Plos One
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Myelomeningocele (MMC) is the most common and severe disabling type of spina bifida resulting in the exposure of vulnerable spinal cord to the hostile intrauterine environment. In this study, we sought to examine the cellular content of fetal amniotic fluid (AF) in MMC and explore a correlation between these cells and pathological development of MMC. MMC was induced in fetal rats by exposing pregnant mothers to all-trans retinoic acid and AF samples were collected before term. ⋯ We found that the appearance of cluster forming cells in cultures from MMC-AF correlated with activation of astrogliosis associated with the spinal cord injury in MMC fetuses. In summary, we identified a neuroepithelial cell population in the AF of MMC fetuses that formed adherent clusters in culture and we characterized cellular markers of these cells. Our data suggests that the phase of the disease is a crucial factor in the emergence of these cells into the AF and that these cells may provide a new and important platform for studying the progression of MMC and development of improved strategies for the repair and diagnosis of MMC prenatally.
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To investigate the factors affecting recovery of diplopia and limited ocular motility in pediatric patients who underwent surgery for orbital wall fracture. ⋯ Presence of muscle incarceration and retrobulbar hemorrhage, horizontal length of floor fracture, supraduction limitation, and time interval from trauma to first visit were correlated with the surgical outcomes in pediatric orbital wall fracture patients. These results strengthen that the soft tissue damage associated with bony fracture affects the orbital functional unit. When managing children with orbital wall fracture, meticulous physical examination and thorough preoperative computed tomography based evaluation will help physicians to identify damage of orbital functional unit.
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This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. ⋯ Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.
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The factors influencing the prognosis of acute kidney injury (AKI) were analyzed in a group of elderly AKI patients to determine the markers of early prognosis. ⋯ Elderly AKI patients are at risk of developing progressive deterioration of renal function. In elderly AKI patients, the high uKIM-1 level may predict the prognosis of kidney function and may be used as an early screening indicator of poor kidney prognosis.
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Historical Article
Engaging with change: Information and communication technology professionals' perspectives on change in the context of the 'Brexit' vote.
Information and Communication Technology (ICT) has been a key agent of change in the 21st century. Given the role of ICT in changing society this research sought to explore the responses and attitudes to change from ICT professionals and ICT academics in dealing with the potentially far reaching political challenge triggered by the UK's 2016 European Union Referendum and its decision to leave the European Union (referred to as Brexit). Whilst the vote was a UK based decision its ramifications have global implications and as such the research was not confined to the UK. ⋯ Data was collected through a survey launched on the first working day after the Brexit referendum vote to leave the EU and kept open for four weeks. The survey contained qualitative and quantitative questions. It sought to understand the opportunities and threats that would exist post-Brexit for ICT professionals and academics triggered by the decision. The research captured a complex rich picture on ICT professionals' responses to the potential challenge of change triggered by the Brexit vote. Immediately after the Brexit decision the research reveals uncertainties amongst ICT professionals regarding what the decision would mean, with just under half of the participants not identifying any opportunities or threats. For those who did, threats outweighed opportunities by just more than double. Whilst understanding the global possibilities and dangers, participants saw their position from national and organizational perspectives. The highest frequency coded threats related to areas outside the participants' control and the highest frequency opportunities related to areas where there was the potential for ICT interventions. This survey is part of longitudinal piece of research. Using the same methodological approach two further surveys are planned. The second survey will be one year after Article 50 was triggered on 29 March 2017. The final survey will be one year after the UK exit from the EU, assuming this occurs.