Search

Background: To synthesize high-quality evidence to compare traditional in-person screening and tele-ophthalmology screening. Methods: Only randomized controlled trials (RCTs) were included in this systematic review and meta-analysis. The intervention of interest was any type of tele-ophthalmology, including screening of diseases using remote devices. Studies involved patients receiving care from any trained provider via tele-ophthalmology, compared with those receiving equivalent face-to-face care. A search was executed on the following databases: Medline, EMBASE, EBM Reviews, Global Health, EBSCO-CINAHL, SCOPUS, ProQuest Dissertations and Theses Global, OCLC Papers First, and Web of Science Core Collection. Six outcomes of care for age-related macular degeneration (AMD), diabetic retinopathy (DR), or glaucoma were measured and analyzed. Results: Two hundred thirty-seven records were assessed at the full-text level; six RCTs fulfilled inclusion criteria and were included in this review. Four studies involved participants with diabetes mellitus, and two studies examined choroidal neovascularization in AMD. Only data of detection of disease and participation in the screening program were used for the meta-analysis. Tele-ophthalmology had a 14% higher odds to detect disease than traditional examination; however, the result was not statistically significant (n = 2,012, odds ratio: 1.14, 95% confidence interval (CI): 0.52–2.53, p = 0.74). Meta-analysis results show that odds of having DR screening in the tele-ophthalmology group was 13.15 (95% CI: 8.01–21.61; p < 0.001) compared to the traditional screening program. Conclusions: The current evidence suggests that tele-ophthalmology for DR and age-related macular degeneration is as effective as in-person examination and potentially increases patient participation in screening.

There should be continued support and drive for innovation and implementation of smartphone-based access to local guidelines. This is the first study, that we're aware of, assessing the use of a smartphone-based clinical handbook in ENT surgery. Use of a smartphone-based handbook is superior to printed or intranet-based guidelines. Use of smartphone apps can support junior doctors with delivery of care. Smartphone-based access to guidelines encourage learning and education to improve the induction process for new doctors. This article is protected by copyright. All rights reserved.

Background: The role of Drug Information Center (DIC) in a health-care setting has increased tremendously owing to the high influx of pharmaceutical molecules that pose serious challenges to physicians. DIC promotes rational prescribing behavior among physicians, leading to better patient outcome. Objectives: This study aimed to explore information-seeking behaviors and awareness of physicians regarding DIC services in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted among physicians working in government and private sectors between June to November 2018 by using an 18-item electronic anonymous questionnaire. Descriptive and inferential statistics were performed using IBM SPSS (Version 21). A P-value of

In the Middle Ages and the premodern period knowledge of alchemical practices and materials was transmitted via collections of recipes often grouped concomitantly with art-technological instructions. In both alchemy and chemical technology particular importance is placed on artisanal and craft practices. Both are concerned with the description of colours. Both require procedures involving precise and specifically defined actions, prescriptions and ingredients. Assuming that alchemical and artistic texts have the same textual format, this raises the question: were they produced, diffused and read by the same people? This paper investigates the authorship and the context of production behind a sample of German alchemical manuscripts dating from the fourteenth to the sixteenth century. It scrutinizes their process of production, compilation and dissemination. This paper also sheds light on the various types of marginalia, and correlates them with their diverse functions. It thus delivers significant information about the readers and users of these manuscripts.

Background Rapid and precise measurement of total and differential nucleated cell counts is a crucial diagnostic component of cavitary and synovial fluid analyses. Objectives The objectives of this study included (1) evaluation of reliability and precision of canine and equine fluid total nucleated cell count (TNCC) determined by the benchtop Abaxis VetScan HM5, in comparison with the automated reference instruments ADVIA 120 and the scil Vet abc, respectively, and (2) comparison of automated with manual canine differential nucleated cell counts. Methods The TNCC and differential counts in canine pleural and peritoneal, and equine synovial fluids were determined on the Abaxis VetScan HM5 and compared with the ADVIA 120 and Vet abc analyzer, respectively. Statistical analyses included correlation, least squares fit linear regression, Passing–Bablok regression, and Bland–Altman difference plots. In addition, precision of the total cell count generated by the VetScan HM5 was determined. Results Agreement was excellent without significant constant or proportional bias for canine cavitary fluid TNCC. Automated and manual differential counts had R2

The casebook developed by the Bander Center for Medical Business Ethics provides a comprehensive instrument for teaching medical business ethics decision making by exploring the effects of relevant variables on medical practice and research and reflecting on the values and motives that influence the behavior of health care professionals.

