assessed using the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) and the Cochrane risk of bias tool (RoB 1), respectively. From a total of 1534 identified studies, 18 were included. Thirteen papers evaluated animal subjects and five studies were carried out on humans. In animals and humans, fibronectin and tenascin expressions were detected in pulp and odontoblast-like cells (OLC); dentine sialoprotein was expressed in both soft and newly-formed mineralized tissue. In animals, bone sialoprotein was early expressed, in association with OLC and predentin; the immunoreactivity for dentine sialophosphoprotein and dentine matrix protein-1 was associated with the OLC and dentine bridge; osteopontin was expressed in OLC, predentine and reparative dentine. A considerable heterogeneity was found in the methodologies of the included studies, as well as interspecies variability of results in terms of time. Within the limited scientific evidence, all non-collagenous ECMM expressions during tertiary dentinogenesis are active and related to soft and hard tissues. There is a shortage of human studies, and future research directions should focus more on them. PROSPERO Protocol : CRD42019121304 [ABSTRACT FROM AUTHOR]

Background: Web-based patient education is increasingly offered to improve patients' ability to learn, remember, and apply health information. Efficient organization, display, and structural design, that is, information architecture (IA), can support patients' ability to independently use web-based patient education. However, the role of IA in the context of web-based patient education has not been examined systematically.Objective: To support intervention designers in making informed choices that enhance patients' learning, this paper describes a randomized experiment on the effects of IA on the effectiveness, use, and user experience of a patient education website and examines the theoretical mechanisms that explain these effects.Methods: Middle-aged and older adults with self-reported hip or knee joint complaints were recruited to use and evaluate 1 of 3 patient education websites containing information on total joint replacement surgery. Each website contained the same textual content based on an existing leaflet but differed in the employed IA design (tunnel, hierarchical, or matrix design). Participants rated the websites on satisfaction, engagement, control, relevance, trust, and novelty and completed an objective knowledge test. Analyses of variance and structural equation modeling were used to examine the effects of IA and construct a theoretical model.Results: We included 215 participants in our analysis. IA did not affect knowledge gain (P=.36) or overall satisfaction (P=.07) directly. However, tunnel (mean 3.22, SD 0.67) and matrix (mean 3.17, SD 0.69) architectures were found to provide more emotional support compared with hierarchical architectures (mean 2.86, SD 0.60; P=.002). Furthermore, increased perceptions of personal relevance in the tunnel IA (β=.18) were found to improve satisfaction (β=.17) indirectly. Increased perceptions of active control in the matrix IA (β=.11) also improved satisfaction (β=.27) indirectly. The final model of the IA effects explained 74.3% of the variance in satisfaction and 6.8% of the variance in knowledge and achieved excellent fit (χ217,215=14.7; P=.62; root mean square error of approximation=0.000; 95% CI [0.000-0.053]; comparative fit index=1.00; standardized root mean square residual=0.044).Conclusions: IA has small but notable effects on users' experiences with web-based health education interventions. Web-based patient education designers can employ tunnel IA designs to guide users through sequentially ordered content or matrix IA to offer users more control over navigation. Both improve user satisfaction by increasing user perceptions of relevance (tunnel) and active control (matrix). Although additional research is needed, hierarchical IA designs are currently not recommended, as hierarchical content is perceived as less supportive, engaging, and relevant, which may diminish the use and, in turn, the effect of the educational intervention. [ABSTRACT FROM AUTHOR]

Background: Researchers developing personal health tools employ a range of approaches to involve prospective users in design and development.Objective: The aim of this paper was to develop a validated measure of the human- or user-centeredness of design and development processes for personal health tools.Methods: We conducted a psychometric analysis of data from a previous systematic review of the design and development processes of 348 personal health tools. Using a conceptual framework of user-centered design, our team of patients, caregivers, health professionals, tool developers, and researchers analyzed how specific practices in tool design and development might be combined and used as a measure. We prioritized variables according to their importance within the conceptual framework and validated the resultant measure using principal component analysis with Varimax rotation, classical item analysis, and confirmatory factor analysis.Results: We retained 11 items in a 3-factor structure explaining 68% of the variance in the data. The Cronbach alpha was .72. Confirmatory factor analysis supported our hypothesis of a latent construct of user-centeredness. Items were whether or not: (1) patient, family, caregiver, or surrogate users were involved in the steps that help tool developers understand users or (2) develop a prototype, (3) asked their opinions, (4) observed using the tool or (5) involved in steps intended to evaluate the tool, (6) the process had 3 or more iterative cycles, (7) changes between cycles were explicitly reported, (8) health professionals were asked their opinion and (9) consulted before the first prototype was developed or (10) between initial and final prototypes, and (11) a panel of other experts was involved.Conclusions: The User-Centered Design 11-item measure (UCD-11) may be used to quantitatively document the user/human-centeredness of design and development processes of patient-centered tools. By building an evidence base about such processes, we can help ensure that tools are adapted to people who will use them, rather than requiring people to adapt to tools. [ABSTRACT FROM AUTHOR]

