Remote physiological monitoring: Clinical, financial, and behavioral outcomes in a heart failure population

This article reports on the outcomes associated with remote physiological monitoring (RPM) conducted as part of a heart failure disease management program. Claims data, medical records, data transmission records, and survey results for 91 individuals ages 50–92 (mean 74 years) successfully completing a heart failure RPM program were analyzed for time periods before, during, and after the monitoring intervention. The program was associated with significant reductions in per member per month costs and emergency room and hospital utilization. More detailed analyses were performed for specific gender and age subgroups. Participant surveys indicated high levels of satisfaction, and improvements in self-perceived health status, self-efficacy, and self-management behaviors. This study is the first to assess the impact of a RPM program following removal of the monitoring equipment. The results indicate that RPM, as a component of a traditional disease management program, has a sustained, beneficial effect on participants’ lifestyles after the monitoring period has ended

Impact of shortened crop rotation of oilseed rape on soil and rhizosphere microbial diversity in relation to yield decline

Oilseed rape (OSR) grown in monoculture shows a decline in yield relative to virgin OSR of up to 25%, but the mechanisms responsible are unknown. A long term field experiment of OSR grown in a range of rotations with wheat was used to determine whether shifts in fungal and bacterial populations of the rhizosphere and bulk soil were associated with the development of OSR yield decline. The communities of fungi and bacteria in the rhizosphere and bulk soil from the field experiment were profiled using terminal restriction fragment length polymorphism (TRFLP) and sequencing of cloned internal transcribed spacer regions and 16S rRNA genes, respectively. OSR cropping frequency had no effect on rhizosphere bacterial communities. However, the rhizosphere fungal communities from continuously grown OSR were significantly different to those from other rotations. This was due primarily to an increase in abundance of two fungi which showed 100% and 95% DNA identity to the plant pathogens Olpidium brassicae and Pyrenochaeta lycopersici, respectively. Real-time PCR confirmed that there was significantly more of these fungi in the continuously grown OSR than the other rotations. These two fungi were isolated from the field and used to inoculate OSR and Brassica oleracea grown under controlled conditions in a glasshouse to determine their effect on yield. At high doses, Olpidium brassicae reduced top growth and root biomass in seedlings and reduced branching and subsequent pod and seed production. Pyrenochaeta sp. formed lesions on the roots of seedlings, and at high doses delayed flowering and had a negative impact on seed quantity and quality

A Wellness Initiative: Mindfulness Training for Unlicensed Assistive Personnel to Promote Self-Care and Enhanced Well-Being

Background: Burnout leads to decreased staff engagement, productivity, and high attrition rates. The nursing staff most impacted are Unlicensed Assistive Personnel (UAP); therefore, to combat burnout, resilience is to be cultivated. Resilience begins with self-care, which is nurturing the self: mind, body, and soul to safeguard well-being. Objectives: This project provided mindfulness training as a wellness initiative to promote self-care skills and enhance well-being among the UAP within a healthcare facility. Methods: This project followed an evidenced-based quality improvement practice framework ( Mindful Self-Care Scale-Brief and IHI- Well-Being Assessment Survey) and used a pre-post-test design to compare self-care and well-being after a mindfulness training program. Results: Nine female UAPs participated in the intervention; seven completed the pre- and post-Mindful Self-Care Scale-B (MSCS-B) and the IHI- Well-Being Assessment Survey. The MSCS-B pre and post-intervention mean scores were favorable for self- care: pre-intervention means = 83.25 (SD =17.351); post-intervention means = 88.57 (SD = 7.525), and paired sample t-test showed an increase in self-care behaviors and proved statistically significant with a p-value \u3c 0.1. The IHI-Well-being Assessment showed no significance statistically. Conclusion: This intervention suggests mindfulness training promotes self-care and may enhance well-being. Self-care benefits are essential to the UAP to build resilience and prevent burnout. Healthcare organizations must embrace mindfulness training as it lends itself to a shift in culture: Better patient interaction, quality of care, and communication, as well as a decreased attrition rate. This step is a start for continued study of mindfulness in the UAP

Treatment of Helicobacter pylori infections: Mitigating factors and prospective natural remedies

Helicobacter pylori is a Gram-negative, microaerophilic spiral or motile rod that infects about half the world’s population with a very high prevalence in the developing world. It is an important aetiological factor in the development of gastritis, peptic ulcer disease, gastric atrophy and B cell mucosa associated lymphoid tissue (MALT) lymphoma. H. pylori infection is responsible for a significant cause of morbidity and mortality imposing a major burden on health care systems world wide. The high prevalence of infection in the developing countries has been attributed to poor socioeconomic status and sanitation as well as an increased trend of antibiotic resistance. Antimicrobial chemotherapy (two antibiotics and a proton pump inhibitor) employed for the treatment of H. pylori infections has emerged as the most important means to resolve these infections. However, antimicrobial therapy is fraught with a number of inherent limitations such as resistance, cost of treatment, unavailability of drugs in rural areas and undesirable side effects necessitating the need to search for alternative approaches from natural sources including vegetables, honey and probiotics amongst others. These could form the basis of novel low cost, efficient, large-scale and alternative/complementary solutions with minimal side effects to decrease or eradicate H. pylori infections in the future

'Clinical triad' findings in pediatric Klippel-Feil patients

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Some solutions to the multivariate Behrens-Fisher problem for dissimilarity-based analyses