The death of the encyclopaedia is increasingly reported in connection with the abandonment of hard copy reference publishing, the dispersal of library reference collections and the preference for end-users to seek information from search engines and social media. Yet this particular form of the book evolved in a very specific way to meet the needs of knowledge-seekers, needs which persist and perhaps flourish in an age of information curiosity. This article uncovers what is meant by ‘encyclopaedia’ by those who produce and use them. Based on survey and interview research carried out with publishers, librarians and higher education students, it demonstrates that certain physical features and qualities are associated with the encyclopaedia and continue to be valued by them. Having identified these qualities, the article then explores whether they apply to three incidences of electronic encyclopaedias, Britannica Online, The Stanford Encyclopedia of Philosophy and Wikipedia. Could it be that rather than falling into obsolescence, their valued qualities are being adopted by online forms of knowledge provision?

Objective: The research sought to evaluate seven drug information resources, specifically designed for analyzing drug interactions for scope, completeness, and ease of use, and determine the consistency of content among the seven resources.Methods: A cross-sectional study was conducted where 100 drug-drug and drug-dietary supplement interactions were analyzed using 7 drug information resources: Lexicomp Interactions module, Micromedex Drug Interactions, Clinical Pharmacology Drug Interaction Report, Facts & Comparisons eAnswers, Stockley’s Drug Interactions (10th edition), Drug Interactions Analysis and Management (2014), and Drug Interaction Facts (2015). The interaction sample was developed based on published resources and peer input. Two independent reviewers gathered data for each interaction from each of the 7 resources using a common form.Results: Eighty-two drug-drug and 18 drug-dietary supplement interactions were analyzed. Scope scores were higher for Lexicomp Interactions (97.0%), Clinical Pharmacology Drug Interaction Report (97.0%), and Micromedex Drug Interactions (93.0%) compared to all other resources (p

This paper collects information on artificial infant feeding published before 1860, the year when commercial formula became available. We have extensive artifactual evidence of thousands of feeding vessels since the Bronze Age. Special museum collections can be found in London, Paris, Cologne, Fécamp, Toronto, New Mexico, and elsewhere. The literature on the use of animal milk for infant feeding begins with Soranus in the 2nd century CE. Literature evidence from the very first printed books in the 15th century proves that physicians, surgeons, midwives, and the laity were aware of the opportunities and risks of artificial infant feeding. Most 17th to 19th century books on infant care contained detailed recipes for one or several of the following infant foods: pap, a semisolid food made of flour or bread crumbs cooked in water with or without milk; gruel, a thin porridge resulting from boiling cereal in water or milk, and panada, a preparation of various cereals or bread cooked in broth. During the 18th century, the published opinion on artificial feeding evolved from health concerns to a moral ideology. This view ignored the social and economic pressures which forced many mothers to forego or shorten breast-feeding. Bottle-feeding has been common practice throughout history.

It is common practice in pediatric autopsies to compare the body and organ measurements of the deceased child against the existing reference data. Although a number of resources are available, many are outdated and have significant limitations. The goal of this study was to assess the reference sources currently used by the Ontario pathologists in pediatric autopsies. A survey of 14 Ontario pathologists, who do coroners' pediatric autopsies, identified 20 publications commonly referenced for body and organ measurements. Of all the cited sources, only a few had all the features regarded by the pathologists as ideal for a reference source. These features included accessibility to the source, large sample size, defined control populations, statistical analyses, and sex distinctions. The results of this study will be used to guide the development of a new reference, based on Ontario data, that will enhance measurement standards in pediatric autopsy practice.

China is a developing country with the largest population of any country in the world. The 2010 sixth national census found that China's population was 1,339,724,852, accounting for about 19 percent of the world's total population. However, higher education in the Chinese dental field started late and developed slowly. In order to acquaint more dental educators worldwide about China's current higher dental education system, this article provides a brief introduction to the present education system, degrees conferred, curriculum setting, training mode, teaching materials, courses, and academic journals.