Background: Perioperative hypothermia during laparoscopy for bowel resection is a risk factor for postoperative medical complications and surgical wound infections. Despite various warming methods used during surgery, a significant number of patients experience perioperative hypothermia. Use of dry, unwarmed insufflation carbon dioxide (CO2) during laparoscopic procedures may contribute to this problem. Evidence exists that the HumiGard device, which humidifies and heats CO2 for insufflation, can reduce the risk of perioperative hypothermia. Objective: The aim is to determine if insufflation with warmed, humidified CO2 using the HumiGard device, alongside standard perioperative warming techniques, can improve patient recovery, including pain, surgical site infections, complications, and the use of analgesia compared with standard care alone. Methods: The study is a multicenter, randomized, blinded (patient, surgeon, and assessor), sham device-controlled, parallel group-controlled trial of 232 patients. The study aims to recruit patients undergoing elective laparoscopic, segmental, or total colectomy. Patients will be randomized to receive HumiGard plus standard care or standard care alone (1:1 ratio). The primary outcome is patient-reported quality of recovery, measured by the validated QoR-40 (quality of recovery) questionnaire, from baseline to postoperative day 1. Secondary outcomes include postoperative pain, the incidence of hypothermia, and the rate of postoperative complications. Results: The information gathered during a small-scale service evaluation at a single hospital was used to inform this study protocol. Before applying for a grant for this full randomized controlled trial, the authors will conduct a feasibility study of 40 patients to ensure that the protocol is feasible and to inform our sample size calculation. Conclusions: The randomized controlled trial is designed to provide high-quality evidence on the effectiveness of the HumiGard device in potentially reducing the risk of perioperative hypothermia in patients scheduled for laparoscopic colectomy. The results will be used to improve the maintenance of adequate patient body temperature during surgery. International Registered Report Identifier (IRRID): PRR1-10.2196/14533 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Clinical studies are emerging to support providing long chain n-3 fatty acids, found in fish oils, to prevent muscle loss, minimize side effects and improve chemotherapy response in patients with cancer. However, a recent report using experimental models made the concluding statement "..., the use of [fish oil] products during chemotherapy treatment should be avoided".1 This recommendation is not in line with current understanding of human nutrient requirements and needs to be carefully weighed against evidence supporting fish oil supplementation. The potential clinical detriment of consuming fish oil when undergoing platinum based therapies claimed by Roodhart et al.1 is not taken within the context of the collective work citing beneficial effects of fish oil in experimental models as well as in humans. Platinum-based therapies are standard of care for lung cancer in many regions of the world with no evidence that they are more or less effective than in countries where oily fish intake is minimal. Overall, the human nutrition recommendations made in the discussion of Roodhart et al.1 are not supported by the experimental evidence provided in the paper nor within the context of other work in this area. [Copyright &y& Elsevier]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To determine the glycemic index (GI) of Malaysian wild honey and Australian honey. Methods: Eight healthy volunteers (5 men and 3 women, aged 24 - 44 y, with normal BMI) were served 50 g carbohydrate portions of two varieties of honey or the reference food (glucose, tested 3 times), on separate occasions. Capillary blood glucose was measured fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the test meals. The GI was calculated by expressing each subject's incremental area under the blood glucose curve (AUC) after honey as a percentage of his or her mean AUC after glucose. Results: The results showed that the mean AUC of the Malaysian and Australian honeys, 174 ± 19 and 158 ± 16 mmol×min/l, respectively, did not differ from each other but were significantly less than that after glucose, 259 ± 15 mmol×min/l (P < 0.001). The mean GI of Malaysian wild honey, 65 ± 7, did not differ from that of Australian honey, 59 ± 5, but both were significantly less than the GI of glucose, 100 (P < 0.001). Conclusions: We conclude that both Malaysian wild honey (GI = 65 ± 7) and Australian honey (GI = 59 ± 5) are intermediate GI foods. [ABSTRACT FROM AUTHOR]