The essence of the generalised multivariate Behrens–Fisher problem (BFP) is how to test the null hypothesis of equality of mean vectors for two or more populations when their dispersion matrices differ. Solutions to the BFP usually assume variables are multivariate normal and do not handle high‐dimensional data. In ecology, species' count data are often high‐dimensional, non‐normal and heterogeneous. Also, interest lies in analysing compositional dissimilarities among whole communities in non‐Euclidean (semi‐metric or non‐metric) multivariate space. Hence, dissimilarity‐based tests by permutation (e.g., PERMANOVA, ANOSIM) are used to detect differences among groups of multivariate samples. Such tests are not robust, however, to heterogeneity of dispersions in the space of the chosen dissimilarity measure, most conspicuously for unbalanced designs. Here, we propose a modification to the PERMANOVA test statistic, coupled with either permutation or bootstrap resampling methods, as a solution to the BFP for dissimilarity‐based tests. Empirical simulations demonstrate that the type I error remains close to nominal significance levels under classical scenarios known to cause problems for the un‐modified test. Furthermore, the permutation approach is found to be more powerful than the (more conservative) bootstrap for detecting changes in community structure for real ecological datasets. The utility of the approach is shown through analysis of 809 species of benthic soft‐sediment invertebrates from 101 sites in five areas spanning 1960 km along the Norwegian continental shelf, based on the Jaccard dissimilarity measure

Observation of associated near-side and away-side long-range correlations in √sNN=5.02 TeV proton-lead collisions with the ATLAS detector

Two-particle correlations in relative azimuthal angle (Δϕ) and pseudorapidity (Δη) are measured in √sNN=5.02  TeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1  μb-1 of data as a function of transverse momentum (pT) and the transverse energy (ΣETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Δη|<5) “near-side” (Δϕ∼0) correlation that grows rapidly with increasing ΣETPb. A long-range “away-side” (Δϕ∼π) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ΣETPb, is found to match the near-side correlation in magnitude, shape (in Δη and Δϕ) and ΣETPb dependence. The resultant Δϕ correlation is approximately symmetric about π/2, and is consistent with a dominant cos⁡2Δϕ modulation for all ΣETPb ranges and particle pT

Search for direct pair production of the top squark in all-hadronic final states in proton-proton collisions at s√=8 TeV with the ATLAS detector

The results of a search for direct pair production of the scalar partner to the top quark using an integrated luminosity of 20.1fb−1 of proton–proton collision data at √s = 8 TeV recorded with the ATLAS detector at the LHC are reported. The top squark is assumed to decay via t˜→tχ˜01 or t˜→ bχ˜±1 →bW(∗)χ˜01 , where χ˜01 (χ˜±1 ) denotes the lightest neutralino (chargino) in supersymmetric models. The search targets a fully-hadronic final state in events with four or more jets and large missing transverse momentum. No significant excess over the Standard Model background prediction is observed, and exclusion limits are reported in terms of the top squark and neutralino masses and as a function of the branching fraction of t˜ → tχ˜01 . For a branching fraction of 100%, top squark masses in the range 270–645 GeV are excluded for χ˜01 masses below 30 GeV. For a branching fraction of 50% to either t˜ → tχ˜01 or t˜ → bχ˜±1 , and assuming the χ˜±1 mass to be twice the χ˜01 mass, top squark masses in the range 250–550 GeV are excluded for χ˜01 masses below 60 GeV

Helicobacter pylori infection and transmission in Africa: Household hygiene and water sources are plausible factors exacerbating spread

Helicobacter pylori (H. pylori) is a microaerophilic motile curve rod that inhabits the gastric mucosa of the human stomach. The organism chronically infects billions of people worldwide and is one of themost genetically diverse of bacterial species. Infection with the bacterium which leads to chronic gastritis, peptic ulceration, gastric cancers and gastric malt lymphoma has been reported to follow a pattern linked to geographic and socio-demographic factors. Studies have documented a higherprevalence in Africa than elsewhere although the pathological outcomes do not correlate with infection. H. pylori transmission pathways are still vague, but the risks of transmission include precarious hygiene standards, over-crowding and contaminated environment and water sources amongst others. The possible routes of transmission include oral-oral, faecal-oral and person- to -person, either with or without transitional transmission steps during episodes of diarrhoea or gastro-oral contact in the eventof vomiting. Use of contaminated water including municipal tap water has also been suspected to have a high impact in the transmission of the organism. To generate the data presented in this paper, we conducted an internet based search on relevant literature pertaining to H. pylori epidemiology in general and Africa in particular. Sites such as Pubmed, AJOL, Scopus and Goggle scholar were mainly used. This paper therefore attempts to appraise the role of household hygiene and water sources in the transmission of this organism in the developing world context

Subtidal macrozoobenthos communities from northern Chile during and post El Niño 1997–1998

Despite a large amount of climatic and oceanographic information dealing with the recurring climate phenomenon El Niño (EN) and its well known impact on diversity of marine benthic communities, most published data are rather descriptive and consequently our understanding of the underlying mechanisms and processes that drive community structure during EN are still very scarce. In this study, we address two questions on the effects of EN on macrozoobenthic communities: (1) how does EN affect species diversity of the communities in northern Chile? and (2) is EN a phenomenon that restarts community assembling processes by affecting species interactions in northern Chile? To answer these questions, we compared species diversity and co-occurrence patterns of soft-bottoms macrozoobenthos communities from the continental shelf off northern Chile during (March 1998) and after (September 1998) the strong EN event 1997–1998. The methods used varied from species diversity and species co-occurrence analyses to multivariate ordination methods. Our results indicate that EN positively affects diversity of macrozoobenthos communities in the study area, increasing the species richness and diversity and decreasing the species dominance. EN represents a strong disturbance that affects species interactions that rule the species assembling processes in shallow-water, sea-bottom environments