Food ingredient fraud and economically motivated adulteration are emerging risks, but a comprehensive compilation of information about known problematic ingredients and detection methods does not currently exist. The objectives of this research were to collect such information from publicly available articles in scholarly journals and general media, organize into a database, and review and analyze the data to identify trends. The results summarized are a database that will be published in the US Pharmacopeial Convention's Food Chemicals Codex, 8th edition, and includes 1305 records, including 1000 records with analytical methods collected from 677 references. Olive oil, milk, honey, and saffron were the most common targets for adulteration reported in scholarly journals, and potentially harmful issues identified include spices diluted with lead chromate and lead tetraoxide, substitution of Chinese star anise with toxic Japanese star anise, and melamine adulteration of high protein content foods. High-performance liquid chromatography and infrared spectroscopy were the most common analytical detection procedures, and chemometrics data analysis was used in a large number of reports. Future expansion of this database will include additional publically available articles published before 1980 and in other languages, as well as data outside the public domain. The authors recommend in-depth analyses of individual incidents. Practical Application: This report describes the development and application of a database of food ingredient fraud issues from publicly available references. The database provides baseline information and data useful to governments, agencies, and individual companies assessing the risks of specific products produced in specific regions as well as products distributed and sold in other regions. In addition, the report describes current analytical technologies for detecting food fraud and identifies trends and developments.

This paper summarizes the key points of a report titled Nuclear Energy Outlook, published in 2008 by the Nuclear Energy Agency of the Organization for Economic Cooperation and Development, which has 30 member nations. The report discusses the commitment of many nations to increase nuclear power generating capacity and the potential rate of building new electricity-generating nuclear plants by 2030 to 2050. The resulting decrease in carbon dioxide emissions from fossil fuel combustion resulting from an increase in nuclear power sources is described. Other topics that are discussed include the need to develop non-proliferative nuclear fuels, the importance of developing geological disposal facilities or reprocessing capabilities for spent nuclear fuel and high-level radioactive waste materials, and the requirements for a larger nuclear workforce and greater cost competitiveness for nuclear power generation.

This article provides tips to improve writing and to inspire readers to write for publication. Simple but powerful ways to improve writing include omitting needless words, using the active voice, and using first-person pronouns. Techniques to help novice writers get started are addressed. The author discusses (and quashes) excuses for not writing and provides important reasons for publishing. Pithy, witty quotes from well-known writers are included. This article should be helpful to experienced as well as novice writers.

The NHS Plan suggests that all patients should be offered copies of letters regarding their treatment which are currently sent from a specialist clinic to their general practitioner (GP). Previous work has suggested that this enhances patient satisfaction, but medical letters can be difficult to understand. This report concerns the production and evaluation of a lung disease glossary to enhance patient understanding of terms used within the letter sent to their GP. Non-clinical staff reviewed 219 letters sent to GPs and words not likely to be understood by patients were listed and used to produce a glossary of 133 terms. One hundred and thirty-one participants from nine respiratory outpatient clinics in a London teaching hospital were sent the glossary and a questionnaire with their copy of the letter also sent to their GP. Of the 131 participants, 93 patients (71%) returned the questionnaire. Eighty-three (89%) found the glossary useful and the number of words checked ranged from 0 to 14 with a median of three words. Those who did not find the glossary useful explained that their understanding was already optimal or that the words they did not understand were not contained within the glossary. This was usually because the words related to non-respiratory comorbidities. This study confirms that the inclusion of a specialty specific glossary with the patients' copy of the letter being sent to their GP is appreciated by patients and appears to aid their understanding.

The OECD Blue Book, "Recombinant DNA: Safety Considerations" was published in 1986. The developed principles and concepts on the stepwise and case-by-case approach for risk assessment in the Blue Book have been used as a foundation for building national biosafety frameworks and international instruments for the regulation of the products of modern biotechnology. Twenty years after the Blue Book was published, OECD continues its activities on unique identifier systems, information-sharing, consensus documents for the biology of crops, trees and microorganisms with respect to harmonization of regulatory oversight and those of novel food and feed safety. These activities benefit, without any doubt, the international community at large, including OECD non-member countries. In order to strengthen its position in the international arena and to better respond to the needs of the changing world, OECD would be encouraged to participate in a more active manner in the technology transfer process and co-existence debate, together with continuing the organization's efforts on information-sharing and harmonization in the field of biotechnology and biosafety.

SummaryBoth episodic memory and spatial navigation require temporal encoding of the relationships between events or locations. In a linear maze, ordered spatial distances between sequential locations were represented by the temporal relations of hippocampal place cell pairs within cycles of theta oscillation in a compressed manner. Such correlations could arise due to spike “phase precession” of independent neurons driven by common theta pacemaker or as a result of temporal coordination among specific hippocampal cell assemblies. We found that temporal correlation between place cell pairs was stronger than predicted by a pacemaker drive of independent neurons, indicating a critical role for synaptic interactions and precise timing within and across cell assemblies in place sequence representation. CA1 and CA3 ensembles, identifying spatial locations, were active preferentially on opposite phases of theta cycles. These observations suggest that interleaving CA3 neuronal sequences bind CA1 assemblies representing overlapping past, present, and future locations into single episodes.

Background: Chinese medicine (CM) has been the subject of increasing interest in the past 30 years, both as a discipline and in the larger context of alternative medicine. It has steadily been accepted by and integrated into the medical and health-care fields in many countries. Objective: This study aims to gain an overview of how CM has been interpreted and presented to the world outside China and to identify emerging trends. Methods: This study is designed to analyse the publishing trends of CM and related subjects in all languages except Chinese, ranging from books and serials to audio-visual and electronic resources found in WorldCat, the world's largest bibliographic database produced by OnLine Computer Library Center (OCLC). Results: The findings showed a flourishing growth of publications in CM and related subjects beginning in the 1970s with greater coverage on acupuncture. The materials in English language constitute the major portion of total output. Conclusion: We conclude that Chinese medicine has steadily gained recognition in the world based on the analysis of publication records. The translation of original works and analysis of journal literature and conference proceedings on Chinese medicine merit further study.

Many published reports state that the type of resuscitation fluid to be used for volume expansion should be "isotonic crystalloid" or "isotonic fluid". Generally, this terminology refers to normal saline (NS) and lactated Ringer's (LR) solution. This terminology is suboptimal technically since not all "isotonic" crystalloids are sufficient volume expanders. A total of 48 reference books from the areas of general pediatrics, pediatric emergency medicine, emergency medicine, pediatric critical care, pediatric surgery, general surgery, internal medicine, family medicine, adult critical care, obstetrics and gynecology, endocrinology, and life support course manuals were reviewed. The description of fluids for hypovolemic shock, trauma, and diabetic ketoacidosis resuscitation was accurate in 46% of the time.

This paper traces the nature and fortunes of Lommius' Medicinal Observations of 1560, its relationship to ancient authors, its two-and-a-half centuries of fame, and its fall. Originating as an accessible manual of diagnosis for municipal authorities, it emphasized the observable aspects of illness and downplayed the role of humors and hidden causes. As a result, it both heralded and served the trend to symptom-based nosology. Eventually, as disease concepts shifted from symptoms to organs, Lommius was eclipsed by the next epistemic fashion: positivistic organicism. The multiple editions of this work invite us to reconsider the sustained influence of ancient writers, including Celsus, in medical pedagogy and semeiology, as well as the timing and location of the development of nosological concepts of disease. Class considerations and the proclivities of twentieth-century scholarship contributed to the obscurity of this book in our time.

Diagnosing genetic disorders and counselling the parents of babies with possible genetic conditions takes up a significant proportion of a neonatologist's clinical time. This article provides a guide to establishing genetic tools and a reference library on a neonatal unit. The availability of good resources may heighten staff awareness of genetic aetiologies in babies with subtle features, and enable possible diagnoses to be considered and a genetics consultation sought. In addition, when a diagnosis is made, information is then readily available to guide the neonatologist in his or her consultations with parents. It is not intended that the tools outlined here should be a replacement for the genetics consultation; their role is merely to facilitate the interaction of neonatologists with geneticists, to the benefit of the parents and the baby.

Robert Hooke played important roles in the early development of the Royal Society of London. As Curator of Experiments of the Society, he became a pioneering microscopist, prolific inventor, astronomer, geologist, architect, and an effective surveyor of the City of London following the Great Fire of 1666. Hooke's Micrographia (1665) revealed the microscopic structures of numerous biological and inorganic objects and became an important source of information for later studies. Aside from the body of detailed observations reported and depicted in Micrographia, the Preface is in itself an extraordinary document that exhibits Hooke's fertile mind, philosophical insights, and rare ability to look into the future.